Weight Management

How many diets have you started so far? Most people cannot answer this question with a single number. Weight is lost, regained after a while, and often a few kilos are added on top. The problem is not the person’s willpower but the method itself: an eating pattern that cannot be sustained will not last, however quickly it produces results.

Weight management is a long-term process that covers losing weight, gaining it when needed and keeping the weight you have reached. On this page you will find the reasons that make weight loss hard, the principles of healthy weight loss, why crash diets backfire, the plateau, and what a lasting plan needs to rest on.

Why is weight management more than counting calories?

Energy balance lies at the root of body weight: if you take in more energy than you use, you gain weight; if less, you lose it. But many factors determine both sides of this equation. Hormones decide how hungry you get and when you feel full; and those hormones are affected by your sleep, your stress level, what your meals contain and your muscle mass. Two people following the same list will not get the same result, because their age, body composition, health and daily lives are different.

This is why weight management asks not only “how many calories” but also these questions: When do you get hungry during the day? At what times does control become difficult? How many hours do you sleep? Which diets have you tried before, and why did you stop? The answers show where the plan should begin.

Why can’t I lose weight? What makes the process harder

“I eat very little but I can’t lose weight” is the sentence heard most often in consultations. One or more of the following usually lies behind it:

• Calories that go unnoticed: Sweetened coffees, fruit juices, tastes taken while cooking, nuts eaten in front of a screen and weekend treats stay outside the daily count. Even a healthy food creates an energy surplus when eaten in large amounts.
• Too little protein and muscle loss: Muscle tissue uses energy even at rest. Diets that are low in protein and very low in calories cause muscle loss; the scales go down, but so does metabolism.
• Lack of sleep: Too little sleep raises the hunger hormone and lowers the fullness hormone. It is no coincidence that the craving for sweets and pastries increases after a sleepless night.
• Stress and emotional eating: If food has become the way to soothe anxiety or tiredness, no list will work on its own. We cover this on the eating behaviour and emotional eating page.
• Back-to-back restrictive diets: The body adapts to a prolonged energy deficit by cutting its expenditure. This is why losing weight gets progressively harder for people who have eaten very few calories for years.
• Inactivity: Exercising three days a week and spending the rest of the day sitting does not make up for movement spread through the day.
• Health conditions and medicines:Insulin resistance, an underactive thyroid, polycystic ovary syndrome and some medicines can make the process harder. These are diagnosed and treated by a doctor.
• Misleading scales: A salty dinner, the days before a period, constipation or the water retained after a hard workout can move the scales by a kilo or two. This is not an increase in fat.

What does healthy weight loss look like?

The aim of healthy weight loss is to reduce body fat while preserving muscle mass, energy levels and your relationship with food. This requires a moderate energy deficit, adequate protein, fibre-rich meals and regular movement.

The rate of weight loss varies from person to person. Starting weight, age, sex, muscle mass and health all determine it. In general, a slow and steady loss is both safer and more lasting than a rapid one. In the first weeks part of the drop on the scales is water; the pace slowing afterwards is to be expected and does not mean that the plan is not working.

Why do crash diets backfire?

Diets based on a single food, skipped meals or very low daily energy bring the scales down in a short time. But a considerable part of what is lost is water and muscle. The body responds to this hunger in several ways:

• Hunger hormones rise and the feeling of fullness weakens; thoughts of food begin to occupy the mind.
• Energy expenditure falls; you need to eat less than before to stay at the same weight.
• Muscle loss reduces energy expenditure at rest.
• Tiredness, hair loss, constipation, irregular periods and feeling cold easily may occur.
• Very rapid weight loss can increase the risk of gallstones.

When the diet ends, the person returns to their old pattern, but now with less muscle and a stronger appetite. The weight comes back, mostly as fat. This is the cycle popularly known as the yo-yo effect, and each time it repeats, losing weight becomes a little harder.

What does a lasting weight-loss plan rest on?

Energy and protein

The plan is built on an energy level that does not fall far below your needs and on enough protein to preserve your muscle mass. The aim is for every main meal to include a source of protein, plenty of vegetables and a moderate amount of whole grains or pulses.

Fitting daily life

A good plan is a plan that can be followed. If you work shifts, eat lunch out, cannot cook separate meals at home or travel often, the plan is written accordingly. The foods you love are not removed from the list; their portion and frequency are adjusted.

Flexibility

Invitations, holidays and busy periods at work are part of life. Talking in advance about what to do on those days prevents the thought “I’ve blown it, so it no longer matters”. A single meal does not ruin the process; what ruins it is abandoning the plan entirely after that meal.

Scales or tape measure? The scales do not tell the whole story

The scales show the total of fat, muscle, water and bowel contents; they cannot tell them apart. Someone who has started regular exercise may see no change on the scales while their waist gets smaller, because muscle has increased as fat has decreased. So when you track progress, looking at your waist and hip measurements and how your clothes fit, alongside the scales, gives a truer picture.

For measurements to be meaningful they need to be taken under similar conditions: at the same time of day, with similar fluid intake and, for women, at the same point in the menstrual cycle if possible. Body composition scales also give estimates; what matters is the trend over time, not a single reading.

The plateau: what to do when weight loss stops

It is a natural part of the process for the scales to stop at some point after moving steadily for weeks. As the body gets lighter it uses less energy; a plan that created a deficit at the start comes into balance over time. During a plateau the following are reviewed:

1. Although the scales have stopped, are your waist and hip measurements still changing? If so, the process is continuing.
2. Portions and snacks may have grown without being noticed; a food record kept for a few days shows this.
3. Are protein intake and resistance exercise adequate? Preserving muscle mass is decisive in getting past a plateau.
4. Have sleep and stress levels changed in recent weeks?
5. If you have been in an energy deficit for a long time, eating at maintenance level for a while rests both body and mind.

The worst response to a plateau is to eat even less. This increases muscle loss and tiredness and makes the process unsustainable.

Nutrition for those who want to gain weight

Weight management is not only about losing weight. Plans are also made for people who are underweight, who have lost weight during illness or intense stress and who have a poor appetite. The aim is not to push the scales up with junk food, but to build meals that are nutritious and energy-dense in a way that increases muscle mass. Increasing the number of meals, adding olive oil, nuts, tahini and full-fat dairy products to dishes, and resistance exercise are the main tools. In unintentional and unexplained weight loss, however, a medical assessment is needed first.

Keeping the weight off

Reaching your target weight is not the end of the process but its second half. In the maintenance period energy intake is increased gradually, and the scales and measurements are monitored for a while longer. People who succeed in keeping weight off have clear things in common: regular meals, adequate protein, continued movement, a habit of monitoring that is at peace with the scales without being fixated on them, and early correction of small deviations.

When should you see a doctor?

If you are losing or gaining weight rapidly without trying, or if the change in weight is accompanied by tiredness, palpitations, excessive thirst, irregular periods, excess hair growth or swelling, see a doctor first. For people with a chronic illness, those on regular medication and women who are pregnant or breastfeeding, the nutrition plan is prepared with the doctor’s knowledge.

Frequently asked questions

Does eating fast really make you eat more?

It can. Fullness signals take time to reach the brain; when you eat quickly, the plate is empty before those signals arrive and you end up eating more than you needed. Chewing well, putting your fork down between bites and not eating in front of a screen can help you feel full sooner on the same meal.

Do I have to cut out bread completely to lose weight?

No. The type and amount of bread are adjusted. Wholegrain bread appears in most plans because it provides fibre and fullness. Banning a food entirely usually increases the desire for it.

Can I lose weight without exercising?

Weight can be lost through diet; but movement makes a great difference in preserving muscle mass and in not regaining the weight lost. Going to a gym is not essential; regular walking and resistance exercises done at home are also effective.

Can I lose weight only from my stomach or hips?

It is not possible to burn fat from a specific part of the body through diet; where fat loss begins is largely determined by genetics. As overall body fat falls, those areas slim down too. The body contouring and lymphatic drainage applications at our centre do not replace the nutrition programme; they accompany it.

Could my metabolism be slow?

Metabolic rate varies from person to person; age, muscle mass, hormones and past diets all affect it. But the difference is usually not as large as people think. Increasing muscle mass, eating enough protein and regulating sleep are the realistic ways to support metabolism.

I use weight-loss injections. Should I still see a dietitian?

Yes. In this period, when appetite is reduced, getting enough protein and nutrients is important to prevent muscle loss. The details are on the nutrition during weight-loss injections page.