If it seems like you work out regularly only to continue to struggle losing weight, you’re not alone. But losing weight in order to improve health may be the wrong approach. First you need to fix what’s holding you back on the inside, so you can see the transformation you want on the outside.

Cliff Edberg cringes every time he hears someone say: I want to lose weight to get healthy. “In my opinion that phrase is backward,” says Edberg, a registered dietician, personal trainer, and certified weight loss coach at Life Time Fitness, The Healthy Way of Life Company. “People need to get healthy first in order to lose weight. Weight gain or being unhealthy isn’t directly caused by a lack of exercise, it’s a side effect of metabolic dysfunction.”

Generally people refer to having “good” metabolism (someone who burns calories quickly) or “bad” metabolism (a slow caloric burn with leftovers stored in body fat). But metabolism is much more than the rate at which calories are burned. Metabolism is the process of breaking down food into smaller molecules for various uses in the body. Certain foods or ingredients might interfere with a person’s metabolism, as can a lack of nutrients, high blood sugar or an overabundance of stress hormones. This metabolic disruption is often behind a person’s inability to lose weight, even when they are taking steps to eat right and exercise.

Michelle Stork, 43, from Chanhassen, Minn., had resigned herself to creeping weight gain, despite diligently working out for years. “As time went on it was easier to gain than lose weight,” she recalls. “Exercise alone wasn’t taking it off.”

She accepted the weight gain as a normal part of getting older, but Edberg, her personal trainer, didn’t. He encouraged her to take a simple blood test to check for underlying metabolic issues. “I could see on paper what the problems were and it motivated me to try what my trainer suggested,” Stork says. She slowly added recommended supplements, including vitamin D, probiotics and fish oil, which increased her energy, but didn’t affect her weight. The next step was to change her diet.

“We discovered a high likelihood that she was sensitive to gluten and dairy,” Edberg says. Unlike an allergy, a sensitivity means the hormones derived from the metabolic process of such foods send confusing messages to the brain, which can cause various symptoms, including weight gain. Within a month of eliminating gluten and dairy from her diet Stork lost more than 10 percent body fat and dropped 12 pounds and two sizes.

“If someone has a thyroid issue, nutrient deficiency, sex hormone imbalance, etc., they will gain weight,” Edberg explains. As a certified weight loss coach, he knows that unless the true underlying metabolic issue is addressed a person will not sustainably lose weight. “All the exercise in the world will not fix a thyroid issue or nutrient deficiency. In some cases it might make the underlying problem worse.”

This “inside out” approach to personal training is the standard at Life Time Fitness. New members take a comprehensive assessment, called myHealthScore, to measure six metabolic markers – cholesterol ratio, triglycerides, blood pressure, body fat ratio, glucose levels and nicotine use – in order to first set goals based on their internal health.

With information from myHealthScore Edberg says he can make precise exercise, nutrition, lifestyle and supplementation recommendations to support each client’s individual metabolism needs.

Stork is impressed with her results, but the implications go beyond a smaller waist line. Her father suffers from Parkinson’s disease, which looms large in her mind. The steps she is taking now she hopes will prevent a dependence on medication later. “I know what may be ahead of me as I get older, and I know I need to start doing things to improve my overall health and fitness to help counter any disease I may develop later in life.”