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When it comes to obesity, do calories count?

Last Modified: July 27, 2022

Family Medicine, Diseases & Disorders

weight loss dr davault

The battle to lose weight can seem endless. If you’ve tried to drop pounds strictly by exercising or forcing yourself to eat food you don’t enjoy, chances are you’ve been unhappy with your results. For help on the matter, we turn to Brian Davault, MD, PPG – Family Medicine. Read on as he discusses how to adjust your approach to weight loss and shares some strategies for long-term success. 

Losing weight can be a difficult process. Many patients I speak with have tried various approaches, but the pounds frequently return soon after they’re lost. This can be very frustrating and disheartening. As a family medicine physician also board-certified in obesity medicine, I want to help shed some light on the situation. 

Benefits to your health

First, why should someone work to lose weight? Obesity is a disease that can damage your health, and from a medical perspective, shedding extra pounds can help you get to a healthy weight for your frame. We typically measure obesity by looking at an individual’s body mass index (BMI), or the measure of their weight in relation to their height. A BMI over 30 can indicate obesity.

Generally, the higher a person’s BMI, the greater their risk for some of the adverse health effects caused by obesity, including high blood pressure, high cholesterol, liver inflammation (and eventually cirrhosis, or liver failure), arthritis and multiple types of cancer. For that reason, my goal as a physician is to help my patients get to a healthy weight through a combination of lifestyle changes and medical assistance (as needed). 

Calories in, calories out

How the human body regulates its weight is a very complex process that still isn’t fully understood. There are many chemicals and hormones involved in helping the body control its weight. At its core, the weight regulation process is about energy usage and storage. Calories in food that we eat get converted to energy for the body to use through daily processes and physical activity.  

Extra “fuel” from unused calories gets stored as adipose tissue or “fat.” This will cause an increase in body weight. If there isn’t enough energy stored to meet demands, the body will use energy stored in the adipose tissue, which causes a decrease in body weight. 

Because the “calories in, calories out” balancing act is so central to weight regulation, it’s often helpful to count calories when trying to lose weight. Calorie counting is based on the principle that weight loss should occur if your body has fewer available calories than it is using. I say “should” because there are times when this doesn’t happen – much to the frustration of the person trying to slim down.

One reason could be that their estimated calories per day, which you can calculate with a calorie-tracking app, are not precisely what that person’s body needs each day. Another possible reason could be that the body is trying to maintain its current weight and is using fewer calories each day than it should. You see, the human body stores as much energy as possible to prepare for instances when food is unavailable. This means some chemical processes within your body often work to prevent losing excess body weight.  

Permanent lifestyle changes vs. temporary diet

You’ve likely heard the term “lifestyle changes” relative to losing weight. We use that phrase because whatever dietary pattern someone uses to lose weight must be continued to sustain the weight loss.  

If your calorie intake returns to what it was before weight loss, the weight is likely to return. After losing weight, your body needs fewer calories than before, so it can store energy in adipose tissue if it gets the same number of calories that it got before losing that excess body weight.

We encourage lifestyle changes instead of a “diet” because a diet is usually a temporary eating pattern used specifically to lose weight in the short term. However, to keep the pounds from returning, it’s important to continue those dietary changes for the rest of a person’s life. 

Because changes need to be realistic and sustainable, when counting calories, I recommend that the foods and the amounts eaten do not frustrate the person or make them miserable. If this is the case, it becomes much harder to maintain those healthy habits long-term. 

The role exercise plays in weight loss

Many people think physical activity is an essential part of weight loss. While physical activity is excellent for overall mental and physical health, it is not as important to weight loss as many believe. Physical activity does play a role, but a person’s food intake is much more crucial. For example, losing one pound would require someone to consume 500 calories less per day for one week or run a marathon (26.2 miles). This example helps illustrate why many people become frustrated when trying to lose weight through exercise alone. Without reducing the number of calories you’re taking in, it takes a lot of activity to burn sufficient calories for weight loss. 

Asking for help

When people have tried changing their diets and increasing their physical activity, but there’s been no sustained weight loss, they feel frustrated that they aren’t making progress despite significant efforts. Fortunately, there are steps you can take and resources you can use if you struggle with losing weight. Seeking assistance from a medical provider familiar with obesity medicine can help, especially when medications, additional advice, and/or counseling may be beneficial. If the main issue is finding ways to stay under the daily calorie goal, then meeting with a registered dietitian can be very helpful. 

Remember, obesity is a disease, and your physician can be an ally in fighting it. Numerous resources are available to help you reach your goals and obtain a healthy weight. Don’t give up!

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