Well, every dictionary I looked up in a 5 minute google search said that a fetish is something by which you have an abnormal attachment. So I would say that it something that "controls you" in a way that is unhealthy. You can make sex a fetish, which I think some people on this board may do, and it may be a root cause of their problems.
The marriage bed folks take the rather unambiguous position that anything you allow to control you to the point of screwing up the natural way of things (in their opinion based on their interpretation of the Bible) is wrong. That is their opinion, and one I happen to agree with. I struggle with a fetish of sorts (more of a mental fantasy that I dwell on too much), and reading their site has really helped me start dealing with it.
And yes, many people with fetishes cannot acheive arousal or orgasm without the fetish in place. Of course, there are different levels of "fetishism" and thus different levels of control. Isn't life complex?
Chrome
"Recollect me darlin, raise me to your lips, two undernourished egos, four rotating hips"