Health Library







Categories > Diet and Nutrition > Weight management

The hidden hurdle: 5 secret factors that may be hindering your weight-loss efforts
Insulin resistance
Basal metabolic rate (BMR)
Thyroid disorders
Lack of shut-eye
Prescription medicine
Are you fooling yourself?
Is weight-loss surgery right for you?


Heart-smart fact
Heart-smart fact

Counting calories or carbs is not enough. To lose weight in a healthy way, you’ll need to limit intake of saturated fat, trans fat, cholesterol, sodium, sugar and alcohol.

Nothing’s more frustrating than doing what you’re told—keeping a food diary, watching your calorie count, heading to the gym daily—and still not losing the weight you want. Especially when your workout buddy seems to be shedding the pounds twice as fast.

It may be that you need to rev up your efforts. Perhaps you aren’t being as conscientious as you think (take the quiz below). But it may be that something else is working against your best efforts. See whether any of the following secret saboteurs sound as if they could apply to you.

Insulin resistance

Some estimates suggest that more than 40 percent of adults experience insulin resistance. The condition prevents body tissue from using the hormone insulin properly to move blood sugar into cells. If your weight gain is concentrated at your abdomen or you have high cholesterol, high blood pressure or hypertension, this may be what’s stalling your weight loss. Ask your doctor to check your blood glucose levels—especially since insulin resistance can lead to diabetes and heart disease if left untreated.

Basal metabolic rate (BMR)

Your BMR is a measure of how fast (or slow) your body burns calories when you’re at rest. Your BMR is inherited, but building muscle mass and exercising can adjust your BMR as well as help you burn calories while at rest. Very few people actually have a metabolism that’s slow enough to significantly impact their ability to lose weight.

Thyroid disorders

The butterfly-shaped thyroid gland at the base of your neck can be subject to a number of conditions that can affect your weight since it produces hormones that regulate metabolism. Hypothyroidism, or underactive thyroid disease, occurs when the gland doesn’t produce enough thyroid hormone. Hypothyroidism can cause you to gain five or 10 pounds, and the weight is generally fluid buildup. A blood test can determine whether you have a sluggish thyroid.

Lack of shut-eye

We all know being tired makes you cranky, but researchers have found it can also make you hungry. In one study, people who were sleep-deprived craved more high-fat, high-carbohydrate foods than those who got a solid eight hours. If you are chronically sleep-deprived, try adding more shut-eye to lessen your appetite.

Prescription medicine

It’s one of the unfair elements of science. A medication that makes you feel better in one area can have a side effect that makes you feel worse in another. Antidepressants are one category of drug that can have the unwanted side effect of making you gain weight. Steroids, some hormones and diabetes medications can do the same. If your weight gain—or weight-loss plateau—is timed to the use of a new drug, ask your doctor about possible weight-related side effects.

Are you fooling yourself?

Take this true or false quiz to see whether you know as much as you think you do about how to lose weight.

Q. Thirty minutes of exercise daily is all it takes to slim down.

A. False. Of course, 30 minutes is better than nothing, but federal dietary guidelines say as much as 60 to 90 minutes of moderate-intensity activity daily is needed to sustain weight loss.

Q. Swapping fresh juices for sugared sodas will help reduce the number of calories you consume.

A. False. While juice can be rich in essential vitamins, it can also be loaded with sugar, which packs on the calories. Read labels carefully and drink water or low-fat milk when possible.

Q. For your afternoon snack, one apple counts as one serving of fruit.

A. True or false: It depends on the apple’s size. An extra large Golden Delicious may count as more than one serving of fruit, again adding more calories to your day than you’re counting.

Is weight-loss surgery right for you?

It sounds like a magic bullet: Schedule a surgical procedure and come out 50 or 100 pounds lighter. But bariatric surgery is a serious undertaking. It isn’t an instant fix and it isn’t for everyone. Talk to your doctor to learn more if you:

  • have a body mass index (BMI), which measures your weight relative to your height, of more than 40.
  • have a BMI of 35 to 39, along with another condition such as sleep apnea, high blood pressure or diabetes.
  • are willing to change your eating habits dramatically, opting for five or six small, low-fat meals a day rather than three squares. If you don’t stick to this diet, you’re likely to experience vomiting and diarrhea.
  • have been unable to lose weight—or keep weight off—by other means.

You should talk to your doctor about nonsurgical weight-loss alternatives if you:

  • have health conditions that make being under the effect of anesthesia a serious risk to your health.
  • have an addiction to alcohol or drugs or have a psychiatric disorder.
  • are overweight but not obese. Patients who respond best to this surgery need to lose at least 100 pounds.