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Lower energy levels Low protein intake can lead to persistent fatigue and reduced daily energy levels

N Engl J Med (2008) 359:157789

18.2% average weight loss at week 68 was observed in patients in the STEP 4 trial, along with reduced blood glucose levels, improved lipid profile and significant improvements in overall quality of life and health status scores

A large prospective cohort study that tracked over 1,700 patients demonstrated that patients who underwent a Roux-en-Y gastric bypass lost an excess 21% of their body mass normalized to their non-surgical matched controls at the 10 year point (corresponding to 35 kg (~77 lbs) greater weight loss)