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41 year old female 5'1 153 pounds and cannot lose weight, what am I doing wrong?

The only medication I take is a vitamin, allegra, and the bc pill which I have taken for years.  I have not been diagnosed with any new medical conditions recently. I've had migraines since I was 25, get maybe one a month not debilitating though, take no scripts for it.   Up until I was in my late 30s I weighed 125 pounds.  I worked out a few days a week, running, elliptical and did not count calories.   If I started to gain all I had to do was count calories and do 1600 a day and the weight came off.    When I was 37 I had laser liposuction to my stomach.  They took out about 5 pounds. I always had a belly, my whole family does and I really wanted to get rid of it.   The fat came back in the same spot.   The doctor was amazed, and wanted to redo it, but I said no way!  Since that time I have progressively been gaining weight and nothing I do will get that weight off.   I am stricter with my diet than I have ever been, 1400 calories and working out burning 500 calories a day. I wear an apple watch it's accurate too.    I have tried eating more, tried not working out.  Tried lifting weights, tried keto, tried hit work outs, tried running,  cut out dairy, seen a weight loss doctor  and the scale moves maybe three to five pounds back and forth and it's water weight.     I have had my thyroid tested repeatedly, been to specialists there is no explanation.  If I drop down to 1200 calories a day and work out I can lose about a pound a month, but I am freaking miserable that entire month and I am not sure it's worth it to keep this up for four years to get the weight off.   I did it for six months and then had to go back to 1400.   I am frustrated, and disappointed in myself. I do not understand what happened.  Every doctor I have seen has told me that there is no way the lipo suction had anything to do with it, its just age related.  I am not in menopause, my hormone levels are good, I had my metabolism tested it's slow, but still average for my age.   I sleep eight hours a night, I am a low stress person. I don't have kids.     I do not gain weight on my regimine.   Do I have to just accept that this is my weight now, and move on?     Help.  
9 Responses
134578 tn?1546634665
I'd be looking at the composition of your diet, not the calories per se. You said you saw a diet doctor, was that doc impressive? Because it seems to me he should have been talking to you about fat content, carbs, the kind of carbs, the kind of fats, in other words, a whole lot about what kind of nutrition you're getting. Calories alone don't explain much.
3 Comments
Ditto the above.  Calories are only one factor in weight and not the most important one.  Counting calories doesn't tend to work long-term -- no "diet" has been found to successfully reduce weight long-term, though most can be successful short-term.  As the above says, it's probably not going to be easy to figure this out, but as to the diet part, it's not the calories as much as what the composition of the food you're eating is.  Diet doctors can't help you or anyone else, as again, no "diet" has been found to work long-term.  The closest has been, I think, Weight Watchers, but the losses aren't large.  Then again, you don't need to lose a ton.  Maybe in the end you are stuck with this -- maybe this is how you were made.  Who knows?  Almost all of us gain as we age, but I don't think you're at that age yet.  Thyroid problems are hard to diagnose, they can be there and take a long time to find.  But there are also many who don't gain weight because of that, so even there it's an individual thing.  Don't know if the surgery you had could have altered something, don't know anything about that surgery, but there are those who do you might consult.  I would say that if you're not obese and you get surgery for your weight, there might be something psychological going on that is getting in your way -- over-obsessing about something can be an impediment.  Checking your watch all the time is more likely to drive you nuts than help you any, as our measurements vary a lot during the day and the week and the month.  So it could be anything or nothing.  Could be some nutrient problem you're having that is impeding your energy output.  Could be a disruption in your intestinal organisms affecting digestion.  Could be a lot.  Could be nothing.  Look at everything but don't let it ruin your life.  Peace.
Need to amend the above -- while no "diet" has proven to work, there are ways of eating you change forever that do.  Not for everyone.  I was only referring to "diets," not long-term changes in what we eat, when we eat, and how much we eat.
Hi all.   The diet doctor placed me on a diet which was pretty simple but meant I ate 3 oz of protein three tims a day, plus one serving of fruits and one of veggies.    I got a good scale so I could make sure that I was doing the portions right.   Then two snacks both veggies or fruits.      They had me keep food diaries and looked everywhere they could to see what was wrong. I was only allowed to drink water, no caffeine  etc.  In three weeks I lost 2 1/2 pounds.  Then they told me to stop exercising so I did that and nothing happened.   I was stalled.     It seems like I would regain and lose the same 2 1/2 pounds.     During the time I was on this diet I was absolutely miserable. I was starving, my head hurt and I wanted to murder everyone I saw.   I did not adjust to it either despite what they said. My stomach growled the entire time, I would even wake up in the middle of the night unable to sleep due to hunger.    But the nutritionists I saw pretty much gave me the same prescription.    So what can I do?  I am a trial lawyer, so if I am hungry I cannot function before juries, and I cannot do my job.      I have been told I am a very small person frame wise and height and likely 1200 calories may be too much to eat for me to loose weight, by several doctors.  I have taken pro biotics did not seem to help.  I have told my resting metaboilic rate is low.   Here's the thing I was NEVER obsessed with weight, because I never gained weight.    I always had a belly pooch, actually everyone in my family has the same exact thing and I just wanted to get rid of that pooch. It only took out like five pounds it was not for weight loss to have liposuction.    I do think that for whatever reason my body has just decided this is where it is.  And while it is theoretically possible for me to lose weight, by eating a lot less, giving up a lot of things, and being all out miserable, I don't want to be there.  This is just me. I should mention that the same thing happened to my Mother.  She was even smaller than me, a size 2 until she hit her early 40s and then nothing that she did took the weight off.  She finally just accepted it.  But it was very hard for her to do that because she had always been skinny, always worked out, took care of herself and ate well.   I wonder if there are other women out there who have just accepted this as their fate?    
134578 tn?1546634665
I would definitely chase this down; 28 pounds (while fighting it) is a lot of gain in only what, four years? It's not like you're 50 or 60, when doctors do sort of shrug and say maybe it's nature's way, etc. You're not drawing a picture of that being the reason at all.

I would re-check the thyroid measurements, but also would bend every effort to find a really good dietician with a natural bent, who can tell you the difference between white rice and other more esoteric grains and why that matters, and how much of one category of food and another category you should be eating, and like that. People sometimes say "I'm eating x calories a day" assuming people know that they mean in a balanced and natural diet, but often they really aren't thinking of anything besides the calorie count. If I were to eat 1400 calories a day but get 500 of it from candy bars, my total calorie count would look fine for losing, but the sugar would put a kibosh on that pretty fast and in no time I would have a tummy, too. Has your diet changed in the last 4 years, even if just by adding one thing that you don't think is significant? (Sometimes, getting into regularly drinking a particular soft drink, sport drink or even sweet tea, is enough to up your weight gain.)

Anyway, I think you sound too young to give it up as your metabolism slowing with age. See if you can find a good doc. Ask at the local health-food store, they should know some dietary advisors.

Good luck!
1 Comments
Thanks. No my diet has not changed at all.  I don't drink alcohol (never have), I don't drink full calorie soft drinks, I may hae a diet soda once a week, I drink mostly water, but some crystal light as well.   I don't eat white rice, don't eat white bread. I have seen two dieticians, I have kept food diaries, I have done weight watchers.  Again the end result seems to be that I just have to be miserable to lose weight.    I guess everyone's degree of misery is different.    Maybe it's just that I could lose weight if I gave up 99% of what I ate and only ate veggies and protein but I am just not willing to do that.    Thanks for your help.
649848 tn?1534637300
COMMUNITY LEADER
I agree with having a recheck on the thyroid; it's one of the main controllers of metabolism and can really slow it down.  Make sure when they test, they are doing the right tests.  They need to be testing Free T4 and Free T3, not just TSH, which many doctors feel is the gold standard for diagnosing a thyroid problem.  It would also be a good idea to have thyroid antibodies tested to determine whether or not you could have Hashimoto's, which is an autoimmune thyroid condition.  One can have Hashimoto's and and of its symptoms/effects before actual thyroid hormones go out of range.

There are other hormones that can affect weight, as well.  Cortisol, which is a stress hormone is one and is noted to add weight around the waist.  Nutritional deficiencies can also have an effect.  

Although many of us do gain weight as we age, I've read numerous articles stating that age isn't the sole reason this happens.  The reason it happens as we age is because our behaviors change as we age - we exercise less/differently, we eat more/differently, etc.  There are many people who age and don't gain weight.  
6 Comments
Thanks for that. i am going to make sure that they are doing the thryoid testing correctly.  Can I have the Cortisol level tested?     I am not sure what nutritional deficency I could have. My vitamin D was low maybe two years ago, doc said it was borderline but I started taking the supplements as directed and at my recent check up I was good.    I exercise more now than I did when I weighed less and I do not eat more.   That's the thing. I could understand if I was eating more, or more bad things, but I am not.  I honestly think that because I was fairly thin before, and worked out a lot and keep a pretty healthy diet that there is not much more that I can do now.  Meaning my body is used to exercising and a decent diet, so what more is there to do?   Seriously my fiance is with me 24/7 and he sees what I eat, he does not get it either.
Yes, cortisol can be tested... it's best to do a 24 hr saliva test as opposed to the single morning saliva test that most doctors will order.  The problem is that most insurance doesn't cover the 24 hr saliva tests.  They can be purchased online for just over $100, though and are much more accurate because they indicate cortisol levels over the course of the day instead of just in the morning.  Cortisol should be highest first thing in the morning as you prepare for the day, then gradually decrease with the lowest level at night as you prepare to sleep.

I'm not sure what your vitamin D was when it was determined to be "good"... most reference ranges go all the way down to 20 at the low end and even though it's higher than 20 your doctor may say it's okay simply because it's within the range, but that's not nearly high enough.  It should be at least, around 50 or so in order to be adequate and some people will say it needs to be higher than that.  It should be noted that Vitamin is actually a hormone, not a vitamin and adequate amounts are necessary for proper metabolism of thyroid hormones.

Selenium, iodine, iron, etc are all nutrients that can have an effect on metabolism/thyroid hormone production or metabolism.  You can ask your doctor to test those, along with vitamin B-12.

It's not just what/how much you eat or how much exercise you get - it's whether or not your body can use the foods/nutrients you're giving it.

If I were you, I'd start with those thyroid tests.  Good luck.
I'm not sure cortisol can accurately be tested in a way most of us could afford.  It varies a lot depending on what's going on in a given day or a given hour.  One close call in a car can elevate it and make that day a total loss in regards to testing.  Because this hormone increases with stress, and because we all vary a lot over each week in our stress levels, again, a lot of things in our bodies can only accurately be tested by doing it several times over a sufficient period of time to get anything close to an accurate assessment of what your normal levels are.  Cortisol would also potentially be tied in to the thyroid, as the thyroid affects the adrenal gland.  I only know this because I'm an anxiety sufferer, and when you're an anxiety sufferer you get very familiar with the fluctuations of cortisol.  Because it originates from the amygdyla in the primitive brain when it is issued in response to stress, it's been a difficult thing to get a handle on, as the primitive brain is very difficult to understand in it's interaction with the later evolution of the cerebrum.  It's why anxiety attacks are so hard to treat, but the research at this point is mostly on the amygdyla and it's been that way for a very long time and there is no sign of unlocking this mystery any time soon.  This problem you're having must be really baffling, because as you describe yourself you're doing pretty well in your eating and your exercise and not seeing any change, nor do you know why you gained the weight.  As you try to get this nailed down by seeing the appropriate specialists, one thing to can try is to change everything up.  Change you diet.  Not for the worse, but just different.  Eat small meals more often.  Do different forms of exercise.  Maybe your metabolism has plateaued and maybe you can stir it back up by altering things.  Don't have a clue if it would work, but it's something to try.  Hope you find your answer.
By the way, there are herbs that can affect the adrenal gland.  They are called adaptogens, and some will stimulate it and some will quiet it down and some will balance it.  True ginseng aged a long time is very stimulating to the adrenals.  American ginseng cuts blood sugar and modulates the adrenals.  Holy basil cuts cortisol production.  Ashwagandha is balancing and calming.  Rhodiola is very stimulating.  Eleuthero is stimulating without being agitating.  I use adaptogens to protect my body from my anxiety problem.  It's something to try if you think your adrenals aren't performing at their peak without having to know exactly what particular levels of any hormones are.  Just something else you can try.  Most serious athletes use them.  There are many of them.  But of course I have no idea if your adrenals have anything wrong with them.  
This information is so helpful thank you for sharing. I am going to puchase the cortisol test and give it a shot. I will ask my doctor specifically what the Vitamin D levels were and be tested fort he other nutrients that you mention as well as the thyroid test.  
I can give a site from which to get the cortisol test if you like.  

It's always to your advantage to get copies of your lab results whenever you have them blood work done.  I keep all of them for my records.  My lab posts them for me, but I can also get them from my doctor's patient portal.  By keeping them in my own records, I can go back and compare results from one time period to another or if I change doctors, I can take relevant results with me without having to get them from the doctor, etc.  I do the same thing with any imaging reports, etc.
649848 tn?1534637300
COMMUNITY LEADER
I agree that it's difficult to get a really accurate adrenal test due to constantly changing levels caused by unlimited variables of daily life, as well as elevated cortisol in the case of those with anxiety.  However, simple tests will accomplish that for our purposes.

On the other hand, it's known that when the thyroid isn't working properly, the adrenals will kick in and try to take up the slack by over-producing cortisol.  

"Because it originates from the amygdyla (sic) in the primitive brain when it is issued in response to stress, it's been a difficult thing to get a handle on, as the primitive brain is very difficult to understand in it's interaction with the later evolution of the cerebrum."  It isn't necessary to get that technical.  The purpose of the suggested 24 hr saliva test isn't to try to get overly scientific and try to figure out a person's brain function, etc; brain function would be for a neurologist to determine.  

Although brain function could be a factor that would take much more sophisticated testing than I can possibly suggest.  For our purposes here, we're dealing with the relationship between thyroid and cortisol, with the understanding that there could be, but usually isn't something deeper and it would take a neurologist or psychiatrist, which none of us is, to determine brain function.

I absolutely agree with the use of herbal adaptogens to help control cortisol levels.  First, one needs to have an idea what might be happening.
2 Comments
Thank you for this explanation.  It is so concise and clear.  I mean one can do google searches and try to get answers from doctors but no one has ever explained it to me like this.     I feel like these days doctors are so overwhelmed they never have time to talk to you about things, you have to figure it out yourself.  Anyways I am not a very how stress person, in fact I am the opposite, and anxiety and worry are two words that really rarely come into my vocabulary. It actually unerves some people how easy going I am.  So I am not sure that there is stress or anxiety going on, I am not depressed either.     Pretty happy in live overall.  
Many of us aren't high stress people, but when we have things going on with our body that we don't understand, inevitably, there's a certain amount of anxiety involved, even if we don't recognize it as such or it doesn't have a major impact on our lives.  This is one of the variables of everyday life and isn't the same as a general anxiety disorder that some people deal with on an ongoing basis.

It also doesn't change the fact that the thyroid can't function without adequate nutrients and when the thyroid fails to produce enough hormones, the adrenal glands will kick in and try to take up the slack in order to try to keep our body going.  This adrenal response, typically, returns to normal when we begin receiving adequate thyroid hormones - such as replacement medication, in the case of those like myself who have been diagnosed with Hashimoto's and/or hypothyroidism.  

I agree that doctors don't always have, or take, adequate time with their patients to get to the bottom of what might be wrong and too many of them go strictly by the lab reports (reference range technology) and they consider anything within range to adequate, when there are actually optimal levels within those ranges.  


134578 tn?1546634665
Here is an article I found fascinating, it's a good take on the new awareness that "counting calories" is often ineffective and why. It's a long article, but maybe you will appreciate the frustrations described. I think the findings described in the article are really important.

https://getpocket.com/explore/item/why-you-shouldn-t-exercise-to-lose-weight-explained-with-60-studies
3 Comments
This is the one (of two that I saved) that is long, but it makes a lot of sense: https://www.1843magazine.com/features/death-of-the-calorie
I totally agree that counting calories isn't an effective way to lose weight and that exercise isn't always as helpful as we might think.  

I haven't had a chance to read either article in its entirety, but I'm looking forward to the chance to be able to do so.  Thank you for posting the links.  
The second one is a tougher read, but it is the most compelling. It's possible to get the jist of it by skimming through and following the main person's story.
134578 tn?1546634665
I'm going to ask Emily tomorrow to delete the link to the first article, it's not nearly as useful as the second one. For one thing, it keeps talking about calories as though they are a useful measure, and it mentions eating a low-fat diet as a good thing, which is by now a debunked approach. I had both articles in a row in my bookmarks, and posted the first thinking it was the second.

The article I do recommend, and the one I found compelling, was the second one. Link:

https://www.1843magazine.com/features/death-of-the-calorie
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