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Do you keep trying weight loss diets but can’t seem to drop the pounds? Are you instead exhausted and frustrated by an ever growing layer of fat?

Calorie-restricted diets have been popular for decades as a way to lose weight, but clearly more is at play as many people under eat and still can’t lose weight or keep it off.

If you’re doing everything right and the fat isn’t budging, the culprit may lie in underlying health issues slowing metabolism and blocking fat burning.

Feast or famine? Dieting slows metabolism for years

For most of human history, life vacillated between feast or famine, with plenty of bouts of famine. The human body body has smart coping mechanisms to get us through hungry times — lowered metabolism and increased fat-storage hormones.

As far as the body is concerned, a low-calorie diet is a famine and it employs the same measures to save you from starving. As a result, each low-calorie diet can add weight in the end when you resume normal caloric intake.

This dieting-caused metabolic slow-down can last for years. The phenomenon was recently documented in participants from the The Biggest Loser reality TV show. Six years after participating, contestants’ metabolic set point was below what it was when they started. They burn up to 800 fewer calories per day! After all that hard work, most of them returned to their pre-show weight and have to under eat in order to prevent weight gain.

Dieting disrupts key hunger hormones

Conversely, if you have a history of overeating or eating too much sugar, you may suffer from leptin resistance, which hinders fat burning.

Leptin is a hormone that controls appetite, satiety — that feeling of being full and satisfied — and whether your body burns or stores fat. A diet is high in starches and sugars causes frequent swings in blood sugar. This leads to chronic insulin surges, which, in turn, cause cellular resistance to leptin. With leptin resistance, you’re constantly hungry and you store fat.

Lowering intake of processed carbohydrates and exercising regularly help sensitize the cells to leptin so your hunger cues and fat burning abilities return to normal.

Underlying health issues hinder weight loss

For most people, weight loss is not as simple as “calories in, calories out.” Sometimes inflammation and other metabolic factors can be a driving factor behind the inability to lose weight.

Many people are surprised to find unwanted pounds drop away when they follow an anti-inflammatory diet. These nutrient-dense diets void of inflammatory triggers are used to manage pain, digestive problems, autoimmune diseases such as rheumatoid arthritis and Hashimoto’s hypothyroidism, high blood pressure, depression  anxiety, and other health issues.

Why do they work? Excess weight can be a symptom of underlying health imbalances that slow metabolism and block weight loss. Systemic inflammation, leptin resistance, hormonal imbalances, stress, leaky gut, blood sugar imbalances, food intolerances, and hypothyroidism are examples of factors that block weight loss.

How do autoimmune protocols and diets fit in?

The autoimmune diet and protocols are effective for people suffering from various chronic illnesses. Anti-inflammatory in nature, special attention is given to gut health and food reactivity.

While highly effective for many in not only managing autoimmunity but also dropping unwanted pounds, sometimes people take these diets to low-calorie extremes. Even if you’re eating healthy foods and avoiding the inflammatory ones, it’s still important not to starve the body and trigger the famine response that holds onto fat.

In fact, increasing healthy fats, protein, and nutrient-dense foods encourages the body to drop pounds. Meeting your nutritional needs, providing healthy sources of fat to remind the body it’s not a time of famine, and enough protein to keep blood sugar stable are key for helping the body increase its metabolic rate and drop extra weight.

Functional medicine has effective ways in working with underlying health issues that hinder weight loss.