On paper, it seems like weight loss should be so simple: Calories in through food; calories out through activity. It doesn't take a Ph.D. in nutrition or exercise science to understand this basic equation—and for some people, weight loss follows this tried-and-true path. But many dieters find themselves hitting a wall, unable to achieve their weight-loss goals through this strategy, and research increasingly shows that a one-size-fits-all approach may set us up for failure.
As seasoned professionals, registered dietitian nutritionists (RDNs) have an arsenal of info at the ready to use as starting points for clients, regardless of their individual weight journey. But when these approaches don't achieve the desired results, they can also help clients explore other avenues. We spoke with several nutrition pros to get the lowdown—what general advice works for most people, and which factors might be standing in the way of weight loss? Faced with these obstacles, how do dietitians tailor their advice to the individual?
Weight-Loss Tips for (Nearly) Everyone
Many dietitians begin by asking clients to access the organ with the most powerful effect on weight: the brain. "I always ask my clients to monitor their food intake by keeping a food journal," says Karolin Saweres, RDN, LD. "I often find that my clients are not aware of how many meals, snacks, nibbles, or handfuls of food they eat each day." Becoming aware of our actual intake may initially be an uncomfortable surprise but can lead to more mindful eating throughout the day.
Jenifer Tharani, MS, RD, also encourages mindful eating as a general strategy. Eating slowly, bringing attention to flavors and textures of foods, and checking in frequently for fullness all promote a feeling of satiation—even when cutting back on portion sizes. "I ask patients during follow-up weight management sessions whether they felt satisfied with eating smaller portions, and they always say yes," she says.
Tharani also educates clients on reading nutrition facts labels, not skipping breakfast, and choosing complex carbs like whole grains and vegetables instead of simple ones like refined grains and sugary beverages.
Focus on protein and fiber.
Others RDNs emphasize a focus on individual nutrients. "Oftentimes, the first place I start is to help someone get adequate protein throughout the day," says Megan Ostler, MS, RDN. "This can help with appetite control. Second, I focus on fiber." In addition to curbing appetite, Ostler says fiber helps stabilize blood sugar and improve gastrointestinal health, important factors that can correlate with healthy weight. Combine good sources of fiber and protein with choices like beans, lentils, and certain grains, such as quinoa and oats.
But what's keeping on excess pounds—and what can you do about it?
"Getting into a calorie deficit can be more difficult than you might think," Ostler says. "Our bodies have a number of metabolic adaptations to keep us from losing weight. Gender, age, the microbiome, and genetics seem to each play a role."
While we can't control our gender or family background, achieving weight loss may simply be a matter of playing with (but not going too low in) daily calorie levels to find the sweet spot, since, according to Saweres, "Older adults usually require fewer calories to meet their needs—and even fewer calories to lose weight."
As for cultivating healthy gut flora, taking a daily probiotic and consuming fermented foods like yogurt, kefir, sauerkraut, and kimchi make for a weight loss-friendly microbiome.
Sleep better—and work on lowering stress levels.
When the scale won't budge, dietitians often take the focus off diet and exercise entirely, exploring issues of stress and sleep instead. "Both lack of sleep and high cortisol levels are associated with lower levels of leptin, a hormone that is key in energy metabolism, weight, and our hunger signals," says Jen Scheinman, RDN. "Individuals must tackle sleep and stress to succeed in weight loss."
Tharani agrees: "For some patients, I don't even talk about food, because food is not their main barrier to weight loss. Instead, stress and lack of self-care are what keeps them from losing weight." Tharani recommends practicing yoga and meditation to decompress. When stress levels are under control, restful sleep tends to follow.
Practicing healthy sleep hygiene can also aid the process. Try turning off electronics an hour before bedtime, developing a soothing bedtime routine, and going to sleep and waking at the same time each day.
Consider other health factors.
Health conditions (and the medications that treat them) also influence the body's ability to shed pounds through diet. "Some clients with chronic conditions such as heart disease, diabetes, or hypertension will need to be monitored and have their medications checked prior to starting any weight loss or exercise plans," Saweres says.
Certain meds may promote weight gain or adversely react with foods that are normally part of a healthy diet. Some blood thinners, for example, are infamous for requiring patients to limit foods that contain vitamin K—the nutrient found in leafy greens and other vegetables. If you suspect medications or health conditions are hampering your efforts, it's worth a discussion with your doctor or dietitian.
Use other means of measure.
When you've hit a weight-loss wall, it may be time to change your thinking. "For some, I recommend focusing on forms of measurement other than the scale, such as body composition changes, energy levels, performance, etc.," Ostler says. "I personally like to have people focus on establishing healthy behaviors that can improve many aspects of health, instead of just weight, which isn't always the best measure of health."
Take a look inside.
Finally, some of us may simply not be emotionally ready to take on a weight-loss journey. Hang-ups from our past, stress in our home or work environment, and other lifestyle or psychological issues may crop up as roadblocks on our journey. "It's not about the food," says Lauren Artise, RDN. "I've found that individual challenges and perceived barriers most often keep patients from reaching their health goals."
Before embarking on a weight-loss journey, do a bit of soul-searching. Time spent in mindful consideration may help you decide if can you fully commit to pursuing a healthy weight—whether or not a traditional path of diet and exercise can get you there.