Well, your comment isn't at all judgemental or based on stereotypes, or in the least ignorant. No, not at all.

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I understand the need to have a standard weight to reach to get the treatment, because you have to draw the line somewhere, but the optics of needing to get less healthy to be allowed help are definitely bad. As has been mentioned, eating right and exercising are better options than a quick fix surgery, but sometimes it's not that easy. I completely overhauled my diet a few years back and lost over 20 pounds, and feel much healthier now. But I have an uncle who is about 340 pounds. He's 6'2 and muscular so he doesn't look as fat as some people his weight, but he still definitely has fat that he needs to get rid of to improve his health. The problem is, if he exercises hard, his back hurts so bad he has to lay in bed for a few days, so he can never really make any progress against the weight. In his case, his frame just can't support it, so the surgery would make sense, and allow him to exercise.

For a number of people, giving up overeating leads to adoption of a new compulsion. In the article this adoption of a new compulsion to replace an old one is called “addiction transfer”. Addiction transfer occurs when someone is unable or unwilling to rely on one compulsion and so switches to a new compulsion due to not having dealt with the underlying issue behind the compulsion. For example, one may overeat because he/she is lonely or depressed, or for any number of other reasons. This person has gastric bypass to deal with being overweight, but does not address the depression/loneliness and therefore develops an alternative compulsion strategy such as gambling, alcoholism or excessive shopping. According to the article there are millions of people who have undergone gastric bypass who are now dealing with issues of addiction transfer.

The article discusses the plight of Carnie Wilson, one of the most widely publicized gastric bypass cases to date, who became an alchoholic to soothe the stress after her post-surgery body made it impossible to rely on overeating as a coping mechanism. Another woman mentioned in the article who lost 200 pounds said she started having affairs to distract herself from stress. Apparently, these woman thought being thin was the answer to all their problems, but when they became thin and still had to deal with stress, the pressure became too great. A quote from the article specifically addresses the surprise these woman and others have when they find out that their weight issue was not the fix-all they thought it to be

That light-bulb moment, counselors say, can trigger depression that some post-operative patients try to medicate with liquor, shopping or cigarettes. And for many, depression is what brought them to a bariatric surgeon’s office in the first place.

In addition the article goes on to say that just the act of having lost weight adds stress.

Lastly, biomedical research suggests that the causes of compulsive behavior no matter what compulsion it may be (alcoholism, overeating, etc) are very similar. Experts also agree that gastric bypass does not cause addiction, rather if someone has an addiction prior to the surgery that it is likely they will have one after, although a different one.