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  • Nachida Hamidi-Sitouah MD

Understanding The Why

Updated: Aug 23, 2019

Why is losing weight challenging?

Weight loss is not as simple as “eating less and moving more”.

Obesity is a disease with abnormal body chemistry and hormonal imbalance.

We live in a toxic environment where it is much easier to eat unhealthy and stay inactive.

How do hormones affect my weight?

Weight is controlled and regulated by hormones, among them are:

Ghrelin: Increases hunger and eating.

Leptin: decreases appetite and increases satiety and fullness.

Sleep, stress, the type of food you eat and how you eat it, weight loss and how you lose it and many other things can affect the levels of these hormones and your weight.

Why most people who lose weight gain it back?

Your body seeks to return to its heaviest weight after weight loss is achieved.

What is Set-Point body weight?

You have a set-point body weight; usually this is your heaviest weight.

That information is engraved in your brain and the cells in your body.

When you lose weight, your body believes it is STARVING and wants to return to that set-point.

The set-point can increase with highly processed and calorie dense foods.

What happens to my body when I lose weight?

As body weight decreases, the hormones that bring the body weight down (Leptin and others) decrease.

At the same time, Ghrelin goes up, and stays higher than before even if you gain back the weight you lost.

How do the numbers look?

With 14% body weight loss, Leptin goes down by 65%, causing you to gain weight

With 17% body weight loss, Ghrelin goes down by 24%.

What does this mean for me?

After weight loss, your appetite goes up and your metabolism (basal metabolic rate: how many calories your body burns naturally) goes down.

If you lose 10% body weight, it will take 300-400 fewer calories per day to maintain the same body weight as somebody who hasn’t lost 10% of their weight. (All of that while feeling hungrier than before). This usually persists for 6 months to 7 years.


Weight loss is difficult for most patients, and once it is achieved, keeping it off is much harder. It is a battle against one’s own biology.

For Weight loss: Guidelines advise to participate for 6 or more months in a comprehensive lifestyle education program with 14 or more sessions.

For Weight maintenance: Guidelines recommend to participate in a long-term (> or =1 year) comprehensive weight loss maintenance program with monthly or more frequent contact to improve successful weight maintenance.

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