Weight that will not move
Eating less and moving more, for months, with nothing to show for it. Usually that is not a failure of will — it is a metabolism that has adjusted.
Almost everyone arriving about weight has already tried. Usually several times, sometimes for years, occasionally with real success followed by everything returning. By the time they sit down they are more or less convinced the problem is their own discipline.
That is rarely what the assessment finds.
What is usually going on underneath
- Insulin resistance — with insulin high, releasing stored fat is physically harder
- An underactive thyroid, sometimes never properly tested
- Sleep that is short or broken, which shifts appetite hormones within days
- Sustained stress and the appetite pattern that comes with it
- Medicines that promote weight gain — some steroids, some antidepressants, some diabetes drugs
- A metabolic rate adapted downwards by repeated cycles of severe restriction
Every one of these is measurable or askable. None is addressed by being told to try harder, which is the advice most people have already received.
The shortcut question
Injections for weight loss are now widely available here, including through channels that involve no examination whatsoever. They are real medicines with real effects and real side effects, and they belong with a physician who has assessed you.
The more important question is what happens when they stop. If the insulin resistance, the sleep, the eating pattern and the stress are all unchanged, the weight has somewhere to return to.
What is measured here
Waist as well as weight, because where it sits matters more than what it totals. Fasting glucose and, where indicated, fasting insulin. Thyroid function. A lipid profile. Liver enzymes. And three honest days of intake — not three careful ones, because a careful record describes a week you do not actually live.
Weight loss that happens without trying is a different matter entirely and should be investigated rather than welcomed. Unexplained loss, particularly with appetite change or fatigue, needs assessment.
Questions people ask
- Why am I not losing weight despite eating less?
- Several reasons are common and none of them is laziness: insulin resistance making fat harder to release, an underactive thyroid, poor sleep, sustained stress, medicines that promote weight gain, and a metabolic rate that has adapted downward after repeated restriction. Which applies to you is a question for measurement rather than guesswork.
- Are weight-loss injections safe?
- They are genuine medicines with genuine effects and genuine side effects, and they belong with a physician who has assessed you, not bought informally. The wider question is what happens afterwards: if nothing underneath has changed, the weight generally returns.
- What should I bring to a weight consultation?
- Three honest days of what you actually eat and drink, your weight history over the years, thyroid and fasting glucose results if you have them, and every medicine you take — several common prescriptions make weight loss considerably harder.