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If you have hypothyroidism, you might deal with daily symptoms like nausea, fatigue, weight gain, constipation, feeling cold, and depression.

While the symptoms that accompany hypothyroidism (an underactive thyroid), can disrupt several parts of your life, weight gain seems to be one area that causes significant distress and frustration.

When your thyroid is underactive, your metabolism slows down, which can lead to weight gain.

Hypothyroidism is typically diagnosed in adulthood, but many people will tell you they remember struggling with their weight and other symptoms for years.

Hypothyroidism becomes more pronounced with age and is far more common in women than men. In fact, 20 percent of women in the United States will develop the condition by age 60.

Healthline talked to three women with hypothyroidism about weight gain, how they’ve accepted their bodies, and the lifestyle changes they’ve made to manage their weight.

Ginny on shifting away from calorie-counting

Maintaining a healthy weight with hypothyroidism has been a challenge for Ginny Mahar, co-founder of Thyroid Refresh. Diagnosed in 2011, Mahar says her doctor’s advice regarding her weight gain was “eat less and exercise more.” Sound familiar?

On being diagnosed

For three years, Mahar followed her doctor’s advice. “I used a popular weight loss program and tracked my food consumption and exercise religiously,” she shares with Healthline.

At first, she was able to drop some weight, but after six months, her body refused to budge. And in spite of her calorie-restricted diet, she started gaining weight. As far as thyroid medication, in 2011 her doctor started her out on levothyroxine (she’s now taking the brand Tirosint).

While treatment can lead to losing any weight gained from an underactive thyroid, that’s often not the case.

Mahar says she’s had to come to a deeper acceptance of her body. “With an underactive thyroid, calorie restriction doesn’t work the way it does for people with normal thyroid function,” she explains.

Because of this, she’s had to shift her mindset from an attitude of opposition to her body to an attitude of love and care for her body.

Mahar says she’s been able to maintain what feels like a healthy, acceptable size, and most importantly, a level of strength and energy that enables her to pursue her dreams and be the person she wants to be.

“Sure, I’d love to lose 10 pounds, but with hypothyroidism, sometimes not gaining more weight can be as much of a victory as losing it,” she says.

Mahar feels that message is important for other thyroid patients to hear so that they don’t give up when the scale doesn’t reflect their efforts.

Making changes for the future

Mahar ditched calorie restriction as a form of weight loss, and now aims for high-nutrient, anti-inflammatory meals composed of organic produce, healthy fats, high-quality animal protein, and some gluten-free grains.

“I no longer count calories, but I keep an eye on my weight, and most importantly, I listen to my body,” she says.

By changing her dieting mentality, Mahar says she’s restored her health. “It feels like someone turned the lights back on inside me, after four years of being in the dark,” she says.

In fact, since making this shift in 2015, her Hashimoto’s antibodies have gone down by half and continue to drop. “I feel so much better and rarely get sick — It’s not an overstatement to say that I got my life back.”

Danna on focusing on health choices that are in her control

Danna Bowman, co-founder of Thyroid Refresh, always assumed that the weight fluctuations she experienced as a teen were a normal part of life. In fact, she blamed herself, thinking she wasn’t eating right or exercising enough.

As a teen, she says the amount she wanted to lose was never more than 10 pounds, but it always seemed like a monumental task. Weight was easy to put on and difficult to take off, thanks to her hormones.

“My weight was like a pendulum swinging back and forth for decades, especially after both of my pregnancies — it was a battle I wasn’t winning,” says Bowman.

On being diagnosed

Finally, after being properly diagnosed in 2012, she had a name and reason for some or most of her lifelong struggle with the scale: Hashimoto’s Disease. Additionally, she started taking thyroid medication. It was at that point that Bowman realized a mindset shift was a necessity.

“Obviously, many factors can contribute to weight issues, but because the metabolism works slower when the thyroid is underactive, what once worked to lose weight, didn’t anymore,” she explains. So, Bowman says, she had to find new ways to create change.

This mindset shift is what helped her finally begin the journey of learning to love and appreciate her body instead of shaming it. “I shifted my focus to things that were in my control,” she says.

Making changes for the future

Bowman changed her diet to organic, anti-inflammatory foods, added daily movement that included walking and Qigong, and committed to mindfulness practices like meditation and gratitude journaling.

“Diet” isn’t a word Bowman uses anymore. Instead, any discussion related to food and meals is about nutrition and adding real, whole, organic, unprocessed, healthy-fat foods and less about deleting things.

“I feel better and more alive now than I have in years,” Bowman says of the result.

Charlene on focusing on day-to-day decisions, not the scale

Charlene Bazarian was 19 years old when she noticed her weight start to climb. In an effort to drop what she thought was the “Freshman 15,” Bazarian cleaned up her eating and exercised more. Yet her weight continued to climb. “I went to several doctors, who each said I was fine,” says Bazarian.

It wasn’t until her mother, who also has hypothyroidism, suggested that she see her endocrinologist, that things made sense.

On being diagnosed

“He could tell just by looking at me that my thyroid was likely the culprit,” she explains. After the diagnosis was confirmed, Bazarian was put on a hypothyroid medication.

She says she remembers the doctor telling her not to expect the weight to just fall off since she was on medication. “And boy, he wasn’t lying,” she says.

This began several years of trying every diet to find something that worked. “I frequently explain on my blog that I feel like I tried everything from Atkins to Weight Watchers,” she explains. “I would lose some weight, then gain it back.”

Making changes for the future

Bazarian says she learned all she could about building muscle and using fitness to increase her energy levels.

She eliminated starchy carbs like bread, rice, and pasta, and replaced them with complex carbs like oatmeal, brown rice, and sweet potato. She also included lean proteins like chicken, fish, bison, and lots of leafy greens.

As far as escaping the toxic diet cycle, Bazarian says that after a spa “aha” moment (being body-shamed by the receptionist because the one-size-fits-all robe was too small), she realized there is no finish line when it comes to maintaining a healthy weight.

“I realized that it’s the day-to-day choices that make the difference and that I have to pay attention to what works for my body,” she says.

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Tips for losing weight while dealing with hypothyroidism

Achieving healthy weight loss starts with finding the right doctor that understands your situation and is willing to look beyond calorie restriction. Additionally, there are lifestyle changes you can make. Mahar and Bowman share four tips for losing weight while dealing with hypothyroidism.

  1. Listen to your body. Being mindful of what your body is telling you is one of the most important steps you can take, Bowman says. “What works for one person may or may NOT work for you,” she explains. Learn to pay attention to the signals your body is giving you and adjust based on those signs.
  2. Food is a foundational piece of the puzzle. “Our bodies need the best nutrition we can give them. That’s why making cooking a priority — as well as preparing meals with clean, organic ingredients — is so important,” says Mahar. Educate yourself about what foods support or thwart thyroid function and autoimmune health, and spend time figuring out your unique dietary triggers.
  3. Choose exercises that work for you. When it comes to exercise, Mahar says, sometimes less is more. “Exercise intolerance, hypermobility, or exercise-induced autoimmune flares are risks that hypothyroid patients need to understand,” she explains.
  4. Treat it as a lifestyle, not a diet. Get off that silly hamster wheel, Bowman says. Aim to make healthy food choices, drink plenty of water, commit to daily movement (whatever exercise works for you), and make yourself a priority. “You get one chance and one body. Make it count.”

Sara Lindberg, BS, MEd, is a freelance health and fitness writer. She holds a bachelor’s in exercise science and a master’s degree in counseling. She’s spent her life educating people on the importance of health, wellness, mindset, and mental health. She specializes in the mind-body connection, with a focus on how our mental and emotional well-being impact our physical fitness and health.