Well, in addition to that hour, they spend a couple of hours on thyroid disease, and that completes their education on nutrition and metabolism. You've heard the old bromide about how most doctors spend about an hour on nutrition in medical school. But they don't know about nutrition.

They know the basic symptom list, they know how to do a thyroid-stimulating hormone (TSH) test, and they know how to write out prescriptions. Another reason doctors don't want to connect thyroid disease with weight gain is that they simply don't understand very much about nutrition, metabolism, and the thyroid. They fear being lumped into the old category of the diet doctors. In fact, the stigma was so bad that today's doctors specializing in weight loss call themselves bariatrics physicians, and they are more likely to be handing out antidepressants and suggesting gastric bypass than testing for an underactive; Today's doctors are afraid that if they connect your weight with your thyroid, you may become a drug-seeker, looking for drugs inappropriately - in this case, looking to get thyroid drugs or taking too many thyroid drugs as a way to lose weight.

Doctors who were known to dispense amphetamines and thyroid drugs for weight loss - the "diet doctors" - had a bad reputation. Perhaps this is because in the past, just as amphetamines were abused by doctors and patients for weight loss, thyroid drugs were also used in a similar way. This is where the issue becomes particularly challenging, because there is a fear among some physicians to even connect thyroid and weight problems. AT-LPL breaks fat down so that fat cells can absorb it. After menopause, an enzyme called adipose tissue lipoprotein lipase (AT-LPL) is more active. During menopause, women become more effective at storing fat and less able to burn fat.

Menopause also adds additional hormonal burdens to metabolism and weight loss. Dehydration can make the body temperature drop slightly, and with a reduction in temperature, the body will attempt to help raise temperature by storing fat to act as an insulator. When the body has taken in sufficient water, body temperature can be maintained for optimal metabolism. The majority of thyroid patients struggle with a variety of symptoms, including fatigue, mood swings, and, of course, weight gain or difficulty losing weight. Unfortunately, that happy ending is for the minority of patients. You may think that if you have an undiagnosed thyroid condition, your weight problems will be over after it is treated. The next chapter expands upon this understanding to explore the linkages between your thyroid, metabolism, and weight-loss efforts. As you can see, the body is a calorie miser, and there are a number of places that these complicated processes can fail, making it easier for you, especially as a thyroid patient, to gain weight, and making it harder to lose weight. One study found that the burning ability of fat taken from the buttocks of postmenopausal women was 75% less than in perimenopausal women.