WHY ISN’T MY PATIENT LOSING WEIGHT?

Jennifer Irvine explores some of the most common reasons your patients might be struggling to lose weight

Weight loss is a common goal for patients. It can be disheartening and upsetting when someone steps on the scales after a period of dieting and finds the number is the same or higher.

The truth is, there are a number of reasons that your patients may not be losing weight. Here I’ve set out some of the most common:

WATER RETENTION

Our weight fluctuates from day to day because our bodies are 50-65% water. The amount of water within these ranges varies daily in conjunction with how dehydrated we are, hormonal fluctuations, and how much sodium we consume, among other factors. Our weight may fluctuate up to 3kg a day depending on how much water we retain, which can be disheartening when we step on the scales.

We know that water retention is necessary to keep our bodies working properly, so you shouldn’t necessarily advise your patients to lose water weight. However, advising them to cut down on sodium (salt) and refined carbohydrates – leading causes of water retention, will benefit their overall health as well as alleviate some of the symptoms.

It can be disheartening and upsetting when someone steps on the scales after a period of dieting and finds the number is the same or higher

SLEEP

Most adults need seven to nine hours of sleep a night. If your patients are not getting enough sleep, their hormones may be out of balance. This can lead to an increased appetite, making it much harder for someone trying to achieve weight loss goals. Additionally, a lack of sleep can impact mood and patience. Your patient could be more likely to reach for comfort food instead of choosing healthier options. Advise patients to track their sleep with an activity tracker. A little extra insight could be helpful for them to understand their sleeping patterns.

SKIPPING MEALS

It may seem counterintuitive to your patients, but too few calories can be just as bad for weight loss as too many. It can be tempting for patients to try to speed up weight loss by eating very little, but our bodies need food to fuel our everyday lives. If you are constantly under-eating, your body can start holding onto more fat than normal to sustain those everyday tasks. It is important for your patients to understand that they need to eat enough of the right foods to hit their goals.

MULTITASKING DURING MEALS

Ask your patients not just what they are eating, but where they are eating. We all lead busy lives and eat our meals on the go or at our desks from time to time. However, this can lead to distraction during eating, and it’s possible that some patients may not even realise the amount of food they are consuming if this is the case, which could increase the number of calories they are taking in. Research shows that mindful eating can be hugely beneficial in aiding weight loss. Advise your patients to track where they eat as well as what they eat for a week. Just as with food logging, they may not realise how often they engage in bad habits.

HORMONE CHANGES

Mixed with hormonal changes caused by age, before, during and after menopause, oestrogen levels are decreased, causing the metabolism to slow, which makes it harder to lose weight. During this time, the body tends to start storing fat around the belly, and with a slower metabolism, this fat can be very hard to shift. This is also paired with the fact that we often lose muscle mass as we age, and muscles burn more calories than fat, making burning that hormonal fat even trickier. Ensuring that those experiencing perimenopause, menopause and post-menopause stay vigilant in their health and well-being practices – eating a healthy and portioncontrolled diet, and exercising often – can help to minimise additional fat stores and help to keep muscle mass up.

THEY HAVE A MEDICAL CONDITION

Sometimes weight gain, or difficulty in losing weight, can be down to a medical issue that your patient may or may not be aware of.

Hyperthyroidism is an issue that can often cause people to put on weight and can affect their metabolism and energy levels. Polycystic ovary syndrome (PCOS) is a condition in which the body finds it much harder to utilise insulin and therefore has to produce more. This insulin resistance can lead to weight gain, making PCOS symptoms even worse, as excess fat causes our body to produce more insulin, making the pattern difficult to break. Ensuring your patient continues to eat healthily is incredibly important for those struggling with PCOS, as weight may come off slower.

There are a number of other medical conditions that can hinder weight loss. Ensure your patient consults with their GP if they suspect they have a problem.

EXERCISING BUT NOT ALTERING DIET

We have all heard the phrase you can’t out exercise a bad diet. And it’s true. So, remind your patients that just because they may be exercising more doesn’t necessarily mean they can eat what they like. Of course, occasional treats are fine in moderation, but allowing ourselves ‘cheat meals’ on a regular basis will hinder weight loss progress.

CUTTING OUT ENTIRE FOOD GROUPS

Whether it’s cutting out foods containing gluten, wheat, dairy or sugar or banning carbs altogether, these days, there are a plethora of diets advocating that we eliminate certain food groups. But is dropping a whole food type – sometimes a whole food group – ever a good idea? Unless your patient has a specific intolerance or a medical reason to cut out a food group (such as coeliac disease), the answer is almost always no.

Cutting out entire food groups can deprive the body of essential nutrients it yearns for. Additionally, carbohydrates or fats tend to get cut first. While cutting out large food groups can dramatically cut calories and lead to weight loss, weight tends to return once such foods are reincorporated back into the diet. Also, if such products are cut out long-term, related deficiencies are a risk and may compromise health.

EATING TOO MUCH – EVEN OF THE RIGHT THINGS

It’s a common misconception that if we’re eating healthily, then there’s no limit to how much we can eat. The only way to actually get rid of fat and lose weight is through consuming fewer calories than you’re burning, i.e. being in a calorie deficit. Eating healthily within a deficit means your body is much healthier, your metabolism speeds up, and you’re less susceptible to diseases such as heart disease and type II diabetes.

Get your patients to review calories in vs calories out using a fitness tracker. This will help them further understand how many calories they need to consume to lose weight.

NOT PLANNING MEALS

Properly planned meals are vital for weight loss. Planning meals ahead means patients will be less likely to reach for a quick unhealthy fix while out and about or opt for a takeaway when at home. It’s also important that patients know the importance of portion control, as even healthy meals can lead to weight gain if too much is eaten.

If you encourage patients to plan portion-controlled meals, healthy and packed full of nutrients, they are much more likely to lose weight and fall into a healthy stride. Services like The Pure Package do all the meal planning and cooking for you, completely removing this stress. Discover more about us at www.jenniferirvine.org

JENNIFER IRVINE

Jennifer Irvine is a food entrepreneur, author, spokesperson, and founder of The Pure Package, which she launched in 2003, having recognised that those leading a busy modern life in London often found it impossible to source and prepare the best, nutritionally balanced food. Her unique concept has developed into an awardwinning business, and, in January 2013, she successfully launched The Pure Package’s sibling, Balance Box. Jennifer is also the creator and chair of The Wellness Awards, which she established in 2016, designed to honour and celebrate the British health and wellness industry.