Weight loss is a touchy but common topic of conversation amongst many people. I am here to tell you that if your goal is weight loss, I support you and the only opinion that matters is your own. But let me take this opportunity to offer some free, professional guidance as a Registered Dietitian and Certified Functional Medicine Practitioner. Weight loss is much more involved and confusing than we are led to believe. Mainstream media and traditional health care would lead us to believe it's only about calories in/calories out, exercise amounts and will power but in my office, this is far from the truth. I want to share with you the top 7 reasons I see in clinical practice that may be impeding your goal towards a healthy weight.
1. Inflammation:
The immune system is an intricate combination of cells and proteins that defend the body against infection. The immune system does its job by releasing a number of hormones and signaling messengers (cytokines). It keeps track of every microbe you’ve ever been exposed to so it can be recognized and destroyed with further exposure.
Inflammation is actually part of a normal and healthy immune response in acute situations. However, chronic inflammation is the detrimental type we seem to hear all about. This type of inflammation keeps the immune system on high alert, sending out hormones and signaling messages that interfere with weight loss.
When it comes to your weight, inflammation can actually predispose you to fat gain and metabolic imbalance. Essentially, inflammation means well, but too much of it, for too long creates an environment that not only makes it difficult to lose weight, but can actually put it increase it. You'll notice a common theme of 'systemic inflammation' as you continue reading about the other contributors to stubborn weight below.
2. Food Sensitivities:
Often an outward reflection of struggling to process a particular food efficiently. Food sensitivities occur when your body reacts to a particular food. While the goal of your immune system is to keep you healthy & protect you from foreign invaders, it can become confused and identify specific foods as a threat.
Unlike a food allergy, food sensitivities can happen hours or days after you eat something. Mounting a response is usually dose-dependent and can take 72 hours, making it difficult to identify the “problem” in most cases.
Food sensitivities can initiate a handful of inflammatory processes in the body in hopes to correct the problem (aka the food you just ate). Long term exposure to a food you’re sensitive to could be causing continual inflammation, which may make it impossible to lose the weight you have or even add weight to you.
The gold standard and most recommended way to truly know if you have a food sensitivity or how the food is affecting your body is to do proper elimination and reintroduction program. I have a food sensitivity program designed to walk you through exactly how to do that on your own here.
Common symptoms of food sensitivities include:
Abdominal pain or bloating
Constipation or diarrhea
Joint pain
Acid reflux
Acne
Skin Rashes
Chronic fatigue or sleep disturbances
Headaches
Common foods people are generally sensitive to:
Wheat
Corn
Dairy
Eggs
Soy
Shellfish
Beef
Pork
3. Thyroid:
Your thyroid has input over everything in your body, consider this gland your central thermostat. A major part of the body your thyroid has control over is your metabolism, or how well you digest and absorb food, utilize energy, and store fat. A decrease in thyroid function (hypothyroidism) often leads to weight gain or inability to lose weight for individuals.
Thyroid issues often get overlooked due to many providers only ordering a TSH and a T4 lab value. This is like looking at a piece of ice floating in the ocean but not seeing there’s a WHOLE iceberg below it that might cause some real damage. In order to see the entire picture, you want to request the following lab values: TSH, T3, reverse T3, T4, and thyroid antibodies.
Optimal ranges can differ in the functional versus conventional medicine worlds. In my practice, when I look at thyroid markers, I am looking to see how the whole team is working together, not just how the captain is performing (TSH). As you may be able to infer, there are a lot of players to look at which leaves a lot of room for sub par performance. If you need more thyroid support, check out my ebook How to Put the Fire Out On Your Thyroid.
4. Stress:
Stress produces cortisol, a hormone that like inflammation, means well and is there to protect you. It's when cortisol is continuously over secreted that it becomes a problem. When you experience stress (physical or perceived), this fight or flight hormone is secreted to make sure you do what’s necessary to stay alive in an emergency (like a tiger running after you).
Cortisol can sabotage your waistline by depositing excess fat in your belly AND by stimulating appetite and preference for calorie-rich foods. You can see how this could become problematic, right? This excess fat tissue will take any inactive form of cortisol (known as cortisone) and reactivate it BACK into cortisol. Read that again. This vicious cycle will increase your cortisol levels and just keep packing those pounds on your belly.
Stress ruins everything, but it’s impossible to pretend you can get rid of it. It’s more about minimizing, reducing, and managing your stress better. Something to take into consideration.
5. Gut health:
An impaired ability to absorb or digest nutrients due to low stomach acid production, low enzyme production, pathogenic overgrowths in the intestinal tract can all cause nutrient deficiencies.
Bacteria in our gut can have an impact on weight in a number of ways but here are a few of the most commons ways I see in clinical practice:
One bacteria known as methanobacter (you may have heard of methane SIBO) can extract the calories out of food and retain them on your body as excess weight.
Too much bad bacteria as a whole can increase an enzyme called beta glucuronidase which can put you in a state of estrogen dominance, leading to weight gain.
Chronic gut infections often cause persistent inflammation aka that cytokine storm I mentioned at the beginning of the article, perpetuating the inflammation-weight gain loop.
6. Sex hormones:
Sex hormones are part of the body’s chemical messaging system is involved in virtually every biological process that happens in the body.
Estrogen: Estrogen has numerous functions, with a particular role in increasing your visceral fat (the fat around your organs). Though it’s there to protect your organs from damage, excess amounts can lead to both aesthetic and health implications.
Progesterone: Progesterone is vital for hormonal harmony. It's your feel good hormone and frankly, it does not get enough credit. An imbalance between estrogen and progesterone can impair the body's ability to burn fat for energy, leading to stubborn weight that you just can't shed.
Testosterone: Testosterone can actually get converted into estrogen by the aromatase pathway. If that happens, you can end up with more estrogen than you originally produced. We’re back to point number one. Excess estrogen can mean extra fat we just can’t get rid of.
7. Calories In vs. Calories Out:
I would be remiss if I didn’t touch on the importance of food choices and amounts. Calories in vs calories out (how much you eat versus how much you “burn”) looks REALLY good on paper… but last I checked we are humans and not a mathematical calculation.
Understanding the principle of caloric intake versus expenditure is truly the best way to quantify weight loss, but we must also be attentive to all the things that have an effect on body stores:
Your appetite
Your daily movement that’s NOT exercise (non-exercise activity thermogenesis or NEAT)
Your exercise frequency, intensity, and duration
Your food choices
How well you absorb your food
Calculating your caloric needs can be incredibly useful in understanding how much you need to eat. It’s a fairly simply equation:
BMR (your body’s needs at rest) x your activity level. Once you have that number, you can navigate through your daily intake.
Calculate your BMR:
Men: (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) + 5
Women: (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) - 161
Activity factor:
1.2: If you are sedentary (little or no exercise) = BMR x 1.2
1.375: If you are lightly active (light exercise/sports 1-3 days/week) = BMR x 1.375
1.55: If you are moderately active (moderate exercise/sports 3-5 days/week) = BMR x 1.55
1.725: If you are very active (hard exercise/sports 6-7 days a week) = BMR x 1.725
1.9: If you are extra active (very hard exercise/sports & physical job or 2x training) = BMR x 1.9
Remember, it’s not just about the type of food. Being able to influence your weight changes (loss or gain) requires you to eat what your body needs for that goal. It also requires harmony between your thyroid, food sensitivities, inflammation, stress, gut health, and hormones.
Your body is doing its absolute best to protect you. If something isn’t responding the way you’d hoped, it’s likely trying to tell you something. Be your own advocate. Investigate things that may be at play here.
Katie Morra MS, RD, LDN, IFMCP is an Institute for Functional Medicine Certified Practitioner and Registered Dietitian Nutritionist specializing in gut and hormone optimization. Katie runs a fully virtual functional medicine practice, Gut Honest Truth, based out of Maryland. Katie focuses on the root causes of inflammation, autoimmune disease, irritable bowel syndrome, food sensitivities, hypothyroidism, hormone imbalance, adrenal dysfunction as well as other chronic disease states.