Dogman quoted:

"I am a physician in the Western US. I have read your book and am in
awe: you have really opened up a can of worms here—and I couldn’t be
happier!

"Among my duties as a doctor is to perform pre-operative assessments
on overweight patients who want to undergo bariatric surgery, a.k.a.
gastric bypass, gastric sleeve, laparoscopic band procedure, etc. All
of these procedures involve surgery to promote weight loss and
avoid/prevent/avert the complications of obesity, such as diabetes and
heart disease, although, for many people, it is vanity-based: They can
buy fake nails and color their hair and wear fancy jewelry, but they
can’t hide their weight. As the volume of patients and the volume of
the patients (i.e. waist circumference) being evaluated for these
procedures continues to rise in our community, I find myself in an
ethical dilemma: How can I, in good conscience, help these patients
undergo an invasive procedure to lose weight when the same and even
better outcome could be achieved by eliminating wheat?

Wheat is addictive for some. High glycemic foods incluing wheat are
addictive for more. Thus eating them is rewarded by the body. With
diet alone there's no physical punishment for eating the wrong thing.
Lap band surgery adds that physical punishment.

Positive reenforcement works better than negative reenforcement. With
addictive foods the positive reenforcement is physical and immediate.
Negative reenforcement is only available in slower behavioral form. To
me that's the key of why diets fail such a high percentage of the time -
Too much immeditate link between behavior and physical reward; too much
delayed link between behavior and psychological punishment.

Until there is some product that offers physical punishment for eating
the wrong food no voluntary diet system is going to work for certain
people. With lap band someone can make the voluntary choice to put
punishment in place. Then it's not voluntary until reversal surgery is
done. Terrible but it's the only working alternative available.