1) Roux-Y is difficult to cheat. Sleeve/Gastric Banding: Drinking microwaved, liquid nutella. Melted ice-cream in buckets. Blending meat or fries, drinking the "smoothie".. 2) Yes. Very much so. Very similar some types of alcoholic 3) Hmmm.. I hate the type who blames its childhood without there being real abuse. Or society/fate/whatever I have obese patients who were raped by their father, beaten to pulp as a toddler, homeless as a kid, left to die in a corner by an alcoholic mother.. but some just whine, and whine and  whine. I want to sometimes just slap them in the face or tell them about the real hardships people can encounter (and overcome!)