With a BMI of 30, insurance would not pay for this procedure but I was determined to have it, trying everything to loose weight with marginal success. Dr. Sasse is in Nevada. He sleeves clients from all over the world. He believes for health reasons there is no reason to not band a client at a lower BMI. I paid out of pocket using an emergency medical withdrawal from my 403 B plan. YOu have to stick with the post op and maintenance routine otherwise the weight doesn't budge. I've lost over 30 lbs and now am 148. Pic shows my starting weight of 178 and me at around 160. Still losing weight, but slower than I imagined....YOu can still put junk in your mouth, so you must be careful. My appetite finally deceased after 7 months, now I stop eating when I am full and I'm exercising. i get a lot of compliments, people notice the weight loss. Even though the scale may not be where I want it, I got my waistline back almost immedietely.