All of Darliene's points are well-made. The HAES movement has made and continues to make formidable contributions to the genuine understanding of fatness. I recently attended a presentation on WLS, which I had long regarded as a sort of metabolic mutilation. I decided to open my mind and listen. And as a formerly fat person who has experienced the regain-with-a-"dividend" syndrome I can well imagine a time when I might again be "super obese" and have the co-morbidities which tend to steer one toward the surgical approach. I was impressed by the sleeve gastrectomy procedure, which has a permanency advantage over banding and results in fewer absorption problems than the RnY surgery. Affordability is a real issue, however. Poor people for whom the surgery is a real option ought not to be denied it. But, as Darliene wisely explains, avoidance of the surgery by other methods is preferable. BTW, here's my own story: http://ireport.cnn.com/docs/DOC-968195