Every day, patients or even friends/family members reach out saying that they are doing everything they can to lose weight with lifestyle measures alone, without success. Many times, if they had lost weight with these changes before, they are no longer working anymore. This brings us to the realization that something doesn’t quite add up. It became abundantly clear to me over and over again that for many patients, lifestyle alone was not going to treat their obesity.
The key reason behind this is metabolic adaptation. So, what is metabolic adaptation?
Metabolic adaptation is that as you continue to lose weight, your metabolic rate goes down disproportionately to the amount of weight you lose. We all know a caloric deficit is the key to losing weight. Metabolic adaptation makes it very hard to stay in enough of a calorie deficit to continue to lose weight or even to keep off the weight one had previously lost, with the exact same things that were working before. The neurohormonal basis for this adaptation is increased production of the hunger-producing hormone ghrelin and reduced levels of the leptin hormone that helps us stay full.
That is the exact reason why many people would require medication or surgery for continued meaningful weight loss.
So, should we stop eating healthy and doing physical activity? We still need to eat healthy and exercise to reap the metabolic health benefits of a healthy diet and exercise in terms of preserving muscle mass, strengthening our bones, lowering the risk of high blood pressure, improving heart health, and lowering the risk of many cancers and diabetes, among so many other benefits.
I am a board-certified Obesity Medicine specialist. Let us help you live a healthful life with our expertise and guidance in not only losing weight but also gaining health! Let’s connect!!