I’ve had a few patients recently tell me they don’t know why they can’t lose weight, even though they’ve been fairly active for a long time.

To me, this is a straightforward question. But it often surprises people because we’ve spent years swimming in mixed messages about weight loss. One of the persistent misunderstandings in the current zeitgeist is that the right kind of exercise is the key.

It isn’t.

Yes, the old calories in, calories out idea is broadly true, but some under-the-hood factors matter more over the long run.

The Real Drivers: Hunger, Stress, and Sleep

The essential problem with using exercise as a weight-loss tool is that our bodies naturally increase hunger signals in proportion to activity level. More exercise → more hunger → more eating.

On top of that, stress and sleep issues can push people to eat for comfort outside of true hunger signals and can disrupt our basal metabolic rate — the bulk of our everyday calorie burn, just to keep us alive.

Since BMR makes up most of our “calories out,” the real key shifts to intake and satiety. In other words:

How do we get full, and how do we stay full?

What Actually Increases Satiety

Protein, fiber, and water — in that order — do the heavy lifting for satiety.

This is why both major “diet camps” end up being partially right. Keeping fat intake somewhere around what’s needed for hormone synthesis (roughly 20–30% of total calories) is ideal. Carbohydrates can be kept relatively low, as long as you have enough for energy and daily functioning.

Unsurprisingly, properly built salads and soups can work well because they activate stretch-receptor satiety signals. But that’s not the only option anymore. There are now high-fiber, resistant-starch breads, bagels, and even rice prep methods that make fullness and blood-sugar stability easier than ever.

Protein remains the keystone, though. It directly triggers the big satiety hormones, leptin and ghrelin. Ideally, each meal should have a solid source of protein; snacking on chips alone just won’t trigger fullness in the same way.

So… Is Exercise Useless?

No — exercise is fantastic for almost everything except weight loss. It helps a little, but the bulk of the challenge is increasing awareness around intake, hunger cues, and general wellness.

Practical Tools That Actually Help

Track Your Intake (Even Briefly)

Apps like MyFitnessPal can give you a more objective sense of your true calorie intake. Many people do well through the week but “let loose” on one or two days. If you keep tracking on those days, you’ll often see how the weekly average ends up far higher than your “good day” calories — and that’s enough to stall progress.

We are very good at taking in a large number of calories at once, so consistency really does matter.

Know Your Numbers

If you’re curious about specifics, look up a TDEE (Total Daily Energy Expenditure) calculator online. Let’s say it gives you 2500 calories/day. Eating about 500 calories below that each day should yield roughly one pound of fat loss per week, assuming everything else is stable.

Just remember: water weight moves much faster than fat. Don’t let normal day-to-day scale fluctuations derail you. Trust the intake tracking, use measurements, or average your weight over a week or month to get a clearer view.

Nutrition is one of those topics that somehow feels both incredibly simple and endlessly complicated. With so much conflicting advice, it’s easy to get lost in the noise. So today, let’s keep it relatively simple and bite off a digestible piece of the nutrition puzzle by tackling one of the biggest myths out there.

Myth: The key to a healthy diet is cutting out an entire macronutrient—fat, carbohydrates, or protein.

The truth is, most bodies do best with a balanced intake of all three macronutrients. The real solution isn’t about elimination—it’s about finding the right quality and balance based on your body’s needs and your lifestyle.

Fats aren’t the villain they were made out to be in the 90s. They’re essential for hormone production, brain health, and absorbing fat-soluble vitamins like A, D, E, and K. There are two things to watch with fats: they’re calorie density, and quality.

Because fats are calorie-dense, moderation is important. Personally, I aim for about 30% of my daily calories from fat, which works out to roughly 50–60 grams. On the quality side, it’s important to know that not all fats support your health equally. The trans fats and highly heated vegetable oils used for things like french fries don’t nourish your body the same way olive oil or coconut oil will.

Carbohydrates play a valuable role in supporting both metabolic health and digestion. Fiber-rich carbohydrates—like vegetables, fruits, and whole grains—help moderate insulin response, support healthy blood sugar levels, and keep your digestive system running smoothly. For active individuals and athletes, carbohydrates provide a readily available source of energy to fuel workouts and aid recovery.

For individuals who are more sedentary and struggling with obesity, reducing highly processed carbohydrates—like sodas, juice, candies, and refined snacks—can be a particularly effective strategy for weight loss. These fast-digesting carbs spike insulin, promote fat storage, and often add a lot of calories without providing lasting satiety. While it’s not about cutting all carbs, focusing on slower-digesting, fiber-rich sources can make a significant difference in controlling hunger, stabilizing energy levels, and encouraging weight loss when needed.

Protein is essential for tissue repair, hormone health, and maintaining muscle mass as we age. The real question is: where should you get your protein? While vegetables and plant foods provide valuable micronutrients, they lack certain critical nutrients that are abundant and highly bioavailable in animal-based foods—specifically vitamin B12, heme iron, and long-chain omega-3 fats.

In the context of weight loss, protein also plays a key role in promoting satiety by influencing the hunger hormones leptin and ghrelin. It’s also uniquely inefficient for the body to convert into usable energy, meaning you can eat more volume while absorbing fewer calories—an advantage when trying to lose weight. On top of that, protein supports muscle growth and maintenance, which helps preserve a higher basal metabolic rate.

With careful planning and supplementation, it’s certainly possible to maintain good health on a fully plant-based diet. But in my view, it’s much easier—and often more sustainable—to support long-term health by including animal-based foods, ideally from free-range and responsibly raised sources for both ethical and nutritional reasons.

In conclusion, there’s a place for each macronutrient in a healthy diet. As cliché as it sounds, lasting health really does come from finding the right balance of whole foods, rather than trying to min-max a single slice of the pie.