Weight Loss - When Diet and Exercise Just Aren't Cutting It

Weight Loss - When Diet and Exercise Just Aren't Cutting It

By Quilla Watt, Integrative Naturopath


The secret to a healthy body weight is as simple as making “calories in” equal to “calories out”, right?

And for weight loss, just eat less, exercise more, and you’ll see those kilos drop away. Right? Well… No. Not always. What about those people who constantly eat healthy, follow a rigorous exercise regime, and struggle to see any results?

We like to view weight loss through a much wider lens than the old “eat less, exercise more” view. While diet and exercise are essential, we also look at key players like thyroid function, stress levels, gut microbiome, and a little hormone called leptin.

But first, let’s start with a little disclaimer. When we talk about healthy body weight, we’re not talking about the zero-body-fat-with-a-six-pack fitspo idea of “healthy”. We’re talking about falling in the healthy BMI range of 18.5 to 24.9, and having a healthy waist circumference (less than 94cm in men, and less than 80cm in women). Orthorexia, which is obsessive behaviour around “clean” or “healthy” eating, is an emerging form of disordered eating, and one we need to be mindful of. When it comes to diet and weight loss, we need to practice moderation, not restriction.

Ok, now onto those key players we mentioned earlier…



Your thyroid is a little like the accelerator on your car. It helps determine how fast your metabolism runs. When it comes to difficulty losing weight, we check for hypothyroidism. With an underactive thyroid, you take your foot off the accelerator, your metabolism slows, and you don’t burn through fuel the way you should. Autoimmune hypothyroidism, called Hashimoto Thyroiditis, is the most common cause of hypothyroidism in Australia. To make thyroid hormone, you also need adequate iron, iodine, selenium, zinc, and protein intake. We can check for hypothyroidism, and work to optimise thyroid function by making sure your body has the building blocks it needs to make thyroid hormone.


Stress, cortisol, and insulin

We all know when we’re stressed, when life is just flat out, we sacrifice our self-care. Less exercise, less mindful eating, relying on takeaway, and grabbing sugary snacks on the run. It’s not hard to see how stress can lead to weight gain, and difficulty with weight loss.

But the story is a little bigger than that, and we take a deeper approach by also looking at the hormonal effects of stress. When we are stressed, our hypothalamic-pituitary-adrenal axis (HPA axis) gets activated. We release cortisol from our adrenal glands. And cortisol is a fantastic hormone. Without it, we would have zero ability to deal with stress. The down side is that when we are under chronic stress, our HPA axis goes haywire, and we pump out way too much cortisol. Chronically high cortisol can be accompanied by increased insulin. Together, cortisol and insulin tell our body to store more fat, and burn less. Not a great combo for weight loss.


Leptin resistance

Leptin is your “satiety hormone”. It is released by your fat cells. Leptin tells the brain that you have plenty of fat stores, you are full, and you don’t need to eat any more. Leptin sounds great, right?

The problem is, your body can become leptin resistant. Leptin resistance is a key player in weight gain and difficulty losing weight. In fact, leptin resistance is now believed to be THE main issue in obesity.

So what’s happening in leptin resistance? Your fat cells produce more and more leptin, but your brain does not listen. Your brain doesn’t register the high leptin levels, and mistakenly thinks your body is starving. So your brain goes into survival mode, and tells the body to eat more, and hold on to fat stores.

How you do you know if you have leptin resistance? If you are always hungry, and carry fat around your middle, it’s likely you have some degree of leptin resistance, and we can do a blood test to confirm it. To reverse leptin resistance, we need to look at diet, exercise, inflammation, sleep hygiene, and stress (there’s that high cortisol again!).



There has been an explosion of interest in the microbiome (those bugs in your gut) in the past decade. With all this research, we’re beginning to understand the impact these bugs have on our immune function, our mood, and our weight.

Our gut bacteria can alter how much energy we gain from our food, the way we store fat, and how much insulin we release in response to glucose.

Where the gut microbiome is concerned, diversity is key. Lean people tend to have a huge diversity of species in their microbiome, while obese people tend to have far fewer. Diet, including prebiotic and probiotic foods, is key to developing and maintaining that diversity.


Weight loss is so much more than diet, exercise, and white-knuckle willpower. If you’re struggling with it, you’re not alone. And if you want to address some of those key players we’ve mentioned, please get in touch.