Why does eat less, move more not work for everyone?
Sometimes, weight loss and especially weight maintenance once you have lost the weight is hard. Who has experienced the yo-yo of weight loss and regain?
Weight regain is real. And there are some very real reasons for this challenge.
How do you “eat less” when you are HUNGRY? With progressive weight gain comes:
Hormonal changes & dysregulation leading to increase in hunger & decreased satiety… Some of the specific changes that occur:
- Increased grehlin levels leading to hunger
- Decreased adiponectin production by fat cells causing altered signaling for weight regulation pathways
- Increased leptin resistance leading to decreased fullness and altered signaling in weight regulation pathways
- Decreased GLP-1 hormone from the small intestine affected weight regulation, satiety and insulin function
- Insulin resistance leading to increased risk for type 2 diabetes, excess visceral fat, fatty liver deposition, metabolic syndrome and increased inflammation
- Increase in inflammation leading to worsening insulin resistance, increased blood clotting due to heightened inflammatory state
Weight loss leads to more pronounced feelings of hunger from these metabolic hormone changes and also comes with a reduced metabolic rate (called metabolic adaptation).
Other factors that exacerbate these hormonal changes:
- Lack of sleep
- Disruption of circadian rhythms
- Emotional stress
- Too much exercise (physical stress)
So how does one fight against this cascade of factors working against you? Here are 9 ways!
1) Understand there is a lot that happens to cause weight regain of lost body fat, specifically we want to reduce #visceralfat to improve metabolic health to prevent diabetes, hypertension, high cholesterol, fatty liver disease, heart disease to name a few. Conditions like obstructive sleep apnea can be improved/reversed with weight loss and osteoarthritis can also improve with less load on the joints. Even a 5-10% decrease can lead to improvements in health.
2) Going slower with changes is often better & more sustainable. To keep the habits and changes, work to avoid extremes in diet changes. You don't have to eat only 500 kcal/day!
3) Build muscle by lifting weights!
4) Aim to get 7-8 hrs of sleep
5) Try to eat more "real foods", more plants, plant and lean animal proteins and more fiber! Your gut microbiome and the associated "dysbiosis" that occurs can be improved by eating this way.
6) Minimize ultra-processed foods! Examples are cookies, chips, candy. These foods have been typically stripped of dietary fiber, have been loaded with added sugars, fats (including heart-harming trans fats) and sodium!
7) Make room for SOME indulgence occasionally- you don’t have to “give up” everything : )
8) Skip the sugary drinks as much as possible... yes this includes soda, lemonade, juices and even the fancy coffees at Starbucks
9) Work on reducing stress, not only for hormones & inflammation, but also so you can cope in other ways (besides comfort foods)
For some people, use of anti-obesity medications can make the difference to fight weight regain (which unfortunately the majority of people undergo who lose body weight), the effects of metabolic adaptation and the brain’s weight set point- similar to how we treat chronic disease, understanding that a long term strategy that combines lifestyle changes and possibly medication can help!
What questions do you have?
Richa Mittal MD