Some details:

upper 30's sister weighed 173 in Aug 2022 and decided to change diet/lifestyle
she is 5'6"
has always struggled with her weight and wanted to make a change (started with food instake)
lost 40 pounds and weighed 133 May 2023
also quit smoking in the summer of 2023
she doesn't consume alcohol
since July, she has gained 15 pounds but has not changed her diet
her diet went from typical American diet to mostly a diet formed around Whole30 (no dairy, no grains, only protein vegetables and fruit)
she even removed fruit a month ago
she also added pilates and 1 mile walks, everyday, for the past 45 days

She is frustrated and stumped and can't figure out why she is gaining weight. I am at a loss as well. There has to be a scientific reason to her body adjusting etc? Any thoughts?

I mean… you've checked every box on your checklist above… with the exception of the first one that pops in my head when a female gains weight… just sayin.

Assuming she isn't pregnant - I know you said she hasn't changed her diet. That could mean she hasn't changed what she eats, but she still could be eating too many calories.

Now that her body is smaller, her BMR is lower - meaning her body needs less calories to function. If she isn't tracking food intake/calories, she may no longer be eating in a caloric deficit (or even maintenance) for her new weight. She may need to cut back on total calories to maintain.

She may also be overeating, and given she is doing a whole food diet, she is most likely overeating fat.

Haha. I am at a loss here. But she cannot have children anymore! Definitely not pregnant.

Great info thank you. I have shared this thread link with her for the replies.

I'm curious how this pans out for her. I'm a few years older, and have been actively working the last few years to shed fat and build muscle.

I put on a few lbs this year (granted some of it is muscle), but my attempts to lose a little fat have not gone as smoothly as they did when I first started this process.

Admittedly, I am not being as strict about what I eat as I was initially, but I also know time isn't on my side. I can literally feel my hormones changing, and nothing gets any easier as I get older.

I do feel like a "trap" of keto and whole food diets is a misnomer that people can eat whatever they want and not gain weight. While it is harder to gain weight when you eat all or mostly protein and veggies, if calories in exceeds calories burned, you will gain weight. And since oils and fatty meats are typically ok on keto and whole food diets, it's easy to over eat fat.

I'm about her same height and weight, and my BMR is about 1400 calories. I can get away with 1500-1700, assuming I'm following my normal exercise routine. But much more than that, and I'll gain weight.

A couple tbsps of oil would blow that calorie limit out of range.

I know calorie counting is not sustainable all the time, but when there is an unexpected an unexplained weight gain like this a good idea would be to track calories.

My fitness pal is a great app with so many foods, drinks etc... already in the database. I also have a Garmin fitness watch that tracks activity and estimates calorie burn. It syncs with My Fitness Pal and will give you an estimated "net" calories for the day. Very insightful when you track absolutely everything for a few days together.

It's helpful to do for a bit because it may give her insight on some sneaky calories and a picture of her macros (Fat/carb/protein). There may be some "diet" food that isn't all that diet. I remember when I did hardcore keto, you have to watch the "keto friendly" marketed food, because some of it was a damned lie.

I fitness watch that tracks steps and even better estimates calories burned, etc.. will also give her an idea if she is getting less exercise or movement. There may be another life change such as job, seasonal outdoor activity that is causing her to burn fewer calories.

Even more hardcore would be a continuous glucose monitor. There is a dude on Insta that installed one of those permanent ones on his arm. He eats food, monitors and posts the rise in his glucose level. @insulinresistant1. Interesting follow to see spike in glucose that you don't expect.

Thank you for this reply. Sending it to her.

Good suggestion. Thank you.

GeorgiAg said:

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I know calorie counting is not sustainable all the time, but when there is an unexpected an unexplained weight gain like this a good idea would be to track calories.

My fitness pal is a great app with so many foods, drinks etc... already in the database. I also have a Garmin fitness watch that tracks activity and estimates calorie burn. It syncs with My Fitness Pal and will give you an estimated "net" calories for the day. Very insightful when you track absolutely everything for a few days together.

It's helpful to do for a bit because it may give her insight on some sneaky calories and a picture of her macros (Fat/carb/protein). There may be some "diet" food that isn't all that diet. I remember when I did hardcore keto, you have to watch the "keto friendly" marketed food, because some of it was a damned lie.

I fitness watch that tracks steps and even better estimates calories burned, etc.. will also give her an idea if she is getting less exercise or movement. There may be another life change such as job, seasonal outdoor activity that is causing her to burn fewer calories.

Even more hardcore would be a continuous glucose monitor. There is a dude on Insta that installed one of those permanent ones on his arm. He eats food, monitors and posts the rise in his glucose level. @insulinresistant1. Interesting follow to see spike in glucose that you don't expect.

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I agree with all of the above except for the bolded part. I know these things are claiming to help with weight loss, but there's just no association between blood glucose levels and weight loss.

I get the need to have some sort of feedback as a proxy for trying to lose weight, but this ain't it.

Please save your money

Thank you all. She is going to download MyFitnessPal and track her calorie and macro intake. I'll circle back in a month!

Quitting smoking is such a fabulous health change for her to make. But it's not uncommon that people see some weight gain after smoking cessation. Does she ever run or participate in other higher pace cardio? Walking burns "nothing" for me but even 5-10 miles a week running shows results pretty quickly. Her age is also a factor. Sure is frustrating but sluggish results are par for the course approaching 40. She's made incredible progress!!

A little bit of light weight training. You need muscles and to use them to help consume calories. Activity level changes?

True Anomaly said:

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I agree with all of the above except for the bolded part. I know these things are claiming to help with weight loss, but there's just no association between blood glucose levels and weight loss.

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There is a strong correlation between insulin and weight gain though, and increased insulin in the body is caused by increased blood sugar. And then as you get fatter your body develops insulin resistance and creates this vicious cycle where your body makes more and more insulin in an effort to try and regulate glucose in your body, which only causes more weight gain.

I don't think most people need to constantly monitor their blood sugar, necessarily, but insulin and insulin resistance definitely impact body fat.

Thyroid function been checked?

Hoss said:

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True Anomaly said:

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I agree with all of the above except for the bolded part. I know these things are claiming to help with weight loss, but there's just no association between blood glucose levels and weight loss.

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There is a strong correlation between insulin and weight gain though, and increased insulin in the body is caused by increased blood sugar. And then as you get fatter your body develops insulin resistance and creates this vicious cycle where your body makes more and more insulin in an effort to try and regulate glucose in your body, which only causes more weight gain.

I don't think most people need to constantly monitor their blood sugar, necessarily, but insulin and insulin resistance definitely impact body fat.

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We already have a measure of insulin resistance- the hemoglobin A1c. If your A1c is not suggestive of insulin resistance, then the concern about taking in more blood sugar leading to more fat deposit has no real world clinical effect

But putting aside that fact….your above scenario is only true if your total energy intake is higher than your energy expenditure.
If energy in < energy out consistently, then the fear of putting on more weight even if you're insulin resistant is unfounded

Doesn't the A1C test check your blood sugar levels only? Most doctors don't check the fasting insulin levels, you usually have to request that one.

Jbob04 said:

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Doesn't the A1C test check your blood sugar levels only? Most doctors don't check the fasting insulin levels, you usually have to request that one.

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It is the best way to get an average of your blood glucose levels over the timespan of 3 months.

You know why doctors don't want to check a fasting insulin level? Because it doesn't tell you anything clinically. It's a number that doesn't signify anything of importance. It especially has nothing to do with weight loss

I understand why some people are concerned about controlling your insulin. But the question is WHY?

Insulin is one of MANY signals that tell the body to store fat. You can easily store body fat without insulin playing any role. And you can LOSE weight with high insulin levels, because we know from direct human observation that high-carb diets also can caused sustained weight loss- just as well as low carb diets can. So how does insulin play a role in weight loss when both high and low carb diets show equal success with losing weight?

Finally….we have a whole new class of drugs that cause significant weight loss all by themselves- the GLP-1s (Ozempic/Wegovy/Monjauro). Do you know that these drugs DIRECTLY STIMULATE INSULIN RELEASE from the pancreas? So how do they cause weight loss if they're also telling your pancreas to constantly release more insulin? Because insulin plays no significant role in actual weight loss

Good info, thanks

The biggest impact could be from quitting smoking. Nicotine stimulates the metabolism and quitting can have a significant effect, especially since she's getting older and her metabolism is slowing down already. The overall effect on her health is 100% worth it, but it's an unpleasant side effect nonetheless. She is probably hungrier in general than before, with a slower metabolism.

From the linked article:

• The nicotine in cigarettes speeds up your metabolism. Nicotine increases the amount of calories your body uses at rest by about 7% to 15%. Without cigarettes, your body may burn food more slowly.
• Cigarettes reduce appetite. When you quit smoking, you may feel hungrier.

Medline: Weight gain after quitting smoking: What to do