How to Lose Weight Healthily: Obesity, Hormones, and Long-Term Solutions
The question "how to lose weight" is one of the most frequently searched health queries in Slovakia, and this is no coincidence. According to Eurobesity, approximately 25% of the adult population in Slovakia lives with obesity, and more than a third fall into the overweight category. In other words: two out of three adult Slovaks have an unhealthy body weight.
But weight loss is not that simple. Studies show that most people who lose weight on a diet cannot maintain their results in the long term. Why? Because the old mantra to "eat less and move more" is simply not enough. The body is not a wallet where you merely deposit and withdraw calories - it is a complex biological system involving hormones, metabolic adaptations, and psychology.
This article serves as an introduction to a series that will show you what the science of weight loss actually knows today.
What is Obesity and Overweight?
Most people do not distinguish between the terms "overweight" and "obesity." In reality, these are two clinically distinct categories that carry different levels of health risk.
The Difference Between Overweight and Obesity
The most widely used indicative measure is the Body Mass Index, or BMI. It is calculated by dividing a person's weight in kilograms by their height in meters squared (kg/m²).
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However, BMI has serious limitations. It does not distinguish between muscle and fat mass, meaning a strength athlete with a low body fat percentage might be classified as overweight according to this number, even if they are objectively in better shape than an average person with a normal BMI.
Body Fat Percentage: A more precise measurement is provided by assessing your body fat percentage (using methods like a DEXA scan, bioelectrical impedance, or calipers).
Waist Circumference: Another crucial metric is waist circumference. A measurement of over 102 cm for men and over 88 cm for women indicates an increased metabolic risk.
There is also a phenomenon known as "normal weight obesity" (NWO). This occurs when the BMI is within the normal range, but there is a high percentage of body fat.
Research from Comenius University in Bratislava, conducted on a sample of over 600 young Slovaks with normal weight, found that NWO occurs in 31.5% of women and 19% of men aged 18 to 30. In other words: the number on the bathroom scale does not tell the whole story.
Obesity as a Chronic Disease
In recent years, the World Health Organization (WHO), the American Medical Association (AMA, 2013), and the European Commission have officially recognized obesity as a chronic disease. It is more than just an aesthetic issue or a lack of willpower. What exactly does this mean?
Adipose tissue (body fat) is not a passive storage for calories. It is an endocrine organ that produces over 100 hormones and signaling molecules (known as adipokines). These substances secreted by adipose tissue affect metabolism, inflammation, and appetite.
In obesity, the balance of these signals is disrupted, leading to chronic low-grade inflammation, which is a strong risk factor for cardiovascular diseases, type 2 diabetes, certain types of cancer, and Alzheimer's disease.
💡 Obesity is a risk factor for over 200 health complications—ranging from diabetes and high blood pressure to depression and osteoarthritis. A weight reduction of just 5–10% can significantly decrease these risks, even if a person does not reach their "ideal" weight. |
We cover the stages of obesity, its causes, and specific health risks in detail in Part 2 of the series: Obesity as a Disease: Stages, Causes, and Health Risks.
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How to Lose Weight Healthily and Sustainably
The foundation is indisputable and physically inevitable: you cannot lose weight without a caloric deficit. A caloric deficit means the body takes in less energy than it expends, and it covers the difference from its reserves - primarily fat. What matters is how you achieve this deficit and how quickly. You either lose fat and maintain the result, or you lose muscle and in half a year you are right back where you started.
What does this depend on?
The source of calories affects the hormonal response. A diet rich in protein increases satiety, preserves muscle mass, and has a higher thermic effect of food (the energy the body uses for digestion). For example, 100 kcal from protein does not affect appetite and metabolism the same way as 100 kcal from white sugar.
Movement outside the gym matters more than you think. Brainum (2022, Applied Metabolics) summarized research showing that prolonged sitting reduces the activity of the enzyme lipoprotein lipase (LPL - the enzyme that allows muscles to use fat as fuel) by up to 90%. If you sit for most of the day, the body "switches" into a mode where it burns fat poorly. Even if you go work out in the evening, you burn fat much less efficiently than you could. The solution is simple: accumulate at least around 8,500 steps (roughly 6 km of walking) during the day. This is the threshold at which the body stays in "burning mode" and exercise works to its fullest potential.
Pacing has its limits. Crash diets (with extreme caloric deficits) lead to muscle loss, a drop in resting metabolic rate, and hormonal adaptations that sabotage long-term success.
And where does body fat actually go? Many think it gets burned for energy or turns into muscle. In reality, most of the fat's mass leaves the body by being exhaled as carbon dioxide. The rest is excreted as water in urine, sweat, and breath. This is a fundamental biochemical process that we detail in the blog article: Where Does Body Fat Go: Facts and Myths About Weight Loss.
💡 Reality instead of promises: A healthy pace of weight loss is 0.5 – 1% of body weight per week, which equates to 2 – 4% per month. For a 90-kg person, this means 0.45 – 0.9 kg per week, or approximately 1.8 – 3.6 kg per month. Not 5 kg per week. Not 10 kg per month. |
Why rapid weight loss fails and how exactly to calculate your optimal pace are discussed in Part 3 of the series: How Much is Healthy to Lose in a Month and Why Rapid Weight Loss Fails.
Practical dietary questions - how much protein, how to distribute macronutrients, what to eat and when - are covered in another article: What to Eat When I Want to Lose Weight: The Basics of Nutrition for Weight Loss.
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The Hormonal Dimension of Weight Loss
Here we get to the least understood and yet most important part of the story. Why do two people who eat the same and exercise the same lose weight differently? Why does the scale "freeze" after a few weeks of dieting? Why does the fat come back with interest after a successful diet?
The answer is: for everything, you must look at hormones.
The body perceives caloric restriction as a threat and actively defends against it. This is not speculation; it is confirmed by the most prestigious studies:
Sumithran et al. in the New England Journal of Medicine (2011) tracked participants of a 10-week diet program. Researchers measured levels of leptin, ghrelin, peptide YY, GLP-1, amylin, cholecystokinin, and insulin at the beginning, at the end of the program, and after a year. The conclusion? Hormonal changes that increase hunger and decrease satiety persisted for a year after the diet ended. The body does not hormonally "accept" the loss of fat over a few weeks.
Fothergill, Hall et al. (2016, Obesity) yielded even more dramatic results - a 6-year follow-up of 14 participants from the American competition "The Biggest Loser," who lost an average of 58.3 kilograms over 30 weeks. After six years, they regained an average of 41 kilos of the lost weight, their resting metabolic rate remained 704 kcal/day below the baseline, and their so-called metabolic adaptation (the difference between expected and actual metabolism) was -499 kcal/day. Translated into plain language: their bodies were burning nearly 500 kcal less per day than would be expected for their size. Permanently.
Which hormones play a role in this?
Leptin: The satiety hormone secreted by fat cells. During weight loss, it drops → the brain gets the signal "we have low reserves, eat!".
Ghrelin: The hunger hormone from the stomach. During weight loss, it rises → stronger hunger signals arrive between meals.
Insulin: Regulates blood sugar levels, and with insulin resistance (decreased cellular sensitivity), fats are hard to mobilize. This is also related to how blood sugar fluctuates during the day. We cover this topic in more detail in the article Glucose Revolution: Keep Your Blood Sugar Balanced.
Testosterone and Growth Hormone (GH) + IGF-1: Anabolic hormones. Their low levels make it difficult to preserve muscle mass during weight loss and worsen insulin sensitivity.
Cortisol: The stress hormone. Chronically high during sleep deprivation and stress, it promotes the storage of visceral fat (the dangerous belly fat around the organs).
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💡 A Brief Note on GLP-1 Medications (Ozempic, Wegovy, Mounjaro) In recent years, there has been a lot of discussion about injectable medications that significantly suppress appetite and lead to a weight loss of about 15–20% per year (Brainum, 5/2024, Applied Metabolics). However, there are three important facts that are often not mentioned in the media:
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You can read in detail about testosterone, IGF-1, insulin, leptin, and cortisol, as well as how to manage them naturally during weight loss, in Part 5 of this series: Hormones and Weight Loss.
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Psychology and Your Relationship with Your Body
This is the most underestimated part of the entire equation. Even if you have the perfect diet and training plan, stress, a lack of sleep, and an unhealthy relationship with food can strip you of all your progress.
All it takes is one tough week at work, a few sleepless nights, and by Friday evening, you find yourself mindlessly emptying the fridge.
A Few Scientifically Backed Facts:
Lack of Sleep: Sleeping less than 7 hours a day increases the levels of ghrelin (the hunger hormone) and cortisol (the stress hormone) while simultaneously decreasing leptin (the satiety hormone). The result? Greater hunger, more cravings for sweet and refined foods, and weakened willpower.
The Impact of Stress: Chronic stress and high cortisol promote fat storage in the abdominal area and worsen insulin sensitivity.
Emotional Eating: This is a very common reason for diet failure. It occurs when we eat not out of physical hunger, but out of boredom, sadness, frustration, or anxiety.
"All-or-Nothing" Thinking: This mindset triggers a harmful cycle: strict diet → the first "slip-up" → a feeling of failure → binge eating → an even stricter diet the next morning. From a long-term perspective, this approach is the least effective way to lose weight.
Body Image: A healthy relationship with your own body is the foundation of long-term success. People who lose weight for themselves and for their own well-being are more likely to achieve good results and maintain them over the long haul.
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The topics of stress, sleep, emotional eating, and building a healthy relationship with your body are covered in Part 6 of the series: Psychology and Weight Loss.
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Important Disclaimer: The information in this article is intended exclusively for educational purposes. It does not constitute medical advice or a recommendation for specific substances. Before using any dietary supplements, especially if you have health issues or are taking medication, consult your doctor or pharmacist.
📚 This article is part of the 6-part series How to Lose Weight Healthily. Continue reading the other articles:
Part 2: Obesity as a Disease: Stages, Causes, and Health Risks
Part 3: How Much is Healthy to Lose in a Month and Why Rapid Weight Loss Fails
Part 4: What to Eat When I Want to Lose Weight: The Basics of Nutrition for Weight Loss
Part 5: Hormones and Weight Loss: Testosterone, IGF-1, and Their Impact on Metabolism
Part 6: Psychology and Weight Loss: Self-Esteem, Stress, and Relationship with Your Body
Sources
EASO Eurobesity. Country Profile – Slovakia. 2024. https://eurobesity.org/advocacy/country-profiles/slovakia/
Global Nutrition Report. Slovakia Country Nutrition Profile. 2022. https://globalnutritionreport.org/resources/nutrition-profiles/europe/eastern-europe/slovakia/
EUFIC. Europe's obesity statistics: figures, trends & rates by country. 2024. https://www.eufic.org/en/healthy-living/article/europes-obesity-statistics-figures-trends-rates-by-country
Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, Proietto J. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597-1604. DOI: 10.1056/NEJMoa1105816 | PubMed: 22029981
Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, Brychta R, Chen KY, Skarulis MC, Walter M, Walter PJ, Hall KD. Persistent metabolic adaptation 6 years after "The Biggest Loser" competition. Obesity (Silver Spring). 2016;24(8):1612-1619. DOI: 10.1002/oby.21538 | PubMed: 27136388
Falbová D, Sulis S, Oravská P, Hozaková A, Švábová P, Beňuš R, Vorobeľová L. The Prevalence of Normal Weight Obesity in Slovak Young Adults and Its Relationship with Body Composition and Lifestyle Habits. Bratislava Medical Journal. 2025;126(10):2698-2707. DOI: 10.1007/s44411-025-00273-8
World Health Organization. Obesity and overweight – Fact sheet. WHO Geneva. 2024. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Brainum J. A Calorie is A Calorie–or is it? Applied Metabolics Newsletter. March 2022. appliedmetabolics.com
Brainum J. Fat Block: Why you Aren't Burning Fat with Exercise. Applied Metabolics Newsletter. December 2022. appliedmetabolics.com
Brainum J. Natural Alternatives to GLP-1 Agonist Drugs. Applied Metabolics Newsletter. May 2024. appliedmetabolics.com
