One nursing unit I worked in received gastric by-pass patients for their post-op from the initial surgery or from surgeries due to complications. I would definitely put these surgeries in the last resort category. Have you tried/considered low carb combined with fasting?
I think what bothers me the most is that the surgery is permanent, but some people regain all the weight initially lost. To have you metabolism altered for life and then to not have permanent weight loss would be tragic. As I said, this would be in my absolutely last resort category.