You are eating right and working out like never before and yet you still can't lose weight. It feels impossible — not to mention highly frustrating.
When you feel like you're making all the right weight-loss moves but aren't shedding pounds, here are a few factors that could be causing the impasse.
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1. A Medical Condition, Hormones or Meds May Be to Blame
Your inability to lose weight may be partly caused by a condition or medication. Having an underactive thyroid, polycystic ovarian syndrome or Cushing syndrome (having too much cortisol, a stress hormone, in the body) may be keeping the pounds from coming off, according to the National Institutes of Health (NIH).
"Whether you have one of these medical conditions or not, hormones drive all our body processes, and this is regulated by our genes," says Diane Norwood, MS, RDN, CDCES. Hormones are a major factor in weight, too. "Hormones affect our weight by influencing our hunger, fat storage and many other things," Norwood says.
When you're under consistent stress, your body releases cortisol, epinephrine and norepinephrine, explains Theresa Gentile, RD and owner of Full Plate Nutrition. "When these hormones remain high, the constant stimulation of fat and carb metabolism for fast energy end in an increase in appetite, causing weight gain," Gentile says. Typically, she says, this weight is deposited in the abdominal area.
If you are on seizure medication, antidepressants or corticosteroids, you may also have a tough time losing weight, according to the NIH.
It's not impossible to lose weight if any of these medical reasons apply to you, but it is worth a having a conversation with your doctor about realistic weight-loss goals and how to reach them.
2. Your Body Composition May Have Changed
If you are working out and have put on muscle, you may not be losing weight, but you're not gaining it either. It can take several weeks into a new workout routine for weight loss to occur.
The good news is that as you gain muscle, you will start burning more calories and you should see that weight come off. Building lean muscle mass increases your metabolic rate, aka the amount of calories you burn, according to an April 2016 study in the International Journal of Exercise Science.
In contrast, as you get older, you lose lean body mass — i.e. muscle — and it's harder to lose weight. The research also mentioned that the largest contributor to a decreased metabolic rate is the loss of muscle. So, if it's been a few years since you focused on building muscle, your metabolic rate may be lower than you thought.
And you may need to shift your calorie intake more than you think. As your body composition changes, so too do your caloric requirements, says Lisa Young, PhD, RD. "Losing lean body mass (especially as we age) can also slow down metabolism, making it more difficult to lose weight. People get used to eating a certain amount, but as they age they need to eat fewer calories," Young says.
3. You're Eating More Than You Think
Have you ever heard of portion distortion? This may be a reason for your body to be resistant to weight loss. You may be eating, or drinking, more than you think.
It's common for restaurants to serve up super-sized portions. And even at home, there might be a tendency to overeat because it's homemade, and homemade is better, right? Researchers found that individuals may underestimate calories in a food if the portion size seems small, per a January 2020 study in Appetite.
You also may be drinking too many calories. Sugar-sweetened beverages — soda, juice, energy drinks, sports drinks and teas — are the largest source of added sugars in the typical diet, according to a February 2018 review in Obesity Facts. All of this sugar has the potential to sabotage your weight-loss efforts.
4. You're Not Eating Enough
No, this is not a drill — this can actually happen. Most of the weight-loss advice you'll hear from nutrition experts is that you need to cut calories to lose weight, but it is possible to cut too many.
Here's why that's a problem: "When you eat very low calories for a long period of time your metabolism will go into 'starvation' mode. The body is not sure when the next meal will come, so it overall slows down and holds on to any fat as a protective mechanism," explains Christina Lombardi, RD and owner of Functional Nutrition Rx.
Plus, drastically cutting your calories can cause an increase in appetite, and it naturally lowers your metabolic rate to conserve energy, according to September 2017 research in Perspectives on Psychological Science. Both of these factors can keep you from losing weight.
If you've nixed too many calories from your diet, an adjustment will get you back on track. By eating the right mix of proteins, carbs and fats, your metabolism will increase and you'll likely begin to lose weight, Lombardi says.
5. The Quality of Your Diet Is Lacking
The quality versus quantity debates applies to many things, and food is right up there. A healthy diet pattern that focuses on the quality of nutrients may be more important than a focus on individual nutrients, according to an August 2019 article in the Journal of Clinical Investigation.
This means cutting out the ultra-processed foods and focusing on fruits, vegetables, lean proteins, whole grains, dairy, nuts and beans. Instead of getting too caught up in how much protein you're getting in a day, focus on following an overall healthy diet pattern, such as the Mediterranean diet or the DASH diet.
6. You're Low on Sleep
By now, you know that the recommendation for sleep is 7 to 8 hours each night. But routinely getting less than that can have some serious implications on your weight.
Getting too little sleep over time is linked with an increase in total caloric intake and the number of meals eaten during the day, and a decrease in physical activity, according to a June 2014 review published in the International Review of Psychiatry.
"Inadequate sleep or poor quality sleep can disrupt our hunger and satiety hormones," points out Vandana Sheth, RD, certified diabetes educator. "When we don't get enough sleep, ghrelin, our hunger hormone, is amped up and you may experience more hunger. This can lead to eating more and negatively affect your weight-loss goals."
If you're finding that the numbers on the scale won't budge, think about the amount — and quality — of sleep you get each night.
7. Yo-Yo Dieting Is in Your Past
Science has not yet determined if a history of yo-yo dieting, or weight cycling, can make it more challenging to lose weight, but it might, according to an October 2016 review in Obesity Research and Clinical Practice.
The theory that past weight cycling leads to difficulty in losing weight now applies to people whose weight is in the normal or healthy range who are still aiming to drop some pounds. While these people may lose weight quickly, they'll lose not only fat mass, but also lean muscle.
They also may gain back more fat than was originally lost, according to a February 2015 review in Obesity Reviews. This additional weight gain from fat and the loss of muscle mass can make it harder to lose weight, because remember — your metabolic rate decreases as you gain body fat.
What to Do if You Can't Lose Weight
If you have exhausted all of your options and you just can't figure out why the weight won't come off, have a conversation with your primary health care provider.
Your health care team may be able to help you crack the code on weight loss and refer you to a registered dietitian who will do a thorough analysis of your diet, lifestyle and medical conditions and give you a personalized plan to get you on the path to losing weight.
- National Institutes of Health: "What Causes Obesity & Overweight?"
- International Journal of Exercise Science: "Increasing Lean Mass and Strength: A Comparison of High Frequency Strength Training to Lower Frequency Strength Training"
- Perspectives in Psychological Science: "Reducing Calorie Intake May Not Help You Lose Body Weight"
- The Journal of Clinical Investigation: "Does Diet Quality or Nutrient Quantity Contribute More to Health?"
- International Review of Psychiatry: "Sleep, Obesity, and Weight Loss in Adults: Is There a Rationale for Providing Sleep Interventions in the Treatment of Obesity?
- Obesity Reviews: "How Dieting Makes the Lean Fatter: From a Perspective of Body Composition Autoregulation Through Adipostats and Proteinstats Awaiting Discovery"
- Obesity Facts: "Sugar-Sweetened Beverages and Weight Gain in Children and Adults: A Systematic Review from 2013 to 2015 and a Comparison with Previous Studies"
- Obesity Research and Clinical Practice: "Does Weight Cycling Promote Obesity and Metabolic Risk Factors?"
- Appetite: "Mixed messages: Assessing Interactions Between Portion-Size and Energy-Density Perceptions in Different Weight and Sex Groups"