Work with your body, not against it, for long-term weight maintenance.

It’s February, and many people are still clinging to their New Year’s resolutions, which for many includes some sort of weight-loss goal. However, while extra pounds often come off, evidence shows they rarely stay off. Among overweight or obese people who are able to lose 10% of their body weight, just one in six is able to maintain the weight loss for at least a year.

Experts say it’s not surprising that weight loss rarely sticks, considering what they now know about how the body works. “Most people believe that obesity is caused by overeating, while we now recognize that the main driver of obesity is one or more disruptions in the body’s normal regulation of the amount of fat we maintain,” says Dr. Lee Kaplan, an associate professor of medicine at Harvard Medical School and director of the Obesity, Metabolism, and Nutrition Institute at Massachusetts General Hospital.

In short: your weight creeps back up not primarily because of your behavior, but because your body is essentially malfunctioning, driving you to store more fat. The drive to store more fat causes you to eat more and to burn fewer of the calories that you eat. But this doesn’t mean all weight-loss efforts are destined to fail. How much fat you store is strongly affected by the environment, so addressing the underlying reasons why your body is gaining weight can help you shed pounds and keep them off, he says.

Understanding the body’s response to weight loss

It helps to think about overweight and obesity the same way you would other physical imbalances. For example, if you had edema (swelling in your skin that comes from fluid retention), you wouldn’t just dehydrate yourself to remove the fluid and expect to solve the problem, says Dr. Kaplan. You’d need to identify and address the reason for the fluid retention in the first place, he says. The issue is similar when the body is storing too much fat. Trying to override your body’s hunger signals and simply eating less is not going to give you an effective long-term solution.

“It’s better to determine why your body wants to store too much fat and make changes that reverse that biological process,” says Dr. Kaplan.

Getting to the root of the problem

So, how exactly can you do this? First, it’s helpful to understand some of the common reasons why your body might be holding on to fat in the first place. These include inadequate sleep, chronic stress, disrupted daily biorhythm, medication that causes weight gain, a diet that is high in processed foods, and muscle atrophy from a complete lack of exercise.

Because causes of weight gain vary, there’s no one-size-fits-all solution, says Dr. Kaplan. Below are some strategies you can use to identify the cause of your excess weight and ideally to address it.

Do some detective work. Ask yourself: When did your excess weight begin? When did you gain the most weight? Was there a trigger? For example, did you put on weight when you stopped working out regularly, when you experienced a lot of stress, or when you started working a night shift? Did your weight problem begin after childbirth, at menopause, after a death in the family, or when you started a new medication? Analyzing when the problem began and when your weight increased the most can help you determine the underlying factor or factors you need to address.

Make changes. Once you determine the underlying cause or causes of your weight gain, work to adjust it. If it’s inadequate sleep, are there things you can do to get more sleep? If it’s stress, are there changes you can make to decrease the chronic stressors in your life?

If you think a medication triggered your weight gain, talk to your doctor about a potential alternative. Drugs that can cause weight gain include some types of antidepressants and mood stabilizers, anticonvulsants, beta blockers, steroids, histamine blockers, and pain medications. “It is important to talk with your doctor before discontinuing any medication you are taking,” says Dr. Kaplan.

Adopt sustainable dietary changes. “There is no single solution or single diet that will be successful for everyone,” says Dr. Kaplan. Recent studies have shown that some people do better with a low-carb diet and others do better with a low-fat diet. These differences are determined by our genetic makeup. The best plan is different for each individual, but choose one that is safe and feasible to continue over the long term, says Dr. Kaplan.

Seek help if you need it. Someone who needs to lose five to 15 pounds might not need outside help, but for others, sustained loss requires professional intervention.

“It’s vital to recognize that you didn’t get there because of something you did. You got there because your body has a disease,” says Dr. Kaplan. Fixing the problem with lifestyle changes alone might not be feasible. “In those cases, you may need more directed medical intervention,” says Dr. Kaplan. “Recognizing that obesity is a disease out of your immediate control can be the first step in solving what can be a frustrating and dangerous dilemma.”

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