Eat less, move more. It makes weight loss sound so simple … and easy.
But, in reality, losing weight is tough, and it’s not because you or anyone else is lazy or just not trying hard enough. It’s because, for many of us, everything from our biology and our environments to our emotions make weight loss an uphill battle against both nature and nurture.
Are Genetics Destiny?
Most of us realize that, one way or another, our genes show up in our jeans. After all, just like the genes our parents and grandparents pass down to us determine our eye and hair color, so, too, can they determine our body composition, to an extent, explains Spencer Nadolsky, a board-certified family and bariatric physician, diplomate of the American Board of Obesity Medicine and author of “The Fat Loss Prescription.”
While some people win the “skinny gene” in the genetic lottery, others are born with a genetic predisposition to being heavy or obese. For instance, in 2007, researchers identified a common obesity-related gene variant that raises the risk of obesity by 20 to 30 percent.
What’s more, an emerging area of focus in the field of genetics, called epigenetics, studies how and what factors modify gene expression, the ability of genes (including obesity-related ones) to play out.
Epigenetic factors include the foods our mothers ate while pregnant, whether we were born via C-section and if we were breast-fed as infants, according to Krista Rompolski, assistant clinical professor of health sciences at Drexel University and a research team member for Girls Gone Strong online fitness community. The body composition of our mothers at the time they were pregnant with us is also a large epigenetic factor, according to research published in the journal Pediatrics.
“Our genome didn’t change a lot in past 30 years, but our environment, from our mothers’ uteruses to our offices, did,” Nadolsky says. “When you place someone with these genes in an obesogenic environment, maintaining a healthy weight becomes exceedingly difficult.”
Our ‘Obesogenic’ Environment
If you want to see an obesogenic environment, just take a look around. Modern society is set up for us to consume more calories than we burn every day, and the result is weight gain. “The combination of technology and a culture that runs on time constraints can lead to unhealthy eating and lifestyle choices in anyone,” says Brunilda Nazario, associate medical director of WebMD and diplomate of the American Board of Obesity Medicine.
We can buy most anything we need – from groceries and toiletries to clothes and home décor – online without ever taking a step. Emailing is a more efficient way to work than walking across the office to chat with a co-worker. Meanwhile, the number of fast food and fast-casual restaurants is growing, and the supermarket shelves are filled with hyper-palatable foods (think: sugar, fat and salt) that don’t actually fill you up, but stoke your hunger even more, Nazario says. The latter is even truer in “food deserts,” areas around the country in which access to fresh, healthy foods is limited, while unhealthy, obesity-promoting foods are plentiful.
Unfortunately, many of these detrimental foods advertise themselves as healthy, making any attempts to maintain a healthy weight that much more difficult, says Holly Lofton, assistant professor of medicine and medical director of the weight management program at NYU Langone Medical Center. “I call it the misrepresentation of food. On the front of the label, a food company can say pretty much whatever it wants.” However, the nutrition label, apart from being placed on the back of the box and out of plain view, is incredibly confusing to most consumers.
Fortunately, the Food and Drug Administration recently announced upcoming revisions planned for food nutrition labels that many experts believe will make healthy eating easier, Nazario says.
Your Body Doesn’t Want to Lose Weight
Whatever your genes and environment, when you try to lose weight, your body automatically works against you.
Your body’s weight loss-stalling efforts include dramatic changes in levels of hormones including leptin, ghrelin, GLP-1 and peptide YY, Nadolsky says. Hunger soars, and maintaining the caloric deficit needed for weight loss becomes a battle between you and your biology.
“It’s not that our bodies don’t want us to be healthy,” Lofton says. “Our bodies don’t want us to starve. These biological mechanisms were meant to keep us from whittling away, but they aren’t doing us any service in our current environment.”
All calorie-consumption aside, weight loss comes with a drop in basal metabolic rate, the number of calories you burn just by being alive. That drop makes sustaining weight loss – and continuing to lose weight – hard. And while, theoretically, any loss in body mass will result in a lower metabolic rate (it takes less fuel to run your body, the less mass your body contains), in practice, that drop is far greater than theory would have expected, Lofton says.
This metabolic adaptation can be seen by comparing two people of the same sex and age, who have equal body weights and compositions. Consider two men who both weigh 200 pounds. If one of them has weighed about 200 pounds his entire adult life, while the other used to weigh 300 pounds, all else being equal, the man who lost weight to get to 200 pounds will have a lower metabolic rate, Nadolsky explains.
He also notes that after people lose weight, they subconsciously engage in less non-exercise activity thermogenesis, or NEAT, such as fidgeting, walking and generally moving than they used to, thereby reducing daily caloric expenditure and the ability to sustain weight loss.
Meanwhile, obesity can contribute to long-term dysfunction in the appetite and reward centers of the brain, as well as insulin and leptin resistance, both of which compound weight-loss difficulties by encouraging fat storage and increased hunger, he says. And age comes with a natural decline in metabolic rate, Rompolski says.
The Psychology of Weight Loss
While binge eating disorder is the most common eating disorder in the U.S., affecting approximately 2 million Americans at a clinical level, according to the National Eating Disorders Association, far more struggle with subclinical disordered eating habits, such as emotional eating, eating past the point of fullness and skipping meals.
A delicate interplay of memories, emotions, coping skills learned in childhood and reward pathways throughout the brain affect how virtually every person relates to food, Nazario says. Humans eat for far more reasons than for hunger, and without addressing the psychological factors behind weight gain, sustained weight loss through healthy eating and exercise isn’t possible.
So What Can You Do to Make Weight Loss Easier?
Weight loss is hard. However, simply understanding that fact – and all of the many biological, environmental and psychological factors behind weight gain and weight loss can help relieve some of the confusion and frustration that people commonly experience when struggling to lose weight, Nadolsky says.
What’s more, none of these obstacles are insurmountable. Twin studies reveal that, while genetics may predispose you to a certain body weight, your lifestyle habits all determine if and how those genes are expressed. For example, in one University of Washington study of 1,224 twins, researchers found that the siblings who got the recommended amount of sleep (seven to nine hours) had significantly lower body mass indexes, a ratio of weight to height, than those who slept less. Meanwhile, although you might not be able to change your city or neighborhood, you have ultimate control over your most important environment: your home, he says. You also have control over how much time you spend strength training, which increases lean muscle to boost that metabolic rate. And trained psychologists and counselors can be integral in your efforts to work through mental roadblocks.
That raises an important point: Reaching out to professionals, whether it’s a registered dietitian, personal trainer, certified strength and conditioning specialists, psychologist or obesity medicine specialist – or all of the above – is not a sign of weakness or cause of shame, Nadolsky says. It’s a sign that you understand that tackling all of these factors requires a personal, professional and multidisciplinary approach. It’s a sign that you know that your health and happiness are worth it.