In report published last July researchers concluded that under the typical conditions of care for obese and overweight individuals that:
“current nonsurgical obesity treatment strategies are failing to achieve sustained weight loss for the majority of obese patients. For patients with a BMI of 30 or greater kilograms per meters squared, maintaining weight loss was rare and the probability of achieving normal weight was extremely low. Research to develop new and more effective approaches to obesity management is urgently required.(58)”
Thankfully the article isn’t purely deterministic. It ends on a more positive note, I recommend reading it. But the point is that once a certain threshold of weight gain is reached, it can be very difficult to reverse the process. Also, the data reviewed was from the UK primary care database. In other words, it doesn’t include people who see dietitians, personal trainers, or who take personal ownership of their own well-being through research and hard work. My doctor friends tell me that it is rare for patients to respond positively to non-surgical and non-prescription intervention recommendations. And there is some evidence that doctors often don’t tell patients that they are over-weight. The same article linked in the previous sentence indicates that many doctors to not feel competent to help patients lose weight and keep it off.
I typically reject deterministic points of view because of their tendency to force people to give up. The more positive note the article ends on is this, “the greatest opportunity for tackling the current obesity epidemic may be found outside primary care (58).”
Alison Fildes et al., “Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records,” American Journal of Public Health 105, no. 9 (July 16, 2015): 54–59.