Do You Really Need to Track Macros to Lose Weight? A Functional Medicine Perspective
By Dr. Simone Sturm, Denver Holistic Medicine
When it comes to weight loss, macro tracking — counting protein, carbohydrates, and fats — is often promoted as the most effective approach. While tracking macros can be helpful for short-term awareness, in my work as a functional medicine practitioner at Denver Holistic Medicine, I’ve found that sustainable weight loss is rarely just about numbers.
For many women, especially those navigating hormonal imbalance, perimenopause, menopause, thyroid dysfunction, and metabolic resistance, weight gain is driven by deeper physiological factors — not lack of discipline.
Let’s explore when macro tracking can be useful — and when addressing root causes leads to far better long-term results.
What Are Macros and Why Do People Track Them?
Macros are the three main nutrients the body uses for energy and regulation:
Protein – supports muscle mass, metabolism, hormones, and satiety
Carbohydrates – fuel energy, blood sugar regulation, and cortisol balance
Fats – support hormones, brain health, and inflammation control
Tracking macros can help with:
✔ Understanding portion sizes
✔ Increasing protein intake
✔ Reducing overeating
✔ Improving food awareness
For some people, this structure creates short-term success.
Why Macro Tracking Often Fails for Hormonal Weight Gain
In functional medicine, we look at why the body holds onto weight in the first place.
Common root causes include:
• Insulin resistance
• Elevated cortisol (chronic stress)
• Thyroid imbalance
• Perimenopause and menopause hormone shifts
• Poor sleep
• Inflammation
• Gut dysfunction
• Loss of lean muscle mass
When these systems are out of balance, the body may resist fat loss — even with perfect macros.
When Tracking Macros Can Be Helpful
I sometimes recommend short-term macro tracking when a patient:
✔ Is under-eating protein
✔ Has no structure around meals
✔ Overconsumes refined carbs
✔ Needs nutritional awareness
Used briefly, it can recalibrate habits.
But it should never replace addressing metabolic and hormonal health.
When Macro Tracking Can Increase Weight Loss Resistance
For many women — especially those with high cortisol, history of dieting, or food anxiety — constant tracking can actually increase stress.
Chronic stress raises cortisol, which promotes:
• Fat storage (especially belly fat)
• Blood sugar imbalance
• Hormonal disruption
In these cases, healing the nervous system is more important than tracking food.
What Matters More Than Macros for Sustainable Weight Loss
From a functional medicine perspective, the most powerful strategies include:
✔ Blood Sugar Regulation
Balanced meals with protein, fiber, and healthy fats improve insulin sensitivity.
✔ Building Lean Muscle Mass
Strength training boosts metabolism and supports hormone balance — especially during perimenopause and menopause.
✔ Cortisol & Stress Management
Sleep, nervous system regulation, and lifestyle balance are critical for fat loss.
✔ Hormone & Thyroid Optimization
Estrogen, progesterone, insulin, and thyroid hormones all impact metabolism.
✔ Gut Health & Inflammation Reduction
A healthy microbiome supports appetite control, nutrient absorption, and metabolic function.
Should You Track Macros to Lose Weight?
The answer is individualized.
Macro tracking can be a helpful short-term educational tool — but for many women struggling with stubborn weight, fatigue, and hormonal symptoms, it doesn’t address the root cause.
The most successful long-term results come from:
✔ Balancing hormones
✔ Improving insulin sensitivity
✔ Reducing chronic stress
✔ Building muscle
✔ Supporting gut health
✔ Eating enough — not restricting
A More Sustainable Functional Medicine Approach to Weight Loss
Instead of focusing on daily macro numbers, I encourage patients to prioritize:
• Protein at every meal
• Whole, nutrient-dense foods
• Strength training 2–4 times per week
• Quality sleep
• Stress regulation
• Consistent meal timing
• Listening to hunger cues
When the body feels safe and supported, weight loss becomes much easier and more natural.
Final Thoughts
Macro tracking is a tool — not a solution.
For women dealing with hormonal shifts, metabolic changes, and chronic stress, addressing the underlying physiology leads to far better and longer-lasting results than chasing calorie or macro targets.
If you’ve been eating “perfectly” and still struggling with weight, it may not be your effort — it may be your hormones, metabolism, or stress response asking for deeper support.
At Denver Holistic Medicine, we help uncover and treat the root causes of weight gain so patients can finally experience sustainable health and confidence.