Dr. Pamela Frank, ND

Recent estimates suggest that if current trends continue, by 2030 half of all Americans will not just be overweight, but obese.1 Weight loss is more complex than just calories out exceeding calories in. A thorough assessment of all the factors contributing to weight gain ensures better long term success.

1| Stabilize Blood Sugar and Improve Insulin Sensitivity

Fluctuating blood sugar levels mean sugar and carb cravings. Consuming these increases insulin. Insulin tells your body to increase fat production. Maintaining a stable blood sugar through a low glycemic index and low glycemic load diet, daily physical activity, and stress reduction are key for weight problems. Stable blood sugar means fewer cravings and more control over what you eat.

Frequent insulin production increases the likelihood of developing insulin resistance or prediabetes. Once “prediabetic”, blood glucose levels stay higher longer, and insulin demands increase causing even more fat production. Zinc,2 cinnamon,3 and aerobic exercise4, among other naturopathic treatments, help improve insulin sensitivity.

2| Reduce Stress, Modulate Cortisol Level, and Support Adrenal Stress Adaptation

Cortisol is a hormone produced by your stress glands, the adrenals, to help you survive stress. Healthy cortisol levels help with energy, immune function and metabolism. Too much or too little cortisol sabotages weight loss. Spikes in cortisol spike blood sugar and insulin, and contribute to poor eating habits, weight gain and obesity.5  Excessive cortisol can also negatively impact thyroid hormone levels and slow metabolism.10 Stress reduction techniques like yoga6, meditation7; massage therapy8; exercise and psychotherapy9 are important for weight loss.

Adaptogenic herbs like Rhodiola roseaSchisandra chinensis, and Eleutherococcus senticosus have demonstrated the ability to moderate cortisol levels, improve mental performance, and increase endurance.11 Adrenal support with vitamins C, B5, B6, magnesium, zinc and adaptogenic herbs like Panax ginseng, and Withania somnifera may improve how well you handle stress and reduce excess cortisol.

3| Caloric, Protein, Amino Acids and Neurotransmitters

Excessive caloric consumption without equal energy expenditure will result in weight gain. However, all calories are not created equal. The energy required to store excess dietary carbohydrate as fat is only 6% to 8%, and for protein is 25% to 30%.12 Thus, a shift from a higher carbohydrate diet to a higher lean protein diet will enhance energy expenditure.

Amino acids are the building blocks for proteins. Certain amino acids are important for the production of brain chemicals called neurotransmitters that dictate mood, sleep, happiness and calmness. Tyrosine and 5-hydroxytryptophan (5HTP) are two amino acids that are used to treat various conditions, including depression, anxiety, insomnia, and obesity. Because tyrosine and 5HTP increase dopamine and serotonin they may help with emotional eating.13, 21 Certain other amino acids, such as leucine, help protect muscles during weight loss and increase loss of body fat.14

4| Behavioral Strategies and Social Support

One healthy habit can breed others. Try writing down achievable health-related goals, such as eliminating soda, avoiding white flour, excluding sugar, daily walks, etc. Journal triggers for overeating so you can reduce these situations.

Relationships with other health-conscious individuals help, particularly if your friends and family aren’t supportive. Online forums provide a sense of community. Websites such as fitday.com and myfitnesspal.com provide the opportunity to track calorie, fat, carbohydrate, and protein intake and exercise.

5| Exercise

Regular exercise is an essential component of your weight loss strategy. It does not require a huge time commitment, an expensive gym membership, or special equipment. Work a brisk 30 minute walk into your day by getting off the bus or parking the car half an hour from work and walking the rest of the way, taking a quick walk on your lunch hour, or as soon as you arrive home from work before starting dinner. Exercise needs to be a daily habit that is as non-negotiable as brushing your teeth.

The question is not if you are going to exercise but when. Choose a time of day that you can be consistent, where you still have the energy and you have few other demands on your time. Early morning is often best. Quick fitness breaks throughout the day are also helpful. Every half hour get up from your desk, throw on some music and bust a move, do 20 push-ups, or have a quick stretch. Humans are programmed to move. Research shows that being sedentary is as detrimental to our health as smoking.

6| Hormones

My weight loss patients often wish they had a thyroid problem to explain why they keep gaining or cannot lose weight, but less than 10% of obese individuals have hypothyroidism15 although, normal thyroid blood tests may not mean optimal thyroid function. Adequate amounts of iodine,16tyrosine, copper,17 and zinc18 and avoidance of excessive selenium19 are important to ensure that the thyroid runs smoothly. Self-medicating with these is not advisable as excessive iodine can contribute to thyroid nodules and hyperthyroidism. Herbs like ashwagandha,20 schisandra, and coleus can help to balance thyroid function.

Declining estrogen levels at menopause can add to insulin resistance and weight gain. Supporting the hormone producing organs at menopause can help balance estrogen levels and also alleviate menopause related complaints like hot flashes and night sweats.

Testosterone helps maintain muscle tissue which burns more calories, even when you are sleeping. Healthy adrenal glands support healthy testosterone production in both men and women.

Leptin is a hormone that helps to decrease food intake and increase metabolism. Adiponectin is a hormone secreted by fat cells that helps to regulate metabolism of fats and sugar. Optimizing these levels may facilitate weight loss. Eicosapentaenoic acid has been shown to increase adiponectin levels in vitro.24 Mild weight loss induced by calorie restriction may have beneficial effects on leptin.25

7| Fat Metabolism

Deficiencies of vitamins B3, B6, and C, zinc, choline, methionine, inositol and magnesium can adversely affect fat metabolism. Chickens fed higher omega-3s (vs higher saturated fat) showed less abdominal fat and higher levels of the thyroid hormone T3.26

Choline and carnitine supplementation with exercise balances carnitine in the tissues to favor fat mobilization.27

8| Sleep and Hydration

Insufficient sleep increases insulin and heightens risk for obesity. One study found that even one night of only 4 hours of sleep caused insulin resistance among healthy participants.28 Seven to eight hours of sleep per night is optimal to maintain a healthy weight.

Dehydration can increase food intake. Stay hydrated with water and herbal teas and avoid sweetened drinks and fruit juices.

9| Adverse Effects of Medications

Anti-depressant medications can lead to weight gain and insulin resistance. The adverse effects of these medications are often very difficult to undo. Addressing the root of anxiety or depression and reducing these medications, may enhance your weight loss efforts.

References:

  1. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK, Lancet. 2011;378(9793):815-825.
  2. Hashemipour M, Kelishadi R, Shapouri J, et al. Effect of zinc supplementation on insulin resistance and components of the metabolic syndrome in prepubertal obese children. Hormones (Athens). 2009;8(4):279-285.
  3. Qin B, Panickar KS, Anderson RA. Cinnamon: potential role in the prevention of insulin resistance, metabolic syndrome, and type 2 diabetes. J Diabetes Sci Technol. 2010;4(3):685-693.
  4. Van der Heijden GJ, Wang ZJ, Chu ZD, et al. A 12-week aerobic exercise program reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity (Silver Spring). 2010:18(2):384-390.
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  8. Han SH, Yang BS, Kim HJ. Effectiveness of aromatherapy massage on abdominal obesity among middle aged women [in Korean]. Taehan Kanho Hakhoe Chi. 2003;33(6):839-846.
  9. Tanofsky-Kraff M, Wilfley DE, Young JF, et al. A pilot study of interpersonal psychotherapy for preventing excess weight gain in adolescent girls at-risk for obesity. Int J Eat Disord. 2010;43(8):701-706.
  10. Kitahara H, Imai Y, Yamauchi K, Tomita A, Mizuno S. Pituitary-thyroid function in patients with Cushing’s syndrome: comparative study before and after extirpation of adrenal cortex tumor [in Japanese]. Nihon Naibunpi Gakkai Zasshi. 1983;59(8):1086-1098.
  11. Panossian A, Wikman G. Evidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity. Curr Clin Pharmacol. 2009;4(3):198-219.
  12. Wilborn C, Beckham J, Campbell B, et al. Obesity: prevalence, theories, medical consequences, management, and research directions. J Int Soc Sports Nutr. 2005;2:4-31.
  13. Trachte GJ, Uncini T, Hinz M. Both stimulatory and inhibitory effects of dietary 5-hydroxytryptophan and tyrosine are found on urinary excretion of serotonin and dopamine in a large human population. Neuropsychiatr Dis Treat. 2009;5:227-235.
  14. Devkota S, Layman DK. Protein metabolic roles in treatment of obesity. Curr Opin Clin Nutr Metab Care. 2010;13(4):403-407.
  15. Douyon L, Schteingart DE. Effect of obesity and starvation on thyroid hormone, growth hormone, and cortisol secretion.Endocrinol Metab Clin North Am. 2002;31(1):173-189.
  16. Mirmiran P, Hajipour R, Azizi F. Iodized salt consumption maintains euthyroidism in iodine-deficient hypothyroid subjects.Int J Vitam Nutr Res. 2003;73(3):187-191.
  17. Bousquet-Moore D, Ma XM, Nillni EA, et al. Reversal of physiological deficits caused by diminished levels of peptidylglycine-amidating monooxygenase by dietary copper. Endocrinology. 2009;150(4):1739-1747.
  18. Kandhro GA, Kazi TG, Afridi HI, et al. Effect of zinc supplementation on the zinc level in serum and urine and their relation to thyroid hormone profile in male and female goitrous patients. Clin Nutr. 2009;28(2):162-168.
  19. Hawkes WC, Keim NL. Dietary selenium intake modulates thyroid hormone and energy metabolism in men. J Nutr. 2003;133(11):3443-3448.
  20. Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol. 1998;50(9):1065-1068.
  21. Halford JC, Harrold JA, Lawton CL, Blundell JE. Serotonin (5-HT) drugs: effects on appetite expression and use for the treatment of obesity. Curr Drug Targets. 2005;6(2):201-213.
  22. Halford JC. Pharmacology of appetite suppression: implication for the treatment of obesity. Curr Drug Targets. 2001;2(4):353-370.
  23. Li X, Rose G, Dongre N, Pan HL, Tobin JR, Eisenach JC. S-nitroso-l-cysteine releases norepinephrine in rat spinal synaptosomes. Brain Res. 2000;872(1-2):301-307.
  24. Tishinsky JM, Ma DW, Robinson LE. Eicosapentaenoic acid and rosiglitazone increase adiponectin in an additive and PPAR-dependent manner in human adipocytes. Obesity (Silver Spring). 2011;19(2):262-268.
  25. Klempel MC, Varady KA. Reliability of leptin, but not adiponectin, as a biomarker for diet-induced weight loss in humans.Nutr Rev. 2011;69(3):145-154.
  26. Ferrini G, Manzanilla EG, Menoyo D, Esteve-Garcia E, Baucells MD, Barroeta AC. Effects of dietary n-3 fatty acids in fat metabolism and thyroid hormone levels when compared to dietary saturated fatty acids in chickens. Livestock Sci. 2010;131(2):287-291.
  27. Hongu N, Sachan DS. Carnitine and choline supplementation with exercise alter carnitine profiles, biochemical markers of fat metabolism and serum leptin concentration in healthy women. J Nutr. 2003;133(1):84-89.
  28. Donga E, van Dijk M, van Dijk JG, et al. A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects. J Clin Endocrinol Metab. 2010;95(6):2963-2968.
Image Copyright: <a href=’https://www.123rf.com/profile_maridav’>maridav / 123RF Stock Photo</a>

Pamela-2013-retouched_resizedPamela Frank, BSc(Hons), ND has been in practice as an ND since 1999 and previously worked for 20 years as a
medical laboratory technologist. She is Clinic Director of Forces of Nature Wellness in Toronto and was twice voted “Best Naturopath in Toronto”. Pamela maintains a busy, diverse practice with particular expertise in naturopathic treatment of PCOS, PMS, menopause, acne, infertility, uterine fibroids and endometriosis. Pamela’s interests include fitness, triathlons, yoga, healthy cooking, tennis and volleyball.

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