Endocrinologist Reveals the Cause
Obesity is not just a matter of discipline but a complex disease influenced by sleep, stress, genetics, and hormones, warns endocrinologist Dijana Džao.
Obesity is not just a matter of discipline but a complex disease influenced by sleep, stress, genetics, and hormones, warns endocrinologist Dijana Džao.
When someone changes their eating habits and starts exercising regularly, yet the scale doesn't budge, it's logical to seek a deeper cause. Endocrinologist Dijana Džao warns that for individuals who struggle to lose weight despite healthier eating and physical activity, it's necessary to consider the bigger picture, as reported by Živim.hr, citing N1 Serbia.
"In people who find it hard to lose weight despite a healthier diet and exercise, we need to look at the broader picture," said Džao, emphasizing that diet and exercise are only part of the whole mosaic. Body weight, she adds, can also be influenced by sleep, stress, medications, genetics, hormonal imbalances, and other health conditions.
When a patient says they can't lose weight, Džao checks thyroid function among the first tests. If it's underactive, i.e., hypothyroidism, the body burns less energy, so weight can increase. However, this doesn't mean every weight gain is due to thyroid issues.
In untreated hypothyroidism, weight gain is usually relatively moderate. Part of that increase isn't due to fat accumulation but to salt and water retention. A person with an underactive thyroid may also be extremely fatigued and less active, further contributing to weight gain.
Many attribute the term "thyroid belly"-fat accumulation around the abdomen-to thyroid problems. However, as Džao points out, this isn't a medical diagnosis. There's no specific fat distribution pattern that would allow a doctor to conclude a person has a thyroid disorder. Gaining weight around the waist is a concern, but on its own, it's not a reason to assume you have hypothyroidism.
To determine if the thyroid is functioning normally, a blood test is the first step. The most important lab marker for assessing thyroid function is TSH, or thyrotropin. This hormone is produced by the pituitary gland and signals the thyroid how much to work.
When the thyroid produces too little hormone, the pituitary increases TSH production to stimulate it. That's why TSH is usually elevated in hypothyroidism. Conversely, in hyperthyroidism, when the thyroid produces too much hormone, TSH decreases. However, blood test results shouldn't be viewed in isolation, warns Džao.
Hormone levels can be affected by various circumstances, including acute illness, stress, and a person's overall health, so a doctor should always correlate the findings with symptoms and the full clinical picture. A normal thyroid result doesn't mean someone who struggles to lose weight simply lacks willpower; quite the opposite. The doctor can then look for other factors affecting body weight, such as glucose metabolism, medications, sleep quality, stress, genetics, dietary habits, and physical activity levels.
