I feel bad for the ugly people who are not fat. But, with the obesity rate above 30%, they are still above the lowest third of the population. They would need mutations to look worse than the fats. If he has warts and boils, he can get those removed. If he has a really bad bone structure in his face, that's harder, but there are still options that should bring him at least up to average without drastic modifications. Even some light makeup could make a good difference. Abe Lincoln was said to be ugly. The gaunt and darkened paintings of him were generous. It doesn't have to be a huge hindrance in life. It sounds like this guy needed someone to pick him up and push him in the right direction 17 years ago. Society can be very "take the hand you are dealt" regarding looks, which is a shame.