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Set-Point & Weight Regulation

Posted Feb 11 2009 3:28pm

Here's a question: What is your set-point?

Do your patients know their respective set-points?

Better question: What is a set-point?

It is not how long it takes to become frustrated in tense situations...

It does not refer to financial stability...

And it has nothing to do with the game of tennis...

But it   is something that may have a profound effect on weight stabilization and management...

Set-point theory is a concept that refers to understanding and respecting a body’s natural weight range - a range that “set” by various factors, such as:

  • heredity
  • health
  • age
  • gender
  • body frame
  • level of physical activity.

The term itself is used to describe the weight range at which one’s body is the healthiest and can be generally maintained by eating a normal amount of food and engaging in a normal, healthy amount of physical activity.

For children and adolescents, set-point is part of a normal pattern of genetically predetermined growth and development. Every person has a unique set-point. However, it is important to note that one's set-point, or "settling point" is not one number on the scale, but rather a range of weight that is within the body’s own natural equilibrium (Shepphird, in press).

As a helpful illustration, I often refer to a thermostat. When a thermostat is "set" at a certain temperature, it will regulate heating and cooling systems in order to maintain the set temperature. Likewise, our bodies have a certain weight “temperature” to which they will naturally gravitate. This temperature is unique to each individual.

Some people tend to gravitate toward the lower range of their set-point, others toward the higher end. However, fluctuating within this healthy weight range is normal.

The human body will tend to resist changes in weight that go beyond set-point range. Thus, practically speaking, if a person misses a meal during the day, the body responds with sensations of hunger in order to increase the desire to eat. Likewise, if a person loses weight below their set-point range,
the body compensates by reducing its metabolic rate in an attempt to return itself to a normal weight. Experts believe that set-point theory may explain why food binges often follow a period of caloric restriction: The body is attempting to ingest the nutrients and energy that it needs in order to maintain a healthy equilibrium (Shepphird, in press).

Have a discussion with your patients/clients about set-point. For example, assess what weight range is the one to which they most often gravitate, or weigh the most frequently when not dieting (and when physical activity levels are normal), or for the longest period of time (after reaching adulthood). A thorough medical examination is advised.

Caution: Your patients may not want to explore their set-point, especially if they are underweight and their set-point is higher than their current weight.

Note: Set-point theory has incorrectly been used to convey the idea that one's weight is their destiny"; pre-determined and unchangeable.

Information and challenges to the set-point theory: One's set-point can be changed as it is affected by other factors that affect rate of metabolism (e.g. exercise, general health, caloric intake). This is important to note for heavier patients who have struggled to lose weight, for example.

Source: Shepphird, S. (in press). 100 Questions and Answers about Anorexia Nervosa. Sudbury, MA: Jones & Bartlett Publishing.

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