Every day I work with women who can’t lose weight, despite trying everything. They’ve counted calories, restricted their eating, and done the complicated workouts, yet nothing seems to make a difference.

So, what do most of these women do?

They blame themselves for not being disciplined enough or convince themselves that they are overweight because of their mother’s genes.

Sadly, most of them give up. Their weight is out of their control, so why should they care? This is what I call “F it syndrome.”

If only these women knew sooner that they have deeper physiological problems that simply need to be addressed.

Today, I want to tell you what the hidden causes of weight loss resistance are.

Hidden Cause One: Hormonal Imbalance

Our hormone systems help to regulate just about every process in our bodies. There are estrogen receptors on every cell in the body.

One functional medicine framework that I love prioritizes healing in the body
in this order:

• Hormones + Nervous System

• Gut + Inflammation

• Detoxification

I love this and see over and over again in my practice that if a woman’s thyroid levels are tanking, cortisol is high, or estrogen is suboptimal - nothing else will work.

Two hormones that can contribute to weight loss resistance are estradiol and cortisol.

Estradiol

Our estradiol levels start to decline after age 35 and estradiol plays an important role in regulating our metabolism. As this hormone gets lower, our body’s ability to regulate glucose levels starts to decline. Women with lower estradiol levels are also more prone to storing fat – especially in their midsection.

There are lifestyle factors that can help to combat depleted estradiol levels. These include eating a nutrient-rich diet and making sure you are getting adequate amounts of key vitamins (such as vitamin B, vitamin D, and DHA/EPA). There are also certain supplements that can help keep your estradiol levels in check (like vitex and maca). However, estradiol decline is going to happen no matter how healthy you are, and at some point, you may decide the best thing to do is hormone replacement therapy (after careful evaluation of the risks and benefits and discussion with your provider).

Cortisol

Cortisol gets a bad name - we actually need it. However, it needs to be secreted in a rhythmic pattern - highest in the morning, and steadily declining to it’s lowest in the evening and overnight.

Cortisol imbalance can impair insulin sensitivity, which can lead to insulin resistance and pre-diabetes. It can also obstruct our hunger signaling by reducing our body’s sensitivity to the hormone leptin. Ever find yourself grazing in the pantry after a stressful event like you’re in a trance?

Here are some of my recommendations for combating cortisol imbalance:

Prioritize sleep. The most important person in this life is you - and you need sleep.. Reverse engineer your days so that you can guarantee enough sleep (whenever possible). You need to make time for consistent, deep sleep in order to have balanced cortisol levels.

Fix your circadian rhythm. I recommend getting direct sunlight within the first hour of waking and getting daily dusk light after dinner. You should also be putting away blue light-emitting devices several hours before bedtime. I know putting the phone down after a long day can be challenging, but trust me when I say your cortisol levels will thank you.

Manage your stress levels. Easier said than done, Emily! I get it. Trust me, I have four kids and a very busy life, and life is just stressful sometimes. However, you need to set aside time each day to focus on your mental health and bring down stress levels. This might mean deep breath work, meditation, playing with your children (unless you need a break from them!), a 15-minute walk, or a break in the sauna. Whatever it is that makes you feel more at peace – make time for it.

Hidden Cause Two: Metabolic Dysfunction

Metabolic issues can start to creep in when we hit our late thirties and forties, with insulin resistance being the primary driver of metabolic dysfunction. In fact, recent studies have suggested that nearly half of US adults are insulin-resistant.

When we are insulin resistant, our body is not able to properly regulate our blood glucose levels. Excess blood sugar is not used as energy by our bodies and is instead stored as fat. This is why losing weight with untreated insulin resistance is so challenging (and oftentimes impossible).

To address this issue, you should first start by monitoring your daily blood sugar levels. You can start with a simple over-the-counter finger prick test or you can try a continuous glucose monitor (this is what I recommend). I’m currently using Theia, which you can read about here.

Once you have a better idea of what your blood sugar patterns are, you can start making changes in your daily life.

Here are some practices I recommend:

Follow a high-protein diet. Getting adequate amounts of protein each day is going to greatly impact how well your body stabilizes glucose. Protein slows down digestion, makes you feel full, and slows your glycemic response (how much your blood sugar jumps when you eat). As we mentioned in last week’s blog (*insert protein intake blog link*), you should be getting a minimum of 100 grams of protein. However, you really should be aiming for one gram of protein per pound of your ideal target weight each day. So, if your target weight is 135 pounds, you should be trying to consume 135 grams of protein each day.

Try time-restricted eating. This does not mean skipping meals – passing on a nourishing, high-protein breakfast is one of the worst things you can do for your metabolism. Instead, this means eating within a certain window. I recommend that women wait at least an hour before eating breakfast and also not eating dinner too late into the evening (we want plenty of time to digest before bed). Most importantly, I advise against extreme intermittent fasting, such as not eating anything until the afternoon.

Pick up the right exercise routine. Strength training (especially with heavy weights) is one of the best forms of exercise for balancing your blood sugar. While some women benefit from occasional intense cardio sessions, such as HIIT workouts, I do not recommend making it your go-to exercise. Instead, incorporate strength training and regular walks into your routine.

Hidden Cause Three: Inflammation

Nearly all diseases today are attributed to chronic inflammation. Even though it is such a prevalent issue, many women do not realize that this is behind their health concerns and symptoms – including weight gain.

Here are some of the major sources of chronic inflammation in our everyday lives:

Gut issues. The best place to start with gut imbalances is an elimination diet. It’s important to learn what foods work with your body and which foods don’t. I also recommend adding a high-quality probiotic to your diet, as well as eating anti-inflammatory foods such as leafy greens, salmon and berries.

Toxic overload. We are exposed to so many chemicals and toxins each day. I know it can be overwhelming to know where to start, so I recommend starting small. I love using the Environmental Working Group database (*insert EWG link) which provides ingredient hazard scores for household items and beauty products. Get rid of any items in your home with high scores now and slowly start removing items with medium level scores overtime. Eliminating alcohol, sugar and smoking from your lifestyle is also going to make a huge impact.

Mold exposure. This is a common inflammation trigger that many people aren’t aware of. Make sure to get plenty of fresh air each day and use an air filter in your home. I also recommend a home inspection for some clients who are dealing with chronic fatigue, thyroid issues and sensitivities.

Chronic infections. Many of us are suffering with infections that have gone undetected for years (or even decades), such as H. pylori and Epstein-Barr. I recommend working with a functional medicine provider who can test you for the most common culprits and has experience treating them.

I find that it tends to take a bit longer for women who are limited by systemic inflammation to start losing weight, than those only dealing with hormonal or metabolic issues. It can feel complex at times and can require pretty big shifts in our daily habits and environment. However, making consistent changes in your day to day life can make a world of difference.

If you’re struggling to lose weight, and my approach resonates with you - reach out. We’re currently accepting clients in Ohio in our medical weight loss program. Find out more here. And set up a call with me and my team here. 

Sources:

https://pubmed.ncbi.nlm.nih.gov/34473288/

https://pubmed.ncbi.nlm.nih.gov/36419765/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141000/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8707429/

https://pubmed.ncbi.nlm.nih.gov/21184659/