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Why can’t I lose weight?: The science behind the non-obvious reasons

No matter the reason you seek to optimize your body’s health, we want to help you achieve physiologic and mental health. In our blog posts, we plan to cover the fundamentals of weight gain and obesity beyond what you already know. We believe that true beauty is within, and that nobody should be judged or stigmatized. If you are struggling with being overweight or obese, we are here to support you and provide you with the tools to create a healthy body in order to optimize your quality of life.  We recognize that health is a lifelong journey and we are here to hopefully assist you in achieving  sustainable positive change. 

Why is losing weight so hard? 

Countless  people have approached us with a story similar to the following:  

I have been dieting and exercising for months now. I lost some weight initially and without making any other changes, I gained the weight back. So I kept cutting and cutting my calorie intake. I am at 700 calories per day now, and I am still not seeing any weight loss. No one believes me. My doctors think I’m lying about my actual food intake, but I’m not. I am not lazy. What is going on? Why can’t I lose weight? 

If this story hits a nerve, we can help. We often think that reducing caloric intake will result in permanent weight loss, so we adjust our three macronutrients- carbohydrates, fats, and proteins- in order to meet the needs of whatever diet we are following (e.g., low-fat diet, low-carb diet, keto, etc.). Some of us achieve initial weight-loss that plateaus or leaves us feeling tired and cranky. Some of us return to our old eating habits after achieving that initial weight-loss goal. Some keep reducing our calorie intake, increasing calorie burn through exercise, and not only stop losing weight, but see weight gain. Why? Because our bodies are smart and will do whatever they need to do to survive during scarce conditions. When you drastically reduce your calorie intake, your body will essentially slow down. In more technical terms, your total energy expenditure will decrease. This means that your body will sacrifice using calories to maintain certain bodily functions (e.g., body temperature, blood pressure regulation) in order to keep you alive during a drastic caloric deficit. In other words, the calories you do take in are not going anywhere and prolonging this lifestyle can be detrimental.

So, what now? Just as the concept of running a marathon is simple (i.e., you put one foot in front of the other), so is the concept of creating a physiologically healthy body. Simple does not mean easy, but you most certainly can do this.

Obesity is often regarded as a disease that results in a variety of obesity-related conditions, including Type 2 diabetes, heart disease, stroke, and even certain types of cancer. While it is true that these conditions are related to obesity, we want you to think of obesity as a result of several metabolic issues that are going on in your body that can be reversed. Obesity is a complex metabolic disease affected by several factors and choices in your daily life. 

The solution to this complex metabolic disease is quite personalized for each individual. The same way not all treatment plans for any other diagnosis (diabetes, depression, high blood pressure, etc.) work uniformly for everyone. Our goal in this blog is to cover several different approaches to diet, exercise, physiologic changes (thyroid, menopause, etc.) , and lifestyle differences. 

There will be a lot of content as well on mindset, and its effect on living a healthy lifestyle and achieving weight loss. Sometimes simply thinking we are “going on a diet” is already limiting.  Simply the language of going on a diet assumes you will one day get off. Several studies have shown most people have tried several different times to lose weight, and despite achieving success in the past gain this weight back. It is common , we have all done it, been for a ride on the weight rollercoaster. This is because, let’s be honest, our society is set up to cater to being unhealthy. It takes time, money, and effort to eat healthy and live a healthy lifestyle.  As healthcare providers, and personally, our goal with patients and with this blog will be to help achieve sustainable consistent weight loss that can be maintained through health for life.  We encourage you to not chase pounds and to not restrict/deprive yourself, this will be an adjustment, but a necessary one. Instead we encourage you as you embark on this journey to think more about what foods you are adding to your diet rather than subtracting. Think about what activities you are adding to your lifestyle, rather than the work you feel you have to put in as a chore. Food is medicine, and quite literally can heal in several ways, but we often develop an unhealthy relationship with food when starting a journey to weight loss in which we regard foods as something we “ cannot have”.  This typically leads to wanting those foods more, it's our classic teenager response. Tell ourselves we cannot have something , now it is more desirable. This is no way to live. This is often the mindset that leads to weight regain eventually. No matter the age, you want to be able to maintain these changes 20, 40, 60 years from now. You cannot do this if you spend life calories counting, restricting/depriving, and punishing yourself. This is stressful, and as we know from studies stress wrecks your gut microbiome and leads to weight gain due to many factors. 

The medical approach to weight loss is often based on personal responsibility. Most patients have recounted at some point in their life having a health care provider tell them something to the effect of: 

You just need to eat right and exercise. 

This is a huge oversimplification, and a statement we now know is less than a half truth. The treatment of obesity is similar to that of  many disease processes , as stated above, it is a complex, often individualized approach that is required.  This culture in medicine is starting to shift, and we are hoping to help this along. I often explain to patients that our society is quite literally addicted to processed sugar, and we have studies that these brain responses are similar to those of any other addiction (drugs, cigarettes , alcohol, etc.). This response is similar to telling an individual struggling from addiction to just give it up , and then have them walk out of your office and have their addiction for sale on every street corner for cheap. Oh, but not only is it really cheap,  your body knows it as what you need to survive. This is what we are up against from a societal perspective alone, in addition to  the challenges we face as individuals to live a healthy lifestyle. 

We will assist you through this blog with losing and maintaining weight through evidence based medicine, personal experience, patient care driven experiences, and mindset reminders. It may feel like you came to this blog, or to this weight loss journey to lose pounds, but this is not what we are all really chasing. We are all really chasing longevity with quality. To live a life to the fullest for however many years we can with our independence  intact. A whole body and mind healthy lifestyle will give you this, and we shall do our best to help you. 




Dr. Ezara Gutierrez: I am a primary care physician specializing in Family and Obesity Medicine who has a passion for helping patients feel their best and achieve health. I have a strong family history of heart disease and diabetes, and have been sparked by a curiosity to help my family, my patients, and myself maintain health. While working as a doctor admitting patients to the hospital, I realized one day that the majority of my patients were in the hospital from complications of diabetes regardless of the admitting diagnosis. This ignited a desire to help all patients access preventative medicine strategies that were realistic and could be maintained so these health issues would not occur. I have learned so much from my patients , and know that while weight is something we all concern ourselves with , we are all really chasing time. We all strive for more quality time in this life with our loved ones, and we can achieve this through full body wellness. I am eager to share these maintainable strategies here. 

Melissa Hernandez FNP-BC: I have been a family nurse practitioner for more than 15 years treating hormones for men and women for the majority of my career. As prepared as I was for the symptoms of difficulty sleeping, lack of energy, reduced mental focus and memory, that are typical of menopause, I was not prepared for the constant battle to maintain my weight. Since entering into my 50’s, it is a constant struggle with my body dynamics constantly shifting. Not only do I need to be concerned with abdominal (visceral) fat, but back fat as well. We all have seen them, those little bulges that creep up under our bra line. I eat a low carb, very low fat (only monounsaturated fat) diet, and yet it is a struggle for all my efforts to reflect on the scale. I work out 4 days a week without fail, and do manage to see a small difference in inches; but that dreaded scale.  Oh the struggles of a menopausal woman! I am excited to impart the wisdom I have learned for myself and patients. 

Maja Beganovic PharmD, MPH:  I am a pharmacist and public health professional with a background in epidemiology with a passion for translating scientific research to optimize patient care. This passion stems both from my professional and personal background. I have been living with Type 1 diabetes since 1996, and have extensive knowledge on the topic as I battled all aspects of it from maintaining and losing control to complete burnout and decision fatigue. Not until I started studying the power of mindset have I come to terms with my lifelong partner and learned to live with it even when we don’t get along. More recently, I was also diagnosed with Hashimoto's. My best friend said autoimmune diseases come in two. Hopefully, I met my quota. I now have intimate knowledge of the frustration that comes with Hashimoto’s (autoimmune thyroiditis). I am excited to share my knowledge and hope to help as many patients as possible.


Dr. Ezara Gutierrez , Melissa Hernandez APRN FNP-BC, Maja Beganovic PharmD, MPH Chasing time with wellness alongside your favorite trio!