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Bariatric surgery often requires BMI 40 or greater, or BMI 35 or greater with serious obesity-related conditions

He outlines the escalation trap: a self-reinforcing cycle where initial interventions create pressures that cannot be exited without accepting defeat

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Pairing treatment with lifestyle changes such as nutrition counseling, regular exercise, and balanced eating habits can help sustain results long-term

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And it is the biological substrate of physical strength, balance, and functional independence, the capacities that determine quality of life in the later decades