I mostly agree. Depends what you mean by drastic lifestyle alteration. Surgery would be an awful idea and unnecessary. It's right that it's not a matter of willpower or behaviour. It's hormonal regulation. Something can be done even if genetic, just not what common knowledge, the media, or most doctors say should be done - which just leads to failure, blame, shame and self loathing.

They sure have.

Actually my friend's hubby is very cuddly and they do have missionary sex, so it can lock in if done right. You have to have a care, but Heavy isn't so fat that it can't be done.