Count calories. Don't count calories. Cut carbs. Carbs are fine. Fast. Never skip breakfast. Eat six small meals. Eat two big ones.
No wonder you're confused.
I've been there myself. Over my life, I've lost and regained hundreds of pounds, 30 or 40 or 50 at a time, again and again. I tried a lot of the advice. Some of it worked for a while. Most of it didn't last.
So let me tell you why weight loss feels so confusing, and how I help people find what works for them.
Quick summary: what you need to know
- Opposite advice can both be true. Calories matter, and insulin matters. Where you land between them depends on your body.
- Your balance beam is unique. Some people have lots of room for error, and in midlife, most of us have less.
- There are three dials. What you eat, how much you eat, and when you eat.
- Why you eat is what jams them. If you're not sticking to your plan, the why is usually the problem.
- The best plan is the one you can live. A perfect plan doesn't work if you're not willing to do it.
Why is there so much conflicting weight loss advice?
There's so much conflicting advice because two true things sit at opposite ends of a spectrum. Calories in, calories out is true. In a lab, energy balance always wins. The effects of insulin and glucose on fat storage are true too. In real life, most people live somewhere in between, and where you land depends on your genetics, your hormones, your health, and your history.
So the person who swears by counting calories is right for them. The person who swears by cutting carbs is right for them. Neither one is wrong. They just live at different spots on the spectrum, and our job is to help you find yours.
Why can some people eat anything and stay thin?
Some people can eat almost anything because they have a wider balance beam. They have more room for error, so the extra dessert or the late-night snack doesn't tip them over.
In midlife, the beam gets narrower for almost everyone. People on a narrow beam have to be more careful with insulin and with how much they eat. That isn't fair, and it's real. Once you know how wide your beam is, you can stop comparing yourself to someone on a different one.
What are the three dials of weight loss?
The three dials are what you eat, how much you eat, and when you eat. Most programs only turn one dial, usually how much. You may need to adjust one, two, or all three, and the right mix is different for every person.
When you eat has parts too: the time of day, the day of the week, where dessert falls in a meal, and how many times a day you eat.
Here's an example. Say you love a 24-ounce coffee with flavored creamer, and you sip it for four hours every morning. If you won't change what it is, could you change how much? If not, could you change when, like drinking it in an hour, or with your protein at breakfast? You pick the change you'll actually keep.
Why can't I stick to my plan?
You can't stick to your plan when why you eat gets in the way. Stress, boredom, loneliness, celebration, exhaustion: why you eat is what jams the dials, so they won't turn no matter how good the plan is.
This was my story. I kept off my last 70 pounds when I changed how I think about food, through life coaching, and when I started planning my food ahead. When I wasn't sticking to my plan, I knew something in my emotional life needed attention, and I had to decide whether to deal with it. I still have to go back and plan on paper from time to time. The difference now is that I know why.
If you're on your plan 85% to 90% of the time and it still isn't working, then the plan needs to change, and we choose which dial to work on next.
Do I need to count calories to lose weight?
You may not need to count calories, at least not first. Calories matter, and most programs start there. I usually don't. I'd rather look at what you're already doing, find the dial that's easiest for you to move, and build confidence that you can do what you say you'll do.
A food journal helps. It isn't about whether a food is good or bad. It's just data, and we use what you write down to see where the easiest wins are.
Where do medications like GLP-1s fit in?
GLP-1 medications can be a helpful tool for the right person, as part of a bigger plan. At AgeWell, a physician-led midlife medicine practice for men and women in Amarillo, Texas, we don't prescribe them on their own. Everyone starts with a full evaluation, and a GLP-1 is used inside a program, alongside the dials, protein, strength training, and body composition checks to protect your muscle.
A GLP-1 can quiet the noise around food. You still need tools for when it's gone or the dose comes down. Read why muscle matters so much when you're losing weight.
How do I find what works for me?
Start with a plan you can live with, then watch what happens. Make a plan ahead of time. Write down what you eat. Notice when you go off plan, and ask why. Then look at your labs, such as fasting insulin, and your body composition, so you're not guessing.
You don't have to figure this out alone. Learn about our approach to metabolic health, or read what fasting insulin can tell you.
Frequently asked questions
What's the best diet for weight loss?
The one you can actually live with. Protein first, plenty of vegetables, and being intentional with carbs works for many people, and the details depend on you.
Why do diets work and then stop working?
Your body adapts, your life changes, and the plan may not fit anymore. That's when it's time to adjust a dial.
Is intermittent fasting good for weight loss?
A 12- to 14-hour overnight fast works well for many people. Longer fasts aren't usually our first choice in midlife, because protein and recovery matter so much. For some people, a longer fast may be exactly what's needed. That's why personalized care matters: the right answer depends on your body, your goals, and what you'll actually stick with.
Do I have to exercise to lose weight?
You don't have to exercise to lose weight, but in my experience, it's virtually impossible to keep it off without it.
See if AgeWell is right for you
This article is for education and isn't a substitute for personalized medical advice. Talk with your clinician about your own situation. If you have severe or urgent symptoms, seek emergency care.
Sources
- Cleveland Clinic: Insulin Resistance
- Cleveland Clinic: Sarcopenia
