Frustration describes the patient unable to lose weight. Despite doing the right things, namely eating well and exercising, many still struggle unsuccessfully. As a physician, managing obesity is one of the most important and rewarding areas in all of medicine. Yet most physicians are also frustrated with our disappointing efforts to help patients by simply repeating the “eat less, exercise more” mantra. Rest assured, there is an answer to the weight loss equation.
In 20 years of practice I’ve helped thousands of people lose weight. Along the way I’ve identified some key elements that can help or harm our weight loss efforts. By evaluating and addressing each element we are usually able to “break through the wall” of that stubborn weight that just won’t budge. Some of the elements require the patient to make the effort while others require the physician to examine more thoroughly.
First and foremost address lifestyle choices including nutrition, exercise, sleep, stress management and social situations. Here are the basics…
Nutrition advice can get too technical, counting calories and measuring portion sizes, or prescribing a detailed and cumbersome menu, and I have found that breaking down nutrition into a few simple rules is most productive. Eliminate sugar and artificially sweetened drinks. Drastically reduce the starchy carbohydrates such as breads, potatoes and pasta. Avoid hydrogenated oils and “trans-fats” found mostly in processed and packaged foods. Limit red meat and dairy to a few servings per week, instead focusing on leaner cuts of fish and fowl.
Fresh, raw, preferably organic fruits and vegetables should make up most of the diet. Whether organic or not I recommend a produce “wash” designed to clean off the dozens of chemicals that are well-known to reside on most produce. Whole grains and proteins should equally make up the rest. A simple routine is to get a daily fruit plate or salad and a daily vegetable salad. Berries are the ideal fruits and the brightly colored green, red, orange, yellow, blue, and black veggies are the best.
Don’t eat everything on your plate if there is too much on your plate! The typical restaurant entrée is usually plenty for two. Using smaller plates has been shown time and again to help control portion sizes. If you don’t cook then learn to! Preparing fresh, healthy food is a key element to weight loss and one of life’s simple pleasures.
Exercise is another key element and it does not have to be fancy or cumbersome. Nor do you need to join a gym or buy expensive equipment. Ideally we should do some aerobic and some strengthening activities. Simple walking or biking is plenty for most people and it does not even have to be all at one time. Taking several shorter walks during the day counts and will add up to a significant amount of exercise. Obviously, running, swimming, or any type of “high-intensity interval training” is even better. Strength training can be a simple as a home exercise program with exercise bands, a few free weights and a pull up bar. Yoga is a great routine for building core strength. Many metabolic pathways and hormones rely on exercise to activate the very systems that help build muscle and lose weight.
Sleep is an under-recognized yet major player in the game of weight control. Most of our beneficial hormones that improve metabolism are produced during the deeper sleep cycles, such as thyroid, testosterone and growth hormone. Important appetite signaling hormones are thrown out of balance with poor sleep and can actually cause increased appetite. Addressing sleep disorders is another key to weight loss.
Managing stress helps control the fat promoting hormone called cortisol. With ongoing stress people keep making too much cortisol, which leads to inflammation, high blood sugar, insulin resistance, lowered thyroid and sex hormone levels, and weight gain, especially weight around the middle and the abdomen. Recognize and remove stressors when possible. From there, even the best of life can be complex, and inherently somewhat stressful, thus managing stress is the goal. This is done on an hour-to-hour and day-to-day basis by simply taking the time to balance the stressors. Taking a short walk, doing a few minutes of deep-breathing exercises, meditation, or restorative yoga are a few techniques to practice regularly. Seeking the guidance of a life-coach or counselor is often very helpful in getting a handle on stress.
Social situations are worth noting as they can have a good or bad effect on weight loss efforts. If you frequent fast food restaurants and hang with “over-indulgent couch-potato” buddies, then eating well and exercising is going to be tough. Try to make healthy eating a part of your social network and spend time with friends who are active.
So, so many times, I’ve had patients doing all of the above and doing it well, yet still not having luck losing weight. It is here that physicians need to jump in and address some other key elements for successful weight loss.
“I’ve struggled with weight my whole life,” says the patient with low thyroid. Or the stressed out patient with high cortisol may complain, “I’ve put on this weight and it’s all stuck right around the middle.” After menopause many women put on 20-30 pounds in the first year due to deficiencies of the ovarian hormones. Men too, usually by age 50, start to show signs of low testosterone manifesting in part as weight gain, especially in the abdomen. Growth hormone is the master hormone for building muscle and burning fat and it, too, declines with aging.
Evaluating and restoring hormone balance is another key to weight control. Sometimes hormone replacement therapy is appropriate and other times there are natural supplements, foods, and activities that will optimize your hormones.
The hunger and metabolic hormones of the digestive system that include insulin, leptin, and adiponectin can also be optimized for weight loss. Using supplements or medications we can assist this important hormone system to control appetite and speed up metabolism.
Intestinal Health and Food Allergies
Addressing gut health is a fairly easy area to really, really help patients with weight loss. Conditions such as leaky-gut or dysbiosis (abnormal gut bacterial ecosystem) can have profound negative impacts on nutrient absorption and metabolic vitamin production. Delayed food allergies that occur 12-72 hours after eating common foods will cause weight gain by stoking up the immune system. We routinely observe 10-20 pound weight loss, especially around the middle, in patients undergoing food allergy elimination diets.
The accumulation of toxic chemicals in the body is unavoidable in the modern world and most of these toxins interfere with various aspects of healthy metabolism. Plus, when losing weight, we release many of these same toxins into the circulation to cause harm elsewhere. We can help you cleanse and detox the body so that your metabolic machinery works better and weight loss does not lead to a huge toxic burden your body.
If you are struggling with weight loss then consider these key elements – one of them just may be the answer to your weight loss solution.