When he arrived for his first appointment with an obesity medicine specialist in April 2014, Scott Goldshine was certain his only hope was bariatric surgery. He had been skinny when he was younger — his nickname was Bones — but around age 30 he began putting on weight and simply could not halt the relentless accumulation of pounds. His study involved 811 overweight and obese adults, randomly assigned to follow one of four diets and undergo behavioral counseling to help them stick to their diets.