You’ve tried the trendy diets. You’ve subscribed to the miracle 10-minute workouts online. Nothing seems to budge the stubborn reading on the bathroom scale. When you feel like nothing is working, it’s time for an assessment of what’s keeping you from meeting your goals.

“Obesity is a multi-factorial, chronic disease,” says Dr. Sara Shields Tarwater, a board-certified, fellowship-trained bariatric surgeon at Tidelands Health, who specializes in weight loss. “We are learning that there is no single cause or treatment for being overweight. Genetics is only one factor that can contribute to obesity. Beyond what’s in the genes, there are some key drivers that we look for with patients who are struggling to lose weight.”

Dr. Shields Tarwater shares common reasons why some people aren’t losing weight. 

A body under stress produces a hormone called cortisol that interferes with your perception of hunger and fullness.

“For some people, eating provides emotional rewards and stress relief,” Dr. Shields Tarwater says. “It’s a very common, unhealthy coping skill.”

A better choice to reduce stress is physical exercise, such as walking, biking or other activities that burn energy and help your body release emotional tension.

If you are taking prescriptions for other medical issues, weight gain may be a side effect that can be managed.

“Sometimes patients may not realize that a medication they are taking is contributing to their unhealthy weight,” Dr. Shields Tarwater says. “We can look for alternatives for their treatment that don’t have that side effect.”

To lose weight, a person should be in a calorie-deficient state, meaning they consume fewer calories than they burn each day.

When the body needs more calories than it is getting through food intake, it will tap into stored energy supplies, or fat.

A dietitian can help establish the appropriate caloric intake needed to trigger fat burning.

Still, it can be hard to know how many calories you are consuming without weighing, measuring or tracking food.

Thankfully, there are food logging apps that can help.

“I always recommend that patients do an honest assessment of what they are eating by tracking their meals and snacks for a period of time,” Dr. Shields Tarwater says. “People are often surprised by how many calories they are eating each day. Deliberate changes in intake can make a significant difference.”

The best place to start addressing your weight is with a primary care provider.

“Primary care providers have lots of experience helping patients find their path to ideal weight,” Dr. Shields Tarwater says. “The good news is there are a variety of treatment alternatives, depending on the patient and how much weight they need to lose.

Often, patients require a combination of approaches to help them reach and maintain their best weight.

Options include:

• Consultation with a dietitian
• Lifestyle changes
• Psychological counseling
• Medication adjustments
• Weight-loss medications
• Weight-loss surgery

“The key is to take that first step,” Dr. Shields Tarwater says. “Get familiar with the weight-loss resources available to you through your primary care provider and get on the path to your healthier life.”