Why Can’t I Lose Weight? Q&A with an Endocrinologist
Weight loss is probably one of the most frustrating things. At some point in our life, we’ve all tried to shed a few extra pounds by doing things like skipping meals, increasing exercise, trying intermittent fasting, eating apples, drinking more apple cider vinegar, and the list goes on. But why is it so hard?
We asked endocrinologist Dr. Sheliza Lalani, who focuses on behavioral therapy, obesity, and nutrition, for her thoughts on weight loss and why it is so challenging.
Firstly, a lot of people believe being obese is due to being lazy and a lack of discipline. What are your thoughts on this?
Obesity is a chronic disease, like heart disease and breast cancer - we should never blame a patient for their medical condition. It is a combination of genetics and the obesogenic environment in which we live. This means that our environment encourages us to eat in an unhealthy way and not exercise enough. But after gaining weight, diet and exercise alone are not a way to treat a medical condition: trying just this is a setup for failure. A diet does not help us change our mindset or how to manage our emotions.
In your opinion why is weight loss so hard?
We evolved from cavemen and are not meant to lose weight. Losing weight is unnatural and our bodies naturally want to retain weight to survive. Often when patients are losing large amounts of weight, we worry about cancer or another disease. Our brains often drive us to re-gain the weight we’ve lost so when we try fad diets to lose weight, they fail.
The first thing a lot of people look for are foods that help with weight loss, like apple cider vinegar, chia seeds, apples - are there any foods or particular diets that can help with weight loss?
There is no diet or food that will lead to weight loss. It is all about a mindset towards a healthy lifestyle. When patients ask me about intermittent fasting or any other diet, my response is simple: ‘if this diet works for your lifestyle - do it. If it’s challenging, don’t.’
Is it possible to lose weight fast?
This is unhealthy and more worrisome.
What is the best advice you can give someone that wants to lose weight?
When I see patients, I often ask them to tell me their values. A change often starts with defining what you value. When you know what you value, you can make more conscious choices and become more aware when you are eating out of boredom versus when you are hungry. It is important to have the right support around you, and behavioral therapy can help. In some instances, talk to your doctor, because there are medications that can help with weight management, but they work alongside changing your mindset towards a healthy lifestyle and managing emotions.
- Lake, A., & Townshend, T. (2006). Obesogenic environments: exploring the built and food environments. The journal of the Royal Society for the Promotion of Health, 126(6), 262–267. https://doi.org/10.1177/1466424006070487
- Devlin, M. J., Goldfein, J. A., Petkova, E., Jiang, H., Raizman, P. S., Wolk, S., Mayer, L., Carino, J., Bellace, D., Kamenetz, C., Dobrow, I., & Walsh, B. T. (2005). Cognitive behavioral therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder. Obesity research, 13(6), 1077–1088. https://doi.org/10.1038/oby.2005.126
- Kim, M., Kim, Y., Go, Y., Lee, S., Na, M., Lee, Y., Choi, S., & Choi, H. J. (2020). Multidimensional Cognitive Behavioral Therapy for Obesity Applied by Psychologists Using a Digital Platform: Open-Label Randomized Controlled Trial. JMIR mHealth and uHealth, 8(4), e14817. https://doi.org/10.2196/14817