We’ve said it before, and we’ll say it again: Weight loss is complicated. And the truth is that the medical industry still has a lot to learn about weight care.
But research has found that our bodies may have a set weight point affected by genetics and underlying biological processes. Plus, body composition—meaning how much lean muscle mass you have in relation to body fat—may also impact weight gain and loss, according to research published in 2021 in Current Biology. So you can see that the old “calories in versus calories out” advice is, well, old.
There’s a fresh, evidence-based perspective that sustainable weight care isn’t about deprivation diets or extreme fitness regimens. Obesity needs to be treated like the medical condition it is. Yes, what you eat and how much you move do matter. But the new thinking involves medical treatment and behavior change.
First, let’s touch on the term “behavior change.” Because—let’s be honest—it can sound condescending. It often implies that you need to cut calories drastically or ditch entire food groups. And that’s not the “change” goal here. Neither is doing a bunch of burpees or treadmill miles unless those are activities you enjoy.
But don’t take our word for it. Highlights from a review of weight loss studies published in the journal Nutrition found that “energy-restricted diets are not only ineffective in promoting long-term weight loss but also may predispose individuals to fat regain” and that “health and wellness coaching, and specifically nutritional coaching, is a promising strategy and potentially highly effective approach for weight loss in short-term, long-term maintenance, and healthy behavior change.”
How does coaching help with behavior change? Because it empowers you to determine your goals and take achievable, actionable steps to reach them—steps that are sustainable and make sense for you. (That’s key!) You make the decisions based on your unique needs, and you have a supportive ally along the way. And that’s what we mean when we say “behavior change.” You’re in the driver’s seat with each step rather than feeling stuck in a hard-to-change cycle (we’ll get to that later).
Proof that coaching-assisted behavior change works: In a review of 33 studies that involved coaching as a weight care strategy or obesity intervention, 87 percent of the papers showed a significant effect on weight loss.
In fact, a study of 186 people with overweight or obesity found that those in a 12-week, web-based nutritional coaching program with SMS reminders and weekly virtual meetings lost on average 9.3 pounds. In comparison, participants in a group that just focused on diet and exercise (with no coaching) lost on average 3.75 pounds.
The concept of behavior change is a cornerstone of weight care. But sometimes, our bodies do what they do despite our best efforts. As a result, losing weight and maintaining it aren’t easy tasks. And that’s why medication may also be needed.
Research has shown that our bodies may have a set weight point determined by age, genetics, hormones, and even environment. We can’t necessarily change this set weight point, but we can challenge it.
Another consideration is that fat tissue—something we all have and need a certain amount of—is highly adaptable (what scientists call “plastic”). The function and makeup of this tissue change based on your body’s energy and other resource needs, according to research published in the journal Cell. Both age and obesity can contribute to a loss of this plasticity, making fat tissue a contributor to disease processes like insulin resistance and other metabolic dysfunctions.
More research is needed to understand how fat tissue behaves when it’s less adaptable. Still, there’s evidence that it ultimately stops responding as effectively to your body’s needs. In the case of obesity, it can impair fat tissue’s important hormone signaling cues to the body and brain—and turn weight care into a fight against some of your own physiological processes.
The process of adaptive thermogenesis may also play a role in weight regain. After losing weight by restricting calories, your body learns to do more with less energy (food), according to research published in the journal Nutrition. This may be human evolution at work: Way, way back in hunting and gathering days, our bodies adapted to expect periods of feast and famine. So even today, when your body senses a famine, it’s hardwired to shift into calorie-conservation mode.
We might be stuck with our biology, but modern medicine is finding ways to disrupt these physiological processes. For example, in a clinical trial of the weight-loss drug Wegovy (semaglutide) published in the New England Journal of Medicine, participants receiving Wegovy lost, on average, 14.9% of their body weight over 68 weeks. That was around 12.4% more than those in the placebo group. Wegovy, a glucagon-like peptide-1 (GLP-1), mimics a natural hormone in the body that helps regulate appetite.
It’s clear that behavior change helps with weight care—ditto medication. But the best approach may be using both tools. Research shows that when combined, these two interventions are likely more effective than one without the other.
For example, one study published in JAMA Network Open split 200 people into two groups. One group took weight-loss medication and went through a weight-loss management program; the other only did the program. At the end of the 12-month study, 62.5% of those in the medication-management group saw at least a 5% body-weight reduction, compared to 44.8% of participants in the program-only group.
Pairing weight-loss medication with behavior change by working with your coach can be the key to successful weight loss. Medication can help combat some of the physiological processes that cause your body to hold onto weight or regain it after you lose it—which makes weight care feel defeating. Leaning on your coach can empower you to take realistic steps that work for your body and lifestyle, so you achieve your goals.
Access to GLP-1s prescriptions is now available as part of Found's weight-loss program. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate or affordable for you, Found providers can help determine if another effective medication is.
Found is among the largest medically-supported weight care clinics in the country, serving more than 200,000 members to date. To start your journey with Found, take our quiz.