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Avatar universal

No results from diet and exercise?

My stats:
- 37M, Caucasian, 183 cm (6'), 83 kg (183 lbs), 30% body fat (bf), I live in the UK
- No smoking, no drugs, rarely alcohol, decent diet
- Medication history: nothing since 11th May. Before that - in August 2017 I started taking Aripiprazole, which induced severe depression. I stopped taking it after 3 months and got prescribed antidepressants (Sertraline) and Sulpiride. Stopped taking Sertraline in September 2019. I was also tapering off Sulpiride (from 200mg) since January 2021 and stopped taking it on 11th May.

The problem:
I have 0 results from exercise and diet, i.e. I can't lose any fat. My weight and body composition stays the same regardless if I diligently exercise and watch my diet or sit all day (I work from home) and eat anything. It has been like that for the past 2 years, since I started taking Sulpiride/Sertraline. Before that I was naturally skinny - 63 kg (140 lbs) and around 14% bf. I started lifting and got to 81 kg (178 lbs) and 18% bf. My body always responded to exercise/diet immediately, I could burn fat or build muscle at will by simply eating more/less calories. Then I had to stop because of an injury and started taking the meds. Since then, I'm 30% bf and NOTHING works. Only if I starve myself (eat less than 1400 kcal) I'll lose a bit of weight, but my bf stays the same and the weight immediately comes back once I start eating a bit more (still less than 2000 kcal though).

What I do:
- Exercise: weightlifting (30min, 3 times a week), fast cycling (30min, 1-2 times a week), brisk walking (45min, at least 3 times a week)
- Diet: around 1500-1600 kcal, 120-150g protein a day. No sugar, fast/preprocessed food, ready meals, etc. Everything I eat is weighted and logged in an app

Tests I did:
- General blood tests
- Liver function tests
- Urea and electrolytes
- Lipids/cholesterol
- Full testosterone profile
- Full thyroid profile
- Full iron profile
- Prolactin
- Vitamin D
- Fasting glucose
- HBA1C

All came back normal apart from cholesterol which was a bit too high. My testosterone used to be quite low (total test: 9 nmol/L [7.9 - 31.3]) and prolactin high (1200 mU/L [45.0 - 375.0]) on Sulpiride so I thought that was the reason for my problems, but now I stopped taking it it's back to normal (total test: 22.94 nmol/L, free test: 0.4529 nmol/L, SHBG: 35 nmol/L, Free Androgen Index: 65.5:1 ratio).

Any ideas what might be wrong? Is there anything else I can test? Cortisol, maybe?

Sorry for the long post, but I'm at my wits end. My doctor just ignores the problem ("you got old"). Thank you for reading.
2 Responses
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649848 tn?1534633700
COMMUNITY LEADER
You said you had a “full thyroid panel” - what tests did that panel include?  You should have Free T4, Free T3 and TSH, at the very least.   It’s important to point out that “normal” test results might not be normal for your body.  I’d be interested in seeing actual results, with reference ranges.

Hypothyroidism and insulin resistance are 2 things that can really make losing weight difficult no matter what you try - trust me, been there, done that and still trying!!   I almost have to starve (way less than 1000 calories/day) in order to lose anything and then I’m lucky if it’s a couple of tenths of a pound.  Frustrating.  

I don’t disagree that the medications you took may have caused the initial gain, but we have to look at a variety of angles.  I took gabapentin for a while for neuropathy and it caused me to gain quite a bit of weight.  It seemed like I was never going to be able to lose it - part of the reason is that I also have hypothyroidism and insulin resistance.
Helpful - 0
4 Comments
Hi, thank you for responding. Sorry to hear about your problems, it does sound frustrating. Can't imagine surviving on less than 1000 kcal/day...It's already a challenge for me to live on 1600 kcal. I posted my thyroid results here as 2 screenshots if you'd like to take a look:

https://ibb.co/QDVwQhy
https://ibb.co/CvHty5r

It says they're "normal", but as you said maybe it's misleading. If that's the case, how can I rule out thyroid or insuline resistance problems? I did keto diet for 5 weeks to see if I'll get any positive reaction from it, but had to stop because of other health reasons. Didn't see any difference thought. Are there any other tests you'd recommend doing? Thanks again!
Just realized the links I posted are not "clickable", sorry I've just started using this forum and don't know yet how it works. They should work if you just copy-paste them into the address bar though :)
Hi - your thyroid levels look "okay", though I disagree that your FT3 is optimal.   Most of us feel better with FT3 levels in the upper third of its range.  Also, your TSH is leaning toward the high side.  I couldn't see a date on the reports but I'd check it periodically, if I were you.  The Antibody tests indicate negative or Hashimoto's, but that's not always correct either as Hashimoto's can be diagnosed without antibodies.   For the meantime, though, we'll just say thyroid is good.

To check for insulin resistance, you'd need glucose tests - Hemoglobin A1c, glucose tolerance and fasting glucose, along with insulin levels, but at this point, I'm not convinced it would be a lot of benefit unless you have symptoms that indicate a problem.

All things considered, I'd agree that the medications you were taking could be a likely cause for weight gain.  I'd think that once out of your system, they wouldn't have so much effect, but I'm definitely not an expert with antidepressants, etc and I do know that some of them can have lasting effects.

If you're eating lots of veggies, lean meats, fish, etc there isn't much more you can do, though what we eat is just as important as how many calories.  You can eat lots of fish and even though the fish that are best for us have a lot of fat, we can still lose weight.  

I love fish and if I eat it a couple times or more/week, I do lose some weight.  My problem is that my husband hates the smell of fish, so I don't cook it at home and it's hard to find good fish in restaurants that isn't deep fried or something.   I'd suggest that you do some research on the Mediterranean Diet - it's the one that most doctors recommend as it incorporates lots of fish and veggies.  
Thanks for taking a look at my results. I do check my throid and glucose/HBA1C regularly as you suggested, so if it gets abnormal I'll hopefully find out quickly. I'm getting a few other tests done soon, so maybe they'll show something. For now I'll try sticking to healthy diet and hope my body goes back to normal with time. Fortunately my wife loves fish so it's baked salmon at least once a week, lucky me! Thanks again and all the best.
Avatar universal
If you're 37, you're a young man, so no, you didn't get old.  Also, getting old doesn't change the mechanics of weight.  Even old people lose weight if they increase energy output and decrease intake of the wrong foods.  The Zoloft is a big weight gainer for a lot of people, but it usually goes away pretty fast when you stop taking it.  There is a problem with putting on muscle, and that is, if you stop resistance training it can sag and turn into fat.  But it doesn't do that if you keep exercising or if you eat a healthy diet.  You don't really say what you eat, so there's no way of knowing.  Eating a lot of protein doesn't tell us anything -- that works for awhile for some but it isn't healthy to eat too much protein for too long for many folks.  I'm guessing the meds did this, but what is going on I have no idea.  How long have you been on your new exercise and eating program?  Sometimes it takes awhile, and what is true is that when you get older it can go more slowly.  I will say that your workouts are pretty short.  You can't really do a lot of weight training in 30 minutes, especially considering you have to rest in between sets and move around to use more equipment.  But starting at zero and doing anything should result in pretty immediate results no matter how little you do.  So no idea what's going on.
Helpful - 0
1 Comments
Thanks for taking the time to respond. I'm a bit relieved I'm not the only one perplexed by this... Yes, as you pointed out my concern is that usually when you start working out and eating sensibly you get results quite quickly. To answer your question, I've been working out for the past 4 months and still weight and look exactly the same as when I was just sitting all day and drinking beer. I agree that 30 min lifting is not a lot, but as you said it's still 90 min lifting and 165-285 min cardio a week, compared to doing absolutely nothing, so I'd expect at least some results. I mentioned protein because I wanted to show that I'm eating enough to build muscle. The diet I have is nothing special, just avoiding things I mentioned and trying to eat lots of veggies, lean meats, fish, eggs, etc. It's not super restrictive (although I did try keto at some point), but it always worked for me in the past. It also works for my wife - we're eating the same stuff, even the same amounts, exercise at the same time, and her weight and body fat is dropping every week, while mine stays the same. I'm getting worried, she's already out of my league ;-) Anyway, thanks again for responding, I ordered some more blood tests today (mostly estrogen, progesterone and cortisol), so maybe this will give me some idea what might be wrong.

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