Weight Loss Doctor: Hormones + Weight

May 15, 2024

Weight Loss Doctor: Hormones + Weight

Dr. Nicole Sundene, NMD

Female Hormone Specialist
"Why don't I lose weight since I turned forty? What is wrong with my hormones? I still have my period." Mindy, Scottsdale, AZ

Weight loss, especially for women, is a very complicated multifaceted hormonal and nutritional condition in my mind as a Naturopathic Hormone Doctor.  Women in their forties and fifties dealing with perimenopausal and menopausal weight gain definitely need a skilled Naturopathic Hormone Doctor.  

Battling weight gain, especially when you are doing everything right and the needle on the scale is not budging can be very stressful and stress ironically worsens weight gain. 

Sadly, many of my hormone imbalance patients are basically starving themselves on very few calories to maintain their weight because their metabolism simply does not work correctly. Especially when they have a thyroid condition or an autoimmune disease such as Rheumatoid Arthritis and Hashimoto's. We correct the metabolism, and they can eat food again in reasonable amounts. 

I am sure you would not be googling natural solutions to solve hormonal weight gain unless you were not getting lasting solutions to maintain your weight that actually worked as I describe in my story about “Why I Became a Naturopathic Doctor.” 

To quickly summarize the story, I was having depression, anxiety, acne, and stomach aches while gaining weight at 205 pounds on a hamster wheel chasing all my different annoying symptoms with prescription drugs and specialty visits. None of the prescription drugs helped me at all, and actually made me gain more weight, until I met a Naturopathic Doctor that fixed me. This is when the trajectory of my career permanently changed because I realized I did not want to go to school to be a pill pushing MD doctor, I wanted to go to school to provide natural lasting solutions that actually solved women's health challenges!

So, I do understand the frustration of not getting lasting solutions that work for weight loss and having to pay a high amount of money in doctor visits, labs, specialty visits, and prescription drugs. Some patients against my advice are maintaining their weight with expensive semaglutide shots (that I do not recommend.) Let's talk about instead what is healthy for your aging body when dealing with weight loss.

First, I would like to take a minute to explain how I help women actually lose weight for good in my Women’s Health and Hormone practice. What we want to do is achieve lasting solutions so that they do not have to rely on prescription drugs.

Here is what I want to do as your Naturopathic Hormone Doctor to fix your weight: 

#1 Why do you have weight gain in the first place? 

#2 What is the "Root Cause” of your weight gain? 

#3 Comprehensive Female Hormone Labs, Macronutrients, Cholesterol, Chem Panel, CBC, inflammatory markers, vitamins, minerals, macronutrients, etc

#4 Look at other health factors such as Diabetes, Insulin Resistance, Anemia, Hypothyroidism, Hashimotos, and other Hormone and Metabolic issues.

#5 Order Comprehensive Nutrition Testing to understand the right diet for your body specifically.  

#6 Implement my 4 week Vegan or 4 Week Meat- Naturopathic Meal Plans I recommend set at 1500 calories per day to create a gradual calorie deficit over a long period of time. While tedious, especially over 40, the studies show slow and steady weight loss is lasting permanent weight loss. As my patients learn new healthy recipes they enjoy eating, they naturally begin to feel better. Proper nutrition means less expensive supplements and medications!

#7 Make sure you are working out with a trainer that is helping you enforce my plan, and/or a counselor or therapist that is helping with any emotional issues making proper nutrition choices. Some of my patients need weekly appointments. Most need monthly at first.

#8 Continue to fine tune nutrition, and use herbal medicine, vitamins and supplements as well as natural hormones or “BHRT” and Armour Thyroid to help you feel your very best and most energetic.

Without understanding #1 and #2 on my list, I sadly have seen many of my hormonal weight loss patients fail over the years, so I write these blogs so my potential new patients understand if they will be a good fit for my women’s health practice or not. 

I want every single patient in my practice to be a success story. Please do treat yourself to a Naturopathic visit with me if you want want real answers, if you have an inquiring mind that wants to know, if you want the right nutrition for your body, want me to fix the underlying hormone imbalance that is most often causing your female hormonal weight gain then lets really do this! 

While I love helping women with weigh loss, and am a proud “Mother Hen” watching them transform, I also have been doing this job for over seventeen years as a Naturopathic Doctor, and twenty five years total in family medicine and have seen women fail to lose weight because these hormone challenged were never properly tested for and treated.

If the same hormone imbalance or nutritional challenges made every woman fat then we would all have the same pill for that, however I see a variety of different types of female hormone imbalance, thyroid, adrenal, insulin, and inflammatory aka autoimmune weight gain that are all completely different from each other, and required different approaches, different hormones, and different herbs and supplements. That is what is so uniquely amazing about women's health! Just like in my "Female Hormones and Anxiety" blog I talk about how we are somewhat like snowflakes with our mental health. While weight gain symptoms all look the same, the Root cause is not always the same!

So if my investigative Women’s Health Naturopathic Hormone process sounds like exactly what you need to feel like the absolute best version of yourself…. then please visit my SCHEDULE page and let’s get working on your weight loss program now!  

#1 question I am asked as a doctor is: "Why can't I lose weight?"

Weight loss programs that fail to address female hormones in women often fail women!

Oftentimes in Women's Health the "Root Cause" of weight gain is hormone imbalance. We need to first diagnose and treat the hormone imbalance as well as implement my basic Naturopathic hormone balancing weight loss program that is 100% free for women to start below.

One thing that always brings me joy as a Naturopathic Hormone Doctor is helping women identify the specific weaknesses in their hormones and metabolism so we can target the exact nutrition program, macros, and hormone balancing supplements to aid weight loss.

Getting to see women transform to their fittest most beautiful version of themselves is such an amazing reward for doing this job! I often receive new patient referrals from my weight loss success stories as their friends and family have always seen them challenged by being overweight and suddenly like magic change right before their eyes.

The truth though is that it is not magic... it is hormone balancing with a splash of hard work.

When we don't understand women's complex female hormones, thyroid, and adrenal profile, expecting weight loss to happen is somewhat like vacuuming in the dark. While vacuuming in the dark will be somewhat helpful, we are missing things, it is inefficient, time consuming, lacks results, and is frustrating. Vacuuming just like hormone balancing becomes a lot easier when we "flip the lights on" and know exactly the obstacles we are dealing with as well as the areas of greatest concern!

By running a full panel of Naturopathic Hormone Labs women can target their nutrition to their own metabolism and understand exactly what ratio of fats, protein, and carbs will works the best for their specific constitution.

This is when I see "the lights come on" for my hormone weight loss patients and everything becomes much easier and efficient. Hacking macros and hormones with labs makes everything so much easier and my women are no longer "bumbling around in the dark" lacking a clear direction of how to best target their efforts.

Bumbling around in the dark is oftentimes why women fail with their weight loss program because they are busy trying different fad diets, and not gathering the specific information that helps optimize their personal metabolic challenges.

Naturopathy can work very well for weight loss when we can take the time to analyze nutrition, metabolism, hormones, and vitamins that can impact weight.

Female hormones are complex and precisely why weight loss for women can be very tricky when complex hormone imbalance is present. To further confuse matters, women experience hormone imbalance and constantly fluctuating hormones every month with PMS. As well as in their forties and fifties with perimenopause and menopause. Therefore it is important we rule out hormonal causes of weight gain with women first and foremost as this is impacting women monthly, and also in midlife when perimenopausal weight gain begins around forty.

When women cannot lose weight with diet and exercise I recommend we conduct hormone and macronutrient testing to determine the correct macro profile of carbs, fats, protein, and fiber needed. Looking at a full set of female hormones, thyroid, and adrenal tests can diagnose the particular hormone imbalance or imbalances impeding the metabolism.

#2 Question I am asked as a Naturopathic Doctor: "Is my thyroid making me fat?"

As a thyroid specialist, I often see thyroid disease causing weight gain, and weight loss, but in women we MUST address all of the other hormones in the "hormone spider web" for a woman to feel properly balanced, healthy, and fit.

If we have a weakness in one part of the web it will impact the stability of the rest of the web.

The impact of estrogen deficiency that suddenly occurs in Menopause, can impact the rest of the hormone web and cause weakness in the thyroid, which is why it is imperative for women to have their thyroids checked when they are perimenopausal and menopausal in their forties and fifties. Some women will naturally start perimenopause earlier in their thirties.

The average age of menopause is 51, and perimenopause generally starts the ten years prior to menopause. Women that enter menopause at 45 will generally exhibit signs of hormone imbalance earlier, in their thirties. Premature Ovarian Failure occurs when women become menopausal sooner than age forty. POF is common in women with anorexia and low body fat as body fat levels directly increase estrogen levels whether too much body fat or not enough.

Menopause can also impact the adrenal glands in our spider web model. When the ovaries cease to produce estrogen, progesterone and testosterone, the adrenal glands become the sole source of hormone production. The hormones DHEA, and cortisol can begin to become deficient in menopause or sooner if there is "Chronic Stress."

Symptoms of adrenal fatigue can cause insomnia, joint pain, stiffness, moodiness, anxiety, depression, and a general blah unmotivated feeling where my patient has become flat and lost their zest for life.

The adrenals and the thyroid also interact with each other and when the adrenals become fatigued and cease to produce hormones that can impact the thyroid gland and tax it further. And vice versa. This is what is going on behind the scenes with many of my weight gain patient's labs.

It is not just always about the Thyroid! We must address our entire "Metabolic Web of Hormones" as I explain in my video about "Hormones and Metabolism" on my free class page.

Hypothyroidism, Hashimoto's, Insulin Resistance, and Adrenal Fatigue can also cause women to gain weight.

#3 Will testosterone help me lose weight?

Testosterone deficiency occurs for most women around the age of 35, this is why our metabolisms slow down when we lose our lean muscle mass with menopause. Each year our metabolism goes down further as we lose our female hormones. Transitioning through perimenopause and menopause also causes the body to become more inflamed and Insulin Resistant. Insulin is the "Weight Gain Hormone," that causes women to gain weight despite following the same diet and exercise regime in their 20's.

"I am doing everything the same, I am not cheating." I commonly hear women complain as they continue to gain weight and cannot figure out why. Most women that are over-weight have insulin resistance and need supplements to address and correct this blood sugar disorder that is common in women with PCOS.

Sluggish liver can also impact the metabolism, as can inflammation from Food Sensitivities and Food Allergies.

Chronic Fatigue and Chronic Pain can cause women to exercise less resulting in less calories burned on the same diet.

The good news is that by addressing female hormone imbalance, and implementing the following Naturopathic weight loss program I will review today, I do see many cases of stubborn hormonal weight gain finally release!

Usually I treat the hormone imbalance with herbs and supplements. Herbal medicine takes time to work, most women only can lose one pound per week and need to be patient. If you have fifty pounds to lose as a woman, that is a year of hard work you need to mentally commit to doing for long term success to keep the weight off.

With menopause, generally Bioidentical Hormones are needed to reduce the inflammation spike causing weight gain. Women under fifty generally do not need hormones and instead have weight gain issues from excessive amounts of hormones as I discuss more in my "Estrogen Dominance" blog. Much of what I do for women and weight loss does involve making dietary changes and taking supplements.

In order to lose weight, one must follow the basic laws of physiology that you must consume fewer calories than you burn each day. This is especially important to follow if you have a thyroid condition, insulin resistance, or estrogen dominance! Expecting your twenty year old metabolism to burn a ton of calories is not realistic without first fine tuning your hormones and then creating a calorie deficit every day.

You must burn more calories from exercise than you consume. If you are inactive and not exercising this is why it is impossible to lose weight especially when lack of exercise is compounded by hormone imbalance.

Addressing the underlying causes behind poor eating and lifestyle habits with regular weekly counseling is the ONLY way to ensure a healthy and long-term approach to weight loss. Food should be fuel and not a treat. The treat is feeling and looking good from perfect fueling!

I know this very well based on how I used to look and feel before I went to Naturopathic school and how I look and feel now. Many people say I look better today than I did in college! That is because I am on the right fuel for my metabolism and hormones!

Eating wrong and not properly fueling your body is the hard way after living both options!

The best approach to weight loss emphasizes lifestyle changes that incorporate whole foods and activity. Many simple sustainable Naturopathic changes in diet and activity can lead to maintainable, long-term weight loss success.

Physical activity guidelines are recommended to complement the nutrition counseling and make this process easier and more productive.

If you are struggling with Seasonal Depression, or post holiday exhaustion it is imperative you get outside for an hour to get 10,000 lux of natural light every day to ensure your energy, metabolism and mood are optimal for weight loss. Especially for women that crave carbs! Lack of light puts us in a fatigued dormant state that is not conducive to fat burning.

Many of my weight loss patients have underlying mental health issues such as depression, anxiety, and PTSD and are using food for comfort instead of fuel. This can create a vicious mental health loop when choices for emotional reasons are worsening physical health, appearance, and self confidence which then drives more unhealthy food choices as "rewards."

Patients constantly seek instant gratification for emotional reasons to treat their poor mood. These poor fuel choices then cause them to feel more fatigued, lethargic, hopeless and depressed.

Depression, sadness, hopelessness and anger trigger more unhealthy food reward behavior and the vicious cycle continues as a woman continues to gain more and more weight.

By using Naturopathy and hormone balancing we can also treat these underlying mental health issues naturally and work to use new rewards such as jewelry, makeup, concerts, events, and fun trips rather than cookies, cake, and candy.

The interesting thing about women's health is that each woman generally has different hormonal metabolic challenges to address. It is not a one sized fit all program, although I generally need my patients following the basics below.

Please do not sign up for hormone balancing work with me if you are not willing to make at least some baby step changes with your diet. Occasionally I get new patients that seem to think all their problems will be fixed with popping a hormone or applying a cream. This is not realistic and we are working to balance the hormones so your metabolism is running optimally and you are receiving benefits from your efforts with diet and exercise.

Hormone testing is important in women's health since many women with hormone imbalance are starving themselves to death to compensate for their sluggish metabolism. Sadly, I see this happening often, and is why I am writing this blog so women know there is a better way than living on 800 calories a day in starvation!

Once I diagnose the metabolic problem and fine tune their hormones they are then able to eat a normal amount of food each day without gaining weight.

While each woman's metabolism is unique like a snowflake and will require labs to develop a custom tailored dietary macro program, I would like to share the basics for hormone balancing that generally work for most women with hormone imbalance.

#4 What is the best diet to support imbalanced female hormones in weight loss?

The best diet for balanced hormones and weight loss is:

• HIGH in fiber-dense carbohydrates found in whole grains, beans, fresh fruits, and vegetables. Also, it is important to drink plenty of water= 60-80oz daily + 8 oz per "vice" of alcohol or caffeine and more water if you are exercising.

 MODERATE in fish and organic lean meats such as chicken and turkey.

 LOW in red meat, animal fats, hydrogenated oils, full-fat dairy products, pre-packaged, processed, and refined foods, sugar, alcohol, and caffeine.

General Tips
• Set a realistic weight loss goal, usually 1 to 2 pounds per week is recommended.
• Balance food intake with activity. The most successful weight loss programs combine increased activity with decreased caloric intake.

Tips to Increase the Amount of Physical Activity in a Day:
• Try some group activity classes at the local gym, fitness center, or swimming pool.
• Work out with family, friends, or neighbors. Motivation is increased with partners.
• Take a walk at lunchtime.
• Use a bike to run local errands and go for pleasure rides.
• Use the stairs instead of the elevator.
• Walk to the bus stop or work
• Park the car a few blocks away and walk.
• Dance to some favorite music at home or sign-up for a series of classes.

Tips to Reduce the Quantity of Food Eaten:
• Plan and prepare meals ahead of time.
• Identify foods that are often over consumed and set limits, or avoid.
• Identify and limit problem foods.
• Eat small, frequent meals and healthful snacks.
• Eat slowly and savor each mouthful. Allow 20-30 minutes for each meal, rest, set the fork down, and/or converse between bites. Chew the food well.
• Wait 10-15 minutes before taking a second helping.
• Serve food on a smaller plate.
• Drink two glasses of water or a cup of hot tea 30 minutes before meals to reduce appetite.
• Postpone a desired snack for at least 10 minutes. It may be helpful to take a walk, get some fresh air, drink a cup of water or tea, or take a short nap during this time.
• At restaurants eat half of the portion and take the rest home. Prepackage the food to go before starting the meal.
• Nurture with nonfood related activities, such as a hot bubble bath or a massage, developing a hobby, relaxing with a good book, or listening to some music.

WHAT DO I DO IF MY PROBLEM WITH WEIGHT LOSS IS BINGE EATING?

Tips to Eliminate Eating Cues that Promote Overeating:
• Designate a specific place in the home to eat, preferably the kitchen or dining room. Eat snacks and meals only when sitting down at this place.
• Avoid watching TV, talking on the phone, reading, or driving while eating. This will help increase the awareness of fullness.
• Do the grocery shopping on a full stomach to decrease impulse buys.
• Create a schedule for eating. Plan meals and snacks at regular intervals, including the types of food to be eaten.
• Carry food to work or when going out, to eliminate long periods without eating.
• To prevent visual food distractions, keep all food stored in the kitchen cupboards or refrigerator, rather than out on the counter.
• Read or listen to motivational books, join a support group, or consider seeing a therapist to help with any emotional issues involving food, eating, and/or weight loss.

Diet, activity, and emotional work can provide feelings of health and wellness, which establish new patterns that support and nurture the body. Food should be eaten for fuel and not just for fun.

When we are on the best fuel we have the best energy and mental health.

Think well! Eat well! Be well! Let's get to work ladies!

If you need my help diagnosing and treating your personal hormone imbalance to determine your personalized weight loss plan, I would be happy to help!

Simply visit my SCHEDULE page to treat yourself to a Naturopathic hormone visit in my Scottsdale clinic or by telemedicine!

Dr. Nicole Sundene

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is a Female Hormone Expert in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause,  Thyroid,  Hashimotos,  PMS, PerimenopauseAutoimmunePostpartumChronic Fatigue, DepressionAnxiety, Food Allergies,  DigestionDermatology, AcnePsoriasis Eczema, and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 23 years of experience in both Prescription and Natural women's health and hormones, she presents to women the best-integrated health solutions for their Chronic Disease. 

She has been an Herbalist for over 28 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan (not Medicaid) and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on InstagramTwitter, and Facebook for more tips on Women's Health, Female Hormones, and Naturopathy!

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