Serious question - what percentage of people do you think genuinely don’t know the stuff you mentioned?
Not a medical provider ... but I would think lack of knowledge is almost never an issue with obesity.
Instead, it seems obvious (without medical training/schooling but as an obese person) that obesity is a multi-factorial affliction -- one's physiological makeup seems to have a large effect. Off the cuff, there also seems to be multiple distinct psychological components (e.g. pleasure-pain/reward 'system' is off or 'hijacked', exercise doesn't yield [sufficient?] endorphins, etc.).
I do know (or rather '
know', because there's likely to be well-supported contrary info out there) that there are a good number of people -- maybe 1 in 5 Americans, maybe more -- that could work out like a triathlete, live on kale, and go get lost in the Andes for a year ... and would still end up having what amounts to a '
Dad bod + beer gut'. And there are also some amount of people that could eat three Thanksgiving dinners every day, lie around on the couch binging Netflix 24/7, and they'd never put on an ounce -- instead, they'd feel nauseous all the time (and probably vomit more than they'd like) from all that excess food their body can't process in some manner (read: digest for nutrients
or store as body fat).
Sigh.
Starting off obese ... and looking to get in some kind of quasi-shape ... that's a big freackin' mountain. It ain't just diet-&-exercise for a little while and you're good. Lifestyle changes? Forever? What? How many of us are really in for that? How many of us can really bootstrap that out of our psyches? And even if you can, you're pretty darned exceptional ... and can you really expect that one-in-a-jillion exceptionality out of all obese people?
Needless to say, there's a lot to work through before you even get to the 'diet & exercise' platitude. Bring on the drugs.