Not everyone who has made this choice "announces" it. I would dare to guess that it's not a spur of the moment or a lightly made decision.
Bariatric surgery.
Usually we have tried to lose weight but to no avail. We starve ourselves, and if we can exercise we usually hit a plateau once a few pounds are lost. For whatever reason, we can never achieve our goal. Now I say if we can exercise because let's face it, to qualify for bariatric surgery to be covered by insurance you have to be at least 100lbs overweight or have a BMI over 40. Usually at that point movement is not easy. In my particular case it is damn near impossible.