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> 5) [The only thing that does seem to work in the long term is gastric surgery.

Arguably not "average" people, but there is a club of "extreme calorie counters" who have maintained substantial weight loss over many years.

I wish I could find the link to the documentary, but the search signal-to-noise ratio is problematic. It feels like something I saw on an investigative journalism program e.g. The Fifth Estate. In any case from recollection, this is what I recall:

- There were something like 30,000 members worldwide - Membership required maintained weight loss - They generally counted and journaled every calorie, with remarkable rigour

This appears to be the one alternative to gastric bypass that has repeatable success. It's just not achievable by most.

Incidentally, only Roux-en-Y laparoscopic gastric bypass has been associated with long term successful weight loss; the "tube" mini-gastric bypass has not; I'm not sure about others, as some experimental alternatives are cropping up.




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