5 Hidden Reasons You Can't Lose Weight (That Your Doctor Isn't Testing For)
Episode Summary
Colin Renaud, PA-C breaks down the hidden drivers of weight loss resistance that smart, disciplined people still run into, covering insulin resistance, sleep deprivation, sex hormone decline, thyroid optimization, and GLP-1 medications. The episode is grounded in patient cases and practical clinical thinking rather than surface-level diet advice. Cole confirms that Colin Renaud, PA-C is actually his own provider. The conversation also covers the carnivore diet as a clinical tool, why the conventional system does not address testosterone, dopamine, and motivation, and how thyroid dysfunction suppresses basal metabolic rate and creates a biological starvation signal that drives overeating. The closing pitch from Colin Renaud, PA-C is one of the most quotable in the podcast library.
Key Topics
- 1
Why smart, disciplined people still struggle with weight in the modern environment (hormonal disruptors, plastics, pesticides, chronic sleep deprivation, hidden calories, mindless eating)
- 2
How small choices accumulate: 5 pounds per year = 50 pounds in 10 years
- 3
Insulin resistance: mechanism, how it blocks fat burning, and what reversal looks like
- 4
Case study: female patient with triglycerides over 400, A1C over 10, lost approximately 15 pounds in 2 months on carnivore diet
- 5
Carnivore diet as an elimination diet for gut inflammation and metabolic dysfunction (not universally recommended)
- 6
How poor sleep raises cortisol, raises ghrelin, lowers leptin, and creates a perfect storm for weight gain
- 7
Population data: average sleep has declined by about 1 hour over the past 50 years
- 8
Sex hormones and weight: how testosterone drives insulin sensitivity, nutrient partitioning, and motivation
- 9
The testosterone-dopamine-prolactin chain: why low testosterone means low dopamine, high prolactin, and low motivation to exercise
- 10
GLP-1 medications: when to use them, which to prefer, patient cases of people losing 30 pounds in 2 months and coming off multiple medications
Quotable Moments
“We live in an environment full of chemicals and plastics and pesticides that disrupt our hormones. We're overworked, underslept, and undernourished.”
“Five pounds a year is not a lot of weight, but over 10 years that is 50 pounds. These little tiny things over time just really pile up.”
“If you are not sleeping well, this might be the factor that people sleep on. People really do underestimate how much it affects their weight.”
“Testosterone improves insulin sensitivity and nutrient partitioning. When you eat a meal, where do the nutrients go? Do they go into the muscles or do they get stored as body fat? That is what testosterone helps with.”
“GLP-1 medications are a tool. An incredible revolutionary tool. But they are not a replacement for good sustainable long-term habits.”
Treatments Mentioned
FAQ
Weight Loss FAQ
Yes. Insulin resistance blocks lipolysis (fat burning) and causes your body to store calories as fat rather than directing them to muscle. Even in a calorie deficit, it becomes much harder to lose body fat when insulin resistance is present.
Sleep deprivation raises ghrelin (hunger hormone), lowers leptin (satiety hormone), and raises cortisol, which promotes fat storage. Population data shows we get about one hour less sleep than 50 years ago, contributing to widespread metabolic dysfunction.
Testosterone improves insulin sensitivity and nutrient partitioning, determining whether calories go to muscle or fat. Low testosterone also reduces dopamine, raises prolactin, and lowers motivation to exercise, creating an indirect pathway to weight gain.
In clinical experience, tirzepatide is much better tolerated with fewer GI side effects. Approximately 40% of patients do not tolerate semaglutide well. Many patients on tirzepatide report that the medication permanently reframed their relationship with food.
Thyroid hormones T3 and T4 set your basal metabolic rate. If T3 is suboptimal, even normal caloric intake can produce weight gain. Low T3 reduces ATP production, causing neurons to sense energy shortage and send starvation signals that drive overeating.
Most doctors only test TSH and prescribe levothyroxine (T4-only). Many people do not adequately convert T4 to active T3. Functional medicine providers test free T3 and optimize from there, frequently producing dramatic improvements in energy and weight.
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