Please ponder on what I am saying. Dr. Now, the FIRST thing that should be done when a new patient enters your program is the counseling that you seldom offer and when you do it comes in many months later. I know personally that "It's not what you are eating, it's what's eating you."
If they can learn more about what is the root cause of their addiction to food, it may increase their success rate. All of your patients (my guess) use food to ease pain, forget bad experiences, as a coping mechanism and on and on. Helping them understand why they turn to food as a comfort will, hopefully, help them find the stronger part of their inner selves for that comfort and healing. In my opinion, if the patient has not received weeks of counseling to achieve these goals, all the weight loss in the world won't heal the problem, only soothe it over for a while. The need to eat will be there inside gnawing at them. Please provide the counseling first. It is as necessary as the surgery or physical therapy.
I am not professional, just a 72-year-old woman who has been overweight most of her life. Thank you!