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DrSugar Answers: Hormonal Imbalance and Obesity?

DrSugar is in the house and answering your questions.

Dear DrSugar,
For the past four years, I can't seem to lose weight despite previously losing 90 pounds through diet and exercise. I know my body and think I might have some kind of imbalance. Can you advice me on how to approach this subject with a doctor, like: What kinds of questions should I ask, what kind of tests should I request. I want some real answers? Something is not right with me, but I can't get anyone to talk to me about it. Thank you!

This is not the only question of this nature that I received recently. To see my answer, just


I find that weight issues are often the most frustrating problems for patients. Some people just cannot lose weight despite diet, exercise, and sometimes even more drastic measures. For most people, problems with obesity and weight gain are directly related to dietary issues, inactivity, and genetic predisposition. However, some people, who have long and frustrating battles with weight problems, actually have underlying hormone imbalances that make it nearly impossible to lose weight. Hormonal syndromes resulting in weight gain are thought to affect up to one to two percent of the population and are often overlooked due to under recognition in the medical community. Because weight problems are so common and usually related to lifestyle issues, it is easy for doctors to under diagnose hormonal disorders.

There are a number of hormone disorders that can cause weight gain and chronic inability to lose weight. The most common syndromes include Growth hormone deficiency, Cushing’s syndrome, and Hypothyroidism. Each syndrome has its own unique features and rarely is weight gain the only symptom. For example, growth hormone deficiency is associated with short stature, thin and dry skin, low muscle mass and mainly abdominal body fat. Cushing’s syndrome can lead to sweating, high blood pressure, depression, anxiety, and stretch marks. Hypothyroidism often causes mental slowing, intolerance to cold, fatigue, and constipation.

If you are obese or very overweight, it is important to seek help because you are at higher risk for diabetes, heart disease and many other medical problems. The good news is that if you have one of these disorders, treatment will often lead to weight loss and improved overall health. If you have any of the symptoms listed, have battled weight problems many years, have gained weight very quickly or are considering more aggressive weight loss methods, such as gastric bypass surgery then I suggest talking to your doctor about the possibility of hormonal testing. For more information check out the website Obesity In America, a good all around resource.

If you have a question for DrSugar, send me a private message here and I will forward it to the good doctor.

DrSugar's posts are for informational purposes only and should not be considered medical advice, diagnosis, or treatment recommendations. Click here for more details.

kia kia 9 years
I gotta go with the birth control as well for some weight gain. Changing between the progesterone and testosterone altering drugs caused me to put on some flub.
wem1975 wem1975 9 years
Thanks to all of you fro telling people about PCOS. I was diagnosed several years ago and have had a hard time losing weight. I work out hard several days a week and meet with a nutritionist but it is still hard.
girliegurl65 girliegurl65 9 years
A hormonal imbalance and weight gain definately go hand in hand. The past year i was diagnosed with having an anxiety disorder and i was prescribed a mild mood stablizer which was called: Citalopram. It worked wonders. Losing weight was harder but because i felt better mentally and emotionally i was able to overcome some of my anxieties. I am now off of it and have found other therapeutic outlets such as: bikram yoga and running. I've been losing 2-4lbs every week for the past month in a half. I've lost 60lbs so far but i owe alot of it to my doctor who helped me keep my hormones and everything else in check. You have to fix the inside before you can fix the outside of your body.
ditorres ditorres 9 years
i have to agree with hoaxerz. If you are intenselly exercising and eating a bare minimum of calories your body is probably hoarding all of the calories and not burning up the fat. Your body needs calories to fuel the burn. Might sound weird but it is true. I realize that most people would rebel against eating more to lose weight ... but you should try it. Eat nutritious meals and work out in a healthy manner!
Hoaxerz Hoaxerz 9 years
Often women overdo the exercise/diet thing and end up killing their metabolism, which can cause similar symptoms to hypothyroidism. That 1500 cal/day diet plus hours of cardio works really well at first, but your body adjusts by burning fuel less efficiently (i.e. lowers your metabolism) so you don't starve. This is especially true if your eating 1500 calories of crap. The solution: eat more, rest more, and weight train more.
ragus ragus 9 years
cvandoorn, et al: If your dr. hasn't tested you I highly suggest going to a different dr. My family dr. was continously treating my for depression put me a a spectrum of anti depressants that made me sick and sleepy.... she ended up saying to me "your spiraling out of control" I dont know what else to do w/ you it's out of my practice.... so I thought omg I'm crazy! then luckily one day my coworkers were talking about hyper-hypothyroid and I thought man that sounds like me... I started researching it in the internet and thought wow this sounds like me even more! I have a ppo insurance that allows me to pick a specialist and I went to a endo. and she tested my blood and sure enough I have hypo and pcos. Ive been taking synthroid since around december now and it has changed my life completly.... Im still struggling with weight but i feel so much better. I urg everyone to keep in mind dr.s are people and can only know so much...thats why they call medicine a "practice"... research yourself... you know your body best in all medical aspects...
Puzzle2397 Puzzle2397 9 years
Spectra - I have read that there are some endocrinologists who believe that the "normal" range for the different thyroid hormones that is traditionally accepted is completely outdated and inaccurate. And the "normal" range used varies by lab; I have seen several different ranges printed at various labs I've been to over the years. It could be that your friend does really have a problem, but the rating scale being used on her is not saying she is. A certain hormone level may be normal for one person, but maybe not for her.
kedawen kedawen 9 years
AMP, I was going to mention PCOS (polycystic ovary syndrome) as well, because I have it and its caused me to gain a lot of weight. I have finally had a bit of success losing weight through a better diet and exercise, plus taking Metformin and the pill (Yaz). It's a continuous struggle, but any progress helps.
faerymagick15 faerymagick15 9 years
I never had a hard time losing weight until I had my tubes tied and then the pounds just came. Even with exercise and eating better it was extremely hard to lose any. It still is even though I had a reversal done almost 10 years ago. Its taken me a good year but I lost 30 pounds and have another 20-30 to go. I have been tested for everything under the problems. So, I really think its a genetic dad's side. And the tubal and just plain getting older. I exercise and eat right. Thats all I can do...and keep trying.
Spectra Spectra 9 years
My doctor put me on a different birth control pill that had a different form of progesterone in it than my old one did and BAM!!...I put on 5 lbs almost instantly. My doctor told me that this particular pill causes more bloating/fluid retention than most other ones out there. Gee thaaaanks, doc. As for hypothyroidism, it's definitely real, but I get irritated with people that automatically blame their weight on having a slow thyroid. I know someone who swears her thyroid's messed up, but she's had her hormone levels checked like 3 separate times and it's always been normal.
anitap anitap 9 years
Insulin Resistance or Polycystic Ovarian Syndrome can also cause hormonal fluctuations that make it difficult to lose weight.
AMP AMP 9 years
I have a hormone imbalance that has been making it very difficult to lose weight also, but mine is a estrogen deficiency. I have PCOS. I need to look into it to find out how to correct it without going on the pill b/c my body HATES the pill! I can't do anything but eat and sleep when I'm on it. So basically my body hates estrogen.
pluckyred pluckyred 9 years
Always go with your intuition. Explain your concerns to your doctor and ask for a referral to an endocrinologist. I'm impressed with the advice seeker's self awareness.
ExpressionEleven ExpressionEleven 9 years
"And those studies that say that birth control doesn't make you gain weight.." Yeah... I went on the pill and put on 10% of my body weight in the 1st year (100 to 110) and was struggling to stay under 120 by my second year. Prior to the pill, my weight had not changed one bit for over 7 years. My 'then' doctor didn't take my sudden weight increase/concerns all that seriously either (I recall her snidely remarking once that 10-20 pounds was just normal water weight fluctuation for her). Any who - I stopped taking the pill and in 6 months was at 105 with really no effort on my part. I don't think my body plans on going back to 100, but that's fine by me - it's like I've got my old body back PLUS boobs! Score!
Puzzle2397 Puzzle2397 9 years
Maybe, in a way, it's been good to have been diagnosed with Graves' disease at the uncommonly young age of 13, so that I have a better chance of not building up weight now that I'm (slightly) hypothyroid, through being aware of what the condition can do. However, even when treated for hypothyroidism, many people still have weight issues. So far, I've been managing ok. But I do think I need to eat less than most other people my age (22), which isn't fair. Thanks a lot, both sides of my family with a history of thyroid disorders.
imcs imcs 9 years
It's really frustrating... this time last year I weighed 120 lbs. and from Dec. 07 to now, I went from 125 to 132... It's driving me nuts. I do two hours of exercise three days a week, and I don't eat that much. I feel like I need to start starving myself in order to fit back into my clothes.
cvandoorn cvandoorn 9 years
And those studies that say that birth control doesn't make you gain weight...I just started a new brand, and what do you know...I think those 4 lbs are because of the new pill i'm taking.
cvandoorn cvandoorn 9 years
I also have a very tough time losing weight, yet I gain it quickly. I work out at a pretty intense level with two rest days during the week, and I eat healthy. It is really frustrating. I went to the doctor and told her my concerns, and she just shrugged it off and said its normal. It really isn't normal to work out so damn hard, to eat healthy, and to still have this frustrating battle with my weight. Just the past 2 weeks I gained 4 lbs...only because I worked out a little less and ate a little more. NOT FAIR!
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