REAL reason so many are overweight. Lawyer Hannah was exhausted and struggled with her size for years... then realised she had little-known yet common condition that affects mainly women

REAL reason so many are overweight. Lawyer Hannah was exhausted and struggled with her size for years..

. then realised she had little-known yet common condition that affects mainly women By CHARLOTTE DOVEY Published: 06:45 EDT, 24 April 2025 | Updated: 06:52 EDT, 24 April 2025 e-mail View comments Walking into the family home at 8pm one night after work, Mark Ross found his three kids - then aged 11, nine and seven - ready for bed but his wife, Hannah, 43, was nowhere to be seen. Concerned, he went upstairs and found her in bed, too tired to move.



Hannah mumbled that she was fine, just shattered. As a mum of three, working as a lawyer four days a week, this was perhaps understandable. But then the same thing happened the next night, and the next.

‘I was used to feeling utterly exhausted, particularly at the end of the day, but usually I was able to push on through – I’d have a few more coffees or a quick cold shower to wake myself up,’ says Hannah, who lives in Hertfordshire. ‘In the past I’d questioned whether this was normal and have mentioned it to my doctor on numerous occasions over the years, but it had always been dismissed – “Of course you’re tired,” he’d say, “you’re a lawyer with three young children, you have long days - you’ll get over it”.’ But this time was different, says Hannah: ‘I’d managed to feed and bathe the kids, but then I felt like I’d hit a brick wall and I physically couldn’t keep going.

‘By the third night Mark thought I was either acutely depressed, or there was something seriously wrong with me.’ Hannah had probably had Hashimoto’s thyroiditis since her teens, which explained years of debilitating symptoms including extreme fatigue and unexplained weight gain In fact she was suffering from undiagnosed Hashimoto’s thyroiditis, a type of autoimmune disease where the body’s immune system mistakenly attacks the thyroid gland. It accounts for 90 per cent of all cases of hypothyroidism, or an underactive thyroid - and Hannah had probably had it since her teens, she was later told, which explained years of debilitating symptoms including extreme fatigue and unexplained weight gain.

Hypothyroidism is thought to affect around two in 100 people - mostly women - although many more could be affected as the symptoms are often missed, according to the British Thyroid Foundation. The thyroid, a butterfly-shaped gland in the throat, produces hormones that play a major part in metabolism and growth, explains Kristien Boelaert, a professor of endocrinology at the University of Birmingham and a consultant endocrinologist at University Hospitals Birmingham. ‘When things go awry and it doesn’t work properly, your whole metabolism starts to slow down – which includes brain function, heart rate and the rate at which food is turned into energy.

’ Extreme tiredness is a common symptom. ‘I don’t ever remember not being tired to be honest,’ says Hannah. ‘I have always been that person who really needs their sleep.

When I was revising for my A-levels my energy levels were so low I struggled to stay up. That continued throughout my degree at Cambridge University. As a high achiever, I partly attributed it to always pushing myself to work hard.

'When I was revising for my A-levels my energy levels were so low I struggled to stay up', says Hannah ‘Nevertheless, I’d regularly have to have duvet days. But you just think that’s how you are don’t you? After a while I did visit my GP who said he’d check my iron levels.’ Iron is essential for carrying oxygen throughout the body.

Low iron levels can lead to constant tiredness - but Hannah’s levels turned out to be fine. At around 19, she also started putting on weight, another common symptom. ‘I wasn’t a massive eater, certainly no more than my friends,’ she recalls.

‘But the weight seemed to pile on regardless. I’m 5ft 51⁄2in and should be around 9st 4lb (60kg) - but by 26, I was probably 12stone 2lb (78kg). ‘I’d have to skip meals or severely cut down on portions - and exercise like crazy.

I would, eventually, be able to just about lose some of the weight, but compared to others, it took months and months of really hard work. ‘Depressingly yo-yo weight gain and loss started to become a part of my life,’ she says. ‘For my wedding in 2010, for instance, I dieted for months to look slimmer in the photos.

I managed to get to a weight I was happy with, but as soon as I relaxed the weight really piled on.’ Unfortunately, this is a common scenario, says Professor Boelaert. Hannah joined an online diet plan recommended by a friend, and the weight dropped off ‘A slowing metabolism means your body burns fewer calories, even at rest, making it incredibly easy to put on weight and a real challenge to lose it.

’ And because your body turns food into energy more slowly, you can feel tired (the condition also affects your sleep cycle, so any sleep you do get is poor). You also slow down mentally, and you can be cold all the time. Your voice can even become hoarse as the muscles in the throat and the vocal cords weaken.

‘The symptoms are so varied and seemingly unrelated that it just doesn’t get picked up, which is why doctors often struggle to diagnose it until it’s well advanced,’ says Professor Boelaert. ‘And left untreated it can cause serious problems such as high cholesterol and atherosclerosis [clogged arteries], as the slowing metabolism also causes a slower breakdown of the removal of “bad” cholesterol from the blood.’ Hashimoto’s runs in families - 50 per cent of people affected have a family history of the condition.

Other potential causes may include stress and viral infections, or sex hormones including oestrogen, testosterone and progesterone - although exactly what that role is isn’t clear, adds Professor Boelaert. The main symptoms Fatigue Unexplained weight gain Difficulty concentrating Inability to tolerate cold Constipation Dry skin Advertisement Another possible trigger is iodine deficiency. ‘The thyroid needs iodine to produce thyroid hormones - as iodine-rich foods include seafood, shellfish and dairy products, this can be a problem for vegans’, says Professor Boelaert.

Hannah has since discovered some distant family members have the condition, suggesting in her case it’s genetic. The constant tiredness while maintaining such a high-pressure career – and having a family – was a never-ending battle, but it was the weight gain that she particularly struggled with. ‘It was embarrassing and upsetting,’ she says.

‘There are so many photos that I made my husband delete because I simply didn’t like the way I looked, or my tummy looked big. ‘I also developed the old trick of making sure I held something in front of my tummy like a handbag – or made sure a child stood there. I always just thought it was my fault I was heavier.

’ There were other symptoms of hypothyroidism that Hannah now recognises, none of which, despite regular medical checks, were ever pieced together. ‘I’ve also always been very susceptible to the cold and had freezing cold hands and feet year-round,’ she says. But it was that night in June 2023, when Hannah was physically unable to move out of bed, that led to the cause of all her symptoms finally being pieced together.

Mark, 43, was so concerned about her exhaustion that he insisted she went for a private medical through his work and this time they tested her thyroid function. ‘Thyroid function is measured by levels of TSH (thyroid stimulating hormone) and free thyroxine (fT4), but TSH is the best marker of thyroid status,’ says Professor Boelaert. ‘Whilst levels vary a fair bit, normal levels are generally between 0.

27 to 4.2 milliinternational units per litre (miU/L).’ Hannah’s were 5.

72 miU/L. Normal levels of fT4 can also vary hugely depending on the tests. In Hannah’s tests, ‘normal’ levels were 12 to 22 picomoles per litre (pmol/L) - Hannah’s were 10.

4pmol/L. While these results may not seem massively outside of the ‘normal’ ranges, Professor Boeleart explains that the extent of the symptoms – and the results from your thyroid tests - may not necessarily correlate. ‘Some people have very mildly abnormal thyroid function test results and lots of symptoms.

Others have grossly abnormal tests and no symptoms.’ After finally getting her diagnosis Hannah admits she was ‘quite angry to start with - angry I’d been dismissed for so long and had missed out on years of having more energy. ‘But then there was relief, of sorts, that I was now going to get help, my energy levels would improve and the years of struggles I’d had with my weight weren’t my fault.

’ Hannah was put on levothyroxine, a synthetic version of the thyroxine hormone produced by the thyroid, which she’ll now have to take for the rest of her life. ‘You certainly don’t feel better overnight - it took four months of “tweaking” the dose but eventually the levels settled, and that continual exhaustion did start to go,’ she says. At the time she was around 14st 4lb (92kg - BMI 31.

6). She joined an online diet plan, It’s so Simple by Rachael Sacerdoti, recommended by a friend, and the weight dropped off - within a year, she had lost nearly 4st (24kg) - going from size 16 to a size 8/10. ‘I can also now happily do a full day’s work in the office and still come home with energy to be with my kids and husband,’ says Hannah.

‘It’s been a long old haul. Now knowing the wide range of symptoms for hypothyroidism it seems pretty obvious what the problem was, but for 25 or so years, nobody was able to piece them all together.’ Share or comment on this article: REAL reason so many are overweight.

Lawyer Hannah was exhausted and struggled with her size for years...

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