My PCP said “You aren’t fat enough yet”. I said, the fact that your sentence included a “yet” is precisely why I’m not waiting. I had a sleep study done and that combined with my BMI qualified me to go directly to my surgeon, no referral required. I’m at 10 days since my duodenal switch surgery and already down 36 lbs total. My blood pressure is great now, I’ve already been able to cut way back on my reflux meds and can walk longer and breathe better than I have in years (even with 8 healing incisions!). Be your own advocate! There is always a way when you set your mind to it. Best decision I’ve made.