5 Commonly Overlooked Reasons You Can’t Lose a Pound
by Dr. Jessie Hehmeyer of Well Empowered
“I’ve tried eating paleo and vegan and low-fat…nothing works! No matter what I do, I can’t lose a pound.
In the past three years, I’ve gained 10 more pounds. I’m almost desperate enough to start jabbing myself with one of those new weight loss drugs, even if it makes me grow a third eye.”
This is what many of my clients say to me when they arrive at my virtual front door, desperate for weight loss. Fortunately, they don’t need to use under-tested weight loss drugs -- I’ve helped numerous clients crack their weight loss codes, shift from self-aggression to self-love in this area of their life, and get the scale to budge.
My experience as a data-driven, heart-centered Functional Medicine practitioner has shown me that understanding some of the science is super helpful and empowering.
Understanding the science of your body opens up the path to take a targeted approach to weight loss rather than adopting a “one size fits all”, diet du jour attempt at weight loss.
Why can’t you get the scale to budge despite your hard work? Today we’ll dive into common answers to this question together.
1. Elevated inflammation
Inflammation – when chronically elevated – pushes the body towards metabolic conservation, aka “fat storage mode”.
For many people breaking the vicious cycle of inflammation is an essential must before their body will begin to release weight.
Inflammation is the body's way of protecting itself from harm, like infections, injuries, or toxins. Through the production of chemicals that cue an inflammatory response, the body calls the immune system to action to engage in the natural healing process.
While acute, short term inflammation is a defense mechanism that initiates healing, chronic, longterm inflammation - aka “inflammation gone wild” - causes damage to the body.
Sometimes people feel they’re inflamed. Maybe their joints hurt or their skin is red or their digestion is a hot mess. But often people don’t have any known symptoms of inflammation. Often inflammation is silent.
This is why when I work with someone who is struggling with their weight, I assess their inflammation via lab tests. Guessing is like throwing darts. To effectively target underlying causes of weight struggles, we need to understand the source.
At a minimum, I test the inflammatory markers hsCRP and homocysteine, and there are times when I test more than these two.
2. Decreased insulin sensitivity
Insulin is a hormone that has many important roles in the body. One of its roles is acting as an escort to sugar, aka glucose.
When we eat carbohydrates – our source of glucose - our body produces insulin.
Insulin (metaphorically speaking) walks up to glucose, grabs glucose by its sticky hands and escorts that glucose molecule to a cell.
At the cell, insulin knocks on the cell’s door. The cell then opens its door and the glucose enters the cell.
But for a variety of reasons over time, the cell may stop “hearing” insulin knock. This leads to more insulin being produced so that it can fulfill its job as an escort. More insulin molecules gang up on the cell to knock on its door, now screaming “let this glucose in!”
This is what we call decreased insulin sensitivity.
How does decreased insulin sensitivity impact the number on the scale?
In addition to being an escort, insulin acts as a controller of metabolism. When you produce insulin, it tells your fat cells:
“Hold on to what you’ve got! Whatever you do, don’t let go of that fat. Keep that fat stored away.”
The more insulin you produce (which again is what happens with decreased insulin sensitivity), the more this message of “store that fat” gets communicated.
Again, we can easily test if this is a factor in your weight loss struggles through a simple lab test. We do this by checking your fasting insulin.
One thing to note is there is a *very* (and I mean very) big difference between “lab normal” insulin levels and “optimal”.
While many labs will count your fasting insulin as normal when it’s as high as 25, the optimal is *7* (yes 7!!) or less.
Above 7 is pointing to decreased insulin sensitivity.
3. Detox pathways “gunked” up
Detoxification is so chic these days. I often think the fast track to making a buck in the supplement world is to slap the term “detox” on your product. But detoxification is about way more than fancy supplements that focus on getting rid of heavy metals, pollutants, and pesticides - some more effectively than others.
It’s not commonly talked about, but our sex hormones - the ones we produce as well as any you may be getting via the birth control pill or hormone replacement therapy - also move through our detoxification pathways.
Our detox pathways get “gunked” up when we have too many toxins churning through the pathways - the machinery - of detoxification, when the machinery of detoxification isn’t working well, or when both of these are combined.
And because the machinery of detoxification is complex, there is a lot that can go wrong.
When our estrogens (yes, there are many different forms of our beloved sex hormone, estrogen) aren’t processed appropriately, this can wreak havoc on metabolism by decreasing energy expenditure (aka slowing our metabolism) and interfering with our production of “satiety” hormones leading to increased hunger.
Needless to say, decreased metabolism + increased hunger is an equation that invariably leads to the scale going up rather than down.
Additionally, when detox pathways are not operating smoothly our body is exposed to more free radicals. These free radicals damage cells and DNA and increase inflammation, exacerbating the inflammation → scale connection.
I typically assess detoxification pathways in a variety of ways including measuring sex hormones, key nutrients that are required to “run” the processes of detoxification, toxic burden and digestion.
What does digestion have to do with detoxification?
Well, if we’re not pooping regularly, we are reabsorbing toxins. Your detox pathways are indeed “gunked” up if you are not pooping daily or nearly daily.
As the saying goes, “We’re not just what we eat. We’re what we don’t excrete.”
4. Nutrient Deficiencies + Insufficiencies
Let’s start here by illuminating the difference between a nutrient deficiency and a nutrient insufficiency.
If you have a nutrient deficiency, lab values will be red. Take vitamin D for example. Most labs call vitamin D “low” if it’s under 20. This means you are at an increased risk of diseases associated with low vitamin D such as osteoporosis. But there is a big difference between “lab normal” and “optimal”.
When nutrients are in suboptimal levels, this is what we call a nutrient insufficiency. If you’re treading water in the nutrient insufficiency world, you may have enough of a nutrient to (likely) prevent a disease state, but you don’t have enough for optimal physiological function. Over time, there is a cost to this. For some people the cost is low energy, difficulty focusing, increased aches and pains, depression or anxiety. For others the cost is a slow metabolism. For most, it is a combination of symptoms.
A few of the nutrients essential for metabolic optimization include vitamin B12, selenium, iodine, omega-3 fatty acids and vitamin D.
5. Stress (in more forms than you think)
When we think of stress, we often think about the emotional and psychological stressors we encounter in life. While these are real and potent stressors in life, the stress that impacts your metabolism extends well beyond events and happenings that leave you “feeling” stressed.
That is to say, you can be physiologically stressed - stressed at the chemical and cellular level - without being psychologically stressed. And of course, you can be both physiologically and psychologically stressed - doubling down on the impact stress has on your metabolism.
Some causes of physiological stress include insufficient sleep, blood sugar instability, nutrient insufficiencies, latent infections, elevated toxins and (here we go again) chronically elevated inflammation.
Whether it’s a physiological stressor or a psychological stressor, one of the end results is the same:
Our body produces loads of cortisol, our primary stress hormone.
And guess what cortisol is superbly skilled at doing?
Slowing your metabolism and kicking in your cravings. Double whammy on the scale.
Just like the other items on our list, practitioners can test cortisol levels. Through a test that includes collection of saliva at multiple times in one day, we can come to understand if physiological and/or psychological stress is playing a role in your weight struggles.
Practitioners like myself or Dee Davidson, FDN-P, also test to understand which physiological stressors are at play in your body, giving us the data we need to take a root-cause approach to healing your metabolism.
Now you may find yourself wondering…
She didn’t mention a word about my thyroid?
Can’t my thyroid be impacting my weight?
The answer to your very good question is “yes and no”.
This is to say, if you find yourself struggling to lose weight, it is essential to have your thyroid *thoroughly* assessed. (By thoroughly, I mean much more than just testing your TSH.)
But…it’s rarely only your thyroid that’s at the source of your slow metabolism. So yes, assess your thyroid function to ensure all metrics are in the *optimal* ranges. If they are not, then supporting your thyroid appropriately will be foundational to moving the needle on the scale.
BUT it’s very likely that one of the above hidden barriers of weight loss is also at play in your body.
To me, the journey to mastering your weight is one of the most challenging and enriching journeys you’ll ever traverse.
Beyond understanding your unique and amazing body, with a Well Empowered approach, you will cultivate the capacity to move from self-love. You will heal old weight wounds. You will drop the broken, inherited paradigm - what I like to call the “all or nothing” approach - which is grounded in self-aggression.
As you come to understand your body and learn the miracles of your body and of yourself, you will find yourself making educated decisions from a place of self-honor. The spiral up benefits of your learnings and insights will show up well beyond the scale (although they will show up there.) They will show up in how you relate to yourself, your amazing body and how you are able to show up for yourself and for others.
Dee Davidson is a Functional Health Practitioner, hormone health expert, and advocate for personalized health and integrative care. With a focus on functional health and functional nutrition, Dee provides bio-individualized solutions to help clients restore balance. To learn more about how functional lab testing, functional medicine, and a holistic health approach can support your wellness journey, listen to her Confidently Balance Your Hormones podcast or schedule a discovery call at ConfidentlyLoveYourself.com.