By Mary J. Shomon
Weight loss is the number one health priority for many Americans. Results from the National Health and Nutrition Examination Survey (NHANES) recently reported that just in the past 22 years, the number of obese adults in America has more than doubled. Currently, one in three adults is obese, and half of us are overweight.
We already know about the health dangers of being overweight. Obesity increases the risk of heart disease, stroke, diabetes, arthritis, problem pregnancies, and many cancers, among other conditions. Obesity is also associated with emotional effects, including depression.
We know that the typical American doesn’t get enough exercise, eats more than ever, and spends too much time in front of the television and computer. Those factors certainly account for some of the epidemic of weight gain in America.
But what’s going on when you find yourself suddenly gaining weight, with no change in your diet or exercise? And why do so many people find it difficult – or, let’s face it, pretty much impossible — to lose weight, despite even the most rigorous diet and exercise program? Is there another factor contributing to the increase in weight problems?
Many experts believe there is.
It’s the epidemic of undiagnosed hypothyroidism. When you’re hypothyroid, your thyroid gland is slow and underfunctioning. Since the thyroid is your master gland of metabolism, it has a profound impact on your energy level. The thyroid controls the way your body uses and stores the food you eat.
It may be no coincidence, then, that just as we’ve seen a dramatic increase in the number of overweight and obese Americans, we’ve also seen new estimates that the number of people with undiagnosed hypothyroidism is reaching unprecedented levels.
One 2005 study actually found that according to thyroid test ranges recommended by the American Association of Clinical Endocrinologists, approximately 20% of the U.S. population – almost 60 million people — are currently hypothyroid!
As a thyroid patient advocate, I hear from people every day who complain that they are “doing everything right” when it comes to diet and exercise. They are following a diet plan — South Beach, Weight Watchers, Jenny Craig, or Ediets, for example — to the letter. They are working out, going to the gym several times a week. Some of the people who write to me are even personal trainers, bodybuilders, or fitness models – the very people who usually know best how to get in shape and stay in shape! Yet, no matter what they do, not only can they not lose a pound, but sometimes, they are even gaining weight.
I still remember the woman who emailed me in despair, saying that she was eating 800 calories a day, running 15 to 25 miles a week, and yet she was still gaining as much as 2 pounds a week. Sometimes, the stories defy science and sound unbelievable; I wouldn’t believe them myself if I hadn’t gone through similar periods of working out, eating little, and yet gaining weight rapidly.
When you start quickly gaining weight despite no change to your diet and exercise plan – or you can’t lose weight no matter what you do – one fact is clear: something is truly wrong.
Many people who reach this sort of crisis point with their weight head to the doctor for evaluation. Unfortunately, what they often hear is “you should get off the couch,” or “stop eating so much” or “What do you expect, you’re getting older, after all!”
Instead, what they should hear is “Let’s evaluate you for hypothyroidism.”
Because undiagnosed or undertreated hypothyroidism can make weight loss – despite diet and exercise – all but impossible, and may be the real reason why you’re suddenly gaining weight for no apparent reason.
Before you give up on a healthy diet and exercise program and resign yourself to being overweight, before you fill that prescription for diet pills, before you sign on for potentially dangerous gastric bypass surgery – be sure that you see a doctor who understands hypothyroidism and its impact on metabolism for a thorough evaluation.
A thorough evaluation should include a full clinical examination. In addition to your weight, the doctor should be looking for other common clinical signs of hypothyroidism, including:
•Hair loss, loss of hair in the outer edge of eyebrows
•Puffiness in the face, eyes, eyelids, hands, and/or feet
•Slowed Achilles reflex
•Enlarged neck, goiter, or palpable lumps or thyroid nodules
The doctor should also evaluate your medical history – that should include particular attention to a family and/or personal history of any past thyroid problems, endocrine conditions (like diabetes), and autoimmune diseases.
Your possible hypothyroidism symptoms should also be evaluated. Some of the more common ones include:
•Brain fog, memory problems, difficulty thinking
•Coarse, rough, and/or dry hair or skin
•Feeling cold, cold extremities
•Menstrual problems, fertility problems, recurrent miscarriage
· Low sex drive
· Husky or hoarse voice, neck pressure, difficulty swallowing
Your doctor will very likely also run blood tests to evaluate thyroid hormone levels and antibodies against your own gland. These tests can help detect an underactive or slowing thyroid.
Keep in mind that hypothyroidism diagnosis and treatment is not a magic cure-all for every weight problem. Even when you do have an undiagnosed thyroid condition contributing to your weight gain, getting diagnosed and properly treated doesn’t necessarily cause the weight to fall off.
Some people do have an initial drop in weight after starting treatment, but that frequently levels off. Then, continuing to lose depends on the old standbys: diet and exercise.
But dealing with underlying hypothyroidism does make the weight loss battle more fair of a fight. What had been a losing proposition – the ability to losing even a single pound – may now become truly possible with a healthy diet and exercise.
Mary Shomon is an internationally-known thyroid patient advocate, and is author of a number of best-selling health books, including Living Well With Hypothyroidism and The Thyroid Diet. Since 1997, she has run the Internet’s most popular thyroid patient sites: About.com Thyroid Site and Thyroid-Info.com.
Fatourechi V, Klee GG, Grebe SK, et al. Effects of reducing the upper limit of normal TSH values. Journal of the American Medical Association. 2003;290:3195-3196.
Ogden, Cynthia et. al. “Prevalence of Overweight and Obesity in the United States, 1999-2004,” Journal of the American Medical Association. 2006;295:1549-1555.
By Mary J. Shomon