You tell Samantha that set point theory describes why it may be extremely [ Select ] difficult easy ridiculous helpful for her to maintain weight loss for long periods of time. Once she decreased her food intake and increased her physical activity, her body underwent many physiological changes to preserve as much energy as possible to maintain a stable weight range. These changes involved [ Select ] fat loss hormone lipolysis satiety and signal changes. For example, in the setting of low calorie intake, her body produced [ Select ] lipase leptin ghrelin cholecystokinin to greatly increase her appetite. Her body knows that it cannot maintain all of its normal functioning without energy, so it does everything in its power to get Samantha to eat enough food! However, the body is resilient,  and it is able to reduce its satiety by down regulating non-essential functions to survive in "starvation mode" with less energy intake. Overtime, it can even manage to function with increasing less calories if needed. This is a great benefit to humankind when it was faced with bouts of famine, but not so helpful when one's environment is laden with calories. You tell Samantha that she should not blame herself for regaining the weight. For most folks, there is no amount of motivation and effort that will help them maintain weight loss in the long term. Even restricting food intake to impossible, dangerous levels and exercising even more may not help her reach her doctor's weight goal for her. However, you reassure her that if she wants, she can craft positive habits, such as increase joyful movement and meditate to reduce stress, to help her reach her health goals. You tell her that these goals are more important to her overall health than a number on a scale.