Read the following paragraph and answer the question. Give ONLY the answer, no other words or explanation.

For example:

Answer: <most likely answer, as short as possible>.

Paragraph: Now that i ' ve lost a few kilos and lost most of my boobs my stomach still remains bigger than ever . It just makes me want to die . I almost feel like i have a tumor inside me it 's just ... freaky . So i ' ve been doing my research and it appears no matter how much you restrict , no matter how much you exercise , if you 're an anxious , stressed person the fat will remain there even when you ' ve lost everywhere else . Americans are lucky .

Question: Why might I have to have a surgical procedure to achieve my goal ?
Because I 've done everything right but can not lose the fat around my waist .
The text does not provide enough information to determine if a surgical procedure is necessary.