There is surgery to remove the skin. I saw it done on some trash tv show, and it's absolutely disgusting. The doctors literally slice off huge flaps of skin, drop it all in a large bucket to weigh, then sew the cut ends together on the person. Apparently it's horribly painful and leaves, of course, a ton of huge scars everywhere. Talk about paying the piper. All that suffering just because they can't or won't stop eating until death or other disaster is imminent.