“Please lose weight. Please lose weight. Please lose weight.”
It was like a mantra I repeated to myself before a client got on the scale during their weekly visit. That was at the beginning of my career long before I learned that weight loss, more importantly fat loss had way more to do with hormones, specific food choices and portion sizes than it did with calories and exercise.
Having a client come in all excited because they followed the plan, food journalled and felt so good all week only to feel so deflated because the number on the scale didn’t move is not a fun part of the job. I assume you’ll agree that success and self-worth shouldn’t in any way be tied to a number on a scale, but try explaining that to your client who wants to see the results of their efforts.
I know, don’t weigh them in the first place. This isn’t an article about self-worth and weight loss, although I could write plenty on that subject from both a personal and professional perspective. This article is about the five reasons why your clients aren’t losing weight… fat and what to do about it.
Over the last decade of working with clients, first as a personal trainer and then as a Registered Holistic Nutritionist I’ve heard every excuse in the book. I used to call the excuses the “But Lori’s”…
- But Lori it was my sons birthday party.
- But Lori I was at a dinner party and their wasn’t any other choice.
- But Lori I was on vacation.
- But Lori my mom made my favorite pie.
- But Lori I was watching my grandchildren and couldn’t help myself.
If you’ve ever worked with clients then you’ve got your own set of But Lori’s. Right? All of the excuses are rational and valid to the client. It makes sense that clients with the ‘But Lori’ excuses aren’t consistently losing weight.
We are human after all and when trying to lose weight willpower only takes us so far.
So what happens with those clients who don’t have the ‘But Lori’s’, the ones who food journal daily, stack on track, make good decisions, stick to their exercise plan and feel really good about their progress and still can’t seem to lose weight?
Let’s go through five physiological and psychological reasons why your clients aren’t losing weight.
1. Blood Sugar Management
The first and most obvious reason is that their blood sugar isn’t balanced. If the client has any cravings for anything related to carbs or fat then it’s safe to assume that they need to balance their blood sugar. Of course you are going to do your job and investigate further but the first question I always asked was “do you have any cravings?”
In my practice, I chose to first focus on balancing blood sugar and then once that seemed to be ok switched over to managing cortisol. Blood sugar management is at the core of so many health issues including weight.
When it comes to blood sugar imbalances versus will power, my money is on giving into the craving every time. Relying on willpower alone to say no when the body is screaming for glucose can make anyone feel crazy and exhausted.
There are two sides to the blood sugar management coin.
- Insulin Resistance – chronically high blood sugar
- Hypoglycemia – blood sugar fluctuations ranging from low to high blood sugar
Insulin resistance is characterized when glucose can no longer effectively enter into the cell resulting in high blood levels of glucose. In response to food intake (mostly carbohydrates), the pancreas pumps out insulin in an effort to regulate blood sugar levels.
See, one of insulin’s jobs is to be a transporter and take glucose molecules from the bloodstream and deposit it into the cells to be stored for later use. The other job insulin has is to help fat cells absorb fatty acids in addition to glucose and as a result, expand over time.
However when the liver, brain and muscles cells don’t unlock to allow glucose to enter because the cell because has become resistant to it, the glucose has to then go somewhere, so it heads back to the bloodstream instead of being stored for later use resulting in chronically high blood levels of glucose.
Insulin resistance is also known as pre-diabetes.
I am no stranger to hypoglycemic symptoms and they are not fun. Clients who have hypoglycemia experience periods of low and high blood sugar. They have surges of insulin as opposed to chronically high levels.
When blood sugar levels are low, adrenaline (a hormone involved in the stress response) is often used to quickly elevate blood sugar causing a sharp rise in blood glucose and therefore insulin.
Symptoms of insulin resistance and hypoglycemia
- Feel tired after meals
- Experience sugar cravings after meals
- Difficulty getting to sleep
- Feel better after eating for a short period of time
- Experience sugar cravings before and in between meals
- Difficulty staying asleep at night
- Mood swings when hungry (“hangry!”)
2. Adrenal System
I started researching adrenal fatigue when I started having symptoms. I thought that my symptoms were related to hypoglycemia but my blood sugar levels were perfectly fine as evidenced by pre- and post- meal blood glucose testing.
So I dug deeper. It turns out I was under producing cortisol as evidenced by blood work a timed saliva test. It made sense – years of inadequate or broken sleep, stress from raising kids, forgetting to eat on busy days, building a business and everything else life throws at you.
The adrenal glands are our body’s primary defense for managing stress and when they are activated they produce a number of hormones that help the body deal with stress i.e. cortisol.
Here’s where blood sugar management and the stress response can sometimes get confusing especially if client’s can really explain their symptoms all too well. Cortisol’s primary function is to increase blood sugar levels during a stress response (physical or emotional) so the brain muscles and organs have enough energy to fight or flee AKA the fight or flight stress response.
A problem arises because these days most stress responses are emotional, so, there is no real need for excess glucose to be released. No extra energy is actually required by the body because there is no fighting or fleeing… just a lot of yelling and crying usually.
Yet, when a person is chronically stressed out – anxious and stressed on a daily basis for a long time, due to life circumstances they produce chronically elevated levels of cortisol to help the body modulate the stress response and return the body to homeostasis.
Chronically elevated cortisol levels = Chronically elevated blood sugar levels = Elevated insulin levels.
High cortisol production + high insulin production = dangerous belly fat.
There are 2 kinds of adrenal system issues:
- Overactive Adrenals
- Underactive Adrenals
Overactive adrenals usually produce too much cortisol which plays a role in elevating blood sugar levels and the overproduction of insulin to modulate blood glucose.
Underactive adrenals produce inadequate amounts of hormones, especially cortisol to maintain homeostasis. Hypoglycemic symptoms are closely related to underactive adrenal function. When cortisol is unavailable, glucose levels can fall to low and then the adrenals release adrenaline as a back-up.
In this case, the symptoms are virtually the same as someone who hypoglycemia would experience, yet, the cause is triggered first by low production of cortisol as opposed to low blood sugar.
3. Gut Imbalances
I became a Registered Holistic Nutritionist because I was fat and had awful digestive system issues that no doctor I saw (regardless of the invasive tests) could help with. Constipation, gas, bloating, vomiting and acid reflux were symptoms I lived with daily for years.
Not once did a doctor ever ask me about my nutrition or even mention that my digestive system was messed up! Candida or leaky gut were two words I never heard about until I went to see a naturopathic doctor.
It’s been said that a healthy functioning gut is the gateway to ultimate health. The human gut contains 10 times more bacteria than all the human cells in the entire body, with over 400 known diverse bacterial species.
When the gut is inflamed and distressed it’s not able to do it’s job of breaking food down so it can be absorbed; allowing nutrients and water in while keeping all of the nasty toxic substances out.
There are so many symptoms linked to gut imbalances, making it hard to pinpoint the root cause.
- Burping after meals
- Undigested food in the stool
- Bad breath
- Acid reflux
- Never feeling satisfied
- Empty feeling in the stomach after just eating
- Cramps/pain/nausea associated with bowel movements
- Food sensitivities
- Joint pain
- Lowered immune function
- And the list goes on….
What’s irrefutable is that a healthy gut and optimal digestion depends on:
- A healthy immune system with low levels of stress
- Consistently balanced intestinal bacteria
- Intact mucosa (the lining of the gut must remained sealed)
When the lining of the gut become porous, microscopic amounts of undigested food leaks out through the lining of the stomach into the bloodstream causing an immune response and inflammation. This condition has become known as leaky gut.
If your client’s present with any type of gut or digestive symptoms, here are some things you can implement:
- Eliminate any food, drinks or self-care products that are known to cause sensitivities
- Balance the gut bacteria with fermented foods and prebiotic/probiotic supplements
- Introduce L. Glutamine – Glutamine can help reverse excessive intestinal permeability, act as fuel for intestinal cells, and might attenuate the allergic response.
- Consider supplementing with a digestive enzyme or digestive bitters – Due to stress and aging, many people underproduce hydrochloric acid – a key digestive enzyme used to mostly break down proteins. Look for a broad spectrum digestive enzyme that include betaine HCl (unless you have a hiatal hernia or it gives you heartburn – then chose one without HCL.)
- Check iron levels (especially in vegans and vegetarians) – Decreased iron levels are associated with with poor gut function.
4. Portion Control
“Do my clients have to count calories?”
We already know that the Calories In – Calories Out philosophy has been disproven. We also know that not all calories are created equal. Some calories wreak havoc on our metabolic hormone systems while others support balanced hormones and weight loss.
Counting calories is a lot of work and is unsustainable for the average person. Without the proper knowledge of which calories to choose client’s end up choosing suboptimal food choices simply because they are ‘low calories’ and fit into their daily recommended caloric amount.
Plus those calories counting apps usually underestimate how many calories a person needs to eat in a day causing client’s to undereat. When we undereat our metabolic function slows down to match our energy intake and no weight loss occurs.
Instead of calorie counting, the goal should be to teach client’s proper portion sizes for each macronutrient category (carb, protein and fat). Regardless of the niche you are an expert in, all client’s need to learn how to create properly portioned, macronutriently balanced meals in order to sustain optimal blood sugar management and lose weight.
5. Emotional Connection To Food
Pasta with melted cheese.
Cheeseburger and fries (with mayo, mustard, ketchup and onion).
Popcorn with melted butter.
Anything fried with potato.
Those are my go-to “make me feel better foods”. It’s been interesting over the past couple of months to pay attention to my food cravings. There have been noticeable times when I’m stressed out, tired or upset that I crave any one (or all) of those foods… except I’m not even hungry.
Although the emotional connection to food is still a very faux pas topic, there is no denying that we all in some way have emotional connections to food that stops us from losing weight. I believe that in order for our client’s to lose weight and keep it off long-term we need to look beyond diet and exercise and investigate WHY they are making the choices they are making.
The best book I’ve read on the psychology of change is Switch: How To Change Things When Change Is Hard written by Chip and Dan Heath. http://heathbrothers.com/books/switch/
“Switch asks the following question: Why is it so hard to make lasting changes in our companies, in our communities, and in our own lives? The primary obstacle, say the Heaths, is a conflict that’s built into our brains. Psychologists have discovered that our minds are ruled by two different systems—the rational mind (the rider) and the emotional mind (the elephant)—that compete for control. The rational mind wants a great beach body; the emotional mind wants that Oreo cookie. The rational mind wants to change something at work; the emotional mind loves the comfort of the existing routine. This tension can doom a change effort—but if it is overcome, change can come quickly.”
The Switch framework gives a very clear methodology that we can apply to working with client’s who have deep emotional connections to food.
Direct The Rider
Motivate The Elephant
Shape The Path
Click to download the 1-page How To Make A Switch PDF from http://heathbrothers.com
The bottom line is that there is more to losing weight than the debunked theory of Calories In – Calories Out. We need to remember that, like anything else, weight loss (fat loss) is a process and doesn’t happen overnight. It’s our responsibility to correct our client’s expectations and give them the knowledge and practical lifestyle tools so they can make the appropriate food, exercise and mindset changes needed to lose the weight and keep it off for good.
We’d love to hear from you
In the comments share one challenge you’ve encountered working with client’s who want to lose weight? Or, if you feel daring and brave share one personal experience you’ve had while trying to lose weight.
This is an important conversation for us to have.
Speak to you in the comments!