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When thyroid hormone levels are low, metabolism slows, leading to: Reduced resting energy expenditure: The body burns fewer calories even during basic functions Fluid retention: Hypothyroidism causes mucopolysaccharide accumulation in tissues, leading to a specific type of swelling called myxedema Fatigue and reduced activity: Low energy levels make consistent exercise challenging Altered appetite signaling: Thyroid hormones influence leptin sensitivity and appetite regulation Insulin resistance: Hypothyroidism is associated with impaired glucose metabolism, making fat storage more likely (Duntas & Brenta, 2018, Thyroid ) Even with adequate levothyroxine replacement, many hypothyroid patients report difficulty losing weight

These mechanisms account for their robust effects on glycemic control and weight reduction in patients with T2D and obesity

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Studies show average reductions of 1015% of total body weight over time