The Physiology of Weight Loss: Beyond Just Nutrition & Exercise

I see a lot of women who are “doing all the right things” when it comes to weight loss. They’re making healthy food choices, exercising regularly, drinking lot of water, attempting to moderate their stress levels—but their goal of weight loss just isn’t happening. It can often feel frustrating to not know where to turn next.

While nutrition and exercise are two foundational pieces to weight management, there are a few other keys to a successful weight loss journey. Today I want to talk about how your biochemistry may be stunting your weight loss.

The Problem: Insulin Resistance & Blood Sugar Stabilization

Let’s first start with insulin, as its effects are becoming a bit more mainstream. We know insulin as the hormone that’s released when food is broken down into glucose, and that glucose gets into our bloodstream. Think of it as the key that unlocks your cells and allows the glucose to get in, which is essential to fueling your cells’ energy.

The problem lies when we have chronically eaten foods that are higher on the glycemic index, meaning they break down into glucose quickly. The more glucose, the more insulin we need to bring it into our cells. Over time, our cells become resistant to the signal of insulin, and then we need more and more insulin to do the same job. That extra insulin starts to promote energy storage into fat tissue.

The Solution: We can test insulin resistance by measuring your fasting insulin levels and determining if they’re in a normal range or not. If they’re too high, we can work with you to shift around the foods you’re eating to optimize insulin levels, and take dietary nutrients to resensitize your cells to the signal of minimal insulin.



The Problem: Hormone Imbalances

One piece of a woman’s hormones that is often forgotten about is the need for testosterone. Testosterone in women is essential for libido, memory and motivation, exercise stamina, and metabolism. And while too much of a good thing can cause problems, not enough testosterone can cause a woman’s metabolism to slow way down.

One root cause of low testosterone in women can stem from past or present use of hormonal birth control. That hormonal contraceptive can lower free testosterone through increasing a protein called Sex Hormone Binding Globulin. And until you work towards clearing out the SHBG, increasing testosterone levels will be difficult work!

In men, the need for testosterone and metabolism is very similar. However, the “normal” amount of testosterone that you need is dependant on your age, as levels tend to decline over the lifespan. Men with low testosterone can start to gain weight, have difficulty putting on muscle mass, experience low mood, and oftentimes, can experience some degree of erectile dysfunction.

I also like to look at estrogen levels in women who are struggling to lose weight, or who have gained weight particularly in their midsection, thighs, and backs of arms. Research has shown that low estrogen levels are correlated with increased weight accumulation and we see this is type of hormone decline in women who are transitioning through menopause and are postmenopausal. Estrogen is also anti-inflammatory, and has influence in your other hormones such as insulin and leptin, so a lack of estrogen can cascade and affect many other systems.

The Solution: Running a hormone panel and monitoring your ebb and flow of symptoms can help us determine if your hormone levels are outside of the normal range. If your levels aren’t optimal, we use researched dietary, lifestyle and natural therapies to bring them back into balance.

The Problem: Leptin Resistance

The influence of leptin on our weight has become a more popular topic in the research over the past few years and we’re finding a lot of interesting clinical correlations. Leptin is often considered both the satiety and starvation hormone. It’s released by our adipose tissue and travels to our brain to let it know that we have enough energy stored, and to reduce caloric intake (a.k.a., decrease our appetite) and start burning the energy stores we have (a.k.a. burning fat).

Leptin resistance is the idea that our brain can become resistant to the hormone leptin, meaning it doesn’t recognize or hear the signal to stop consuming calories, regardless of how much energy we have stored. So our brains continue to believe that our bodies are in ‘starvation mode’ and prompt us to continue to consume and store energy, regardless of what our leptin is telling us!

The Solution: Leptin is a marker we can run on a blood panel to determine if you leptin resistance is contributing to difficulty with weight loss. If it is out of balance, we can work towards re-training your hormones and your brain to communicate more effectively!

The Problem: Nutrient Deficiencies

Although many of my patients make healthier decisions on their meals, I always like to recommend working with our functional dietitian to create a customized meal plan that takes a 360 view of their food choices. It’s not only the calories you consume or the macronutrient balance that can cause weight gain, but also the lack of nutrients in those foods.

Researchers are finding that nutrient deficiencies are more widespread than you might even imagine. When you’re deficient in nutrients such as magnesium, chromium, vitamin D, vitamin C, and vitamin E, it can lead to things like high inflammation levels, blood sugar control issues, insulin resistance, thyroid imbalances, and much more.

The Solution: We can test for nutrient deficiencies through blood panels, and oftentimes determine what nutrients you may be lacking based on a diet-recall, medications you’re taking, or symptoms you’re experiencing.

The Problem: Thyroid Function

Thyroid function is a huge hot topic, and I left it for last on purpose. The thyroid gets a lot of the blame for slow metabolism (as it rightfully should), but we must also remember that it’s only one piece of the bigger puzzle. After you’ve had a full, in-depth thyroid panel (see what I recommend here), we can start to assess if your thyroid is the one causing the hold-up in your weight loss journey. There are several places on the thyroid hormone pathway where issues can arise, so it’s important to know your thyroid values.

The two biggest places where I see problems arise are with the conversion of inactive hormone T4, to the active hormone T3. T3 is what is absorbed into your cells and gives you the good-feeling effects, including metabolism, bowel normalcy, and a clear mind. When you’re not able to convert your hormone properly, you won’t have enough T3 to support essential cellular functions, so other functions such as metabolism are going to be deprioritized.

The other place I see problems arise are when that active T3 can’t be absorbed into the cells and is converted into the waste, storage form of hormone called Reverse T3. RT3 is not only inactive, but it can also stop other, good T3 from being absorbed into your cells and sort of sabotage you—from multiple angles. I see high levels of Reverse T3 in patients who are chronically stressed to the max, or have high levels of inflammation.

The Solution: Run a full thyroid panel to see where your values are. Once we have a clear picture of how your thyroid is functioning, we can craft a specific treatment plan to support your needs.

Interested in if your struggle with weight loss could be physiological? Give us a call for a free, 15-minute consult to see if we can help you in your journey.