Why Can't I Lose Weight? What Should I Check?

Why Do We Gain Weight?

Weight gain or obesity is often the result of multiple factors working together. Here are the primary causes:

1. Diet: Consuming too much food, especially poor-quality foods like processed items, which are high in calories but low in fiber and nutrients. This can lead to overeating and excessive calorie intake.
2. Lack of Exercise: Modern conveniences have reduced our need to be physically active, leading to less energy expenditure and more energy storage as fat.
3. Stress and Emotions: Stress and emotions like depression can affect hormone levels, such as increasing cortisol, which can lead to increased appetite and overeating.
4. Sleep: Research shows that people who sleep less are more likely to gain weight compared to those who sleep 7-8 hours a night. Poor sleep can disrupt hunger hormones, increasing ghrelin (which makes you feel hungry) and decreasing leptin (which makes you feel full).
5. Genetics: Certain genes can affect metabolism, hunger, and fat storage. For example, the FTO and MC4R genes can influence hunger and metabolism, while the ADIPOQ and PPARG genes can affect fat storage.
6. Medical Conditions:
   • Hypothyroidism: A condition where the thyroid gland is underactive, leading to a slower metabolism and weight gain.
   • Insulin Resistance: A condition where the body produces more insulin to manage blood sugar, which can lead to fat storage and difficulty losing weight.
   • Polycystic Ovarian Syndrome (PCOS): A hormonal disorder that can lead to weight gain, irregular periods, and difficulty conceiving.
7. Gut Microbiota: Recent studies suggest that the diversity of gut bacteria can influence weight. People with obesity tend to have less diverse gut microbiota and different bacterial compositions compared to healthy individuals.

What Should You Check?

If you're struggling with weight gain, consider these tests in addition to general blood tests like lipid levels, blood sugar, and liver and kidney function:

1. Thyroid Function Test: To check for hypothyroidism, which can be treated to help normalize your weight.
2. Insulin Resistance Test: This can be assessed through a C-peptide test, which is more stable and easier to measure than insulin. High levels may indicate insulin resistance, and lifestyle changes or medication can help manage this condition and promote weight loss.
3. PCOS Diagnosis: A doctor can diagnose PCOS through medical history, physical examination (irregular periods, excess body hair, acne), and an ultrasound. Treatment can include lifestyle changes and medications.
4. Genetic Testing: To understand your metabolic rate, hunger control, and fat storage tendencies. Knowing your genetic predispositions can help tailor your lifestyle to reduce the risk of weight gain.
5. Gut Microbiome Test: This stool test can reveal the balance of good and bad bacteria in your gut. With this information, you can adjust your diet to include more prebiotics and probiotics, which may aid in weight management.

By identifying and addressing these underlying factors, you can create a more effective plan to manage your weight and improve your overall health.