I love helping people lose weight and get healthier. It can be challenging and very rewarding. And while every single patient in my practice is different, there are a few themes that come up frequently enough in conversation I thought it was worth sharing with everyone. I also want to convey that so many people are struggling with obesity and weight loss, and you are not alone in this journey!
#1 - Blaming Yourself For Struggling to Lose Weight
The science is clear - obesity is NOT a disease of willpower. Like most diseases, there's a HUGE biological basis for why some people suffer with obesity and other's don't. We all intuitively know this - we all have a friend that only eats take out and never exercises and yet somehow has a normal BMI. (It goes without saying that person is not necessarily healthy, just not suffering from obesity.) Then we all know people who have obesity that exercise and eat well and still struggle to lose weight. Why??
Obesity is complex, and multifactorial. Here are some of the underlying ways individuals prone to obesity are different, biologically:
Food can light up the brain's reward circuit, much like drugs and alcohol can in individuals prone to addiction.
Many people never feel "full." The gut hormones that tell our brains to stop eating are not the same for everyone.
Similarly, many people are hungry all the time.
Different people have different resting metabolic rates. These rates decline with age. No, it's not fair.
#2 - Eating "Good" All Day Only to Come Home Starving
I can't tell you how many people do "good" (their words, not mine!) for breakfast and lunch, then come home at the end of the day and eat anything they can find in the kitchen! The reality is if you feel famished at the end of the day, you UNDERate all day. It's so much better to eat a substantial breakfast and lunch and come home feeling satisfied than to come home, eat 7 different snack foods, or get take out because you can't wait to eat dinner.
Also, the "good" breakfast and lunch tends to be either carb-heavy but low in protein and fiber, or all vegetables. I recommend substantial (i.e. filling) meals that include a protein and good fiber source.
The biggest culprit? What one of my patients accurately dubbed the "sad salad." It's sad because it's boring and it makes you sad to eat it. Often made without any good protein source. While it seems like you're being healthy because the calorie content is low and it's full of vegetables, I tend to see people make more progress with their weight loss (and stick with their nutrition plan) when they're eating something much more substantial than the sad salad.
#3 - Following a Nutrition Plan with an End Date
All diets work. This has actually been studied. But the only ones that work in the long term are the ones you can stick to. That's why I encourage my patients to make gradual changes they can sustain for the rest of their lives. That means not labelling a certain food group as "bad" or "forbidden." It also means planning for times when you're going to go to a wedding and want to have a piece of cake. Food should be enjoyed, and a healthy diet based on moderation allows for enjoyment and flexibility.
"When you're 80 years old are you really going to want to be drinking a meal replacement shake?" – Me, regularly
#4 - Overlooking Sleep and Mental Health
Yes, nutrition and physical activity are important, but did you know if you are chronically sleep deprived or have uncontrolled anxiety or depression or addiction it is very difficult to lose weight? Chronic stress tells the body that something bad is happening, and if think back to our long evolutionary history, usually those bad things are famines or war or something terrible you're going to be forced to survive. The body responds by slowing its resting metabolic rate to conserve energy (i.e. fat stores). Your body doesn't differentiate physical stress from say, hating your job and every moment you're at work...it responds similarly in both scenarios, and the result is weight loss resistance (plateau).
The same happens when you're chronically tired - maybe you're simply not scheduling enough sleep, or you suffer from a sleep disorder like obstructive sleep apnea or insomnia.
At my first appointment, I screen for these issues and we make a plan to work on them while we're looking at diet and exercise. One of my most successful patients spent her first few months working with me on her depression. Only when that was appropriately managed could she move past her weight loss plateau.
#5 - Taking Too Much Advice From the Internet
Everyone has an opinion! From recommending adding butter to your coffee to suggesting certain fruits and vegetables are bad for you...I've heard a lot of crazy things from the internet. So much of it goes against common sense. I've found the more patients read online, the more confused they get. It becomes so overwhelming and eating feels too complicated. Do I eat berries or bananas? Should I cut out dairy? Is gluten making me gain weight? Is more olive oil better?
Keeping it simple is always better. Less processed. More fresh fruits and veggies. Grassfed beef and naturally raised poultry - or less processed non-animal proteins if that's your preference. It's so hard to combat the complexity of advice that's freely given out online (more from influencers than actual dieticians or medical professionals!) Don't go down the internet rabbit hole - after hours of searching you're guaranteed to feel hopeless and not any closer to a healthy plan!
You are Not Alone
The struggle is real. Despite what many diet plans and gurus promise, there's not one simple way to lose weight that works for everyone. But you can take charge of your health. Take ownership of the situation and talk with your doctor about steps you can take to get healthier and lose weight (if that's your goal.) If you need help, I love working one-on-one with people in my Weight Wellness Program! Check it out here.