What You Need to Know About Hypothyroidism and Weight Lossfreemixer – Getty Images
Losing weight takes dedication, patience, and a whole lot of discipline, but it can be especially difficult for people with hypothyroidism. Fortunately, there are expert-approved tips and tricks that can make losing weight with hypothyroidism more achievable.
Hypothyroidism is an autoimmune disorder in which the thyroid gland (located in the neck) doesn’t produce enough thyroid hormones, which are responsible for regulating metabolism, energy production, and other vital bodily functions, says Avantika Waring, MD, endocrinologist and chief medical officer of 9amHealth. Nearly five out of every 100 Americans ages 12 and older have hypothyroidism, and it’s most commonly diagnosed in women and people over age 60, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
The causes of hypothyroidism can vary, but it usually occurs when the immune system produces antibodies that attack the thyroid gland, ultimately resulting in thyroid dysfunction, says Andres Splenser, MD, an endocrinologist at Memorial Hermann. Common symptoms associated with low thyroid function can then include fatigue, sensitivity to cold, dry skin, hair loss, constipation, mental fogginess, menstrual irregularities and weight gain, he says.
But how can you lose weight with hypothyroidism? Below, experts offer tips to make losing weight less stressful and more manageable.
Meet the experts: Avantika Waring, MD, is an endocrinologist and chief medical officer at 9amHealth. Andres Splenser, MD, is an endocrinologist at Memorial Hermann and a clinical instructor at Baylor College of Medicine. Chelsea Stegman, RD, is a registered dietitian and founder of Chelsea Stegman Nutrition.
The Thyroid and Weight Gain Connection
“I often describe the thyroid as the key to your energy and metabolism, so when thyroid hormone production is low, it’s almost like you have one foot on the gas pedal and one on the brake,” says Chelsea Stegman, RD, a registered dietitian and founder of Chelsea Stegman Nutrition. As a result, your metabolism slows down, leading to fewer calories burned at rest and potential weight gain, she says.
Your thyroid hormones, triiodothyronine (T3) and thyroxine (T4), are also responsible for digestion and metabolism. The less T3 and T4 your body produces, the fewer calories your body burns for fuel, which can lead to weight gain, according to a study in the International Journal of General Medicine.
That said, significant weight gain is typically more common when thyroid hormone levels are low for an extended period of time, Dr. Waring says. The amount of weight gain also depends on the severity of hypothyroidism, genetics and environmental factors, Dr. Splenser says.
How to Lose Weight with Hypothyroidism
Here, experts offer practical weight loss tips, starting with lifestyle and diet changes you can implement right away.
Don’t be stingy with sleep.
Lack of sleep can cause you to gain weight because it disrupts your hunger and fullness hormones, Dr. Splenser says. As a result, sleep deprivation can lead to late-night snacking and poor food choices, ultimately increasing your daily calorie intake. When you’re sleep deprived, your body also tends to crave immediate energy in the form of carbohydrates, refined sugars, and caffeine, so do your best to get at least seven to eight hours of sleep each night, he says.
Keep stress under control.
It’s easier said than done, but stress can negatively impact your health by interfering with sleep and appetite regulation, so daily stress-management strategies like yoga, meditation and deep breathing exercises can help, Stegman says. Lowering your stress also lowers your cortisol levels (your stress hormone), and high cortisol levels can make weight loss harder, Dr. Waring says.
Make sure you eat enough.
It may sound counterintuitive, but eating enough calories throughout the day is the key to supporting thyroid function, preventing long-term malnutrition, and improving metabolic efficiency, Stegman says. Long-term calorie restriction can also slow your metabolism and change the way your hormones work, which is why you should never go below 1,200 calories per day in your weight-loss efforts. (That said, 1,200 calories per day is a minimum, and your required calorie intake is likely much higher!)
Your exact calorie needs depend on your age, gender, activity level, muscle mass, current weight, and the number of calories you burn at rest (also called your basal metabolic rate), so it’s best to work with a doctor or registered dietitian to find a calorie “sweet spot,” Stegman says. From there, a professional will help you determine the right calorie needs (including adequate protein, fat, and carbs) to support your thyroid, energy, and metabolism.
Eat more foods rich in antioxidants.
Hypothyroidism may be associated with increased oxidative stress (a physical condition that occurs when your antioxidant levels are low), and high oxidative stress has been linked to increased body weight, studies suggest. Luckily, adding more antioxidants to your diet can help reduce oxidative stress in the body, so it’s worth snacking on berries, green tea, leafy greens, turmeric, beets, and even a little dark chocolate, Stegman says.
Be aware of your selenium intake.
Selenium is not only a mineral needed for the production of thyroid hormones, but it’s also a powerful antioxidant that can help reduce inflammation in the body, Stegman says. A generally balanced diet can usually meet your daily selenium intake, but it’s worth adding salmon, chicken, turkey, tuna and Brazil nuts — which are high in selenium — to your weekly menu. The recommended daily intake of selenium is 55 micrograms (mcg) for adults ages 19 to 70, 60 mcg for pregnant women and 70 mcg for breastfeeding women, according to the National Institutes of Health (NIH). (Fun fact: Eating one Brazil nut a day can help you meet your daily requirement, as one nut contains 68 to 91 mcg.)
Think of a Mediterranean diet.
The Mediterranean diet consists of whole grains, nuts, seeds, fruits, vegetables, legumes and lean proteins like fish, chicken and seafood, making the diet plan a great potential weight-loss tool, says Dr. Splenser. Why? It emphasizes nutrient-dense foods that provide fiber to keep you feeling full, help regulate blood sugar levels and support gut health, all of which support a healthy metabolism, says Dr. Waring. Plus, eating fruits and vegetables and cutting out sugar and processed foods helps you stay full longer, which can reduce overeating.
The Mediterranean diet has also been associated with improved markers of glycemic control, including fasting glucose, insulin, and hemoglobin A1C (HbA1c), according to a 2021 review published in the Journal of Internal Medicine. And even without intentional calorie restriction, a diet rich in fruits, vegetables, and whole foods often results in reduced belly weight and weight loss, according to a 2022 study in the journal Nutrients.
Prioritize regular exercise.
Exercise boosts your metabolism and promotes weight loss by burning calories, so Dr. Waring recommends working out for at least 30 minutes a day. The type of exercise is up to you, but a mix of aerobic workouts (such as walking, swimming, or biking) and strength training can be a good idea, Dr. Waring says. Strength training, for example, has a significant impact on your metabolism and fat-burning ability, research shows. So doing resistance training at least three days a week can help you see results.
When should you see a doctor?
If you’re experiencing symptoms of hypothyroidism, such as fatigue, constipation, menstrual changes, sensitivity to cold, dry skin, hair loss and brain fog along with weight gain, it’s time to see a doctor, Dr. Splenser says. Then, they’ll order a simple blood test to check your thyroid hormone levels, perform a physical exam and ask questions about your symptoms, family history and medical history, he says.
If low thyroid levels are confirmed, hypothyroidism is treated by taking medication to replace the missing hormone, commonly known as thyroid hormone replacement, Dr. Waring says. The medication (levothyroxine) comes as an oral tablet, capsule, or liquid solution and is taken daily on an empty stomach, she says.
Unfortunately, there is no “cure” for hypothyroidism, but the condition can be successfully treated with thyroid hormone replacement, says Dr. Splenser. “Thyroid hormone replacement with medication can bring levels back to the normal range and allow patients to live healthy, happy lives.”
That said, starting a thyroid medication doesn’t necessarily mean you’ll suddenly lose weight. “Taking thyroid hormone alone — or overtreatment with thyroid replacement — is unlikely to result in weight loss without appropriate lifestyle changes,” Dr. Splenser says. In fact, too much thyroid hormone can have serious health consequences, including heart palpitations, anxiety, a higher risk of an irregular heartbeat (arrhythmia), weakening of the bones (osteopenia, or worsening osteoporosis), and even increased appetite in some people, he says.
The bottom line? Consult your doctor before making any major decisions and know that the solution is not the same for everyone.
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