Introduction
Do you struggle losing weight or maintaining weight loss? Have you ever gone to see your doctor frustrated because you’ve been eating right and exercising profusely for them to only tell you that all you need is more willpower?
Weight gain is one of the biggest reasons women especially seek professional medical help. However, they follow the advice and do all the right things but the weight still won’t budge. Why, they ask, if they work out like a tennis champion five days a week and eat like a bird, do they still have problems losing weight?
There is a well-known equation: calories in < calories out= weight loss. For some, this rings true, however, for a lot of people, this is an oversimplification. Women require different strategies to men and reaching their weight or performance goals require a different set of rules. A woman’s body composition and biochemical make up is very different from a male’s testosterone-driven metabolic type. When it comes to weight loss, one size definitely does not fit all and this is very true when it comes to the difference in the sexes. The saying “women are from Venus and men are from Mars,” has never rung as true as it does in the realm of health and fitness.
In addition to the relation between caloric intake and activity, several other factors contribute to a patient’s overall health and, therefore, to his or her actual ability to lose weight in a healthy way and maintain that weight loss. These factors include:
1. Damaged metabolism
It’s very frustrating when you try all sorts of different diets to lose weight, when you skip meals and restrict the amount you eat and you still don’t lose weight. Unfortunately, a lot of these strategies (such as “yo-yo” dieting, low protein diets, low-fat or high-carbohydrate diets, chronic undereating, excessive cardiovascular exercise) touted by weight loss programs are potentially harmful for a lot of people. When done chronically or excessively, these strategies are harmful to your metabolism. At first, weight loss may occur for a short period but often this is not from the loss of fat but from the breakdown of your cell structures, organ tissue, bone and muscle. During this process, your body uses up vital proteins and fats- which are not being replaced with good nutrition- just to stay alive. Over time, your body reaches a plateau, where you are exhausted. At this point, eating even less and exercising even more intensely can actually result in gaining more weight back than was lost. This is because your body tends to default towards conservation and conserves resources due to deprivation.
2. Food sensitivities and inflammation
Undiagnosed food sensitivities may contribute to weight gain, fluid retention, increased appetite and inflammation and are one of the main reasons people find it hard to lose weight. Food intolerances lead to the production of IgG antibodies, which activate the immune system when you eat an offending food. This leads to inflammation in the body raising certain inflammatory markers such as TNF-a and C-reactive protein (CRP). Increased chronic inflammation impairs the brain’s ability to receive leptin’s appetite-suppressing communications. Leptin is the hormone responsible for sending signals to the brain to suppress appetite and speed up metabolism, assisting with weight loss. Inflammation also increases water retention and bloating, making you less likely to want to engage in physical activity.
3. Poor liver function and toxic chemical exposure
Poor liver function prevents weight loss as the liver is the body’s primary fat metaboliser. If the liver is not functioning properly, it can lead to accumulation of fat in your liver. This in turn can decrease your body’s normal responses to insulin (insulin resistance) which is produced in your pancreas and helps control the amount of glucose or sugar in your bloodstream. Insulin resistance can lead to weight gain and eventually the onset of type 2 diabetes. Some symptoms of poor liver function include itchy skin, liver spots on the skin, hypertension, excessive sweating and unpleasant body odor, chronic fatigue, depression or irritability, abdominal pain, poor tolerance to fatty foods, bad breath, pale stools, nausea and hormonal imbalances.
The liver is also responsible for processing and eliminating toxins you’re exposed to on a daily basis including pesticides, fungicides and heavy metals. When the ability of your liver to remove toxins is compromised, your body stores fat to protect your vital organs from exposure. The only way to shed this fat is to rid yourself of toxins via detoxification.
4. High stress
Stress can make it not only harder for you to lose weight but can also make you gain weight in the first place in a variety of ways. Cortisol, your primary stress hormone, is an adrenal hormone that helps you run faster, hear better and pump fuel into your bloodstream for quick energy. When you are in this “fight or flight” state and your body needs to prioritise the stressor over its normal functions, cortisol shuts down digestion and slows metabolism. If left unchecked in periods of prolonged stress, high levels of cortisol can lead to high blood sugar, increased belly fat, high blood pressure, high cholesterol and muscle loss as it causes the body to “store and reserve” resources for a later time when you may need them. High cortisol also increases your appetite making you reach for sweet, high calorific foods and can impair your ability to produce enzymes necessary for the breakdown and absorption of nutrients. Stress also influences sleep quality and duration as well as levels of insulin and glucose and can result in increased oxidative stress, inflammation and sodium retention.
5. Thyroid dysfunction
Hypothyroidism, a condition where the thyroid does not produce enough thyroid hormone, is characterised by unexplained weight gain and/or difficulty losing weight. Thyroid hormones help regulate metabolism and how efficiently your body burns food for energy. If your thyroid is under-functioning as is the case in hypothyroidism, your metabolism slows down, leading to weight gain. Another major issue and a common cause of persistent hypothyroid symptoms is the inability of your body to effectively convert T4, your inactive thyroid hormone, to T3, your active thyroid hormone. Some of the factors that can cause an inability to convert T4 to T3 include nutrient deficiencies especially iodine, selenium or zinc, gluten intolerance, medications, heavy metal toxicity and stress. Some signs and symptoms of hypothyroidism include fatigue, constipation, depression, cold intolerance, dry skin, hair loss and heavy and prolonged irregular menstrual bleeding
6. Estrogen imbalance
Excess estrogen can also make it hard for you to lose weight. Amongst women, estrogen exposure is known to cause weight gain, primarily through its influence on thyroid inhibition. Some suggest this is a woman’s mechanism by which she may accrue adequate fat reserves to be able to sustain a pregnancy. Xenoestrogens can also influence weight gain and the inability to lose weight. Xenoestrogens are endocrine disruptors which are a category of chemicals that alter the normal function of hormones. When xenoestrogens enter the body, they increase the total amount of estrogen. They are not biodegradable and are thus stored in our fat cells. A build-up of xenoestrogens have been indicated in many conditions including breast, prostate and testicular cancer, obesity, infertility, endometriosis, early onset puberty, miscarriages and diabetes. The most common sources of exposure include animal products, parabens, plastics and BPAs.
Low estrogen states, such as in menopause, can also lead to a stubborn type of weight gain. One form of estrogen, called estradiol, which helps to regulate metabolism and body weight decreases at menopause. Lower levels may thus lead to weight gain. Lack of estrogen may also cause the body to use starches and blood sugar less effectively, leading to increased fat storage and making it harder to lose weight.
7. Insulin imbalance and PCOS
Insulin imbalance is one of the leading causes of stubborn weight loss. Insulin is the hormone that unlocks the door to your cells to allow glucose into them. Insulin resistance occurs when the body is forced to release far too much insulin due to high levels of glucose in your bloodstream. Your cells are unable to absorb the extra blood glucose your body keeps generating from the food you eat and your liver converts the glucose into fat. Insulin imbalance can lead to Type 2 diabetes and obesity. It is also an underlying driver of Polycystic Ovarian syndrome (PCOS) where the high levels of insulin increase the production of androgens (male hormones) which can lead to irregular periods, male pattern hair growth, acne and weight gain. With PCOS, the hormones that regulate satiety and feelings of fullness are also not working properly so you’re more likely to feel hungry even when your body doesn’t need food.
8. Low testosterone
When testosterone levels fall below normal, this can have an effect on your metabolism as your muscle mass declines. Muscle mass is metabolically active so declining muscle mass can lead to weight gain and stubborn fat that doesn’t budge despite your best efforts at eating right and working out.
9. Lack of quality sleep
There are various ways lack of sleep contributes to weight gain or the inability to lose weight. Sleep affects two important appetite hormones in your body- leptin and ghrelin. Leptin is a hormone that decreases appetite so when leptin levels are high, the fuller you feel. Ghrelin, on the other hand, is known as the “hunger hormone” because it is responsible for the feeling of hunger. Research has found that lack of sleep increases levels of ghrelin and reduces leptin, making it harder for your body to know when to stop eating and increases the retention of fat. As well as the influence it has on appetite hormones, reduced sleep has also been shown to have an impact on food selection and the way your brain perceives food, making you more likely to reach for carbohydrate-rich foods and sugar-filled snacks. Lack of sleep also influences metabolism, particularly glucose metabolism and can impair your body’s response to insulin, leading to insulin resistance. An excess of glucose (both from increased intake and a reduced ability to uptake into the tissues) could be converted to fatty acids and stored as fat.
10. Prescription medications
Certain prescription medications can also be a contributor to stubborn weight loss. Some of these include:
- Drugs for diabetes, such as insulin, thiazolidinediones, and sulfonylureas
- Antipsychotic drugs such as haloperidol, clozapine, and lithium
- Antidepressant drugs like amitriptyline, paroxetine, and sertraline
- Drugs for epilepsy like valproate and carbamazepine
- Steroid hormone drugs like prednisone or birth control pills
- Blood pressure-reducing drugs like beta-blockers
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