@Youcantellalotofthingsabouttheflowers @NattyTurtle
I never said that it had nothing to do with calories in. I said obesity is more than calories in versus calories out.
A gastric bypass is a more effective tool for weight loss than counting calories in versus calories out, because it induces physiological changes that make sustained weight loss achievable.
Of course it restricts calorie intake, by reducing the stomach size and limiting the amount of food that can be consumed.
But it also relies on physical limitations rather than solely on willpower and discipline to restrict calories.
Surgery reduces the absorption of calories by bypassing a portion of the small intestine. As you state it alters gut hormones like ghrelin which regulate hunger, satiety, and metabolism, making it easier to feel full on fewer calories. There is also the physical feelings of discomfort or vomiting if the person over eats, which does not happen with calorie counting.
restricting calories without considering the hormonal impact of foods will lead to a slowed metabolism as the body tries to compensate and burn fewer calories. Calories are not all metabolized the same way by the body. The hormonal response to different foods impacts how calories are used or stored as fat.
Surgery can set in motion metabolic changes that help reset and increase metabolism, making weight loss and maintenance easier compared to just restricting calories.
calorie counting is based solely on conscious restriction, where as gastric bypass surgery facilitates weight loss through mechanical, hormonal, and metabolic changes that make it a more effective and longer-lasting solution for severe obesity.
So… yes, it is more complex than calories in vs calories out.
Of course, if it was as simple as eating less, then there wouldn't be the obesity crisis that we are seeing today.