Why Can't I Lose Weight?

Mary came to me with several health problems. The most pressing was her 100-plus extra pounds. Over the years, she had tried various programs, sometimes dropping significant weight—only to regain it. She wanted a new approach.

Are you frustrated with your inability to lose weight? Many of my patients feel the same way. For some, weight was never an issue until they reached middle age. Others have carried substantial excess weight for much of their life, posing a serious health risk. Still, they can’t take it off—or if they do, even worse, they “yo-yo.”

Weight loss resistance is complicated, often exacerbated by conflicting advice from “experts” promoting various diets: low fat, low carb, keto, paleo, vegan, vegetarian, carnivore, and more. Yikes! More importantly, neglected underlying health issues can significantly impede one’s efforts. Also, not to be minimized, our psyche, our relationship with food, and our family and friends can all play a role.

It is critical to adopt a sustainable way of eating that can be part of your life long-term—not just another fad diet. It is possible to crave a salad! A gradual and consistent approach to weight loss is ideal. Briefly, the guidelines I suggest are a clean (think low pesticides), plant-forward, whole foods diet. This means fairly strict avoidance of processed foods and added sugars. As Michael Pollan quips in his book Food Rules: “Don't eat anything your great-grandmother wouldn't recognize as food.” For a stretch goal, aim for 6–8 cups of vegetables a day—a colorful variety of non-starchy choices.

But diet is rarely enough. It is key to address underlying health issues that may be getting in your way. While this may seem daunting, these common factors that contribute to weight loss resistance can be overcome:

• Insulin resistance (optimal blood sugar control)

• Stress leading to excess cortisol

• Disturbed gastrointestinal health (intestinal bacteria or microbiome imbalance, “leaky gut,” poor digestion, gut inflammation)

• Hormone imbalances (thyroid, sex hormones)

• Toxins (a common contributor to metabolic dysfunction)

• Chronic inflammation

• Nutritional deficiencies

• Lack of sleep or circadian rhythm disruption

I often see one or more of these problems show up in people who already follow an ideal diet and exercise regularly but can’t shed pounds.

Finally, if you have a dysfunctional relationship with food, work on cultivating an attitude that honors food as nutrition for your body. Apply a mindful approach to eating with a sense of gratitude. Creating a shift from an orientation of denial to reframing food as nourishment can be a game changer. It can also help to surround yourself with others who equally engage in healthful lifestyle and food choices.

Together, Mary and I crafted a personalized plan focusing on her gut health, hormone balance, stress management, and reducing toxic load. She incorporated fundamental lifestyle changes—good sleep habits, increased movement, and healthy food choices. Nine months after she started these interventions, she informed me that she had lost 45 pounds. She said, “It’s funny that I am not focused on weight at all (for the first time ever), and because it’s secondary, I am not obsessed with it at all. I only weigh myself occasionally out of curiosity.”

No longer using a “dieting” approach to weight loss, Mary was engaging a whole-person approach to being healthy.

I know this isn’t easy, but just like Mary, you can transform your health, energy, and zest for life.

Dr. Katie Bayliss, MD

Originally published in Shepherd Express

Bayliss, K. (2022b, April 5). Why can’t I lose weight? Shepherd Express. https://shepherdexpress.com/lifestyle/health/why-cant-i-lose-weight/