As spring arrives, I notice a familiar change in clinic. People start thinking about summer, getting outside more and, inevitably, the conversation about weight starts to come up again. And let’s be honest, Wegovy is changing the conversation.
There is a huge amount of pressure around having a particular body for summer. We are surrounded by messages telling us that we need to lose weight, eat less, exercise more and somehow transform ourselves before the warmer weather arrives. But weight regulation is much more complicated than the diet or pharmaceutical industry would have us believe.
Calories do matter. The amount of energy we consume and use is part of the picture, but our bodies are not calculators simply adding up calories in and calories out. Your body is a living, adaptive system that is constantly responding to what is happening around you, including your food intake, stress levels, sleep, hormones, muscle mass, physical activity and energy availability.
Your body is constantly trying to keep you safe
One of the more useful ways to think about weight regulation is to imagine your body as having a regulated range. Your brain is constantly receiving information about what is happening inside and outside of your body, sensing things such as your food intake, stored body fat, hormones, and energy availability, as well as stress levels, temperature, and activity requirements. It uses this information to help regulate hunger, fullness, energy expenditure and movement. It will even drive how appealing food is to you.
I think of it more like a thermostat than a calculator. Your body is constantly making adjustments to keep you within a range that it considers safe for the environment you are living in.
That makes sense from an evolutionary perspective. If food suddenly became scarce, your body would not simply continue burning energy at the same rate and allow you to lose weight indefinitely. It would start making adjustments to conserve energy and encourage you to seek food.
This is one reason why aggressive calorie restriction can initially produce weight loss but becomes increasingly difficult to maintain. It’s also why in the long run you gain the weight back and some.
What happens when you drastically cut calories?
Imagine someone suddenly decides they are going to eat significantly less. Initially, they may lose weight, but the body doesn't necessarily respond by simply allowing that weight loss to continue indefinitely.
Hunger will usually increase, food thoughts can become more prominent (‘food noise’), energy can decrease and spontaneous movement can drop. You may find yourself sitting on the couch rather than getting up and moving around without really noticing that you are doing it. It might be as small as no longer tapping your foot to the background music. Your body is becoming more efficient with the energy that is available.
This is part of why so many people experience the familiar pattern of losing weight, reaching a plateau, becoming increasingly frustrated, returning to their previous eating pattern and then regaining the weight. For many people, they often eventually gain more weight than they originally lost.
We all know the cycle of yo yo dieting, and when it happens repeatedly, it can be very easy to conclude that the problem is a lack of willpower because that works with a billion dollar diet industry narrative, we’ve been sold as science.
Your body responds to the environment you give it
If your body is constantly receiving signals that energy is scarce, while at the same time you are stressed, sleeping poorly and not maintaining much muscle, you are creating a very different physiological environment from someone who is well rested, adequately nourished, physically active and metabolically healthy.
This is why I don't like approaching weight management simply by asking, "How little can can you get away with eating?" I would much rather ask, "How can I create an environment where your body can regulate your metabolic health well?"
That is a very different question, and it changes what we focus on.
Stress matters more than most people realise
Stress is one of the first things I want to explore when someone is struggling with weight. Chronic stress creates a different physiological environment and can influence cortisol and have an affect on appetite, food cravings, blood glucose and how much energy you have available for movement and meal preparation, and enjoying life.
There is also the practical side of stress. When you're exhausted and overwhelmed, you may have less capacity to plan meals, cook from scratch or think about what you are going to eat, so convenience food suddenly becomes much more attractive.
This isn't necessarily because you don't know what healthy food looks like. Sometimes you simply don't have the capacity to execute it.
That's why I don't always want to give someone another list of foods they should be avoiding. Sometimes the more useful question is, "What can we do to reduce the physiological load you're carrying?" That might mean looking at stress management, boundaries, workload, movement, sleep, or simply making food preparation easier.
Sleep is part of weight regulation too
Sleep is another piece of the puzzle that is too often overlooked. We know that poor sleep will affect hunger, cravings and food choices, and when you're tired, you may be more likely to seek out quick energy and highly rewarding foods while having less energy and motivation to prepare meals or exercise. What few realise is it’s not just the exhaustion that’s driving this response. It’s hormonal. Ghrelin, the hormone that actually increases your appetite is higher after a bad nights sleep. Your body is clinging to hope of more energy, and driving physiological mechanisms to make this happen. Nothing to do with will power. This is biology! This is survival.
If you're consistently sleeping poorly, telling yourself to eat less is in no way helpful, or going to work. If you're trying to improve metabolic health and manage your weight, sleep deserves to be part of the conversation.
Sometimes going to bed a little earlier is a more useful intervention than looking at YouTube clips of healthy meal prep strategies. And then you're exhausted the next day and can’t put those healthy meal prep ideas into practice anyway.
Muscle changes the conversation
When we talk about exercise and weight loss, the conversation often becomes focused on how many calories we can burn. But there is a much more useful question to ask: "Am I getting stronger?"
Strength training isn't simply about burning calories. It sends an important signal to your body that this muscle is useful and needs to be maintained.
And muscle is metabolically active tissue. If you want to focus on calorie burn, then muscle will continue to use up fuel (aka calories) well after the workout and even while you’re sleeping.
Exercise should never be thought of purely as a punishment for eating. I’ve heard that too many times in my years in clinic. Movement should be about much more than burning off food.
Walking, dancing, gardening, strength training, cardiovascular exercise and everyday movement all have important roles in metabolic health, but if we're talking specifically about having a metabolically healthy body, then preserving muscle, and getting stronger is ultimately the goal.
Are you eating enough protein?
Protein is another area we can’t overlook with clients who are trying to improve their metabolic health. We are all inundated with messaging about protein, and there is a reason. Protein helps with satiety, so we’re less likely to mindlessly snack, and it provides the amino acids needed to maintain and build that muscle we just determined is critical.
Rather than obsessing over calories, one of the first questions I might ask is, "Are you actually eating enough protein?" For many people, this means increasing their food intake, not reducing it, and making sure there is a good source of protein at breakfast, lunch and dinner. So often the kiwi dinner of meat and three vege is the first appearance of a decent serve of protein all day.
Eggs, Greek yoghurt, fish, chicken, meat, tofu, tempeh, legumes, and seeds can all form part of a balanced diet. The exact amount someone needs will depend on their individual circumstances, but the broader principle is simple: build satisfying meals rather than trying to make meals as small as possible.
What can you add rather than what can you remove?
This is probably one of my biggest differences from the traditional diet approach. I am much more interested in asking what we can add than creating a long list of things that need to be removed.
Can we add more vegetables, legumes, berries, wholegrains, nuts and seeds, herbs and spices? Can we increase the variety of plants and fibre in the diet while making meals more satisfying?
The more diverse the diet, the more opportunities we create to provide our gut microbiome with different types of fibre and plant compounds. This matters for metabolic health too, and it is another, big reason I don't want people to think about weight management purely in terms of restriction.
A diet built around a wide variety of whole plant foods can be incredibly nourishing while still supporting healthy weight regulation. It’s how we build a microbiome that lowers inflammation and is aligned with metabolic health
Fibre and plants support metabolic health
I know I sound like a broken record when I talk about eating lots of plants, but there is a reason I keep coming back to it.
Vegetables, fruit, legumes, wholegrains, nuts, seeds, herbs and spices provide fibre and a huge variety of plant compounds to feed different microorganisms. A diverse gut microbiome supports weight management by influencing how efficiently we extract energy from food, regulate appetite and maintain healthy blood glucose levels.
Beneficial bacteria also produce short-chain fatty acids, which help regulate inflammation, improve insulin sensitivity and support metabolic health. A greater diversity of gut bacteria is associated with a healthier metabolic profile and can help create an internal environment that supports sustainable weight loss.
Insulin is part of the conversation
Insulin is often portrayed as the villain in conversations about weight, but it is actually a very important hormone with an essential job. One of its roles is to help keep blood glucose within a safe range by helping glucose move into cells and by supporting the storage of energy.
Good metabolic health involves being able to respond appropriately to insulin and regulate blood glucose effectively. With that in mind, I am interested in improving insulin sensitivity rather than simply telling someone to eat fewer calories.
Regular physical activity, maintaining muscle, eating a fibre rich diet, getting enough protein, hydrating and supporting good sleep all impact insulin and form part of a broader approach to metabolic health.
Two people can eat similarly and have very different experiences
This is something I think gets missed in many conversations about weight. Two people can eat a broadly similar diet and have very different experiences with hunger, energy, blood glucose and weight.
That doesn't mean calories don't matter. It means that the human body is not a mathematical equation.
Hormones, sleep, stress, muscle mass, inflammation, medications, metabolic health, activity levels and individual physiology can all influence what happens after we eat. This is why personalised nutrition is so valuable.
Rather than assuming that the same diet should work for everyone, we need to look at what is actually happening in that person's body and life.
A different way to approach weight loss
If someone is doing all of these things and their weight remains stubbornly difficult to shift, the answer is seldom to make the diet more restrictive.
That's when I would want to look more deeply. Depending on the individual, this could include factors such as perimenopause, thyroid function, PMOS, insulin resistance, medications, sleep disorders, chronic stress or loss of muscle mass.
There may also be other aspects of health that need investigating. Sometimes the most important part of the process is identifying what is getting in the way.
Instead of asking, "Why can't I stick to my diet?", I would encourage you to ask, "What is my body responding to, and what can I change that will make healthy weight regulation easier?"
That might mean improving your sleep, finding better ways to manage stress, starting strength training, eating more protein, increasing the diversity of plants in your diet or looking at your blood glucose and metabolic health.
And if your weight remains difficult to shift despite making consistent changes, its time to investigate deeper.
The goal isn't to fight your body. The goal is to work with it.
Your summer health checklist
If you were looking for a quick fix to lose weight and that’s how you stumbled into this article, or you're heading into summer and feeling the pressure to suddenly lose weight, take a step back before you start another restrictive diet.
Instead, ask yourself:
How your sleep is going and how you are managing stress.
Are you eating protein at each meal?
Are you getting stronger?
Are you eating enough fibre and a good diversity of plants?
Are you moving regularly throughout the day?
Are your meals satisfying, or are you constantly trying to eat as little as possible?
And if your weight remains difficult to shift despite making consistent changes, ask whether there is something else that needs investigating.
These questions are much more useful than simply asking how many calories you can cut.
Listen to the podcast
This article accompanies Tracy's conversation on The Most FM, where she discusses why weight loss isn't as straightforward as "eat less and move more", and why stress, sleep, muscle, protein and plant diversity all deserve a place in the conversation.
Listen to the podcast: A Naturopathic Approach to Weight Loss and Why Calories Aren't the Whole Story
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