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Why is it so hard to maintain weight loss?

Last Modified: March 10, 2020

Family Medicine

Weight loss

This post was written by Jolynn Wann, NP, PPG – Weight Management & Bariatric Surgery.

Obesity is a disease, no different than diabetes, hypertension or depression. It’s very complex, involving several different hormones and variations of the disease.

The biology

When dealing with any weight loss, you are dealing with the individual’s metabolism. Metabolism is how your body converts your calories into energy. Ideally, the goal is to burn off that energy daily, but when that doesn’t happen, excessive energy is stored into fat cells for our body to use at a later time.

When someone loses a significant amount of weight, they can actually slow down their metabolism. At the higher weight, your metabolism was more comfortable and functioning in a “memory” mode for so long it knew exactly what to do. Our bodies have a set point, almost like a thermostat, and when we dip under that set point our bodies tell our brain that our weight is too low and we need to fire that engine back up. It fires up the ghrelin hormone, which tells our brain we are hungry and next thing we know we are eating our pounds back on.


For this, and so many other reasons, you are more likely to regain weight when you opt for a restrictive, rapid-loss diet. We are talking about a disease process here. It might feel like you gained this weight in a short amount of time, and I understand we live in an age when we need instant results, but weight loss and maintaining weight loss does not fit the “quick results” category.

The long game

Obesity can start as early as in the womb or during childhood, so some people have dealt with this disease for the entire life. It’s a long-term disease and requires long-term planning for change. Obesity is like any other disease process, and it can go in and out of the disease state at any time.

If you notice yourself struggling to maintain weight loss or find yourself yo-yo dieting, come back to the reality of the disease state. There is no shame or blame here. This is not meant to depress you. It’s very likely your condition isn’t even entirely your fault. Like any other disease process, there are medications to help combat these pesky hormones from resisting your life goals. Some patients can even explore bariatric surgery to help balance the metabolism and support long-term weight maintenance.

Consider making your goals a lifestyle rather than just “doing a diet”. When you’re talking about a lifestyle, you’re more likely to stick to your habits rather than think of them as short-term.

Frequently monitor your weight so you know when to make adjustments in your routines before your weight gets too far out of control. Try to incorporate 30-60 minutes of physical activity 5 days per week into your daily routine in the maintenance phase. Track your food and make sure you are getting plenty of sleep. Don’t forget to take time out for yourself. Stress hormones play a big part in our metabolism as well.

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