Weight loss…

…why is it so difficult for some? And what you can do.

Losing weight can be a challenging and frustrating experience for many people. Despite the best intentions and efforts, shedding excess pounds can seem like an uphill battle. While there are many factors that contribute to this difficulty, a few key factors play a particularly significant role. In this article, we'll explore some of the reasons why it can be hard to lose weight, including insulin resistance, hormones, and sleep.

Insulin Resistance:

One of the major culprits behind difficulty losing weight is insulin resistance. Insulin is a hormone produced by the pancreas that regulates the amount of sugar in your blood. Insulin resistance occurs when cells in the body become resistant to insulin's effects, leading to elevated blood sugar levels. This can cause the body to produce more insulin, which can promote fat storage and make weight loss more difficult.

Research has shown that insulin resistance is strongly associated with obesity and weight gain (1). In addition, a study published in the journal Obesity found that insulin resistance can predict weight gain in both men and women (2). To combat insulin resistance, it's important to maintain a healthy diet and exercise regularly.

Hormones:

Another factor that can make weight loss difficult is hormones. Hormones are chemical messengers that help regulate many bodily processes, including metabolism and appetite. Imbalances in these hormones can make it harder to lose weight.

For example, the hormone leptin plays a role in regulating appetite and metabolism. Leptin levels tend to be higher in people who are overweight or obese, which can make weight loss more challenging (3). In addition, studies have shown that the hormone cortisol, which is released in response to stress, can increase appetite and promote fat storage (4).

Additionally, sex hormone imbalances or deficiencies can contribute to inability to lose weight. For example, correcting low testosterone in men can produce sustained weight loss without re-gain of the weight (5)

Sleep:

Finally, sleep is another critical factor that can affect weight loss. Lack of sleep has been linked to weight gain and obesity in numerous studies (5). One reason for this may be that sleep deprivation can disrupt hormones that regulate appetite, such as leptin and ghrelin (6). In addition, sleep deprivation can increase levels of the hormone cortisol, which can promote fat storage (7).

In conclusion, losing weight can be a difficult and frustrating process, but understanding the factors that contribute to this challenge can help. Insulin resistance, hormones, and sleep are just a few of the many factors that can make weight loss more difficult. By maintaining a healthy diet, exercising regularly, and getting adequate sleep, you can improve your chances of success.

So, what can you do?

First, we recommend a comprehensive evaluation by a doctor with a good understanding in these areas. This should include a discussion with you, exam, blood work that should include insulin, glucose, A1C and a hormone panel at the very least. You may need a sleep study as well. Once you identify problem areas it is best to attack those areas first (i.e. address sleep apnea if present). It is important to look take a holistic approach and examine you entire lifestyle, including diet, exercise, stress management, et… Additionally, there are many metabolic therapies, such as macronutrient restriction & fasting in additional to pharmaceuticals that can help. When starting any intervention it is important to also have an exit in mind. When will you scale back and then stop the intervention? If you need help in these areas, we are here for you!

References:

1. Kahn, S. E., Hull, R. L., & Utzschneider, K. M. (2006). Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature, 444(7121), 840-846.

2. McLaughlin, T., Abbasi, F., Cheal, K., Chu, J., Lamendola, C., & Reaven, G. (2003). Use of metabolic markers to identify overweight individuals who are insulin resistant. Annals of Internal Medicine, 139(10), 802-809.

3. Harris, R. B. S. (2000). Leptin—much more than a satiety signal. Annual Review of Nutrition, 20(1), 45-75.

4. Epel, E. S., McEwen, B., Seeman, T., Matthews, K., Castellazzo, G., Brownell, K. D., ... & Ickovics, J. R. (2000). Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosomatic Medicine, 62(5), 623-632.

5. Traish, A.M. (2014) Testosteron and weight loss: the evidence. Curr Opin Endocrinol Diabetes Obes. 21(5):313-322

6. Patel, S. R., & Hu, F. B. (2008). Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring). 16(3):643-53

7. Spiegel, K., Leproult, R., & Van Cauter, E. (1999). Impact of sleep debt on metabolic and endocrine function. The Lancet, 354(9188), 1435-1439.

8. Spiegel, K., Leproult, R., Van Cauter, E. (2005). Impact of sleep on the endocrine system, glucose regulation and diabetes mellitus. The European Journal of Clinical Investigation, 35(8), 30-38.