I’ve been helping people shed fat and tone muscle for over a decade. I dedicate a ton of energy to stay on top of the “most effective” approaches to healthy weight management. However, if there’s one thing I have learned (and been humbled by), it’s that there is no one-size-fits-all approach to health and fitness.
During my undergraduate studies in Kinesiology, I spent hours and hours learning about metabolic processes, how food is converted to energy, and how that energy can be best used to burn fat and build lean muscle. My brain would ache as I made my way through the mountain of textbooks and research papers in front of me each night.
Then, upon graduating, I began a focused career in fitness and rehabilitation. My game plan was simple: conduct a consultation and assessment with the new client, take that information and construct a solid fitness protocol with dietary guidelines, and then we’d get down to business. However, for every 10 or so people that were able to attain their weight management goals, there was always someone whose effort would not be reflected in their weight and body composition. I would wrack my brain endlessly trying to figure out what I was doing wrong and it wouldn’t take long for frustration to set in.
That’s when everything changed…
It was this exploration into the reasons for stubborn weight loss that turned out to be one of the main driving forces that led me to a career in Naturopathic Medicine, with a strong Functional Medicine approach.
Below, I will sum up the main reasons for stubborn weight loss and what can be done to correct it. This is one of the most valuable and information-rich articles I’ve posted, so get comfy…
Foundation:
The first thing that needs to be addressed is the degree to which there is potential for significant and lasting weight loss to occur. Time and time again, I have patients who are concerned about their inability to lose weight, but they only drink one or two cups of water daily, sleep four or five hours per night and wake unrefreshed, eat a diet rich in processed foods and carbohydrates, and spend all their workout time doing only steady-state cardio (in all fairness, many times this is through no fault of their own and rather due to a lack of education and empowerment).
I actually quite like these cases, since they are the easiest to correct. Once we get the ball rolling on establishing the appropriate foundations of health – sleep, hydration, nutrition, movement, mindfulness – the rest is very straight forward. That said, we’ll spend time working on sleep hygiene techniques, replacing processed foods with nutritionally dense vegetables, healthy fats, and lean protein, supporting awareness regarding fluid intake and moving more throughout the day, modifying the workout routine to be focused on strength training and interval style cardio, and encouraging simple but consistent mindfulness meditation.
Mind-body connection:
The ability to manage stress effectively plays a major role in healthy weight and body composition. Stress, whether real or perceived, causes the release of several hormones which serve a sound purpose in the face of an acute stressful event, but lead to increased muscle breakdown and fat storage when elevated for prolonged periods of time. This is because the body continues to get the alarm message that a stressful event is persisting and, as a result, will take measures to increase energy reserves in the form of fat (the body’s most efficient energy storage format). Also, to make matters worse, stress is associated with emotional eating. So what can be done? You can’t always control your exposure to stressors, but you can enhance the way in which you respond to and manage stress. Meditation is something I use personally and with almost all of my patients to support healthy stress management. If you’re interested in meditation, but don’t know where to begin, check out The Essential Guided Meditation Series and simply start by paying attention to your breath (as demonstrated in the Breathing Meditation CD).
Additionally, the topic of goal setting falls into this category as it relates to intention and motivation. Setting specific, realistic, attainable, measurable, and time oriented goals continues to be a sound approach. However, going beyond that, I always encourage that we explore the underlying motivation for goals. What I’m getting at is this: before you start setting your goals, explore why it’s even important to you. Is it to fill a void? Is it to appease your family, friends, or colleagues? Or is it to nurture a deeper part of your being? Whether your goal is to drop 10 pounds or tighten up and tone, if you are honest with yourself about your motivation and put in the inner work that addresses any insecurities that may lie at the root, you will better position yourself to see lasting changes…changes that impact every aspect of your life.
Lastly, there continues to be more and more awareness of the mind-body connection in weight management, and that was the focus of The Mind-Body Weight Management Summit. All of the expert panelists shared tons of information on how to support the mind (heart/spirit/soul) to promote healthy weight management. These topics resonated strongly with me as I continue to see a very interesting trend in clinical practice: when a patient addresses underlying self-destructive thought patterns that pertain to body image, self-love, or being deserving/worthy of others’ love, excess weight starts to shed away.
Structural integrity:
We often overlook the importance of sound structural integrity in allowing optimal health to foster. What I’m referring to here is healthy neurological and visceral (organ) function, which relates to the way our nervous and circulatory systems are impacted by our skeletal architecture and muscle imbalances.
To better understand this, just imagine what would happen if the electrical wires leading to your house were pinched off and/or the pipes draining your bathroom were clogged. Not so good, right?
The body can be viewed in a similar light. Therefore, ensuring healthy delivery of electrical signals and nutrients to muscles and organs, as well as promoting effective waste removal, are fundamental to attaining optimal body composition.
This is addressed through various physical medicine practices commonly employed by naturopathic doctors, osteopathic manual practitioners, chiropractors, massage therapists, acupuncturists, and physiotherapists. A simple structural and functional assessment conducted by any of these health professionals will expose where deficits lie and provide insight into what needs to be done to put you in the best position to reach your weight management goals.
Genetics:
When we face stubborn weight loss, the topic of genetics usually pops up and there has been some interesting research into the role genes play in weight management.
For instance, it appears that genetically influenced variations in perceived taste can impact weight. This study demonstrated that participants with above average taste perceptions, as compared with population averages, had greater increases in HbA1C (a marker for blood sugar levels), waist circumference, and body weight. It has been suggested that the increases in food consumption is not only due to enhanced taste, but also the amount of pleasure these individuals receive from consumption of flavourful and texture-rich foods.
Other research has explored the connection between taste perception and vegetable intake. This study demonstrated that heightened sensitivity to bitter tastes in children predicted for lower vegetable consumption (don’t let your kids know that their distain for veggies is possibly genetic, you’ll lose them forever).
These two studies looked at the how the ability to perceive fatty acids in food impacted overall fat consumption. The results demonstrated that a genetic hypersensitivity to fatty acids was related to lower fat intake and BMI (body mass index, a marker of weight control and obesity), and the inability to perceive low concentrations of fatty acids was related to greater consumption of fatty foods. In other words, if you are genetically inclined to detect fat content in food, you may be less inclined to over-consume fat. When you consider that a gram of fat has over double the calories than a gram of protein or carbohydrate, you can see that the overconsumption of fat can easily contribute to increased BMI.
There is still much to learn about how our genes impact our ability to maintain a healthy weight. However, with the emerging field of epigenetics, we are beginning to appreciate how our actions and environment affect how our genes are expressed. Therefore, regardless of your genetic predisposition, the lifestyle choices you make can still play a role in how your genetic makeup will ultimately be expressed…so choose wisely.
Digestion:
It’s interesting, when I conduct a medical history with a new patient, they are often unaware of what is considered healthy digestive function and the role of digestion in overall health. I witness shocked faces when I educate them around the fact that one bowel movement per week is not ideal, that it isn’t normal to have diarrhea every day, or that bloating after a meal is a sign of gastrointestinal distress. Also, I get even more shocked looks when we explore the connections between digestive health and their seemingly unrelated health concern(s), whether it be allergies, rheumatoid arthritis, or inability to lose weight.
With respect to weight management, you can think about it this way: you can eat the best diet in the world, but if you’re not able to properly digest the food, absorb the nutrients, and/or eliminate toxins, then we have a problem. We need healthy gastric function (mechanical breakdown properties of the stomach as well as healthy stomach acid constitution) to ensure foods are broken down effectively by the time they reach the small intestine. We need a relatively sterile small intestine to ensure effective absorption of nutrients into the blood stream (sometimes bacterial overgrowths can throw a wrench into digestive function). We need a balanced microbiota to be able to promote overall health and prevent obesity. We need healthy organs of detoxification and elimination to ensure effective processing and removal of toxins and hormones.
If you experience digestive issues (constipation, diarrhea, nausea, vomiting, heartburn, bloating, gas, etc), it’s in your best interest to resolve these issues and restore healthy gut function to provide a platform for healthy weight management to occur. Naturopathic doctors employ effective and targeted interventions to support healthy digestion. I highly recommend seeking formal care, and not relying on internet searches and friend’s anecdotes, as each persons’ requirements will be different (chronic diarrhea and heartburn will require two completely different approaches) and individuals respond to different treatments uniquely.
Hormone Dysfunction:
Difficulty loosing weight can be a sign of thyroid dysfunction, as thyroid hormones play a role in energy metabolism. Thyroid disorders can be congenital, autoimmune, iatrogenic (occur following a medical intervention, such as surgery or drug therapy), or related to iodine deficiency. In a nutshell, an under-active thyroid gland can lead to sluggish metabolism and make it difficult for your body to maintain a healthy body composition and weight. If you experience the inability to lose weight, along with chronic fatigue, constipation, dry skin, sensitivity to cold, and/or irritability, you should speak with you primary care provider to have the necessary workup and explore the potential for thyroid dysfunction. If you have an existing hypothyroid condition, there is a lot that can be done to support healthy thyroid function and healthy weight management through naturopathic approaches, including dietary modification, with nutritional and herbal supplementation. It should also be noted that excess stress, and poor stress management, can impact thyroid function…more incentive to start meditating.
Another interesting concept, and one where misinformation is common, is that of leptin resistance. Leptin is a hormone secreted by fat tissue and is involved with the regulation of food intake and energy expenditure. Fat is the body’s main source of stored energy, and as such, provides information to the brain (through the action of leptin) regarding available energy reserves. When we burn fat, leptin levels go down and the brain responds by increasing food intake (hunger, desire to eat) and slows energy expenditure, in order to restore lost fat (and restore leptin levels to the previous baseline). In genetic leptin-deficiency states, leptin administration has been shown to restore metabolic abnormalities. However, this does not appear to be the case for obese individuals who are resistant to leptin. In leptin resistance, which may be caused by elevated inflammation, free fatty acids in the blood, and baseline leptin levels, individuals with excess body fat produce chronically high levels of leptin, to the point where the receptors at the brain become desensitized (similar to insulin resistance in type 2 diabetics). This leptin resistance then causes further weight gain due to increased hunger and decreased energy expenditure. To address this, focus on the basics: reduce inflammatory food consumption (processed foods, trans-fats), exercise regularly, get restful sleep, eat a balanced diet rich in plants and lean protein, and maintain healthy triglyceride levels (moderate carbohydrate intake).
Bottom line:
Weight management isn’t as straightforward as many fad diets and exercise infomercials would make it seem. Though we always focus on the basics – healthy diet and lifestyle habits – there may be more to someone’s weight management issues than meets the eye. On top of that, it’s not always easy to pin-point the reason(s) for not being able to reach your weight management goals. However, know that there are qualified health professionals to help you along the path. For example, a naturopathic doctor can help explore the underlying reasons for stubborn weight loss and structure a comprehensive treatment plan to meet your individual needs . It can be very disheartening to be putting in the work and not reaping the rewards, but I urge you not to give up hope. Seek support and break the cycle…we’re here to help!
