congrats, you are the exception. But 3 - 5% are still a lot of people, population wise.. so, you're not alone with your success!!  But a medical intervention (e.g. a diet) with a success-rate of 3-5 % is absolute shite. So.. what to do???? I don't know why it doesn't work better. I really don't. The euphoria of success is not enough, no.  They don't lose weight to qualify for surgery. We still perform surgery even if they put on weight or stay the same during the year. It's mostly about the nutritional training so they cope with the food preparing after surgery.. the tiny portioning etc. The exercise is a bonus, training lung capacity an mobility and very basic stuff. Some lose 5-10 kg, some 15 -20 kg a lot nothing at all. Some I'm happy they have stopped gaining.  I can't tell you much about CISCO weight loss from personal experience, as I said, it was one patient who lost about 30kg in the assessment year, opted out of surgery, lost 90 more and suck with it. I've had about 30-40 Patients opt out and trying to stick with it. Bout half came back after 6 Mo- 2 y, the other half.... some gained and just gave up, some went to another doctor.. some perhaps made it, I don't check up on everyone..  Post surgery quality of life is rather good. Very happy people. Lots of letters, thank-you notes..pictures, first job, first date, first vacation..