[cm2012]

If its just a few lbs, follow the advice here. Otherwise get bariatric surgery.

Every legitimate long term study of non surgical weight loss shows that it doesn't happen for the vast, vast majority of people.

1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453)

2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full)

3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/)

4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data.

5) [The only thing that does seem to work in the long term is gastric surgery.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/)

Moreover, you won't find any reputable study on the web where the average person lost 10%+ of their body weight and kept it off for five years. Not even one.

[anotherevan]

If the issue is obesity (e.g., you need to shed over a third of your current body weight) then I agree that bariatric surgery is definitely an option to consider. The odds really are against you trying to lose that amount of weight via diet and exercise alone at the parent post suggests.

(Considering surgery is certainly a more helpful suggestion then, "Have you tried eating less and moving more?" like they are the first person to ever tell you that. The way different bodies process things is far more nuanced than that, involving so many factors including hormones, age, gut bacteria and heaps of other things, not just will power. The more we discover about nutrition shows how much we don't know about nutrition. End rant.)

From my own personal experience[1] I would consider a gastric bypass or gastric sleeve, but avoid a lapband - all other factors being equal.

Obviously seek competent advice from medical specialists on the matter before doing something irreversible.

[1] http://www.michevan.id.au/content/adventures-in-bariatric-su...

[dugword]

Suggesting surgery is dangerous advice.

The "vast vast majority" of people that regain the weight in those studies are likely to be those who are the most prone to do so, and this can also be interpreted that structured weight-loss programs don't work: http://www.nytimes.com/1999/05/25/health/95-regain-lost-weig...

Look AHEAD: 8-year results (nearly 40% of participants who lost >-10% of initial weight at year 1 maintained this loss at year 8): http://www.obesity.org/obesity/news/press-releases/look-ahea...

You are correct, that it is impossible to track your calories everyday, for every meal, for the rest of your life.

If your diet takes work, or requires special foods (e.g. Nutrisystem), you'll eventually stop doing it and it'll fail.

To lose weight you have to make permanent lifestyle changes. Stop eating junk/processed food, rarely eating out, learning to cook, and eating primarily healthy foods.

I know this is anecdotal, but I know a dozen or so people in my life that have made lifestyle changes to their diet have kept the weight off for 10+ years. And they are the vast majority of people I know who have lost a significant amount of weight.

They didn't join any weight loss programs, so I don't know how a researcher would ever find statistics on them.

[csa]

While I like and agree with a lot of your comments, I think it's a bit of an accurate-but-myopic look at the issue.

Most/all of these weight loss programs usually seem to target the byproduct of the problem (being overweight) rather than the actual problem (an unhealthy relationship with calories).

While I have not seen any studies on people who have made "lifestyle changes", my personal anecdata suggests that this type of weight loss is sustainable at a fairly decent yield (not 100%, but not 0.2% either).

I realize that well-done studies like this will be hard to execute, but I hope they get done. In the meantime, I hope that people suggest seeking a lifestyle change (likely including doctors, nutritionists, and psychologists) before they do something drastic like getting gastric bypass surgery.