Written by Amelia Heimerman

Is Your Weight Loss Stunted? Here’s What You Should Discuss With Your Doctor. Calorie Deficit? Check. Are you meeting your protein goals? Check. Regular exercise? Check. Weight loss? Nope.

If you’re familiar with the above scenario, you may be feeling discouraged. It is frustrating to adjust to new, health-promoting habits and not reap the benefits. Have you considered potential underlying issues that could be preventing you from losing weight? If you have tried everything and still struggle to achieve your goals, you should reach out to your primary care provider (PCP) or medical doctor (MD) and discuss the following tests. This article is not written to scare you, but to encourage you to reach out to your care provider and find the best options for you and your health journey.

Upon your visit with your doctor, tell them what is wrong. It is important to discuss your symptoms rather than suggesting you have a specific problem. You can begin with “I have been having trouble losing weight” and mention the current steps you are taking to do so. Your MD will continue the conversation from there (Thomas). It can be helpful to bring a list of symptoms and blood tests you would like to discuss with your PCP to ensure all your concerns are addressed (Testing). Lastly, asking questions is a great way for you to effectively communicate with your doctor (National Institute of Health). If you are ever confused about terminology, do not be afraid to ask for clarification. You have the power to sway the conversation in any way you would like rather than merely following your doctor’s lead. With these tips in mind, you can facilitate a thorough conversation with your doctor and begin navigating any potential threats to your weight loss journey. There are a few conditions that commonly impact patients’ ability to lose weight. Each of these conditions is typically diagnosed through blood tests, which can be requested by your MD and performed in either a hospital or lab setting. Please note that this blog post is not meant to diagnose any of the following conditions, but instead serves the purpose of increasing awareness of these issues.

Hypothyroidism

is a condition where one’s thyroid gland is not making a sufficient amount of thyroid hormone (TH) to meet the body’s needs. In other words, the thyroid is underactive (National Institute of Diabetes and Digestive and Kidney Diseases). The thyroid hormones thyroxine (T4) and triiodothyronine (T3) control how the body uses its energy and affects every organ in the body, including the heart. Therefore, when the thyroid is

underproducing TH, the body responds by slowing down its daily actions to conserve energy. This can make weight loss difficult and contribute to high cholesterol levels. Some symptoms of hypothyroidism include, but are not limited to weight gain, high cholesterol, fatigue, joint and muscle pain, trouble tolerating the cold, and slowed heart rate. Diagnosis of hypothyroidism is determined by testing the levels of thyroid stimulating hormone (TSH) and thyroxine (T4) (National Institute of Diabetes and Digestive and Kidney Diseases). Thyroid stimulating hormone is a hormone in the pituitary gland that is responsible for telling the thyroid how much

T4 and T3 to make. If the thyroid is not producing an adequate amount of TH, the pituitary attempts to compensate by increasing its release of TSH to create more TH. Therefore, high TSH levels can be an indicator of hypothyroidism. A low T4 level in the blood is the second factor needed for diagnosis. T3 levels are more useful for the diagnosis of hyperthyroidism rather than hypothyroidism, so it is typically ignored for this condition.

Insulin resistance

is another condition that can impact weight loss. It occurs when cells in the body do not respond well to insulin and resist its attempts to move sugar out of the blood (Nebraska Medicine). Insulin resistance is often confused with diabetes, but the two are different since prediabetes is defined by the pancreas’s inability to produce adequate amounts of insulin to maintain blood sugar levels. In the case of insulin resistance, more insulin can be made by the pancreas to combat the issue, but not in the case of prediabetes. No one test leads to an insulin resistance diagnosis. It is important to consider blood sugar and cholesterol levels as well as look for any darkening of the skin during a physical exam. A fasting insulin test alongside a fasting glucose test can be beneficial to determine whether the amount of insulin in the blood can account for the amount of sugar in the blood. If blood sugar is high and insulin is low, this can indicate prediabetes. If both blood sugar and insulin levels are high, this can indicate insulin resistance.

Prediabetes

diagnosis is usually determined by the results of three tests: A1C, fasting blood glucose, and oral glucose tolerance test. The A1C test allows the MD to see your average blood sugar trend over the past three months. The fasting glucose test differs from this since it identifies the amount of sugar in the blood at the time the test is taken. The oral glucose tolerance test identifies how the body handles glucose after the consumption of a meal, but this test is expensive and more difficult to administer. In a perfect world, the pancreas creates adequate amounts of insulin to remove glucose from blood cells to regulate the sugar content in the blood post-meal. Any abnormalities in this system can be detected by the previous three tests. A final condition that can be impacting one’s ability to achieve successful weight loss is metabolic syndrome.

Metabolic syndrome

is diagnosed when a patient meets three of the five criteria (National Heart, Lung, and Blood Institute):

1. High blood pressure (130/85 mm Hg or higher)

2. High blood sugar, diabetic level(126 mg/dL or higher, indication of diabetes)

3. High blood cholesterol (HDL below 50 mg/dL for women, below 40 mg/dL for men)

4. High blood triglycerides (over 150 mg/dL)

5. Abdominal obesity (waist is over 40” in men, over 35” in women)

Four of the five tests above are blood tests you can discuss with your doctor. The waist measurement can be observed in a physical exam. Outside of these blood exams, experts from So Well suggest testing the presence of Vitamin B12 in the blood. Vitamin B12 plays a vital role in blood and nerve cell maintenance, DNA creation, and the prevention of megaloblastic anemia (National Institute of Health). By warding off anemia that oftentimes results in patients feeling tired and weak, vitamin B12 allows the body to have the energy needed to commit to healthy lifestyle changes.

It is easy to blame ourselves for the inability to lose weight, but we fail to consider our options. Seeing your doctor and having an open conversation about your struggles is a great way to peer into the next steps for your health journey. This article is not written to diagnose you, but to make you aware of potential underlying issues that can impact one’s ability to lose weight. Being aware of specific conditions, blood tests, and terminology will help you prepare questions for your MD in advance to make your next doctor’s visit less daunting. As they say, knowledge is power!

Works Cited

National Heart, Lung, and Blood Institute. “Metabolic Syndrome Diagnosis.” National Institute of Health, 18 May 2022, https://www.nhlbi.nih.gov/health/metabolic-syndrome/diagnosis.

National Institute of Diabetes and Digestive and Kidney Diseases. “Hypothyroidism (Underactive Thyroid).” National Institute of Health, Mar. 2021, https://www.niddk.nih.gov/health-information/endocrine-diseases/hypothyroidism#:~:text=Trials%20for%20Hypothyroidism-,What%20is%20hypothyroidism%3F,the%20front%20of%20your%20neck.

National Institute of Health Office of Dietary Supplements. “Vitamin B12.” National Institute of Health, 7 Jul. 2021, https://ods.od.nih.gov/factsheets/VitaminB12-Consumer/.

National Institute on Aging. “What Should I Ask My Doctor During a Checkup?” National Institute of Health, 3 Feb. 2020, https://www.nia.nih.gov/health/what-should-i-ask-my-doctor-during-checkup.

So Well. “The Weight Biology Kit.” SoWell, https://www.getsowell.com/weight-biology-kit/.Testing. “How to Talk to Your Doctor About Your Lab Tests.” Testing, 12 Mar. 2021,https://www.testing.com/articles/how-talk-your-doctor-about-your-lab-tests/.

“The difference between insulin resistance and prediabetes.” Nebraska Medicine, 31 Aug. 2022, https://www.nebraskamed.com/diabetes/the-difference-between-insulin-resistance-and-prediabetes#:~:text=The%20difference%20between%20prediabetes%20and%20insulin%20resistance&text=Prediabetes%20and%20diabetes%20occur%20when,not%20respond%20well%20to%20insulin.

Thomas, Reid. “Response to: How do I ask my doctor for a specific blood test without sounding

demanding?” Quora, 2022, https://www.quora.com/How-do-I-ask-my-doctor-for-specific-blood-test-without-sounding-demanding#:~:text=Tell%20them%20what%27s%20wrong.,ll%20take%20it%20from%20there.

Walk In Lab. “Insulin Fasting Blood Test.” Walk In Lab, https://www.walkinlab.com/products/view/insulin-fasting-blood-test#:~:text=The%20insulin%20fasting%20blood%20test,glucose%20in%20in%20the%20blood.

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