The struggle is real for those grappling with weight issues. If I could have a penny for every time some ‘normal weight’ but well-meaning person has said “it’s simple to lose weight, all you have to do is eat a balanced diet and exercise”, well I’d be a millionaire by now. The reality is that it is not as simple as that for many people and there are so many obstacles to weight loss. Some of these obstacles are well known and others not so much. My motivation for writing about this topic is personal, in that I’d like to see that the myths and stigmas about weight management are dispelled. Additionally, I think that even commonly held knowledge about the topic requires some rethinking. For example, I don’t believe that the solution to weight loss is as simple as calorie restriction and this is confirmed by current research.1 I’d like to open the subject for discussion in the hope that it may help to offset the misunderstanding and judgement that being overweight is ‘your own fault’ and solely your responsibility to fix. This unhealthy and inaccurate mindset can become a deeply held belief in the psyche of those who are overweight that they are ‘guilty’, ‘lazy’, ‘helpless’ and ‘lack self-control’. These thoughts can become a soul-destroying, negative thought pattern that is absolutely counterproductive to the process of finding optimum wellbeing.2 There are such a variety of factors working against those individuals, internally and externally, many of which they have very little chance of controlling, especially if they do not have someone to help them identify and understand their own particular obstacles to weight loss.
Over my 22 years of practice I have heard so many people’s stories where they genuinely have tried so many methods for losing excess body weight without lasting success. In fact, some of the most self-disciplined and fit people I know carry extra weight and struggle with maintaining it. Unfortunately, this is a difficult for those without this predicament to accept and understand. When you stop to consider how complex this all is, it is no wonder that there is so much confusion around the topic.
If you are not yet convinced on the complexity of this problem, some key issues that can be obstacles to weight loss include, but are not limited to:
- Carbohydrate intolerance / Insulin resistance – this may be experienced as fluctuating blood sugar and hunger levels, sleepiness after eating, weight gain particularly around the waistline, fatigue especially while exercising.3
- High stress / Cortisol imbalance – this may present as feeling anxious or ‘on edge’, having higher blood pressure and poorer sleep.4
- Poor thyroid gland function – some symptoms of low thyroid function include thinning hair and eyebrows, intolerance to cold, low libido, poor concentration, weight gain, difficulty losing weight despite efforts to do so, fatigue, dry skin and constipation.5
- Female or male hormonal changes and imbalances – some instances when hormonal changes will negatively affect weight loss efforts include: testosterone deficiency in men and Polycystic Ovarian Syndrome.6,7
- Poor sleep – long term poor sleep patterns can change the way your body uses sugars (decreases insulin sensitivity), can increase stress hormones and disrupt the Leptin cycle (important for appetite control)8,9
- Toxicity – some types of chemical exposures have been linked with obesity and hormone disruption, they are collectively named “Obesogens”. Some examples of obesogens include: Persistent organic pollutants (chemical that have been used in agriculture such as organochlorine pesticides, DDT and PCBs), plastics and plasticisers (BisphenolA, phthalates) and flame retardants (Polybrominated diphenylethers) and there are many more.10
- Gut and/or liver dysfunction – The liver is the organ that processes fats, waste products, toxins and therefore is critical for effective fat regulation. The state of your microbiome (gut bacteria and microflora) can influence your body weight. For instance, the presence of certain gut bacteria may influence what food choices you make, as shown in recent studies! A good variety of gut bacteria can improve insulin sensitivity, whereas low diversity has been linked to conditions like metabolic syndrome which is often characterised by excess body fat.11,12,13,14
- Inflammatory conditions and processes – inflammation can occur generally, as well as in specific areas of the body. If inflammation is ongoing, it can lead to changes that impact body weight regulation. This would include conditions like osteoarthritis, metabolic syndrome, autoimmune conditions, type 2 diabetes and thyroiditis.15,16
- Genetic factors – there have been certain gene variants that have been associated with an increased risk of being overweight or obese. There are also epigenetic factors (i.e. gene changes that have happened after conception and over the lifespan) that can modify genes to make a person more prone to weight issues.17
- Physiological differences – there is an increasing amount of research evidence to indicate that there is a mechanism in many overweight individuals to preserve their own fat mass i.e. your body recognises a certain weight to be your ‘norm’ and will alter your responses to keep it there. This physiological mechanism will keep individuals at a high ‘set point’ for their weight and slow or stop them from losing extra body fat.18,19,20
We also must be aware that there are multiple psychological and mindset obstacles to weight loss. Self-limiting thoughts, catastrophic thinking, emotional or situational triggers, lack of accurate education and lack of support to implement solutions are all very real obstacles to weight loss.21 People that have diagnosable mental health disorders, such as anxiety, depression, Post Traumatic Stress Disorder and addiction disorders are likely to have additional challenges in implementing weight loss strategies.22,23
Moving passed your obstacles can be tricky business, but the first step in this process is to find out what they are! It is important if you identify with any of the issues above that you get accurately assessed by your doctor and healthcare professionals. They will be able to guide you towards investigations and tests that may need to be performed for a proper diagnosis. Importantly, they will take into account your results, symptoms and health history and be able to interpret all of that information for you. Naturopaths may suggest further functional tests, alongside your medical assessment by your doctor. It is essential to get the help you require for identifying your weight loss obstacles and then to use that information to come up with a plan to address these obstacles. You may be suggested to consider specific prescription medications, dietary and lifestyle changes. It is useful to support that process as needed with detailed nutritional advice, herbal medicines, coaching, ongoing monitoring and emotional support. A key to success is having a plan with goals and time frames in mind, implementing these changes as you can, getting the additional professional support that you require for your specific obstacles and reassessing your goals as you reach them. Remember that there is no quick fix solution that will last a lifetime! In identifying your own obstacles to weight loss, there is an opportunity to seek individualised advice and to find realistic ways to get to your health goals.
written by Emily Grieger – Naturopath.
- Schwartz MW, Seeley RJ, Zeltser LM, Drewnowski A, Ravussin E, Redman LM, et al. Obesity pathogenesis: an Endocrine Society Scientific Statement.Endocr Rev. 2017 Aug 1;38(4):267-296.
- Hunger JM, Major B, Blodorn A, Miller CT. Weighed down by stigma: how weight-based social identity threat contributes to weight gain and poor health. Sc Personal Psychol Compass. 2015;9(6):255-268.
- Volek J. The Cardiometabolic benefits of a low carbohydrate/ketogenic eating plan. The 2015 International Congress on Natural Medicine. Melbourne, 06/06/2015.
- Ferris HA, Kahn CR. New mechanisms of glucocorticoid-induced insulin resistance: make no bones about it. J Clin Invest. 2012 Nov;122(11):3854-7.
- De Lange P, Cioffi F, Silvestri E, Moreno M, Goglia F, Lanni A. (Healthy) ageing: focus on iodothyronines. Int J Mol Sci. 2013 Jul 4;14(7):13873-92.
- Huhtaniemi IT. Andropause-lessons from the European Male Ageing Study. Ann Endocrinol (Paris). 2014 May;75(2):128-31.
- Peeke,P. Obesity: Science and Challenges. The 2018 International Congress on Natural Medicine, Day 1. Metagenics. 2018 June 9;1:127.
- Brady EM, Bodicoat DH, Hall AP, Khunti K, Yates T, Edwardson C, et al. Sleep duration, obesity and insulin resistance in a multi-ethnic UK population at high risk of diabetes. Diabetes Res Clin Pract. 2018 May;139:195-202.
- Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004 Dec;1(3):e62.
- Darbre PD. Endocrine Disruptors and Obesity. Current Obesity Reports. 2017;6(1):18-27.
- Volk BM, et al. Effects of step-wise increases in dietary carbohydrates on circulating saturated Fatty Acids and palmitoleic Acid in adults with metabolic syndrome. PLoS One. 2014 Nov21;9(11):e113605.
- Alcock J, Maley CC, Aktipis CA. Is eating behaviour manipulated by the gastrointestinal microbiota? Evolutionary pressures and potential mechanisms. Bioessays. 2014 Oct;36(10):940-9.
- Suez J, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014 Oct9;514(7521):181-6.
- Andreasen AS, et al. Effects of Lactobacillus acidopholus NCFM on insulin sensitivity and the systemic inflammatory response in human subjects. Br J Nutr. 2010 Dec;104(12):1831-8.
- Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006 Dec14;444(7121):860-7.
- Kim JA, Montagnani M, Koh KK, Quon MJ. Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms. Circulation. 2006 Apr 18;113(15):1888-904.
- Den Hoed M, Loos RJF. In: Bray GA, Bouchard C, Boca Raton FL eds. Handbook of Obesity. CRC Press. 2014;1(3rd ed):105-119.
- Schwartz et al. Ibid.
- Speakman JR, Levitsky DA, Allison DB, Bray MS, de Castro JM, Clegg DJ, et al. Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity. Dis Model Mech. 2011 Nov;4(6):733-45.
- Rosenbaum M, Leibel RL. Brain reorganization following weight loss. Nestle Nutr Inst Workshop Ser. 2012;73:1-20.
- Kelley CP, Sbrocco G, Sbrocco T. Behavioural modification for the management of obesity. Primary Care. 2016;43(1):159-175.
- Rajan T, Menon V. Psychiatric disorders and obesity: A review of association studies. J Postgrad Med. 2017;63(3):182-190.
- Hemingsson E, Johansson K, Reynisdottir S. Effects of childhood abuse on adult obesity: a systematic review and meta-analysis. Obes Rev. 2014 Nov;15(11):882-93.