Weight loss resistance
Doing everything right and getting nothing back is a physiological finding rather than a character one, and every part of it is measurable.
A caloric deficit is necessary and not sufficient. Insulin resistance limits fat mobilization. Impaired thyroid conversion lowers expenditure. Elevated cortisol drives retention and visceral storage. Low lean mass shrinks the base rate. Poor sleep degrades all four. Which is why identical effort produces very different outcomes in different people.
Hyperinsulinemia. Impaired T4 to T3 conversion, often with a normal TSH. Sustained cortisol elevation from workload, undersleeping or excessive training. Low testosterone in men, PCOS or perimenopausal change in women. Chronic underconsumption of protein. Muscle lost to years of dieting without resistance training — itself a risk factor for the next attempt failing.
Whatever assessment identifies, in order of impact. Insulin sensitivity restored through carbohydrate timing, protein intake and resistance training before any deficit is deepened. Thyroid and hormone correction where indicated. Cortisol and sleep addressed rather than trained through. Medication where the markers support it, never as the whole plan.
Fasting insulin and HOMA-IR. Complete thyroid function including free T3 and reverse T3. Cortisol rhythm. Full sex hormone status. hs-CRP. Ferritin and vitamin D. And body composition rather than weight alone, since lean mass is the variable that determines what happens next.
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