FAQ: I hear amazing claims about intermittent fasting, time restricted eating, fasting mimicking diets, protein powders, low calorie shakes, soup diets, Adkins, keto, vegetarian, vegan, Mediterranean, DASH, Ranch Malibu, probiotics, prebiotics, supplements, medications, injectables, and exercise. What actually works for weight loss?
Our approach to weight management starts with your mindset. If you grew up in the U.S., you learned to make snap judgements about bodies including your own, and to believe that skinny is healthy.
Along these lines is the idea that people gain weight due to lack of willpower. Even some doctors still think this. In our clinic we hear things like: "If I stopped eating carbs and just ran a marathon, I know the pounds would come right off."
The reality is you need carbs to 'just' run a marathon. Lots of carbs. More to the point: we know patients who exercise four times a week, avoid alcohol, eat mostly plants, fish and chicken, and they struggle with their weight. We know someone who did everything right during a year-long sabbatical and their weight didn't budge. It can be crazy-making.
Weight is the complex sum of things you can control and things you can't. How you eat and move are genuinely important, but age, sleep, addiction tendency, hormone levels, and even your gut microbiome can be factors. Then there's genetics. That person who seems to eat everything and never gains weight? That's not just superior mental discipline.
At Sequoia Project Internal Medicine, we home in on what a healthy body looks like internally, starting with your metabolism. We examine your habits alongside lab and imaging markers. We care more about numbers like lean mass and visceral fat than BMI.
Then we challenge you to work towards achievable goals. There's good science to explain why many well-known weight loss strategies can be successful — but you have to do the part that works. The art is in finding the best fit for your life right now. Like the sabbatical patient who joined our practice just before returning to work. It was the food noise, and we identified a more effective approach to get to a healthier weight.
Maintaining a healthier weight isn't necessarily more of the same. Your body will fight to return you to your prior weight, sometimes called the yo-yo effect. That's the next part of the journey, and we support that too.