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Weight Loss Questions & Answers #2

6) Why is weight loss so slow?

A usual medical and metabolic explanation is that for each pound of fat that is to be metabolized and consumed by the body, a calorie deficit of about 3,500 needs to occur. So if a person is in a stable metabolic state and eating 2000 calories a day, without any gain or loss of weight, and they decide to lose weight by reducing their calorie intake down by 500 calories to a daily intake of 1500 calories, then at the end of a week they will theoretically lose one (1) pound of fat. Since 500 calories X 7 days equals 3,500 calories, or one pound of fat. However, because some people may have a slightly higher or lower metabolic rate, their rate of weight loss may be faster or slower. But the concept is that it takes about a 3,500 calorie reduction to lose a pound of fat, and this takes some time to accomplish.

7) Why is it so hard to keep lost weight off, and weight regain usually happens?

There is usually a weight regain following a period of weight loss because of several 'counter regulatory' metabolic and hormonal changes which were developed through evolutionary adaptations to prevent starvation. Following weight loss, the hunger stimulating hormone Ghrelin increases to increase appetite; muscle efficiency increases to allow more movement with fewer calories; thyroid hormone secretion decreases to cause a reduction in Metabolic rate; Leptin levels decrease which signals the brain that the body's energy reserves are low and stimulates the brain to seek out and eat more food. In addition, individuals tend to return to their prior eating habits and social patterns of eating behaviors.

8) What is the best diet for weight loss?

The diet and eating plan that you follow and stay on. It does not really matter that much from which food groups the calories come from, what matters most is the amount of calories that you eat. While eating refined sugar laden snack and fast foods will cause you to crave more of those same foods, as opposed to protein rich foods (lean meats, fish, sea foods, poultry, nuts), it is the amount of calories not where they come from that matters the most.

9) Is sugar addicting?

No, refined sugar is not addicting, but it addictive-like. While it has the ability to stimulate certain areas of the brain and is associated with the neurotransmitter dopamine, it does not have the intensity of stimulation like truly addictive substances such as amphetamines, alcohol, nicotine, and opioids. Also, there are no classic withdrawal symptoms experienced when an individual stops eating or drinking refined sugar products.

10) Do most overweight individuals have a low metabolic rate?

This is often thought by many overweight individuals as their cause for weight gain. However, I believe that only about 5-8% of the overweight population suffer from a low metabolic rate or hypothyroidism. A simple blood test to measure the level of thyroid hormone can easily answer the question. While I doubt that a low thyroid level is the cause for weight gain in most individuals, I believe that every overweight person who wants to lose weight should have their levels tested and rule this out.


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Peter Vash MD, MPH

Internist / Endocrinologist

Specialty in Obesity Medicine

2080 Century Park E Suite 1511

Los Angeles

CA 90067


Monday to Friday 8 am to 4 pm

Tel: 310 553-0804

Copyright © 2018 Dr. Peter Vash MD. All rights reserved. Our content does not constitute a medical consultation. Call Dr. Vash MD for a medical diagnosis.

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