About a decade. As is typical of this surgery but not for most other GI surgery, there was a fair amount of behavioral prep and post-surgical behavioral support, which was helpful for several years until it pretty much became same-old, same-old. It's actually not that hard for old behaviors to defeat the effectiveness of the surgery over time if you don't truly embed new behaviors, so both the insurance companies and the surgical teams have found it to be good business to target that problem. I have a friend who dealt with that by lying her way through the process and not doing any of the work -- turned out to be a bad idea, but hey, we all get to own our choices.