But Doctor, I'm Telling the Truth

Is Your Thyroid Making You Fat?
by Sanford Siegal, D.O., M.D.

My patient looks troubled.

“I don't care what that doctor says, there has to be something wrong with my metabolism.”

She's one of today's new patients. Her name is Marie. We've just met. She doesn't hesitate to tell me of her dissatisfaction with the last doctor she saw. I gather that her former doctor thinks she just eats too much.

“He said the tests showed that my thyroid was just fine. I followed his diet but it was just like all the others. It didn't work. I just want to be thin. What's wrong with me?”

Her words and her manner don't startle me. I've heard such words spoken too many times in the past. I truly sympathize, but at the same time I'm impatient. There's work to be done. I've a lot of questions to ask. I will do an examination. Then there will be much explaining.

Clearly Marie wants to vent her feelings, and it may be doing her good. From experience with many others, I know those feelings. At this point, I can see that she will repeat her complaint for emphasis, but I don't want to be impolite, so I let her go on. And she does.

There's no complaint I've heard more frequently during that most important first patient visit than what Marie has just expressed. Her monologue is so typical that after the first few words I could have completed her remarks. In the last thirty-eight years, I've had literally thousands of patients voice that same complaint. Of course, they aren't all as bold as this patient. They don't all blame their former doctors. They do express this same discontent, but they phrase it in many different ways:

“I don't understand why I'm so fat; I eat very little.”

“I've had my thyroid tested. There's nothing wrong. Why can't I lose weight?”

“Will you give me something to burn up this fat? Nothing seems to work.”

“Maybe I have a thyroid problem or something.”

“No matter what I do, it won't come off.”

Let's make it clear why they're telling this to me in the first place. It is because I specialize in treating overweight problems. In my medical practice, those are the only kinds of patients I see. I don't accept those whose complaint is a sore throat, a broken arm, a nasty rash, or a nose that needs to be reshaped. For forty years, I've limited myself to helping people whose ailment is an excess of fat. My experience has been acquired from hundreds of thousands of overweight patients. (I've truly lost count.)

True, a formidable number of my new patients do admit to major indiscretions. “I eat like a pig” isn't that infrequent. Marie is clearly not in that camp.

She has come to me because she has an acquaintance who seems to have undergone some sort of metamorphosis. Her friend, a once pudgy, dull, couch potato, has a new svelte figure and radiates an astounding personality change. She's given up her menial employment and is going to school to learn court reporting.

Marie knows that her friend has been my patient for a while and that I must have had something to do with that transformation. She believes that the effect of the diet I prescribed for the lady was to reduce her weight and that all the other benefits were derived from some newfound confidence. Her remade friend is now proud of her body and has acquired a self-image that causes her to regard the world as her personal oyster.

She's wrong about her friend in a lot of ways.

First of all, it isn't diet alone that is responsible for the drastic improvement in the friend's shape. And it isn't newfound confidence that makes that lady get up and go. It is the medication I prescribed for her previously undiscovered ailment that is responsible for all the changes. Taking that medication, she would have emerged from hibernation even if she hadn't been fat and lost weight. Her friend has hypothyroidism.

Marie clearly doesn't know the whole story. She's hoping I have some sort of magic diet that will finally get the weight off of her. Unlike her friend, she doesn't need her psyche altered. She has enough motivation to do things and she would do them if she weren't so tired all the time. Of course, she blames that on the extra weight she is carrying.

She isn't going to find a magic diet at my office. She has already been on too many diets. She's hostile toward her last doctor because his diet didn't work. She followed it faithfully for almost a month and lost barely four pounds. At that rate it would take her forever to get thin. He didn't seem to listen to her when she told him that she loses poorly even on the strictest of diets.

Now she's trying again. What she's telling me is that there's something wrong with the way she handles food. It's her “metabolism or something.” I sense that she isn't sure of this. After all, the last doctor spent a fair amount of her money at the medical laboratory and proved to her that there's nothing wrong with her metabolism. He said that her thyroid was fine and then explained to her that “thyroid” and “metabolism” were sort of the same thing. In making his explanation, he used such mysterious terms as TSH and T3 and T4. Who can argue when such scientific proof is presented? Does any ordinary mortal dare question TSH, T3, and T4?

Like Marie, at least half of my new patients believe that something has gone wrong inside of them. They declare that, given their eating habits, they shouldn't be as fat as they are.

Many of these people have been to other doctors and have had various laboratory tests intended to show whether there was some sort of metabolic problem. More often than not, the tests come back with the results quite normal. The lab asserts that there's nothing wrong with this person's thyroid. This is one of the few instances in which a patient is truly disappointed to find out that the lab tests rule out some disease. Were the tests to have suggested a metabolic abnormality, the patient's own character would nicely be off the hook. That would prove that the obesity isn't from a lack of discipline or from some character flaw. It would show that the patient's metabolism was the culprit. No such luck for the lady sitting across from me.

On the basis of laboratory tests, doctors often form their opinions. The problem is that many of them have more confidence in laboratory results than in their own good sense. Too often, they ignore the basic principles they learned during their training and rely upon high-tech innovations to show them the way. If we doubt our own perceptions when they are inconsistent with the output of high-tech procedures, we increase the chance for a faulty diagnosis. Consequently, I believe that a large number of people suffer from an ailment that causes them to be overweight and that this condition isn't diagnosed, or perhaps it is even ignored, by a lot of physicians. The ailment is hypothyroidism.

It might not be possible to find another doctor in my area who has done more thyroid testing of patients than I have. After all, I have forty years under my belt and each patient during that time has had at least a potential thyroid problem. By the time I had perhaps seen my five thousandth or ten thousandth patient, I was already pretty disillusioned with the value of thyroid tests. Today, years later, I regard those tests as practically useless. This awareness was the major motivation for my writing this book.

Copyright © 2000 by Sanford Siegal

About the Author

SANFORD SIEGAL, D.O., M.D., lives in Miami, Florida, where he has directed fourteen weight-loss clinics catering to 500,000 patients. He's the author of several books, including Dr. Siegal's Natural Fiber Permanent Weight-Loss Diet and Hunger Control Without Drugs: The Doctor's Appestatic Diet.