You’re doing it! You’re lowering your calorie intake. You’re exercising. And yet, your scale doesn’t seem to want to recognize your hard work. Or maybe it did for a while. But now your weight has stayed steady despite your best efforts. Or even more frustrating — it’s creeping back up. 

It’s an all-too-common scenario. But you’re not alone. And it’s not your fault. 

“People used to think that if you increase your exercise, or cut your food intake, you’re going to lose weight,” says endocrinologist and obesity specialist Marcio Griebeler, MD. “But obesity is a disease. It is a physiologic dysfunction. In a variety of ways, your body will work to defend itself and keep you from losing weight.” 

But … why? And what can you do about it? We talked with Dr. Griebeler about set point theory — the idea that explains why your weight may not change much even when you’re dieting and exercising. Read on for tips to get to a healthier weight range, even when your body wants to fight you every step of the way. 

The truth about obesity 

Obesity isn’t just a number on a scale or a measurement of your body mass index (BMI). Instead, those numbers are symptoms — indications of something more complicated than weight alone.  

Think of it like this: Your cough may be a symptom of a cold. But a cold is more than a cough, it’s an upper respiratory infection that may also be causing your runny nose, fatigue and so on. 

The same is true of obesity. Your BMI is a sign of obesity, but obesity itself is a chronic condition that affects the way your body functions in a range of ways.  

Dr. Griebeler says that when you’re living with obesity, it changes the way your body functions. It changes the way you metabolize food. It changes your hormonal function. It puts you at risk for conditions like:  

• Heart disease. 
• High blood pressure. 
• Sleep apnea. 
• Diabetes. 
• High cholesterol.   
• Stroke. 
• Asthma. 
• Osteoporosis. 
• Gout. 

Obesity is defined as a BMI of 30 or greater. BMI is a calculation that takes into account your height and weight as an indication of whether your weight is putting you at risk for health complications. And while health researchers and practitioners agree that BMI is a rather crude method of understanding your health and risk, it’s the best indication we have at this time.  

“BMI is an easy calculation, and it gives us a good idea of whether a person is at risk of obesity and related conditions, but it’s far from a perfect indication of your overall health,” Dr. Griebeler states. 

What is set point theory? 

If you’re living with obesity, you know that losing weight — and sustaining weight loss — can be a monumental challenge.

Set point theory is a scientific explanation for that phenomenon. It says that your body mounts a defense to keep you from losing weight. The idea is basically that your body fights tooth and nail to keep weight on. And it thinks it’s doing you a favor. 

“What we see all the time is that people will change their diet and exercise to lose weight, and maybe they will lose some weight at first. But then their weight will hit a plateau and get stuck there,” Dr. Griebeler says. “That’s because there’s a difference between losing weight and changing your set point. If you’re going to have lasting weight loss, you need to change the set point.” (And that’s possible. More on that later.) 

How your body reacts to weight loss  

Diet and exercise are supposed to be the path to getting to a healthy weight, right? At least that’s what everyone seems to say. So, why aren’t you getting results? 

The issue is that your body doesn’t want to give up the weight. And it has some built-in defense mechanisms to keep you at your set point. 

As you work to lose weight, your body reacts by releasing more ghrelin hormones. Those are the ones that make you feel hungry. And it sends out less of the leptin hormone (the one that makes you feel full).  

So, it’s not just in your head. As you diet, the very