Need for New Approaches to Weight-loss – Longview News-Journal (blog)

Recently the media was all a buzz over brand-new research which concluded that
“The Biggest Loser” contestants not only gained their weight back but
now had slower resting body metabolism.¹ This of course is
not the reality which those struggling to lose weight would like to
achieve, especially after all of the grueling hours spent exercising and
dieting. The weight-loss and dieting problems experienced by “The
Biggest Loser” contestants bring attention to the need for brand-new
approaches to weight-loss and control.

Kevin Hall, a federal research scientist, decided to follow the
contestants of the reality TV show for six years to discover their fate.¹
He found that not only did they have slower resting body metabolism,
but they also had lower levels of leptin, an appetite suppressing
hormone. The change in body chemistry caused the former contestants to
be constantly hungry. However, now with slower resting body metabolism,
they also required far fewer calories to maintain their goal weight than
a typical person their size. Additionally, Hall discovered that the
body works very hard to get back to its original weight before the
weight was lost. This is not that surprising since the body has numerous
mechanisms to maintain homeostasis. Unfortunately, maintaining weight
ultimately proved to be a losing battle for the contestants. Not only
did they gain the weight back, but some now weigh even more.

Prior to Hall’s study, it had actually been known that “The Biggest
Loser” contestants where not able to maintain the weight they had lost
during the show. This is a prime example of what happens when people
diet. The fact is, diets ultimately don’t work. The majority of people
eventually go back to their same negative diet and lifestyle behaviors.

Obesity and weight-loss is very complex, and even after numerous years of
scientific research we still don’t have all of the answers. The
pathogenesis of obesity is considered to be overeating (greater energy
input than output).²⁽³⁶⁴⁾ It seems to be this simple, but it
isn’t. Often for weight-loss, the emphasis is placed on the amount of
calories a person consumes. But, this is not completely accurate because
not all calories are created equal. They are absorbed and burned by the
body differently. For victory in overcoming obesity, a treatment
protocol should include medical, nutritional, emotional, physical
exercise and lifestyle. The sole focus should not be on losing weight. ²⁽³⁶⁶⁾

There can be numerous causes of obesity. Factors that can cause obesity
include genetic, behavioral, environmental which includes food allergies
and toxins, various health conditions such as Diabetes, Hypothyroidism,
Stress Induced High Cortisol, Cushing’s Disease, PCOS, Hypothalamic
Defects, Growth Hormone Deficiency, Immobility, Sarcopenia (Muscle
Loss), and also iatrogenic causes from medications such as
antidepressants, antipsychotics, steroids, contraceptives and others.
Imbalances in the gut microbiome are also being linked as a cause of
obesity. It is very important to identify or rule out any underlying
causes of obesity.

Based on the Centers for Disease Control and Prevention’s National
Center for Health Statistics, more than two-thirds of Americans are
either overweight or obese. ^3(1108) In the past 20 years,
obesity has increased 50% in adults and doubled in children. This is
primarily caused by diet and lifestyle factors and not by genetic
polymorphisms. However, there can be monogenic (single defects) in genes
involving the production of leptin, the appetite regulating hormone,
but this would be extremely rare. A more common genetic influence of
obesity is polygenetic where various polymorphisms or gene mutations can
predispose an increased risk of obesity. However this is only likely to
be expressed when other factors are involved such as the consumption of
excess calories. Genetic factors can play a role but they are typically
not the direct cause of obesity.

Obesity is a proinflammatory condition. numerous health conditions are
linked to obesity such as insulin resistance, Type 2 Diabetes, metabolic
syndrome, heart disease, hypertension, dyslipidemia, hypothyroidism,
polycystic ovarian syndrome (PCOS), Cushing Syndrome, cancer, bone and
joint disorders, breathing disorders such as asthma and sleep apnea,
osteoarthritis, gallstone formation, fatty liver disease,
gastroesophageal reflux (GERD), menstrual abnormalities, infertility and
gout. ^{3(1108), 2(364)}

Type 2 Diabetes is significantly linked to being overweight. In fact,
80% of people with Type 2 Diabetes are overweight. An important factor
to note about fat cells is that they are endocrine-producing cells and
not just cells that store fat. An abundance of these fat cells in turn
overproduce hormones such as estrogen, leptin and resistin as well as
cytokins, such as tumor necrosis factor alpha (TNFa), that can lead to
elevated free fatty acids, very low density lipoproteins or VLDL
particles and increased triacylglycerol synthesis. ^3(1109)
Abnormal lipid levels are often associated with obesity and increased
risk of cardiovascular disease. The elevated lipids in turn interfere
with insulin and its ability to stimulate the protein kinase B (PKB)
signaling pathway and the GLUT4 transporter of cells. This reduces
insulin’s ability to lower blood glucose levels. The primary cause of
Type 2 Diabetes is insulin resistance caused by obesity. ^3(1110)
Another health risk involved in obesity is cancer. The same
insulin-signaling pathways involved in increased levels of insulin
needed to maintain blood glucose homeostasis also can increase cell
proliferation. High blood pressure also can result from hyperinsulinemia
which causes sodium and water retention as well as the vasoconstriction
of blood vessels. With increased weight gain, cells will begin to
hypertrophy or increase in size. As more weight is gained hyperplasia
occurs which is an increase in the number of fat cells. Excess fat will
then accumulate in other areas such as that seen in fatty liver disease,
Sarcopenic obesity and elevated blood lipids. As you can see, obesity
can disrupt the body’s function leading to numerous health issues and
diseases. There is no such thing as healthy obesity.

Instead of a fad diet and quick weight-loss plans, focus should be on
making healthy lifestyle and diet changes that are lasting. A weight
loss of 5%-10% over 3 to 4 months can improve blood glucose, abnormal
lipids, high blood pressure, joint pain, breathing, and stop the
progression of diabetes and heart disease. ²⁽³⁶⁶⁾

Stress causes increased levels of the glucocorticoid hormone cortisol.
Excess cortisol causes sugar cravings, abdominal obesity, insulin
resistance, weakness, shakiness between meals, irritability,
hypertension, amenorrhea, impotence, sleep disturbance and more. ^4(559-560)

2) Get 7 to 8 Hours of Sleep Each Night
People with less sleep also can have increased appetite because they
have lower leptin levels which controls satiety along with elevated
ghrelin, a hunger hormone. Lack of sleep appears to also affect food
choices causing people to eat more high calorie foods that are also high
in carbohydrates.⁵⁽⁵⁴⁹⁾
Sleep deprivation can cause weight gain. Research studies have shown that people who sleep the least weigh more.

Obesity causes an imbalance of body water because fat does not contain water. ⁵⁽³⁵¹⁾

Water is extremely important and is needed to remove metabolic reaction
by products to maintain homeostasis. An imbalance of body water will
cause the body to prioritize physiologic functions such as pH and
temperature while suppressing acid-producing pathways like fat
oxidation.

4) Increase Fiber

Fiber can aid in regulation of blood glucose, help create satiety, act
as a prebiotic for GI microflora which reduces inflammation and helps
build and maintain a healthy microbiome. Fiber also removes excess
hormones. Fiber consumption should be between 25-38 grams a day for
weight-loss. ⁵⁽³⁶⁴⁾

5) Address Nutrition Deficiencies

Nutrition is vital to the body’s biological functioning which includes
the metabolism of fats, carbohydrates and protein and the production of
energy. For example B1, B2, B3, B5 and lipoate are important in
carbohydrate and amino acid metabolism. ⁴⁽²¹⁶⁾
Low vitamin D levels are often linked with obesity. This is because
excess fat can impair the transport of fat-soluble vitamins and
nutrients such as Vitamin D, lutein, xeoxanthin and lycopene. The
thyroid for example requires nutrients such as iodine, selenium, zinc,
iron, niacin (B3) and amino acids such as phenylalanine and tyrosine. ⁴⁽²¹⁶⁾
As previously mentioned, hypothyroidism can cause obesity so it is
very important to make sure that the thyroid is properly supported with
the essential nutrients that it needs to produce active thyroid
hormones.

6) Focus on a Quality Whole Food Low Glycemic Diet

In obese conditions, there is a high need for alkalinizing foods such as
fruit (apples, pears, berries, citrus fruits, avocado) and vegetables
(especially leafy greens and green vegetables), fat-soluble vitamins and
other phytonutrients. Focus should be on increased plant fiber and a
reduction in foods that are high calorie energy dense processed foods
that elevate insulin levels. As previously mentioned, Insulin is a
hormone that increases growth, DNA synthesis and cell replication. Its
main function is the regulation and uptake of blood glucose into cells.
This stimulates lipogenesis and increases the synthesis of fatty acids
and triacylglycerol for fat storage. ⁴⁽⁵⁵⁶⁾

7) Address Behavioral and Emotional Issues, Including Food Addiction

Consider partnering with an experienced Nutrition and Lifestyle Coach
who can provide ongoing support and education for lasting health and
nutrition changes.

8) Get Regular Physical Exercise and Sunshine!

Thank you very much for reading my blog!

I wish you good health, happiness and love!

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Danielle Heard, MS, MS, HHC

Clinical & Functional Nutritionist
1. Kolata G. After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight. The brand-new York Times; May 2, 2016. http://ift.tt/1TF7S5a. Accessed May 9, 2016.

2. Rakel D. Integrative Medicine, Third Edition. Philadelphia, PA: Elsevier Saunders; 2012: 364.

3. Devlin T. Textbook of Biochemistry with Clinical Correlations, 7th Edition. Hoboken, NJ: John Wiley & Sons, Inc; 2011: 1107.

4. Lord R. Bralley J. Laboratory Evaluations for Integrative and Functional Medicine, 2nd Edition. Duluth, GA: Genova Diagnostics; 2012: 559-560.

5. Kohlstadt I. Advancing Medicine with Food and Nutrients, Second Edition. Boca Raton, FL: Taylor and Francis Group; 2013: 549.

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