Calorie restriction for obesity treatment results in weight loss—initially—giving patients the impression they have conscious control over their body weight. But predictable biological responses oppose weight loss, including decreased metabolic rate and elevated hunger. Therefore, ongoing weight loss requires progressively more severe calorie restriction, even as hunger increases. Few people achieve clinically significant weight loss over the long term with this approach. Those who cannot might feel implicitly stigmatized as lacking in self-control.
Source: The carbohydrate-insulin model: a physiological perspective on the obesity pandemic | The American Journal of Clinical Nutrition | Oxford Academic