Anecdotal...I was a friend's support person when they got bariatric surgery. They had to demonstrate their weight was exercise-resistant and had to demonstrate failed diet control attempts. The caveat here is the person lied about the extent. She exercised for one month or dieted for one month and greatly exaggerated a history of "failed sorts exercise regimes." At the time she was 21. I don't personally think her weight was wholly due to her lifestyle but she never gave it a real go and I know this because I was with her a lot pre and post surgery...we frequented taco bell a LOT. She kind of exaggerated that her weight was diet-resistant because she was an unhealthy vegetarian for several years in high school. But you know..an unhealthy one...a high calorie eats fast food one.

After her surgery it was really interesting....with her newfound "skinnyness" she engaged in really reckless behaviors. She put herself in debt buying new clothes, she engaged in risky sexual practices, she avoided dumping syndrome by eating less and drinking alcohol more. She went full party girl. In fact, she sort of went into a weird "man-eater" phase where she leveraged her new-found attractiveness and confidence to scam men out of money or gifts. And as far as follow-up care regarding mental health after surgery... non-existent. Her diet never actually got better either. She didn't have a surgery and use it as a tool to be healthier. It was really all in all I think a negative on her overall health. She's gained most of the weight back now five years later. :(

We aren't really friends anymore...but I think her age and her mental state played an extraordinary role in how it all played out that gets really overlooked in many patients who struggle with weight.