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Other reasons why you’re not losing weight - part 1

Some people do not lose weight despite following a rigorous diet and exercise programme. Refusal of the body to lose more weight when it reaches the normal range, using slimming diets that have such a low energy content that the body switches off all its weight loss mechanisms, and the disastrous effects of yo-yo dieting might be factors. But other factors can play a role.

 
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There are many other reasons why you may not be losing the desired amount of weight. These include:

  • Hormonal imbalances;
  • Use of medications which promote weight gain;
  • Depression and/or anxiety;
  • Self-deception.

Hormonal imbalances

If you have an under-active thyroid, insulin-resistance or polycystic ovarian syndrome, you may find it very difficult to lose weight even if you are on an energy-restricted diet and doing exercise.

Hypothyroidism

The human body is very sensitive to the levels of hormones that it produces. Hypothyroidism is a condition where your thyroid gland does not produce sufficient thyroid hormone to keep your metabolism ticking over at a normal rate. This condition is often, but not always, associated with resistant weight gain, i.e. weight that is difficult to lose.

If you suspect that your thyroid is under-active, you should have it checked. The doctor will prescribe thyroid hormone tablets to provide the hormone that your body requires. It may take three or more months for the tablets to have an effect. You may also have to adjust the dose with the doctor’s help, but this should help you to lose weight. It is of course necessary to combine the thyroid treatment with a slimming diet and exercise to get the best results.

Insulin-resistance

If you suffer from insulin-resistance, the levels of circulating insulin in your body remain high instead of falling to normal levels 1-2 hours after a meal. This excess insulin stimulates your body cells to take up more and more energy in the form of glucose, which is then converted to fat.

Treatment of this syndrome is difficult, but your doctor will prescribe medications that should help to reverse the process. The combination of medications and a high-fibre, low-fat diet accompanied by exercise will promote weight loss. Unfortunately, you may find that it takes time and that you lose weight at a slower rate than normal.

The polycystic ovarian syndrome

The polycystic ovarian syndrome is also a complicated condition that requires a multi-faceted approach using hormones, a low-fat diet and exercise to try and restore the hormonal balance and stimulate weight loss.

Medications that promote weight gain

The package inserts of a wide variety of medicines state that weight gain is one of the side-effects associated with tablet X or capsule Y. Medications which are commonly associated with weight gain include female hormone treatments (the pill, hormone replacement therapy and female hormones used for acne treatment), corticosteroids, antidepressants and anxiolytics.

If you are taking medication, particularly on a chronic basis, and you struggle to lose weight, the problem should be discussed with your doctor. Ask your doctor to prescribe another type of medication, or to adjust the dose to alleviate the weight-promoting effect.

If there is no alternative and you need a certain dosage of a specific medicine to treat a serious physical or mental condition, you should monitor your diet carefully and use exercise to prevent weight gain. Consult your doctor about an exercise routine, paying particular attention to the intensity of the exercise.

When to use Xenical

The use of Xenical, accompanied by a very-low-fat diet, may be an option in certain circumstances to prevent obesity. If you are suffering from a serious condition that requires the use of medication that promotes weight gain and your illness prevents you from exercising, this option should be considered. Xenical has to be prescribed and monitored by a medical doctor, so consult your physician about this option.

The role of depression and self-deception will be discussed in next week's article.

Dr I V van Heerden


 
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