Weight Loss: A New Approach

How hard is it to lose weight? If you ask the 3.12 billion people globally diagnosed with obesity6, they will probably tell you very hard. They might even describe the years of ineffective methods that were never sustainable for their weight loss journeys. Weight loss is not a “one size fits all” approach, and typically incorporates facets within biological and psychological parameters.

Biological Aspects of Weight Loss

Obesity is defined by a measurement of body mass index (BMI) which is a weight to height calculation6. A flaw in BMI as a standard for body composition categories has been recognized by medical and wellness professionals over the past decade. BMI does not account for body fat percentage, skeletal muscle mass, total body water, or visceral fat4. Therefore, a reduction of BMI does not automatically mean a healthier physiology. However, reduction of total weight is the typical response to losing weight. Caloric deficits or caloric restriction (CR) has been the prescription for weight loss in those with elevated BMI. The body ingests less food which should be utilized by the body to convert to energy without storing more as fat. Pair this mentality with an exercise routine, and weight loss is effective3. The majority of the population will not do this incrementally, though, by intermittent fasting and developing moderate exercise routines. Undereating and overtraining can be a result of this mindset around weight loss. This mindset has been linked to injury, immune deficits, cardiovascular disruptions, endocrine imbalances resulting in reproductive issues, energy and sleep disturbances, and the development of osteoperosis3. In fact, a more positive trend in weight loss is showing to be effective with a conscientiousness of macronutrients (i.e., carbohydrate, fat, and protein ratio) and micronutrients (i.e., essential vitamins and minerals)5. In a metanalysis comparing various diets and macronutrient breakdowns, the ultimate factors to body composition change relied on 1) the roles of proteins, carbs, and fats in the individual gut microbiome and how the body used them efficiently; 2) selection of whole foods versus processed foods; 3) metabolic flexibility5.

Psychological Aspects of Weight Loss

Dopamine. This neurotransmitter and hormone is largely responsible for what we find pleasurable. It is a key neurotransmitter communicating in our motivation centers of the limbic system1. Eating something sweet? Dopamine is released. Enjoying a challenging workout? Dopamine is released. Dopamine production is also why we continue to eat that sweet treat or go back to that group fitness class. Think of dopamine as an opioid; when so much is released it continues to drive our behavior toward that “thing” that gave us pleasure—no matter the obstacle1. Weight loss needs to address the motivations and behaviors of the individual as much as the physiological aspects. Self-determination theory (SDT) is a theory of motivation in which intrinsically, or autonomously, choosing the motivator and actions toward that motivator are significantly more lasting than when motivators or actions are delegated2. Another motivational model attributed to weight loss strategies is the transtheoretical model for change (TM). TM states that individuals will not be motivated to change patterns of behavior without entering into the contemplation, preparation, and action stage of the change model2. With regards to weight loss, studies which implemented computer-tailored diet plans were not effective for body composition changes long-term due to the participants not autonomously choosing their diet structure or ready for that change in lifestyle as they thought upon the start of the study2. In conclusion, the psychological approach to weight loss shows it is most effective when we are ready to make lasting changes to our dietary and lifestyle habits, have the autonomous choices to create—with nutritional education—our dietary plan, and find pleasure in those foods and plan will it be a lasting effect.

Considerations for Your Weight Loss Journey 

1.     Decide if this is a temporary goal or a long-term change you are trying to make in your life. Is this to look good in a bathing suit in two weeks or to be able to take your grandkids to an amusement park in 20+ years? Goals that are only outcome-based will not elicit the same vision of wellness.

2.     Work with a medical professional to evaluate blood work relevant to micronutrient levels, glucose, insulin, leptin, thyroid, and food sensitivity. These might show biological obstacles to weight loss.

3.     Talk to a nutrition expert about foods and supplements which nourish the body and address micronutrient, macronutrient, and food sensitivity needs. Another consideration is to discuss detox protocols and cleanses to reset the gut microbiome.

4.     Find movement that releases dopamine over a “killer” workout. Be realistic with where you are in your fitness and make plans to increase strength to decrease body fat. Talking with an experienced personal trainer could provide a plan for this progress.

5.     Consider health and wellness coaching sessions to establish that vision of wellness and have accountability toward your actions.

References

1. Cleveland Clinic. (2022). Dopamine. ClevelandClinic.org. https://my.clevelandclinic.org/health/articles/22581-dopamine

2. Coumans, J. M. J., Bolman, C. A. W., Oenema, A., & Lechner, L. (2022). The effects of a web-based computer-tailored diet and physical activity intervention based on self-determination theory and motivational interviewing: A randomized controlled trial. Internet Interventions, 28(1), Article 100537. https://doi.org/10.1016/j.invent.2022.100537

3. Delemaris, I. (2014). Potential biological adverse effects of excessive exercise and overtraining among healthy individuals. Acta Medica Martiniana, 14(3), 5-12. 10.1515/acm-2015-0001

4. Gutin, I. (2018). In BMI we trust: Reframing the body mass index as a measure of health. Social Theory & Health, 16(3), 256-271. 10.1057/s41285-017-0055-0

5. Kim, J. Y. (2021). Optimal diet strategies for weight loss and weight maintenance. Journal of Obesity and Metabolic Syndrome, 30(1), 20-31. 10.7570/jomes20065

6. Ritchie, H., & Roser, M. (2017). Obesity. OurWorldInData.org. https://ourworldindata.org/obesity#:~:text=13%25%20of%20adults%20in%20the,of%20energy%20intake%20and%20expenditure.