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For the great majority of people, I'm sure you're right. But I don't think that covers the outliers.

A 500 Cal a day diet is so far below the energy cost of simply being alive that even folk who're in a coma require a greater caloric intake a day. Given what's actually known about how the body works in caloric deficit, evidence of what happens to individuals who consistently eat below their daily energy requirements (whether those examples come from supervised metabolic studies, bariatric surgery or refugee camps etc) a claim of lack of weight loss on a 500Cal a day diet is close to a biological impossibility.

Patients can easily fool their doctors as well as themselves.
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