Think of it this way - once you're in a state of obesity, resolving that situation is quite difficult. Eating healthy may not be enough, particularly if there are other metabolic issues going on.
The imbalance of fat to muscle leads to insulin resistance. Insulin resistance gets in the way of weight loss. After a long time of trying other means, I decided to directly tackle the insulin resistance problem. And it's been the only thing that's worked.
Agreed, but thermodynamics (calorie in/out) still holds. If you actually eat healthy (say 2500 calories), you will lose weight if you're obese and need >3000 to maintain weight, period.
Sustaining that healthy diet is harder insulin resistance, agreed!
But you said you ate healthy for a decade. To me that's not eating obesity-maintenance level amounts of otherwise healthy foods, but rather eating healthy foods at a normal (say 2500 kcal daily) amount.
In other words, under your statement the behavioral impact of insulin resistance was already overcome, you were eating properly, and still didn't lose weight. And that's just not conform the science, which states that you lose weight even with high insulin resistance, as long as you're eating healthy (i.e. in a caloric deficit vis-a-vis obesity level maintenance).
The imbalance of fat to muscle leads to insulin resistance. Insulin resistance gets in the way of weight loss. After a long time of trying other means, I decided to directly tackle the insulin resistance problem. And it's been the only thing that's worked.