A Q&A with Dr. Sara Gottfried
Sometimes diet and efforts at the gym just don’t pay off on the scale—do you believe that weight loss comes down to one calorie in, one calorie out?
Ah, I’ve totally been there, feeling like nothing works. I struggled with weight loss after the birth of my daughters. At age thirty-eight, I went to my doctor, who smugly told me that weight loss is just a case of simple math—that all it takes is to “eat less and exercise more.” At first I was humiliated, but then I got angry, as I considered that millions of women are made to feel bad by this common misperception, i.e., that they just need more self-control when it comes to weight loss. Which is totally wrong.
I left his office and went to the lab to test my hormones myself, thinking that they were off. I was stunned, though, to find that my cortisol, the main stress hormone, was three times what it should be: Cortisol causes belly fat deposits, PMS, and a short fuse. My insulin was too high, which made my blood sugar high (insulin wasn’t doing its main job, which is driving glucose into cells). My leptin was blocked too, causing me to be ravenous. My thyroid was borderline slow, leading to hair loss and fluid retention. The list went on.
So the solution was to fix my hormones—and when I did, something awesome happened: I not only lost weight more easily, my mood improved. I was more generous and patient with my kids. I wanted to go to yoga at night instead of the wine bar. I graduated from couple’s therapy! I connected again to my essential nature of joy. My daily outlook was no longer determined by the bathroom scale and my battle of the bulge; I had more energy for bigger things.
“I discovered that the calorie-in/calorie-out hypothesis has been widely disproven and remains the greatest misconception people have about diet and weight loss. Calories matter, more to some people than others, but hormones matter more.”
After digging into the research, I learned that 99 percent of weight loss resistance is hormonal. I discovered that the calorie-in/calorie-out hypothesis has been widely disproven and remains the greatest misconception people have about diet and weight loss. Calories matter, more to some people than others, but hormones matter more. Almost anyone who struggles with weight also battles a hormone imbalance. It amazes me how easy weight loss becomes once hormones are back in their sweet spot. Hormones control how efficiently a calorie makes you fat.
Most diets don’t work for women, because they fail to address the hormonal root causes that are the most common reasons for weight loss resistance, like excess cortisol, insulin and/or leptin blockage, estrogen dominance, a sluggish thyroid, low testosterone, and problems with the HPA (hypothalamic–pituitary–adrenal) control system. I struggled with every single one of these hormonal misfires, and learned through trial and error how to fix them rapidly with functional medicine: I developed a three-step protocol, starting first with lifestyle redesign and filling nutrient deficiencies (step 1), administering herbal therapies if symptoms don’t resolve (step 2), and finally adding bioidentical hormones if imbalances still exist (step 3), but in the lowest doses and for the shortest duration possible.
Overhead Squats (Front Squats scale) 115/80
RX plus: 225/155 DL and 160/110 for OHS