As I said in my last blog, weight gain of 2 – 5kg is common in perimenopause. There are no end of diets out there that can aid in weight loss – ketogenic, low fat, Mediterranean, intermittent fasting, time restricted eating. They all work for some BUT the holy grail for nutrition researchers is how to keep the damn weight off.
We know the main reasons for putting weight on include a sedentary lifestyle and not enough exercise, not eating enough protein, eating too much junk, not sleeping enough, chronic stress and an unhealthy gut microbiome. Add a few unbalanced hormones and you have the perfect storm.
Unfortunately, our body’s physiology is all about protecting us and regulating our body weight. As a result we have a ‘set point’ of healthy weight. When we restrict energy (by eating less calories) our body adapts and tries to find a balance. It doesn’t want us to starve because it loves us. Bless!
Researchers believe that it’s an increased drive to eat that may contribute to both weight plateaus and weight gain. The body basically fights back and will do whatever it takes to stop us losing weight and overtime, constant dieting can actually make it harder to keep weight off.
An analysis of 29 studies showed that more than half of the lost weight in study participants was regained within 2 years and after 5 years 80% of the weight lost was regained (1)
Those of us that have ever been on a diet and regained the weight know that it is easy to feel guilty that we somehow lacked willpower or motivation or that we didn’t diet properly. This isn’t true.
Our ‘set point’ is the sweet point where energy expenditure and hunger meet. There is growing evidence that obesity is a disorder of energy balance and that the set point for obese individuals is reset at a higher level (2).
During times of weight loss, the body fights to maintain this higher set point by increasing hunger and reducing energy expenditure in response to higher energy demands (e.g. exercise) or reduced energy intake (e.g. dieting).
This would explain why putting weight back on having been on a diet is so common. So lowering that set point is one of the keys to weight loss.
Another problem is resistance to a hormone called Leptin, which is a powerful hormone that is responsible for our satiety (feeling full). It appears that obesity increases leptin. (3) Leptin resistance then occurs whereby the body is pumping out leptin telling us we don’t need to eat anymore but the body ignores it (as an aside exposure to BPA may increase leptin resistance). (4)
We also live in what is known as an ‘obesogenic environment’ i.e. our society encourages overeating and we have been in energy excess mode for more than 5 decades. We are eating more of everything, portions and servings have increased, choices have increased, processed and quick foods have increased, access to junk foods have increased, we are scared to be hungry, we eat for emotional reasons rather than because we are truly hungry and many of us live on snack foods rather than whole foods.
Our brain releases dopamine when we eat for emotional reasons and that gives us pleasure and becomes addictive. Fat, carbohydrates and protein all stimulate dopamine but combining high amounts of fat and refined carbohydrate together is worse. (5)
So we are fighting a hard battle. We can’t overcome our biology but we can certainly make things easier.
Here are some tips:
Eating moderate amounts of protein
Eating enough protein (25-30g per meal) increases our satiety and thereby reduces calories from fats and carbohydrates. Protein also increases heat in the body which helps to burn energy and helps alter that ‘set point’.
Restricting carbohydrate OR fat and Low palatability
Research suggests that restricting either fat OR carbohydrate can increase weight loss and help reset that ‘set point’.
Hyperpalalatable foods (foods that basically taste yummy) such as foods containing processed carbohydrates, lots of fat, salts and flavour enhancers increase dopamine which stimulates the reward and pleasure system and reinforces food addiction. Whole foods, veggies and fruit are considered to be low palatable foods and that’s what we should be eating.
When we reduce our calories, energy expenditure is also reduced as the body tries to defend its set point. A study (known as the MATADOR study) (6) assessed the impact of diet breaks. What they found was that structured breaks were shown to be effective at stopping this response. They also found that weight and fat loss was greater than when people just followed a steady diet. What that means in practice is a form of intermittent fasting except that participants dieted for 2 weeks and then ate normally for 2 weeks.
Poor sleep quality affects weight regulation by increasing our appetite hormone (grehlin) and reducing our satiety hormone (leptin). It also reduces insulin sensitivity and decreases melatonin which in turn decreases metabolism. So ensuring a good quality sleep of between 8-10 hours is recommended.
Exercise and movement also reduces the set point as well as increasing energy expenditure
An area of increasing research is that of the link between the gut microbiome and obesity. Healthy gut bacteria have been shown to influence glucose control, leptin, and energy storage. Studies in rats show that certain bacteria can influence cravings and create obesity.
Bifidobacterium animalis ssp. lactis B-420 ™ has been studied in both animals and humans and was shown to significantly improve fat mass, abdominal fat, waist circumference as well as general calorie consumption (7, 8, 9 ).
Being mindful of the reasons why you eat is also key. Research has also shown that monitoring your eating habits and slowing down can really help keep that weight off (10).
So in summary, the 8 keys to lowering the set point and keeping the weight off are:
- Eating enough protein
- Either restricting carbohydrate OR fat but not both
- Eating low palatable foods
- Diet breaks
- Adequate sleep
- A healthy gut microbiome
- Be aware of your environment and your relationship with food.