'I'm eating well and exercising but nothing seems to be working' – a common complaint I hear in my clinic. Losing weight is often associated with food restrictions and exercising but the popular belief of 'eating less than you burn' doesn’t always work. Sometimes even dietary plans put together by dieticians do not bring the desired results. If you dream about long lasting weight loss, this article will uncover some of the potential road blocks to achieving that success.
1. Nutrient deficit: metabolism is fuelled by nutrients. Diets can be restrictive in fat, which limits not only the fat soluble vitamins and essential fatty acids necessary for weight loss, but also disturbs hunger and satiety signalling. It's a syndrome of an overfed body and a starving brain. Nutrient-poor diets result in the storage of ingested energy as fat for future use because the body senses a potential famine - it's a protective mechanism. Nutrient deficit may also result in specific cravings, depending on deficiencies, e.g. neurotransmitter imbalance can cause emotional eating. Digestive problems also warrant a mention here because if digestion is malfunctioning, nutrients cannot be extracted from food and utilised.
2. Chronic stress: the body does not recognise the source of stress. Nutrient deficiency, skipping meals, inadequate sleep and poor regeneration, over exercising, chronic illness, unstable blood sugar, food intolerances, emotions, work and unhappy relationships can all stimulate the overproduction of the stress hormone cortisol. Cortisol not only increases appetite, but also breaks down muscle tissue. As a result, there may be a few pounds less on the scales (muscle is heavier than fat) but the body is lacking tone, often accompanied by a 'cortisol belly'. The foundation of true weight loss is burning fat - not losing water or muscle.
2. Inflammation and insulin resistance: insulin's main function is to transport glucose from blood to cell. Too much glucose is inflammatory to cells, so the body responds by employing a protective mechanism called insulin resistance, resulting in cells shutting down for fear of more glucose being brought in, and not responding to insulin any more. Insulin counteracts glucagon, a hormone that burns fat. As a result, the 'unused' insulin that's now present in the bloodstream blocks fat burning. Insulin also increases testosterone in women which is one of the culprits of Polycystic Ovarian Syndrome, often associated with weight gain. In men, insulin increases oestrogen, which results in male breasts and decreased body tone.
3. Underactive thyroid: although it is commonly known that an underactive thyroid can slow down metabolism, thyroid underactivity can be left undiagnosed. Often upon sole inspection of Thyroid Stimulating Hormone (TSH), one may arrive at a wrong diagnosis. Not only does this not present a full picture, but also diagnostic ranges vary between countries, labs, conventional and functional medicine. Hashimoto's thyroiditis is an autoimmune condition, and autoimmunity often goes hand in hand with insulin resistance. Yet, thyroid antibodies are dismissed in routine health check-ups. I have clients with optimal TSH, and yet high anti-thyroid antibodies.
5. Gut microbes: certain strains of bacteria are associated with weight gain. One experiment showed how implanting gut bacteria from obese into sterile mice made them put on weight. Moreover, beneficial gut bacteria guard the small intestine from becoming 'leaky'. Leaky gut is associated with inflammatory processes, and inflammation results in insulin resistance. Also, some organisms (e.g. candida) drive cravings towards starch and sugar, which can also result in a blood sugar roller coaster and ultimately, insulin resistance.
6. Lifestyle and beliefs - diet is only a portion of the holistic approach to long term weight loss. Both, under and over exercising are associated with metabolic disorders, and so is the wrong type of physical activity or lack of variety. Spending too much time indoors, little contact with nature, exposure to blue light after 8pm, being a 'night owl', sleeping less than 7 hours, lack of hobbies, life goals or not being part of a community, misconceptions about what really is healthy may all slow down weight loss.
What do do?
A weight loss plan should be personalised, with thorough diagnostics and health evaluation. ‘Template’ plans taken from the internet or advice from a friend who’s had amazing results on a certain diet is not a successful strategy because they don't take any individual aspects into account. Food can be both medicine and poison, depending on who eats it. Lack of sufficient knowledge on bodily processes, physiology and metabolism can do more harm than good – and this is where a professional can step in. A food and symptom diary is a great place to start. By observing how your body reacts to foods in terms of energy, cravings, bowel movements, skin eruptions, etc. can be an invaluable tool to guide you down the right path.