Sharma pointed the way to this video
1 & 2, Eat less, move more, OK, but how do we do that?
3 Motivation, how does one motivate oneself 24/7 against our prevailing society, culture and environment. We like and need food (genetic, inbred, ingrained, instinctive survival) and society pushes food. We need to always make the proper choices, not what industry tells us is healthy. So what is the proper choices for me?
4 Coping with life, or a replacements for the relief eating provides. Overeating is a maladaptive behavior, or one conducted as a soother for life. Insulin and high blood glucose is a sedative. So when we take away the food, how do we learn coping methods for skills we obese do not have, and the thin do not understand their methods?
So this is a psychological problem. Back in 2004 or so, I tried getting more help (information, understanding, whatever) for this near life long obesity issue from Weight Wise, Dr. Sharma's organization. I was 158 kg at the weigh in. Soon then provided a list of suggested psychologists, of which there was only one dealing with weight issues and available. When I went to the first appointment, she was bigger than I, and was a fruitcake. I paid my $150, and left to never return.
Then when I got on a role and eliminated wheat, (sugar was already gone) and was busy losing weight, they through me out of their program for non-compliance, hence my opinion of the good doctor.
Solving step 3 and 4 are the solution to the psychological side of the issue, but the physical side includes learning to live with ongoing hunger, cravings, angst, what ever this physical feeling is, and the doctors do not have the answer. So much for the medical community. It is beyond there knowledge, but there is good money in studying the problem.