Weight loss: When willpower isn’t enough
The popular belief that the ability to lose weight is solely linked to willpower is far from the truth. But doctors practicing integrative, functional medicine can consistently help individuals struggling with weight loss by simply identifying the cause of excessive weight, writes Dr. Sly Nedic.
For years, obesity has been a raging pandemic affecting both the developed and developing world. With the increased global availability of unhealthy, nutrient-poor convenience and processed foods, it’s no real surprise that we’ve been piling on the kilos. As a result, researchers have been hard at work to find sustainable weight-loss interventions.
Many minds were blown when Harvard research indicated that certain gut bacteria activate dormant genes linked to weight control. The preliminary findings showed that good bacteria, fed with vegetable fibre, can even be slimming enough to mimic the effects of gastric bypass surgery. Gut issues and bad bacteria were identified as the leading cause of excessive weight in the individuals studied.
The cost of sugary comforts
Over the course of the ongoing Covid-19 pandemic and ensuing lockdowns, many people have continually complained about increased food intake, predominantly ‘comfort foods’ that are high in carbs and simple sugars (consider all those early-lockdown banana breads). The inability to stop this cycle arises from complex biochemical processes that do not allow us to make a simple decision to stop.
Any food that is high in carbohydrates (high glycaemic load) will produce a sharp spike in our blood glucose levels. In order to adjust for this rapid increase, our body releases the hormone insulin into the bloodstream. Insulin then lowers the blood glucose levels by storing it in the form of fat. Every time we eat a meal high in carbohydrates – such as a sandwich, chips or chocolate – our insulin levels shoot up to manage the high blood sugar and convert it into fat.
Elevated insulin also intensifies our hunger levels by pushing blood glucose into our cells, causing blood sugar to drop. This event typically results in a bout of hunger accompanied by cravings for more sugar. Feeding these cravings causes our insulin to rise again, and the vicious cycle endures. When insulin levels are high, it is absolutely impossible to burn fat without medical intervention.
What is of real concern during this process is that we lose magnesium and chromium, which are heavily involved in carbohydrate metabolism and cravings. Both high sugar intake and elevated insulin levels have been shown to increase magnesium’s excretion by the kidneys. Chromium is necessary to bind insulin, increasing the number and sensitivity of insulin receptors, and sugar intake may also increase chromium’s urinary excretion. If these two elements are depleted, replacing magnesium and chromium can terminate sugar cravings.
Long-standing weight problems, usually if driven by insulin resistance, are almost always accompanied by three metabolic disturbances that prevent us from losing weight: inflammation, detoxification problems, and hormonal changes.
No amount of willpower, diet, and/or exercise would suffice to overcome these metabolic imbalances, as they make the weight-loss process utterly stubborn to change.
Chronic inflammation is particularly dangerous, as it increases inflammatory cytokine production, especially in visceral fat tissue (between our internal organs), driving insulin resistance to a more advanced level. These inflammatory cytokines are involved in developing full-body insulin resistance, which increases the risk of heart problems, chronic kidney failure, and certain cancers.
Inflammation also interferes with our body’s response to the satiety hormone leptin. This increases the likelihood of eating to excess. Leptin resistance is a significant metabolic problem that contributes to excessive weight gain and, here, just utilizing willpower is not of much use. This process simply needs to be understood and then reversed.
We often underestimate the various factors that lead to chronic inflammation. These are:
- Exposure to environmental toxins, food additives, pesticides, harmful chemicals from household cleaners, cosmetics, etc.
- Chronic stress with altered cortisol levels.
- Inflammatory foods – processed, junk, or burnt – and food lacking wholesome ingredients.
- Excess weight, especially if nutritional depletions present (low levels of vitamin D, B12, B6, etc.).
By taking these varying factors into account, it becomes easier to see how someone with elevated cortisol levels due to stress – which then results in the increased deposition of visceral fat, adding to stubborn body fat – will be unable to lose weight by simply using willpower to change their eating habits. A tailored nutritional plan is a start, but will only be successful with interventions that target the high cortisol levels. Hence, the cause of stubborn fat must always be known for a successful outcome.
Excessive fat tends to hold toxins, which presents challenges to detoxification and contributes to water retention. The fluid is also retained to buffer the inflamed areas. This is why sufficient detoxification is essential for any personalized weight-loss program.
Stubborn fat, especially with underlying insulin resistance and high inflammatory cytokine production, causes hormonal disturbances that drive complex outcomes. This includes estrogen dominance in men, high testosterone in women, decreased thyroid activity, etc.
In the genes?
After finding the FTO gene (fat mass and obesity-associated protein) in 2007, which is responsible for a 30% increased risk of obesity, the PPAR gene that drives insulin resistance, and LEP gene for leptin resistance, our knowledge of how to treat excessive weight dramatically improved.
We can now routinely check for the obesity and insulin resistance genes (appetite control genes, energy expenditure, adipogenesis genes, lipid metabolism genes, etc.) that are helping us to understand propensities towards weight problems. Being equipped with this knowledge and knowing they may be predisposed to obesity also improves patient compliance.
For the most part, long-term weight loss can only be achieved by fully understanding the causes behind stubborn fat. Once we have tested the genes, checked the biomarkers, and observed the environmental influences (pollutants, sedentary lifestyle, stress, poor dietary habits, etc.), we would be able to prescribe a comprehensive nutritional plan that aims to recreate a healthy body state. And a healthy body sheds fat quite quickly!