If losing weight seems impossible then rest assured for there is an answer to the weight loss equation and it lies at the heart of integrative medicine. By taking a holistic functional medicine approach, integrating behavioral coaching with medical science, everyone can “break down the wall” to weight loss.
Of course diet and exercise are important, but for many, eating exceptionally well and exercising like mad is not enough. The “eat less and exercise more” mantra just isn’t going to work for everyone. I’ve seen it countless times and these patients need more than simple advice. They need a functional medicine work up that addresses the sneaky underlying medical issues that are blocking their success.
For others, lifestyle choices are not the best, and they do need guidance on nutrition, meal planning and cooking. Or maybe a little direction on the best type of exercise along with a plan to help insure it happens. Help with sleep and stress management is often a subtle part of losing weight.
The Lifestyle 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. 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 cause increased appetite.
Managing stress helps control the fat promoting hormone called cortisol, which causes weight gain especially around the middle. Recognize and remove stressors when possible. From there, 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.
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 gonna be tough. Try to make healthy eating a part of your social network and spend time with friends who are active.
So many times I’ve had patients doing all of the above yet still not losing weight. It is here that physicians need to jump in and address some other key elements for successful weight loss.
The Medical Path
“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 as more belly fat and less muscle. Growth hormone is the master hormone for building muscle and burning fat and it too declines with aging. Evaluating and restoring hormone balance is key to weight control.
The hunger and metabolic hormones of the digestive system including insulin, leptin, ghrelin 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.
Addressing intestinal health is a fairly easy area to help patients with weight loss. Conditions such as leaky-gut or a disrupted gut bacterial ecosystem can have profound negative impacts on nutrient absorption and metabolic vitamin production. Delayed food allergies will cause weight gain by stoking up the immune system. We routinely observe 10-20 pound weight loss in patients undergoing food allergy elimination diets. Insufficient nutrients, overloaded detoxification pathways and genetic mutations called polymorphisms are yet other areas that we can test for and treat.
Catalysts for Weight Loss
Finally there are several prescriptions that can help to really get weight loss started. HCG is a hormone that works to promote weight loss by opening up access to stubborn fat reserves so that a restricted calorie diet causes rapid fat loss as it is burned for fuel. Sermorelin is a compound that can be taken to stimulate the natural release of human growth hormone. B12 injections combined with the fat-burning trio of compounds called MIC, or methione-inositol-choline, is another great adjuvant to use. Protein shakes for meal replacement work well. Recently, the diabetic medication called Semaglutide has been recognized as a good option for weight loss. I’ve also had good success using prescription appetite suppressants such as phentermine.
Our Weight Loss Program
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. Our basic weight loss program starts with a thorough history and physical with one of our functional medicine experts and might include weekly visits with our health coach to address nutrition or to use our private fitness studio for one-on-one strength or yoga training.
Scott Rollins, MD, is Board Certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He specializes in bioidentical hormone replacement for men and women, thyroid and adrenal disorders, fibromyalgia and other complex medical conditions. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com) and Bellezza Laser Aesthetics (www.bellezzalaser.com). Call (970) 245-6911 for an appointment or more information.