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"Why is it so hard to lose the last 10 pounds? And why is it harder to lose weight the smaller I get?"
-- Tamara
Anyone who has tried to lose weight knows about those frustratingly immobile final five or 10 pounds. And while there are a lot of suggestions (just Google "last 10 pounds" and you'll enter an echo-chamber of weight loss advice, scientific half-truths and can-do enthusiasm), the truth is that several pretty straight-forward reasons can explain that unshakeable weight.
The first is easy to fix, but also the most psychologically daunting: it could be something called "diet fatigue," in which the repetitive behaviors dieting requires -- keeping a food journal, weighing portion sizes, skipping that glass of wine -- become arduous, hard to manage and, frankly, boring.
"Dieters become less careful, they are not taking the precautions they did in terms of knowing what they ate, how much," says Carla Wolper, Ed.D., R,D., research faculty at the Obesity Research Center at St. Luke’s and assistant professor in the Department of Psychiatry at Columbia Medical Center. "They may not realize they’re not as careful anymore."
That's not an invitation for blame -- it can happen insidiously and there's an easy solution. If the scale needle slows its descent, simply write what you eat down in a food journal. "Keeping food records is always recommended," says Wolper. "Studies show that people will lose weight, even if they don’t do anything different to their diet but simply start writing it down."
There is also the possibility that it's time to recalculate. When a person begins to lose weight, their metabolic rate drops. In other words, they need fewer calories to meet basic functioning and requirements. While a 150-pound woman might have a certain basic metabolic rate, that rate may drop when she becomes a 130-pound woman. That's why it's a good idea to reevaluate caloric needs after more than 10 pounds of weight loss, according to Wolper.
"People who are normal weight tend to eat fewer calories than people who are overweight, every day, forever," agrees Rebecca E. Lee, director of the Texas Obesity Research Center and a professor of nutrition in the Department of Health and Human Performance at the University of Houston. "It takes fewer calories to maintain a lower body weight. This doesn't necessarily mean that they eat less volume -- they might, but they also might eat more nutrient dense foods that have fewer calories, like vegetables, fruits, lean meats, etc."
There's an additional consideration regarding metabolism: something called "metabolic adaptation."
"When dieting, your body is forced to work on a reduced number of calories per day. Eventually your body adapts and trains itself to live on whatever calories it gets -- without losing weight. This built-in survival mechanism is your body’s way to protect you against starvation," says Dr. Caroline J. Cederquist, a metabolic expert and board-certified medical weight management specialists. "Once you have hit this point, you may manage to lose a few bonus pounds, but they will come off much more slowly and, before you know it, the weight you lost may start to come back on!"
So what can you do? Interestingly, the answer is not exercise. (Which is not to say you shouldn't exercise. Please exercise!) Very often we're told that building muscle mass will help rev up our metabolisms because muscle tissue burns more calories per hour than fat tissue does. But, as Wolper explains, the difference in caloric burn rate is minor. Fat tissue burns about two calories per pound per day, while muscle tissue of the same weight burns seven calories per day. If someone made a significant change -- transformed two pounds of fat into two pounds of muscle, that would amount to a difference of 10 more calories burned per day.
"The truth is that skeletal muscle doesn’t burn that much more than fat. Our brains burn the most calories. In fact, the lean tissue that burns a lot of calories is our heart, lungs, liver and brain. About 60 percent of the calories that are burned come from those four sources," says Wolper.
Exercise may help create a greater calorie deficit and that will help further along weight loss or help maintain sustained weight loss -- but it won't make a big metabolic difference.
Instead, in addition to redoubling food journal efforts and recalculating caloric intake for one's new size, Cederquist recommends something she calls a "metabolic adjustment phase." Instead of reducing calories, she suggests a two-week period of increased meal sizes. "During this phase, the goal is not to lose weight, but to readjust your body’s ability to metabolize an increasing number of calories, by increasing portion sizes and bumping up caloric intake."
Most of all, it's important to evaluate one's goals. Have you reached a healthy weight? If so and if continued weight loss is a huge struggle, it may be time to consider entering a maintenance phase. "Focus on the benefits of maintaining your weight loss," says Cederquist. "And remember that maintaining is as important as losing."
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