4ish years ago. I watched a close friend drop from 390 ish to 190.  Took him around a year total. Basically high protein and exercise.  His hunger never subsided. He felt starved at all times and snacks on almonds incessantly.  His stomach has shrunk to the point, that he can only consume small meals. Yet He still feels hungry always, even after a full meal. 19 months ago he gave up and has gained 1# per week since.