Originally Posted by 'nother
I have never mentioned anything about "trying harder", but I won't stop with the "simplistic" response of calories in < calories out, because this is a basic fact of human physiology....
Let's discuss human physiology and beginning endocrinology.
For the morbidly obese, the body is simply incapable of converting sugar into energy. You exercise; the body's normal response is to release sugar from the liver into the bloodstream to feed the cells. For the morbidly obese, the cells are not able to process the sugar. In spite of the sugar in the bloodstream, the cells are starving for food -- and you become incredibly hungry. No matter how much you eat, however, your hunger cannot be sated.
It's easy for somebody like me (5'9", 150#) and you to say "You just need more willpower." But the fact is the hunger drive is incredibly difficult to overcome, especially when that drive is coming straight from your starving, underfed cells.
Even if you have normal caloric intake for your activity level, because your cells are out of whack and aren't properly metabolizing the blood sugar, the sugar in your bloodstream just gets converted straight to fat.