No matter what I do, I can't lose this extra weight!
Have you ever heard this lament from your own head or someone you know? It's not always as simple as eating less and exercising more. Some people follow a strict regimen of both a healthy diet and regular physical activity and still can't lose those extra pounds. They may wonder what's going on and how to overcome their obstacles to getting fit and feeling better.
Many organ systems go into creating a healthy metabolism for the body so that it efficiently burns calories and doesn't store excess amounts of them. But the physiology can be led off track by a combination of stress, lifestyle factors, genetic predispositions, mental-emotional factors, and other imbalances in the body. Here is a quick mnemonic about healthy weight loss:
In other words, there are many processes in the body that can influence the tendency toward weight gain. Let's take a closer look at each of these influences in the next section.
Weight Gain Influences
It may sound strange to hear that hormonal balance plays a large part in achieving a healthy weight and in keeping it too. If you just eat better and exercise 3-5 times a week, the weight should just come off and stay off, right?
In fact, many hormonal pathways are involved in the physiology of maintaining a healthy weight for your unique frame. These hormone pathways also communicate with each other so that when one system is out of balance, it can create imbalance in other hormones as well. Without addressing underlying hormonal imbalances, it can be hard to get results other than yo-yo weight fluctuations using diet and exercise. What kinds of hormones are we talking about?
It depends for each person. Typically, when one hormone system is acting up it's a good idea to look at the whole picture just in case there are other pieces of the puzzle to pay attention to. Looking at the following hormonal factors in turn, it becomes easier to see how they can affect one another.
Energy! That's what the thyroid hormones, T3 and T4, that come from the thyroid gland provide our bodies. Thyroid hormones work jointly with the adrenal glands to trigger metabolism by telling cells how fast to burn energy. When levels of these hormones become too low, it's called hypothyroidism. Some people experience many hypothyroid symptoms even despite normal lab results, and this is called subclinical hypothyroidism.
During a hypothyroid state, the body becomes very inefficient at burning energy. More of it is stored and untapped, leading to weight gain, fatigue, and lethargy. Along with a low physical energy state, mental-emotional health often becomes sapped of energy too, leading to symptoms of depression which can lead to even more weight gain. Getting thyroid symptoms and levels checked out is a good idea when weight is being gained too easily. For more information on hypothyroid-related symptoms, check out the Adrenal Cluster and the Autoimmune Cluster.
The Greek word root 'andro-' translates to 'man,' and androgens are steroid-type hormones that promote the development of male sexual organs and traits in men. Women have small amounts of them as well which help jump start puberty, support bone health, maintain sexual libido, and support energy levels.
The main androgen we often talk about is testosterone. In both men and women, appropriate amounts of testosterone are important for healthy weight and energy levels. For men, when andropause hits in middle age, testosterone levels start declining and so does energy. Men become much more susceptible to gaining weight during this time period and on top of that stress and unsupportive lifestyle habits can further lower testosterone. Fat cells are able to convert testosterone into estrogen, lowering testosterone even more. Estrogen is a fat-storing hormone, and the cycle continues.
In women, testosterone levels can decline along with the female hormones estrogen and progesterone during peri-menopause and menopause. Low testosterone levels contribute to bringing down energy, libido, strength...but not weight. Women become more prone to weight gain, which is often worse in the presence of accumulated stress and and other lifestyle factors. For more information, visit the Men's Health section.
Instead of calling estrogen and progesterone "female hormones," we'll just call them by their names. Men have small levels of estrogen and progesterone too, so calling them strictly female hormones is a misnomer. What do these two hormones have to do with weight gain in females? It is actually the ratio of P to E that dictates a lot of what happens.
Progesterone is a hormone that promotes the burning of fuel in the body. It is also a diuretic, meaning that it limits fluid retention and promotes urination. Estrogen is actually quite opposite in its actions. It promotes fat storage and fluid retention (often seen in the form of bloating around the midsection).
So long as a healthy level of progesterone exists to balance out the estrogen, things are okay. But when a situation called Estrogen Dominance sets in, the body is in a position to pack on pounds. Estrogen dominance happens when estrogen levels aren't balanced by enough progesterone. The unopposed estrogen equals more fat storage along with more weight from excess fluid retention.
Women who are going through peri-menopause are particularly susceptible to hormone fluctuations and resulting estrogen dominance. Menopausal women have a reduction in all sex hormones and a slowing of metabolism, especially predisposing them to weight gain.
Men have small amounts of E and P and as long as levels aren't too high or low, it's A-ok. Too much estrogen can lead to weight gain. Like we mentioned above, excess fat cells can convert testosterone into estrogen and create an even bigger problem. For more information on these two hormones, visit the Women's Balance section.
So, we see that Thyroid Hormones, Androgens, and E & P can all play a part in stubborn weight gain. Two other hormones also come into the picture: Cortisol and Insulin. Read about them in the next two tabs.
Stress creates a mess for both metabolism and the body's weight regulation in more ways than one. Everyone goes through stress and that's unavoidable. But if we allow stress to flow in without any physical and mental traffic light in place, there will be some problems at our intersection of health and life. You'll see traffic jams, angry drivers, and collisions. Of course this is a metaphor and we'll now take a closer look at what this means inside the body.
Your body can handle a certain level of stress okay. Each person is different in his or her personality and constitution so one person's stress is not directly comparable to another's. This is important because it's useful to notice where your own personal threshold for stress is at. The body typically provides you with enough fuel to get through a day and its typical challenges. When occasional stress arises, the body provides you a boost of energy to deal with it. The hormone called cortisol, released from the adrenal glands, helps your body prepare for and deal with stressful situations.
Cortisol already swims in your blood daily regardless of stress. It helps provide your body with glucose when you're not actively eating and digesting a meal. In other words, it helps support balanced blood sugar levels. Now picture your body in stress. Cortisol is giving you more glucose so you can deal with extra stress. But when you experience stress day after day, month after month, and then year after year, cortisol doesn't get to enjoy its natural balance and there are more fluctuations in its levels and blood sugar levels.
Not all of your stress is physically demanding enough to use up all this released glucose. Some of it comes from perceived stress, including worries and anxieties. Some of it comes from mental-emotional challenges. Extra glucose that isn't used often gets restored as fat around the midsection. The body notes that it has to keep the additional fuel readily available in case of further stressful situations.
There's more. All the glucose surges in the blood from stress disrupts blood sugar controls. At one point, insulin could do its job just fine when blood sugar was more balanced. Now that there are more blood sugar fluctuations dependent on stress, insulin is a more confused worker. The body's tissues even start ignoring its requests to let glucose into the cells. Even more insulin is released from the pancreas to adjust for the insulin resistance. Insulin resistance predisposes the body to store extra blood sugar as--yes, more fat.
There's still more. Increased cortisol levels upset the balance of thyroid hormones (often leading to a hypothyroid state) and sex hormones. As we read about in the last section, thyroid and sex hormones are important for weight regulation too. Eventually, the adrenal glands can just become exhausted altogether.
We briefly mentioned insulin's role in this section. Let's talk about it in more depth in the next tab.
Blood sugar is closely regulated by many hormones in the body. You know what too much sugar does in the mouth? It easily sticks to the teeth and can eventually lead to tooth erosion and cavities. In oral hygiene, sugar combines with bacteria and saliva to form a coating around the teeth that can even make them feel sticky at times.
Now imagine what excess sugar in the blood stream can do to the walls of arteries and the tissues it travels to. It combines easily with other molecules and can form a sticky coating anywhere, disrupting physiology and metabolism. That's why the body closely regulates how much sugar (glucose) is left sticking around in the blood.
Insulin is the main hormone that signals to the body's cells to let sugar in from the blood stream. A lot of the glucose goes to muscle and fat cells. Using specific receptors located on cells, insulin knocks on the cell doors to help invite glucose inside. Without insulin, the glucose will just hang out in the blood, unavailable to the body for use in energy production.
Too much sugar and refined wheat in the diet actually starts annoying the body and can lead to weight gain in a couple ways.
Cells only need so much fuel at a time. Insulin can invite in a certain amount of glucose into cells, but there's a limit. Eventually, the body will have extra glucose on its hands and this energy needs to go somewhere. It tends to get stored as fat around the midsection.
When the diet is constantly supplying too much sugar, the body's tissues will start ignoring the insulin's knocking as we mentioned in the last section. Why? If the party in the house is already pretty full with glucose molecules, the cells aren't willing to send out as many invitations using insulin. They therefore become less sensitive to insulin's presence altogether.
The pancreas keeps getting signals, though, that sugar is crowding the streets (blood vessels). So it sends more insulin which makes the cells even more resistant. This whole phenomenon is appropriately called insulin resistance. The insulin resistant state makes it even easier to gain weight and is a risk factor for Type 2 Diabetes. Visit the "Weight Gain Stars" section for more info.
Inefficient Energy Production
Second, think about a body that can't use its calories efficiently because of an influx of too much glucose. The body is tied up in trying to figure out what to do with all the extra blood sugar--an extra chore. The body is normally able to provide a more smooth and balanced flow of energy to its cells.
The metabolism, and person, often starts to feel more sluggish and tired. A body at rest tends to stay at rest, right? Without enough energy, the body feels less prepared to exercise and engage in enough physical activity to maintain a healthy weight. As with many imbalances in health, these events can become a self-perpetuating cycle:
...and so on.
--Click on the next tab to read about how lifestyle factors can influence weight gain.
A balance in weight requires a balance in how a healthy lifestyle is approached. That's why yo-yo diets and other extreme habits geared toward losing weight fast often fall short in really making you feel better about your body. What sorts of things contribute to settling in to a healthy weight?
Sleep habits are often overlooked when it comes to excess weight. In fact, chronic oversleeping and undersleeping can both contribute to weight gain. How? Both habits affect the natural daily cortisol release that your body is used to from 8 am until it's time to sleep. This cortisol curve is involved in weight regulation, as we described in the "Unchecked Stress" tab. It basically helps balance blood sugar away from meals. When we get too much or too little sleep, the cortisol curve can change too. This shift can affect the way we feel in terms of stress and energy, often making people eat more than they normally would. Having a regular sleep schedule with around 8 hours of sleep will support a healthy appetite and cortisol curve for weight regulation.
It's true that eating more calories than are expended leads to weight gain. It's also true that a diet high in sugar, saturated fat, and refined carbs increases the likelihood of gaining weight. What else is important to remember when eating throughout the day? Basically, a diet that has a regular schedule is just as important as what you eat. The cortisol curve we described above has its best day and week when meals are eaten around the same times everyday in pretty regular proportions. Here are the mealtime tips that best support a healthy cortisol curve and daily use of the energy you get from food:
- Eat breakfast every morning within an hour of waking
- Limit food portions so you don't feel like unbuttoning your pants after eating
- Try not to wait until you're raging hungry to eat...
- ...meaning eat small snacks throughout the day to tie you over between meals
- Eat dinner as early as you can, ideally between 5 and 7 p.m.
- The less heavy your dinner feels to you, the better because digestion likes to rest at night too
- Chill out for around 5 minutes after a meal to aid in smooth digestion
All these tips ensure that cortisol doesn't have to come a sudden rescue with blood sugar support due to erratic eating habits. It also means that your balanced blood sugar will support a healthy weight.
Does the thought of exercise make you think of gym equipment and spandex... after which you cringe? Not everyone has this reaction, but for some people, it can feel like a chore to "get ready" for exercising. The constant dread about physical activity can for some people just add to stress and even make an exercise session less effective.
If you share this reaction, it's extra important to find a way to get movement and physical activity into your week in a way that feels natural to you. Just because some magazine says squats are the way to go or all your friends belong to a gym doesn't mean this will ultimately be your approach. If you like dancing or a sport, try to incorporate it into your week. If walks or hikes in nature feel good, go with it. If you like socializing while exercising, give that a go. Whatever you do, be creative and make sure the time energizes you rather than making you feel like you "have to" do it.
Thoughts and Emotions
Almost everyone is familiar with what comfort eating is. Food has a natural property of bringing nourishment and comfort to the body. But in times of excessive mental and emotional stress, food can sometimes be the first thing people turn to in order to feel better--especially heavy foods full of fat and sugar. Rather than make strict rules around food and eating, it can be helpful to pay attention to the relationship that exists for you between emotions and the way you eat. The comfort food cravings let you know that you're going through something that's worth noticing and dealing with. As you support yourself through stressful times and offer yourself natural comfort, food's role in that can become less.
Excess weight gain often leads to a host of symptoms that tend to make each other, and the weight gain worse. The body's frame and physiology can only take on so many extra pounds before the weight starts to affect different organ systems. On top of that, the mental-emotional factors of weight gain, including self perception of body image, fear surrounding losing weight, and reliance on habits like comfort eating can be strong and difficult to swerve.
Don't worry, you don't have to swerve them if you're trying to lose weight. All of these factors don't have to feel like an oncoming truck. If you take everything one step at a time, go through the challenge of losing weight in your own way, and be open to learning, then the process of weight loss can be made smoother and easier to handle.
The Weight Gain Stars section covers conditions that have an increased chance of occurring in the presence of excess weight. They include:
- Type 2 Diabetes
- Stress on the Heart
- Hormonal Imbalance
- Mental-Emotional Impact
- Musculoskeletal Pains
But how do you know how much weight is too much? Read the next section on one tool typically used to figure that out called body mass index.
Body Mass Index
Keep in mind that it's not just higher weight that predisposes to more health issues, but more so the weight relative to someone's height. That is why a numerical tool called Body Mass Index (BMI) is often used to gauge this relationship. BMI is calculated from a person's weight and height and research shows it serves as a good alternative for the direct measure of body fat.
You can calculate your BMI by dividing the number of pounds you weigh by how many inches you stand tall (squared--aka, multiply the inches times the inches). Take the resulting number and multiply by 703. Weight, huh? But it works to get your BMI.
For example, if you weigh 105 pounds and are 5 feet 2 inches tall (62 inches total), then your BMI is:
The normal range for BMI is considered between 18.5 and 24.9. Though BMI is not on its own diagnostic, taking into account other symptoms and factors of health it can help you see what weight range you fall into. Below 18.5 is considered underweight while above 24.9 is considered overweight. A BMI at 30 and above falls into the category of obesity.
-Where on your body do you see most of the weight accumulating?
-Is this new or unusual for your health?
-If it's new, has anything changed lately in your life?
-Are there any other symptoms you're experiencing that coincide with the weight gain?
-How is your stress level?
-Calculate your BMI. Is the number what you expected?
-How important is it to you to feel a healthier weight?
-What obstacles do you see that are in the way of you achieving your healthy weight?
Read the Weight Gain Stars section below that focuses on individual health issues that often arise with excess weight gain.
Weight Gain Stars
Click through the symptoms and conditions below to learn more about how excessive weight gain can affect overall health both in the short-term and long-term. For more information and help on how to resolve weight-related issues that may be affecting your health, click on the button below to take the Metabolic Survey and visit our Services page.
Type 2 Diabetes
Under the "Blood Sugar Control" tab, we talked about insulin resistance. Insulin resistance is problematic for both blood sugar balance and efforts to maintain a healthy weight.
During insulin resistance, the body's tissues start ignoring insulin's signals so that glucose is left lingering in the blood rather than entering cells. Increased blood sugar levels signal to the pancreas to send more insulin to compensate, which makes the cells even more resistant.
But, the glucose has to go somewhere! Excess calories from lingering blood sugar tends to be stored as fat around the midsection. But the pancreas can't provide an endless supply of insulin to make up for the lack of response from the body. Eventually insulin levels can become extremely challenged, leading to unchecked blood glucose and Type 2 (adult onset) Diabetes.
On the flip side, excess weight gain can actually encourage an insulin resistant state in the body. How does this happen? Research is not completely clear on that yet. Let's brainstorm a bit and see how a common sense connection can be made.
Insulin's main job is to press the "clock in" button for glucose. It works with the hormones cortisol and glucagon to say "Hey glucose--the body needs energy over here and over there, pronto." Insulin does this after meals, while cortisol and glucagon both perform this duty during off hours (away from meals). Glucagon performs the opposite job of insulin, bringing glucose out of cells and into the blood.
We're assuming that the body is in need of energy in the first place when we describe these hormones' typical actions. Energy comes in a couple forms. One is found in the structure of food, and it is extracted during the process of digestion. Another is stored energy. Glucose is stored in the liver in the form of 'glycogen' for use during off hours. Fat is stored in the body too with potential for energy use when needed.
When the body is carrying too much weight, another way of looking at it is it's also carrying too much stored (or potential) energy. If the body is registering an abundance of stored energy, it makes sense that it would become less responsive and interested in the glucose coming in from the food that we eat. It will even start ignoring insulin's signals. For smoother physiology, it's better to use stored energy in a way that balances the food you eat. That way the body can become more responsive to insulin and use energy more efficiently. While the body doesn't literally talk this out, its chemical messengers do relay signals to each other that embody this concept.
In reality not everyone who is overweight ends up with type 2 diabetes. But insulin resistance is common in overweight states and it can lead to many imbalances in health, including diabetes.
Stress on the Heart
When a Body Mass Index level places someone in the category of overweight or obese, it's time to start thinking about the effect this can have on the heart and cardiovascular system. Heart disease is common in the population and sometimes that's from stress alone. When you add weight issues into the equation, the heart is especially at risk for increased stress and illness.
A higher body mass index means that a person is carrying an amount of weight that is overwhelming for his or her height and frame. The heart has to pump blood out to a larger area, and in order to do that it must work harder. The extra work is translated into stress on the heart tissue, which is actually a muscle. You know when you overdo an exercise and feel a muscle strain for the next few days? Well, imagine the heart enduring this kind of strain daily for years. As long as the weight extends beyond what's comfortable for the frame to carry, the heart will go through stress.
Unfortunately, after years of heart strain, a person will be more at risk for heart disease when weight loss measures might have helped lower that risk earlier on. It's important to remember that a weight issue is hardly ever just a weight issue. It can also become a heart issue.
High Blood Pressure
High blood pressure, aka "hypertension,"means that for some reason the blood vessels are pushing blood through them with some difficulty. There are many different contributors to high blood pressure, and a common one in the population is excess weight gain and obesity.
What makes it difficult to push blood through the vessels in someone who is overweight? Basically, the composition of the blood has changed when there are more fat stores in the body. Fatty molecules are redistributed and moved around in the blood quite a bit in the form of lipids and cholesterol. These fats are not tiny molecules and are packaged in a special way so that they can travel through blood vessels. Still, they take up room in the blood stream.
The more fatty molecules are flowing through the circulation, and the longer the duration, the more chance there is of the fat depositing as plaques along the walls inside arteries. When this happens, the diameter of some of the tubes that the heart pumps blood through (out to the body) will be smaller. The same amount of blood volume traveling through shrunken tubes equals--yes, high blood pressure. Now the heart has to work even harder to push blood through the unwelcoming blood vessels.
Constantly high blood pressure puts someone at risk of heart disease down the line as well as other health issues. For overall health it's key to maintain a healthy weight, especially in the presence of high blood pressure.
Many different factors affect hormonal balance, and weight gain is no exception.
Weight gain affects sex hormone levels in both men and women. Fat cells have the ability to convert androgens, including testosterone, into the more predominantly female hormone called estrogen. Excess estrogen in women can lead to symptoms of estrogen dominance. During estrogen dominance, there is not enough progesterone to balance out some of the unwanted effects of estrogen, including bloating, mood swings, and PMS.
Men who are overweight will also have some conversion of their male sex hormones into estrogen. The extra weight can actually bring on symptoms of low testosterone including a low libido, less energy, and moodiness. The problem is, estrogen is a fuel storing hormone. While testosterone and progesterone tend to promote weight loss, estrogen promotes weight gain. So in both men and women, a predominance or excess of estrogen will lead to more weight gain, which leads to more estrogen, and so on...
What other hormones can be affected by excess fat? Insulin is affected, as described in the "Type 2 Diabetes" Star. Often, energy goes down as weight goes up, placing stress on the adrenal glands and levels of the stress-relief hormone, cortisol, in the body. Thyroid hormones are responsible for orchestrating metabolism and because excess weight affects how the body uses energy, it also places stress on the thyroid. An imbalance in a lot of these hormones promote weight gain, often making matters worse.
If weight isn't coming off and staying off, it can be valuable to get hormone levels checked to offer clues into any possible hormonal imbalance. Once hormones reach better levels for health, weight should be easier to shed too.
The mental-emotional impact of being overweight often isn't mentioned as a symptom, but why not? The thoughts and emotions surrounding appearance, if ignored, often add even more stress to life and actually make it harder to lose weight and take care of oneself for overall health.
It may not be the most fun thing to look at, but eating habits and weight gain can have underlying rumblings of challenges that have come up in life, frustrations, pressures, and expectations. Everyone has an area of health that may feel weaker while other areas feel stronger. The ones that are weaker will show the most shifting with stress, thoughts, and emotions that come up in life. Suppressed emotions especially are held inside the body and have more potential to stress a weaker area of health.
In the case of excess weight, any mental-emotional factors underlying weight gain and challenges surrounding weight loss are very unique to the person. For some people, there are negative experiences or memories surrounding body image and appearance. For others, comfort eating is a habit surrounding stress. If weight loss has been a continual struggle, looking at thoughts and beliefs surrounding the weight can sometimes be the first key to getting where you want to go.
Picture your ideal weight, the one that fits well with your body frame and feels healthy. This weight will distribute itself in the right areas and put a manageable amount of pressure on the joints and muscles of the musculoskeletal system. When you move around whether it's walking, lifting, running, or jumping, your frame will support the weight as it shifts in action.
Weight gain presents a problem. It gives your frame extra weight to carry on the joints, especially the knees, placing additional stress on the muscles that connect the joints as well. The location in which weight is often gained also becomes a problem. The midsection of the body, a loop surrounding the belly button, is a common area where extra weight deposits itself. Now, extra pressure is placed on the low back to support the added weight on the other side of the spine. The core of the body which is also located near the belly button becomes weaker as more weight becomes added to it.
The combination of extra weight on the joints, muscles, and at the body's core puts an overall strain on the musculoskeletal system which after enough time can lead to chronic pain in the body. Joints can start aching after even a little exertion, making exercise more difficult. Abdominal muscles can go slack as they get pulled outward by extra belly mass. As the weight sends the body's center of balance forward, the low back can painfully strain to rebalance the center. Low back pain easily radiates to the legs, the rest of the spine, and affects overall posture.The body can also become more injury prone.
For the prevention of chronic pain syndromes, it's helpful to look at weight gain not just as extra fat in the body but also as an extra weight on musculoskeletal functioning which can lead to pain.