I’ve seen hundreds, (maybe even thousands) of clients who eat well, exercise, take care of themselves and struggle with difficult weight loss. They are told by doctors to watch what they eat, to eat less, to exercise.  “But I do all those things” is often met with skepticism, accusations of ‘cheating’ or a shrug.

While it is becoming evident that the calorie-in vs. calorie-out model does not work for an increasing percentage of the population, most medical doctors still use this model to advise patients on healthy weight loss and research on weight loss (even difficult weight loss) accepts it as a premise.

Why is difficult weight loss so difficult?  And why doesn’t what works for one person, work for another?  In this article, I’m going to discuss the several conditions that affect fat loss for people who experience difficult weight loss.

• Thyroid dysfunction
  Thyroid dysfunction, often sub-function (low function), may be accompanied by adrenal dysfunction.  The thyroid hormones are responsible for setting the metabolic rate or the speed at which reactions happen in the body.  When thyroid hormones are not being produced or utilized properly, reactions (which utilize energy) happen more slowly, even fluids move more slowly and can gel, tissues swell as does the weight.  It should be noted that thyroid hormone function is not readily detected through blood work.  “Normal” blood work can be very misleading.

• Liver congestion
  The liver is the main metabolic organ.  It is responsible for detoxifying chemicals, hormones (both internal and external), metabolizing fats, making proteins and a whole bunch of other things.  It is a big, important organ, with big, important jobs. Fatty liver, unfortunately is on the rise.  In this condition, the cells of liver (where work happens) become filled with storage fat and cannot perform as well.  When the liver is not working well, normal fat loss becomes quite difficult and slow. Once again, so-called “liver function tests” are not actually assessing liver function, and blood work may remain normal even in cases of fatty liver.

• Blood sugar and insulin regulation
  Poor regulation of blood sugar often leads to insulin resistance.  Insulin resistance generally means that the insulin levels get increasingly high.  Insulin is our body’s main fat-storage hormone, so when insulin is high, it is very difficult to lose weight.  Often this condition is associated with inflammatory factors, poor metabolism of lipids and fat storage in or around the organs.
• High cortisol
  Stress is a common contributor to weight gain and difficult weight loss.  A ‘buffalo hump’, red stretch marks and fat placed mostly in the mid-section may be indicators that cortisol is a problem. Mechanisms are not fully understood, but may involve increased blood sugar and insulin.

There are other reasons for difficult weight loss:  sex hormone imbalances, food sensitivities, leptin-resistance, chronic inflammation, issues with the hypothalamus and others.  Often there is more than one causative factor and all four (and more) of the above can be working together to make weight loss extremely challenging.

For some individuals, weight loss will be a life-long struggle, for others, weight issues can be overcome, but will involve immense patience and determination.  One thing is certain, however:  there are no easy or fast answers to this issue.  It is an issue for which we do not have all the answers at this point in time.  My advice for someone that is experiencing difficult weight loss is this:

• Be patient. You cannot expect the issue to just go away, it is a long-term endeavor and anyone promising fast results does not have an understanding of the complexity or chronic nature of the problem.
• Be persistent. While I do not believe that all bodies should be thin, I do think we all deserve to feel happy and healthy.  If losing some body fat will actually contribute to better overall health and well-being, then it is worth striving for.
• Find a practitioner who believes you. Do not accept being told that you are cheating on a plan or not following instructions properly when you know you are adhering to given guidelines.  This is a cop-out for systems and practitioners who cannot admit they do not have all the answers and are not willing to look any further.
• Be open. Our bodies are complicated and our minds even more so and they parts of one unit, work together and both affect weight.  There are systems in play, that we are not even aware of.  Be open to trying things that might be “outside the box”.

~ Dr. Tanya