Boosting Our Metabolism

Can we increase our body's energy expenditure to lose weight and become healthier?

Common question: What can I do to increase my metabolism? I’ve been exercising more than an hour a day and not losing weight. Are there supplements or prescription meds I can take to help boost my metabolism?

One of the most reductionist ideas about losing weight is that the following equation holds true:

body weight = (calories consumed) - (calories burned)

If only this were true, we could simply adjust the caloric variables and lose weight. But I have learned over the years, listening to my patients’ frustrations, that something must be very wrong with this equation. Simply cutting calories does not add up to the weight loss we expect. Embarking on a back-breaking and knee-injuring exercise program does not burn off the weight we expect either. And sure enough, we are learning more about the many buffers built into our metabolism that prevent easy weight loss. I think the equation is more like this:

body weight = (calories consumed) - (calories burned) + (a whole bunch of compensatory metabolic switches that aim to maintain whatever body weight set point we’re currently at, consistent with the evolutionary advantages of a flexible metabolism that’s geared towards preserving life, but not necessarily preserving a societal construct of beauty)

OK, so that equation needs some work. It won’t be going viral anytime soon. If I lied like a celebrity doctor, and told you losing weight was as simple as eating “green-coffee bean extract,” I too might make millions and sit next to Oprah.

But instead, I’m going to grind through the nuanced, hard truths about metabolism, and what we are increasingly learning about it through scientific study. I hope this validates your experiences, and provides some evidence-based guidance on how to realistically and successfully approach weight loss. And at the end I’ll throw in some family doctor advice of my own about losing weight as collected from scientific studies, patient stories, and medical literature. This post is a long read, and I’ve packed it dense with nutrients like a massaged kale salad.

We will even note that there are no overweight apes. Even those in captivity do not become obese. Why is that?