Thursday, August 13, 2020

It’s happened to just about everyone who has ever tried to lose weight. You’re sticking to your meal plan, getting plenty of exercise and, initially, the pounds fall off pretty consistently. The early success motivates you to stick with it, so you do. But then your progress comes to a screeching halt. You’ve hit the dreaded “weight loss plateau”. So, you cut your calories even more and spend extra time at the gym. For weeks, maybe even months. Yet the scale still won’t move. It’s a crushing blow that leads many dieters to just give up.

Lana Nelson, DO, weight loss surgeon with Journey Clinic says it’s a common scenario. So why does it happen? It turns out your own body is trying to sabotage your weight loss efforts.

“The body perceives weight loss as a threat,” said Dr. Nelson. “So when you start cutting calories your body is going to go into protection mode. It doesn’t know you’re cutting calories by choice. It thinks you’re experiencing famine so it goes into survival mode.”

Set Point Theory

Dr. Nelson says this process is explained by Set Point Theory, the internal regulation within our bodies to maintain a certain weight. It’s why weight loss stalls at a certain point and why most people who lose weight through diet and exercise gain it back within two years.

“When a person begins to restrict the amount of calories being consumed, the body becomes more efficient by lowering its metabolism. The body also increases levels of ghrelin, also known as the hunger hormone. This protects the set point,” Dr. Nelson said.

To put it simply, your body slows down your metabolism while also making you want to eat more. The effects can be long-lasting which makes it difficult to continue losing weight and keeping it off.

Counteracting Your Set Point

It’s not impossible to counteract your set point, but it can be difficult. Dr. Nelson says it works better for people only looking to lose 10-20 pounds. She suggests eating foods that are low in calories but high in volume.

“100 calories of broccoli is three heaping cups of food while 100 calories of oil is just a tablespoon. Filling up your stomach with lower calorie foods may trigger those satiety signals that make you feel full,” said Dr. Nelson.

When it comes to exercise, slow and steady wins the race. Dr. Nelson suggests strength training and low to moderate intensity cardiovascular exercises.

“The greater the intensity of the exercise, the more likely it is to drive hunger.”

You will also need to exercise for longer periods of time. The recommendation of 150 minutes a week of physical activity is for general health, cardiovascular health, and weight maintenance. You will need to increase the amount for weight loss.

It’s important that as you increase physical activity, you don’t reward yourself with food. You may think that since you worked out, it is okay to go ahead with an extra serving or a special treat, but this will negate calories burned. Many times it leads to consuming more calories than actually burned with the workout, leading to weight gain instead of weight loss.

How Bariatric Surgery Helps

People with the biggest struggles altering their set point typically have a significant amount of weight to lose. For those people, bariatric surgery may be an option because it actually lowers the body’s set point.

“This essentially gives your body “permission” to exist at a lower weight,” Dr. Nelson said. “This happens not just through calorie restriction, but also through altering hormonal response to eating, decreasing hunger and increasing those feelings of fullness. This is why when we evaluate patients 20 years after surgery, they still maintain a lower weight than their counterpoints that have not undergone surgery.”

Weight Loss is Complex

Ultimately, the set point theory explains one part of obesity as a disease process. There are many other contributing factors as well. This includes genetic factors, environmental factors (whose influence starts in utero), health factors, medications, cultural influences, socioeconomic status, mental and physiologic stress, to name a few. Since obesity is not a simple disease process, neither is its treatment. Although diet and physical activity are contributors to weight loss and weight gain, it is a complex system that frequently requires a multilayered approach.

If you are struggling with your weight, Journey Clinic can help. Call 405-515-2049 to learn more.