When women come to us saying they can't lose weight, we test for these seven metabolic roadblocks:
1. Insulin Resistance (The Silent Weight Blocker)
Insulin resistance means your cells stop responding to insulin properly. Insulin is a storage hormone. When it's high, your body stores fat instead of burning it. Even "healthy" foods like quinoa or fruit can spike insulin in someone with insulin resistance, triggering fat storage.
Common signs: Belly fat, can't go without eating, energy crashes after meals, intense cravings for carbs
Tests needed: Fasting insulin, A1C, fasting glucose, HOMA-IR
Why doctors miss it: They only test glucose, which stays normal until you're diabetic
2. Thyroid Dysfunction (Even When TSH is "Normal")
Your thyroid hormones control your metabolism. What T3 is low, your metabolism slows way down. Even at 1,200 calories, your body thinks it's starving and holds onto fat.
Common signs: Always cold, tired all the time, brain fog, hair loss, can't lose weight despite eating very little
Tests needed: TSH, Free T3, Free T4, Reverse T3, antibodies
3. Chronic High Cortisol (Stress Is Making You Store Fat)
Cortisol is your stress hormone. When it's chronically elevated, it signals your body to store belly fat. Even with a perfect diet, high cortisol overrides fat-burning.
Common signs: Belly fat that won't budge, feeling wired but tired, waking at 3 AM, intense cravings for sugar or salt
4. Estrogen Dominance
When estrogen is high relative to progesterone, your body stores fat and retains fluid. Estrogen promotes fat storage, especially in hips and thighs.
Common signs: Gaining weight in hips and thighs, heavy periods, severe PMS, breast tenderness, bloating that's worse before your period
5. Leptin Resistance
Leptin signals "we have enough fat; stop eating." When you're leptin resistant, your brain thinks you're starving even though you have plenty of stored fat. This makes you constantly hungry and slows your metabolism.
6. Gut Dysfunction
Your gut bacteria affect how many calories you extract from food and how your body stores weight. When you have the wrong balance of bacteria (dysbiosis), your gut can extract more calories from the same food.
Common signs: Bloating after meals, irregular bowel movements, food sensitivities
7. Chronic Inflammation
Systemic inflammation from food sensitivities, toxins, or stress triggers insulin resistance and prevents fat burning. When your body is inflamed, it prioritizes survival over fat loss.
Common signs: Joint pain, skin issues, fatigue, weight that won't budge
Here's what matters: One or more of these is driving your weight loss resistance. Cutting more calories won't fix broken insulin sensitivity. More cardio won't fix high cortisol. You need testing to see what's actually broken. That's why we use comprehensive testing that looks at all these systems.
When Dieting and Exercise Backfire
This is the part most doctors don't understand: when your metabolism is broken, traditional weight loss advice can dig you deeper into the hole.
Eating Too Little Slows Metabolism Further
When your thyroid is already low, severe calorie restriction makes it worse. Your body goes into "starvation mode" and slows T3 production even more. You lose muscle mass, which drops your metabolism further.
The result: You gain weight eating even less than before.
Too Much Exercise Raises Cortisol
If your cortisol is already high, intense exercise makes it worse. More cardio equals more cortisol equals more belly fat storage. Your body sees exercise as another stressor, not a beneficial activity. Inflammation increases, and weight loss stops completely.
Restriction Triggers Leptin Resistance
Chronic dieting makes leptin resistance worse. Your brain thinks you're starving, so hunger increases and metabolism slows. This is the classic "yo-yo dieting" pattern: lose weight, gain it back plus more, repeat.
The Result: Women come to us eating 1,000-1,200 calories, doing intense workouts 5-6 days a week, and gaining weight. They're doing everything "right" for a healthy metabolism, but their metabolism is broken, so it backfires.
Why Your Doctor Says "Just Eat Less" (And Why That Doesn't Work)
They Only Test Basic Thyroid (TSH)
TSH can be "normal" with terrible T3 conversion. They never test Reverse T3 or thyroid metabolites. They miss 85% of thyroid-related weight issues because they're only looking at one marker.
They Don't Test Insulin Until You're Diabetic
Fasting glucose stays normal for years, even with severe insulin resistance. Insulin resistance happens 10-15 years before diabetes shows up in blood sugar tests. By the time your blood sugar is high, the damage is done and weight loss has become nearly impossible.
Cortisol Testing Is "Not a Nothing"
They only test for extreme cases like tumors. They miss chronic elevated cortisol that drives belly fat. They don't test morning vs. evening levels throughout the day, which is critical for understanding stress hormone dysregulation.
They Don't Connect Hormones to Weight
Medical training focuses on calories, not hormones. They don't learn about hormone-driven weight issues. Women get told it's "willpower" or "portion control" when the real problem is metabolic dysfunction that was never diagnosed.
The result: Women get blamed for not trying hard enough when the real problem is metabolic dysfunction that was never diagnosed or addressed. You lose more credibility. You feel defeated. And the real problem goes untreated.
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