I had to do 6 consecutive months of doctor-supervised diet and exercise with my primary care doc, one nutritionist meeting, a psych eval, a meeting with a nurse practitioner from the surgeon's office, get a letter of recommendation from my PCP, write my own letter about why I felt like I needed the surgery, and meet with the surgeon before any of my info was submitted to insurance.
Now that I've been approved by insurance and a date has been set, I'll have four hours of nutrition workshops and a support group meeting about a month before surgery. Two weeks before the surgery date I'll have bloodwork (including an arterial blood gas which I'm not looking forward to), chest x-ray, abdominal ultrasound, a physical and health history with an NP from the surgeon's office, and another meeting with the surgeon to go over the hospital stay and early recovery.