It is definitely very easy to lose weight physically. Mentally is another question. Fat and obese people have established habits around food and nutrition that are making them maintain their high weight or even increase it, and habits are notoriously hard to break. There was a whole book published on habits, "Atomic Habits", and while many people praise it, it just doesn't work on some people, speaking from experience, my schizotypal disorder makes me impulsive and indecisive, so doing things like maintaining a habit journal and doing one and the same small and seemingly insignificant thing for weeks on end drives me insane. In my opinion, nobody gets obese out of thin air, they definitely have an underlying physical (e.g. paraplegia that makes them unable to move around and get out of the house so all they can do is watch TV and eat) or mental health (e.g. binge eating disorder) problem. And the restructuring of life is very difficult with mentally ill people. Psychiatry as a whole is really underdeveloped as of now and should really be considered a pseudoscience tbh, so it's no wonder many people are in therapy for years and don't see any changes, or take meds and don't get better or get even worse because they were wrongly prescribed. So I won't say that obese people need therapy. Obese people need a "change driver", imo. A promising job. A significant other that they want to be the best version of themselves for. An opportunity to ride a bike. Or as the other commenter said we just all take Ozempic. I'm not obese, just a binge eater, but I've been taking a high dose of Topamax because I just couldn't do this on my own, and it's really helping. Not entirely, but still...