It all depends on your BC/BS. I have Anthem BC/BS HMO - I had to jump through the standard hoops, but was approved within 24 hours of submitting insurance. Took me 3 months from my first seminar to approval... surgery in less than 6 weeks now!
I just came from my pre-op class and they addressed this very issue.
The doctor said that they've had self-pay patients come in demanding fills and had them stomp out without the fill. They say they will not be bullied into doing fills, that there's an adjustment time between fills, filling too quickly can lead to erosion, etc.
It's your well being they have in mind - they want you to suceed as well!
If you're not losing, maybe chart every single thing you're eating to see if changes can be made and kick up your exercise some. You've lost 30 pounds since January, that's something to be proud of!