You might be reading this article because you have difficulty losing weight. And that’s okay. Every year, more than 60% of people identified as having obesity attempt to lose weight (1). The problem is, most don’t succeed, and those who do succeed in the short term inevitably gain most or all of it back (2). Over half of those who try never achieve significant weight loss, and those who lose weight gain back over 80% of the lost weight within five years (1,2). Suffice it to say, that is not a great success rate.
Why is weight loss so hard? This is a composite problem that is a hell of a lot harder to answer than most fitness professionals will tell you. Over 8% of worldwide deaths in 2017 were attributed to obesity. 39% of adults in the world are overweight, and these issues generally get more and more prevalent in more developed countries (7). If it was so easy, why are obesity rates going up across the board? Why are we becoming more overweight, less healthy, and less satisfied with our physical wellbeing as we become more and more advanced? Throughout this article, I am going to dig deeper into these questions, and put in scope the many factors that affect what may be keeping YOU from shedding unwanted pounds.
My Experience Struggling With Weight-Loss & Body Image
When I was younger, I struggled with my weight. I never really understood what caused my bodyweight to increase or decrease. I was always embarrassed to change clothes in the locker room, I hated getting weighed in front of class at the beginning of the year in school, and I absolutely refused to take my shirt off at the beach / pool.
I started exercising when I was just 10 years old. Everyone I talked to and everything I read made me believe that if I couldn’t lose weight, I just wasn’t trying hard enough. Sound familiar? It wasn’t until years later that I would figure out the truth about weight loss.
When I was 17, I started to get serious about working out. I started going to the gym at my college (before this, I exercised at home). I started training with other people, watching videos on the internet on how to perform exercises, and following programs I found online. Between ages 10 and 17, I worked out often, but it never resulted in the type of changes I truly wanted.
I never paid too much attention to what I ate. I figured, “as long as I’m working out hard and consistently, I’m going to get big muscles, right?” “I’ll have a six pack if I just do enough sit-ups and Russian twists.” “All those people that say abs are made in the kitchen are just lazy in the gym!” “I don’t REALLY need to worry about diet.” These are the types of things I would tell myself, to rationalize avoiding uncomfortable changes. Because I had no clue where to start. Hell, I didn’t even know I had a problem. Diet always seemed to be in the realm of physiology, nutrition, or other things I didn’t care about. Who cares if your diet isn’t PERFECT? It can’t have THAT much of an effect on how you look, can it?
I turned 20 at the end of 2010, and by that point I was already starting to develop pain in my wrists, elbows, knees, and back from training. At the end of the day, I didn’t have the abs I wanted, and I still hadn’t achieved the “look” I wanted. I felt defeated. At this point, I took a few months off from training.
Patience & What It Truly Means To Be Consistent
By early 2011, it hit me. I had been exercising for nearly a DECADE, yet I wasn’t happy or satisfied with my results. I had done all the ab workouts in the world, every cool new exercise I could find, ran until my feet hurt. It wasn’t working. I finally decided I was going to pick a plan and follow it to completion. It was an old program on the Muscle & Strength website called “The Hardcore 40”. At the time, I thought that because it was “hardcore” and the article talked big game, that THIS was the reason why it would work. After all, I had tried dozens of workouts before; my problem must have been the workout, right? It couldn’t be anything else, I thought.
The problem wasn’t that I was following the wrong programs. It was that I wasn’t sticking to ANY program. You see, what I know now is that, with the right consistency and mindset, almost any (yes, you read that correctly, ANY) workout and / or diet program can work. So why do they almost unanimously fail?
Unfortunately, there exists a multi billion dollar industry that preys on people who are desperate to lose weight. I know because I am involved in that industry, and it is one of my core principles NOT to do that. Some people in the industry may be purposefully unclear, because the nuts and bolts that drive weight loss ARE so simple. But just because something is simple doesn’t mean it is easy.
Diet & Caloric Deficit
The concept of energy balance - the coordinated homeostatic balance of energy intake and energy expenditure - is central to weight loss. When it comes to losing weight, the only thing that matters is calories. That is true to a point. If you consume less energy than your body utilizes, you will lose weight. This is called a caloric deficit. If you consume more energy than your body utilizes, you will gain weight. This is called a caloric surplus.
Here is the problem: calorie deficit does not always work in the real world. Reducing calorie intake may fail, because it ignores the mechanisms the body uses to maintain its existing weight (6). In reality, the human body is a complex system that adjusts and modulates its hunger, metabolism, movement, and other factors, based on the complex series of inputs that we experience in our everyday lives. These inputs are both physical and psychological, and can influence how your body’s weight changes.
There are many complex inputs that can trigger hunger, affect hunger during eating, and cause you to stop or continue consuming food in a sitting. These range from hormone secretion, varying satiety due to the properties of the food you are consuming, the amount of food volume in your stomach, anticipated pleasure and reward, post-ingestive information signals your stomach sends, and a whole host of complex psychological processes that are likely of unquantifiable complexity, among other things (8).
I don’t think it is a winning strategy to focus on any single one of these things. While at the surface, decreasing calories WILL create weight loss, this weight loss does not always occur immediately. Many get discouraged when they see the scale refuse to budge, despite their best efforts, and being certain that they are eating in a caloric deficit. It takes time for the scale to “catch up” sometimes - time which quickly tests the patience of many weight loss enthusiasts. There's also the whole thing about weight fluctuations.
But do realize, energy balance isn’t really a strategy for weight loss any more than gravity is a strategy for jumping. Gravity exists regardless of anything you can do, similar to how energy balance exists. Gravity may determine how long you will stay in the air during a jump, but you can still train your ability to jump higher, wear springier shoes, increase strength, or adjust jumping technique in order to more effectively make a jump. Similarly, you can acknowledge that calorie balance is the reason weight is either lost or not lost, but then deepen your strategy and do more than just calorie counting to make the change happen.
Increasing Physical Activity
Calorie balance is more than just how much you eat. That is only one side of the equation. So what’s on the other side? The other side of the equation contains how many calories your body utilizes or “burns”. The is often referred to as your metabolism.
The term “metabolism” is often misunderstood or misused. When people talk about metabolism, they often think that it is some sort of a fixed thing. Many have said that their metabolism may be too low to lose weight, and it is out of their control. The first part of this statement may be true, but the second part is not.
Your metabolism refers to all the physical and chemical processes in the body that convert or use energy (9). This includes everything from your breathing, heart beating, digestion, brain activity, and even moving throughout your day. There are certain aspects of your metabolism that you don’t control. However, one of the largest contributors to your metabolism is something that you can control.
I’m not talking about exercise. I’m talking about NEAT. Non-exercise Activity Thermogenesis (NEAT) is the amount of movement an individual performs in a given day outside of organized exercise bouts. The impact that NEAT can have on your weight cannot be understated. NEAT varies widely among populations, and can literally make a difference of thousands of calories daily (10).
People often talk about raising your metabolism. The true way to raise your metabolism isn’t by using untested supplements, fat burners, energy drinks, or anything of the sort. You are not “broken”. You have the capacity to change and make positive improvements in your metabolism. You can do this by moving more, in just about any way. General movement is the largest modifiable factor when it comes to metabolism.
Granted, there are instances where if you have severe hormone issues, this can impede your metabolism in a way you may not be able to fully control (11). However, hope is not lost. Existing data shows that nutrition, exercise, and general movement play a key role in helping you maintain a healthy body weight, and they are likely even more important for people with these issues (12).
The message of the last two sections is to move more, and eat an appropriate amount of calories. Both are core principles of weight loss. For an idea of what your appropriate calories might look like, check out the NIH Bodyweight Planner here.
Moderation and Patience
The real key to weight loss - and more importantly, long-term happiness with your body - starts with realizing this one thing: it took YEARS for your body to get to where you are. The accumulation of excess body fat, lack of movement, bad eating habits, and negative self image, is not something that disappears overnight. Why would we expect using a single product, or exercising for one month to change this?
For starters, most people have a very, very inaccurate perception of serving sizes vs portion sizes. Serving size is the amount of a food that is recommended you eat in one sitting, while portion size is the amount of a food you actually eat. Many foods that are packaged as one portion actually have multiple servings (14).
Humans are not even close to good at estimating portion sizes. Adults have a massive range of error when it comes to this, underestimating calorie intake by an average of close to 50% in some studies (15), while in others, they overestimate. This lack of consistency in the findings makes it hard to give one blanket recommendation on the matter. One study even quotes: “None of the other measures showed a consistent pattern of under- or overestimation” (16). Even photographing food with cameras and then using complex computer software to detect portion sizes can be off by up to 30% (17).
There are a few things consistent across most findings, though. Higher calorie foods tend to have calories underestimated more consistently. Those who have trouble losing weight generally tend to largely underestimate consumed calories. Those with more experience and education in food tracking did better in accurately estimating calories (15, 16, 17).
On top of this, the food packages themselves may not be accurate. A study published in 2014 found that all foods they tested had some level of discrepancy between the calories on the label and the actual calories within the food. Actual metabolized calories were 4.3% higher than the label statements on average, but they could be quite a bit higher, depending on the individual snack (18). The average recommended calorie deficit for weight loss is 500-1000 calories, which might be anywhere from a 10%-50% reduction in calories consumed (19). While 4.3% might not seem huge, if your calorie deficit is only 10%, this discrepancy can wipe out almost half of your deficit.
Dietary adherence is paramount to long term weight loss success (20). In fact, it is even shown in research that those who lose weight a bit quicker upfront have better long-term success when it comes to staying adherent (21). If you can’t lose weight upfront because of these inaccuracies in calorie estimation, it is more likely you will fall off the wagon and give up before you figure out how to accurately track your calories.
And here is one of the true keys to weight loss success that no one wants to hear: time + consistency = results. Even if you can’t lose weight quickly upfront, the same study noted that if the subjects adhered, there was NO significant difference in weight-loss or maintenance success between slow, moderate, or fast losers (21). Making these lifestyle changes is what really drives success, and most people who have obesity are not addressing these key factors that lead to long term results.
Genetics vs Environment
The issue of weight loss is obviously not as simple as just telling someone to eat less. This issue is multifactorial in origin, reflecting inherited, environmental, cultural, socioeconomic, and psychological conditions. Increasing evidence suggests that being overweight is not a simple problem of willpower, but a complex disorder of appetite regulation and energy metabolism (4).
Obesity absolutely seems to have a genetic component. There have been identified literally dozens of genes that are linked with one’s development of obesity. (22). As discussed, there are many biological pathways that are involved in regulating hunger, and genes that affect these pathways have been discovered. Interaction between these genetic factors and the environment in which you are raised may influence the development of obesity (4).
So what does this mean practically? For those with a genetic predisposition to obesity, does this mean that you are doomed to fail at weight-loss? No. While the success rate isn't great for the general population, things such as increasing exercise, talking to your doctor about prescription weight-loss medications (1), and even hiring your own personal trainer can all significantly increase your odds of successfully changing your behaviors, and losing weight (34). Thousands of people incur significant weight-loss each year. Hell, I have helped some of them myself, to lose weight, and keep it off.
It seems that a combination of genetics, environment, your own actions / choices, and other complex factors influence one’s chance of developing obesity. While genetics and environment absolutely do play a role, it is not helpful to focus on them. We have no control over our genetics, and limited control over our environment, so it does no good to rely on these if you want to actually create positive change. Acknowledging these factors, but then honing in on modifiable lifestyle factors can set you up for a better chance of success. Let’s focus on the things we can control.
Focusing On The Wrong Things
I recently read a study where water intake was not shown to reliably decrease calorie consumption (23). This contradicts conventional recommendations to ”drink more water” to lose weight. How many times have you seen friends, family, or co-workers, carrying around their water bottle, and refilling it, telling you it is a big factor in their weight loss? Hell, I used to believe and do this myself.
This is just one example of something that may not be effective for weight loss on its own, yet is a major area of focus for many. There are other studies showing that when used in conjunction with calorie deficit, drinking more water leads to weight-loss (24). Weight loss needs to address the problem from multiple angles to work. Focusing on one thing, especially when that one thing may not work or be a significant contributor to success on its own, is not helpful.
Another thing that people often focus on is nutrient composition, or the general “healthiness” of food. While nutrient composition is important for overall health and fitness, it has a limited effect on weight loss. In fact, if you consume the same number of calories, you will see the same level of weight loss, regardless of where those calories come from. In fact, there have even been examples of people eating diets that would be considered extremely “unhealthy” from a nutrient composition standpoint, such as this guy who lost almost 30 pounds in 10 weeks eating mainly Twinkies, or even my own Pizza Diet.
Although, eating foods that are generally “healthier” can help you maintain a calorie deficit. This, in turn, will lead to weight loss. Foods that are “healthier” tend to be lower in calories, more nutrient dense, and filling - all important things that help adherence to a calorie deficit. But they are neither necessary nor causative of weight-loss.
Calorie deficit is the actual mechanism that causes weight loss, similar to how gravity is what causes a high jumper to fall after they jump, as we explored earlier. Any strategy that successfully creates weight loss needs to address this, whether directly or indirectly. Some approaches, like Weight Watchers, the ketogenic diet, Atkins, or veganism don’t track calories per se. But they still manipulate calorie intake through the food choices you are selecting.
All of these diets work by manipulating calories in one way or another. Weight Watchers, for example, uses “points” as a rough proxy for calories. The Atkins diet reduces carbohydrate intake, thus lowering calories (all other things remaining constant). Keto diets eliminate practically ALL carbohydrates, and can be very effective for short-term weight loss if adhered to. However, adherence to keto diets is no higher than other dietary interventions, and they come with the possibility of added severe adverse risks (26).
The main problems I see with all of these approaches is that they do not teach the user anything about why or how to lose weight. They make the user reliant on that method. Once the (usually lofty and very restrictive) parameters of the diet cannot be met, the user often gives up or binges. Furthermore, some of these methods are very restrictive, and cause significant stress on the user. This actually increases the user’s risk of binge eating or breaking the diet (27).
What really matters, based on my years of experience and understanding of the practical evidence, is the following:
Calorie deficit.
Consistency / adherence.
Finding what works for you.
If you can put these together, using the tips and knowledge presented in this article, you have a solid starting point.
Education
A suggested potential strategy to solve our international weight management crisis is to educate healthcare professionals about all of the contributors to weight gain and loss (3). Such a strategy may help, but it is not necessarily the be all and end all to solving the problem. Education starts with the practitioners. Doctors, nurses, dietitians, personal trainers, etc. should be knowledgeable about the causes of weight gain and effective strategies for reducing body weight for health purposes. In turn, they should then pass this knowledge on to you, the end user.
But education alone is not enough. Evidence is lacking on whether or not simply educating a patient or client will actually make solving their problem easier. Most people know that eating less and exercising more will cause weight loss. Most people can identify “healthy” and “unhealthy” foods. But knowing and doing are two different things.
The Australian Food and Grocery Council suggests that education only has a limited impact on the actual changing of habits. Those who are more likely to be overweight or obese are actually less likely to the use new education to change habits (28). It would seem that habit change is not as simple as simply knowing what is good for you.
One more effective measure may be to increase the availability of healthier food options. Many communities do not have local access to stores that stock a variety of healthy, affordable food options. Even those that do may not have options that appear appetizing or desirable to the consumer. And even if your local grocery stores and takeout restaurants do have healthy, appetizing options, are those options affordable and easy to access? Does a healthy meal look like driving across town to go to the one healthy restaurant, or spending hours doing meal prep? While the unhealthy option may be much more easily accessible, i.e. just grabbing something from a drive-thru, or throwing something in the microwave. The environment and ease of access to healthy foods can have a massive impact on your personal food choices.
We, as a society, also need to take a look at what makes unhealthy food so desirable. On a population level, this may mean government subsidies to make healthier foods more affordable, or social marketing campaigns that address the issues of why populations find unhealthy foods so desirable. Over time, the public’s image that healthy food is not as tasty as unhealthy food could be shifted. (28).
On an individual level, which is probably why you're reading this article, is where this gets more actionable. When it comes to individual education and action, much of this depends upon your starting point. Are you someone who has struggled with weight issues before? Have you tried numerous diets, and they all failed? Are you open to further educating yourself on dietary resources, and using these to self guide your weight-loss? Have you tried all of this before, and you perhaps need outside intervention?
Actually motivating yourself to make the change is another story. Again, just because you're able to make the change, have all of the necessary resources, and want to do it, doesn't mean you will succeed. You can however, give yourself a better chance of success by doing the following. The first step is identifying what you, the individual, value. Do you enjoy the taste of food? Do you not want to eat healthier because you feel it reduces your ability to go out and enjoy yourself with friends? How much do you care about weight loss?
All of these questions, and similar, are important to ask, because if you do not believe that what you are doing is worth it, you are less likely to follow through. These reasons are highly individualized and do not tend to be homogenous across the population. Indeed, psychological aspects of weight seem to be much more prevalent causes of habit changes than the actual health or wellness burdens of being at an unhealthy bodyweight (30).
Therefore, it is of utmost importance that you take action for YOU, not for anyone else. Find an aspect of fitness that you enjoy. Find your reason for making positive change. If you do not value weight loss, realize that there are dozens of other benefits of eating right and exercising. If you don’t care about these benefits, perhaps you want to be able to be more active with your kids (or future children?). Perhaps you want to be able to run a mile, just to say you can? Maybe you just want to look better? Whatever the case may be, having a solid reason that you believe in for getting started, and sticking to it, is one of the most important factors, in my experience, in your long term success.
If you want to get started, there are tons of great links at the end of this article. Virtually everything I talk about here is sourced there. If you’re not into reading research papers, sign up for my newsletter. I provide tips, articles, motivation, and regular helpful information to get you jump started and continued on with your fitness journey. If you still find yourself struggling, consider filling out my coaching application and we can get you started today.
“Methods whose primary goal is short-term rapid or unsupervised weight loss, or that rely on diet aids such as drinks, prepackaged foods, or pharmacologic agents but do not include education in and eventual transition to a lasting pattern of healthful eating and activity, have never been shown to lead to long-term success” (4). Remember, there are no substitutes for time or consistency. Being patient and working through the issues you find yourself having are so, so important to ensuring you achieve your weight goals, and then maintain them for life.
Dissatisfaction With Ourselves
Many who try to achieve weight loss do so out of guilt (4). Telling yourself that you lack willpower and you need to change may motivate some, but not all. I have found throughout my years of being a personal trainer that this strategy NEVER works. It may work for some people, but I have yet to meet or coach them.
More often, I encounter clients who are sad and depressed with their physical state. You tell yourself that you suck, and that being overweight or having obesity is entirely your own fault. You may think that you are weak, flawed, or otherwise not trying hard enough. You feel like you are doing everything in your power, yet nothing is working. Why is it so easy for person x to lose weight / maintain a healthy body weight, yet I struggle so much? I must just be terrible and I can’t succeed.
This type of negative self talk is toxic. It is not helpful in reaching your goals, and sabotages you out of the gate. In fact, it is even scientifically proven to do so. Negative self-criticism is strongly associated with decreased actual wellbeing, both directly and indirectly (29). Being critical of yourself is only helpful if it is in a way that drives progress, as has been noted in sports and other fields (31). We can translate this to weight loss.
Especially if you are looking to self-direct your own weight loss, positive self-talk is imperative. One very important concept that I heavily promote is to no longer use the term “dieting”. Dieting implies a temporary state. Most people think diets don’t work, or are doomed to fail. I prefer to use terms such as “nutrition”, “dietary approach”, “goal dependent eating” and “lifestyle modification”.
How you frame your thoughts and talk to yourself can influence your actions. Self-efficacy correlates positively with success in all realms of personal endeavor. Through positive reinforcement, enhancing your sense of self worth, and developing self efficacy, we can help others, and ourselves, become more self-reliant (32). Over time, these built up habits will translate to an enhanced ability to take your own health and fitness into your own hands.
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