Why Weight Loss Can Be Challenging
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Medically reviewed by Jane Kim, MDMedically reviewed by Jane Kim, MDWeight management is an important aspect of healthy living, as it helps reduce the risk of several health conditions linked to obesity, such as diabetes, kidney disease, and heart disease. However, if you're trying to lose weight, it may feel like your body is working against you.Energy intake exceeding energy expenditure is the primary driver of weight gain. This means you are likely to gain weight if the amount of energy your body gets from foods, in the form of calories, exceeds the amount of energy it burns or uses up. The excess energy gets stored as fat.Still, weight changes go beyond a direct relationship between the energy your body takes in and the energy it expends. They also involve complex interactions between other components and physiological processes that regulate body weight and fat, such as metabolism, hormones, environmental factors, and genes. These factors can make it difficult to lose weight despite your best efforts of eating nutritious foods and exercising.1. MetabolismMetabolism is the chain of chemical reactions that takes place in a living thing, resulting in energy being released for life sustenance. It is the process by which the body changes food into energy to fuel its functions.Your metabolism plays a significant role in regulating body weight, and its intensity varies from person to person. People with a slow metabolism tend to gain weight because their bodies don’t expend much energy or burn calories at a fast rate (ultimately burning fewer calories at rest or during an activity). This may be one reason weight loss is difficult for you, especially considering that metabolism is mostly genetic. However, doing things like interval training, strength training, and de-stressing may help increase it.2. HormonesHormones strongly influence body weight and fat through different mechanisms, including digestion, food-seeking behavior, nutrient metabolism, and physical activity. For instance, insulin supports weight gain by inhibiting fat breakdown and synthesizing glycogen (stored in the liver) from excess glucose (sugar). Abnormal estrogen levels and chronically high levels of cortisol (the stress hormone) are also linked to obesity.3. Environmental FactorsEnvironmental factors can either support weight loss or make it more difficult. Living in an area with an abundance of fast-food restaurants selling high-calorie, ultra-processed foods and working a job that requires a lot of sitting with less time for physical activity can promote weight gain. Other environmental factors that may make it easier to gain unwanted weight include:Eating dinners later in the evening and sleeping too lateLiving in areas that rely on car usage rather than walkingBeing exposed to certain chemicals or toxins that may influence weightHaving high levels of chronic stressEarning a low-incomeLacking resources to tools that help with well-being, such as healthcare, gyms, and grocery stores4. Genes and Family HistorySome people have a genetic predisposition to obesity, and this can pose challenges with weight management. One review of studies found that your chances of developing obesity are higher if one or both of your parents also have obesity. Genome-wide association studies have suggested that multiple genetic mutations are involved in obesity, and people who inherit large subsets of the genes that promote obesity are more likely to gain weight. Genes may play a role in how physically active you are, your appetite, the amount of fat your body stores, and how the accumulated fat is distributed in your body.5. Gut MicrobiomeThere are harmless, dynamic bacteria that naturally live in your gastrointestinal tract. This community of diverse microorganisms (known as the microbiome or microbiota) shares a symbiotic relationship with the digestive system, meaning that both benefit from each other.When in a healthy, functional state, the gut microbiota interacts with food, digesting it to release energy, interacting with cells, and helping protect against pathogens. Conversely, an imbalance in the microbiome—which may be due to the loss of some key bacterial species or an increased presence of harmful microorganisms—has been linked to metabolic syndromes, insulin resistance, and obesity.6. Health Conditions and MedicationsSeveral underlying health conditions are also linked to obesity, making it easier for you to gain weight. These conditions include:Hypothyroidism (underactive thyroid)Eating disorders Polycystic ovarian syndrome, or PCOS (a hormonal condition that occurs when the ovaries make more male androgen hormones than needed)Chronic stressCushing’s syndrome (a condition caused by excess levels of the stress hormone cortisol)Damage to the hypothalamus (a part of your brain that helps regulate the endocrine system)Certain medications can also affect your metabolism or energy balance, contributing to weight gain. These include steroids, antidepressants, diabetes drugs, antihistamines, and blood pressure medications.7. Psychological FactorsThe state of your mental health also greatly influences your physical well-being. For example, conditions like binge eating disorder, depression, and anxiety can all cause changes in appetite, making it difficult to manage your weight effectively.Other psychological factors like low self-confidence and negative self-perception of your body image may become barriers to weight loss or long-term weight maintenance. Tending to your mental health and getting care when needed can help improve your quality of life and support weight management.Why the Body Resists Weight LossOne study followed up with participants who underwent intensive diet and exercise interventions as part of the “Biggest Loser” competition. It found that six years later, all but one had regained a significant amount of the weight they had lost. Their resting metabolisms were also slower than what they had at the end of the competition, and ultimately, they burned fewer calories.This study, along with some other different challenging experiences of people with weight loss, paints the picture that sometimes, it appears the body resists weight loss. There are a few possible explanations for this.Set Point TheorySome scientists have hypothesized a theory that every person has a predetermined weight called “weight set point,” which is established early in life. The set point concept implies the body wants to be a certain weight, and when you try to gain or lose weight, your hormones and metabolism adjust to return your body to the set point.Set point can change over time depending on factors like genetics, environmental, and nutritional components.Metabolic CompensationThis is a survival mechanism where the body interprets a shortage of calories as a sign of distress. Therefore, when trying to lose weight, the body’s compensatory behavioral mechanisms kick in by slowing down metabolism, causing you to burn calories slowly and releasing hormones like leptin to stimulate food intake. This promotes the storage of extra calories as fat, which makes losing or maintaining weight more challenging.In short, when you are trying to lose weight, your body gets the message that things aren’t right and uses different mechanisms to try and get you back to what it perceives as the normal weight for you.Strategies for Overcoming Weight Management ChallengesThe differences in environmental, metabolic, hormonal, and genetic factors show there is no “one-size-fits-all” for weight management. If you are finding it difficult to lose or maintain your weight, the following strategies may be helpful:Eat NutritiouslyInstead of a strict calorie-restriction diet, create a meal plan that supports whole, natural foods that are nutrient-dense. Here are a few tips:Eat more protein, as it takes more time for the body to break down protein, making you feel fuller for longer. It may also ramp up metabolism, causing the body to use more energy for digestion.Aim to eat up to the recommended 25-30 grams of fiber daily, as it can help promote satiety and encourage weight loss. Take Care of Your BodyImplementing lifestyle strategies that prioritize your physical and mental health can help you manage weight. Constant stress can trigger the release of cortisol, which promotes weight gain and the buildup of abdominal fat. Stress management techniques like yoga or meditation can help.Exercising daily is also important to keep your body active and help burn calories. Rest is just as essential., so aim for 7-9 hours of sleep per night.Ask For HelpWeight management can be difficult, no matter what stage you're at. If you're experiencing challenges with your body, self-image, or underlying conditions like obesity, speak with a healthcare provider.They may ask questions about your personal and family medical history or suggest some tests to help determine any underlying conditions that may be causing weight gain. They can also refer you to a registered dietitian (RD) or registered dietitian nutritionist (RDN) to help you develop a meal plan to achieve your goals.A Quick ReviewSome people find it more challenging to lose weight than others. Factors that are sometimes out of your control, like genetics, hormones, and metabolism, can make weight loss difficult.If you are trying to lose weight and having difficulty doing so, reach out to your healthcare team for support. Weight management isn't a task on your to-do list that you can check off—it's a lifestyle change that takes time. Focus on making helpful lifestyle changes, ask for help when you need it, and be patient with your body as it changes. 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