Confused about weight loss? Endocrinologist explains where to start right
Endocrinologist explains how to build a realistic weight-loss plan that can help you lose fat without regaining it
 "Confused about weight loss? Endocrinologist explains where to start right")
Most people don’t struggle with weight loss because they lack discipline, but because they follow plans that don’t account for how the body actually works. Doctors say weight loss is shaped by hormones, metabolism, sleep, stress, and habits, not just diet and exercise. “Understanding this is the first step to building a plan that leads to real, lasting results,” says Dr Jatin Kumar Majhi, Associate Consultant – Endocrinology at Manipal Hospital, Bhubaneswar.
“If weight loss were just about eating less and moving more, most patients wouldn’t still be stuck in the loop of diets that start on Mondays and disappear by Fridays. The real reason weight loss feels so hard is that the body is a complex hormonal, emotional, and adaptive system,” he further says.
So how do you actually build a weight-loss plan that works for your body, not against it?
How to set a realistic weight-loss goal that actually reflects fat loss
“Weight loss should never be attributed solely to the weighing scale,” explains Dr Majhi. A drop in kilos doesn’t tell you if you are losing fat, muscle, or just water.
Instead, he says, waist circumference and body-fat percentage are far more meaningful because they reflect loss of visceral fat, which is the deep abdominal fat linked to diabetes, heart disease, and hormonal imbalance. Metabolic markers such as blood sugar, cholesterol, insulin levels, and blood pressure matter just as much.
So, what’s the sweet spot?
According to Dr Majhi, a weight loss of 5–10 per cent over three to six months is enough to produce clear metabolic benefits.
Does a calorie deficit still matter, or is it all about hormones?
Calories still matter, but are not the whole story.
“A calorie deficit is necessary, but it’s not sufficient on its own,” says Dr Majhi. Hormones like insulin, leptin, ghrelin, cortisol, and thyroid hormones play a decisive role in hunger, fat storage, and energy use.
When calories are slashed aggressively, the body responds defensively by slowing metabolism and amplifying hunger signals. This is why crash diets feel heroic at first and miserable soon after.
He also stresses that sleep, stress, insulin sensitivity, age, and sex hormones are also very important factors when it comes to weight loss.
“Poor sleep and chronic stress raise cortisol levels, which push the body towards storing fat, especially around the abdomen,” Dr Majhi explains.
Genetics do play a role, but they are often exaggerated. So are claims around gut ‘cleanses’ and metabolism-boosting supplements. “Many of these ideas have little scientific basis,” he adds.
Is there one ideal diet for weight loss that works for everyone?
From an endocrine perspective, Dr Majhi says adequate protein is a non-negotiable. “It preserves muscle and helps control appetite,” he stresses.
Carbohydrates should be individualised. He recommends lower for people with insulin resistance or PCOS (polycystic ovary syndrome), moderate for others, with a focus on high-fibre, low-glycaemic sources. Healthy fats support hormonal health but need portion control.
“Low-carb diets, high-protein plans, and intermittent fasting can all work if they create a calorie deficit and are sustainable. Adherence matters a lot in the weight-loss journey,” he says.
What kind of exercise actually helps burn fat and keep it off?
“Exercise helps preserve muscle, improves insulin sensitivity, and protects metabolic rate,” says Dr Majhi. It’s crucial at all ages, especially to prevent muscle loss and metabolic slowdown.
Walking remains one of the most underrated tools. Beginners and people with obesity should start with low-intensity activity, while older adults should prioritise muscle-strengthening exercises that protect the joints.
The best exercise, he emphasises, is the one you can do consistently.
Why weight-loss plateaus happen even when you’re doing everything right
As weight drops, metabolism slows, energy requirements decrease, and hunger hormones rise. “This is the body adapting,” Dr Majhi explains.
Instead of cutting calories further, smarter adjustments include improving sleep, managing stress, increasing protein, changing exercise stimulus, or even maintaining weight temporarily to allow hormones to stabilise.
Why weight loss gets harder for women during PCOS, perimenopause and menopause
According to Dr Majhi, hormonal fluctuations make women’s weight loss uniquely complex. With PCOS, insulin resistance makes carbohydrate management critical. During perimenopause and menopause, falling oestrogen levels shift fat storage towards the abdomen and slow metabolism.
“Weight training, higher protein intake, stress management, and realistic expectations become especially important,” says Dr Majhi.
When should weight-loss medicines be considered, and who needs them?
Medications may be an option for people with a BMI of 30 or more, or 27 and above if obesity-related conditions such as diabetes or hypertension are present.
“These drugs regulate appetite, hunger, and metabolism, but they are not a substitute for lifestyle change,” Dr Majhi cautions. Without addressing diet, movement, sleep, and stress, weight regain after stopping medication is common.
What separates quick weight-loss plans from long-term weight loss
Short-term plans rely on motivation. Long-term success relies on systems.
Sustainable weight loss allows flexibility, including social meals, cultural foods, rest days, without guilt as it moves away from perfection and towards an actual identity change. “The goal is to see yourself as a healthy person, not someone perpetually ‘on a diet’,” Dr Majhi notes.
Red flags that your weight-loss plan is unhealthy or backfiring
Some of the red flags of an unhealthy weight-loss plan, according to Dr Majhi, include:
- promises of rapid weight loss
- extreme calorie cuts
- eliminating entire food groups without medical need
- fear of eating
- obsessive weighing
- menstrual disturbances
- hair fall
- fatigue
- mood changes
- declining mental health
“From an endocrinologist’s perspective, a healthy plan should improve energy, hormones, and quality of life, not damage them,” Dr Majhi says.
To those on this journey, and those struggling to start one, Dr Majhi reassures that weight loss is not a punishment, it is an act of love to your future self.
A doctor-recommended weight-loss plan template
| Component | What to aim for | Why it matters |
|---|---|---|
| Primary Goal | 5–10% body weight reduction over 3–6 months | Even modest weight loss leads to meaningful improvements in blood sugar, cholesterol, blood pressure, and hormones |
| Progress Tracking | Waist circumference, body-fat %, energy levels, metabolic markers | The scale alone doesn’t show fat loss or metabolic health |
| Calories | Mild, sustainable calorie deficit (not extreme) | Prevents metabolic slowdown, fat storage, and excessive hunger |
| Protein Intake | Adequate protein at every meal | Preserves muscle, controls appetite, supports metabolism |
| Carbohydrates | Individualised: lower if insulin resistant or PCOS; moderate otherwise | Helps manage insulin levels and fat storage |
| Fats | Healthy fats in controlled portions | Essential for hormone health, but calorie-dense |
| Diet Pattern | Any approach that’s sustainable (balanced, low-carb, Intermittent Fasting, etc.) | Adherence matters more than diet type |
| Exercise – Daily Movement | Walking or light activity most days | Improves insulin sensitivity and heart health |
| Exercise – Strength | 2–3 days/week muscle-strengthening exercises | Prevents muscle loss and metabolic slowdown |
| Sleep | 7–8 hours, consistent timing | Poor sleep raises cortisol and increases fat storage |
| Stress Management | Mindfulness, rest days, boundaries | Chronic stress blocks fat loss through hormonal pathways |
| Plateau Strategy | Improve sleep, protein, training variety; hold weight temporarily | Plateaus are biological adaptation, not failure |
| Women-Specific Adjustments | Higher protein, strength training, realistic goals | Hormonal shifts affect fat distribution and metabolism |
| Medications (if needed) | Only with medical supervision and lifestyle change | Not a replacement for habits; regain risk otherwise |
| Mindset | Progress over perfection; identity shift | Long-term success depends on habits, not motivation |
| Red Flags to Avoid | Rapid loss claims, extreme restriction, food fear | Signals unhealthy or unsustainable plans |
This content is for informational purposes only and is not a substitute for professional medical advice.