Why do diets fail? Gastroenterologist explains hidden factors damaging your weight loss journey

For many people struggling with obesity, the most exhausting part is not losing weight, but repeatedly trying to lose it. A new diet plan, stricter calorie limits, intense workout schedules, and cutting out favourite foods often become part of a familiar cycle. While some individuals may initially see results, many eventually hit a plateau or regain the weight they worked hard to lose.

“Weight loss is not always a matter of discipline. The body responds to prolonged calorie restriction in ways that can make sustained results increasingly difficult to achieve. Metabolism may slow to conserve energy, hunger hormones may rise, and cravings may become harder to control. Over time, the body may begin to resist further weight loss, leading many to feel frustrated and defeated,” Gastroenterologist Dr Lokesh L. V. at SPARSH Hospital tells Health Shots.

Can PMOS make it hard to lose weight?

Underlying medical conditions can make this even more challenging. In women, especially, hormonal disorders such as hypothyroidism and Polyendocrine Metabolic Ovarian Syndrome (PMOS), insulin resistance, poor sleep, chronic stress, and certain medications can all influence how the body stores fat and regulates appetite. In many cases, individuals may be following the right habits but still struggle because the underlying issue remains unaddressed. This is why obesity treatment has evolved beyond conventional dieting.

What lifestyle changes can help prevent obesity?

Lifestyle changes remain the first line of treatment. Still, medical interventions are increasingly being considered for individuals who do not achieve sustainable results with traditional methods alone. These interventions are especially important in addressing the complex factors contributing to obesity and achieving lasting weight management.

1. One such option is Endoscopic Sleeve Gastroplasty (ESG). This minimally invasive procedure reduces stomach volume using an endoscope inserted through the mouth. By helping patients feel full faster, ESG can support long-term weight loss when combined with dietary and lifestyle changes.
2. Another option is the Intragastric Balloon, in which a temporary balloon is placed in the stomach to promote portion control and help individuals build healthier eating habits. This approach is often effective for those looking for less invasive alternatives to surgical procedures.
3. For patients who have previously undergone gastric bypass surgery and are experiencing weight regain, Transoral Outlet Reduction (TORe) offers another alternative. This procedure helps reduce the size of the gastric outlet and pouch opening, improving satiety after meals.

The larger message is clear: when diets stop working, repeating the same strategy may not always be the answer. Sometimes, the more effective approach lies in understanding why weight loss has become difficult and in exploring treatments better aligned with how the body works to create sustainable change. With a comprehensive understanding of these factors, individuals can find lasting solutions tailored to their unique needs.