It’s literally cals in cals out.
Its math. There metabolism can slow or change and if they kep eating the same amount you will not lose weight
How does ozempic work? It tricks you to eat less.
Old, young, woman, man, medication, cake, chocolate, sit on the couch, etc…. it only matters about calories in vs calories out.
Cals in/out is true but very oversimplified. The amount of calories your body needs, metabolic efficiency, internal resource allocation, etc, can change a lot with age or hormone changes. So you might not be able to accurately assess your caloric needs and it’s very difficult to revamp your habits/lifestyle to adjust, especially as you get older and less active.
Even if you are well-versed in weight loss, even if you know calories by heart, even if you run and weight-train, even if you’ve tried every diet, for some ungodly reason, it’s not difficult to lose weight over, say, age 50, it’s damn near impossible.
Mother nature protects women in old age, we need fewer calories to maintain weight. A LOT fewer, which is great if you’re a hunter-gatherer, not so much in 2024.
People typically lose 3–8% of their muscle mass each decade after age 30, and the rate of decline increases after age 60. Muscles are your metabolism engines. Muscle tissue can absorb glucose, which results in improved insulin sensitivity and lower blood sugar levels, and it stores excess glucose as glycogen; and when people lose muscle mass, this entire process becomes less efficient and they can become more insulin resistant.
To put it in ELI5 terms.
Losing weight is simply Calories In/Calories Out.
Calories out refers to how much your calories you burn from everything whether that’s exercise or from just existing (metabolism.)
Most things that makes it harder to lose weight affect the Calories Out. Things like PCOS and other things effect hormones which effects yours metabolism which causes the calories out to decrease, meaning you need less calories in to lose weight.
Hormones and activity play a major role in how much calories we burn. Just standing burns a lot more calories than sitting. Walking burns more yet. Generally as we get older we do far less activity even if that means just sitting more instead of standing. Couple that with hormonal influence on appetite and now you feel hungrier than normal so you eat more. Many people don’t even realize they’re beginning to eat more than they had. Finally when you are young, you’re not only burning calories for energy but also to grow and build your body. This takes an enormous amount of calories. You no longer need those additional calories beyond when your are done growing.
I heard this analogy that’s saying “weight is about calories in/calories out” is like saying “you win a basketball game by scoring more points”. It’s true, but also mostly uninformative and not that helpful.
In answer to your specific question: accumulation of fat and efficiency of calorie usage change with age and hormones. The specific chemistry/biology of why an individual person is having trouble losing weight is hard to pin down (because if we knew pharma companies would have a way easier time selling them weight loss drugs)
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