Rebecca Toutant, MA, RD, CSSD, LDN, CEDS, CDCES, cPT

Countless women have set foot in my office complaining of unexplained weight gain, exhaustion, difficulty sleeping, and unclear food sensitivities. They are convinced something is wrong with them and they’re only in my office because either the doctor told them to come or they believe it must be cause they’re “eating wrong.” Labs for thyroid function, allergies, anemia, deficiencies, and diabetes are normal. There is nothing “clinically” wrong with them. What is going on?!
It’s a common constellation of symptoms, any of which could indicate a serious health problem. However, more often than not, western medicine doesn’t have an answer. It makes clients feel like it’s all in their head and leaves them in tears in my office crying, “WHAT IS WRONG WITH ME?!” 
However, after talking for an hour one thing is almost always clear – they are pushing themselves to the max. Often I find these are women who are “trying to have it all” (if you will) by

  • working long / odd hours
  • caring for elderly family members
  • active in their community
  • taking care of their children
  • doing long / intense workouts
  • taking care of their house, and
  • sometimes while managing a chronic physical or mental health condition all while “eating the least they can”  
They aren’t sleeping well at night, so they start to use more caffeine during the day and perhaps alcohol at night to wind down – both of which edge out water.  As the weight creeps up, they increase their workouts and try to eat less. Their mood plummets and interest in being social or intimate with their partner plummets. Limited time / energy pinches out food preparation so more and more meals are frozen or take out.
They’ve done this for years but suddenly, it just “stops working.” All the “tricks” that used to “work” to control their lives are failing them. They look around and believe get caught in the comparison trap – “Sally is doing MORE and just fine…so clearly it’s my fault.”
Sound familiar?
I used to work for a provider who regularly diagnosed and treated people with a condition called, “adrenal fatigue.” This is a controversial condition because it is not recognized by conventional medicine – only by alternative practitioners. The theory is that long term stressors (physical or emotional) disrupt the hormonal balance of the body – elevating cortisol production by the adrenal glands, which are eventually exhausted and fail to fire appropriately. It is often diagnosed by monitoring urine or salivary cortisol levels and noticing disruption. Treatment is designed to “rest” the adrenal glands using supplements and A LOT of lifestyle change.

I am not an alternative medicine provider. I’m trained in western medicine. It’s unlikely that I’ll ever totally jump on this bandwagon until it’s validated. There is little to no medical research about the condition, other than to say it doesn’t exist (for the systematic review debunking it, click here). 

Want to learn more?

Regan Jones from This Unmillennial Life just did a wonderful podcast exploring both sides of the topic (episode 49)

However, other health conditions such as chronic fatigue syndrome and fibromyalgia also did not exist…until they did.  
And whether or not it’s a health condition, the symptoms are quite real.
And whether or not it’s a health condition, no one argues that chronic stress  is “great” for the body.

​It’s even more important to note that the primary treatment is NOT often medicine. For every patient that came in complaining of this situation, I’ve found tremendous success using the same lifestyle adjustments alternative providers recommend: 

  • Turning off screens – particularly around and during sleep
  • Eating a balanced diet INCLUDING ALL foods
  • Addressing mental health
  • Meditation / deep breathing
  • Hydration
  • Less caffeine
  • Less alcohol / drugs / nicotine
  • Time for self
  • Connecting with others
  • Balanced exercise
What’s more concerning to me is that often providers will blame a patient’s weight for the symptoms instead of exploring how the patient is living. If you notice the above, the high stress and lack of sleep drive the other behaviors which in turn may cause weight gain. The weight gain is a symptom of the disruption – not an indicator of behavior. Trying to lose weight under these conditions by eating less and moving more only INCREASES the stress and exacerbates the condition)

It speaks more to the idea that that so many women believe they should be able to always “do more with less.” That time for self is selfish and eating less / moving more is “always better.” There is no creature on earth that is always working. Everything needs rest – including you.
Health is not a behavior in isolation. It is built on a foundation of caring for mental and physical needs by balancing our need for adequate rest, food, water, movement, and mental health. It is not realistic to expect one pillar to make- up for weakness in another (and please note that adequate food is NOT a low carb diet – “low” is the very definition of inadequate).
If you are experiencing the above constellation of symptoms, certainly explore them with your doctor. It’s very important to rule out any other conditions. However, please don’t forget that your life balance affects your physical health.

Stay nourished friends!