I have seen a show similar to 'Botched' here in England though it may have had a different title. Most run to a similar format each show so I only ever watched it once as in every show it is usually the same.For reasons she can't explain my wife likes to watch a show called Botched which, for those who have never seen or heard of it, is about two surgeons based in southern California who attempt to correct seriously flawed (i.e., disfiguring to varying degrees) cosmetic surgeries--nose jobs, tummy tucks, bust enhancements, corrective surgeries after some form of trauma, and so on, that previous surgeons (or non-surgeons, in some cases) made a mess of. But they also get their fair share of lunatics who want surgery so they can look like a Barbie doll, or a cartoon character, or an alien, or...well, you name it.
I'm sure most viewers just want to see the "freak show", but I'd bet there is a percentage of viewers who watch shows like this and Dr. Pimple Popper, and others of that ilk, so they can feel better about themselves. "I might not be perfect, but at least I'm not as screwed up as that guy/gal."
I am one of those who have almost no sympathy for those Fat People shows, unless a serious medical problem makes them fat. Most of the people featured have a few mental problems but do they really get to 400lbs +,(28 stone +) and bed ridden through that or is it from being lazy and watching TV, playing computer games, eating while watching etc? Eventually for a lucky few maybe a TV company will highlight their problem so they can cry their way to hospital, get put on a healthy diet but then break down on the next show and go off and order a Bargain Bucket to cuddle up to and justify their laziness. A total waste of a TV 'show'(because that is what it is, a show).