You eat well, exercise, yet your weight keeps climbing. As dietician Susie Burrell explains, it could be due to a hormone problem.
Sally was a slim kid and she remained thin throughout her 20s and 30s. By the time she'd hit her mid-40s, however, things had changed.
By this age, Sally was performing a supreme juggle. There were three children to take care of and a demanding full-time job.
Despite regular trips to the gym and following a healthy, low-fat diet, the scales showed a weight gain of 15kg.
No diet or exercise program seemed to be able to help Sally lose weight. In fact, the more she exercised, the more she seemed to weigh and she was tired, bloated and craving sugar.
I took one look at her and knew straight away — here was a client with insulin resistance.
Insulin resistance is a clinical condition in which insulin, the hormone secreted by the pancreas to control blood glucose levels in the body, is no longer working as efficiently as it should.
Over time, numerous factors, including a diet high in processed carbohydrates, a relatively inactive lifestyle and often genetics, affect insulin, which becomes less and less efficient at processing the glucose we consume in carbohydrate-based foods such as bread, cereals, fruit and sugars.
When insulin is not working properly, the body is forced to produce more insulin to process the same amount of glucose that we consume in food, to fuel the muscles and the brain.
The unfortunate thing when it comes to weight control is that the higher the amount of insulin you have circulating in your body, the harder it becomes to burn fat.
This means that if you have insulin resistance, you can be eating an extremely healthy diet and exercise regimen, but still be physically unable to lose weight.
In fact, as insulin is the central regulator of both glucose and fat metabolism in the body, when it is not working, the basic energy balance equation for weight loss (calories in versus calories out) simply does not hold true.
The situation Sally was facing — getting older, dealing with hormonal fluctuations and an inactive job, combined with a high-carbohydrate, low-fat diet, were likely to result in a further 10kg-20kg weight gain over 10 to 20 years.
Worse, if left unmanaged, insulin resistance will ultimately lead to Type 2 diabetes.
The good news is that if diagnosed early, insulin resistance can not only be managed, but even reversed with the right mix of diet and exercise training.
The body may show signs of insulin resistance in a number of ways. As resistance builds up over many months, if not years, these signs and symptoms can be subtle before becoming more noticeable.
Fatigue is common as glucose is not being taken to the cells as efficiently as it should be. Sugar cravings are common, too, as insulin and glucose levels fluctuate wildly during the day.
Perhaps the most powerful sign that insulin resistance may be present is in the way fat is deposited on the body.
Insulin likes to deposit fat around the abdominal area, which is why women (and men) with severe insulin resistance have a large belly and the reason a waist measurement greater than 80cm for a female may be a sign that insulin resistance is present.
If you are experiencing any of the symptoms of insulin resistance and find that you are constantly struggling with your weight, the best thing you can do is visit your GP or endocrinologist and have a glucose tolerance test to identify if insulin resistance is present.