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Weight Care Is Complex. Here’s Why You Might Need a Medical Team to Succeed

Sarah Romotsky, RD

What you learn in your junior high health class makes weight care sound simple: Burn more calories than you eat. It sounds easier than algebra. All you have to do is balance the calorie equation, right? But in real life, maintaining a healthy weight isn’t so easy. Having a baby, working a demanding desk job, suffering an injury that limits you, or just getting older can make weight care complicated. Many of us start to feel shame as we gain weight: It’s just calories in, calories out, right? What am I doing wrong? If you’ve thought that, you’re not alone. Many people try over and over again, regaining weight after every attempt to lose it. Some people become reluctant to talk to their doctors or afraid to step on the scale.

The truth is that managing your weight isn’t a simple equation. Our bodies are bodies, after all, not calculators! Researchers are learning more about just how complicated weight is. Multiple factors influence it, and not all of them are easy to identify or manage on your own. Body weight is so complex that in 2013 the American Medical Association officially recognized obesity as a chronic, progressive disease that requires medical treatment (as the U.S. National Institutes of Health did years earlier). 

 

Some of the factors that influence your body weight include: 

 

  • Age: After age 30, our bodies start to change in ways that can change weight. Specifically, we begin to lose muscle mass, and our body fat percentage increases.  

  • Hormones: There are multiple ways hormones can influence body weight. Hormonal changes from pregnancy and menopause, problems with the hormones that control appetite and satiety, stress hormones, thyroid imbalances, and insulin resistance can all lead to weight gain. 

  • Genes: For some people, the genetic influence on body weight is as high as 80 percent. If you have a lot of family members who have struggled with weight, or you’ve struggled with weight since an early age, it’s likely genetic. There are over 400 genetic factors that influence body weight and 11 genetic abnormalities that cause obesity.

  • Prescription medications: Several drugs may trigger weight gain, including some steroid hormones, antidepressants, anti-seizure drugs, beta-blockers, hormone therapy drugs, diabetes medications, and antihistamines.

  • Diseases: Some diseases can cause people to gain weight, leading to obesity. Polycystic Ovary Syndrome (PCOS), Cushing’s syndrome, and depression are some of those conditions.

  • Environment: A community that has too many elements that contribute to weight gain and not enough that contribute to healthy activity and eating is known among scientific and public health professionals as an obesogenic environment. It may have a lot of fast food places and convenience stores and not enough grocery stores for fresh food (an area with a lack of grocery stores is also known as a “food desert”). It might lack sidewalks, public transportation, public parks and green spaces, or it may be a place where people don’t feel safe spending time outdoors. Areas with elevated air pollution and other types of contaminants can also cause weight issues.   

  • Sleep: Poor sleep has a significant impact on appetite and the way your body manages stress hormones, glucose, and energy. 

 

That’s a lot to take in! But don’t let this list overwhelm you. The big takeaways are that weight care isn’t simple and that you absolutely deserve professional help. You shouldn’t feel shame or guilt if you’ve inexplicably gained weight or if you haven’t been able to control your weight on your own. None of the factors that influence weight mean that health is out of reach, because we know many lifestyle interventions do work:

  • Healthy eating: Eating more fresh produce, lean proteins, complex carbs, and healthy fats can help you feel satisfied and fuel your body with high-quality nutrients.

  • Routine movement: Staying active does more than just burn some calories. Moving more will help manage stress, improve sleep, and maintain muscle mass as you age—all good strategies in a weight care plan.

  • Good sleep: Establishing good sleep hygiene, including a regular bed time, can have a significant impact on maintaining or reaching a healthy weight.

  • Reducing stress: Managing your stress through movement, sleep, meditation, and relaxing activities is an important part of weight care. 

 

Another benefit of all the research that’s being done around body weight is that scientists and care providers now know that the best approach is a combination of medical treatment, coaching, and social support. That includes:

  • Medication. In recent years the U.S. Food and Drug Administration approved several prescription drugs to treat chronic weight. They provide an effective method for long-term weight loss for those who qualify—specifically, people who have a body mass index (BMI) over 30, or a BMI over 27 with weight-related health conditions such as high blood pressure, diabetes or pre-diabetes, sleep apnea, or other conditions.  

  • Personalized coaching and support. A number of studies show that people who receive personalized coaching in a weight management program lose more weight than people who don’t get any coaching and maintain weight loss. A German study shows people who receive telecoaching for weight care also do better at improving their blood pressure, cholesterol, and A1C (a measure of blood sugar levels).

  • Community and social support. Sharing a health journey with people who have the same goal is proven to help people lose weight, and continued participation in peer groups may help people maintain weight loss long term. 

 

Found combines these strategies to offer effective weight care. On average, Found members have lost ten percent of their weight by month six and have kept it off. In total, members have lost nearly 300,000 pounds with Found in 2020 and 2021 combined.

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