So what is the setpoint really? It is a weight that our intake and output are equal, and therefore no change in our weight. Our intake, eating matches our output energy. So all those factors that effect our intake and output come into play.
So when we realize we are addicted to wheat and ban wheat from our diet, we have a new setpoint. Or when we injure our back and stop doing heavy physical work, our output decreases, yet we are in the habit of eating, so we rapidly gain until we make the effort to restrict intake, but then realize that our eating is epigenetic set now so we have a major struggle and are likely to lose the battle long term without a psychological shakeup and superhuman effort.
It is that psychological / educational shakeup that the medical industry does not understand. Neither does the diet industry. The exercise industry only promotes exercise which is all fine for the uninjured and healthy, but not for those with active physical problems. Some exercise is required for life, but not anything like the amount required to deal with a weight problem. Oh well, we are on our own with no government help. In fact, the government is working against us, both actively and passively.
The government goes on spouting wrong information about food and diet, they actively promote and allow other to promote overeating. Again we are on our own. The press promotes whatever without any concern for the correctness nor the effect. Many now know more of what is correct, but it takes an massive effort to get that information into the public's hands, and it must overcome the wrong information competing. Only one can be correct, and wrong side is still winning. Oh well, some of us know what is correct, and are trying to live it. It is difficult when those around us will not be persuaded of what we need.
Human society, as we live today is doomed. Oh well, the big effects will not be severe in my lifetime. Soon the wild fish will be gone, the oceans to acidic to grow much, oxygen producing plankton unable to keep up to our carbon-dioxide production. As the carbondioxide production is tied to population and lifestyle, and we are unwilling to give up lifestyle, the only choice is reduction in population back to the level it was when the oceans could keep up to our carbondioxide production rate. A return to 1960 population more or less. 50% of current. Oh well, itewajda. (In the end we all just die anyway.)
How will this occur. Our excess will shorten the lives of many. Those living in excess do not reproduce healthy populations, but others that live in excess. Religions will need to be banned or subjected to forced population control. All will need to promote birth control, one child families, and similar method of zero growth after the big reduction occurs.
What will cause the big reduction? famine in regions, war-civil and against immigrants or invaders, and disease... resistant bacteria may be a big item. Carbondixoide induced change in weather, and the inability to mount rescue missions, and those who are unable to deal with the high dioxide levels physically, emphysema and other breathing issues. We are unable to convince the governments into real effective actions, just token actions. Oh well, itewajda.