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How Your Thyroid Impacts Your Weight | Weight Gain with Thyroid, During Thyroid, Problems
Thyroid and weight - the science
For many thyroid patients, weight control is one of their biggest frustrations. This article, written by the American Thyroid Association sets out why and how thyroid disorders affect a person’s weight

What is the relationship between thyroid and weight?
It has been appreciated for a very long time that there is a complex relationship between thyroid disease, body weight and metabolism. Thyroid hormone regulates metabolism in both animals and humans. Metabolism is determined by measuring the amount of oxygen used by the body over a specific amount of time. If the measurement is made at rest, it is known as the basal metabolic rate (BMR). In fact, measurement of the BMR was one of the earliest tests used to assess a patient’s thyroid status. Patients whose thyroid glands were not working were found to have low BMRs, and those with over-active thyroid glands had high BMRs. Later studies linked these observations with measurements of thyroid hormone levels and showed that low thyroid hormone levels were associated with low BMRs and high thyroid hormone levels were associated with high BMRs. Most doctors no longer use BMR due to the complexity in doing the test and because the BMR is subject to many other influences other than the state of the thyroid.

What is the relationship between BMR and weight?
Differences in BMRs are associated with changes in energy balance. Energy balance reflects the difference between the amount of calories eaten and the amount of calories the body uses. If a high BMR is induced by the administration of drugs, such as amphetamines, animals often have a negative energy balance which leads to weight loss. Based on such studies many people have concluded that changes in thyroid hormone levels, which lead to changes in BMR, should also cause changes in energy balance and similar changes in body weight. However, BMRs are not the whole story relating weight and thyroid. For example, when metabolic rates are reduced in animals by various means (for example by decreasing the body temperature), these animals often do not show the expected excess weight gain. Thus, the relationship between metabolic rates, energy balance, and weight changes is very complex. There are many other hormones (besides thyroid hormone), proteins, and other chemicals that are very important for controlling energy expenditure, food intake, and body weight. Because all these substances interact on both the brain centres that regulate energy expenditure and tissues throughout the body that control energy expenditure and energy intake, it is difficult to predict the effect of altering only one of these factors (such as thyroid hormone) on body weight as a whole. As a consequence, at this time, it is impossible to predict the effect of a changing thyroid state on any individual’s body weight

What is the relationship between hypothyroidism and weight gain?
Since the BMR in a person with hypothyroidism is decreased, an underactive thyroid is generally associated with some weight gain. The weight gain is often greater in those individuals with more severe hypothyroidism. However, the decrease in BMR due to hypothyroidism is usually much less dramatic than the marked increase seen in hyperthyroidism, leading to smaller alterations in weight due to an under-active thyroid. The cause of the weight gain in a hypothyroid person is also complex, and not always related to excess fat accumulation. Most of the extra weight gained in hypothyroid individuals is due to excess accumulation of salt and water. Massive weight gain is rarely associated with hypothyroidism. In general, 5-10 pounds of body weight may be attributable to the thyroid, depending on the severity of the hypothyroidism.

How much weight can I expect to lose once the hypothyroidism is treated?
Since much of the weight gain in hypothyroidism is accumulation in salt and water, when the hypothyroidism is treated one can expect a small (usually less than 10% of body weight) weight loss. As in the treatment with hyperthyroidism, treatment of the abnormal state of hypothyroidism with thyroid hormone should result in a return of body weight to what it was before the hypothyroidism developed. However, since hypothyroidism usually develops over a long period of time, it is fairly common to find that there is no significant weight loss after successful treatment of hypothyroidism.