Derek Burnett
Derek Burnett is a Contributing Writer at Bottom Line Personal, where he writes frequently on health and wellness. He is also a contributing editor with Reader’s Digest magazine.
Shedding pounds can be a weary slog. You step on the scale and see no change. You lose a few pounds, then gain them back again. You make great progress, then plateau, unable to quite get to your goal. You hit your goal and then watch in horror as the pounds creep back on. One of the most common questions people ask their doctors is, “Why am I not losing weight with diet and exercise?” The possible reasons are many.
An uneven playing field. Unfortunately, two mistaken beliefs circulate freely in the popular imagination. The first is that obese people are obese because they are weak-willed. The second is that maintaining a healthy bodyweight is equally difficult (or easy) for everyone. In other words, if you stand an obese person up beside a non-obese person, the perception is, on one side is a paragon of self-discipline and moderation and, on the other, an example of sloth, gluttony, and self-indulgence.
Neither of these things are true. It does take great force of will to lose weight, but the harsh reality is that it is easier—sometimes far, far easier—for some people than for others. That doesn’t mean it’s impossible, but it does mean that you may have to work harder than others to achieve the same results. Think of it this way…most young men could, with sufficient training, practice, and dedication, develop the ability to dunk a basketball. But it’s hardly controversial to point out that it will be easier for people who are six and a half feet tall than for those who are five and a half feet tall. While the physiological characteristics that affect basketball-dunking are immediately visible to the untrained eye, those governing the ability to lose weight and keep it off are largely hidden.
Genetics. While it was once thought that there might be “an obesity gene” that predisposed some people to being overweight, research over the past decades has revealed that in fact more than 400 genes could play a role. Your genetic makeup might mean you burn calories more slowly than normal, have a stronger propensity for inactivity, less efficiently convert fat into energy, or store fat more readily than others. Such factors likely go some way toward explaining why obesity often runs in families.
But your genetics are not your destiny. After all, obesity rates have skyrocketed over the last 30 years as our lifestyles have become more sedentary and our access to ultraprocessed and other unhealthy food has become constant. Meanwhile, it’s highly unlikely that the broad public’s genetic makeup changed significantly over that same period. This suggests that our behaviors and food choices are at least as important, if not more so, as our genetic makeup.
Your body’s set point. Your amazing body has an intricately interactive series of systems that establish various “set points,” which you might picture as thermostats regulating different aspects of your physiology. Whether it’s literally your body temperature, or the pH level of the fluid around your cells, or how much fat you carry, the body sets a target and then constantly adjusts its levels to maintain the proper amount.
When it comes to body weight, some people appear to have a higher set point than others. Their bodies will keep sending hormones to the brain encouraging them to keep eating, after someone with a lower set point will have stopped. Essentially, their bodies are fighting them, concerned about starvation as if we’re still roaming the savannahs as hunter-gatherers instead of surrounded by amounts of food that would have boggled the minds of our ancient ancestors.
The good news is that you can change your set point. Researchers believe that too-rapid weight loss causes the body to go into protective mode. If you’re also stressed out and not getting enough sleep, your body might feel that you’re under some kind of prolonged threat where you’re going to need every calorie to survive. Moving the needle on your weight loss might mean slowing your roll, reducing stress, getting better sleep, setting more modest targets, and generally reassuring your body that it’s perfectly safe for you to exist at a lighter weight.
Some people try all that and still fail. Weight-loss medications and surgery are both ways of adjusting the set point.
Gut bacteria. Many of the 100 million microbial cells in your digestive system play a role in body weight. Some affect the production of hunger and fullness hormones. Some encourage the absorption of calories through the fermentation of carbohydrates. Some prompt the body to store more fat. A healthy eating pattern heavy on plant-based foods, whole grains, and non-animal fats, and light on sugar, refined carbohydrates, salt, and animal fats, can quickly alter your gut microbiome to improve the balance of good bacteria (those that encourage a healthy body weight) and bad bacteria (those that promote obesity). If you’ve been losing weight by restricting calories without paying attention to the quality of the food you’re eating, you may be missing out on the benefits of healthy gut flora.
What to do when you’re stuck. First, take stock of your situation. Are you still dangerously obese, or are you at a healthy weight but just having trouble losing the last 10 or 15 pounds that would make you feel more confident in a swimsuit? If the latter, you may need to adjust your mindset. Is it really worth the heartache to shed the last few pounds for cosmetic reasons? Or couldn’t you perhaps make peace with the healthy body you’ve got, realizing that you’re a human being and not an airbrushed magazine image?
If you still need to lose weight for health reasons, make one last concerted effort to move the needle. This time, keep logs, track your calories, avoid unhealthy foods and drinks, get plenty of exercise, get the sleep you need, and drink lots of water. Do everything right, and document it all. If after a couple of months nothing has changed, talk to an obesity specialist and share with them your earnest efforts. It’s probably time to talk about weight-loss medications and potentially surgery. You’ll feel better about embracing those solutions when you’ve tried every other option.
It doesn’t hurt to do some careful review of the methods you’ve been using to try to lose weight. Here are a few common mistakes:
Too-rapid weight loss. As pointed out above, losing a lot of weight all at once may not be sustainable. A pound or two per week is fast enough, and more likely to stay off.
A “dieting” mindset. Have you committed to eating in a healthy way for the rest of your life? If you still think of yourself as “being on a diet,” you’ve essentially told yourself that you’re doing something temporary and extraordinary, deviating from a baseline you consider normal. With that mindset, you’re likely to take breaks or revert to old ways, especially if you slip up and eat an unhealthy food, which in your mind means you’re now “off your diet.”
Not sweating the small stuff. Sometimes even when people are logging what they eat in pursuit of achieving a calorie deficit each day, they fail to account for some significant sources of calories. Especially common culprits are beverages, condiments, and dressings. Take the time and effort to learn how many calories are in such “add-ons,” and then be honest about how much of them you’re taking in.
