When two people start weight care at the same time and eat the same food, it seems to follow that the same thing should happen to both, so a gap between them reads as proof that one of them is doing something different. That reasoning starts from something true: overweight and obesity can develop over time when you take in more calories than you use, which is called an energy imbalance. The calories you use are your own, spent on things such as breathing, digesting food and being physically active, so you can check a gap between two people one factor at a time instead of reading it as a verdict on yourself.
What sets each person's weight besides the dinners you share
Besides the dinners you share, everyday factors can play a role in your weight, and the risk of developing overweight or obesity is determined by more than how much you eat. That risk also takes in the types and amount of food and drink you have across each day, your level of physical activity, for example whether you sit at an office desk or are on your feet all day, and how much good-quality sleep you get each night. All of these factors, as well as many others, can contribute to weight gain.
Some of those factors belong to the person, such as knowledge, skills and behaviors, and others sit in the places around them, such as a school, a workplace or a neighborhood. Food industry practices and marketing, and social and cultural norms and values, can affect the risk as well. Two people who share a kitchen can still differ on most of these.
Which parts of what the two of you do are actually the same
The part the two of you actually do the same is one meal a day. Of the six factors below, it touches only diet, and the six are not the whole list.
- Diet. Breakfast, lunch, drinks and anything eaten between meals are each person's own, and so is the amount that goes on each plate at the shared table.
- Activity level. A working day at a desk and a working day on your feet use different amounts of energy.
- Stress level. Long-term and even short-term stress can affect the brain and trigger the body to make hormones, such as cortisol, that control energy balance and hunger urges, and those hormone changes can make a person eat more and store more fat.
- Sleep habits. Research has shown a link between poor sleep and a high BMI, where poor sleep means too little sleep or too little good-quality sleep, and regularly getting less than 7 hours a night can affect the hormones that control hunger urges. Sharing a bedroom does not mean sharing the same hours or quality of sleep.
- Family history and genetics. Some people are predisposed to being heavier, and researchers have found at least 15 genes that influence obesity. For people with a genetic high risk for obesity, making healthy lifestyle changes can help lower that risk.
- Age. Age can play a part in your weight too, and partners are not always close in age.
Several of these, such as your genes and your age, are not choices, and you may not be able to change all of your risk factors. Your surroundings count as well: your environment includes your home, the buildings where you work or shop, the streets and the open spaces, and a couple who share a home can still spend their days in different ones. A desk job, a night of broken sleep or a hard stretch at work is seldom decided at the dinner table.
What moving more does while the scale stays still
Increased physical activity may not have a big impact on weight loss, yet it has important health benefits that are independent of weight loss itself, and many that are independent of other healthy behaviors, like good nutrition.
Some benefit comes from any amount of activity, and some can come quickly: physical activity can reduce anxiety and blood pressure and improve quality of sleep, among other things. The most benefit comes when an adult does at least 150 to 300 minutes of moderate-intensity aerobic activity a week, a brisk walk being one kind, plus muscle-strengthening activity, such as push-ups, on no fewer than 2 days each week (see Why the same routine does less once you reach your goal weight). Kept up over time, meeting those recommendations can lead to even more long-term benefits, which for adults include helping to prevent several types of cancer, reducing the risk of dementia, heart disease, stroke, high blood pressure, type 2 diabetes and depression, and improving bone health, physical function and quality of life.
Keeping track of your weight is one way to check for changes in your health, but it cannot tell you the whole story, because your weight is the total of your muscle, bone, fat and water. A scale reading leaves out benefits such as lower blood pressure or better sleep, so a weight that has not moved does not mean the extra activity did nothing.
When chest pain or shortness of breath means calling 911
Chest pain, heaviness or discomfort, pain or discomfort in one or both arms, the back, shoulders, neck or jaw, and shortness of breath at rest or while doing a little physical activity are among the symptoms of a heart attack, which can start slowly and be mild, or be more serious and sudden. If you think you might be having a heart attack, on a walk or anywhere else, call 911 without waiting to be certain, and do it before you write to your NicoCares care team in Spruce, because NicoCares publishes no time by which a message there gets an answer. Let the ambulance take you even if your partner offers to drive, since people who arrive by ambulance often get faster treatment at the hospital.
What is worth asking your own doctor about your weight
Your own doctor can check what no comparison at home can: during a visit, your doctor may review any medical problems you have and the medicines or dietary supplements you take, to see whether they may be affecting your weight or your weight loss. Sometimes a general office visit passes without anyone raising food, physical activity or weight, so you may need to bring the subject up yourself.
Weight that has been climbing while you try to bring it down is weight gained without trying, and gaining or losing weight without trying is a reason to talk to your own doctor. A sudden, unexpected change in weight can be a sign of a medical problem, and causes of sudden weight gain can include certain medicines, thyroid problems, heart failure, kidney disease and liver disease. Call that doctor's office and ask for a visit about it. Some conditions, such as metabolic syndrome and polycystic ovary syndrome, cause people to gain weight, and they must be treated for a person's weight to come close to or into the normal range.
Medicines can play a part as well. Some medicines cause weight gain by disrupting the chemical signals that tell your brain you are hungry, including antidepressants, antipsychotics, beta-blockers used for high blood pressure, birth control, glucocorticoids, which are often used to treat autoimmune disease, and the hormone people with diabetes take to control their blood sugar. If your weight has gone up while you take one of them, ask the doctor who prescribed it whether there are other forms of the same medicine, or other medicines that can treat your condition with less of an effect on your weight. Talk with that doctor or your pharmacist before you stop taking a medicine your doctor prescribed (see Could your antidepressant be part of the weight gain?).
As a NicoCares patient, your plan comes from the physician who reviewed your answers and is built around your own health profile and goals, and NicoCares measures success in energy, comfort and mobility. If you take any of the medicines above, tell your care team about it in Spruce as well.
