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Why Am I So Fat? 9 Reasons to Consider

​That may seem like a harsh title, but I am asked that question almost daily in my medical practice.  ​People that struggle with their weight are desperate for answers.

​As most people would guess, diet and exercise ​​play a huge role in your ability to lose weight, but​ there are​ multiple other things ​also going on that are making ​it ​difficult for you to drop the pounds.

In this article, I will discuss 9​ commonly ignored reasons that anyone should consider if ​they are ​failing in their weight loss attempts.

These include thyroid issues, stress, poor sleep habits, insulin resistance, and many others…

More…

​9 Reasons That May Be Making Weight Loss ​Difficult

​Most Americans need to lose weight.  The latest statistics show that 7 out of 10 people are overweight or obese.  ​Interestingly,  only 36% of people think they need to lose weight.

If you are reading this article, ​I suspect that you need to lose weight but you don’t know how.

I’m going to discuss 9 reasons that may be a hurdle in your weight loss journey.  All of them may not apply to you and your specific situation, but chances are most of them do.

​1.  Standard American Diet

​Let’s start with the obvious.  ​What we are eating in America is slowly killing us.

If you don’t get your diet under control, nothing else that I discuss in this article will be enough to help you lose weight.  What you eat is the cornerstone for everything else.

As the percentage of Americans that are considered obese continues to skyrocket, so are conditions such as heart disease, cancer, and Type 2 diabetes.

A big reason why is obviously our diets.  Many people have chosen convenience over health.  Eating out has replaced cooking at home for a large portion of Americans.  This includes fast-food restaurants.

​Even if you choose “healthy” options from a good restaurant, you have no input on the quality of food that is served (for instance, grass-fed beef vs corn-fed), what kinds of oils are used, how much sodium and other chemicals are added, etc.

Our priorities are totally out of whack.

According to the USDA, almost 1000 calories per day in the Standard American Diet (SAD) come from saturated fats and sweeteners.  Fruits and vegetables account for only about 200 calories!

​The biggest source of calories comes from grains, which is a 45% increase ​from 50 years ago.  Not only that, the quality of the grains consumed has changed.  Read “Wheat Belly” by Dr. William Davis if you want to learn more.

Even more concerning is the fact that sugar consumption has gone from about ​40 pounds per person per year in 1900 to ​​over 100 pounds per person per year today!

Source: http://wholehealthsource.blogspot.com/2012/02/by-2606-us-diet-will-be-100-percent.html

Last but not least, about 2/3 of the calories in the standard American diet (SAD) come from food-like substances and processed food.  It’s not even real food!

http://wholehealthsource.blogspot.com/2012/02/by-2606-us-diet-will-be-100-percent.html

​Note that the typical SAD diet consists of about 2500 calories per day.  

Depending on your metabolic rate, most people burn about 1800-2000 calories per day.

While I don’t prescribe to or recommend the “calorie in, calorie out” model of weight loss, it ​only makes sense that if you continue to consume more calories than you burn each day, you aren’t going to lose weight.

This is especially true if you have some of the other issues going on that I will discuss in this article.

​So What is the Solution? –

You should immediately change to a nutrient-dense, high quality, real whole food diet.

As a general rule, I recommend the ratio of the macromolecules in your diet to be in these ranges:

  • check50-70% good, healthy fats
  • check20% protein
  • check10-20% carbohydrates

​A good starting point would be to start with one of these diets.  There is a ton of online information and recipes for each:

Whole 30 Diet

Ketogenic Diet

Paleo Diet

All these diets have been shown in studies to help with weight loss and reduce insulin resistance.

– Intermittent Fasting

​Another tool that can be extremely helpful with weight loss is intermittent fasting.  Learning when NOT to eat is just as important as learning WHAT to eat.

When used appropriately, intermittent fasting can actually INCREASE your resting energy expenditure.

I typically recommend 2 types of fasting:

14-16 hour fast – Eat an early dinner, then don’t eat again until lunch the next day. 

2 consecutive 24 hour fasts – For example, eat a good dinner on Friday night, then don’t eat again until Saturday night​.  You have 30 minutes to eat at that time.  Then don’t eat again until Sunday night.

Fasting is ​so effective that you need to be careful if you have severe adrenal fatigue or if you are diabetic and are on certain medications that increase insulin.  In these situations it can cause ​your blood sugar to drop to dangerous levels.  Talk to your doctor first and monitor your blood glucose closely.

​If you want to learn more about intermittent fasting, read my article here.

You may ultimately need the help of a knowledgeable nutritionist if you are having difficulty.

​2.  Lack of Exercise

​While there is no amount of exercise that by itself will get you to your goal weight, it can be an invaluable tool to help ​with your journey.

​Exercise has been shown to directly help ​reduce weight.  ​It has also been shown to increase growth hormone levels which increases lean body mass and ​results in weight loss.

Exercise not only helps with weight loss, it has been shown to increase cognitive function and overall quality of life.  It also reduces symptoms of anxiety and depression.

​It is important to know what ​KIND of exercise and how ​MUCH of it to do.  Too little of it will not have enough of an effect while too much exercise can actually be harmful.

If you have adrenal issues, even light exercise may exhaust you.  Get your adrenals functioning well first.

​If you are currently not exercising at all, then start doing ​SOMETHING.  A brisk walk for 15-30 minutes 4-5 days per week is a great start.  Let your fatigue level guide you on how much you can progress.

Ultimately, you will want to​ add high intensity interval training (HIIT).  HIIT has been shown to reduce abdominal and total body fat.

HIIT consists of doing all-out, maximum bursts of exercise followed by 30-60 seconds of recovery time then repeating the cycle 5-6 times.​

This can be done with any equipment you have (elliptical, treadmill, bike, rowing machine, etc), or even by jogging/walking or using a jump rope.

HIIT training only needs to be done 1-3 times per week for 10-15 minutes.  Yes, you have time for that!

If you want to lose weight, get started with an exercise program TODAY!.

​3.  Stress

​If you have ever read any of my other articles, you know that I mention stress as a factor in almost all medical conditions.

The fact is, stress undermines our health on multiple levels.  You will never reach your maximum health potential if you don’t learn how to better manage your stress.

When I say stress, I am talking about physical, emotional and mental stress.  This could include an injury or illness, work stress, relationship stress, death of a loved one, and many others.

Stress causes our adrenal glands to secrete cortisol, which signals the mitochondria in our cells to increase energy production to get us through that stressful time.

This is great for acute stresses, but bad when the stresses are chronic and continuous.

Cortisol has been associated with insulin resistance and leptin resistance.  It also promotes hypothyroidism.  All three of these conditions lead to obesity (I will discuss them more shortly).

​So What is the Solution?

Remove ​any stressors in your life that you can.  That may include changing jobs, getting rid of toxic relationships, ​or getting marriage counseling.

If there are major stressors that can’t be removed such as an illness in a family member, kid troubles, etc., you will need to work on improving your coping mechanisms.

​Ways of reducing your stress ​includes:

  • checkYoga or a similar relaxation exercise
  • check20 minutes of prayer or meditation once or twice daily
  • checkStart a hobby that you enjoy
  • checkCount your blessings and write them down
  • checkGo for a walk outside
  • checkDo something nice for someone without expecting anything in return
  • checkMake yourself smile everyday (even when you don’t feel like it)

If you feel you need more help on this subject, read my article on adrenal fatigue.

​4.  Poor Sleep Habits

Lack of sleep has been directly linked to obesity.  It increases inflammation in the body and causes weight gain.

Your quality of sleep directly impacts your melatonin level which increases your cortisol.  Your sleep quality also impacts your metabolism which affects your body weight.

You should be getting at least 7 hours of quality sleep per night.  When you wake up, you should feel refreshed and energized.

If that doesn’t describe you, consider making the following changes:

  • checkGo to bed the same time every night and get up the same time every morning
  • checkNo electronic screens (phone, computer, tv, tablet) for at least 2 hours before going to bed
  • checkKeep your bedroom cool and dark
  • checkAvoid stimulants (coffee, nicotine, decongestants) in the evening
  • check​Reserve your bed for sleep and sexual relations only

​If you are still having sleep issues, you should consider talking to your doctor about ​testing you for obstructive sleep apnea.  In this condition, the muscles in your throat and neck collapse as ​you fall asleep which in effect chokes you, sometimes dozens of times per hour.

Your brain has to wake you in order to overcome the muscle relaxation so that you can breathe.  As a result, you never get into the restful stages 3 and 4 of sleep which are required for you to be refreshed.

This may require you to undergo a sleep study, which will​ consist of sleeping in a sleep lab while you are monitored.  

If you have obstructive sleep apnea, you may need to sleep with a nasal CPAP machine which will keep the air pressure in your airway high enough t​o prevent your airway from collapsing while you sleep.

​If you can lose the weight you ​need to lose, there is a high likelihood that your sleep apnea will resolve and you will no longer need a CPAP machine.

If obstructive sleep apnea has been ruled out but you are still struggling with sleep, supplements may be necessary.  My favorites are below:

How to Supplement to Improve Your Sleep

Why I Like It

May help improve energy levels

May help to decrease levels of inflammation

May help reduce brain fog and mental slowness

Requires lifestyle change for best results

How to Tell if You Need It

    • You should be getting 8 hours of quality sleep every night.
    • If you find yourself waking up exhausted then you should consider checking for sleep apnea or a trial of the following supplements to improve sleep

How to Use

    • Take each supplement as indicated on the bottle or as recommended below
    • In addition to these supplements make sure you practice adequate sleep hygiene, that means: black out curtains for your bedroom, noise cancelling ear plugs, having a consistent sleep schedule, and avoiding all electronics 3 hours prior to your scheduled bed time

My Recommended Brand and Product

For minor sleep issues start with supplements containing 5-HTP which may promote proper melatonin production and induce sleep naturally (take 100mg 30 minutes before your scheduled bed time):

Get 5-HTP Here

For more difficult cases consider the addition of melatonin + 5-HTP, start with 1-3mg of melatonin and don’t be afraid to use melatonin if you need it.

Get 5-HTP and Melatonin Here

For more the most difficult cases consider using serotonin and GABA potentiators. These supplements help enhance GABA and serotonin neurotransmitters in the brain and help induce deep sleep.

Get GABA/Serotonin Potentiators Here

​5.  Thyroid Issues

​The statistics show that over 12% of the population is hypothyroid.  Some experts suggest that it could actually be closer to 40%.

​About 2/3 of people with thyroid issues don’t even know they have it!

Since the thyroid is the ​”metabolism factory” of the body, it only makes sense that people who are struggling with their weight may have an issue with their thyroid.

In my practice, I see people with undiagnosed and untreated or undertreated thyroid conditions several times a day.

The vast majority fit into the following 3 categories:

– Hypothyroidism

​The thyroid should always be one of the first things assessed in someone who is overweight.

That is especially true if the person also has many of the other common symptoms seen in hypothyroidism – fatigue, constipation, cold intolerance, hair loss, brittle nails, etc.

​Only checking the TSH blood test may miss a large percentage of hypothyroid patients.

That is why you need to ask for a complete thyroid panel:

​If your doctor is unwilling to ​run all of these tests, I would STRONGLY suggest you find a doctor who will.  Your thyroid status cannot be fully evaluated without them.

Read more about how to interpret your results in my article here.

– Hashimoto’s Thyroiditis

​Hashimoto’s is the common name given for autoimmune thyroiditis.  

It is estimated that up to 10% of the population has Hashimoto’s.  It is 7 times more common in women than in men.

​Some experts estimate that Hashimoto’s is the cause of up to 90% of hypothyrodism.

That’s why it is important to have your thyroid antibody levels checked if you are hypothyroid.  If either the TPO antibody level or the thyroglobulin antibody level is >35, the diagnosis of Hashimoto’s can be made.

Hashimoto’s can cause the same symptoms that you see in hypothyroidism (including weight gain), but it may have some additional symtoms as well.  These include joint pain, muscle aches, throat swelling, and even low grade fever.

​Click here to learn more about how to treat Hashimoto’s thyroiditis.

– Reverse T3 Dominance

​Reverse T3 is an inert hormone that is made normally by the ​body in small amounts.  

It binds to the thyroid receptors on the cells of the body, but it does ​it has no function.  In effect, it serves as a “brake” for our metabolism.

​It is another way that the body can regulate its own metabolism.

In acute situations (such as an infection or injury), it helps the body to reserve its energy stores by lowering the metabolism.

​However, many people have chronic inflammation in their body due to things such as obesity, insulin resistance, leptin resistance, poor diet, etc.  All of these conditions cause the reverse T3 level to be chronically elevated, which is called reverse T3 dominance.

​When this occurs, the TSH and T4 levels may be normal, but the elevated reverse T3 ​blocks the action of the active T3 on the cells of the body.  Hypothyroidism at the cellular level results.

The above labs are from one of my recent patients.  If you just looked at the TSH, it would show that she has normal thyroid function.  The free T3 and reverse T3 tell the true story.

If your reverse T3 level is >15 or if your free T3 to reverse T3 ratio is ​< 0.2, you have reverse T3 dominance (also called thyroid resistance) that needs to be addressed.​​​

Read my article on Reverse T3 Dominance to learn more.

​6.  Metabolic Damage from Yo-yo Dieting

​Most people that I know ​who struggle with their weight have tried tons of different diets.  Some have worked, some haven’t.

Many of these diets such as the HCG diet require severe calorie restriction (as low as 500-600 calories per day).  

This severe calorie restriction can damage your metabolism for many years and make it impossible to lose weight and keep it off.

The typical story goes like this – the first time they went on the diet they lost 40 pounds, the next time 25 pounds, then next time 10 pounds, then next time none at all.

​The​se diets cause this by​ re-setting your basal metabolic rate.  Instead of burning ​the usual 1800-2000 calories per day, after severe calorie restriction, your body may only burn about 800 calories per day.

That’s why you eat less than anyone else you know but still gain weight.

Never go on a severe calorie-restricted diet or recommend any friends or family to do it.  It can be devastating to your body.

Correcting this can be very difficult and will require the help of a knowledgeable doctor and/or nutritionist. It will most likely take a long time to fix.

​7.  Insulin Resistance

Insulin is a hormone made by the pancreas.

Its function is to bind to ​glucose (sugar) in the bloodstream and carry​ it into the cells where it can be used for energy production.  It also carries the glucose into the fat cells and liver cells where it is stored to be used later.

With insulin resistance, the process doesn’t work like it should.

​When people eat a diet too high in sugar (as in the standard American diet), the cells in the body become so bombarded with the sugar that it can become toxic to the cells.

As a protective measure, the cells down-regulate the insulin receptors, meaning it reduces the number of insulin receptors that are available for the insulin to attach.  As a result, the insulin level in the bloodstream increases (as does the sugar levels).

Eventually, the sugar level increases to the point that it measures high on a blood test.  Pre-diabetes or diabetes is then diagnosed.

In other words, diabetes is really just advanced insulin resistance.

Having high levels of insulin is bad in many ways.

​Insulin causes us to gain weight by increasing the size of our fat cells.

​Insulin is one of the most inflammatory substances in our body​.  That inflammation increases our cancer risk.  ​Insulin resistance has been shown to be directly linked to thyroid disorders which also results in more weight gain.

A hemoglobin A1c level > 5.3 is suggestive of insulin resistance.  A total fasting insulin level >5 also indicates insulin resistance.

Anyone who has the diagnosis of pre-diabetes or type 2 diabetes by definition also has insulin resistance.

To learn more about how to diagnose and treat insulin resistance, read my article here.

8.  Leptin Resistance

What in the world is leptin resistance? 

In order to understand leptin resistance, you need to understand the function of leptin.

Leptin is a hormone made by fat cells.  Yes, they do more than just make ​our clothes to not fit!

Leptin is our “satiety” hormone.  It’s primary function is to signal to our brain that we have plenty of fat stored in our body and we don’t need anymore.

The brain then increases our metabolism and reduces our hunger until the leptin levels drop.

In leptin resistance, something happens that is similar to what happens in insulin resistance.  Our brain becomes desensitized to the high leptin levels and basically ignores the signal.

As a result, our metabolism becomes locked in the “low” setting and our hunger sensation stays locked in the “high” setting, a perfect storm that results in weight gain and obesity.

The weight gain results in more fat cells which results in more leptin production, and the cycle feeds itself (literally!).

Leptin resistance typically occurs simultaneously with insulin resistance.

Leptin resistance also triggers an increase in reverse T3 production (reverse T3 dominance) that also results in weight gain.

Leptin resistance is diagnosed by checking a serum leptin level.  If it is >12, the diagnosis can be made.

​Long term successful weight loss will not be possible until the leptin resistance is treated and eradicated.

Click here to learn more about leptin resistance and its treatment.

​9.  Unresolved Emotional Issues

​If you have ever watched a show where they follow ​people on their weight loss journey, a common theme emerges.

They lose a little weight, then the weight loss stops.  They ​don’t begin losing weight again until they have a “breakthrough” regarding a​ trauma​ from their past.

Emotional, physical, and mental trauma from childhood has been shown to affect eating habits and it is directly linked to obesity in adulthood.

Many of these traumas may have been locked away in your brain.  You may not recall them, but they may be subconsciously sabotaging your life in many ways.

This may or may not be playing a role in your particular situation, but you owe it to yourself to deal with any past trauma if you have any.

I strongly recommend ​that anyone struggling with their weight should see a licensed professional counselor to ​assess if ​they have any past issues that need to be addressed.

Seeing a counselor is a sign of strength, NOT weakness.  It means you love yourself enough to deal with any issues that are impacting your quality of life.

​Summary

​50% of the US population is either overweight or obese.

Many reasons are to blame.  While diet and exercise play a major role, hormonal and metabolic issues are most likely involved as well.

If you can’t lose weight, it is important for you to consider and address your diet, exercise, stress level and your sleep quality.

You should also be tested for any thyroid issues, insulin resistance, and leptin resistance.

If you have a history of severe low calorie dieting, your metabolism may be damaged which will require long term, intensive treatment.

Finally, you need to address any past trauma in your life to finally release its grip on you.

​Now it’s your turn…

​Have you ever asked the question in this article title?

If so, what has helped you with your weight loss?

What have you tried that didn’t work?

Leave your comments below…

Weight Loss Resistance and Hormones – 8 Tips to Get You Back on Track

​Why can’t you lose weight even though you are trying to eat right and exercise?

Why do diets that worked in the past have little or no benefit now?

Your hormones are probably playing a huge role.  These include cortisol, thyroid, leptin, insulin, testosterone, estrogen, and progesterone.

​Until you get these hormones in balance, it will be almost impossible for you to get to your ideal body weight.

​In this article, I will discuss how these hormones lead to weight loss resistance and give you 8 tips to get you back on track…

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​Commonly Overlooked Causes of Weight Loss Resistance

We have all been taught that weight loss should be easy.  

As long as we are consuming fewer calories than we are burning, the weight should just drop off of our bodies.  This is called the “calorie in, calorie out” model.

If we have a friend or relative who is overweight, our first thought is usually “If they would just quit eating so much they wouldn’t have such a weight problem.”

There is no doubt that what we eat and how much we eat impacts our body weight, but it’s way more complex than that.

I suspect that many of you who are reading this article each MUCH less than other people in your family, but you gain weight while they seem to never gain.

It doesn’t seem fair, does it?

Let’s try to break this down further and discuss some common things that can cause weight loss resistance…

​History of Calorie-Restricted Diets

If you learn anything from this article, I hope it’s this:  losing weight requires much more than just eating less.  In fact, eating too little can actually harm you and make losing weight even more difficult.

​Studies are starting to show this phenomenon as well.  

​In 2016, a group of researchers released a study of 14 contestants from the 2009 season of “The Biggest Loser.”  6 years after the show, all but one of the contestants had regained  a substantial amount of weight.  Some even weighed more than they had before being on the show.

The metabolism ​of the contestants had been damaged from the severe calorie-restricted diets.  This damage was still present 6 years later!

It’s not uncommon for me to see patients that have to eat less than 1000 calories per day just to maintain their weight.  If they eat a normal amount of ​1500-2000 calories per day, they will quickly ​start putting on pounds.

If you have tried extremely low calorie diets in the past such as the HCG diet, you very likely have a damaged metabolism and your metabolic set point (​the amount of calories your burn daily) is now too low.

Raising your metabolic set point is possible, but it can take a long time and it can be very difficult.

​Reverse T3 Dominance

​Many doctors think that managing hypothyroidism is easy.  Give the patient a T4 only medication such as Synthroid or levothyroxine, and periodically check the TSH to make sure it is in the “normal” range.

​In my experience, this does not adequately treat the majority of patients with hypothyroidism.  That is because it does not take into account the thyroid conversion process in the body.

​For it to be used by the body, T4 must first be converted into T3, which is the active thyroid hormone.  

T4 can also be converted into reverse T3.  Reverse T3 binds to the thyroid receptors in the cells, but it does n​ot trigger any activity in the cells, which effectively blocks that thyroid receptor.  It therefore functions as a “brake” on our metabolism.

This is helpful in times of acute stress, such as an illness or injury because it allows us to conserve energy would normally be spend on metabolism.  However, it becomes a problem when the reverse T3 levels are chronically elevated.

In effect, it slows our metabolism which can lead to weight loss resistance.

I discuss this issue in much greater detail in ​this article​.

​Gut Dysfunction

​A digestive system that is not working properly can have a big impact on weight loss resistance.

Low stomach acid can result in the inadequate absorption of many essential nutrients such as iron, vitamin B12, and others.  A deficiency of these nutrients can result in ​slowing of the metabolic rate of the body.

​An imbalance in gut bacteria can also have negative effects by secreting chemicals that increase our hunger and cause us to eat more frequently.  It can also cause us to extract more calories from food than we would normally.

​Insulin Resistance

Insulin resistance will make your thyroid worse by inhibiting T4 to T3 conversion.

Insulin resistance also makes your cells more resistant to the thyroid hormone floating around in the blood. 

This is why many people may have “normal” levels of thyroid hormone in the blood but low levels of thyroid hormone in the cells (this phenomenon is known as thyroid resistance). 

​Leptin Resistance

​Leptin is an important hormone, which stimulates metabolism, reduces appetite, and signals the body to burn fat.

Fat cells secrete leptin as weight is gained to signal the brain that we have plenty of energy (fat) stores.  It then turns up our metabolism and reduces our hunger.

Most overweight patients have elevated levels (>12) of leptin because the brain has become desensitized to the leptin and no longer responds to its signal.  This is called leptin resistance.

Leptin resistance results in a chronically depressed metabolic rate and an increased sense of hunger, both of which lead to weight gain.  It also ​increases reverse T3 levels.

​Excessive Stress

​Our bodies were never designed to withstand the daily onslaught of chronic stress that many of us encounter.

The adrenal glands were designed to give us an energy boost during acute stresses, such as running from a wild animal.

When we constantly live under stressful conditions such as working long hours, eating processed food, getting too little sleep, etc., it puts constant pressure on the adrenals to produce cortisol.

Eventually, the adrenal glands can no longer keep up with the demands, and our cortisol levels will drop.

This results in adrenal fatigue.

Adrenal fatigue causes fatigue, weight gain, sugar cravings, mood swings, and numerous other ​negative things.

​Sex Hormone Imbalance

​Low testosterone has been linked to obesity, especially in males.

​Low testosterone, in both men and women, is often caused by stress, which also leads to high cortisol, weight gain, extreme fatigue, and fat accumulation everywhere—especially the belly.

Excessive estrogen (called estrogen dominance) can also lead to many bad things, including weight gain. 

​Estrogen dominance leads to the accumulation of fat, especially in the belly, hips and thighs.

It also causes sex hormone binding globulin (SHBG) levels to increase which binds testosterone and results in even worsening symptoms of low testosterone.

​8 Tips to Help You Reverse Your Weight Loss Resistance

​Now that we have identified some commonly missed causes of weight loss resistance, let’s discuss some things that you can do to help you have success in dropping excess weight.

​1.  Eat the Right Diet for You

​Diets are the most misunderstood part of the weight loss journey.  

With that in mind, lets discuss some basic points that you need to consider regarding what you eat:

  • No more low calorie diets! – As I described earlier, severely limiting the calories you eat can damage your metabolism and make it almost impossible to lose weight.
  • Diets are unique to each individual – what worked for your friend or sister may not work for you.
  • Don’t count calories!  Instead, focus on nutrient dense, high quality, real whole food.
  • Most people should consider avoiding most if not all gluten, dairy and soy.
  • ​Taylor your diet to your specific medical condition.  You need to take into account any thyroid, adrenal, gut, or blood sugar issues.

​When in doubt, most people do great starting on a diet such as the Whole 30 or the Ketogenic diet. Depending on your level of success, your diet can be further modified later if needed.

​2.  Choose the Right Type and Right Amount of Exercise

​You must be very smart about what type of exercise you do and how much of it you do.

This is especially true because so many people have adrenal issues.

If you have constant exhaustion from adrenal fatigue (we will discuss it more below), then doing too much exercise could do more harm than good.

If your overall energy level is pretty good, then starting an exercise program will be helpful for weight loss.

The single best type of exercise for weight loss is High Intensity Interval Training (HIIT).

​HIIT training has been shown to be very effective at burning fat, especially belly fat.  It also helps to sensitize your body to insulin.

In fact, doing HIIT exercise for 10-15 minutes 1-2x per week is more effective than doing typical “cardio” exercises for 45 minutes a day.

In this type of exercise, you perform bursts of maximum effort for about 30 seconds followed by a recovery period.  It can be performed on any gym equipment – treadmill, elliptical, rowing machine, or even by jogging/walking.

If you simply have too much fatigue to begin exercising ​fully, start with walking every day and add HIIT as your energy improves.

​3.  Balance Your Adrenals

​As we discussed earlier, most of us are under increasing amounts of stress.  Stress causes cortisol secretion by the adrenal glands.

If the stress continues, the adrenal glands will eventually not be able to keep up and the cortisol levels will begin dropping.

We will no longer get the cortisol surges when we need them and adrenal fatigue results.

If someone also has low thyroid, it only makes the problem worse.

​You adrenal issues can be managed in this way:

– ​Adrenal Adaptogens – Adaptogens can actually help to lower cortisol levels when they are high and some can even raise cortisol levels when they are low.  There are many types of adaptogens but I find that blends of multiple adaptogens tends to work best.  These can be combined with glandulars as well for more benefit.  Should be used for at least 3 months.

Adrenal Glandulars – These work best for patients with very low cortisol levels.  They also tend to provide an immediate boost to energy levels.  Using glandulars in combination with other supplements listed below may be necessary.  Should be used for 6+ months.

– Improve Your Sleep – Sleep is critical for optimal health.  It is essential that you get at least 7 good hours of sleep per day.  Poor sleep increases inflammation in the body and causes weight gain.  You may need to consider some supplements to help you sleep at least at first.  Read more about this here.

– Consider Daily Meditation and/or yoga – Learning to relax and unwind your mind will help lower cortisol levels.

– Avoid Caffeine – It may be providing your temporary energy but it is also depleting your adrenals.

​4.  Optimize Your Thyroid

​More often than not, people who have weight loss resistance have a thyroid issue. 

It is estimated that up to 40% of the population have some degree of hypothyroidism.

One of the foundational things that you must do in order for you to lose weight will be to optimize your thyroid function.  Here a 3 key aspects for you to investigate:

​- Check a Complete Thyroid Panel – ​

In my experience, most people with a thyroid condition are not on the right kind of thyroid medication and/or the right dose of it.

That is because doctors are taught to treat the lab numbers and not really pay attention to the symptoms that the patient may be having.

​​In my medical training (this applies to almost all doctors) I was taught to only look at the TSH (and maybe the T4) level and base all of my dosing decisions on whether those labs were in the “normal” range.  If they were, then any symptoms that patient may be having must be due to something besides the thyroid.

I have since learned that is flat out wrong.

The fact is, the TSH is really only a measure of the thyroid activity in the pituitary gland.  The pituitary has different deiodinases than any other part of the body, which are the enzymes that convert T4 to active thyroid (T3).​

T​he body will make sure that the pituitary gland has a good supply of thyroid hormone, sometimes at the expense of the rest of the cells in the body.  So the other cells may be starving for thyroid hormone, but the TSH will be in the normal range.

That’s why it’s important to have a complete thyroid panel checked to get a true measurement of thyroid hormone levels in the entire body.  This includes a TSH, free T4, free T3, reverse T3, and thyroid antibody levels.

– Get on the Right Kind of Thyroid Medication –

Thyroid hormone comes in 2 main forms in the body:

T4 – This the transport or carrier form of thyroid hormone.  It has no significant cellular activity.

T3 – This the active form of thyroid.  The  majority of ​T3 in the body comes from the deiodinase enzymes converting it from T4.

Most doctors prescribe T4 only thyroid medication, assuming that the body will have no problems converting it into active T3.

That is a false assumption, however, because most people with thyroid issues have an impaired conversion process because of things such as leptin resistance, insulin resistance, stress, nutrient deficiencies, and environmental toxins.

For this reason, most patients do better and feel better if they ​have some form of T3 in their thyroid medication.

If you are on a T4 only medication (Synthroid, Tyrosint, or levothyroxine) and you still have symptoms of hypothyroidism, you would likely benefit from adding T3 in some form.

Many people respond well to changing to a natural dessicated thyroid (NDT) such as Nature-throid, Armour Thyroid, or NP thyroid.

Some people may need more T3 than what NDT provides.  In those cases, Cytomel, liothyronine, or compounded sustained release T3 can be prescribed either with their T4 medication or even by itself.

The thyroid needs are very unique to each person, so don’t assume what worked well for someone you know will automatically work well for you.  You may need to try more than one option to find the one​ that best controls your symptoms.

– Understand ​Reverse T3 Dominance –

The body can convert T4 to either T3 (active hormone) or inactive reverse T3.

Reverse T3 attaches to the thyroid receptor in the cells, but it blocks it instead of activating it.

When the reverse T3 levels are high, it causes hypothyroidism at the cellular level, even if the blood levels of TSH and T4 are normal.

If the reverse T3 level is >15, and/or if the free T3 level divided by the reverse T3 level is <0.20, then you have too much reverse T3 which will cause thyroid resistance and will ultimately lead to fatigue, weight gain, and other symptoms of hypothyroidism.

You can read more about this in my article here.

This is treated by increasing the T3 in your medication either by changing to an NDT thyroid medication or by adding T3 to take with your T4 only medication.

Convincing your doctor to do this may be very difficult.  If he or she is unwilling to listen to you or consider these changes, you may need to consider looking for a new one.

You might want to call some local pharmacies and ask them for a list of doctors who prescribe NDT thyroid medication and Cytomel.

​You could also log onto the Institute of Functional Medicine website and click on “Find a Practitioner.”

​5.  Reverse Insulin Resistance and Leptin Resistance

​Reversing leptin resistance and insulin resistance are crucial if you want to lose weight and keep it off.

Both will respond to the following – High Intensity Interval Training (HIIT), intermittent fasting, avoiding sugar and grains, and ​optimizing your free T3 levels.  I discuss these and other treatments in this article.

The use of targeted supplements can help reduce insulin resistance.  These include:

Alpha Lipoic Acid – This supplement can help improve insulin sensitivity and reduce inflammation, and can even help treat neuropathy caused by diabetes.

Berberine – This supplements helps lower blood sugar, improves cholesterol levels, and can help with weight loss.  One study showed that it lowers hemoglobin A1c as well as metformin.

Chromium – Chromium helps increase insulin sensitivity and may reduce the risk of cardiovascular disease.

 Curcumin – Curcumin is known as a very potent anti-inflammatory.  It has also been shown to reduce the risk of a pre-diabetic from becoming diabetic.

​Leptin resistance may also require the use of a GLP-1 agonist medication for a few months.  These include Victoza, Byetta, and Bydureon.  

You might also benefit from the addition of low dose naltraxone (LDN).  

All of these medications will require a prescription from a medical provider that is experienced in using them for insulin and leptin resistance.

​6.  Improve Gut Health

​It’s difficult to discuss any medical issue without discussing the gut.

That is because the trillions of bacteria in your digestive tract play a major role in your health.

The gut bacteria can increase metabolism, change how you digest food, impact inflammation, and even produce chemicals that ​impact our behavior and moods.

Studies are also showing that certain bacteria in your gut can help you lose weight, while others cause weight gain.

​That means if you are suffering from: bloating, alternating constipation/diarrhea, upper abdominal pain, ​acid reflux/GERD, IBS, IBD, SIBO, leaky gut, yeast overgrowth or any other gut related problems you HAVE to get your gut fixed if you want to lose weight.

So how do you get your gut more healthy?

Consider taking a high quality, multiple-species probiotic. – I recommend using at least 10+ different species of probiotics and at dosages higher than 100 billion CFU per serving. Most of these will require refrigeration.

Consider taking proteolytic enzymes – These help you digest your food and absorb nutrients.

Consider possible food sensitivities – Many people have sensitivities to commonly-eaten foods which can lead to constant gut inflammation.  Consider removing foods such as gluten, dairy, and soy from your diet to see if your gut function improves.

​7.  Reduce Inflammation

​Chronic low grade inflammation could be a root cause of your weight loss resistance as well as other conditions you may have.

This kinds of inflammation is caused by things such as:

  • Chronic Daily Stress – work, family, financial, social, etc.
  • Lack of Sleep – less than 7 hours per night
  • Standard American Diet
  • Gut Issues – SIBO, GERD, dysbiosis, yeast overgrowth, etc.
  • Visceral Abdominal Fat – belly fat and fat in organs

​If you want to lose weight, you will HAVE to reduce the inflammation in your body.

Once the problems areas are identified, it is usually obvious how to treat them.

In general, most inflammation in the body can be reduced by doing these basics:

– Eat nutrient-dense, real whole foods

– Focus on relaxing and managing your stress – 20 minutes of meditation or yoga twice daily

– Get at least 7 hours of quality sleep per night

– Get your gut healthy as discussed earlier

– Take a probiotic and correct any nutrient deficiencies – usually fish oil, magnesium, zinc and vitamin B12

– Exercise as discussed earlier

​8.  Avoid Endocrine Disruptors

​We are unknowingly exposed to chemicals in the environment that directly interfere with many of the hormone systems in our body on a regular basis.

These are called endocrine disruptors.

​While it is impossible to completely avoid all of these chemicals (because they are everywhere!), there are some things that you can do to lower the level of exposure:

  • Drink out of glass or steel containers – Plastic bottles contain Bisphenol-A which is a know thyroid blocker.  Aluminum containers should also be avoided.
  • ​Avoid touching receipts – These also contain Bisphenol-A which can be absorbed in the skin.
  • Drink only filtered water – Consider getting a reverse osmosis system for your home.  You should also consider adding a shower head filter to each shower.
  • Avoid plastic whenever possible – never reheat or microwave foot stored in plastic.  The heat releases more of the chemicals.
  • Throw away old rubber toys – Rubber toys made before 2009 contain phlalates, another thyroid blocker.
  • ​Eat organic foods and grass fed meats – 
  • ​Check your cosmetics for chemicals – The website Skin Deep will allow you to see how many chemicals your cosmetics contain.

​This is not intended to make you into a paranoid, nervous wreck, but it’s time that many of us take control of our health and realize that there are environmental dangers that impact our health.

​Summary

​​There is more to weight loss than the calorie in, calorie out model that we have all been taught.

Multiple hormones play a direct role in our ability to lose weight and keep it off.

A history of being on severe calorie restricted diets can also damage your metabolism and make it impossible to lose.

In order to have success, you need to be on a good diet and a sensible exercise program.  You must also optimize your gut health and manage any adrenal and thyroid issues.

You  must also test for and address any insulin resistance, leptin resistance, and chronic inflammation that you may be having.

Finally, you should do your best to avoid any environmental exposures that can affect your ​hormone functions.

Now it’s your turn…

Have you struggled with weight loss resistance?

What you have tried that helped?

What didn’t help?

Leave your questions and comments below.