Reasons You’re Not Losing Weight Even When in a Calorie Deficit

“Calories in and calories out.” It’s not always that simple when it comes to weight.

And truth be told, a calorie deficit when it is too drastic can actually slow the metabolism with the typical increase seen with the Reverse T3 thyroid hormone. The body is not easily fooled; it’s going to focus on surviving in the way it deems necessary, which often includes with conservation of energy.

But the point of this article is actually different than what the title alludes to, but for good reason.

Calories (too little or too much) might not actually not be the biggest factor at play and in my opinion, there is a hyperfocus on calorie deficits as a strategy to try to induce weight loss.

In my 13 years as a registered dietitian, what I have learned (and seen a lot) over time is that when people report concerns of difficulty with weight loss:

It’s often not a “calories in/calories out” issue. It’s often some sort of bodily dysfunction especially when they already tried it a few time.

Struggles with weight are often a “check engine light.” Look Deeper. These are other stones to consider overturning:

• Intestinal gut dysbiosis (imbalance of “good” and “bad” bacteria)
• Increased intestinal permeability or “leaky gut”
• Sex hormone imbalances including, high estrogen & low estrogen, low progesterone, high testosterone, and low testosterone
• Thyroid dysfunction, even if subclinical
• Toxic indoor mold exposure
• Heavy metal bioaccumulation even if not life threatening levels
• Nutrient deficiencies, especially those that support various types of proper hormone function and are required for phase 1 & 2 liver detoxification
• Exposure to endocrine disruptors, obesogens and “forever chemicals” commonly found in household cleaning products and personal care products
• Stress, cascading to adaptive HPA axis dysfunctional (subclinical cortisol issues)
• Poor sleep quality or full on sleep apnea, cascading to decreased resting metabolic rate
• Low grade chronic inflammation
• PTLDS -(Post Treatment Lyme Disease Syndrome) & other coinfections
• Insulin resistance
• Leptin resistance
• Trauma that is “stored” in the fascia

Given all these potential contributing factors, a deeper dive may be a better approach. Also note, there are medical conditions too that can cause weight concerns.

“Eating less and moving more” is not my go to strategy with patients, especially when they have already tried the diet of the week and it didn’t yield weight loss.

Instead, I focus efforts on proper nourishment. The body “heals” best when it is adequately fed and not restricted. Restriction usually backfires in the long run and can worsen most of the potential factors that I listed above.

Find the nutrition related dysfunction and address this.

*I refer out when something is out of my scope of practice and/or not addressable via nutrition interventions.

Heal, don’t starve.

Consider scheduling a consult package if you would like professional advice in navigating your concerns with weight loss difficulty or unintentional weight gain.

Obviously not everything on the list above applies to all of those with weight loss resistance. But you can start overturning those stone.

• For screening for intestinal gut dysbiosis (imbalance of “good” and “bad” bacteria), consider getting a GIMAP. This is the top test I order in practice. I have no financial relationship with GIMAP, it’s just an amazing test that gives us lots of data.
  • There are over 100 studies that show an imbalanced gut microbiome independent of diet or exercise can lead to weight gain or weight loss resistance
• For screening for Sex hormone imbalances, start with bloodwork. If abnormal, there is a ton of nuance to this conversation but the short answer for women is:
  • If menstruating, find the root cause of the abnormal hormone as it’s just a messenger
  • If postmenopausal, talk to a bioidentical hormone replacement specialist to see if you are a candidate
• For suspected thyroid dysfunction, even subclinical (a dietitian cannot diagnose-see a Physician), but we can look a full thyroid panel and provide medical nutrition therapy based on labwork as nutrition and lack thereof can impact thyroid function. A lowER t3 can influence weight, a higher reverse t3 can influence weight.
• If toxic indoor mold exposure is suspect (way more common than you think!). Get an ERMI dust kit #1 of your home. It’s a simple dust collection. If the score is >5, then you must hire a certified mold inspector and remediator to find the where, why it grew, and pursue remediation. Register for my Healing from Mold Online Program for a comprehensive protocol
• If heavy metal bioaccumulation is suspected that is not life threatening, this is big topic to tackle succinctly, but consider taking my online program: Discerningly Detoxing
• If Nutrient deficiencies are suspected, especially those that support various types of proper hormone function and are required for phase 1 & 2 liver detoxification. You can screen for deficiencies and self order here and have drawn at any Quest labs and then work with A dietitian
• If you suspect exposure to endocrine disruptors and obesogens, start swapping out your every day products for safer ones. Check out my “supply closet” tab for recommendations
• If you suspect stress cascading to adaptive HPA axis dysfunctional (subclinical cortisol issues) you can check your diurnal cortisol pattern here to see levels but know that ultimately need to find and deal with the stressors which is easier said than done.
• If you suspect poor sleep quality possibly cascading to decreased resting metabolic rate,
  • Cut back on caffeine
  • Talk to your doctor about ordering a sleep study especially if you snore
  • Invest in good pillows and mattress
  • Try to get sunlight in the morning to support your circadian rhythm
  • Try magnesium glycinate bedtime around 300mg
• If you suspect lyme or you have PTLDS (Post Treatment Lyme Disease Syndrome) & other coinfections, you can test for this (look into Igenex testing) or discuss and ELISA and Immunoblot with your Doctor. This is not a straightforward one to explain but I have blog on this
• If you suspect insulin resistance, read my blog all on insulin resistance and look into inositol supplement
• If you suspect Leptin resistance (our fat storage hormone being too high), have to figure out the root cause of this which is often toxic indoor mold. Check out my Healing from Mold Online Program
• If you have experienced trauma, this is something to explore with behavioral health experts. Trauma can be “stored” in the fascia

Above is the tip of the iceberg for care plans on the various topics listed. But big picture: start overturning stones if dieting isn’t yield weight loss results. I see so many people spend years hyperfocusing on a better more restrictive set of food rules; meanwhile there is an elephant in the room that is the real driver of the weight loss resistance. Make sure you test and don’t guess!

*This blog on the Dietetics with Driessens LLC website is maintained by Katie Driessens, Owner. All opinions are her own and for general educational purposes. Advertising, affiliate links or other forms of compensation are within this website and a small commission is earned for sales made through these links (with no extra cost to you) that help cover costs of running a small business. Products and services listed are prior carefully created and/or evaluated to ensure that they are accurate and supported by scientific evidence. Items or programs that are endorsed are based on Katie’s professional experience and expertise & are worthy of such endorsement. Dietetics with Driessens LLC assumes no responsibility or liability for damage or injury to persons arising from any use of any product, information, or opinion contained in the information of this blog, none of which is to be considered personal medical advice. By viewing, using, and shopping from this website, you agree to release Dietetics with Driessens LLC from full responsibility to the fullest extent allowed by law. Products & Services sold are not intended to diagnose or cure any disease. Consult your physician before beginning any exercise, supplement, meal plan or program. Thank you!