I think it's similar to other addictive behaviors like hoarding etc. where there's other things going on that are much deeper than just being needy or careless. A hoarder can clean things out of their place to get rid of the clutter, but soon it all comes back because what caused the 'need' for stuff didn't get resolved.
Per the gastric bypass, etc., I'm in the same vein for juice diets etc. Habits have to be broken, and good ones need to be established for positive long term effects. It's easy to get impatient, but personally I find it way more rewarding to get back to a healthy weight or work to heal back issues with PT over time than a quick fix like just getting adjusted every 3 weeks.
I'm reading some stuff currently about how important it is for people to hold themselves responsible to help themselves and diet, finances etc. are prime examples. It's tricky--the solutions can be really simple (want to save money? Don't spend money on useless stuff.), but can also be really complicated to work through.
Yeah, there's a huge psychological component to these things. I have a family member who has always been a bigger person (not 900 lbs big, but very overweight) his whole life. He insists that "I just can't lose weight, it's just not possible for me." He goes on diets for a week or two, and if he doesn't see huge losses, he gives up. Or, he says "I went for a walk 3 times last week and I didn't lose a frickin' pound." Meanwhile, he's eating out for just about every meal and that includes McDonald's at least once a week.
I'm grateful to not have any addictive tendencies. I'm also glad I learned about nutrition during and after college. My family did not have any understanding of nutrition growing up. I would easily down a 12 pk of Mt. Dew on the average Saturday when I was in grade school and HS. I'd play a baseball game and then down a quart of ice cream. I was young and my body could absorb those things without being overweight, but I still wasted a lot of prime physical years by participating in horrible nutrition.