Weight Management

IN THIS SECTION
 

In modern society we find ourselves far away from our hunter-gatherer days.

Cell phones and fast food restaurants have replaced snare traps and bison cookouts over open fire.

Few of us are active and moderate in our eating behaviors.

Many of us feel fat, unattractive, and tired.

While personal discipline is important in keeping a healthy weight, the physical issues caused by chronic stress cannot be ignored.

Weight management sounds a bit like a class we should have all taken in school. However it is likely the teacher would be just as puzzled as anyone else on what advice to give: Should you go with a high-protein diet, or a high-carbohydrate diet? Eat fat or don’t eat fat? How many calories should you consume in a day? Should you even worry about calories? Should you eat a vegan, Paleolithic, or 40-30-30 diet?

If you are confused about weight management, you are definitely not alone. When asked, most people will describe what they eat as “healthy”,1 and yet, waistlines continue grow. Americans are heavier now than they have ever been. Recent studies show that over 60 percent of Americans are overweight, with one-half of those considered obese.

This article does not focus on underweight conditions or related eating disorders, but more on this topic can be found in articles written by Dr. Nicola McFadzean.

What are we eating?
overweight peopleA survey of more than 12,000 Americans revealed this about their eating habits: 2

  • A survey of more than 12,000 Americans revealed this about their eating habits:
  • More than three-fourths of the obese survey respondents characterized their eating habits as “very healthy” or “somewhat healthy.”
  • Just 2.9 percent of all Americans and 11.2 percent of morbidly obese Americans characterized their eating habits as “not at all healthy.”
  • 43.1 percent of survey respondents said they did not eat fast food on a weekly basis. However 37.6 percent said they ate fast food one or two times per week.
  • The majority of those fast food orders were not “super-sized,” but 22.3 percent of Americans said they sometimes ask for the “super” or “biggie” size and another 3.6 percent said they super-size their orders “all of the time.”
  • About half of survey respondents said they exercise three or more times per week. The number declines sharply in line with body mass indexes: 40 percent of obese individuals said they exercised regularly; the number dropped to 24.8 percent in the morbidly obese category.

None of the above sounds too bad, but clearly something is going on that is contributing to our ever-expanding waistlines.

Take a Look at Your Stress
Stress has a big impact on your ability to lose, gain, or maintain a healthy weight. Let’s take a closer look at how stress can add fat to your body:

  • Chronic Stress and Elevated Cortisol: What can you do if you want to reduce cortisol (assuming you are producing high levels (see HPA Syndrome)? First, focus on becoming stress resistant. One of the best things to reduce stress and improve insulin sensitivity, for example, is getting regular exercise, even a daily brisk walk. Exercise not only helps promote weight loss by burning calories, but is also beneficial because it helps neutralize stress and its effects, which in turn helps you keep weight off.
  • Hormone Imbalances: Under chronic stress, the HPA glands increase their output of cortisol—often referred to as the “stress hormone.” The principal hormones produced by the HPA glands—cortisol, dehydroepiandrosterone (DHEA), aldosterone, testosterone, estrogens, and progesterone—share a common precursor, the master hormone called pregnenolone. Under stress, your HPA glands are hyperstimulated and pregnenolone is diverted (stolen) from the pathways that produce the principal hormones. Instead, the pregnenolone is used to produce cortisol.
  • Increased Consumption: Stress (especially chronic stress) appears to increase overall food intake in a number of ways. First, stress affects our appetite and alters our eating patterns by causing us to eat more often; many people know this as stress-eating. Second, stress is associated with a greater desire for high-caloric foods.3
  • Binge Eating: Many obese people report that stress is the common trigger for binge eating. People with binge eating disorder (BED) have a higher stress/cortisol response than people without the disorder. 4
  • Metabolic Syndrome: Metabolic syndrome, a collection of abdominal obesity, high cholesterol and high blood pressure, has a strong relationship to high-cortisol (stress hormones) conditions. Scientists who study metabolic syndrome suggest that prolonged exposure to stress hormones and hyperactivity of the hypothalamic-pituitary-HPA (HPA) axis leads to a state of “functional hypercortisolism,” or high stress hormones.5

Weight Management
Medical Approaches

  • appleReducing Calories: The standard medical advice for losing weight is caloric restriction. Suggestions usually amount to reducing portions and/or number of meals. Some medical practitioners suggest calorie intakes as low as 1,000 – 1600 a day. For many people, calorie restriction is an impossible suggestion to follow.
  • Appetite Suppressers: Certain medications can allow you to feel full more quickly as a way to lose weight (Meridia). Side effects include high blood pressure, rapid heartbeat, headache, constipation, insomnia and dry mouth.
  • Blockers: Certain medications can block the absorption of fat (Xenical). These medications tend to lead to diarrhea, flatulence, and increased urgency in many people taking them. They may also lead to a decreased absorption of certain fat-soluble vitamins (vitamins A, E, D and K).
  • Surgery: Gastric bypass, Laparoscopic adjustable gastric banding (LAGB) and biliopancreatic diversion are all options for weight loss that are generally reserved for obese patients. These surgeries have the potential to lead to malabsorption syndromes including vitamin deficiencies.

Integrative Approach to Weight Management

  • Functional Lab Testing: As with any health condition or prevention plan, one should devote resources towards doing as much lab testing as possible to identify dysfunction. The body’s fat burning mechanisms will perform poorly if the body is prioritizing its energy to compensate for problems or heal them.
  • HPA Hormone Balancing: When the HPA glands are performing at their best, the negative effects of insulin resistance and propensity for storing fat are drastically reduced. With saliva based lab tests that measure cortisol and DHEA patterns, natural therapies for hormone balance can be developed. Get your hormones tested and balanced.
  • Exercise: One of the best ways to help control body fat is through regular aerobic exercise, such as walking, stair climbing, cycling, or swimming. For weight loss, you should exercise between 30- 40 minutes a day (more if you are obese). 6Breaking up the exercise into several sessions throughout the day works as well as one long stretch. Stay loose, flexible, and always be conscious of breathing and posture.
  • Low-glycemic-index foods: Diets that emphasize low-glycemic foods have been shown to help reduce appetite, especially when compared to high-glycemic food.7
  • Nutritional Supplements: While not intended to replace a healthy diet, nutritional supplements can make a big difference.