Are you—or have you—struggled with losing weight?
I’ve been there… I understand how the struggle feels.
For many of us, the desire to lose weight, whether it’s 5 pounds or 50 pounds, transcends just wanting to look good. Being in a right-sized body (for you) often goes hand-in-hand with wanting to feel well physically, emotionally and mentally—less aches and pains, more energy, focus, strength, vitality and confidence…
About 15 years ago, I went through a period of what seemed like steady weight gain. It wasn’t a dramatic increase, but every time I stepped on the scale, I seemed to gain another pound. I felt frustrated, dismayed and confused because I thought I was doing all the “right” things and did not understand what caused the weight gain. My usual go-to solution of increasing the intensity and/or frequency of my workouts (already 2 hours) backfired on me …in fact, as a result of exercising more, I gained even more weight! Since then, I’ve learned “eating less” and “exercising more” is rarely a long-term sustainable weight loss solution.
Weight gain is a symptom that something—physically, emotionally, psychologically or spiritually—is out of balance in your life. And, until that imbalance(s) is addressed, any weight you lose via extreme diets, surgery, or weight loss injections (e.g, Ozempic, Wegovy), is very likely to come back.
If you have been doing all the “right” things—eating “healthy”, watching portion sizes, doing harder, longer or more frequent workouts—yet, you’re still not losing weight, these may be the reasons why.
1. You have nutrient deficiencies that stall fat loss.
When clients schedule an initial consultation with me, I typically review their bloodwork (from a recent physical) beforehand for potential red flags. If weight loss is a goal, your bloodwork can reveal nutrient deficiencies that prevent you from achieving the weight loss results you want.
Common nutrient deficiencies that can stall fat loss include: Iron / ferritin (Ferritin is a blood protein that stores iron, and it is an indicator of whether your iron stores are high or low. For example, low ferritin can indicate iron deficiency anemia.). Vitamin B12. Folate. Zinc. Vitamin D3. Magnesium.
Iron, folate and vitamin B12 are essential nutrients in the production of healthy red blood cells, which transport oxygen from the lungs to the cells of the body. Iron deficiency anemia is associated with increased body weight and BMI (1).
Your cells need oxygen to function optimally: less oxygen translates to less fat burning! A ferritin level, somewhere between 70 and 90 units and B-12, in the high-middle to upper ranges, are in optimal ranges.
Zinc, magnesium and Vitamin D3 are also important for fat loss and metabolism. Why? Because these nutrients affect insulin sensitivity (2, 3, 4). When your body is insulin sensitive, you are able to lose weight more efficiently.
Unfortunately, because of chronic stress, medications, high-sugar diets, poor gut health and hormone imbalances, many people today are woefully deficient in these vitamins and minerals.
Could you have nutritional deficiencies? This nutrient panel offers insights needed to make informed decisions about nutritional intake and supplementation.
2. You are relying ONLY on exercise to lose weight…and you haven’t changed your food choices.
In my practice, a common confession (or pledge) that I hear is: “I need to—or I intend to—go to the gym more.”
The hard truth? Body transformation is 80% food choices and 20% movement. Don’t get me wrong: our bodies are designed to move. Exercise has myriad health benefits, but exercise alone will not help you lose weight.
A few things happen when you rely only on exercise to lose weight.
Exercise can cast a “halo effect” on less healthy choices. For example, if you’ve exercised vigorously for an hour, you may feel that your calorie-burning efforts entitle you to eat (or overeat) a favorite processed food—pizza, cheesecake, soda, etc.
You burn way less calories than you think. In reality, it is difficult for most people to create a calorie deficit through exercise alone. Eat one New York-style slice of pizza, and you are consuming over 400 calories, roughly 20 grams of unhealthy fat and loads of sodium. Or, maybe you have a Shake Shack Double Shackburger (855 calories) and an order of fries (420 calories) at lunch. In either case, you would have to spend a lot of time and energy exercising to ”burn off” those calories. The average person burns approximately 100 calories for every mile of walking or running; that’s it!
Exercise is usually the first thing to go when my clients get busy or they have to travel…”no time”!
Exercising more creates a hormonal chain reaction (5). Increasing the frequency, duration and/or intensity of exercise—like running, biking, power walking—creates a hormonal domino effect. In other words, more exercise can also intensify hunger and cravings. This can cause you to overeat or to crave fatty, high-sugar, carb-starchy or salty foods and sabotage your weight loss efforts.
Too much exercise (for your body) or overtraining can lead to hormone imbalances; for example, elevating cortisol (stress hormone) levels or negatively impacting thyroid function—causing you to gain weight.
You have acquired mobility issues. In recent years, I have worked with many clients who have acquired mobility issues due to chronic medical conditions (e.g., arthritis or respiratory problems); injury; accidents; chronic pain (especially the knees and/or back); and neurological complications, including impaired mobility, from the C*V*D-19 vaccine. In all of these cases, “exercising more” was not an option.
3. Your hormones are not in balance.
We tend to think of hormones as they relate to a woman’s menstrual cycle, pregnancy, or male erectile dysfunction. But hormones are vital to our existence. They act as chemical messengers in our body that control bodily functions, such as hunger, energy, cravings, sleep and mood. For example, ghrelin is a hormone that stimulates hunger and promotes fat storage, while leptin is a hormone that signals satiety (feeling full). When these signals get crossed, you can gain weight (6). Certain hormones tell the body to burn fat or store fat (7).
Thyroid dysfunction is a common hormone imbalance. I, myself, have hypothyroidism, an underactive (low) thyroid, and I understand, firsthand, how the thyroid can affect your metabolism. Prior to my diagnosis in 2013, I worked out 2 to 3 hours almost daily (under the misguided notion that more exercise = weight loss) and could not fathom why I was still gaining weight!!
Once I addressed my thyroid dysfunction—by making different food and lifestyle choices; through targeted supplementation; by taking natural thyroid hormone and low dose bioidentical hormones; incorporating stress reduction strategies (other than “the gym”); working on negative self-talk and resolving past trauma—my overall health improved dramatically. By the way, my food choices and lifestyle evolved over time—not overnight!
Over the last year, my workout routine has changed dramatically because of my busy schedule. These days, I prioritize walking 5 to 6 miles daily (cumulative over the day), and I engage in thyroid-friendly metabolic conditioning workouts (under 20 minutes) about 3-5 times a week—in my bedroom! This is what I have time for during this particular phase of my life…and that’s okay. Moving my body regularly is the goal.
Your thyroid is the main metabolism gland. Every cell in your body has receptors for thyroid hormone; as a result, the thyroid also controls how sensitive your body is to other hormones, like estrogen, progesterone, testosterone, insulin and cortisol. If your thyroid is off—either underactive or overactive—other hormones and bodily functions are affected. If you have an underperforming (low) thyroid, you may have low energy, fatigue, brain fog, depression, anxiety, mood swings, a sluggish metabolism and feel cold all the time.
If your thyroid is not working properly, you will have a hard time losing weight. You will also likely have digestive issues (such as constipation) and poor elimination; the inability to poop—at least once a day—also contributes to extra weight.
Hormone imbalances occur after giving birth; at perimenopause (the period of hormonal fluctuations prior to menopause that can start from age 35 and last up to 10 to 13 years); menopause (absence of a period for one year); and andropause (a.k.a., male menopause, where testosterone gradually declines, beginning around age 40).
That said, poor food and lifestyle choices—at any age—can lead to hormonal imbalances that cause weight gain.
These imbalances can include insulin resistance, where the body is producing too much insulin (a fat-storing hormone); adrenal dysfunction (under duress, the adrenals release cortisol, a stress hormone; excess cortisol stores fat); and, sex hormone imbalances (e.g., too much or too little estrogen, progesterone or testosterone), like PCOS (polycystic ovarian syndrome) or uterine fibroids.
Discover what your current hormone status is with a Healthy Women’s Lab Panel OR the men’s Testosterone and Prostate Health Panel.
4. You use calorie counting as your only approach to losing weight.
We have been programmed to believe that we can lose weight simply by cutting calories—either by eating less calories and/or by “burning off” extra calories by exercising more. This approach treats the body like it is a calculator: Calories In = Calories Out.
Cutting calories usually does result in short-term weight loss. But, at some point, the weight loss will stop. Why? Because your body is highly adaptive; it operates more like a thermostat. Your body perceives a low-calorie diet as “STRESS!!”; and, in response to perceived “starvation”, it adapts to a lower calorie intake. As a result, your metabolism slows down in order to hold onto every calorie it gets—and those calories are more likely to be stored as fat!
Calorie restriction (that is too low for your body and/or consists of mostly ultra-processed foods) also throws your hormones out of balance: you’ll know this because you will feel tired or low energy; feel hungry; and have cravings for fatty, sugary, salty and/or high-calorie foods.
Remember: all calories are not created equal. What happens when your “breakfast” consists of a Dunkin’ Donuts “Reduced Fat” Blueberry Muffin (410 calories, 40 grams of sugar) and a small iced coffee sweetened with brown sugar syrup (110 calories), versus a 3-egg vegetable omelet (apx. 368 calories) and one cup unsweetened green tea (0 calories)? Your choices will affect your hormones differently. For example, the Dunkin’ Donuts combination of caffeine, sugar and fat will increase hunger and cravings, whereas a vegetable omelet, containing protein, fiber and healthy fat, promotes satiety and stable blood sugar.
In my practice, I encourage clients to choose hormone-balancing foods—not count calories. Weight loss is often a happy side effect of balanced hormones (not the other way around).
5. You have undiagnosed food sensitivities.
If there is one thing that irritates me to no end, it’s the misguided notion that we can all eat whatever we want or love—as long as it’s in “moderation”.
Sorry…I vehemently disagree.
In my Healthy Body Reset program, clients can choose to eliminate common allergenic foods for 30 days. Food sensitivities are rampant, and if you have them, you can struggle with losing weight—even if you’re eating “healthy”. A food sensitivity is not the same as a food allergy, like a peanut allergy, which triggers an immediate immune system response, such as swelling of the tongue and throat, after an exposure.
A sensitivity is usually a delayed reaction (up to 3 days) to a food, drink or food compound that is poorly tolerated by the body. It can manifest, among other symptoms, as bloating, gas, heartburn, joint pain, fatigue, brain fog, mood swings, acne, migraines, hives, rashes and/or weight gain. Sometimes, your body responds to a food sensitivity by retaining water. Food sensitivities can also affect hormones that affect your digestion or metabolism, preventing weight loss (8, 9).
I, myself, have multiple food sensitivities. In addition to gluten, grains, dairy and soy, I have a strong intolerance to “healthy” foods, like apples, figs, citrus and button mushrooms! Every client with whom I have worked has had at least one food sensitivity (usually more).
We often develop sensitivities to foods that we eat regularly or every day. When you constantly eat foods to which you are sensitive, this puts your immune system in overdrive, creating a chronic state of inflammation. Some common food sensitivities include eggs, corn, gluten, dairy and soy.
If you’re unsure whether food sensitivities are an issue for you, consider my Do-It-Yourself 7-Day Body Reset Detox program, a whole foods-based detox (so, yes, you will be eating!) that eliminates common allergenic offenders for 7 days, then reintroduces one at a time.
6. You have gut issues.
Your gut microbiome is home to trillions of microbes, consisting of some 1,000 species of bacteria, both good and bad (10). Approximately 80% of your immune system resides in your gut. When your gut flora is in balance, it supports healthy digestion, protects you from infection and regulates metabolism.
If the ratio of bacteria in your microbiome is out of balance, where bad bacteria outnumber the good bacteria, this can, over time, lead to chronic diseases, including inflammatory bowel disease, diabetes, heart disease, cancer, autoimmune conditions, like rheumatoid arthritis, and obesity (11, 12).
What creates unhealthy gut flora? Prescription drugs (e.g., antibiotics and other medications). Birth control pills. Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen (e.g., Advil, Motril). A diet high in processed foods, refined carbohydrates and sugar. Infections. Stress. A diet high in inflammatory foods, like wheat and highly refined “vegetable” oils (canola, soybean, corn) that cause intestinal permeability. Overconsuming alcohol (13).
Studies have shown that the microbes living in your gut can determine, to some extent, how easy it is for you to lose weight and how well your metabolism functions. For example, when too many bad bugs reside in your gut, your body can make too much insulin, which can lead to insulin resistance (14).
How do you know if you have gut issues? If you have flatulence (gas), IBS, constipation, diarrhea, anxiety, depression, mood swings, joint pain, migraines, any kind of skin condition (eczema, rosacea, psoriasis), chronic sinusitis, post-nasal drip, to name just a few symptoms, you have gut issues!
Can you heal your gut with a probiotic? Unfortunately, there is no magic bullet. A probiotic is most beneficial when you support your overall health with an anti-inflammatory, hormone-balancing food choices and healthy lifestyle habits. Once these are in place, you’ll experience the maximum benefits of taking a probiotic.
7. You skimp on sleep.
If you don’t get enough sleep, you won’t lose weight as quickly as you want—or maybe not at all.
Studies have linked poor sleep with a higher BMI (body mass index) and weight gain (15). In one experimental study, participants—16 healthy adults (ages 22 to 26) —were allowed to sleep 5 hours for 5 consecutive nights. The result? They gained, on average, approximately 2 pounds (16).
This study reflects my own experience with sleep loss and weight gain. If I sleep 6 hours (instead of 8), I am, literally, two pounds heavier when I step on the scale in the morning! Though sleep needs can vary from person to person, most studies have linked changes in weight to people who sleep less than 7 hours nightly (17).
Oversleeping (10-plus hours every day) can be a symptom of poor health (e.g., heart disease) and depression. The reality, however, is that most people need 8 to 9 hours of sleep for optimal health, including weight management. If you have a hormone imbalance, like PCOS, or, an autoimmune condition, like Hashimoto’s thyroiditis, your sleep needs are greater—8 to 9 hours. Being hypothyroid, I know that I need at least 8 hours of sleep.
Sleep has a lot to do with how our bodies gain and lose weight. Yes…we’re back to hormones! When you get too little sleep OR you regularly sleep against your natural circadian rhythm (for example, working the graveyard shift), this elevates cortisol, the stress hormone. A consistently high level of cortisol makes you vulnerable to gaining belly fat. Getting enough sleep also helps you produce human growth hormone (HGH), which helps you lose fat and gain muscle. Blow off sleep…and you deprive your body of a hormone that helps you get the results you want.
Lack of sleep triggers a hormonal domino effect that often leads to overeating. When you don’t get enough sleep, your body makes more ghrelin (the hunger hormone) and less leptin (the satiety hormone), which leaves you feeling hungry and ravenous. Sleep deprivation raises cortisol levels, which can also increase appetite—and prevent you from losing fat because you make less HGH (human growth hormone).
Researchers found that sleep loss affected eating patterns. Cravings, especially for carbohydrates, intensified. Study participants also ate smaller breakfasts and larger nighttime meals, eating more carbohydrate, protein and fiber calories—by as much as 42%. Snacking after dinner, particularly on carbohydrates, also increased, setting the stage for overeating calories and weight gain (18).
Obviously, if you don’t sleep enough, you will feel more exhausted and less likely to exercise. And, so, the cycle continues.
8. You take a medication where weight gain is a side effect.
Commonly prescribed medications can contribute to weight gain. These include—but are by no means limited to—the following:
–Statins. Statin use is associated with increased calorie intake due to reduced levels of leptin, the satiety hormone, which can lead to weight gain. In a 2018 study published in Physiological Reports, researchers conducted an invitro experiment using human white preadipocytes cells that were treated with 2 statins, simvastatin and atorvastatin. The objective was to see the direct effect that statins would have on leptin expression; in other words, would statin treatment increase or decrease leptin levels?
What they found: in response to atorvastatin and simvastatin treatment, leptin levels decreased by 20% (19). When leptin is low, this signals “starvation!” to the brain, and, consequently, triggers an increase in appetite that leads to greater food intake—and weight gain over time.
–Corticosteroids (aka, glucocorticoids). A synthetic prescription medication (e.g., Prednisone, cortisone shots, etc.) that reduces inflammation in the body, corticosteroids are often prescribed for pain relief; autoimmune conditions, like lupus or rheumatoid arthritis; or, health conditions, like asthma or eczema. While glucocorticoids, a subcategory of corticosteroids, can be an effective treatment for pain, weight gain is a common side effect of long-term glucocorticoid treatment (20). In one study, researchers found that substantial weight gain occurred in 70% of all patients using chronic corticoid therapy (21). The weight gain associated with glucocorticoid therapy—in apx. 20% of patients—can be significant…upwards of 22 pounds or more in the first year of treatment (22).
–Beta blockers. Used to treat heart and circulatory conditions (e.g., coronary artery disease, angina, hypertension, etc.), beta blockers are strongly linked with weight gain, especially in the first few months of treatment (23, 24). Beta blockers can also negatively affect cholesterol and insulin sensitivity, increasing the potential for new onset diabetes (25, 26).
–Psychiatric drugs. As of 2023, 11.4% of adults, ages 18 and over, took a prescription medication for depression, with women (15.3%) being twice as likely to be taking an antidepressant than men (7.4%) (27). Among antidepressants, most SSRI’s (Selective Serotonin Reuptake Inhibitors), like Paxil, Lexapro and Zoloft, are associated with weight gain, especially if taken long-term (a year or more) (28).
Weight gain is a common side effect of psychiatric drugs used to treat depression, anxiety, bipolar disorder and schizophrenia (29). Psychotropic medications, including antidepressants, antipsychotics and mood stabilizers, can potentially cause a weight gain of 4 to 37 pounds over the course of treatment (30).
–Birth control pills. If and when you started taking the pill, did you gain weight? I know I did! I was 21 when I took the pill. Within 3 months, I gained 10 pounds, despite being very physically active. I felt miserable and out-of-balance because I was bloated and swollen all the time. After 3 months, I stopped taking the pill—and never ever took hormonal contraceptives after that experience. Although the mainstream medical narrative often dismisses anecdotal reports of the birth control pill causing weight gain as a “myth”, “many women report weight gain as a side effect, and it’s actually listed as a side effect in the package inserts,” writes Dr. Jolene Brighten, a naturopathic endocrinologist and author of Beyond the Pill (31). When you’re on the pill, your body is trying to process synthetic (lab-made) forms of estrogen and progesterone—often much more potent than natural estrogen and progesterone—which can then promote fluid retention; affect hormones regulating hunger, appetite and metabolism; and negatively affect liver and gut health, also key in weight management.
Deciding to stop or taper off a medication is always a conversation you need to have with your doctor. For example, you should never stop taking an antidepressant (especially SSRIs) cold-turkey because you can potentially experience severe withdrawal symptoms.
9. You have experienced trauma.
“Trauma” literally means wound, shock, or injury. Psychological trauma results from an event—it can be a one-time occurrence or an ongoing series of occurrences—perceived as harmful or life-threatening (32). There are different types of trauma, including acute (e.g., a car accident, assault), chronic (e.g., bullying; emotional, physical and/or sexual abuse); and complex (e.g., repeated child abuse).
Trauma can adversely impact weight.
Interestingly, the significance of Adverse Childhood Experiences (ACEs) was accidentally discovered in an obesity clinic run by Dr. Vincent Felitti, chief of Kaiser Permanente’s Department of Preventive Medicine, in 1985. Felliti’s program had a 50% dropout rate every year for 5 years. Mystified, and wanting to understand why this was happening, Felitti and his colleagues interviewed a sample of dropouts. What they discovered: Of the 286 dropouts interviewed, most had been sexually abused as children (33).
This discovery led Felliti and Dr. Robert Anda, a medical epidemiologist, to develop a scoring system for ACEs. An ACE score refers to the cumulative score of adverse childhood experiences that one has lived through between ages 0 to 17. The ACE score includes the following categories: abuse (physical, emotional or sexual); neglect (emotional or physical) and household challenges (domestic violence, substance/alcohol abuse, mental illness, parental separation/divorce and incarceration, where a household member went to prison) (34). A higher ACE score indicates greater exposure to childhood trauma and, consequently, a higher risk of medical, mental, and social problems as an adult.
In a 2022 study published in Clinical Child Psychology and Psychiatry, researchers found that ACEs are not just associated with the prevalence of obesity, but also with its severity: patients with severe obesity were more likely to have a a high ACE score (50%) compared to others (24-25%). Also, the average Body Mass Index (BMI) in the high-risk ACE group was nearly 4x higher than those in the low-risk ACE group (35).
Experiencing abuse in childhood, especially sexual abuse, significantly changes a victim’s brain, altering its function, cognition and emotion (36). Trauma can also result in a hypervigilant nervous system, where your nervous system is always on “high alert” for potential threats. Your fight-or-flight stress response is always “on”, which increases levels of cortisol, a fat-storing stress hormone. Chronically elevated levels of cortisol is linked to weight gain.
To this point… In a study published in Pediatrics, researchers tracked the body mass development of two groups of females over two decades, from ages 6 to 27. One group consisted of 84 females with confirmed childhood sexual abuse. The second group consisted of 89 females (demographically similar to the first group) who had not been abused. What researchers found: While obesity rates were not different in childhood or adolescence for both groups, once these women reached young adulthood (ages 20 to 27), the sexually abused female subjects were significantly more likely to be obese (42.3%) than the non-abused group (28.4%). (37)
Unfortunately, childhood sexual abuse, including incest, is an all-too- common form of trauma. For example, when I worked with 61-year-old Tamara (not her real name), weight loss was a main goal as she had long struggled with her weight. When Tamara shared her history with me, I understood why her struggle felt so mammoth: Tamara had been repeatedly sexually abused by six different family members between the ages of 6 and 10. At 21, she married a man who physically abused her for years before she was able to leave him. Trauma elevates stress hormones and affects hormone signaling that can contribute to overweight and obesity. Extra weight may also serve as a subconscious form of “protection” from an abuser, of which many victims are not consciously aware.
10. You are over-exposed to environmental toxins on the regular.
Nearly 20 years ago, when I was a freelance writer, the health editor at Oprah Magazine asked me to write a piece on “obesogens”. I had never heard of environmental obesogens before, and I had no idea how they could possibly affect health. After interviewing a number of experts for the article, I learned that:
Environmental toxins, many of which are synthetic chemicals, a.k.a., endocrine disrupting chemicals (EDCs), are called “obesogens” because EDCs can interfere with our endocrine system and, consequently, the hormones that regulate our weight and metabolism (38). The endocrine system consists of tissues and glands, like the thyroid, pancreas, pineal and adrenal glands, that create and release hormones that affect weight and metabolism (39).
EDCs can disrupt natural hormone balance and function and metabolic processes, leading to increased fat storage and weight gain by (40, 41):
–Increasing the total number of fat cells
–Increasing fat storage in existing fat cells
–Increasing production of new fat cells
–Shifting calorie burning to calorie storage
–Altering your gut microbiome to promote food storage
–Altering hormones that affect appetite and fullness
At last count, 1,000 chemicals were identified as endocrine disrupting chemicals (42). EDCs are found in virtually every product we consume, including pesticide-sprayed produce and grains, personal care products, cosmetics, food and beverage packaging, toys, infant formula and baby food, carpets and household cleaning products, among many others (43). Contact with EDCs can occur through inhalation (the air we breathe); absorption (through products applied to the skin); ingestion (food that we eat); and through the water we drink. Even low doses of EDCs can negatively affect our endocrine system and lead to health problems, especially in utero and in children (44).
A few common EDCs include (45):
–Bisphenol A (BPA). Used in plastics
–Phthalates. Used to soften plastics and also as a fixative for scent. Found in everything, from shower curtains and garden hoses, to personal care products. Phthalates also leach into food through food packaging; e.g., fast food, canned food and processed foods (46).
–Atrazine. A synthetic herbicide sprayed on crops like corn, sorghum and sugarcane, as well as lawns and golf courses.
–Organophosphates. Used as insecticides and herbicides sprayed on conventional crops.
–Organobromines. Used as flame retardant.
–Monosodium Glutamate (MSG). Used as a seasoning for frozen foods, salty snacks, sauces and sausages.
–Perfluorooctanoic acid (PFOA). Used in non-stick cookware, waterproof clothing and microwaveable food items.
While we cannot avoid or remove EDCs entirely, we can make informed choices—whether it means choosing organic food, filtering our water or using less plastic and more glass—to reduce our exposure to EDCs as much as we can.
I know… It’s easy to feel overwhelmed but start small. Try a 7-Day Seasonal Cleanse, where you will be eliminating inflammatory offenders and making mindful food (emphasis on organic) and self-care choices.
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