Women's Health Promotion Unit

-- Name withheld

Your query about having difficulty in weight reduction, possible related to hypothyroidism, is very, very common. Three considerations are relevant:

First, the replacement dosage of the thyroxine necessary for correcting the hypothyroidism may need adjusting upward. Your symptoms and laboratory data will guide your physician in assisting with this option. Other clinical conditions associated with excess body weight are diabetes, excess androgen (male hormone) production, and a hyperactive pituitary gland, Your physician will be able to assess your health in relation to this differential diagnosis.

Second, it may be that your level of 'feeling good' has prompted you to become more interested in living, including an interest in food. This may be a trap for individuals who enjoy cooking, and working with food, perhaps as an occupation. Your appetite may have increased from this dynamic.

Third, the difficulty shared by many individuals is having and eating nutritious food in excess of body needs. This returns one to the issue of the types and amounts of food ingested versus the types and amounts of activities that utilize the energy produced by the food ingested.

The following review article makes excellent points about the problem of obesity and its causes: The etiology of obesity: relative contribution of metabolic factors, diet, and physical activity. Weinsier RL, Hunter GR, Heini AF, Goran MI, Sell SM Department of Nutrition Sciences, University of Alabama at Birmingham, 35294, USA. Am J Med 1998 Aug;105(2):145-50

Three major factors modulate body weight: metabolic factors, diet, and physical activity, each influenced by genetic traits. Despite recent advances in these areas, the prevalence of obesity in Westernized societies has increased. In contrast to monogenic animal models and rare human genetic syndromes, predisposition to common forms of obesity is probably influenced by numerous susceptibility genes, accounting for variations in energy requirements, fuel utilization, muscle metabolic characteristics, and taste preferences. Although recent increases in obesity prevalence cannot be explained by changes in the gene pool, previously "silent" genetic variants may now play important permissive roles in modern societies. Available data suggest that variations in resting energy expenditure, thermic effect of food, and fuel utilization exist but, by themselves, are unlikely to explain the onset of obesity. Regarding diet, the best available trend survey data indicate that fat and energy intake have fallen, in this and other Westernized countries. Diverging trends of decreasing energy intake and increasing body weight suggest that reduced physical activity may be the most important current factor explaining the rising prevalence of obesity. Subsistence in modern societies requires extreme adaptations in previously useful energy-conserving diet and exercise behaviors. Recognizing the difficulties in sustaining energy-restricted diets in the presence of fast foods and social feasts, the current trend toward increasing body weight is not likely to be reversed solely through recommendations for further reductions in energy intake. In all likelihood, activity levels will have to increase in response to an environment engineered to be more physically demanding.

I hope that this information is helpful for you, and Good Health!

LeRoy Heinrichs, MD

HIV Status

Hypothyroidism

Dysmenorrhea with Fibroids

Thyroid Hormone and Menopause