I've read all about setpoint, yet people lose weight permanently. No one can deny that even with some fluctuation with eating and exercise habits that their body tends to want to stick at a certain weight.
My explanation for why a set point can be artificially high and why it can change has to do with the health of your system. If the obese people stayed on a diet for 6-9 months after losing weight and that diet was healthier, eventually their digestive tracks may clean up and be more efficient and digesting food, making it easier for their weight to stay low. Also, the lower weight would take load off of the heart, liver and other organs again allowing healing and transformation, lowering the "set point".
I'm no doctor - this is just a theory that developed over time in my head. I think there could be something to it.