You don't understand medical literature. ITT is the standard -- you don't get to invent a magical world where everyone does whatever you tell them to do, and people frolic amongst the chocolate rivers and gumdrop trees. If people don't listen to your brilliant medical intervention after you make a best effort to get them to do so -- or don't do it "correctly" -- that's on you, not them.

Otherwise, I have a brilliant plan to end all obesity, worldwide: don't eat when you're fat. Guaranteed to work. If it fails, it's your fault for not following the plan.