Dr Samuel Klein is Chief of the Division of Geriatrics and Nutritional Science at Washington University School of Medicine
Question: I’ve tried all types of diets and I think I’ve ruined my metabolism. I don’t eat that much, but I still can’t lose weight — nothing works. How can I fix my metabolism? Is there any hope for me?
Answer: Trying to lose weight can be frustrating. If we refer to metabolism as the number of calories the body burns every day, the good news is that people cannot “ruin their metabolism.” This common belief is simply not true.
The most difficult part about dieting is maintaining weight loss long term. Many people who lose weight, regain their lost weight over time. This weight regain does not mean that you have permanently decreased your metabolism or put your body in starvation mode by dieting.
There is no evidence of permanent metabolic changes after short-term diets involving reduced calories or even after years of so-called yo-yo dieting (weight loss and gain). But as you lose weight, your daily caloric needs do decrease, because it takes fewer calories to maintain a smaller body size.
Weight loss is about energy balance. Calories are a measure of energy, and weight loss occurs when you are in negative energy balance – that is, when you consume fewer calories than you are burning.
If you feel that you are not consuming very many calories and are still unable to lose weight or even gain weight, try keeping a food diary to get a better idea of how many calories you are actually consuming. Be as accurate as possible – include beverages and measure your portion sizes.
You may also want to meet with a registered dietitian to get a handle on the calories you are taking in and to help develop a more realistic meal plan for weight loss.
If you have tried all of the above without success, then look for a structured weight loss program that provides an integration of dietary supplements with physician monitoring; behavioral and dietary counseling; a sensible, tailored exercise plan; and group support meetings.
The most important advice is not to give up – this is a lifelong process and there is definitely hope! Your previous dieting attempts have not ruined your metabolism. You just need to find a realistic plan that you can stick to and get the support you need. If you consume fewer calories than you burn, you will lose weight.