I just had surgery for my 27th birthday and wish I had done it sooner. If your insurance covers it, and she is serious, let her get it. It will change her 20s and help her avoid heart ache etc. I look back at my wedding pictures and regret being so heavy. When I hit goal weight, my husband and I are going to have a vow renewal and retake photos, but years of my life were wasted being fat and unhappy, don't make her go through the same thing.