Hormonal
Lifestyle interventions (diet and exercise) alone are insufficient for the majority (80%) of patients with obesity and fail to produce sustained weight loss without addressing the underlying biological disease mechanisms.
If you have obesity, relying solely on diet and exercise is likely to fail for you because your body's biological regulation of weight is disrupted. This is not your fault. You need medical treatment (pharmacotherapy or surgery) to address the biology first; lifestyle changes are only useful for maintenance after the biological drivers are managed.
Twenty percent of patients with obesity may respond to approaches based on healthy behaviour, but the 80% who do not respond should not be stigmatised but rather their treatment should be escalated.
Why this rating
Based on a review of clinical trials (STEP studies) and epidemiological data, though it is a narrative review rather than a primary RCT.
Source
The Concept of Healthy Behaviours in Obesity May Have Unintended Consequences
Hilary C. Craig et al. · Nutrients · 2022
DOI 10.3390/nu15010012
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