Hi Holly, If you have lost 18 lbs AND QUIT SMOKING, you can have this surgery, lose the weight and change your life. Think of your health and your quality of life.....your energy and your self esteme. I ask myself, how can I NOT have this surgery? It's my last chance to become healthy and with this new tool(WLS) that I will get on Nov 25th, I can do it. And you can too. Did you know that kicking the smoking habit is as hard as kicking cocaine?? And YOU DID IT!! I am so proud of you and amazed at your strength because I can't quit smoking. You may not be strong enough to lose the weight on your own but with WLS to help you, you CAN do it. Have faith in yourself and be strong and positive and keep fighting for your insurance approval! We are with you! HUGS! Carol Percel