Illustration by Michael Burmesch
Scale with footprints illustration
Mary came to me with several health problems, the most pressing of which was her 100-plus extra pounds. She had tried various programs over the years, sometimes dropping significant weight but then putting it back on. She wanted a new approach.
Many patients come to me frustrated with their inability to lose weight. For many, weight was never an issue until they reached middle age. Others have carried substantial excess weight 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. There is confusion brought on by the onslaught of “experts” touting “the best diet” (often with conflicting approaches): 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, and not to be minimized, our psyche, our relationship with food, our family and friends can all play a role.
It is critical to adopt a way of eating that can be part of a way of life—for life. So not a fad diet. If you regularly consume a lot of unhealthy food, it can take time to shift your palate, but with some initial consistency, it happens. It is possible to crave a salad! Slow and steady 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.
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Overcoming Resistance
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 and applying 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 healthful lifestyle and food choices
Mary and I worked together to form a plan prioritizing her health—-gut health, hormone balance, stress management and 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—like Mary‑it can be transformative to your health, your energy and your zest for life.
