with me my BMI is 38 so if it was 40 I would be approved but I have high blood pressure that my family doctor did put me on meds that was approved by my weight loss doctor as ok yea with that med you qualify. So if your BMI is not high enough you may still be able to get the surgery if you have one of these problems. If you have kinda high blood sugar but not really your doctor can put you on one water pill/ high blood sugar med and you will qualify with that kind. Just ask your weight loss doctor what kinda meds do I need to get on to be approved. If you don't qualify don't get upset you can still try the pre-op diet you can look for it on pintrest and it help shrink your tummy and get you ready for surgery. Some people say they couldnt get the surgery but did a week or 2 of the pre-op diet and it help them lose and then they just did the after surgery diet like they did get the surgery. And made their self it smaller meals that way. I mean is works for some people. Best of luck to everyone trying to lose weight