So sorry you have been turned down again....seems so unfair the way different PCT`s work ,can i ask without being to personal what your weight and height is?...i had a bmi of 55 and i am 5`8 when i first went to my doctors and asked about wls.
I know you have listed all the reasons for needing weight loss surgery,but is this all off your own back,would it be in your favour if you have the doctors backing and could they help you fight the appeal?