I wrote the first part of the below a few weeks ago and left it in draft...Amber's reaction to being told to go away for a year just confirms what I thought the second she tried starting this arc:
All this sperging and speculating about weight-loss surgery, and Amber's in no way, shape or form mentally "there" for losing weight. Surgery is her end-goal, and she expects it to do the heavy lifting (heh) for her. She's still eating crap, and way too much of it. She still sees junk food as the prize.
Maybe surgery is the only hope for someone > 500 lbs (though for the same money you can spend a month or more at a *really* nice fat farm - it's not like Amber has a job that keeps her from going away awhile - to a place where there is no junk food, your intake is completely controlled, and you are obliged to move a lot. It's at least a jumpstart on normalcy as prep for surgery), I don't know.
These surgeons require someone to lose a token amount of weight (whatever amount) to prove they have willpower and tenacity, but as with the Slaytons and Amber, a lot of the patients fixate on hitting the magic number to get what they want and no more. An hour meeting with a dietician/ nutritionist (even an hour weekly/I have no idea what's standard) is great...and lasts exactly until the second time they pass a McDonald's. It's no wonder so many people eat past the surgery and fail to lose/regain in short order. They are still food-obsessed, see food as the best reward and comfort, and without a Pavlovian setup (i.e., no "hit the magic number -> get what you want," bc all they wanted was the surgery) they are lost when it comes to actually pitching in and developing some discipline and willingness to experience rewiring their dopamine pathways (if that's not technically correct, then take my term as a lay-figure of speech).
(back to present day)
As anyone who has tried to quit a habit or exchange short-term rewards for longer health and contentment knows, there are a lot of layers to the process - the physical habit/associated behaviors, the absence of the hit, the discomfort/panic of space/nothingness when you're used to its being filled, the depression/reality smack due to the lack of excuses for not getting up and doing something other than whatever your habit is, and the effort required to find a better balance, more patience, trust in the process, and grit/perseverance against how you may have been living for decades/life.
...Amber's response to being told no for now will be telling (well, it's 99% likely she's exactly as always, 1% she digs in deeper). She can have a good cry, acknowledge the disappointment but determine that with or without surgery, she is committed to doing better for herself, with or without it. That would be a mature mindset, one of a person not looking for excuses.
But, right. 99% - and not just, but definitely partly, because she is ALR - this will be the next excuse and rationalization for deciding to live life on a sofa...only it won't be a "decision" in her perspective, but rather it will be another victimization, in this case by the mean dietician who prevented her from a healthy life.