Hi there I started In January 09 I got a referred by my general practioner there was no problem he agreed with me that i needed it. Then the south san francisco kaiser calls u with an appt to go to a class that is very very long they weigh u in and that is the weight they go by as your first weigh iin after that they expect u to lose at least 26 percent of it u have to then see a nutirionist and they dont play if u havent lost at least 10 to 15 percent by the time u see them they will make it hard for u to have your next appt then u see the np for the department and he tells u how much u must be down by the next time he sees u oh yea and u have to see the psych in between that all this takes about 6 months just make sure u lose the weight then u see the doctor and get your date for surgery good luck