A Comprehensive Approach to Weight Management

Dr. Miranda Wiley, ND

The paradigm of excess weight being the result of excess caloric intake coupled with lack of activity has failed to produce consistent results in weight management over the decades, nor does it explain why some individuals can avoid exercise and eat a bag of cookies and stay slim while others eat well and exercise regularly yet can’t shift unwanted weight from their bodies.  A deeper understanding of weight control requires a more holistic view of the body and the conditions that stimulate weight conservation, and those that support weight reduction.  Effective and permanent weight management is the result of lifestyle and dietary modifications, hormone balance, effective detoxification, sufficient amounts of quality sleep, and functional stress management.  Some of these underlying imbalances can be resolved quickly and/or easily, while others require a longer, more consistent approach, but a healthy weight – correlated with less inflammation, better cardiovascular health throughout the lifespan, and reduced signs of aging – is absolutely attainable!

  1. Stabilize blood sugar and insulin levels

There are a number of hormones that help to release energy stored in the adipose (aka fat) cells, but none of them will act when insulin is around.  Insulin is a hormone released from the pancreas in response to sugar in the blood stream, and from stretch receptors on the stomach.  Its job is to deal with the excess of energy available to the body and get it into cells where it can be used, or into storage.  Fat cells are particularly responsive to insulin so that sugar can be taken out of the blood stream quickly before it can do damage inside the blood vessel walls.

Diet is certainly a contributor to weight, however, there is a growing body of research that shows that it is not simply the number of calories ingested but the source of the calories that is important.  Foods that are nutrient dense with a low glycemic index should provide the bulk of dietary fuel, with good quality fats and proteins included to increase satiety, provide necessary compounds to the body, and influence the rate of nutrient absorption.

Dietary changes that ensure stable blood sugar levels will in turn allow for regulated insulin levels.  Exercise also helps to lower blood sugar levels.  Various nutrients and herbs may also be necessary to encourage the body to regulate blood sugar, but these are best assessed and prescribed on a case by case basis.  Portion control is important as stretched digestive organs from too much food, will also stimulate the release of insulin into the blood stream.

  1.  Add light weight training and interval training to activity level

Regular activity is essential for overall health of the body including weight management, cardiovascular health, beautiful skin, stress management, and so on.  To enhance the benefits of exercise for your body include some weight training to build lean muscle mass (which burns energy more quickly that fat tissue), and interval training to get more effective results from aerobic activity.  If you are new to exercise consult a physician before starting an exercise regime.  If fatigue is a concern that prevents regular activity, the cause of fatigue needs to be assessed and addressed immediately.

  1. Support digestion and detoxification pathways

Poor digestion contributes to a weight imbalance through malabsorption of nutrients, inflammation of the digestive tract, and the development of toxic compounds that, if unable to efficiently removed from the body, are sequestered away in fat tissue and “insulated” to protect the body from their damaging effects.  Enhancing digestive processes and maximizing liver function allow the body to regulate nutrient levels and eliminate toxins that may encourage weight retention.  Any digestive symptoms such as diarrhea or constipation, gas, heartburn, bloating, abdominal pain or discomfort will need to be addressed for optimal weight balance, as will seemingly unrelated symptoms such as allergies, joint pain, headaches, or skin conditions including acne, psoriasis, and eczema.

  1. Assess hormone and/or neurotransmitter levels and activity

Hormones are chemical messengers that tell cells how to behave, and in the case of weight management, they have a direct effect on how effectively fat cells take in or release energy, and how quickly muscle cells burn fuel.  If hormones are out of balance it can be very difficult to achieve and maintain a healthy weight – as is seen with high levels of circulating insulin.  Of chief importance in the regulation of weight are the adrenal hormones cortisol and DHEA and their levels both overall and in relation to each other, thyroid hormone levels, and sex hormones estrogen, progesterone and testosterone.

Adrenal hormones such as cortisol, epinephrine, norepinephrine and DHEA are released in response to stress.  Chronic stress can have a significant effect on weight, and also affects inflammation in the body, mood and mental function, the balance of other hormones, bone health, cardiovascular health, and diseases of aging.

Excess cortisol leads to the development of a “spare tire” around the middle, breaks down lean muscle mass, and elevates blood sugar (in turn stimulating higher insulin levels).  A lack of cortisol contributes to fatigue and blood sugar imbalances.  DHEA opposes the action of cortisol and supports blood sugar balance and lean muscle mass.  Excess DHEA is associated with acne, unwanted hair growth, and aggression.  As with all things in life the key is in the balance between the hormones.

Thyroid hormones act as the metronome or “RPM” of the body.  Low thyroid function leads to unintentional weight gain and difficulty losing weight, and other symptoms such as chilliness, fatigue, and constipation.  An overactive thyroid leads to unintentional weight loss, difficulty gaining weight and other symptoms such as palpitations and anxiety.

Sex hormone imbalances can also contribute to changes in weight and weight distribution.  Too little estrogen leads to a thickening of the waist and loss of hour-glass figure in women, while too much estrogen stimulates the production of fat cells – on the hips and thighs in premenopausal women, and on the tummy in men and postmenopausal women.  Progesterone increases metabolism (the rate at which the body burns fuel) so a deficiency of progesterone, relative to estrogen levels, can also contribute to additional unnecessary weight.  Testosterone supports the development of lean muscle mass, but like DHEA too much testosterone is not a good thing.

Hormones interact and inter-relate.  The adrenal hormones affect thyroid function and sex hormone levels; thyroid hormone influences the adrenals and gonads; and sex hormones shift thyroid and adrenal activity.  With hormones it all comes down to balance.  Balanced hormones set the stage for stable, healthy weight and support balance in other areas of life and long-term health as well.

Neurotransmitters (NTs) also act as chemical messengers but their action is contained within the nervous system of the body.  Neurotransmitters and hormones have a mutually influential relationship.  Key NTs in the management of weight are serotonin and dopamine for their influence on appetite and cravings, although once again, the bottom line is balance making all of the NTs relevant to a certain degree.  Epinephrine, norepinephrine, GABA, and glutamate all factor into stress response and adrenal stimulation so while they don’t necessarily affect weight levels directly they still play into overall health, balance, and weight management.  Lack of sleep increases appetite (and fatigue) and can therefore also affect weight.  Insomnia and stress management must both be addressed in the quest for achieving a healthy weight.

Hormone and neurotransmitter levels can be assessed in a variety of ways including blood, urine and saliva – the body fluid used depends upon the hormone or neurotransmitter to be tested.  Once the levels have been identified a plan for balancing them can be established.

  1. Smile!

Stay positive on the journey to a healthy weight knowing that you are positively affecting your long term health on all levels with the changes to diet and lifestyle and quest for internal balance!