Most of us don’t just embark on a weight loss journey once in our lives - most of us will gain and lose weight around major life events, such as going to college, getting married, having a baby, or focusing on career development.
If you’ve lost weight after gaining it once before, you likely go into a serious attempt at losing weight with confidence. After all, you did it before, right?
But you start doing all the same things as last time, and you don’t see the same results. Why? Is it just that you’re older?
Why Willpower Alone Doesn’t Work
If you go to the average personal trainer and ask them about how you should go about losing weight, they’ll likely say something along the lines of, “it’s just calories in, versus calories out. Eat the right things and work out.”
And why there is truth in that idea, and it’s certainly not a bad place to start your weight loss journey, medical doctors have discovered that we have a biological “set weight.”
Excess weight is a chronic medical condition, not a lack of willpower. It can result from a variety of underlying biological factors including hormonal, metabolic, and genetic factors.
What is a set weight point?
New studies have discovered that your body wants to keep you at your highest weight. This is called the Set-Point, and it’s the reason why sustained weight loss is so difficult to achieve.Your body resists weight loss and views it as a problem. Following weight loss, your body makes physiological changes to restore body weight back up to your highest weight, or “Set-Point.” In response to weight loss, your body lowers your metabolic rate to make it easier to regain the weight. It also lowers levels of a peptide called GLP-1,that specifically regulates when you feel full. Lower levels of GLP-1 increase hunger hormones, leading to increased cravings and appetite.
Is a set weight point the same thing as a plateau?
Yes, they often are. Most people find that the weight comes off relatively easily until they reach a certain point, at which the scale stops changing by more than a pound or two in either direction for weeks. Suddenly, you’re stuck at a certain weight.
Why can’t I lose weight?
1. It could be genetic.
There are 125 different genes that contribute to your metabolism,
any of which could be making it harder for you to lose weight than somebody else.
2. It could be your 'Set Point'.
If you have success dieting short term, but when you stop your weight snaps right back, the reason is biological.
During weight loss, your body lowers your metabolic rate to make it easier to regain the weight. New research has shown your body seeks to return to it's highest weight, or 'Set Point'.
3. It could be biological.
After multiple weight loss attempts, aka yo-yo dieting, you no longer see any weight loss even during extreme dieting.
The reason is every time you lose more than 5% of your body weight, your levels of naturally produced GLP-1 drop, triggering dramatically increased hunger.
When GLP-1 levels are low, calorie restriction is unattainable because you’re so hungry.
How much does genetics play a role in my set point weight?
There’s a lot in life we can do to change the way we look, regardless of what genetics gave us, but there’s no controlling whether you got your mother or father’s eye color, your grandmother’s thick hair, or your grandfather’s thin hair, and so on. Whether we like it or not, short of turning to plastic surgery or cosmetics, there’s nothing we can do to change these factors.
Similarly, your body is going to be predisposed to be a certain size and shape. There’s an old (and fortunately, outdated) saying that you should take a look at a potential partner’s same-sex parent before you marry them to find out what they’ll look like in thirty years’ time. And, while this idea is focused more on aesthetics than anyone wants a partner to be, there is a grain of truth in there. Your body will likely want to look like that of your parents, and this idea was backed up by a 2018 study.
Similarly, doctors ask whether diseases run in the family because, if it’s genetic, it may be passed down and if it’s environmental (like obesity), you may be more predisposed to it - often biologically, but it can simply be because we tend to develop the same habits as our family members.
So am I stuck at this weight for good?
Finally, I have some good news for you - you’re not stuck at this weight for good. It’s possible to ‘reset’ your set point. You can’t change your genetics, but you can change your environment, which can help you reach your goal weight.
At my clinic we prescribe GLP-1 medications because research shows that, when combined with coaching, they are the safest and most effective option for long-term weight loss. Because losing weight is not about willpower alone. Learn more about my weight loss program here.
Dr. Nancy Rahnama, MD, ABOM, ABIM, is a medical doctor board certified by both the American Board of Obesity Medicine and the American Board of Internal Medicine. Her specialty is Clinical Nutrition, that is, the use of nutrition by a medical doctor to diagnose and treat disease. Dr. Rahnama has helped thousands of people achieve their goals of weight loss, gut health, improved mood and sleep, and managing chronic disease.