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This Could Be Why You STILL Can't Lose Weight

Author:

Wendie Trubow, M.D., MBA

September 22, 2017

Functional Medicine Gynecologist

By Wendie Trubow, M.D., MBA

Functional Medicine Gynecologist

Wendie Trubow is a functional medicine gynecologist with almost 10 years of training in the field. She received her M.D. from Tufts University.

September 22, 2017

If you've struggled to lose weight, you're not alone. Especially now, weight gain is one of the most common concerns my patients come in with. Out of my entire practice, I have two women who are trying to gain weight—all the rest are trying to lose it! If you are doing everything right (eating well, exercising), and still not losing weight, then you may have an adrenal problem. It's not the only thing that can cause weight-loss resistance, but it's one of the most common.

Let's talk about metabolism.

Before we dive into the adrenals, we need to address the metabolism elephant in the room. I don't typically recommend calorie restriction as the way to lose weight, and it's because when you restrict calories, you "reset" your internal metabolism to get used to the new intake. So, when you first start this new "diet," you'll lose weight, but then after some period of time, the weight loss will stall out. This is because your body has become "used to" the new caloric intake level and adjusted accordingly.

In addition, when you go on a "diet" it implies a temporary state, and then inevitably, when you stop your "diet" you gain all the weight back that you lost. This is because you trained your body to get by on a smaller amount of calories, so when you increase the calories, you gain weight. An effective weight-loss plan needs to be designed around the quality of the food, the nutrient density, and the avoidance of processed and sugary foods. (But more about the ideal diet later!)

Adrenal fatigue and your weight.

Take my patient Emily; she came to see me because her hair had begun falling out and she had gained almost 30 pounds over the past five years. When she arrived in my office, she had just completed a four-month weight-loss program that was, by anyone's definition, extreme. It focused on extreme calorie restriction and exercise. And after four months, she had lost a whopping half a pound. Needless to say, she wasn't happy.

Emily is perimenopausal, and that can make weight loss difficult, but that wasn't the end of her story. Five years ago, her husband was in a terrible accident and had a traumatic brain injury. He could no longer work. Overnight, she became the sole breadwinner and her husband's primary caregiver, dealing with crushing medical bills. They had two young children, and Emily's commute was well over 90 minutes every day—each way.

She was in bed for seven hours of sleep a night, but it was broken up by the various needs of her husband and kids. Oh, and did I mention that she was sleeping in the living room on a cot? Her meals were spotty; she often returned home long after dinner was done and was living on salads that she got at work, which was often her only meal of the day. Her kids, not surprisingly, had issues in school and were particularly needy. Exercise? Forget about it. Meditation? No way. Rest and relaxation? Not a chance. Weekends were spent getting her life together so she could start this cycle over again every Monday.

The science behind chronic stress and weight gain.

Now, I recognize that Emily's situation is extreme, but this beautifully highlights the role the adrenals play in weight loss. Emily had been in a state of fight/flight/freeze for five years. Here's the bottom line: When your adrenals are stressed, a whole complicated cascade of events occur in your body. During the short term, your digestion and absorption stop when you are exposed to a stressor. Then, the adrenals tell the liver to release its glucose stores, and your blood sugar levels increase and insulin resistance can develop. Your senses and reflexes get sharper, your pupils widen, and your reaction times get better.

The problem is that these stress responses were designed for short-term stressors, like running from a lion. They were never meant to be chronic or long-lasting, and when the stressors become chronic, this insulin resistance leads to deposition of fat in our abdomen. This is called "angry fat" because it's more inflammatory and irritates the rest of your system. It's also harder to lose than other weight. Because your adrenals are on alert for needing to run from a lion, you begin to desperately hold on to every calorie your body gets.

Here's what you can do to soothe your nervous system and lose weight.

It's critical to turn off this fight/flight/freeze response and direct the body into more natural processes. How do you do this? First, see a good functional medicine provider. You can get tests and have a professional evaluate your stress levels and adrenal function. In the meantime, eliminate processed carbs (I know you're craving them!) and sugar and make sure you get high-quality rest, which means seven to nine hours a night of unbroken sleep.

Another great thing to do is to start meditating. Don't worry about being an expert; just sit still and breathe. Make your exhales longer than your inhales; this activates your parasympathetic nervous system, which is all about rest, relaxation, digestion, restoration. And finally, slowly and methodically work on resolving the underlying causes of your stress one at a time. It takes some dedication and patience, but it is entirely possible to heal the adrenals and lose those pesky extra pounds!