The Science Behind What Your Body Really Needs to Lose Weight

One doctor shares her expert insight into the science behind weight loss


Science continues to show that losing weight is highly individual process. What works for one person may not be an effective strategy of another.

Unfortunately, this sometimes makes figuring out what will work for you a complicated and frustrating situation. But while there are many different strategies to choose from,at the end of the day losing weight boils down to a few key factors.

To help sift through all of the confusing and often conflicting information we frequently hear about losing weight, dieting and getting in shape we recruited the expertise of Dr. Caroline Cederquist M.D., creator of bistroMD and author of “The MD Factor Diet,” which centers around the science behind what the body really needs to successfully lose weight and keep it off for good.

The Active Times: What are the different factors that make weight loss a different journey for each individual? Are there any factors that are uniform throughout, like things that absolutely every person should focus on?
Dr. Caroline Cederquist:
Well, for starters, each person is different (different weight, different lifestyle, different tastes, etc.) so in order to make weight loss successful, it needs to become a part of a person’s life, and not a burden. Some people may be able to start a healthy diet program and exercise right away after starting a diet, although I don’t typically recommend this, while others may need to incorporate a little bit of exercise after they have the meal plan down. This usually allows people to ease into a lifestyle change without feeling overwhelmed and this technique tends to be more successful.

The one thing I can’t stress enough is actually eating. My patients see the best results when they eat three meals a day, accompanied by protein-based snacks — 3 for men, 2 for women. This keeps a person’s metabolism burning at a consistent rate throughout the day. It’s hard to kick your metabolism into gear if you only eat three large meals a day or conversely only one meal a day rather than having smaller proportional meals with the protein snacks between.

Can you talk a little bit about why “mainstream” diets don’t tend to work for most people?
Mainstream and fad diets typically don’t work because they don’t provide the necessary nutrients people need for long-term, successful and sustainable weight loss. When people go on a diet that doesn’t provide them with these nutrients, they tend to lose mainly water weight, or worse, they may even be losing muscle mass, which plays an important role in burning excess calories. There is a lot more to dieting than just watching calorie intake. If people don’t try to lose weight the correct way, they may be losing muscle, gaining fat and hurting their metabolism in the long run.

The other concern is that a majority of people who struggle with weight have a metabolic condition which further complicates the picture. I refer to this condition as Metabolism Dysfunction (or the MD Factor), but in medical circles it is known as insulin resistance. If you have the MD Factor, it may be hard to lose weight, even if you are following a reduced calorie diet. I have found that this common metabolic condition can be corrected by requiring a specific balance of lean protein, complex carbs and healthy fat for weight loss — simply eating fewer calories may actually make it harder for someone to lose weight.

What is science saying about what people “really need” to lose weight and keep it off for the long term?
For people who want to lose weight and keep it off, which I think everyone does, they need to give their bodies the key nutrients they can receive from lean protein, complex carbs and healthy fats. To get the necessary amount of protein I suggest three meals per day that include adequate lean protein and snacks in between that also contain protein because your body continuously needs it throughout the day. You must maintain your muscle mass in order to keep your metabolic rate up. If you skimp on protein, you are opening yourself up to lose muscle tissue. If you lose muscle tissue, your resting metabolic rate, the largest driver of your metabolism, drops and you are likely to regain weight even if you are not eating more.

Can you talk about some of the “food myths” you mention in your book and explain why they’re not true?
A concern that I see with many new patients is they don’t understand how much protein they do or don’t need. One myth that I would like to bust now is a lot of people assume that if a little bit of protein is good, then a lot must be even better. This is not the case, but it’s not their fault. A lot of websites and online articles seem to portray that eating lots of protein will give you toned muscles, stamina and athleticism. This is not true all by itself. Yes, your body does need protein to maintain muscle mass and for muscle mass to grow (when you exercise), but any excess protein that your body does not use will turn into glucose for energy or be stored as fat, which is exactly what we want to avoid.

In the past, I have heard from patients that they have tried everything from only having a small salad for dinner to even barely eating, and they still cannot lose weight. A huge myth that has been around for a while is that you can count calories and lose weight. This might not always be the case. For those with metabolism dysfunction, insulin resistance or other medical concerns, the primary focus of ours is to correct their metabolism because losing weight is more than counting calories. 

Sugar and alcohol are common diet “culprits,” do you have any tips for healthily including them in a balanced diet?
I think an important factor for many who are trying to lose weight is the feeling of being deprived. If you want to incorporate sugar or alcohol into your diet then you may do so, but the amount, in order to lose weight, may be less than what is typically considered moderate intake. Moderate alcohol intake, for example, means a maximum of 10 standard drinks per week for men and five standard drinks per week for women. Women’s livers are much smaller than men’s; this is why women can get intoxicated more quickly if they consume the same amount of alcohol as men. A standard drink is defined as: 12 ounces of beer, 5 ounces of wine, 1.5 ounces of spirits (vodka, whisky, etc.).

Recently, I have been asking my patients, “Can you drink one glass of wine, or does one glass always lead to two?” The same for sweets and desserts. If you can have one cookie or one glass of wine as a treat per day, for five days a week, then feel free to incorporate it five days per week. If having one cookie means you eat the whole box, then have dessert out and make it an occasion. This way, you will only get a single serving size. The same for wine, if you always have two to three glasses, then pick one or two nights per week to drink and don’t have any on the other days. This will help you limit the amount of “empty carbs” you ingest. You still get to have treats, but you can control them rather than the treats control you.

Where should people start when they’re trying to figure out what will be the best way to lose weight for them?
I think the first place to start is to correct your diet. Many have heard that, “you can’t exercise off a bad diet,” and that’s true. I have broken down the science of metabolism dysfunction and healthy weight loss in my book, and there are a lot of helpful resources on bistroMD for correcting and preventing metabolism dysfunction as well as for successful, healthy and sustainable weight loss. You can also take the free quiz to find out your MD Factor score.

Final words of advice…
I have had the great fortune to work with thousands of wonderful patients over the years who were motivated to lose weight. Through medical testing and lab work analysis, I was able to determine that the vast majority of the people who came to see me had the MD Factor. In one year, 89 percent of the patients I saw had this condition while most of them were not even aware of it. Distinguishing this with simple blood testing (or by taking the MD Factor Quiz) gives those who have been unable to lose weight, access to weight loss and a happy, healthy future.

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