Understanding Set Point

Our culture encourages us to think about our weight as a number that we can determine ourselves; that is, if we have enough “self control” and eat “right” we can reach our aesthetic ideal.  The truth, however, is that our weight is determined by numerous factors, most of which are outside of our control.

All of us have what is known as a “set point” weight or a “natural weight.” This is a basic weight that the body fights to maintain. This set range is determined by 1) genetics 2) physiological mechanisms, including your metabolic rate and hormones that influence appetite and 3) environmental factors, including how you have eaten over your lifetime, any medications you take, and how active you are.[1]   As you can see, the reality is much more complicated than what our culture sells us.

So why are people able to gain and lose weight over time if we all have a natural weight?  The short answer is that we can influence our weight, but often only in the short term.  What’s more, dieting tends to predispose people to gain weight over time.

Many people have had the experience of going on a diet, losing weight, and then slowly watching weight creep back over a short – or long – period of time, often to a higher weight than where they started.  Part of weight regain in these instances is related to behavior – often diets are so restrictive, time-consuming, or socially limiting that most people can’t stick with them long term.  But even people who remain extraordinarily faithful to their diets often regain weight over time.  This is where physiological factors come in. Once someone loses weight (out of their set point range), the body adjusts some of its physiological controls to get them right back to their set point weight.  Metabolism slows down and the hormones increasing appetite go up – meaning not only are they burning fewer calories, but actually feeling hungry more often and with more intensity.  The combination of these two factors, plus the behavioral difficulty of maintaining a highly controlled diet and exercise routine, contributes to making weight regain a certainty for most people (95% of dieters regain weight – yes, 95%). And there’s evidence that even when the body is back where it wants to be, at its original weight, metabolism may not return to its pre-diet state.

There’s some evidence suggesting “settling points” rather than a single set point range exist_ – in other words, you might be able to influence your weight enough that it will begin to hover around a different weight range than you’ve historically occupied.[2]  But, the greater the difference between this settling point and your body’s natural set point, the greater the difficulty you will face in maintaining it long term.  So, a sensible, moderate goal is very important here.

At Columbus Park, we see many people who have struggled for years with being overweight – and often times, they are objectively at weights inflated by emotional eating or binge eating.  Most of these individuals have been around the “diet block” dozens of times (or more).   The answer for these individuals is not in “the right diet” or some kind of magical summoning of willpower.  Recognizing that diet/willpower is not the answer is a critical step in normalizing one’s behavior and ultimately, one’s weight.  It makes sense: consistently eating for reasons other than hunger is bound to result in excess pounds.

So the work–via targeted behavioral therapy–is to tackle over-eating, mindless eating, and emotional eating in order to decrease (not eliminate!  It’s normal to overeat sometimes) these episodes.  In the absence of chronic overeating, many bodies will normalize to a range that is healthier and more in line with where the body will rest most comfortably.

[1] Garner, D.M. & Garfinkel, P.E. (1997) Handbook of Treatment for Eating Disorders. 2nd Ed. New York, NY: Guilford Press.

[2] Keesey, R.E. & Hirvonen, M.D. “Body Weight Set-Points: Determination and Adjustment.” Journal of Nutrition. 127 (9). 1875S-1883S.