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Managing weight with hypothyroidism involves dietary changes, physical activity, and stress reduction.

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Hypothyroidism occurs when the thyroid gland does not produce enough hormones.

While a reduction in metabolism can make weight loss difficult, it is not impossible. Steps to managing weight often involve:

  • lifestyle changes such as:
    • diet
    • physical activity
    • stress management
  • treatment for the underlying cause
  • hormone level checks

This article reviews weight and hypothyroidism and the changes people can make to help manage and lose weight with hypothyroidism.

Serious cases of hypothyroidism can lead to an estimated 50% loss in metabolism, leading to weight gain and issues with losing weight.

A person may also gain about 5–10 pounds directly due to hypothyroidism. This weight gain mainly comes from water and salt retention, but it should clear once treatment or lifestyle changes start.

Read on for the ways a person can lose weight with hypothyroidism.

Dietary changes may help with weight management. However, a person with hypothyroidism should consider how certain foods may affect their thyroid and include or exclude them from their diet.

Currently, there is no specialized diet for hypothyroidism. However, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) suggests that food has the following possible effects on hypothyroidism:

  • certain foods may interfere with medications
  • foods with certain nutrients may help maintain thyroid function, such as:
  • some foods may contribute to a diminished thyroid function

Hypothyroidism may occur due to much or too little iodine intake. The thyroid needs a certain amount of iodine to function properly.

However, people with Hashimoto’s thyroiditis, an autoimmune disorder that is a common cause of hypothyroidism, or other autoimmune disorders affecting the thyroid may negatively react to foods and supplements containing large amounts of iodine. This could lead to diminished thyroid function.

To avoid

Other foods to avoid include gluten and processed foods.

Evidence suggests that people with Hashimoto’s thyroiditis have a higher rate of celiac disease. Further research suggests that gluten can negatively affect a person with Hashimoto’s thyroiditis.

To eat

A person should focus on following a balanced diet and consuming foods such as:

To help a person lose weight and avoid exacerbating their hypothyroidism symptoms, a person can follow a balanced diet and limit foods that are:

  1. processed
  2. high fat
  3. simple carbohydrates like sugar

Read more about foods to eat and avoid with hypothyroidism.

A food journal may help a person understand the foods they are eating and be more mindful of what they consume each day. This is a form of mindful eating.

The benefits of food journaling can include helping a person:

  • determine if they are eating too little or too much each day
  • remember what they consumed each day
  • see when they get hungry each day and adjust their eating habits
  • determine if they are eating due to boredom instead of hunger
  • achieve their goal

However, journaling may not be for everyone. A person should discuss this method with a doctor or nutritionist before trialing it.

Increased activity can work in conjunction with improvements to diet. A person needs to be more active to lose weight or maintain it.

Researchers in a 2015 study attributed improvements in thyroid function with decreased weight due to regular exercise. They observed these effects mostly in people with hypothyroidism.

Exercise types

At a minimum, a person should aim to get at least 150 minutes of moderate physical activity every week. A person can break this down into 5 days of 30-minute exercise sessions or moderate intensity activities, which can include:

  • tennis
  • basketball
  • running
  • walking
  • rowing
  • swimming

In addition to cardio workouts, a person should aim to participate in resistance training twice a week. Resistance training can include:

  • lifting weights
  • using exercise bands
  • doing bodyweight exercises, such as pushups or pullups
  • using kettlebells

However, before starting any new activity or exercise program, a person should consider talking with a doctor or physical therapist to discuss suitable levels of exercise for them.

Find out more about exercise and fitness from our dedicated hub.

Research from 2018 shows that stress can contribute to weight gain and the development of obesity in individuals.

While the specific links between stress and hypothyroidism are not conclusive, finding ways to manage stress may help a person lose weight and maintain weight loss.

Though people may respond differently to interventions, some ways to reduce stress include:

Learn more about stress-reduction strategies.

To treat hypothyroidism, a doctor will typically prescribe medications to replace the hormones the thyroid should be making.

A doctor may also recommend treatment to address an underlying cause of the condition.

The NIDDK suggests several factors can cause hypothyroidism, such as:

  • Hashimoto’s thyroiditis
  • surgery
  • radiation near the thyroid
  • congenital causes
  • certain medications

A person should follow all instructions from a doctor regarding when and how to take the medication and adhere to any other treatment methods needed.

By addressing hypothyroidism, a person may lose some weight through treatment. A person can lose a small amount of weight when starting hormone medications, but it is generally less than 10% from medication alone, meaning a person will still need other methods to help lose weight.

As part of treatment, a person should have their hormone levels checked regularly. This can help ensure that treatment is effective for the person.

Typically, a doctor checks a person’s blood work every 6–8 weeks after a person starts medication and after every medication change. If hormone levels appear to be stabilizing, a doctor will likely check a person’s levels every 6–12 months.

Losing weight safely generally involves a combination of lifestyle changes, including increased exercise and changes to diet.

People interested in losing weight may want to check out support programs for further guidance. For example, Weight Watchers, rebranded as WW, provides support, meal plans, and other advice on losing weight.

Learn more about science-backed ways to lose weight.

The following sections answer some frequently asked questions about weight loss and hypothyroidism.

How long will it take to lose weight with hypothyroidism?

Weight loss with hypothyroidism will typically take about the same time as it would if the person did not have hypothyroidism.

Once treatment starts, a person can expect to lose some weight associated with hypothyroidism.

How to lose 20 pounds with hypothyroidism?

A person hoping to lose more weight can take some time. With or without hypothyroidism, a person can only lose so much weight at any given period.

People can generally safely lose up to 2 pounds a week with regular exercise and a healthy diet.

A person can speak with a doctor to explore other weight loss measures, particularly if they have hypothyroidism, to avoid any complications.

Can rapid weight loss cause hypothyroidism?

Extreme dieting can have negative health impacts. According to a 2014 study, weight loss can lead to a minimal decrease in thyroid hormone activity levels. The study suggests that drastic dieting and bariatric surgery can lead to potential thyroid issues.

If a person restricts their diet too much, it can lead to a decrease in a necessary nutrient, iodine. An iodine deficiency may lead to hypothyroidism.

To maintain their iodine intake, a person can use iodized table salt and eat iodine-rich foods, such as dairy products, seafood and meat, and eggs. They can also take a multivitamin with iodine.

Note that iodine deficiency in Western countries is relatively rare.

People should speak with a doctor to discuss suitable diet options, with or without hypothyroidism.

Hypothyroidism can cause some weight gain and make it more difficult to lose weight. However, with successful treatment and lifestyle changes, a person can lose weight or maintain a moderate weight.

People should stick with their treatment plan and discuss any issues with a doctor. A doctor can also recommend how much exercise a person should do and dietary changes that may help.