Weight Regain

Weight maintenance is a struggle for us all. While weight loss is difficult in its own right, keeping the weight off can be even harder. Often, when we regain some weight, we blame ourselves for a lack of control; however, as the science around obesity medicine continues to develop, it becomes more and more evident that reasons behind weight regain are not simple. While a decrease in adherence to a diet program may contribute to regain, the fact is, your body is fighting against you too. As disheartening as this sounds, it doesn't mean that we can't lose weight and keep it off; rather, it will require a conscious effort.
As you may know, earlier in April I attended a conference on obesity medicine with other members of our team. Throughout the conference weight regain was a recurring topic, focusing on why we regain weight and how we can keep it off. Frankly, the science is frustrating. Studies demonstrate that as we lose weight, our basal metabolic rate (the number of calories we burn in a day) decreases; unfortunately, this means that as we shed weight, our bodies require even fewer calories! The reasons behind this decrease are not fully understood; although, it likely originated as a protective mechanism against starvation. Thus, our body protects itself against weight loss, but it does not prioritize weight gain in the same way.
Hunger, and the light-headedness that can accompany low blood sugar, tells us that we need to eat something; however, we have no real physical symptoms to tell us not to eat, or resist eating in the maintenance phase. Furthermore even when we have lost weight, our body continues to fight against us. It automatically decreases the number of calories we need in a day. As a result, weight maintenance is just as challenging as weight loss.
While it is true that our bodies naturally fight us during weight loss and even after, there are strategies that we can employ to minimize weight regain. Most importantly, we need to prepare for "maintenance mode” from the beginning. It is important that we view the weight loss process not as a "quick-fix” diet, but as a lifestyle change. We are creating good habits that can and will last a lifetime. Does this mean that you are never going to have your favourite dessert again, or potato chips, or cake on your daughter's birthday? Of course not! But successful weight maintenance does demand selectivity. It means choosing which calories and treats are worth it to you; being more conscious of choices. Is a hamburger bun really worth the extra carbs, or would you rather save them for something special? To me, successful weight loss and maintenance requires planning, but it also requires that we celebrate our treats. Savour them. When slip-ups do happen, as they inevitably will, get back on the plan.
As always, my intention in writing this letter has been one of encouragement. Yes, weight loss is hard, and yes, weight maintenance is difficult in its own right. But understanding the commitment required is critical to success, as is the ability to cut yourself some slack if some regain does occur. You can do it. You will do it. Believe it.
Good luck, Dr. Doug