Weight Loss Advice/Success

Why Can’t I Lose Those Last 5 Pounds?

A common dieter’s question answered

Most of us who have tried to lose weight have gotten close to our goal — but just couldn’t lose those last few pounds. Maybe it was even more than a few! Over the past few years, I’ve gone from 365 pounds to 192 pounds. I had wanted to get down to 182.5 pounds — so I’d be “half the man I used to be.” But I couldn’t get below 192.

I achieved the weight loss I did in various versions of low-carb eating, at various levels of understanding as to what I was doing. In fact, at first, I didn’t even realize I was cutting back on carbs. This article chronicles my journey to 365 pounds and back down to 192:

But when I hit my plateau, I was eating the same way that led to shedding my 173rd pound. And over the previous few weeks, the weight loss had been tapering off. Then one week it just stopped.

I knew enough about weight management to understand that if I started eating more carbs, I’d gain weight. I knew that low-carb needed to be my new lifestyle if I wanted to stay in my leaner form. But it always bugged me that I couldn’t lose those last 9.5 pounds to make me half the weight I had been.

Mind Vs. Body

The human body has several “systems” that run in the background to keep us alive. These are systems that we don’t have much if any, conscious control over.

One of these systems deals with respiration and it’s one of our background systems that we actually have a lot of conscious control over. We typically breathe without really thinking about it. But we can control our breathing and we can even hold our breath — that is, we can stop breathing altogether. But the body won’t let us hold our breath to the point of dying. Even if we hold our breath to the point of passing out, the background system takes over and we’ll start breathing again.

There are certain parameters the body wants to maintain in a particular range — all to aid in keeping us alive. One of these is body temperature: the “temperature control system” seeks to keep our body within a fairly narrow operating temperature range. Resting body temperature for most people is between 97 and 99 degrees Fahrenheit (36.1 and 37.2 degrees Celsius). But when we exert ourselves, and body temperature rises, our body tries to cool itself down by sweating; if we get too cold, the body shivers to try to bring body temperature up. We’d be hard-pressed to override this system — we can distract ourselves from the uncomfortable feelings of being very hot or very cold, but we can’t make ourselves stop sweating on a hot day or shivering on a cold one.

Another system we have seeks to control the level of sugar (glucose) in our blood. We need some glucose in our blood at all times. But too much can lead to significant health issues. We evolved with a system that tries to keep blood glucose between 70 and 100 mg/dL when fasted.

Weight SetPoint

Some people believe in the Set Point Theory of Body Weight. This model hypothesizes that the like temperature and blood glucose levels, the body has a weight it seeks to keep you at. The only problem with this notion is that the body has no internal system to measure, monitor, and/or control your weight.

If you stop to think about it, how could the body measure its own weight? How do we weigh something — including ourselves? We put the thing on a scale. When you order a pound of ham at the deli, the employee slices the ham, and puts the slices on a scale — once they get to 1.2 pounds they stop, saying “it’s a bit over, is that okay?” Trucks, at the “, weigh station”, drive onto a big scale. When we go to the doctor’s office we stand on the scale — after taking off our shoes, putting our phones, wallets, glasses, spare change, etc., on the closest flat surface…

So how could the human body measure its own weight without an external scale? It can’t.

Weight, what?

Our weight has nothing to do with weight. And this is part of why we can’t shed those last few pounds. My body has no sense of how much I weighed at my peak and no appreciation of how cool it would be to be able to say, “I’m half the man I used to be.” More broadly, our conscious weight goal not only falls on deaf ears — the notion of our ideal weight doesn’t register in any way with the systems running in the background that keep us alive.

If you’ve read this article, you know that our weight is just a side effect of energy management.

So, while the body doesn’t measure, monitor, or control our weight directly, it does measure, monitor, and control our energy input, storage, and usage.

Given we need the energy to stay alive, it makes sense that we have a system, running in the background, to keep our stored energy within some acceptable range. This is where I think Set Point Theory is relevant. Here, it’s important to keep in mind the food environment that existed when our “behind-the-scenes” processes and systems evolved. Clearly, food was not as consistently available as it is today. Even in Italy — which has a strong tradition of family time over making money — you can find grocery stores that are open 24/7. And now, with lockdowns, many deliver food to your door.

In the time of our ancient ancestors, it seems that while the food was often abundant, it wasn’t consistently so. Our energy management system certainly works well in such an environment. To simplify the basics, we have hormones that influence how much energy we take in (ghrelin is what makes us feel hungry and leptin is what makes us feel full), how much energy goes into short-term and long-term storage (insulin) and how much is taken out of long-term storage (glucagon) when the energy in short-term storage is used up.

Another important difference in the food environment for our ancient ancestors was the level of carbohydrates in the diet. Recent nitrogen stable-isotope analysis points to our ancestors’ reliance on meat in the diet. While some carbohydrate was eaten, we evolved to be what we are today because we mostly ate meat. In fact, to this day, we don’t digest plants very well. The oxidative stress we try to counteract with antioxidants generally comes from the plants we eat.

Our Big Fat Advantage

In an uncertain food environment, it helps to have body fat. The average person can survive a few weeks without eating anything — and live off the stored energy in their body fat. In a low-carbohydrate food environment, when we eat a meal, most of the energy we take in is stored. Some gets stored as short-term, glucose-based, energy in all of our cells while the rest gets stored as long-term, fat-based energy in our fat cells. Insulin is responsible for energy storage.

Using glucose-based energy doesn’t require any hormonal trigger. As mentioned earlier, too much glucose in our blood can be dangerous — the body evolved in such a way as to use up glucose as fast as possible.

Using fat for energy does require a hormonal trigger — until blood insulin levels are low enough (indicating excess glucose is gone), glucagon is kept from doing its job. I see this as a sort of failsafe against dangerous glucose levels.

Anyone who eats a low-carb diet can tell you that after a few weeks (the time it takes your body to switch from being used to a high-carb diet to the low) of low-carb eating, you don’t get the urge to snack between meals. Why? Because after the short-term, glucose-based energy is used up, your body starts using energy from long-term storage — body fat. If one follows their natural hormonal signaling for when to eat and when to stop eating, eating a low-carb diet will maintain their weight. If you start in on a low-carb diet when you are overweight, it will help you lose weight at first, then maintain weight. But remember — your weight is really just a side effect of energy management.

Energy SetPoint

The notion of a set point is, in my opinion, appropriate — but it needs to be applied to energy, not weight. Let’s look at the “hunger” and “full” hormones of ghrelin and leptin. Ghrelin tells us to add more energy into the system. We don’t always have the “eat more” signal, so there must be a trigger point — when our energy stores dip below this trigger, we get hungry.

As we eat (take in energy) and as it gets stored as body fat, leptin is released. Leptin signals we have enough stored energy, and we can stop eating — we are full. This suggests that there is some point (or range) of stored energy that is a target for our energy management system. It’s like the energy management system on a smartphone — with one important difference.

On my smartphone, if the battery gets too low, it alerts me to connect it to a charger — it tells me my phone is hungry. If I don’t charge it, it will go into “power saver mode” and shut down non-essential functions. This is what the body does on an energy-deficit diet. It slows down operating systems, so you don’t run out of energy — which is why energy-deficit diets (eat less/move more!) don’t work over the long term.

Here’s the difference between our body and the smartphone — once the battery on the phone reaches 100% full, it stops charging. Unfortunately, we don’t! And we can “over-charge” our long-term storage even if we don’t overeat, if we consume a high-carb diet — as the above-linked article describes.

If you are overweight and switch to a low-carb diet, you will lose weight. As I describe in detail in the article above, your body will waste energy — specifically energy that was stored as fat — on a low-carb diet. But you won’t lose weight forever.

Dr. Ben Bikman, Associate Professor of Physiology & Developmental Biology at Brigham Young University was among the first to describe the uncoupled response of fat cell mitochondria to ketones. In an email conversation we had, he confirmed that, indeed, “at some point, a body will begin vigorous defending remaining lean and fat mass to prevent true starvation (i.e., the loss of all fat).” You can starve yourself to death, but your body will kick and scream until the end. The mechanisms that go into “vigorous defense” are, according to Bikman, a “combination of multiple factors, including reducing metabolic rate, becoming insulin resistant, and increasing cortisol.” So, just like the body defends against an energy-deficit diet by slowing metabolism, the same tactic is used once your energy reserves get to a lower but acceptable level.

The exact mechanism for triggering the vigorous defense is yet to be explored, but my guess is it has to do with the strength of leptin signaling coming from stored fat: as levels of stored fat get lower, leptin signals get weaker. At a certain point, the weak signal triggers an increase in cortisol, which stops the uncoupled production of ATP, which reduces metabolism.

It seems, in the end, that the body defends our energy reserves. If you try to lose weight by imposing an energy imbalance upon your body, it defends your energy stores, and you won’t lose weight over the long term. If you provide your body with the types of energy that were plentiful when we evolved (proteins and fats), it will waste energy if you have a lot of stored fat, then switch to a maintenance mode when your stored energy gets to some set point level.

But if your weight goal requires a level of energy storage that is below the setpoint, you won’t get there without unhealthy measures — and not likely in a way that would last over the long term.

Thank you for reading this article — hopefully it contained something you found useful.

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