Breaking The Weight Barrier: Set Point

Set PointHave you lost weight in the past only to regain all of it and perhaps a bit more?  You are not alone, most dieters regain their weight.  Our body has a genetically determined set point for weight it wants to maintain.  The Set Point for weight is an internal physiological system.  It involves hormones that work on the brain to regulate hunger and satiation.

The Physiological Feedback Loop

Leptin is a protein made by fat cells that signals the brain that the body is full.  Along with insulin, another hormone released when we eat, our body has a physiological mechanism for maintaining weight homeostasis or set point.  According to ObesityAction.org, we have a body fat thermostat that influences our appetite.  When weight goes up, more insulin and leptin are released, reducing appetite.  When weight goes down, insulin and leptin levels decrease, increasing appetite.  A gradual weight gain over time can raise the set point making it difficult to lose weight, especially when one feels constantly hungry.

In a WebMD interview with Robert Lustig, MD, a member of the Endocrine Society’s Obesity Task Force, he states that “Leptin is the way your fat cells tell your brain that your energy thermostat is set right”.   He goes on to say that with obesity, despite the high levels of leptin, the brain does not get the message to slow down eating.  He talks about the brain thinking it is in a “starvation mode” because it is not getting the leptin message:

 “The leptin is being made by the fat cells, the fat cells are trying to tell the brain, ‘Hey, I don’t need to eat so much,’ but the brain can’t get the signal. You feel hungrier and the reward doesn’t get extinguished. It only gets fostered, and so you eat more and you keep going and it becomes a vicious cycle. If your brain can’t see the leptin signal, you’re going to get obese.”

Lustig calls this “leptin resistance” and believes that it is caused by insulin resistance:  impaired ability for the body to recognize insulin.  He believes the best way to address insulin resistance is to not let insulin levels get high in the first place, by reducing sugar intake.

Resetting The Set Point

Dr George Blackburn, Associate Director of the Division of Nutrition at Harvard Medical School, discusses in his book, Breaking Through The Set Point:  How To Finally Lose The Weight You Want And Keep It Off, how to lower one’s set point.  Based on Set Point theory developed by Bennett and Gurin, Blackburn recommends a combination of physical activity and dietary changes.  He believes that people should lose weight gradually and maintain it for at least six months in order to reset their set point.  He has observed that rapid weight loss results in rapid weight gain.  He also observes that after someone has lost 10% of their weight, the body starts to conserve calories.  He has found that if someone can maintain the weight loss for six months, the set point will be reset and more weight can be lost if desired.

Looking At What Works

The National Weight Control Registry, a registry that tracks individuals who have lost 30 pounds or more and have kept it off for a year, lists common behavior patterns.  94% of these individuals increased their physical activity with 90% of them exercising for an hour on average a day.  98% have changed their eating habits eating a lower calorie, lower fat diet and 78% eat breakfast daily.  You can read more individual success stories here.

Making Sustainable Lifestyle Changes

Although dieting can get someone into that bikini quickly, I believe finding a broader purpose for losing weight is going to give more lasting motivation and sustainable results.  Excess weight tends to creep on over many years, so it should come off gradually – no more than a half pound or pound a week.  I believe the focus should be on getting healthy, not losing weight which connotes something negative about the process.  Personally, I believe in finding a daily exercise plan that can work throughout the seasons whether it’s walking outside, having personal equipment or videos, or going to the gym.  I believe in eating a diet high in fruits, vegetables, lean protein and no refined grains or processed food.  I believe it requires looking at habits and finding good substitutes for unhealthy habits.  I believe it’s making small permanent changes at a pace that seems natural and interesting.  I believe it starts with an attitude of curiosity and adventure, that ends with better health and satisfaction.

Barbara writes a biweekly blog to help inform and empower people to live healthy lives.  Please “share” her articles and “like” her facebook page to help spread the word

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