Posted on Apr 22, 2019, 4 p.m.
No-one can wake up and decide what their weight will be, however weight is not a behavior and it is not always a choice. That being said healthy and unhealthy behaviors are subject to incentives and disincentives that are all too easily dismissed and forgotten.
There is no doubt that weight is largely the byproduct of choices and behaviors, such as how much we eat, how often we eat, what we eat, and how active we are that contributes to calories in calories out, but this isn’t really how it works completely. The math of energy balance and the premise of our choices being in charge of it are influenced by other factors.
Choices we make are dependent on the options available, and in the case of energy balance it appears as if modern culture is conspiring against making healthy choices. Take foods in particular, foods are now designed to be all but addictive and maximize calories it takes to get full, designed with the aid of technologies and are a potent sabotage of personal responsibility and good choices. However even that doesn’t stop a person from going organic and making meals at home to bring about, which again brings about another consideration of the actual elevated cost of eating healthy not all can afford.
Two individuals may make the very same choices regarding diet and exercise and still end up being at very different weights; categorically people can eat and exercise the same amount yet one will become obese and the other stay thin. This is when genetics come into play, and how the individual’s body functions and responds to stressors/triggers, etc. Let’s not forget that life isn’t always necessarily fair, at best it is fairly unfair over time.
Despite comparable choices in diet and activity really do nothing more than repudiate the laws of thermodynamics when it comes to differential weight outcomes. Relationships between matter and energy characterized by Newton are a basic tenet of physics but are unassailable by those who debate the relevance of calories to no valuable count, regardless of what some trends say calories do count. Calories are a measure of energy, should anyone care to contest this relationship they will need to go toe to toe with Sir Isaac who has yet to lose.
Rather than going into the long route of physics to explain the paradox of differential weight outcomes, more general terms serve better, take for example cars. When looking at cars one of the attributes highlighted is fuel efficiency which varies, this does not alter the properties of fuel nor does it challenge the reliable meaning of a gallon/liter, rather this indicates that not all engines are created equally.
This inequality of car engines is also true of the human engine, metabolism. Humans vary in fuel efficiency due to a wide range of factors such as heritage. There are populations whose ancestors adapted to survive in frugal desert environments who are very fuel efficient, such groups gain weight with ease when exposed to modern living and shed those pounds laboriously; underlying ethnic variation is genetic variation responsible to particular doses of calories in/out being partially explained by genetics. Body composition also partly explains it which is in turn partly explained by other genes and experiential factors. For example a higher mass of muscles increases calories needed to maintain weight; lower mass of muscles and higher fat content will have the opposite effect.
There are other known factors and most likely unknown factors that will also influence weight outcomes. Hormonal responses, in particular that of insulin are beginning to be appreciated. Those who need higher levels of insulin to maintain normal blood sugar are preferentially disposed to deposit calories and gain weight, weight gain tends to worsen with insulin resistance which can become degenerating and spiral.
Status of microbiome bacteria that colonize our bodies especially in the gastrointestinal tract is an increasingly salient consideration. Bacteria outnumber cells by roughly 10 to 1 and are important to digestion, new studies are emerging showing how important these bacteria are to other body functions from immune responses to hormonal balance. Significant alterations of gastrointestinal flora can produce alteration in weight, in some cases it can even result in weight loss resistance.
People in the weight loss resistance category may eat frugally, exercise strenuously and still can’t drop any weight. However in some cases people are in this category because they are telling themselves and physicians little white lies such as how few calories they eat, what they eat, and how physically active they are. Some in this category have had full metabolic testing to verify the truth of their claims, and are shockingly fuel efficient being vulnerable to weight gain and resistant to weight loss.
There are cases where weight loss resistance has been linked to disruption of gastrointestinal flora due to antibiotics or trauma. In some cases fecal transplant has proven to be therapeutic, and in lesser instances some respond to probiotics, prebiotics, or a combination. Metformin may also be useful as it enhances insulin sensitivity and can potentially treat insulin resistance. Cinnamon can help to stabilize insulin and blood sugar levels; Garcinia cambogia can help to attenuate appetite; PGX made from dietary fiber can blunt glycemic effect of food; and green coffee bean extract appears to safely boost metabolism slightly.
Systemic imbalance including hormonal imbalances, thyroid imbalance, and adrenal imbalance can physiologically block weight loss and cause a relentless struggle as the body is vulnerable to disruption, especially after the age of 35. Once the body is out of balance it can be incredibly hard to lose weight, and if there is any lost it will come back unless the root systemic imbalance is addressed. Digestive imbalances, detoxification issues, and inflammation can also contribute to weight loss resistance.
Response to weight loss resistance will vary, and in some cases it may mean learning to love the skin you are in. Not everyone who wants to lose weight needs to, if you carry just a few extra pounds but are fit, eating well, are vital, physically active, and healthy perhaps you should learn to accept your natural weight, shape, and size.
If your health is compromised by being overweight, or those who can’t/won’t accept their weight should explore options with a healthcare professional for addressing weight loss resistance who knows what they are doing. This approach should be fully individualized, and will likely involve some trial and error, but keep the faith it can result in success, very little in life is easy.
Being completely honest about the choices we make, making healthier food choices, learning to manage stress, getting enough sleep, exercise, learning how to promote a healthy gut flora, and doing more to be less sedentary are all behavior choices which will go along way. Even though many may suggest weight loss resistance is not real, just as many will suggest it is real. Weight, per se, is not always a choice, understanding it with compassion is, this is a choice we can all make.
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This article is not intended to provide medical endorsement, advice, diagnosis or treatment.