Answer:
Strong when he can resist how much he eat
Explanation:he eat too much but as long as you can limit yourself and stop, he can still lose weight but when he eat too much and strong not stopping he overwork/overdrive his digestive system. He take in too much of some calories, to lose weight is going to be hard for him. It take a lot of time and patience for him to lose weight.
It's is all of the above. Just a little hint for you, when there is the option- all of the above, chances are that's the answer.
The Valsalva manuever gives up to 20%
I'm pretty sure its called a compound fracture