AIBU Endocrinologists are the real solution to weight loss?

[noyodo]

Gastric sleeves and even Gastric By pass result in gaining back the weight within 5 years.

AIBU to think the only real solution is to see an endocrinologist to see what is causing/driving weight gain?

I am a menopausal woman with underactive thyroid. One of the side-effects of underactive thyroid is high cholesterol, even if your thyroid is medicated. I am currently on a mission to shed weight and there is no magic bullet. What is working for me is not having breakfast at all and not eating until between noon and 1pm, eating lots of overnight oats with berries/banana for breakfast, cutting out butter, cheese, red meat, pastries. Minimising intake of chocolate, cake, biscuits. No booze. Eating more oily fish, avocados. It's working not bad so far, I am 7kg down since mid-October.

@noyodo to manage it myself I mean I get my thyroid levels checked every now and then with my GP, ask then the exact figures and then self medicate by taking thyroxine I buy in Spain. I buy it in 25mcg abd 100mcg doses so I can change if need be because there are times I need to take 125 snd times 150. I prefer to keep my TSH around 1. But also agreeing with what others have said here, unless I am really careful with my diet I do put on weight easily. It’s annoying. Especially now going into peri.

Hmm, I'm not sure that's entirely true, none of my skinny friends (I include myself here) have disproportionate weight-gain around the middle and we're all in our 50's.

So, whilst is can definitely be contributory, I'd say it's not the whole story.

I certainly have thickened up a little from the 22" waist of my younger years, I'm 27" now at 52 and 5' 9", so not bad!

@Freetodowhatiwant Do you get T3 there too to treat your thyroid?

Agreeing. I'm a few years post menopause, now and never found it so easy to maintain a consistent weight.

What is an endocrinologist?

@Fiscus So a good few inches for you too. Imagine if you were an average size to begin with.

I think we massively ignore hormones to our detriment; not just in terms of weight, but behaviour too. Depression, anger, fatigue, motivation....I'm sure all of the emotions are much more locked up in hormones, than anything else.

https://letmegooglethat.com/

5'9" with a 22" waist? wow.

If endocrinology is the solution, then does that mean that people who never got fat in spite of no / almost no medication, had magically good endocrinology numbers? I'm struggling to buy that. The people I know age 60+ who are not fat are very conscious about daily getting what exercise they can do comfortably ... and portion control.

Friend almost 40yo, lovely person, struggles with obesity, openly owns that she just plain eats too much. No hormone blame required.

The vast majority of people with excess weight have it due to eating to much, the only solution is to eat less. You don't need a dr to tell you this. A combination of a better diet and less overall is the solution

My thyroid has failed. The only diet that works for me is tiny meals x2, no carbs, soup that’s it

It's estimated that approximately 12% of Americans have a thyroid disorder. That's 20 million people. It's not an insignificant number by any means.

And of course this is only one disorder that affects weight. There are countless others. And indeed medication often causes weight gain.

Interesting!

What's is the man's excuse? 😆

I’m 54 and have lost two and three quarter stone since July by cutting down on carbs.

It can be difficult to work out how little we need to eat particularly in relation to portion size.

I had polycystic ovaries, early menopause aged 40 & am currently on medication for nerve pain a side effect of which can be weight gain. I did put on weight until I started the 16/8 fasting plan of eating.

I lost a stone between October & December in 2022 and another half stone by Feb 2023. I do eat 'treats' from time to time but maintain the fasting 90% of the time otherwise I know that weight would just go back on.

If your thyroid medication levels and hormones levels are right you will not need to skip normal meals to maintain your weight. I do not skip meals now my medication levels are correct (i.e. not just what a lab test says but what my body shows me it needs)

There's also a theory that not eating in the morning is detrimental to your cortisol levels and puts the body into starvation mode (where it then down regulates your metabolism because it thinks there's a scarcity of food)

Cholesterol is high in people with hashimotos because the metabolism is often down regulated, there is inflammation (antibodies to your own thyroid tissue) and most importantly your body makes steroid hormones from your cholesterol, and isn't getting enough so raises it. The queen of hormones pregnenolone is made from your cholesterol, so aiming to get it low if you are not adequately treated isn't necessarily something to aim for in and of itself. Once adequately treated it should and often does come down naturally. In the past your cholesterol levels was one of the markers doctors measured to see how well your treatment was progressing. Sad to say that knowledge has disappeared with the development of thyroid lab testing, which is held up to the detriment of ongoing symptoms.

That said everyone has to do what they think is best. There's an ongoing debate about whether intermittent fasting for e.g. is helpful or not, some say it's helpful for inflammation some say no...cardio exercise is good or not etc etc etc...theres always controversy!

@lljkk, ya, I was very slender as a youth (up until I had babies l, I think I went up to a 24" waist post babies), and then I guess the body changes a bit, I was always broad shouldered and thin-hipped though.

There are certainly endocrinological reasons for weight gain in many people, it's not as simple as food in - food out.

I've always been pretty slender and there's nothing particularly exceptional or virtuous about my behaviour compared to my more sturdily built contemporaries, certainly height helps, but 50-odd years of observation tells me that there's more to weight than a very simple explanation

Carbs do cause insulin spikes or something like that, which causes weight gain. Hopefully somebody more knowledgeable can explain.

What's is the man's excuse?

Maybe decreasing testosterone?
But men can of course have some of the same endocrine problems as women - hypothyroidism, insulin resistance.

Oestrogen plays a key role in where fat is stored in women. When oestrogen levels start falling, fat is more likely to be stored around the middle than the hips. Plus, fat cells themselves produce small amounts of oestrogen.

Hormones play a small part. Reality is we are very lazy in modern society. A lot of women my age in the gym, weight training and cardio (I’m a boxer) and none of us are fat. 90% of it is diet and exercise levels. Sugar is in EVERYTHING and it makes you hungry. A few cubes of cheese when hungry may seem silly but it’s useable fats that satiate you. Instead we’re fed low fat shite rammed with carbs we can’t burn and we crave more. I think we need to take the sting out of the words “greedy” and “lazy” as it’s not the fault of the individual, it’s how society has been steered. Less downtime for exercise, more healthy food that’s designed to keep you eating, and no health care in place freely available to educate. Just my thoughts.

Furthermore, thick midsection is not the preserve of menopausal women given the high % of women who are overweight or obese pre menopause who have no waist either.

It's estimated that approximately 12% of Americans have a thyroid disorder.

Did people in 1920s-1950s America not get thyroid disorders, or much less often? Why were Americans much more slender then? Changing ethnic composition, maybe? But then why are the whitest Americans (flyover states) the biggest people on average?

Which lifestyle changes since 1950s led to more thyroid disorders in Americans? Do Mormons get more obesity than people in Colorado? Why are people in OK so much fatter than people in CO? DC is notoriously one of the poorest most deprived populations in USA, yet self-reported least fat.

Whilst the change in hormones due to the menopause is partly responsible for some weight gain and redistribution of fat, and some people have underactive thyroid or PCOS, for the majority their weight problem is down to the fact that they do very little/no proper exercise and they eat/drink too much. I'm pushing 60 and just outside a healthy BMI - something that has only happened with the menopause but I exercise 3 or 4 times a week and eat mostly healthy food. Many of my friends of the same/similar age are overweight/obese but do very little exercise and eat too many cakes/biscuits/fatty foods or drink far too much alcohol. So I doubt an endocrinologist could help them. They need to sort out the issues that cause them to eat too many calories and stop them from exercising.