Why Do I Eat Less but Not Lose Weight?

Why Am I Eating Less but Not Losing Weight? Understanding the Factors

In my daily practice as an endocrinologist, I often encounter patients who report struggling to lose weight despite following strict and controlled diets. For many, the frustration of not seeing the desired results despite eating little can be disheartening. Firstly, it is essential to understand that the process of losing weight is influenced by a combination of factors, of which reducing food portions is only one aspect.

Hormonal responses play a crucial role in regulating body weight. Hormones such as insulin, leptin, and ghrelin perform important functions in modulating appetite, metabolism, and fat storage. 

A key factor is the basal metabolic rate (BMR), which is the number of calories the body burns at rest to maintain its vital functions. Genetics, age, sex, and body composition (distribution of muscles and fat) influence the basal metabolic rate of each individual.

When you eat less in an attempt to lose weight, the body may interpret this as a sign of food scarcity and react by reducing the basal metabolic rate. This can cause the body to conserve energy, making weight loss more difficult.

Additionally, very restrictive diets can lead to hormonal imbalances. For example, severe calorie restriction can result in low levels of leptin, a hormone that plays a crucial role in regulating appetite and metabolism. When leptin levels drop, the body may respond by increasing hunger and reducing energy expenditure, which can further hinder weight loss.

Psychological factors also play a crucial role in the weight loss process. Stress, inadequate sleep, anxiety, or depression can impact eating habits and the body's hormonal response, making the relationship between food intake and weight loss even more complex.

Another important point is food quality, assessed during a consultation with an endocrinologist and adjusted in conjunction with a nutritionist. Beyond the importance of reducing portion sizes, cutting daily calorie intake, making healthier and more nutritious food swaps, and increasing the intake of more satiating foods like fibers, vegetables, and lean proteins is essential for maintaining future weight after weight loss.

A comprehensive medical evaluation, considering individual factors, is essential to develop an effective and sustainable weight loss plan.