by Dr Deborah Lee, Dr Fox Online Pharmacy
Photo by Thought Catalog on Unsplash
We all know that being overweight or obese is bad for our health. At any one time, 38% of UK adults are following a weight loss diet (2019 Kantar Consumer Survey). However, most of us are sadly unsuccessful. 2 out of every 5 people give up the diet within 7 days! Only 1 in 5 people manages to stick with a diet for as long as 4 weeks.
It’s very common for dieters to become dispirited as they are not losing weight – or not losing weight fast enough. This is soul-destroying, frustrating, and upsetting. What could be going wrong? Why is that even though weight loss occurs rapidly to start with, it tails off and weight becomes harder and harder to lose?
If you are having trouble losing weight, why not take a look at the list of possible reasons, set out below? Read on and find out.
Failing to lose weight – Medical reasons
Various medical conditions are associated with weight gain
Hypothyroidism – An underactive thyroid gland produces too little of the hormone thyroxine. This slows our metabolic rate, meaning you are burning fewer calories. The condition can also make you feel tired, sluggish and sleepy.
Cushing’s syndrome – This occurs when your adrenal glands produce too much cortisol. Taking high doses of steroids can produce Cushingoid features, such as a fat pad on the back of the neck, a round abdomen but stick-like legs. High levels of cortisol result in weight gain. This is also seen, although to a lesser extent, when you are under stress.
Polycystic Ovarian Syndrome (PCOS) – This is a metabolic condition associated with disordered ovulation, obesity and hirsutism. It affects around 1 in 10 women in the UK. Women with PCOS often have insulin resistance, meaning the cells in their bodies are less sensitive to the hormone insulin. As a result, insulin and blood glucose levels are higher than normal. It can be very difficult for women with PCOS to lose weight.
Stress – Chronic stress results in overactivity of the sympathetic nervous system (SNS). This is the ‘fight, fright, and flight’ mechanism that kicks into action when your body is faced with danger. When the SNS is activated, large quantities of adrenaline and cortisol are released into the bloodstream. However, when stress is chronic, you don’t physically need to run anywhere. However, your body perceives you need more energy and tells you it’s time to eat. Consequently, chronic stress is linked to hunger and obesity.
Your microbiome – Your gastrointestinal tract contains trillions of bacteria that make up your microbiome. The function of these bacteria is integral to your body’s physiology and metabolism. Obese people are known to have a higher proportion of firmicutes, whereas those with a normal BMI have more bacteroides. You may want to try probiotics, which have been shown in human studies to help reduce visceral fat.
Depression – Depression can cause weight loss or weight gain. When you are depressed, you tend to stop enjoying things you used to enjoy and stay at home. Depression is often characterised by loos energy, tiredness and inertia. On top of this, some people comfort eat when they feel low.
Medication
Common examples of drugs that can cause weight gain include
- Antidepressants – such as the SSRI’s citalopram, fluoxetine, mirtazapine, and sertraline.
- Mood stabilisers – such as lithium, olanzapine, quetiapine and risperidone.
- Diabetes medications – such as glipizide, glibenclamide, glimepiride and insulin.
- Steroids – such as prednisolone, prednisone, and methylprednisolone.
- Anticonvulsants – such as amitriptyline, nortriptyline and valproic acid.
- Heart medication – such as atenolol, metoprolol, and propranolol.
- Antiallergy medication – such as cetirizine, fexofenadine and loratadine.
Failure to lose weight – Diet mistakes
With the best will in the world, sometimes we quite unknowingly, make dieting mistakes. Some of these are listed below –
Understanding the weight loss plateau – Your body is primed to undermine your best weight-losing efforts. For each kilogram of weight lost, your daily calorie expenditure decreases 20-30% per day, whereas your appetite increases 100 calories per day above the level before you began your diet. As a result, weight is lost quite easily at the start of the diet but naturally slows as time passes. You have to be even more determined as time goes by, to lose weight and keep it off.
Not enough sleep – Adults are recommended 7 hours of good quality sleep per night. During sleep, your metabolism is highly active, restoring and replenishing your tissues and getting rid of waste products. During sleep, the hunger hormones leptin and ghrelin are produced. These help you feel less hungry and feel fuller for longer. If you don’t get enough sleep, this disrupts the production of leptin and ghrelin. Obesity is also associated with various sleep disorders.
Not enough exercise – Research tells us that for maximal weight loss, we need to be doing regular physical exercise. To lose weight you need to do more than the bare minimum. The American Academy of Sports Medicine recommends that for weight loss, you do 200-300 minutes per week of moderate-intensity exercise. This should be done in sessions of 30-60 minutes and equates to one exercise session per day. Being sedentary is bad news for weight loss. You need to get up and get moving!
Not being honest about what you eat – We human beings are not good about recounting honestly what we’ve been eating! We tend to underestimate the food and overestimate the exercise! The only way to deal with this is to keep a food diary and write down honestly everything you have put in your mouth that day!
Take care with portion control – Try a smaller plate. Half the plate is for salad or vegetables, a quarter of the plate is for protein, and the other quarter is for complex carbs (such as rice or potato). High-fat foods such as cheese, oil or butter should be only half of one tablespoon.
If you need to snack, always choose a healthy snack. Eat plain fruit, or a handful of nuts – avoid cakes, biscuits, sweets, and chocolate. Avoid alcohol which is full of calories.
Not drinking enough water – Although this doesn’t cause weight loss, if you are thirsty, you can mistake thirst for hunger and start eating. Make sure you drink at least 2 L of water per day.
Eating the wrong carbs – Choose carbs with a low GI index – these release energy slowly, meaning they help you feel fuller for longer. Examples include unrefined carbs found in whole grains such as brown bread, brown rice, and brown pasta. A baked potato has a medium GI index.
Avoid foods with a high GI index, for example, white foods – white bread, white rice, and white pasta. Also avoid cakes, biscuits, and sweets.
Not eating enough protein – Your body uses up more calories to digest protein than it does for fat and carbohydrate. If you don’t eat enough protein, this can lead to hunger and stall weight loss. Increasing protein in your diet can speed up your calorie consumption by 80-100 calories per day, compared to eating a low protein diet.
Not eating enough fibre – Fibre is an indigestible carbohydrate that passes out of your gut in the faeces, unchanged. Fibre bulks out the intestinal contents and stimulates the gut wall to keep things moving through the gut at the right speed. Too little fibre reduces gut motility and leads to constipation. Having plenty of fibre speeds up the transit of food and loosens the stools. Fibre also helps to reduce the absorption of fat. Make sure you include plenty of high fibre foods in your diet – for example, figs, prunes and kiwi fruit. Fibre is also present in whole grains found in brown bread, brown rice and pasta.
Going it alone – Weight loss is more likely if you have peer support – so why not join a weight loss group? Research suggests you are more likely to stick to a diet and lose weight if you join a group rather than going it alone.
Final thoughts
Dieting is very hard work. However, there is such an amazing feeling of accomplishment when you reach your desired goal weight!
If you’re having trouble losing weight, can you identify with any of the possible reasons set out above?