Sarah had wanted to lose weight for a long time. After her second baby was born, she was carrying an extra 10 kilos that she could not budge. When her youngest finally went to preschool at four years old, Sarah made the commitment to losing that weight.
If you could be awarded a gold medal for discipline and commitment, Sarah would be the proud recipient. For 12 weeks, she ate well, watched her portion sizes and exercised regularly both at the gym and with a personal trainer. She did everything right but by the end of it she had only shifted two kilos.
To say she felt disappointed is an understatement.
She described the process as “pushing a boulder up a hill”. Lots of effort and little reward left her feeling frustrated. She was losing hope that she would ever be able to get back to her pre-baby weight.
I've treated lots of women like Sarah during my ten plus years in clinical practise, and often we find that the odds were stacked against them from the start.
Why no weight loss?
Unbeknownst to her, Sarah was experiencing a hormonal imbalance. In her case it was a thyroid gland that was not behaving, while for other women it might be a high-stress lifestyle that is compromising her ability to shed the weight.
The thyroid connection
Your thyroid gland is located in front of your neck and it is often called the master gland of the body because it plays such an important role in your physical and mental wellbeing. When it becomes under active (called hypothyroidism) it results in a slow down in metabolism, among many other things. When low levels of thyroid hormone are produced, you see an inability to lose pre-existing excess weight and you can experience unexplained weight gain!
Super frustrating.
Chronic stress as a culprit
The other possible hormone imbalance you can see playing a role is an increase in stress hormone and a subsequent increase in insulin. Your stress hormone, cortisol, is responsible for helping you navigate your way through the fight or flight response your body mounts when it thinks there is a danger. One of its functions is to increase the availability of glucose for the body to use as an energy source to help you survive the stress. In a nutshell it unlocks energy for the body to use to get away from danger.
Insulin, on the other hand, has the role of packing away excess sugar you don’t need right away (say, when you eat a dozen Tim Tams) in the form of glycogen and fat for use on another day. If your body only ever encounters stress in short bursts and not very often, this system works beautifully. However that is not how the real world works for most women.
Chances are you are living a busy and often stressful lifestyle and are creating more cortisol than you should be most of the time. Chronic stress causes a negative change in how these hormones work. Issues with your partner, stress at work, parenting troubles, dramas with your mother-in-law, ongoing arguments with those neighbours - these are all stressors.
This triggers a release of glucose but what we don’t do is vigorously physically exert ourselves (ie, run away from the lion - or mother in law - at high speed) to burn through that glucose that's now floating around in our bloodstream.
The result is high blood sugars that insulin needs to pack away as glycogen or fat for another day.
This is the basic process by which chronic stress can cause insulin resistance and weight gain.
When estrogen levels change
Weight gain can also be due to changes in certain types of estrogen in the body. When a type of estrogen called estradiol begins to drop in perimenopause you can see weight gain. One of its jobs is to help us maintain a healthy weight. When we stop producing it we see weight gain that is often on the hips, mid section (think a tyre around your waist look!) and the thighs. Nice.
Another thing our bodies do is make estrogen in fat tissue. The more fat cells you have the more estrogen you make and this can create an estrogen dominant situation. Estrogen dominance can make you fat. This ends up being a vicious cycle of weight gain and hormonal issues.
What you can do
If you do have trouble shifting weight weight despite doing all the right things, or you are committing to reaching a healthy weight, seeing your health practitioner to get your hormones investigated is a great idea.
You can have your thyroid hormones, thyroid antibodies and thyroid cofactors tested through a general pathology lab. You can also test women’s hormones, blood cortisol levels, fasting blood glucose and insulin levels to see how your hormones are currently placed. (Not eating the Tim Tams also helps, but you knew that.)
Sarah went off to see the GP. It turned out that her thyroid was very under active and that she was deficient in nutrients that help her thyroid function well.
She had found the missing piece of the puzzle. By addressing the imbalance we were able to start a treatment plan.
The result? In the 10 weeks after she started treatment, Sarah lost 9.2 kilos. It felt like she had won a gold medal.