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You could have medical anomolies that slow metabolism, so that weight loss is extremely difficult, but even then a reduction in caloric intake will cause weight loss. But somebody surviving on 2000 a day dropping 200 calories out is easy, compared to somebody sustaining on an 800 calorie diet and trying to cut 200 out.
There are some meds like olanzipine? that tweak your metabolism and it uses calories more efficiently, therby causing weight gain on same caloric intake, so the remedy on that med is eat less calories