Well, I think they're food addicts. They have the hallmarks of addiction and they almost never get help for their underlying physical and psychological issues. So of course most of them go back to those behaviors. Look at "My 600 lb Life". That doctor makes a bunch of them get therapy and nutritional counseling. That's why they do better long-term I ate junk food for almost all of my life. I'm 45. I still get cravings for it. But now I just say "NO". I don't think those cravings will ever go away. But it's called self-control and personal responsibility. If you don't have the internal ability to control yourself, then you will not exhibit basic adult behaviors and you'll give in to childish, self-destructive behaviors, like gluttony. Which is why I don't need therapy. I handle these cravings like a rational adult.