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You can write $dV_g' = f dV_g$ where $f\to 1$ in $C^1$. Then $div_g(X)(f-1) dV_g = div_G(X(f-1))dV_g - gX,\nabla (f-1))dV_g$. The first term integrated on $\Omega$ is $o(1)$ since $|X(f-1)| \to 0$ in $C^0$ and then the second is also $o(1)$ since $f\to 1$ in $C^1$ and $|X|\leq 1$. The issue raised by @OrangeMushroom can be fixed by shrinking $X$ a bit to compensate for the fact that $g'$ is measuring things slightly bigger/smaller than $g$ (but this stretch factor is $1+o(1)$ so goes away.
Yes, you should be able to construct such a metric. Form "bubbles" on $R^2$ i.e. spheres connected sum with the flat plane to produce a small neck. It's clear that the neck is very good isoperimetrically. Now, make two spheres that contain volume V together, and have total neck area A, and make another single sphere with volume V and area A. You should be able to argue that the isoperimtric problem at this volume V has a solution given by two disks and also one given by one. It may take a bit of work to make this rigorous, but I am pretty sure it can be done by a limit argument..
Your modified equation is the Euler Lagrange equation of $\int |\nabla u|^2 + h(x) W(u)$ where $W'=F$. So probably most of the basic ideas go through. You should be able to find some papers about this equation. I don't know of any intrinsic reason to consider this modification but there may be physical models where it's natural.