I am desperately trying to lose 50 pounds. I joined a gym three months ago and go twice a day, five days a week. In the morning I do 45 to 60 minutes of aerobics and 45 to 60 minutes of body sculpting. Each evening I do 30 to 45 minutes on the treadmill and then the weight machines. I threw away all junk food and eat salads two to three times a day. After almost three months of hard work guess what? I gained three pounds. How can that be? My doctor said my thyroid is fine. Why is nothing happening?

I can certainly understand why you are discouraged, but take a deep breath, relax, and let's "rethink."

You formulated what looks like a very good strategy. It ought to be "working". For some reason it's not. So acknowledge your disappointment, and now let's roll up our sleeves and go back to the "strategy drawing board."

Several things could be happening:

1. With such an ambitious workout routine you undoubtedly gained some muscle. You probably also lost some body fat. Even though the scale may not reflect it, chances are there is a small but measurable shift in body composition, which you're not seeing on the scale. I know that's not a lot, but wait, there's more.
2. If you haven't weighed yourself in three months, you don't have a good reliable indicator of what's going on. There are all kinds of fluctuations from day to day. If you're going to use the scale, pick one specific scale, decide on whether or not to wear clothes (I suggest not), pick a time of day (I prefer early morning before eating) and then consistently weigh yourself under the exact same conditions with the same scale every time to determine whether things are moving in the right direction. Different scale, different time, different anything makes the comparison like comparing clocks in the bank with clocks in the subway with clocks on the street -- they're all off by a minute to three minutes, so you can go nuts if you're making comparisons.

3. You didn't gain that 50 pounds overnight; you need to look at this as a long-term strategy. There are many reported cases of people who worked out for many months before finally getting their sluggish metabolism to respond, at which point they finally began to see results.
4. I wouldn't completely trust that thyroid test. Low thyroid is one of the most misdiagnosed or underdiagnosed conditions, and many traditional doctors simply don't catch it. You can do an at-home test to see whether this is worth pursuing further. Take your underarm temperature upon arising two or three days in a row, not on menstruating days. If it's consistently below 97.8, make the doctor check again with a complete panel including TSH.
5. Rethink the food strategy. You have started a very heavy exercise program at the same time as a very big reduction in calories. Your body may be reacting by "conserving" energy and slowing your metabolism down somewhat. Also, I want you to consider that you may not be getting enough fat, especially the right ones. So I want to make sure you're eating enough to fuel these hard workouts and that you are not on a "no fat" diet. If you're comfortable with the concept of counting calories, try to aim for 1,300-1,500. A good place to start is with 40 percent from carbs, 30 percent from protein and 30 percent from fat. This is a very good beginning template. You may need to adjust the contribution from carbohydrates down a bit if nothing continues to happen. My colleague Ann Louise Gittleman reports that she has seen women move off of the kind of stubborn "plateaus" you're on just by adding supplemental fats of the right kind, such as flaxseed, fish oil and evening primrose oil.
6. Consider supplementation. If your body is not getting optimal amounts of the right nutrients, the metabolism may be performing sluggishly since it may not have all the nutrients it needs to break down food and fat stores for energy in an optimal way. Some people have had good results with, at the very least, extra B vitamins and definitely chromium picolinate. And a number of nutritionists theorize, with good reason, that many overweight people are not getting enough carnitine in their diet, so supplementation with carnitine might be worth a shot.

The point is this: Keep checking your strategy. There's no need to be desperate. You may feel as if you're looking at a locked door right now, but believe me, there is a key on that key ring. It's just a matter of finding it.

Got a question or comment for Jonny? Post it on the Shape Up message board!