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I Lost Weight Before, Why Can’t I Now? Your Set Point


by Dr. Nancy Rahnama

Director of Health & Nurition

Most of us don’t just embark on a weight loss journey once in our lives - most of us will gain and lose weight around major life events, such as going to college, getting married, having a baby, or focusing on career development.

If you’ve lost weight after gaining it once before, you likely go into a serious attempt at losing weight with confidence. After all, you did it before, right?

But you start doing all the same things as last time, and you don’t see the same results. Why? Is it just that you’re older?

Why Willpower Alone Doesn’t Work

If you go to the average personal trainer and ask them about how you should go about losing weight, they’ll likely say something along the lines of, “it’s just calories in, versus calories out. Eat the right things and work out.”

And why there is truth in that idea, and it’s certainly not a bad place to start your weight loss journey, medical doctors have discovered that we have a biological “set weight.”

What is a set weight point?

Your set point or “set weight” is the weight your body wants to maintain. The set point is established by your biology, genetics, and environment, and is regulated via the brain through diet, sleep, and stress.

Is a set weight point the same thing as a plateau?

Yes, they often are. Most people find that the weight comes off relatively easily until they reach a certain point, at which the scale stops changing by more than a pound or two in either direction for weeks. Suddenly, you’re stuck at a certain weight.

Why can’t I lose weight?

This plateau effect occurs because your body is actively working against you to keep you at the same weight. It doesn’t understand that you’re losing weight to be more healthy, it worries that you’re going to starve. It has no concept of supermarkets or fast food, and so instead of allowing the weight to melt away, knowing food is easy to find, it does everything to hold on to what it perceives as a “safe” weight to be at. The set point weight is the weight it believes it needs to be at to perform optimally.

The body maintains this weight by slowing the metabolism so you burn fewer calories, increasing hunger hormones so you’re more likely to seek out food, and decreasing fullness hormones, so you’re more likely to overeat.

This is why willpower alone won’t keep you losing weight.

How much does genetics play a role in my set point weight?

There’s a lot in life we can do to change the way we look, regardless of what genetics gave us, but there’s no controlling whether you got your mother or father’s eye color, your grandmother’s thick hair, or your grandfather’s thin hair, and so on. Whether we like it or not, short of turning to plastic surgery or cosmetics, there’s nothing we can do to change these factors.

Similarly, your body is going to be predisposed to be a certain size and shape. There’s an old (and fortunately, outdated) saying that you should take a look at a potential partner’s same-sex parent before you marry them to find out what they’ll look like in thirty years’ time. And, while this idea is focused more on aesthetics than anyone wants a partner to be, there is a grain of truth in there. Your body will likely want to look like that of your parents, and this idea was backed up by a 2018 study.

Similarly, doctors ask whether diseases run in the family because, if it’s genetic, it may be passed down and if it’s environmental (like obesity), you may be more predisposed to it - often biologically, but it can simply be because we tend to develop the same habits as our family members.

 

So am I stuck at this weight for good?

Finally, I have some good news for you - you’re not stuck at this weight for good. It’s possible to ‘reset’ your set point. You can’t change your genetics, but you can change your environment, which can help you reach your goal weight.

 

 


Dr. Nancy Rahnama, MD, ABOM, ABIM, is a medical doctor board certified by both the American Board of Obesity Medicine and the American Board of Internal Medicine. Her specialty is Clinical Nutrition, that is, the use of nutrition by a medical doctor to diagnose and treat disease. Dr. Rahnama has helped thousands of people achieve their goals of weight loss, gut health, improved mood and sleep, and managing chronic disease. In addition to her private practice in Beverly Hills, she is also the co-founder and Director of Nutrition for Dr Nancy MD.

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