When someone has a high or very high BMI, that means they have probably had excess fat for months or even years. This size and weight is the new normal, a set point for the individual. When the body has metabolic syndrome caused by the lengthy time of being overweight, the body’s ability to use the energy (food) coming in is broken. The insulin doesn’t respond well. The hunger and satiety hormones do not work well either. Essentially the hormonal system is broken. It takes a lot more effort than just diet and exercise to make lifelong shifts into a normal weight system. It takes a whole mind and body overhaul, focus, and lifestyle changes that one can commit to, long term.
We need to look at adrenal fatigue, stress and anxiety levels, sleep patterns, family support or sabotage, water intake, and a whole lot more.
I suggest those struggling to lose weight after being very heavy for a while get medical tests from their health practitioner, as well as a wellness coach to support the journey. I think a mind overhaul and emotional sharing with famly and friends is necessary as well. Journaling one’s daily feelings around what they eat and why they choose the foods they eat will help with identifying patterns of self destruction. I believe the negative self thoughts have a physiological effect as well. Silence through walks in nature, yoga, or meditation also can be a positive tool.
Unfortunately, most folks who lose weight on a fad diet gain it back and more within 2 years. Getting one person who you trust to hold you accountable on a long term plan and vision is priceless. An exercise buddy and a food preparation buddy will make the work more fun and educational instead of a chore.
Those with a high BMI need to work harder and longer to achieve their goals. It is a life long struggle, but the health and peace within are well worth the efforts.
I hope this has helped you on your life's journey.