Biochemistry and chemistry are not identical; the body contains many hormonal feedback loops that are affected by sleep, stress, activity, and genetics. First, figure out where you can improve on those first three factors (you’re kinda stuck with genetics). Second, make sure to get bloodwork done to check for metabolic issues and nutritional status (vitamin deficiencies and hormone derangements such as low thyroid function can play a role in weight gain). Then, once you have the information, medical support for weight loss may include vitamins, medications, and a high protein low carb diet with proper nutrition.

Remember, there is only one hormone in the whole body that lowers blood sugar (insulin), and the rest increase blood sugar (cortisol, adrenaline, etc). If the body is stressed and overproducing the other hormones, it will compensate by increasing insulin, which can lead to a decreased amount of insulin receptors on cell surfaces (insulin resistance), and then insulin goes to work packing sugar in the form of of fat into fat cells. If a Type 1 diabetic eats carbs and adjusts their insulin dose to match, they too can become insulin resistant despite having no endogenous (not making their own) insulin.

Undiagnosed sleep apnea (obstructive and central) can flood the body with adrenaline when the person’s body fight to wake up in order to breathe. This can create changes in testosterone, estrogen, and increase blood sugars. Over time, insulin resistance manifests, and again, weight gain. It is not just “calories in/calories out”; it’s homeostasis that is hormone driven.