Difficulty Losing Weight?

February 28, 2017
Weight Loss

Just like that it’s the end of February! And it is that time when you are beginning to get frustrated with your weight loss program; the latest, best rated, trending weight-loss plan that everyone is raving about on social media, the one you have been diligently following since the new year began has not helped you one bit. You are discouraged and think it is time to quit. This might sound familiar but instead of giving up, it is would be best to stop and reflect - reflect on why this trending weight-loss plan seems to be working for everyone (or so it seems!) but not for you. This blog attempts to provide some insights regarding this topic and identifies some critical components, that may be missing in popular weight-loss programs.

In my experience, a weight-loss plan is successful only if it is truly customized for each patient, based on his/her medical and social history. There is no ‘one fits all’ plan. Scientific literature heavily supports the fact that weight-loss programs based solely on ‘Eat Less, Exercise More’ or ‘Calories in versus Calories out’ are not the most effective, especially long-term. Programs that address behavior modification and provide sustainable lifestyle recommendations seem to provide effective, long-term weight loss.

I explain to all my weight-loss patients that it is not enough to shed extra pounds and get a pat on the back when you return to the Normal BMI range of 18.5- 24.9 (Body Mass Index= Weight in Kg/ Height squared in meters). It is more important that you lose the weight and are able to keep it off without having to count calories and have 2-hour work-out sessions on a daily basis. It is also important that you feel healthy once you have reached your target weight. What does ‘feel healthy’ really mean? As per the World Health Organization’s definition, it means "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity". In my practice, this translates to feeling energized throughout the day, being productive at work, looking forward to time with friends and family and getting restful sleep. Additionally, it means not having chronic complaints such as headaches, joint pain, gas, bloating, anxiety or mood swings on a daily basis. This may sound unrealistic at first, but my patients who have achieved their weight loss goals will tell you that they would not opt for anything less.

Based on my research and clinical experience, I have identified these 5 factors that seem to be critical for a weight-loss program to be successful:

Focus on nourishment from food, not on counting calories
Though reducing calories may be important for some morbidly obese patients, the body will not continue to shed weight if the focus remains only on caloric values of the food and not on its nutrient content. The lack of essential nutrients can be one of the reasons for resistance to weight loss. What are calories and what are nutrients?

Calories are calculated by estimating the amount of energy released by metabolizing the three main macronutrients in food: carbohydrates, fats and proteins. The caloric value of the food does not take into account, its micronutrient content: vitamins, minerals, anti-oxidants and breakdown products of the caloric food groups: amino acids from proteins, fatty acids from fats and glucose from carbohydrates. These micronutrients including the 20 different amino acids and fatty acids such as Omega-3s are building blocks of enzymes, connective tissues, cell membranes, immune cells, cytokines and hormones in our body. Your body requires that you have a constant, balanced and adequate supply of all these nutrients for the creation, maintenance and functioning of healthy cells and tissues. The preferred fuel for energy required for all metabolic activities in the body is glucose from carbohydrates. If you lack adequate carbohydrates, then the body will burn fat- this is the basis of the low carbohydrate diets. Though this makes sense intuitively and works in the short-term, if you continue deprive your body of essential nutrients, its ability to metabolize fat will be comprised due to the lack of nutrients that help in this process.


To summarize, if you restrict calories and ignore nutrients, your body may become nutrient-deficient and malnourished leading to a decreased metabolic rate hindering your weight loss efforts.


2. Correct hormonal imbalance with the help of your Doctor. As per the American Thyroid Association, up to 60% of the people with a thyroid problem are undiagnosed and therefore, at risk for various cardiovascular and metabolic diseases.  A study published in 2015 revealed that a sub-optimally functioning thyroid could be a contributing factor to insulin resistance, which can eventually lead to Type 2 diabetes. Obesity and Type2 diabetes are like a ‘chicken-egg’ syndrome – there is always a question of ‘what came first’. A thyroid imbalance often signals some form of adrenal gland deficit as well.
Adrenal fatigue is a term that is used by integrative doctors to indicate an imbalance in cortisol, a hormone produced in times of stress.   Cortisol can be helpful if produced in right amounts only when needed. A high demand for cortisol due to chronic stress can lead to adrenal dysfunction and eventually exhaustion. With adrenal dysfunction, fat tends to deposit around the central part of your body (casually known as ‘muffin-top’ or ‘beer-belly’) as protection for covering the vital organs for survival.
Hormones produced by the adrenal glands and thyroid are part of the endocrine system in the body and are known as endocrine hormones. The levels of these and many other endocrine hormones such as insulin, melatonin, estrogen, progesterone have an effect on multiple organs and organ systems; any disruption in the feedback mechanisms, which affect the optimal levels of these hormones, can make it difficult to lose weight. Once there is a good understanding of which hormone pathways need attention and help with balancing, a strategy can be implemented to correct the imbalances, consequently helping your body to lose excess weight.

3.Find the right type of exercise for your body
When I speak of individualizing a treatment plan, each aspect of your lifestyle has to addressed, including regular exercise. Adhering to long, high-intensity workouts might seem possible in the beginning of a weight loss program but may not be sustainable long term. Choose a form of exercise that you enjoy and can would look forward to rather than avoid. Some people might enjoy a Zumba class or others might prefer to join a yoga or Pilates group. Make it the 30-minutes or hour that you will dedicate to help your body rejuvenate. If you exercise the way you like and consistently, you will begin to see that your body will crave workout sessions! Keep it simple- simple does not mean you do not challenge yourself or push to the next level of intensity, but it means simple to follow through.

It is important that you choose the right intensity of exercise for your health:

  • Exercise helps release adrenaline and endorphins and you should feel energized after a workout. However, if you get exhausted after a 30-minute moderate intensity workout session, choose a low intensity exercise like yoga until you have corrected the underlying hormonal or nutrition deficit.
  • If you keep exercising at the same intensity all the time, you may not get the results you are looking for. Seek help from a professional trainer or physical therapist along with advise from your doctor. High Intensity Interval Training (HIIT) may be more effective for some people than spending long hours at the gym.
  • Based on your medical history you may need to avoid certain types of exercises; for example, persons with knee pain should avoid treadmills and use bicycles instead for a cardio workout.


4. Keep a positive attitude-especially towards food
As a classic example of Mind-Body medicine, if you are constantly feeling deprived –deprived of eating your favorite foods, deprived of spending quality time with your friends and family because you have to be at the gym- your body will simply just ‘not let go’. It is very critical that you understand the importance of the healthy changes you are implementing by educating yourself. This will help you keep a positive and motivated attitude towards your weight-loss goals. Staying positive does not mean you will never be sad or annoyed since these are healthy emotions when expressed appropriately. However, when these emotions become your predominant state of mind, an unhealthy attitude towards food will develop, and if not caught early can lead to eating disorders like bulimia and anorexia.
With adequate counseling and support from your health care providers, staying positive should not be a challenge. Additionally, if the focus remains on nourishing the body rather than counting calories, as the body gets healthier, your internal biochemistry will start to favor and harbor a positive attitude.

5.Build a strong support system
The best way to stay motivated is to have both a personal and professional team helping you.  
Your personal team could and should include anyone who matters to you: your spouse, parents, siblings, friends, co-workers and pets. Educate them as to why it is important for you to be healthy and lose weight. You can have them remind you of your goals as often as you want- they will be your cheerleaders when you make progress towards these goals. The value of a good social support network must not be underestimated when trying to achieve your health goals.

​Your professional team should include the doctor who has designed and is supervising your weight-loss  plan, plus, one or more of the following: physical therapist, trainer, dietitian, therapist or other healthcare providers. This team will help you analyze the objective data and can provide action oriented solutions and resources to help you succeed. Simple recommendations such as increased water intake may have a huge impact on your progress rate, but to detect inadequate hydration would  be the first step, and that is why your professional team is important.

Typically, once all of the above factors are addressed and adhering to a weight loss program designed specifically for you, will be much easier. Challenges will show up but with the help of your support teams, you will overcome them and be successful.
Now go ahead, re-assess your weight-loss plan, address the above factors and start working towards your new goals.  

If you would like help regarding these factors and would like me to be a part of your professional support system, schedule a free consult through our website.

Keeping it simple,

Preeti Kulkarni, ND

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