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Why You Can’t Lose Weight: The Underlying Causes of Weight Retention

Holtorf Medical Group

According to 2018 data from the National Health and Nutrition Examination Survey, nearly 40 percent of adults in America are obese. Sadly, for many of these nearly 100 million people, reaching a healthy weight feels impossible.

Underlying Causes of Weight Retention

Despite popular belief, the challenge of weight loss is usually not a question of commitment but rather unfamiliarity of powerful weight loss inhibitors. More often than not, weight loss aspirants unwittingly live with underlying issues that severely impede their weight loss efforts. Some of the most frequently overlooked weight loss roadblocks are discussed below.

Low Basal Metabolic Rate

The basal metabolic rate or BMR greatly influences the body’s ability to burn calories and lose weight. A low or malfunctioning BMR means the body burns fewer calories while at rest. This can cause fluctuations in energy level and encourage weight retention. If you feel fatigued and have not seen any benefit from diet and exercise, you may have a low BMR. Assessing your metabolic rate can be done by taking a test that measures the amount of oxygen the body burns over a 10-minute period. If you have weight loss troubles speak with your doctor about getting your BMR tested.

Irregular SetPoint

If you consistently return to the same weight regardless of your diet, activity, and lifestyle you may have a malfunctioning set point. The body’s set point regulates weight and attempts to keep it within a physiologically established range. The higher the body’s set point, the heavier they are likely to be. As such, an inappropriate change in your set point can make it so your body is in direct opposition of your weight loss goals. Unfortunately, you can unwittingly destabilize your set point by taking certain medications. The following medications may increase your set point, thereby inhibiting weight loss:

  • Antidepressants
  • Mood modulators
  • SNRIs (serotonin–norepinephrine reuptake inhibitors)
  • Anti-seizure and pain medications that increase insulin production
  • Blood pressure medications
  • Eliminating these set point disruptors can help return the set point to a healthy range thereby enabling weight loss. However, be sure to speak with a doctor before halting any prescribed medications.


Thyroid Dysfunction

The thyroid gland is an important regulator of numerous bodily functions including weight regulation. This is primarily because the thyroid has significant influence over metabolic and hormone activity. Unfortunately, thyroid conditions such as hypothyroidism (reduced thyroid activity) are frequently overlooked or undertreated because standard lab tests only assess one specific component of thyroid function. For an accurate diagnosis, thyroid testing must at minimum include TSH, Free T4, Free T3, and Reverse T3. If any of these hormones are out of balance, it is likely that you are suffering from some degree of thyroid dysfunction.

Learn more about thyroid dysfunction here.

Iodine Deficiency

Although commonly overlooked and considered uncommon, iodine deficiency can contribute to thyroid dysfunction and subsequent weight problems. Iodine is required for synthesis of thyroid hormones which have a great deal of influence on weight. Reduced iodine levels can result in weight gain and fatigue due to poor thyroid function.

Many incorrectly believe that they acquire enough iodine through their diet alone. If experiencing symptoms of deficiency, be sure to get your levels tested. If a deficiency is discovered, you may increase your iodine values through supplementation and dietary improvements.

Autoimmune Thyroid Disease (Hashimoto’s Thyroiditis)

A common cause of thyroid disease, specifically hypothyroidism, and subsequent weight gain is an autoimmune thyroid condition known as Hashimoto’s thyroiditis. This condition causes the body’s immune system to attack healthy thyroid tissue. This results in an ever-worsening case of hypothyroidism, immune irregularities, and a broad collection of symptoms that may be easily misattributed to other disorders. As such, diagnosing Hashimoto’s requires specific testing. The best method for identifying Hashimoto’s is by assessing the levels of thyroid peroxidase antibody and antithyroglobulin antibody. Elevated thyroid antibodies values are highly indicative of Hashimoto’s.

Leptin Resistance

Leptin is a hormone that is pivotal in regulating weight and metabolic activity. When working as intended, leptin informs the body whether it should be storing or burning fat. If the body becomes less receptive to leptin, known as leptin resistance, the signals that trigger fat burning and utilization become suppressed. Furthermore, leptin resistance can induce hypothyroidism at a cellular level, which is not diagnosable through standard forms of thyroid testing. Some studies indicate that the large majority of obese individuals suffer from at least some degree of leptin resistance. Fortunately, leptin resistance may be diagnosed through a simple blood test.

Learn more about leptin and leptin resistance here.

Food Sensitivities and Intolerances

Most are aware of common food allergies such as shellfish and peanuts. However, food intolerances that cause unwanted bloating, water retention, inflammation, and weight gain are not as well known.

Some problematic foods that can impede weight loss efforts by triggering an immune response are gluten, soy, corn, dairy, eggs, and nuts. Consumption of these and other allergenic substances can discourage weight loss while prompting the development of various symptoms. Regularly experiencing diarrhea, constipation, eczema, muscle and joint pain, headaches, and fatigue after eating or being exposed to certain foods may be indicative of food intolerance. If you have a food sensitivity, your best option is avoidance of the food in question.

Discovering the Root Cause

If you are struggling with your weight loss goals, it is important to consider the possible influence of underlying weight loss inhibitors. Metabolic malfunction, thyroid issues, and unrecognized food sensitivities are just some of the many often overlooked barriers to reaching a healthy weight. Fortunately, by being well-informed of, actively testing for, and attending to common weight-loss roadblocks you can greatly improve your chances of reaching your weight loss goals.

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to find the underlying cause of your weight retention. If you’re experiencing unexplained weight gain and/or weight retention, give us a call at 877-508-1177 to see how we can help you!


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  2. Müller MJ et al.“Is there evidence for a set point that regulates human body weight?” F1000 Med Rep. 2010;2:59.

  3. BIDMC Contributor. “Week One: The Science of Set Point.” Beth Israel Deaconess Medical Center.

  4. Kent Holtorf, MD. “Understanding Local Control of Thyroid Hormones: (Deiodinases Function and Activity).”

  5. Kent Holtorf, MD. “Thyroid Hormone Transport.”

  6. Chung HR. “Iodine and thyroid function.” Ann Pediatr Endocrinol Metab. 2014;19(1):8–12.

  7. NIH. “Chapter 1: Dietary Reference Intake for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Nutrient Recommendations: Dietary Reference Intakes (DRI).” National Institutes of Health (NIH).

  8. Dana L. Mincer; Ishwarlal Jialal. “Hashimoto Thyroiditis.”

  9. Mancour LV et al. “Ligand-induced architecture of the leptin receptor signaling complex.” Mol Cell. 2012 Nov 30;48(4):655-61.

  10. Brostoff J, Gamlin L. “Food Allergies and Food Intolerances.” 2000, Healing Arts Press.

Holtorf Medical GroupThe Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease. We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.

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