It's still a matter of being fat "by choice", though. If you've ever been in the throes of carbohydrate addiction to the degree that you'd eat yourself immobile, it doesn't FEEL like a choice to eat those chips. Yes, everyone has the basic capacity to limit food consumption, but whether for medical/metabolic OR emotional disorders that mess with that mechanism, some people aren't able to save themselves FROM themselves without drastic forms of intervention. That's where gastric bypass can come in.

I mean, think about it. Without an underlying condition affecting the hungry/full mechanism, would someone actually CHOOSE to eat until they feel sick, harm their health, and become the kind of sideshow people really seem to get a kick out of wagging a shaming finger at?