New Delhi:The conventional method used for losing weight for decades can be summed up in one simple formula: eating less and exercising more. This may sound simple enough, but anyone who has tried to lose weight knows that things are not as straightforward as they appear.
As Dr Pankaj Desai, Senior Consultant Obstetrician and Gynaecologist at Janani Maternity Hospital suggests, often don't consider the biological, hormonal and behavioural factors that influence body weight.
Obesity is more than a calorie problem
“Obesity is increasingly being treated as a chronic, multifactorial disease and not simply as a matter of eating too many calories,” says Dr. Desai.
The human body is not a passive calorie counter. Instead, it’s a highly flexible biological system that works constantly to maintain energy balance and fend off perceived threats to survival, he says.
This means that when calorie intake is significantly reduced, the body responds in ways that can make it harder to lose weight further.
The body's resistance to weight loss
A lot of people lose weight quickly when they first start dieting, but then plateau later on. This was not necessarily a sign of poor discipline, Dr Desai said.
“When you cut calories a lot, your body has a number of compensatory mechanisms that kick in,” he explains. “Resting metabolic rate may drop, energy expenditure becomes more efficient and hormones that stimulate hunger increase.”
At the same time, you may experience a drop in hormones that make you feel full, making it harder to stay in a calorie deficit long term.
“This physiological response can explain a common experience among people trying to lose weight: an initial period of success, then a plateau or eventual weight regain,” says Dr Desai.
Not all calories affect the body in the same way
And Dr Desai also challenges the popular notion that all calories are created equal. The old notion that “a calorie is a calorie” is a gross oversimplification of the metabolic impact of different foods, he says. He says diets high in refined carbohydrate, added sugar and ultra-processed food can cause rapid swings in blood sugar and insulin levels. This can cause increased hunger and overeating.
On the other hand, foods high in protein, fibre and healthy fats have been shown to increase satiety and help people feel full for longer.
Stress, sleep and emotions play an important role
Weight management is not just about what you eat. "Very often the emotional and behavioural factors are a major part of the equation," says Dr Desai.
‘Stress, emotions, lack of sleep, environment and habit tend to affect eating patterns,’ he adds.
Sleep, in particular, deserves special attention.
Dr Desai explains that “a lack of sleep affects hormones that control appetite, such as ghrelin and leptin, leading to greater hunger, more cravings and less energy expenditure.”
Stress, on the other hand, can hinder weight-loss efforts via its effects on hormonal mechanisms that regulate appetite and fat storage.
Obesity doesn’t mean you’re a failure. It’s not a lack of will power.
In modern medicine, obesity has been understood very differently over the years.
“Modern medicine is increasingly recognising that obesity is not just a failure of self-control, but rather the complex interaction between genetics, metabolism, neurohormonal regulation, behaviour, environment and lifestyle,” says Dr Desai.
This has resulted in health care professionals adopting a more holistic approach to treatment.
A modern approach to sustainable weight loss
“Nutrition, physical activity, behavioural modification, stress management and adequate sleep are the bedrock of healthy weight management, said Dr Desai.
Importantly, he emphasises that these treatments are not a quick fix.
“Instead, they are evidence-based interventions that complement lifestyle modification within a structured, multidisciplinary framework,” he says.
Dr Desai’s message is clear: to achieve sustainable weight loss, one needs to understand the body’s function better.
“The wider message is clear. You can not get sustainable weight loss from the simplistic advice of ‘just eat less’, he says.
Understanding the roles of biology, psychology, lifestyle and environment helps people to approach weight management with greater realism and compassion. The goal is not just to lose weight, but to develop sustainable habits that support health and wellbeing over the long term, experts say.
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