I was under the impression that weight loss surgery was for those who were so desperately obese that not losing weight would equal death in short order. It's not for people who "just want to lose weight." Even if you got surgery, you still have to maintain the weight loss and get over the mentality that caused weight gain to begin with.
If ALR got surgery, it's obvious that she would be just another failure. Honestly, failing after such a procedure is just scary. The complications are terrifying.
Nah, I don't think you have to be that drastically overweight. In the US, at least. There are tons of centers, and they all advertise, I don't think they could support so many practices if they only catered to the super-morbidly obese. I'm guessing insurance only pays for it if you're a deathfat, but they'd probably take a self-pay who needs to lose 70+ lbs. Maybe less, I don't know.
I think our perception of super morbidly obese has changed since the surgery became popularized. I remember in the early 90's, carnie wilson was the fat sister of the one-hit-wonder Wilson Phillips. She got a gastric bypass and went on to pose in playboy. Then she gained it back, was on celeb fit club, then had a lap band a few years ago, looked her up, still heavy. Also, she now makes cake for a living. Fitting....
Anyway, when she had her first wls surgery, I remember thinking omg she's so obese, but what a drastic thing to do. But looking her up just now, she was 300 and 5'3, which seems like a ton till you think of amber at 600 and 5'3. In the late 80's/early 90's I don't think there was vanity sizing, the leggings and oversized-top fad was dying/dead, and I think normal clothing sizes ended at 10 with very few 12s. Now normal clothing goes up to 14, 16 maybe even 18! Now 300 and 5'3 sounds like 120-150 lbs overweight and within the realm of dieting that away (as opposed to 600 lbs), and in 1992, 150-170 and 5'3 would have been really overweight.