Why weight loss can be so hard with thyroid issues — and what actually works

We see a lot of patients who come in with a similar problem of not being able to lose weight. Even after regularly exercising and maintaining a diet, they face difficulty in losing weight.

In cases like this, we suspect the reason to be thyroid. In women, hypothyroidism can be a major reason why people may end up thinking that weight loss is impossible. But that is not the case, it is just that the usual “eat less, move more” advice might not be enough.The T3 (triiodothyronine) and T4 (thyroxine) hormones are which are very important for controlling the metabolic rate as well as the use of energy. These are released by our Thyroid glands.

Hence, when it lags, the metabolism drops and you burn very few calories. People who suffer from hypothyroidism might feel cold, fatigued and lethargic in addition to gaining weight or finding it impossible to lose weight. The symptoms are often subtle and weight gain happens mainly due to fluid retention, accumulation of fat and very little calorie burn.

Why weight loss feels impossible

Thyroid-related weight issues aren't just about a slower metabolism. There are other factors at play as well:Fatigue: Hypothyroidism can leave you too exhausted to exercise consistently.

Mood changes: Depression or low motivation, common in thyroid disorders, can derail healthy habits.Hormonal imbalance: Thyroid hormones are mainly involved with the production of insulin, cortisol, and sex hormones. These are in turn responsible for maintaining an individual’s appetite, fat storage and weight. So, reduced thyroid hormones strike an imbalance in these as well.Muscle loss: Slowed-down thyroid glands can also lead to muscle breakdown which in turn reduces the basal metabolic rate of the body, thus causing the rate of calories that our body usually burns to come down.What’s especially frustrating is that even after starting thyroid medication, many people don't immediately lose weight. That’s because medication stabilizes hormone levels but doesn’t automatically reset your metabolism. It still requires a strategic, consistent approach.

What actually works for weight loss with thyroid issues

The silver lining in this situation is that weight loss with thyroid problems is possible — but it requires a more informed and tailored strategy.Get your thyroid properly treatedFirst and foremost, it is essential to consult a doctor and make sure that your thyroid levels are balanced. For this, synthetic thyroid hormone is recommended so that the TSH (Thyroid-Stimulating Hormone) comes down to the required range. This, however, does not work for everyone and some people profit from getting their free T3 and T4 levels balanced.Prioritize strength trainingPracticing strength training at least 2-3 times a week can negate the effects of hypothyroidism.

Strength training helps the body develop lean and strong muscle mass. It also boosts metabolism and contributes to long-term weight control goals.Choose the right carbsThere are specific forms of thyroid disease that are autoimmune in nature, like Hashimoto’s Thyroiditis. People suffering from such conditions maybe prone to blood sugar imbalance. Hence, following a strict diet consisting of fiber and complex carbohydrates as well as one that is low in processed foods and sugar can help to control insulin levels and support weight loss.Manage stress and sleepThere are certain hormones in the body that can worsen the condition even more. One of them is the stress hormone, cortisol. It can interfere with the function of the thyroid gland and make losing weight difficult. Engaging in destressing activities is the solution for it. Getting at least 7-8 hours of sleep every night, practicing relaxing techniques like reading a book or yoga and avoiding overexercising are a few ways of not letting cortisol affect the thyroid gland.Address nutrient deficienciesFor a healthy functioning of the gland, iodine, selenium, zinc, vitamin D, and B12 are a few of the major nutrients. A deficiency in any of these can impair hormone production and energy metabolism. It’s worth checking your levels and considering supplements if needed, under your doctor’s supervision.It surely is hard to lose weight, especially if you are suffering from hypothyroidism. It’s not about extreme diets or working out until you drop. It’s about understanding what your body needs and giving it the right kind of support. Correct diagnosis and recognising the type of thyroid disorder that the individual suffers from is important, marking the first step towards recovery. The right medical support, appropriate diet and fitness plan are what will bring about change.

Your thyroid doesn’t have to define your body or your health journey. You’re still in charge and every small step counts.Dr. Narendra BS, Lead Consultant – Endocrinology & Diabetology, Aster Whitefield Hospital, Bengaluru