I acknowledge my hyperbole. My point is just that while you try to convince a patient that they need to improve their willpower, they are suffering from the eff

I acknowledge my hyperbole. My point is just that while you try to convince a patient that they need to improve their willpower, they are suffering from the effects of obesity, which has innumerable other comorbidities. Every day that they spend obese is courting health problems related to obesity. > I don't share your surprise, but might agree awareness is only the first step to individual progress. I think I can say with near certainty that awareness is in fact only the first step. The question is what the next steps are. Saying "psychological help" is a dodge -- what specific psychological methodologies have been proven to work in this regard (I'll give a hint here, none of them). So what comes next? If you lecture them about willpower and stop the mollycoddling (which I assure you, no mainstream medical professional has anything but the harshest things to say about diet or fat positivity), and you give them an exam that proves that they understand what it comes down to, but they keep the weight or gain more weight, then what? Lock 'em up? Put them in a more advanced class to teach them? > surgical procedures cannot be considered breakthroughs Sure they can be. We have to be very very very cautious about surgical approaches, because our understanding of human physiology is far from perfect, and there might be long-term problems, etc. But if we make a better, less impactful procedure with fewer side effects, then surely that can count as a breakthrough. The transformation from open surgery for gastric bypass to laproscopic procedures (lap bands and later sleeve gastroplasties) was huge because it greatly reduced complications, and the move to endoscopic procedures (which are non-surgical) has dropped the risk of surgical complications to close to zero. Similarly the progress on GLP-1 agonists have shown some impressive improvements over previous generations of drugs (like fen-phen) that were actively dangerous. Pursuing healthy weight change or trying to address the food chain issues or other problems may present better long-term alternatives to having healthier weight, but in the meantime, these procedures/drugs can significantly reduce the health risks that come organically from excess weight.