However replacing the junk with real food is the cure, no calorie reduction required.
Clearly I have a lot to learn. My point is that I find it very difficult to believe calories in vs out has NOTHING to do with it and the research you posted didn't tell me that was the case. Also, replacing junk food with real food is going to cause quite a major reduction in calories, unless a lot of the 'real food' is coming from grain but even at that, I would find it very hard to believe you could equal the caloric intake of a ~400lbs person with primarily meat and veg.... Would probably need to eat every hour.
Another point here is that low calorie diets DO work for a lot of people. I'm talking about things like slim fast, weight watchers, etc. Diets that I would never recommend. They work on the theory of calorie restriction and clearly, there is 'something' in that approach which works - as much as I hate to admit it. These plans normally penalise you for protein and especially fat. Infact I once calcuated my daily intake in 'points' according to the weight watchers chart and I was 5 times over the amount of points they would allow me to have, due to the amount of protein and fat I eat (you get hammered for eggs).
Just because the weight comes back on with a reduced calorie approach doesn't mean it didn't work. If you fit the lifestyle to the diet and not the diet to the lifestyle then people will always go back to their old ways. I've seen a 365lbs guy drop 100lbs in under a year on weight watchers. There's stories like that all over the place. I'm not saying that's the way to go all i'm saying is that reducing calories cleary has SOMETHING to do with it.
It's worth noting I agree with you 100% in the 'fix' (low carb/real food). However, what 400lbs person is going to have a smooth transition into a paleo-style diet? In my view you have no chance. You need to address things on a much simpler level.
I mentioned that I would be more concerned with the amount of pizzas and donuts they binge on per day and that led you to claim I don't know what happens when you eat (???). But, then you recommend a low carb approach to fix it? What's the difference? I believe the difference here is in the application. That's all i'm getting at. I would want to approach it in terms of dropping/replacing bad habbits but by the sounds of it, you think you can prescribe a paleo/PN style diet and actually believe someone that big will stick to it? I agree on the eventual solution but not the approach.
Lowering calories MAY cause weight loss for a limited period of time in the significantly overweight. However the hunger will make their underlying problem worse, stimulate their appetite and it teaches them NOTHING about nutrition. All they are doing is eating less of the same crap that got them in trouble to begin with.
Now in extremely low calorie diets, it has to be also low carb by definition. So it's just an ineffective low carb diet with not enough calories to stave off hunger and metabolism issues and not enough protein to provide for healthy muscles tissue. Maybe not even enough fat to provide for all vital body functions.
Let me try to explain this. Your body is not just a box, where you put something in and you take something out. The calories don't go anywhere by magic. There has to be some sort of enzyme or hormone that makes it do whatever it normally does in your typical person. The hormone levels are regulated not only by environmental factors, but also by receptors in the brain. Let's say you have no insulin. That would make you a type 1 diabetic. So insulin stores fat and synthesizes cholesterol. That means with no insulin it is IMPOSSIBLE to store fat, no matter how much you eat. You also have all that sugar in your blood, and you are peeing it out like crazy. Your body can't get nutrients to the cells, because you have no insulin. So you're fat and muscle are being eaten up rapidly to keep you alive, you then go into diabetic ketoacidosis. You are eating and drinking like crazy, thousands of calories. Yet you waste away to NOTHING anyway. Why? Because you need a hormone to do those things. Then you are diagnosed, you get insulin injections and suddenly everything works again. So if you body was just a gas tank, put fuel in, use fuel, and nothing else; Then there would be no such thing as an endocrinologist.
Now, what if you have or don't have, or are to sensitive or not sensetive enough to insulin, glucogon, grhelin, HGH, thyroid hormones, testosterone, estrogen, progesterone, etc. What if you have problems with receptors or the neurotransmitters that act on them. Maybe you have too much or too little dopamine, or seratonin, epinepherine, norepinepherine, or Something is wrong with a certain subset of your alpha receptors or beta receptors, or various peptide receptors, or thyroid or pituitary gland and on and on and on.
Like I said there are doctors who go to school for 8 plus years JUST for hormones. Some of them may even specialize in certain ones.
If all that wasn't crazy enough, we still have many genes we don't fully understand yet. It has been but 1 decade since we finished the human genome project.
I almost forgot about feedback loops. The body will try to compensate if you eat a lot, or not enough, or if you try to put on more than a certain amount of muscle, or make any changes at all.