Why Can’t I Lose Weight No Matter What I Do?
by Dr Westin Childs
You're not alone.
I can say that confidently after treating hundreds of patients with hormone imbalances and after talking to literally thousands of you. And the truth is this:
Doctors don't really know how to help. They may give lip service to the idea by saying you need to "eat less and exercise more" - but when has that ever worked... for ANYONE?
Calorie restricted diets have a 99% long term failure rate, so why on earth would anyone keep doing them? And I know you don't need to see the studies to know that they fail EVERY single time.
Because you've tried them before! We all have. If you're overweight there's a VERY high chance that you've done this no less than 3 to 4 times in your life.
If it was really that easy then we wouldn't have the obesity epidemic we do now.
I've been able to successfully help patients lose weight because weight gain is about an imbalance in hormones, NOT an imbalance in how many calories you consume.
You will never lose weight if these hormone systems are out of balance:
If you aren't properly treated or on the right medication and dose your metabolism will be slowed and it will be impossible for you to lose weight. Yes, even if you are on a 500 calorie diet. Low thyroid will ultimately reduce your metabolism and you will slowly gain weight over time.
Statistically speaking 50% of you have an issue with insulin (meaning it's too high) and, no surprise here, most Doctors don't even check it. Insulin is a FAT STORING hormone which takes energy you consume and puts it right into your fat cells. High fasting insulin (or insulin resistance) is a huge problem for women with PCOS and those with blood sugar issues. Has your doctor checked your fasting insulin and Hgb A1c? Your Hgb A1c should be less than 5.5 and your insulin should be less than 5 (12 hour fast).
High levels of stress, lack of sleep and chronic illness causes high levels of cortisol = weight gain in the belly. Cortisol is your stress hormone and it's helpful in small doses, but in high doses and if sustained it can be part of the problem. Problems with cortisol cause "adrenal fatigue" or low energy.
Serum cortisol should be between 14-16 with an 8 am sample. Both low and high levels (outside of this range) can lead to weight gain.
High levels (estrogen dominance) causes weight gain in the butt/thighs and hips, but in addition to that low levels will also do the same! (Think menopause). Estrogen dominance is worse with excess weight gain. In addition, exposure to xenoestrogens can trigger estrogen receptors and cause the symptoms of estrogen excess even with normal serum levels.
Has your doctor checked your estrogen and progesterone levels in the serum?
Have a ravenous appetite despite eating ALL the time? Is your metabolism abnormally low? Has your weight been increasing despite eating the same? Leptin resistance may be causing your problem. Leptin resistance is under-treated and under-diagnosed. In terms of importance, I put this as number 1 or 2 as it relates to your ability to lose weight.
Get your doctor to check your fasting leptin level (12 hour). It should be less than 10. If you are overweight and it is higher than 10 then you have leptin resistance.
Yes, even women need testosterone! Low levels cause depression, weight gain, decreased libido and the inability to lose weight.
Testosterone (free and total) should be in the upper 50% of the reference range.
Putting it all together
Assessing these hormones will help give you an idea of WHERE you need to put your effort and make changes.
Most hypothyroid (low thyroid) patients suffer from the unholy triad of leptin resistance, insulin resistance AND thyroid resistance (low T3 or high reverse T3.
If that's you, and there's a good chance it is, then what are you supposed to do about it?
You have to get serious about weight loss by taking the RIGHT approach.
This is what a comprehensive weight loss program looks like:
1. Proper hormone management (this may include thyroid hormone, T3, NDT, Testosterone replacement therapy, etc.)
2. Changes in your diet to MATCH your hormone imbalances (proper macromolecule ratios of protein/fat/carbohydrates). *Note: this does not mean calorie restriction.
3. Exercise routine that focuses on muscle strength and muscle building to increase metabolism.
4. Targeted supplements in therapeutic dosages that ACTUALLY work.
5. Evaluation of intestinal health to improve intestinal microbiota.
6. Detox routine to help remove endocrine disrupting chemicals and xenoestrogens (weight loss can liberate these toxins and halt weight loss).
7. Potential use of targeted weight loss medications with the RIGHT frequency and at the RIGHT dose (LDN, GLP-1 agonists, etc.).
This is the kind of plan that will help you not only lose weight but actually keep it off.
Dr. Westin Childs is a Doctor focusing on personalized and Functional Medicine and his passion is in balancing hormones for long last ingweight loss.