For a lot of people with serious weight problems, bariatric surgery, that is, surgery where their digestive system is altered in some way to stop them from eating too much, is an answer. On a personal level, the idea of such surgery scares me greatly. I realize that for desperate people, it is almost certainly a good solution, particularly if they're at a do or die (literally) point. Perhaps I actually should be desperate, but I'm not, at least not yet.
The surgery scares me on multiple levels. I've had relatively minor surgery twice in my life, once in childhood and once as a young adult, and it's very painful and traumatic. What is more, I think that our bodies have a balance which we have to try to maintain and damaging myself intentionally to stop myself from overeating doesn't feel right for me. Please don't mistake my saying that as a criticism of people who have weight loss surgery. I have nothing but compassion for their situation (as it is pretty much where I am now) and absolutely do not have any issues with their having made such a choice. If anything, they are much braver than me and are reaping the benefits far more rapidly than my approach.
This may be some sort of complex I have, or part of a broader notion of the meaning of existence, but I think I'm fat for a reason. I think that there is a battle I'm meant to fight as a means of spiritual growth and having surgery would be doing an end-run around the way in which I'm supposed to develop control over my emphasis on a particular sensory pleasure. I'm not a religious person, but I do have a sense that we're all here to learn something and our bodies have been designed to provide opportunities to learn. I have a sense that if I take a "short cut" around the psychological adjustments, then I'm going to find myself back here in the next life (yes, I believe in reincarnation) having to start all over again.
I once had a conversation with my husband about weight loss surgery, and told him that, even if I decided to take that path, I was worried about the long term health effects. He said that, though he could understand that thinking, he felt that the effects of being greatly overweight would probably be worse. Of course, he was right, but it never really felt like the right option for me. I don't doubt at all that it is the right option for some people, and more power to them.