Are you planning to lose weight by the end of this year? Alternatively, do you pay full attention to your diet, exercise regularly, have good sleep hygiene, or take FDA-approved weight loss medications? If, after all these efforts, you still haven’t noticed any progress in your weight loss, the problem might not be your weight loss plan or approaches towards it but certain medical conditions that make it nearly impossible to lose weight.
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These medical conditions are a hidden culprit to the stubborn weight, which doesn’t go away. Read on as we explain 5 potential medical conditions that are hindering your weight loss. What’s more, you will also get to learn about the hormones responsible for weight gain and the different kinds of medication.
What Are the Signs of Unhealthy Weight Gain?
Typically, there is a possibility that some people gain weight mainly due to natural processes and not an underlying disease. Weight gain during pregnancy is healthy and an optimum amount of weight gain is essential in the growing ages of a child. On the other hand, weight gain can be a symptom of underlying health issues such as chronic medical conditions linked to any of the body systems; endocrine, respiratory, cardiac, or even neurologic.
Possible Symptoms that May Occur along with Weight Gain
There are a set of possible symptoms that may accompany unhealthy weight gain as listed below:
- Temperature sensitivity
- Abnormal menstrual cycle
- Vision changes
In certain conditions, failure to lose weight can be due to life-threatening underlying systemic diseases. Such symptoms should be addressed immediately, and emergency care should be administered.
1. Hormonal Changes in Women
You are a determined woman, and you have tried the best diet, exercise, or weight loss medication, you may not be aged, but still, there are no signs of weight loss progress. What could be the problem? The answer could be your hormones might be responsible for not losing weight.
Suppose you are going through menopause or even pre-menopause. It is likely that you must have experienced difficulties managing your weight and achieving weight loss is not as easy as before. It is getting difficult to keep off extra pounds, and no workout seems to help. I like to call this phase ‘transition of life’ for women.
And weight loss difficulty is not the only reason to call it ‘transition of life.’ There are a whole plethora of critical changes in the woman’s body during menopause. Some other changes include;
- Sexual Dysfunction
- Hot Flashes
- Joint Aches and More
- Sleeping Disturbance
The hormone responsible for the above conditions is ‘ESTROGEN.’ Reduced levels of the female hormone estrogen are the sole culprit for all the changes in the body.
The Female Hormone ‘Estrogen’: Basics
Estrogen, along with another hormone – progesterone, is the primary female sex hormone. These hormones are produced by the female ovaries and then face various changes as they get transported to other body regions. Estrogen has many types, and each type of estrogen has a distinct role in the body but for our interest, let’s just focus on understanding estradiol as it is responsible for weight management and metabolism regulation.
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‘Estradiol’ – Estradiol is the most important hormone during the menstruating ages. It is also the most active type that is linked to certain gynecological conditions such as endometriosis and reproductive cancers. Weight and metabolism is not the only function, the hormone has many other functions as shown below:
- Plays Significant Roles during a Female’S Puberty
- Breastfeeding and Pregnancy
- Pre-Menopause and Menopause
There are several reasons your hormone levels can go down other than the natural phenomenon. Certain lifestyle changes, habits, and lacking disturb hormones in early life.
What Conditions Affect Estrogen Levels?
- Polycystic Ovarian Syndrome
- Vigor Exercise and Extended Training Programs
- Bilateral Oophorectomy
- Anorexia Nervosa
We now land on the point of interest. So, what is the link between low estrogen levels and weight gain, and how to manage this? Certain conditions cannot be reversed, but weight management and diet can lower any disease associated with weight gain.
As the estradiol—the hormone responsible for body metabolism regulation—decreases after menopause; you are most likely to gain weight. The decrease in this form of estrogen also slows down the resting calorie expenditure, and so without physical activity or proper diet, what you are left with is fat build-up.
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Perhaps you’ve noticed that all women throughout their life gain weight over the hips and thighs, but after menopause and decline of estrogen, the fat starts building up at the midsection of the abdomen.
Point of Concern
This type of visceral fat does not go away quickly and has many other complications associated with it. Other than estrogen, many life factors also account for your calorie burn. So, how can you manage this weight along with the hormonal imbalance? Below is a detailed insight surrounding weight management strategies with hormonal imbalance.
- Maintaining a healthy weight, after concerns related to hormone imbalance in women, using medical treatment
- Hormone replacement therapy (HRT)
Bioidentical hormone replacement is the easiest and most effective way to balance hormones when your body has naturally stopped making it. You can administer HRT such as; transdermal, mouth patch, del-delivery, and many more.
For women, diet is a more significant factor than workout and exercise to achieve weight loss. Specific dietary changes make it all too easy to attain your desired weight. Apart from these approaches here are other key things to put into consideration:
- Avoid processed foods
- Drink lots of water
- Avoid sugary beverages such as carbonated drinks and alcoholic beverages
- Shift to organic foods such as fruits and vegetables
- Include grain and rely more on plant-based fats
2. Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is prevalent and is a concern among women of reproductive ages. It is a hormonal disorder in which women experience infrequent or prolonged menstrual periods and an excess in the male hormones (androgens) levels. The ovaries develop small, numerous fluid-filled sacs and fail to release eggs regularly. However, the exact cause of PCOS is still unknown to the doctor.
What Are Polycystic Ovaries?
Polycystic ovaries are made up of multiple harmless follicles that are around 8mm in size. These follicles are little sacs in which female eggs develop. In this condition, the pouches are unable to release eggs, so ovulation does not occur.
Symptoms of Polycystic Ovaries Syndrome
Note that women with this condition do not experience a normal ovulation cycle. Even so, before we check on the symptoms, let’s take a peek into the three most prominent features of PCOS.
- The ovaries don’t release eggs regularly, which also means ‘irregular periods. You might have fewer than nine periods in a year or more than 35 days interval between cycles. The situation can also entail experiencing abnormally heavy periods.
- High levels of androgen or ‘male hormones’ causes excess facial and body hair. Severe acne and male pattern baldness are also seen.
- Ovaries become large and get swollen. The ovaries might even fail to function.
These signs and symptoms usually become prominent in the late teens or early 20s. There are even higher risks of developing chronic diseases with this condition, such as; Diabetes type 2 and increased levels of blood cholesterol levels.
What Causes PCOS?
Doctors so far cannot explain what exactly causes PCOS, but they tend to believe that it is the excess levels of male hormones that prevent ovaries from regular ovulation. There are three main causes of PCOS; genes, insulin, resistance, and inflammation. Whatever causes PCOS in women, the complication is always related to weight gain. PCOS comes with a baggage of long-term complications with it.
The most important part for us to know is that most women with PCOS are overweight and obese. Why does polycystic ovarian syndrome (PCOS) cause weight gain? Here I will have to repeat the story, but to cut it short, PCOS increases the insulin in the body and over stimulates the ovaries to produce more male hormones- Androgens.
Now, this directly links with weight gain because it is triggered by the male androgen hormones. Typically in the area of the abdomen, women with this condition experience body shape change from a typical pear shape to apple shape. Abdominal fat is also known as the most dangerous type of fat as it comes with major heart problems and other insidious medical conditions over time. PCOS has a complicated relationship with weight but is not a hopeless case. There are certain ways a woman can manage her weight along with PCOS.
Useful Tips for Managing Your Weight along with PCOS
Tip 1: Reduce Carbohydrate Intake
Lowering carb consumption has a profound effect on insulin levels and helps manage PCOS.
Tip 2: Consume More Fibers
The best quality fibers offer includes; helping you stay full for longer times, so consuming more fibers will keep you away from binge eating and extra meals.
Tip 3: High Protein Diet
High protein diets boost your immune system and weight loss regulation, especially in women with PCOS. High protein foods like eggs, nuts, and seafood are a great source of healthy protein.
Tip 4: Eat Healthy Fats
High-density lipoproteins also termed as ‘good fats,’ are very good at satisfying your hunger. These fats are also a good option in curbing appetite and lowering the cholesterol levels in the body.
Tip 5: Probiotic Foods Are a Great Option with PCOS
Women with PCOS have a lower number of beneficial bacteria in their gut. Fermented and probiotic foods are a great way to enhance the friendly bacteria as well as initiate weight loss.
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Tip 6: Avoid Emotional Eating
Women with PCOS are more likely to promote eating disorders and consume different types of food during mood swings. Awareness of eating cues helps you understand when and where to eat and what to avoid. This small step helps train your brain and enhance the achievement of weight loss.
Tip 7: Weight Loss Medication
Lifestyle changes significantly help weight loss drugs to have a positive impact on an individual. ‘Orlistat’ weight loss drug helps women with PCOS trim down their fat by improving their metabolic functions.
What can you do to overcome weight issues? Get the medical barriers treated as soon as possible. Also, watch your diet and physical activity. Exercise and trimming down the calorie intake is your only way to achieve weight loss with PCOS.
3. Cushing Syndrome
You probably already know about Cushing syndrome, also referred to as hypercortisolism. But what you may not know is that this medical condition could also be a potential barrier in either increasing your weight or hindering your efforts to reduce it—especially when it comes to late diagnosis or maltreatment. Read on to understand the concept.
What Is Cushing Syndrome?
Cushing syndrome is a condition depicted by relatively high levels of cortisol hormone in the body. The situation occurs when the body starts overproduction of cortisol. An average cortisol level is essential for many normal functions of the body. Cortisol is responsible for the following purposes;
The sympathetic nervous system gets activated when the body is under stress. The sympathetic nervous system is responsible for fight and flight response. This response elicits a cascade of processes necessary for body function regulation under stress. The hormone is also known as ‘stress home.’
The presence of optimal cortisol levels increases the availability of glucose to the brain. Cortisol acts on significant body organs for this purpose; liver, muscles, adipose tissue, and pancreas. Thus under stress, glucose availability becomes easy and accessible to all major organs of the body, and the body can perform its functions in harmful external and internal environments.
The problem starts when the production of cortisol levels goes over. The overproduction of cortisol becomes a significant medical condition, as stated before. There are some significant symptoms of Cushing syndrome.
Symptoms of Cushing Syndrome
The signs and symptoms of Cushing syndrome vary according to the levels of cortisol produced in an individual’s body.
- Round/moon face
- Fatty hump between the shoulders.
- Bone loss
- Type 2 diabetes
- Pinkish purple stretch marks on the body
- Fatty tissue deposit and immense weight gain, fat is usually deposited around the abdomen, upper back, face, and between the shoulders
- Decreased fertility
- Fragile and thin skin
- Slow healing of wounds
- High blood pressure
- More facial hair (hirsutism)
- Abnormal or absent menstrual cycle
- Erectile dysfunction
As you have read some prominent signs and symptoms of Cushing syndrome, it is important to note the possible causes of this medical condition.
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Causes of Cushing Syndrome
As we have learned before, excess levels of cortisol hormones are responsible for Cushing syndrome. However, there are many causes your body may develop overproduction of cortisol. Here are two of the reasons leading to Cushing syndrome:
- Corticosteroid medicine
- Pituitary gland tumor
How Does Cushing’S Syndrome Affect Metabolism and Weight?
Cushing syndrome is well known for its weight gain complications. Many people with Cushing syndrome complain of putting on unwanted weight despite many weight management strategies. So, how does Cushing’s syndrome affect metabolism and weight? People with Cushing syndrome experience the inability to lose weight due to their conditions.
There are many types of Cushing’s syndromes. Typically, no exercise or diet helps with weight loss, and neither can stop the symptoms of the disease from forming. The reason is evident with Cushing syndrome, your body experiences very high levels of cortisol, also known as the stress hormone, and so many tissues and cellular alterations occur.
High levels of cortisol cause excessive fat stores in the body and transports excess circulating fat deposits into the body cavities such as the abdomens, which, when neglected, advances to obesity.
Finally, these links and connections suggest that Cushing syndrome is one of the primary reasons why you are unable to drop any pounds despite hard work at the gym, diet, and therapies.
I will share 4 lifestyle changing tips that will help you taper your weight successfully despite having Cushing syndrome.
Four Lifestyle-changing Strategies to Manage Weight With Cushing’s Syndrome
1: Strict Diet Check
Make sure you have a strict diet plan to follow after consulting a nutritionist. Your diet plan must contain all the foods that are rich in antioxidants. Fruits and vegetables are very high in antioxidants. Along with these, you also need to consume whole grains, fibers, lean proteins, and healthy fats.
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Also, make sure you consume adequate amounts of calcium and vitamins. Your doctor can best guide you on what sorts of food are beneficial for your condition and weight loss.
2: Gentle Exercise
Low impact exercise makes a significant impact on your weight. You don’t have to rush into very vigorous exercise. Even if diet makes you feel like losing weight, training is compulsory to keep that weight off.
3: Cushing Syndrome Medication
Cushing syndrome has adverse effects on your brain; depression with Cushing syndrome is common. Your mental health can take a toll on you—adversely impacting how impacting on how you go about carrying out diet or exercise. It is, therefore, essential to take your medication correctly as prescribed by the doctor. Your doctor may also prescribe antidepressants and other medicines to keep you motivated throughout the blues.
4: Take Proper Rest
Cushing syndrome can give you a harder time dealing with problems. There are many ups and downs when following the treatment plan. Some days might go off smoothly, and the rest may be hopeless. Treat yourself gently, and do not get harsh on yourself. Changes like weight loss take a considerable amount of time; the progress varies among two people with the same circumstances. Give yourself a chance. The results are worth it!
A lot of research and studies have been conducted in this regard, and it turns out that hypothyroidism has a profound effect on weight loss. The ‘why?’ And ‘how?’ of the above statement is described below, keep reading!
So, what is hypothyroidism? Hypothyroidism, also known as ‘underactive thyroid,’ is a condition where the thyroid gland stops producing adequate amounts of hormones.
How does the thyroid gland work? It is a vital hormone gland that plays a significant role in the metabolism, growth, and development of the human body. It regulates body functions via the steady release of thyroid hormones. Hypothyroidism has many symptoms and causes many health problems, which mainly include; Obesity, heart disease, infertility, and joint pain.
Symptoms of Hypothyroidism
The signs and symptoms of this disease vary according to the severity of the hormone deficiency. Mainly the complications and symptoms are progressive. At first, very mild symptoms appear like fatigue and weight gain. As the metabolism slows down, you may experience more severe complications and symptoms.
Sign and symptoms may include;
- Weight gain
- Sensitivity to cold
- Dry skin
- Puffy face
- Muscle aches, muscle weakness
- Increase cholesterol levels
- Irregular menstrual cycle
- Decrease heart rate
- Swelling, stiffness, and pain in joints
- Weaker hair
- Impaired memory
When the thyroid gland fails to produce enough hormones, the balance of the chemical reactions in the body gets disturbed. There are several causes for this situation, let’s dive in.
Causes of Hypothyroidism
Autoimmune Diseases – One of the common causes of this disorder is an autoimmune disease known as Hashimoto’s thyroiditis. Autoimmune diseases result from the reactions when the immune system produces antibodies that attack your body cells. The process also involves your thyroid gland.
The reason for the condition is still unknown to scientists but could arise due to a combination of many factors such as genes or environmental triggers. When these antibodies affect the thyroid gland, it stops making adequate hormones for normal body functioning.
Congenital Disease – Unfortunately, some babies happen to be born with a defective thyroid gland or without any. And in many other cases, the thyroid gland does not function normally for unknown reasons—several children have an inherited form of this disorder. Babies born with hypothyroidism seem healthy at birth and miss out on early diagnosis and treatment. Even so, the state has taken measures to introduce thyroid screening at the time of delivery.
Pregnancy – The reason for this is still unexplained, but some subjects have experienced an inflamed thyroid gland after pregnancy. This condition is called ‘postpartum thyroiditis.’ Women experiencing such a condition have elevated levels of thyroid hormones at first, followed by a sharp drop in production. This condition is, however, reversible after the postpartum period.
Lack of Iodine in the Diet – The body does not make iodine, and that is why you need to have a proper intake of iodine to produce thyroid hormones. The availability of iodine is fast and straightforward, and it is readily available in table salt. Other rich sources of iodine are; Saltwater fish, eggs, dairy products, and seaweed.
Risk Factors of Hypothyroidism
- Age higher than 60 years
- More in women
- Autoimmune diseases
- Positive family history of hypothyroidism
- Partial thyroidectomy
- Radioactive iodine treatment
Untreated hypothyroidism can cause several serious problems. Since we are focused on understanding the link between hypothyroidism and weight, we’ll start by breaking it into two parts: Weight gain and weight loss, and later discuss some tips to lose weight with this condition.
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Weight Problems Due to Hypothyroidism
Hypothyroidism and Weight Loss: The thyroid gland produces hormones that are responsible for several body functions. These functions mainly include; regulating body temperature, utilizing energy, keeping optimal functions of the body, and regulating metabolism.
Studies show that if thyroid levels are low, people tend to gain weight, mainly due to bodies’ inability to burn calories, which could be possible with a healthier thyroid gland. The weight loss can be maintained if the thyroid hormones are restored.
Hypothyroidism and Weight Gain: When the thyroid does not function properly, body functions slow down. So does the resting metabolic rate, the reason why underactive thyroid is a direct cause of weight gain. The more severe the condition, the more weight you are most likely to put on.
If you are unable to achieve weight loss once you have successfully treated the condition, it does not mean your treatment has failed; instead, this allows a healthy shift towards lifestyle changes and dietary habits that you should then focus on going forward.
Six Practical Weight Loss Tips for Hypothyroidism
Use these six strategies to kick-start weight loss with hypothyroidism.
1. Anti-Inflammatory Food
Anti-Inflammatory foods are very beneficial for overall health in hypothyroidism. These foods help to ease joint aches, treat depression, as well as soothe immune system regulation. The diet decreases inflammation and provides essential nutrients to manage thyroid dysfunction.
Nutrients useful for hypothyroidism treatment are; Vitamin B, zinc, iron, vitamin C. Tomatoes, leafy green veggies, fruits all ensure the supply of essential nutrients, and decrease the burden of diet and weight gain. A healthy diet also ensures you have a healthy liver—a required state both for fat metabolism and thyroid hormones.
2. Eliminate Simple Carbs and Sugars
A moderate carbohydrate diet containing complex carbohydrates and eliminating simple sugars is great to jump-start weight loss in hypothyroidism. According to many research pieces, foods with a high glycemic index tend to increase inflammation in the body, worsening your underlying medical conditions.
3. Stick to Smaller Meals
Hypothyroidism affects your digestive system and slows it down. Eating a smaller meal frequently, based on essential macro and micronutrients, is a great way to survive weight gain. Smaller meals containing high protein, complex carbohydrates, and high-fat food regulate blood sugar and cholesterol levels very well.
4. Low Impact Exercise
If you want to burn calories, you can’t ignore exercise. Even the healthiest diets claim to link compulsory physical activity to boost weight loss and keep that weight off forever. In hypothyroidism, the case is a little different. Exercise is only encouraged if your hypothyroid medications are working well, and your body is improving with time.
5. Keep a Food Account
Your daily caloric intake can increase if you do not keep an account of what you eat and how much you burn. This also ensures that your diet plan is adequately balanced and not missing any essential nutrients. Keeping a food journal is very important for someone with hypothyroidism to track their progress and relate it to their daily food intake.
6. Never Miss Thyroid Medication
Some medications come with specific guidelines, such as the thyroid medication. You need to take your thyroid medicine first thing in the morning on an empty stomach. Avoid taking any food or other medication, which may end up triggering harmful drug interactions.
Then wait for 30-60 minutes for breakfast. Any weight loss medications are to be used under a doctor’s prescriptions and guidelines. A lot of emphasis on taking thyroid medication is made due to its effects on weight loss.
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Your medication needs to work if you want to reduce weight as a result of having hypothyroidism. If, for any reason, your medicine is not working, discuss it with your doctor immediately. As you can see, hypothyroidism has potential effects on weight and overall body.
Sure, treatment for the underlying conditions is still essential, but making dietary modifications along with medication and changing lifestyle throughout and after the disease is necessary. And once you have understood this, it’s time for our next medical barrier of weight loss.
5. Syndrome X
You might feel that this medical condition’s name sounds like it belongs to Hollywood’s sci-fi controversy movie. But sadly, this is as much a real issue and also as problematic as it seems!
Syndrome X has another decent name called “metabolic syndrome.” Syndrome X is a group of conditions that occur together. It increases your risk of health complications—one of which undoubtedly is difficulty with weight loss or unwanted weight gain.
The conditions that come alongside metabolic syndrome include; heart issues, diabetes, excess body fat, especially around the waist, increased cholesterol, and triglycerides (bad habit) levels.
Having any one of the diseases doesn’t mean that you have metabolic syndrome; instead, this warns you that you have a higher chance of getting this disease. The incidence of metabolic syndrome across the USA is one-third of the total population. The American Heart Association reports that about 23% of adults have metabolic syndrome currently in America.
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What Are the Possible Causes and Risk Factors of Syndrome X?
Metabolic syndrome has two primary causes:
- Insulin resistance
Syndrome X is also linked to the condition called ‘insulin resistance.’ The human digestive system breaks down the foods into sugar. Insulin is the hormone produced by the pancreas, which helps sugar get utilized by the body cells. People with insulin resistance cannot use glucose, and so the blood sugar level elevates, and the body still keeps on making more and more insulin.
The following risk factors also contribute to increasing the risk of getting metabolic syndrome.
- Age – The probability and chances of getting syndrome X increase as the age increases.
- Ethnicity – The trends in America show that the American-Hispanic population is more prone to develop metabolic syndrome.
- Obesity – Carrying excess weight in the area of the abdomen or being obese also makes it likely to develop metabolic syndrome.
- Diabetes – Gestational diabetes (diabetes during the pregnancy), or if you have diabetes type 2, most probably, metabolic syndrome is going to hit you at some point in your life.
- Other diseases – Many other health problems increase the risk of getting metabolic syndrome such as; polycystic ovarian syndrome, fatty liver disease, sleep apnea.
Which people typically have metabolic syndrome?
- People with central obesity
- People with diabetes Mellitus
- People experiencing skin changes (darkened underarms or neck area)
- Target ethnic groups
Complications of Metabolic Syndrome X
Having metabolic syndrome increases the risk of many chronic complications, including weight gain. It is directly associated with syndrome X due to the following reasons:
- Increase levels of LDL – bad cholesterol and triglycerides
- Having excess fat deposited in the abdominal area
- High blood pressure
- High blood sugar levels
Even so, there is good news in all this mysterious conditional disorder! With slight changes to diet and physical activity, you can manage your weight. But before that, it is essential to reverse the metabolic syndrome through proper medical treatment.
If you have metabolic syndrome and you are slacking on the follow-up and treatment, there are even potentially more significant complications other than weight gain. Treating metabolic syndrome (Syndrome X) requires the treatment of many conditions together.
Below is a list of two primary strategies that work against metabolic syndrome-related weight gain:
Exercise is the core component of weight management. You need to incorporate at least 2 hours and 30 minutes of moderate to vigorous exercise if you want to make a difference in weight and body shape. Don’t get into the 2-hour gym routine directly. Instead, start by walking briskly, and later you can increase your endurance and strength besides experimenting with your body’s capacity. Hiring a gym trainer is also an excellent idea for those who can make out time and expenses.
Metabolic Syndrome DASH DIET
The Dash Diet emphasizes consuming fruits, lean meats, and vegetables rich in nutrients such as zinc and dairy products. The dash diet also focuses on the meal proportion, meal size, and encourages realistic goals for people with metabolic syndrome. Incorporations of healthy veggies and lean meats restrict terrible calories and promote weight loss in people with metabolic syndrome.
There is another potential complication of metabolic syndrome worth mentioning- type 2 diabetes. Metabolic syndrome X is a highly prevalent clinical syndrome. Also, type 2 diabetes has a close association with metabolic syndrome. It is, therefore, considered to be a hallmark complication for this condition.
Insulin resistance is the critical phase when the body starts developing type 2 diabetes. Mainly in metabolic syndrome, the pathway that accounts for this condition development is the destruction of pancreatic beta cells. These cells are solely responsible for insulin production. Once the beta cells die, the output goes instantly down.
Hyperinsulinemia becomes the compensatory mechanism in the body until the pancreas fully gets destroyed. As the insulin production stops, the body goes into the late phase, which is hyperglycemia. The person then shifts from metabolic syndrome to overt diabetes.
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What is the outlook of patients dealing with metabolic syndrome? The outlook of patients with metabolic syndrome (syndrome X) is useful if the symptoms are to be adequately controlled through treatment. It is essential to follow the correct treatment plan, follow your doctor’s advice, engage in physical exercise, diet, stop alcohol intake, plus avoid smoking.
Are you experiencing any of the above medical barriers to your weight loss? Your management plan and diet charts must have medical oversight. What’s more, now that you have learned about the significant medical barriers that may be preventing you from weight loss, it’s time to take the right actions.
Reach out to us, and we will connect you to an accredited physician to facilitate your treatment plan. At Mango Clinic, we can help you work on your weight loss goals.
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