Roughly 80% of people who lose a significant amount of body fat have a difficult time keeping all of it off for even 12 months afterward. This struggle is across virtually every type of diet, from low-carb to keto.
The best way to lose weight and keep it off is to understand your body’s biology. Simply restricting calories can cause your body to interpret these changes as a threat, spiking appetite hormones like ghrelin and lowering your resting metabolic rate. Many other factors also contribute to obesity, including menopause and andropause (aka low T), genes, medications, sleep and the microbiome.
At Balanced Medical Solutions, we see San Francisco Bay Area patients in Hayward, CA, every week who have been through this cycle multiple times and are ready to break it. Often, they aren’t eating poorly or avoiding exercise; their bodies are simply fighting against them, and they need additional support to lose weight for good. If you are ready to be a healthier weight by 2027, we are here to help. Come see us at our clinic in the St. Rose Hospital Medical Office Building.
How to Set a Realistic Timeline for Your Weight Loss
When losing weight, it is important to establish goals that are achievable and healthy for your body. You should plan to lose weight at a pace that your body can sustain without triggering biological responses that cause weight gain.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends aiming for around a 5%-10% reduction in your weight as a starting point. Even a 5% reduction can provide measurable improvements in blood pressure, blood sugar and cholesterol. Weight loss should happen at a rate of about one to two pounds per week in order to be safe and healthy. Those who lose weight gradually are more likely to keep it off. Starting in June, a 5-10% reduction by 2027 is a reasonable goal for most people, with steady and consistent habits.
Supporting Your Goals With Medical Weight Loss
More than one-third of adults in the U.S. meet the clinical definition of obesity according to CDC data from 2023. Many of these individuals have been told to simply eat less and move more, but have not been evaluated for underlying medical factors that are driving their weight gain.
With medical weight loss, you spend time with medical providers specializing in weight challenges who help uncover root causes, set realistic weight loss goals, provide medical assistance when needed, and check in often to make sure you are making good progress and staying healthy. During our medical weight loss evaluation at Balanced Medical Solutions, we start by exploring factors behind weight gain, such as:
Metabolic Factors
Your metabolism is used to describe the processes your body uses to convert food into energy. Underlying medical issues can affect your metabolism and cause the body to burn fewer calories or store more fuel as fat. Conditions like insulin resistance can make weight gain more likely by changing how the body handles sugar and fat. Even modest calorie intake can be harder to balance with metabolic changes.
Hormonal Factors
Hormones influence hunger, feelings of fullness, blood sugar control, fat storage and how efficiently the body uses energy. When there are problems with sex hormones, like estrogen or testosterone, or other hormones like thyroid, insulin and cortisol, it can lead to unexpected weight gain. Growth hormone decline can also cause some people to gain weight more easily.
Furthermore, as the body ages, hormonal shifts during menopause in women and andropause (declining testosterone production) in men, change how fat is stored and how efficiently calories are burned. These hormones normally help regulate metabolism, maintain muscle mass, and direct fat to healthier storage areas like the hips and thighs. When levels drop, muscle mass decreases and metabolism slows, making it easier to gain weight – even without major changes in diet or activity. At the same time, the body becomes less sensitive to insulin, which promotes fat storage and increases cravings and energy fluctuations.
One of the most noticeable effects is a shift toward storing fat in the abdominal area, particularly as visceral fat around internal organs. This type of fat is more metabolically active and releases inflammatory compounds that worsen insulin resistance and encourage further fat accumulation, creating a cycle that’s difficult to break. Hormonal imbalances can also elevate cortisol levels, which further drives belly fat storage. As a result, menopause and andropause push the body toward a fat-storing state – especially in the midsection – while increasing long-term health risks like heart disease, diabetes, and metabolic dysfunction. Thus, if you are over 40 years old, that “beer belly” or “pot belly” is most likely a “hormonal belly.”
Genetic Factors
Genetics play a meaningful role in how your body regulates weight, often shaping your baseline before lifestyle factors even come into play. Certain inherited traits influence appetite regulation, meaning some people naturally feel hungrier or less satisfied after eating due to differences in hormones like leptin (satiety) and ghrelin (hunger). Others may have a genetically slower metabolic rate, causing them to burn fewer calories at rest compared to someone with a faster metabolism. Genetics can also affect insulin sensitivity, making it easier for the body to store calories as fat – especially when combined with age-related hormonal changes like declining estrogen and/or testosterone.
In addition, your genes help determine where fat is stored, which is why some individuals are more prone to accumulating weight around the midsection as visceral fat, while others store it in less risky subcutaneous areas. There are also genetic variations that influence how your body responds to different types of diets and exercise, meaning a plan that works well for one person may not be as effective for another. While genetics don’t make weight gain inevitable, they can make it more challenging, highlighting the importance of personalized, medically guided approaches to weight management that work with your biology rather than against it.
Weight Loss Treatment Options
Hormone Replacement Therapy
If we find a hormone imbalance during your evaluation, we may recommend including hormone replacement therapy with other weight loss solutions to help maintain any weight loss achieved. Hormone replacement therapy (HRT) is administered via injections, hormone pellets, oral medication or topical cream. They help boost levels of hormones that are too low or lower levels that are too high. Our hormone treatments include testosterone replacement therapy, or TRT with testosterone cypionate and estrogen blockers, to help men with low testosterone, and bioidentical hormone replacement therapy (BHRT) with naturally-derived testosterone for both men and women
GLP-1 Shots
GLP-1 injections, also known as Skinny Shots, or more accurately, GLP-1 receptor agonists, are a class of medications that mimic a naturally occurring hormone in the body called glucagon-like peptide-1. This hormone plays a key role in regulating appetite, blood sugar, and digestion. When used therapeutically, these medications work by signaling the brain that you’re full, reducing appetite and helping patients naturally eat less without feeling deprived.
In addition to appetite control, these medications slow gastric emptying, meaning food stays in the stomach longer, prolonging the feeling of fullness after meals. They also improve insulin sensitivity and help regulate blood sugar levels, which reduces cravings and minimizes fat storage – especially in patients dealing with insulin resistance. Unlike outdated “quick fix” approaches, GLP-1-based therapies target the biological drivers of weight gain, including hormonal imbalances and disrupted hunger signals, making them particularly effective for individuals who feel like they are constantly hungry despite dieting.
It’s worth noting that the term “skinny shots” can be misleading—these are medical treatments, not cosmetic shortcuts. They are most effective when used as part of a personalized, comprehensive plan that includes nutrition, lifestyle changes, and ongoing medical supervision. When properly prescribed and monitored, GLP-1 therapies can lead to sustainable weight loss, improved metabolic health, and better long-term outcomes, especially for patients whose weight gain is driven by hormonal or metabolic factors. For patients who also have an estrogen and/or testosterone imbalance, adding a hormone replacement therapy in their weight loss plan can help ensure that weight will not be regained upon stopping GLP-1s.
Appetite Suppressants
After years of dieting, your body’s hunger signals can be out of balance. The hormones that tell you to eat get louder, while the hormones that tell you to stop get quieter. Physician-prescribed appetite suppressants help recalibrate these imbalances to help you eat healthier and more reasonable portions without constant cravings. We offer different options in addition to GLP-1 injections, including phentermine and oxytocin.
Lipotropic B12 Shots
Lipotropic B12 with MIC injections combine amino acids (methionine, inositol and choline) with vitamin B12. Together, these compounds support how your body processes and transports fat, particularly through the liver. These compounds are known as “lipotropic agents” because they help “mobilize” fat, encouraging it to be broken down and used for energy rather than stored. Choline and inositol play a key role in preventing fat from accumulating in the liver (which can contribute to fatty liver), while methionine supports important detoxification pathways that help the body safely process byproducts of fat metabolism.
Vitamin B12 adds another layer of support by helping convert nutrients into usable energy and supporting red blood cell production, which can improve overall energy levels and reduce fatigue – especially in patients who are dieting or losing weight. Together, this combination helps the body more efficiently release stored fat, transport it through the liver, and convert it into energy, rather than allowing it to build up in organs or be redeposited elsewhere. While not a standalone weight loss solution, Lipotropic B12 + MIC injections can be a powerful adjunct to a medically guided weight loss program by supporting metabolism, liver health, and overall fat utilization in a safe and effective way.
HI-EMT Body Sculpting
For patients who want to build muscle tone while losing fat in targeted areas, HI-EMT (High-Intensity Electromagnetic) body sculpting triggers thousands of micro muscle contractions in a single session. This technology was originally used in professional sports rehabilitation before becoming available to the public. It is noninvasive and requires no downtime. Building lean muscle mass also has a metabolic benefit: muscle tissue burns more calories at rest than fat tissue, which means HI-EMT can support your weight loss plan while sculpting your body in the areas where you need the most support.
What Is Medical Weight Loss Like?
Once you come in for an evaluation, we will follow a structured plan including:
- Diagnosis: We identify which of the above factors, or more, are making it harder for you to lose weight. We use lab testing, examination of current symptoms and a close look at medical history to find out more about your situation.
- Customization: We recommend one or more treatments that address the challenges that you face with weight loss.
- Ongoing Support: We provide ongoing support through FREE check-in appointments and follow-up consultations for life. During these follow-ups, medication adjustments can be made, if needed, along with continued medical support and ongoing accountability.
Take the Next Step
If you are in Hayward, San Jose, Oakland or anywhere in the greater SF Bay Area and you’re ready to stop repeating the same cycle, the starting point is a medical evaluation to find out what is going on in your body and get your own personalized weight loss plan at Balanced Medical Solutions.
