Among many of them, it is considered a matter of life or death,
The US medical system has a lot to answer for. This is them pushing a medical treatment and using threatened suicide as a lever for all kinds of cosmetic surgery.
And of course, this is probably why nobody anywhere is doing genuine, long-term, thorough follow up studies, with different cohorts to examine whether all this treatment is genuinely helping or not.
If it was proven that these patients did equally well with CBT, the whole gravy train (and, I suspect, the hero complexes of some of the medics) would draw to a halt.