Weight Management & Nutrition
How to Lose Weight
I thought about waiting until the new year before publishing this post but why wait, right? The best time to improve your health and get into shape is now.
Every time someone ask me what do I do for a living, I kind of cringe because as soon as I say, “I’m a Registered Dietitian”, I get comments like, “Oh, how do I lose weight?” or “What’s the secret to losing weight?” I cringe because the answer to those questions is not a silver bullet answer and it’s sssooooo individual and there’s so much to that question. I usually respond by saying, “Weight might just be a symptom of something else going on in your body.” There are health risks with being overweight or obese. Even thin people with a higher amount of fat % or visceral fat are at higher risk of such conditions like diabetes, heart disease, high blood pressure, stroke, cancer, sleep apnea, asthma, and premature death.
If weight was just a mathematical equation, like calories in versus calories out, then most of us wouldn’t be overweight, let alone obese, but this isn’t the case. Please don’t misinterpret my meaning, though. Calories do count! I know a lot of the latest diets now are all about manipulating macronutrients (protein, carbohydrates, and fat) and they say that you don’t have to count calories but I am here to say that calories do count but that’s not all of it.
Calories
It takes 3,500 calories to equal a pound. It would make sense that if you decreased your calorie intake by 500 calories a day, so a total of 3,500 calories a week, then you’d lose almost 1 pound every week, so about 4 pounds a month. Sounds straight forward, right? That’s like skipping out on your sugary fufu coffee drink that you used to consume every day.
Here’s the thing. That’s so mathematical and our bodies are so much more complex than that for sure! You will lose a bit of weight by cutting out your sugary fufu coffee drink (liquid sugary drinks should definitely go) but it’s not so cut and dry as a mathematical calculation because so many other things are involved including hormones, gut health, detoxification pathways, your endocrine system, your liver, and micronutrients or lack of them. Where calories count is when you have passed your fat or calorie threshold.
Personal Fat/Calorie Threshold
I can’t take credit for the term “fat threshold”. I first heard of it when I was reading Roy Taylor’s research on “Normal weight individuals who develop type 2 diabetes: the personal fat threshold.” What he was saying is that every person has a maximum capacity to store fat, so if you go beyond that fat intake, your body will store the extra calorie as fat and if you are not one of those “lucky” people that have lots of fat cells, you’ll store the fat in your liver or other organs which can lead to type 2 diabetes or fatty liver disease. That kind of fat is called visceral fat. Sometimes people with visceral fat don’t even know they are fat because they don’t look fat. These are your TOFIs – thin outside, fat inside. You may even see people who look normal from behind, but you see abnormally large abdomen
Wait, what? …”lucky” people that have lots of fat cells…?
Yes, lucky. If you are fortunate to have lots of fat cells, then that means that you store your extra calories stored as fat in your fat cells where it belongs versus your vital organs like your liver. Yes, you may look overweight or obese but it’s a “safer” fat and healthier – that would be called subcutaneous fat – fat underneath your skin, in your fat cells.
So simply,
subcutaneous fat = good,
visceral fat = bad.
You see why calories count now? If you exceed your own personal fat threshold, then anything beyond that won’t just disappear (wouldn’t that be magical?), but it will be stored as fat. In other words, if your fat threshold is 2000 calories, and you eat another 300 extra calories, whether it’s from fruits, potatoes, chicken or olive oil, it has to be stored. Genetics might play a role whether it is stored as subcutaneous fat or visceral fat.
This explains the calorie theory and why some people lose weight just by cutting calories. They count their calories and they’re good. However, the calorie theory does not explain why some people DON’T lose weight when they cut back on calories. There are some people that are on calorie restrictive diets who just can’t seem to move the scale at all. I know some of these people. They can tell me all about their food to the gram/ounce and calorie. These people count they’re calories and even restrict their calories but are still overweight. It’s not all about calories in versus calories out, but calories do matter. It just isn’t all that matters. So what happened? One of the things to unsolved this mystery has a lot to do with hormones.
Hormones
So many things come to play besides just counting calories. We need to think of our body as a whole, including all the hormones that can affect our weight.
INSULIN
This pancreatic hormone, insulin, regulates blood glucose/sugar by bringing sugar to your muscle, liver and fat cells. Insulin “unlocks the key” to let glucose into the cell. Remember insulin resistance – where your cell receptors are not allowing insulin to shuttle sugar from your blood into the cell, then your pancreas pumps out more insulin to “force” the sugar into cells and after awhile, the pancreas gets “tired” and sugar stays in the blood with all this insulin. Perhaps your cells have too much glucose inside of its cells already and when insulin comes “knocking” on the door, the cell ignores it because it has enough glucose already. In either case, this represents insulin resistance where you have high insulin and glucose circulating in your blood. This can also raise estrogen levels which returns the favor and leads to insulin resistance, which makes you gain weight.
What would cause insulin resistance in the first place?
Eating excess amount of refined carbohydrates and excess added sugars.
Exceeding your personal fat threshold is another reason. If fat cells are all full, then excess fat will be stored on liver or pancreas which will lead to insulin resistance.
In this case, check your fasting insulin, fasting blood glucose, and hemoglobin. If these are higher than the optimal lab values, then work with me to work on balancing insulin back to its optimal levels and that may mean you need to lose weight. It could be fasting, going on a low calorie diet, going on a low carbohydrate diet, a keto diet, a Mediterranean diet, a DASH diet, a whole foods, unprocessed diet. Diet is very individualized so don’t just follow the latest fad diet. Let’s talk about which diet might work the best for you.
Generally speaking, don’t exceed your personal fat threshold and eat whole, real foods. Don’t eat refined carbohydrates and sugar and processed foods. I can help you figure out the best way for you to lose weight, especially if you feel that you’ve tried “everything” and nothing worked.
Let that all sink in for now. Next week, more on hormones featuring leptin.
Welcome back.
Hopefully, you learned something about the importance of how insulin is involved in weight management and the importance of not going over your personal fat threshold. Here’s another hormone involved in weight management.
LEPTIN
This hormone, that is released by fat, controls your hunger or appetite and determines whether or not to store fat in your belly. Just like how you can become insulin resistant, you can also become leptin resistant. Leptin is supposed to tell your brain (hypothalamus) to decrease your appetite when you have enough fat stored. The opposite is true too – if you don’t have enough fat stored, then your appetite will increase. This way, leptin helps to regulate your levels of energy so you don’t starve or overeat. The more fat mass, the more leptin is secreted to tell your brain that you have enough and to decrease appetite.
This could be a theory behind yo-yo dieting where when you lose weight, you have less fat mass and your leptin levels naturally fall and tell your brain to increase appetite and so, for some, losing weight is a battle because of the increased appetite.
What if you’re leptin resistant? If you have enough fat mass and thus more leptin, but your brain is not getting the signal from leptin to decrease appetite, then your brain is still thinking that it is starving which then it will increase your appetite (eat more) and your brain will tell your body to burn less fat. You may feel like you’re always starving or never satiated. Yikes!
In this case, it could be that it’s not that you have lack of willpower or that the root cause of obesity is because of overeating per se, but because of leptin resistance.
What would cause leptin resistance?
Having an inflammatory diet (fried foods, processed foods, refined carbohydrates and excess sugar, rancid oils, high omega 6 to omega 3 ratios).
Being overweight.
Remember, to keep your leptin levels in balance, eat a diet consisting of whole, real foods with lots of fiber, avoid eating a diet high in refined carbohydrates and sugar, and avoid processed foods. Talk to me about protein and increasing lean muscle mass.
Ok – that wasn’t too bad, right? Next week – Ghrelin.
Today, it’s all about Ghrelin.
GHRELIN
This is the hormone, produced in the gut, that is responsible for making you hungry, look for food and store more fat. It also regulates energy homeostasis. It signals to your brain to eat more especially when you’re “dieting” or losing weight or starving.
The more ghrelin you have, the hungrier you feel.
What would cause an increase in ghrelin?
An increase in ghrelin normally happens when your stomach is empty. In other words, when your stomach is empty, ghrelin levels will rise and then you feel hungry. This is a natural process to protect you from starving to death. Neat, huh?
In this case, if you are overweight or obese, it could also be that you are just sensitive to ghrelin or sometimes you have more active ghrelin receptors causing you to be hungrier. This can be challenging especially if you’re trying to lose weight.
What to do about ghrelin sensitivity and/or increased ghrelin levels?
It’s hard to say, really. Here’s a few things you could do.
Maintain a healthy weight. I know, I know! Don’t shoot the messenger. I’m trying to say that if you are over or under weight, ghrelin levels changes.
Get good and deep sleep. Yes, not enough of it can increase your ghrelin levels.
I’m going to repeat myself here and I hope you read this many times because I want you to get this: eat a diet consisting of whole, real foods with lots of fiber, avoid eating a diet high in refined carbohydrates and sugar, and avoid processed and packaged foods. Let’s talk about protein and increasing lean muscle mass.
That’s all for now. Please review other hormones we talked about in the past and also how ghrelin may play a role in managing your weight.
Until next week! We will dive into estrogen!
Let’s look at estrogen today.
ESTROGEN
This is a sex hormone that helps women be women (hips and breast, for example). It’s the main female hormone that helps with mood, appetite, sleep and other neurotransmitters in the brain. As with most things in the body, you want the right balance of hormones, not too little, not too much. Estrogen is no exeption. Remember that fat cells produce more estrogen. The more weight you have, the more estrogen you produce. The more estrogen you produce, the more fat you will gain and this can lead to you becoming overweight or obese.
What would cause an increase in estrogen?
Well, you need estrogen for some of the reasons I have mentioned previously, but your body also needs to metabolize it or break it down and get it out through your poop, so if you’re not doing this efficiently, then your body starts to recycle and reuse some of the estrogen that didn’t make it out. This kind of estrogen that was supposed to be broken down and excreted but didn’t isn’t the kind of estrogen you want in your body either because it’s no longer “young and vibrant”. Now you have “old” estrogen hanging out in your body causing an increase of estrogen. If you’re lucky enough to know what kind of estrogen your body breaks it down into, then more power to you. Without getting into too much details here, I’ll just simply say that if you are metabolizing your estrogens into more of the 16Beta-Hydroxyestrone form, then this could be part of the reason why you have more weight than you wanted.
Another way women get too much estrogen (and, again, the wrong kind of estrogen) is through things called xenoestrogens or environmental hormones. These xenoestrogens are not your own estrogens but more like imposters so they sit on your estrogen receptors but don’t give you any of the benefit of what your own estrogens are supposed to do. They are endocrine disruptors because they change the way our own estrogens are supposed to function. They can accumulate in your body cause estrogen levels to rise. You can find xenoestrogens in your makeup, plastic containers, non-organic food. Remember, these are toxic and these toxins can accumulate in your body. Guess where? In your fat, so if you have trouble with stubborn fat that you can’t get rid of, maybe your body is doing you a favor by protecting you and keeping it in your fat so that the toxins are not in your circulation wreaking havoc or poisoning you.
What to do?
- Get tested to see if your estrogen levels are too high. Compare your estrogen with progesterone and testosterone.
- Sweat it out especially through sauna therapy where you sweat out some toxins.You can also sweat through exercise to also support detoxification.
- Lose weight. I know, you’re reading this because you’re trying to lose weight already. If losing weight was so simple, you wouldn’t still be here reading this, but seriously, as you lose weight, you lower estrogen levels because estrogen is stored in your fat.
- Eat organic.
- Drink clean water.Get a good water filter because water can contain toxins and even endocrine disruptors that we were just talking about.
- Use “green” personal care, cleaning solutions, and beauty products.
Chew on that for a bit. Next week – Cortisol.
We’re diving into cortisol today
CORTISOL
This is your main stress hormone that also regulates blood sugar especially under stress, and regulates blood pressure, and your immune system. Yes, stress can make you fat. Why? Because stress sends hormonal signals that can make you gain weight and even become insulin resistant when it’s a constant stress. Normally, high cortisol from stress (remember that stress triggers cortisol to be released) will divert your blood from your gut to your arms and legs so that you can fight or flee. Priorities – under perceived stress (term paper is due, divorce, fire in the building) it’s time to fight or flee, not rest and digest! That’s a good emergency response, but not if you feel stressed 24/7. In other words, too much cortisol, especially constant high levels of cortisol will slow down your digestion, slow your metabolism and pump out more glucose into your blood so you can fight or flee. Remember insulin and glucose? Full circle, right? But this kind of weight gain from a steady stream of high cortisol puts fat in your belly! Plus, cortisol can break down muscle so you lose muscle. Boo!
What to do?
Manage your stress. Yes, everyone will have stress, but it’s really how you handle it and how you perceive it. Is there another way to look at the situation in a more positive light?
Meditate. Even to slow the breath down or being aware of your breath can help calm you.
Exercise. If you are stressed and it’s truly a constant stressful situation, maybe do what your body’s hormones thinks you’re going to do and RUN! No, actually, exercise and use up the blood sugar your cortisol helped you put into your blood and don’t stress eat because your digestion is shut down.
Next week, we’ll touch on thyroid. Have a great week.
If you’re having stubborn weight issues, then it may be a good idea to check your thyroid.
THYROID
Thyroid hormones play a big role in your metabolism and weight. If you have inadequate thyroid hormones, then your body will slow down metabolism and gaining weight becomes too easy.
What to do?
Get your thyroid hormones checked. Get the right tests that includes TSH, free T4, free T3, reverse T3 and antibodies.
Check for food sensitivities that may not be supportive of good thyroid health in some sensitive people, such as gluten, soy, raw cruciferous vegetables.
All these different hormones don’t work alone either. No, they work together and talk to each other. For example, estrogen levels in the optimal range will talk with leptin to control your appetite. However, if your estrogen is below the optimal range, then your appetite will increase because estrogen uses the same pathway as leptin, the “hunger” hormone that tells you that you’re hungry.
Diet
Besides different hormones wreaking havoc on your weight, don’t forget about your diet. I mentioned in the beginning of this article that calories do count for something but it’s certainly not the only thing that matters when it comes to weight. Quality of your diet counts a whole lot too. A calorie is a calorie is calorie? Not true. Your body responds to 100 calories of carrots very differently than a 100 calories of M&Ms. Different foods trigger and signal different enzymes and hormones (again with the hormones!) and need different requirements to breakdown, absorb, excrete and store the food – all of which can affect your weight.
What could cause a that is less than ideal for you?
Vitamin and nutrient deficiencies could cause you to crave more food or certain types of food because your body needs it. Craving chocolate? Maybe you need magnesium, but not the whole bar! Better yet, let a Registered Dietitian educate you on what foods your body might be starving for so that your cravings can be managed better.
The same goes for total calories. I already mentioned that calories do count and to be careful not to exceed your personal fat threshold so I won’t go into details here.
Quality of food is so important. Your body needs vitamins, minerals, protein, fat, carbohydrate, calories, polyphenols and other antioxidants, fiber and water to make what it needs for your body and mind to stay healthy.
Generally speaking, here are foods to include:
Good quality protein from grass fed animals and organs, wild caught, small fish (for example, wild caught salmon), or organic plant based proteins that has been sprouted, soaked or fermented (for example, soaked beans)
Good quality fats from grass fed animals (for example, butter) and/or wild caught fish, and organic fattier plant foods (for example, nuts, seeds, avocadoes, olives)
Organic tubers
Organic, seasonal fruits and berries
Organic, seasonal vegetables
Generally speaking, here are foods to exclude or minimize:
Processed foods
Packaged foods
Fast foods
Liquid sugar (for example, soda, juice, fancy coffee drinks)
Added sweeteners including zero calorie sweeteners (for example, sugar, corn syrup, aspartame)
Vegetable and seed oils. These are highly processed using high heat and chemicals were used to get rid of the smell.
Rancid oils. Even if you have the highest quality extra virgin olive oil, but it went bad, don’t use it. That means the oil was oxidized and is now not a healthy oil. Your body needs good, quality fats and oils, including your cell membranes. If you give your body “cheap and bad” quality fats and oils to work with, that’s what it will use and your cell membranes will be rigid instead flexible which could be a contributing factor in many health issues.
How your food is cooked also affects your weight as well as your health. Avoid cooking your foods in high heat, like frying, because this will change your healthy oils to something toxic.
Other Things To Be Aware Of That Might Be Sabotaging Your Weight Goals
Check for underlying infections.
Check for heavy metal toxicity.
Check for mold/fungal toxicity.
Leading an active lifestyle and daily movement may be enough for some, such as gardening, walking to your local park or library, but check with your primary physician about adding exercise to manage your weight too.
Remember, your weight might just be a symptom of something going on in the body, and your symptoms is your body’s way of communicating with you. Listen to your body.
I hope this will help someone out there. Of course, this isn’t everything that contributes to weight issues, but it’s a start.
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Disclaimer
Onki Chan, MS, RD is a Registered Dietitian (Nutritionist).
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