That person who's 20 lb overweight might have as many or more issues than someone who's 100 lb overweight. They may just be better at keeping the weight off by whatever (often unhealthy) means but want desperately to be off the treadmill of food obsession and body image obsession forever. Just like most people here did and do.

When we had the huge debate a few months back on setting high goal weights, I realised I felt disgusting, miserable and unhealthy enough at a BMI that many people would be thrilled to achieve and maintain. It was always doomed to become a fight like it did because how can you say that you felt awful at x weight without offending someone who's worked hard to get to x weight and feels fabulous? Yet I was simply desperate about my weight and losing it has changed my life. Yet my BMI was never more than 35. If someone had said to me that they were offended by my desire to have LAP-BAND® surgery becuase they thought they I had no right to it at my "low" weight I would have been pretty defensive about it.

You can never get inside someone's head, although I do agree 20lb is hardly a problem requiring surgery - yet. I wouldnt say they should start banding people that are 20lb overweight by a long shot, I think that banding in Australia from a BMI of 30 is sensible policy - why wait for health problems to occur? If you've a BMI of 30, chances are one day it will be 40. Statistics tend to bear that out.

With regard to younger people, well statistically, fat kids become fat adults. Why discriminate against them for their age and not having had all those fruitless, pointless, doomed attempts at one diet after another? Why on earth not just nip the problem in the bud right now before they ever become morbidly obese. I wasnt that young, I was 38, I hadnt developed health problems at that point but for me banding was not only cosmetic (and I see absolutely NOTHING wrong with that, its little different to, say, inserting silicone bags in your chest for the look of them) but also about PREVENTING future health problems, and staving off feeling, acting and looking old well before my time. I was beginning to feel decidedly middle aged and that scared the sh%t out of me. The greatest joy every day since banding is actually not what I see when I look in the mirror but how I feel inside, going out for a run and being able to do it is such a pure joy, I'm so sorry I wasted 8 years of my life being obese.

So yeah, I really dont make any judgement at all on how overweight someone else is when they choose the surgical option. I really dont believe those who are fatter have more right to it or deserve it more, I just think we should be grateful its an option and I'm very grateful it was available and that I could afford to choose it. And I'm thrilled for anyone who embarks on the journey and really hope it works for them as well as it has for me.

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Jacqui