Are You Destined to be Overweight Forever? (The Answer is No)
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Are You Destined to be Overweight Forever? (The Answer is No)

This is a question that I'm sure many of you think about. Perhaps you've even given up on the idea of getting back to a 'normal' weight.

The truth is that there is definitely a chance for you to get back to whatever is normal for you, even if you suffer from hormone imbalances such as thyroid disease, leptin resistance, or insulin resistance. 

The way to do this, though, starts by understanding the causes of weight gain. Only then will you be able to actually address the underlying causes of weight gain and start to lose weight. 

This article will help you do just that. It will also give you an idea as to how likely you are to lose weight based on your history and your medical conditions. 

All of these factors influence both your ability to lose weight and how quickly that weight loss will occur

Let's jump in: 

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The Causes of Weight Gain: Are We Confused? 

Before we jump in here I want to make one quick statement regarding obesity, your weight, and personal image. 

I know that it is very important for you to love your body and to be at peace with your physical appearance and I'm not discounting that importance. 

The purpose of this blog is to describe the importance of weight loss and its impact on your metabolic function. My goal is always to try and help you to be the best version of yourself which means helping you FEEL good. 

It just so happens that when you lose weight a number of things start to happen in your body and these things almost always result in more energy, better mood (1), improved sleep (2), better overall health and so on. 

So with that in mind, is it actually possible to lose weight and to keep it off forever? 

I think one of the biggest mistakes that Doctors make (and perhaps even you) is that we treat all people with obesity as if they are the same. 

Obesity is simply a medical condition and one which has a single treatment. 

There's one big problem with that (in my eyes):

No two cases of obesity are the same and that means that each case should be treated differently! (3)

As long as doctors and researchers continue to believe that obesity has one common cause (for the majority of people) then we will never find 'the treatment' for it. 

What's even more interesting is that obesity is one of those conditions which is not treated similarly to other common medical conditions. 

Compare obesity to that of high blood pressure:

It is well known that having high blood pressure is something that may eventually kill you. High blood pressure leads to an increased risk of stroke and heart disease and it's something you want to treat. 

While the treatment for high blood pressure is largely the same: use high blood pressure medications, at least doctors understand that there are MANY different conditions which can lead to high blood pressure, some of which are actually reversible. 

Conditions such as kidney issues, obesity, sleep apnea, certain medications, diet, and some cancers (4) can all cause high blood pressure which can be reversed. 

It would be silly to treat these patients with high blood pressure medication without at least considering the CAUSE of the blood pressure (even though this does happen). 

This same type of logic can be applied to those who are overweight. 

Often the treatment for obesity (the incorrect treatment, I might add) is to automatically tell someone to eat less and to exercise more if they want to lose weight. 

But this approach is no different than simply giving all people with high blood pressure a blood pressure lowering medication. The only difference that the 'medication' in this case is the 'eat less and exercise more' prescription. 

This method does not take into account ANY of the underlying causes of obesity, which as far as I can tell include mostly hormone imbalances and hormone resistant states. 

These conditions (and I'll describe many of them below) all play a role in regulating your weight and your metabolism. 

One of the most important is your thyroid hormone system. 

The Special Role That your Thyroid Plays

Your thyroid, in my opinion, is the most important hormone in regulating your weight. 

Thyroid hormone, particularly T3, which is the active form of thyroid hormone, is responsible for regulating the majority of your resting metabolic rate. 

You can think of your resting metabolic rate (or REE) as how many calories you burn at rest. 

The lower this number, the more likely you are to gain weight, feel fatigued, have brain fog, and experience the symptoms of hypothyroidism. 

But, there's a big problem when it comes to your thyroid and your weight. 

Most physicians, including endocrinologists, do NOT believe that it impacts your weight. 

They may believe that hypothyroidism causes weight GAIN but they certainly don't believe that replacing thyroid hormone results in weight loss. 

But how can this be? 

This is a rather crazy proposition considering the fact that we know just how important the metabolism is in regulating your overall weight. 

After all, all you need to do is take a look at a few studies which highlight the importance of metabolism is maintaining weight. 

So why do physicians discount the importance of the thyroid as it relates to weight loss?

thyroid metabolism reset poster for side bar

Much of this has to do with the current treatment paradigm as it relates to treating low thyroid function. 

It is my belief, based upon numerous studies which you can find here, that our current treatment model for hypothyroidism does NOT result in the complete and adequate replacement of thyroid hormone in many cases. 

So, it's not that the thyroid does NOT play a role in weight loss, it's just that most people are not getting an adequate amount to experience the normalization of their weight. 

But make no mistake:

If you are experiencing hypothyroidism, from any cause, then it will be incredibly difficult to lose weight unless your thyroid is properly managed and you are on the right type of thyroid medication. 

Replacing thyroid hormone adequately results in an improvement in free and total T3 levels, an improvement in body temperature, and an improvement in resting metabolic rate. 

All of these factors help your body burn more calories and lose weight. And what's even more interesting about this is that most patients who are treated adequately often experience weight loss without reducing their calories or exercising more (5). 

This is why it's so important for thyroid patients to be advocates for themselves. 

And it's also why it's so important for you to ensure that you fight for the right medication and the right approach to thyroid management. 

You can learn more about how thyroid function impacts your weight here and a new, better approach, to thyroid management here

My Current Understanding of Weight Loss (& Weight Gain)

This leads me to my next point which has to do with the real CAUSE of obesity. 

My working model of obesity and weight gain has been evolving over the last several years as I've researched, tested, and adapted. 

The list below contains my most updated ideas on what causes obesity but even this is not a complete list. 

This list is relevant to probably 95+% of people, though! 

What causes obesity?

  • Hormone resistance syndromes - Perhaps the most common syndromes leading to obesity include insulin resistance, leptin resistance, and cortisol resistance. Insulin and leptin resistance can easily be tested for with standard lab tests while cortisol resistance is probably the underlying cause of 'adrenal fatigue' in many patients. 
  • High or low hormones - Other hormones (aside from insulin and leptin) which are important in regulating your weight include sex hormones (estrogen, progesterone, and testosterone) as well as thyroid hormone. It is well known that these hormone states impact your weight and it is also well known that standard doctors know very little about hormone management or hormone replacement therapy! This fact may explain why some doctors are hesitant to pick up on the connection between hormone imbalance and weight gain. 
  • Dietary consumption issues - There are certainly some people who either knowingly or unknowingly consume more calories than they should, but in order for this to cause weight gain it must also be combined with some other factor such as underlying hormone imbalance or the consumption of inflammatory foods. Some evidence suggests that short overfeeding periods do NOT result in weight gain but instead an increase in metabolism by the body to simply burn more energy during the overfeeding period. But, if overfeeding is also accompanied by other issues such as hormone imbalances (or the consumption of unhealthy food) then it can certainly lead to weight gain. 
  • Psychological issues - Included in this list are conditions such as binge eating disorders, depression, and trauma to the brain (hypothalamic dysfunction). 
  • Inflammation - Inflammation is at the heart of many chronic diseases and it certainly plays a role in obesity as well. It's known that your fat cells can actually become inflamed and 'sick' which is known as adiposopathy (6). These inflamed cells no longer function the way that they are supposed to which may contribute to weight loss resistance. 
  • Gut dysfunction - Last, but certainly not least, is the role that your gut plays in regulating your weight. The interaction between your intestinal microbiota (bacteria in your gut) and the food that you consume has the potential to impact how many calories you absorb from the food that you eat (7). They also play a role in regulating hormone systems in the body and in either turning down or turning on inflammation. 
healthy fat loss vs unhealthy fat loss

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601187/​​​It is the connection between all of these factors and variables which lead to weight gain in many individuals. 

You can compare this list to that of the overly simplified 'eat more and gain weight' approach (8). 

By using this approach I've been able to help hundreds of people lose weight and keep it off for many years. 

While I don't believe that this is a completed list, I do think it's a step in the right direction and I'm open to your opinions, thoughts, and criticism! 

Conditions that make Weight Loss Very Difficult

It is definitely true that no two cases of obesity should be treated in the same. 

One of the most troubling consequences of some disease states is that they make weight loss more difficult compared to others. 

These conditions often lead people (perhaps even you) constantly looking for the answer to your weight even though it's right in front of you. 

In my experience, I've found that there are a number of conditions which make weight loss very difficult. 

If you have any of these conditions then you just need to be aware that losing weight will be more difficult for you which means it will take longer and it will be slower. 

  • Those with a history of binge eating disorders - the longer you've had these issues the more difficult it will be to lose weight. It appears that binge eating disorders cause severe metabolic damage which can take a very long time to recover from (on the order of years). 
  • Those with VERY high fasting leptin/insulin levels - These values can easily be tested for in the fasted state (meaning you don't eat any food prior to your lab tests for 12 hours). The higher these values are in the fasted state the more difficult it will be for you to lose weight (generally). High levels of these hormones often represent the presence of hormone resistance syndromes. 
  • Those with multiple hormone imbalances - In general, the more issues you have with your hormones the more difficult it will be to lose weight. For instance, if you are post menopausal AND you have hypothyroidism AND you have high leptin it will be much more difficult for you to lose weight compared to someone with only 1 hormone-related issue. 
  • Those who have a history of multiple diets in the past - If you are someone who has dieted more than 5-7 times in their life you are probably going to have a more difficult time compared to those who haven't. My recommendation to you is to avoid these diets because even though they may cause temporary weight loss they almost never lead to lasting weight loss. 
  • Those who are eating around 1,000 calories to 1,200 calories per day to maintain their weight - There is a growing number of people who manage their weight by consciously suppressing their calories. The main problem here is that this approach causes metabolic damage and will make losing weight difficult. People in this scenario often find that they gain weight even after eating a normal amount of food (1,500 or more calories in a single day). 
  • Those without a thyroid or those who have undergone radioactive iodine ablation - It's already difficult to lose weight if you have hypothyroidism or Hashimoto's but this problem is compounded if you don't have a thyroid at all. If you fit into this category it's still possible to lose weight but you need to be very vigilant about getting on the right dose of thyroid medication and optimizing your free and total T3 levels
  • Those with a history of sleep apnea - Sleep apnea is a tricky condition because of how sleep can impact your body weight. Sometimes a lack of sleep can lead to weight gain while it's also possible that weight gain can lead to a lack of sleep (9). Because this connection is bi-directional (meaning it can go both ways) it's important to always evaluate sleeping patterns and test for sleep apnea if you are overweight! Sometimes, people don't lose any weight (despite their best efforts) until they are treated for sleep apnea!  
the connection between sleep apnea and weight gain

This list is based on my own experience helping people lose weight and is currently not complete (there are other conditions which make weight loss difficult as well). 

People who Can Lose Weight Easily

On the flip side, there are some people who can easily lose weight, especially when compared to those who fall into the categories listed above. 

Perhaps you would like to know how likely it is for you to lose weight?

Below, I've included a list of people who I generally find are able to lose weight the easiest: 

  • Those without a prior and extensive history of dieting in the past - The fewer times you've dieted in your life the better. 
  • Those with relatively 'normal' hormone lab tests - The fewer hormone imbalances you have the better and the easier it will be to lose weight. 
  • Those who start YOUNG - In general I find that the younger you start looking at and managing your weight the better. If you allow your weight to 'set in' it becomes difficult to lose weight in the long run. For instance, if you have been 50 pounds overweight for 15 years it will be harder to lose weight than if you've only been 50 pounds overweight for 6-12 months. By young I'm not talking about those in their teenage years but rather those who are in their 20's and 30's compared to their 40's and 50's. 
  • Those who are pre-menopausal - Once women hit menopause (which occurs around age 50 for most women) it becomes a lot more difficult to lose weight. This has to do with the impact that menopause has on sex hormones such as estrogen and progesterone. If you are a woman, make sure you focus on losing weight BEFORE you hit menopause. 
  • Men - Men (of pretty much any age) seem to have an easier time losing weight when compared to women. This probably has to do with the impact that testosterone has on metabolic function and how easy it is to replace low testosterone in men. Testosterone plays a similar role in women but not nearly to the same degree. 

Is it Possible to Get Back to Normal? 

The odds of you losing weight using the standard approach (of eating less and exercising more) is around 1 in 220 based on recent studies

If this sounds depressing don't let it be because this number doesn't have to be the reality for you. 

This number is only true if you are someone who follows the conventional weight loss advice. 

If you are reading this, and it's resonating with you, then you are one of the few who may actually be able to lose weight and keep it off, but it starts with ignoring probably everything that you think you know about weight loss. 

So the answer to whether or not it's possible to get back to a normal weight largely depends on the treatment that you choose to follow!

Remember as well that when you lose weight the correct way it can take a while to get back to a normal weight. 

If you attempt to lose weight too rapidly then you risk causing more harm than good and ultimately gaining back the weight you have lost. 

On average, most people can safely lose around 5-10 pounds per month. 

If you have any of the conditions I've listed above then this amount may be cut in half so you can expect to lose around 2-5 pounds per month. 

What YOU Can Do

I won't be able to talk about the specifics of treatment due to the sheer volume of information required to discuss the therapies associated with the problems listed above, but I can give you a quick overview of how you should approach your problem: 

  • Understand that there is a better way to lose weight - It's going to be difficult, but necessary for you to realize that what you've done in the past for weight loss isn't going to work. You'll have to unlearn what you already know and trust in a new process (one which has been proven). 
  • Get a complete hormone and metabolic panel - The first place you should start is with a complete set of labs. These labs are necessary because they can help you understand what your issues are. From there you can then tailor your diet, exercise routine, supplements, and medications (if necessary) to help you along the way. While diet is certainly important to help you lose weight, certain diets are better for certain conditions and hormone imbalances. 
  • Target your treatment to YOUR conditions - Once you have an understanding of what is causing your weight gain you can then target that problem. Do you have a thyroid problem? Maybe the answer is getting on the right type of thyroid medication. Do you have leptin resistance? Maybe you should look at diets which help treat high leptin. Do you have insulin resistance? Maybe the ketogenic diet is the first place to start along with some supplements and medications
  • Find a doctor willing to help you -  It may not seem surprising that a doctor is recommending that you find another doctor to get help, but I really do think it's necessary if you want to get serious about weight loss. First off, you'll need someone to help you order the right kind of labs. And secondly, there are a number of medications which can potentially be helpful. You don't necessarily have to use them (you can definitely lose weight without them), but it's always nice to have them as an option to fall back on.
  • Get help and guidance here - Even if you can get your doctor to order labs, it may be difficult to get them on board with some of the newer therapies designed to help people lose weight. The old adage 'you can't teach an old dog new tricks' seems to apply nicely to physicians who are often unwilling to use new therapies even though they are FDA approved and have plenty of studies showing their efficacy. If you fit into this category then you may find success in utilizing the information in my weight loss guide to help you along the way. The guide includes videos, recommendations, dietary tips, exercise tips, and so on. 

The main thing I want you to get out of this article is the fact that it is definitely possible to lose weight and to get back to whatever your normal is. 

The journey may be long, it may be hard, but it will definitely be worth it in the end! 

Conclusion

Is it possible to lose weight and keep it off?

The answer is yes, but it will take some work on your part and a fresh outlook on new weight-loss therapies. 

The bottom line is that some of you will have an easier time than others because how much and how quickly you are able to lose weight will depend on the cause of weight gain in your body. 

Now I want to hear from you:

Have you been able to lose weight and keep it off?

What strategies and therapies have you used?

Are you stuck in the weight loss/weight gain treadmill using conventional advice?

Leave your questions or comments below! 

References (Click to Expand)

Westin Childs
 

Dr. Westin Childs is a Doctor of Osteopathic Medicine. He provides well-researched actionable information about hormone-related disorders and formulates supplements to treat these disorders. He is trained in Internal Medicine, Functional Medicine and Integrative Medicine. His focus is on managing thyroid disorders, weight loss resistance, and other sex hormone imbalances. You can read more about his own personal journey here.

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