Top 5 Reasons Weight loss isn’t working (That Have Nothing To Do With Eating or Exercise)
It’s only March, but here in San Diego, we’ve experienced our first 80+ degree day of 2022. All over social media there were photos of people out at the beach enjoying the sunshine. Surely some look forward to the opportunity to strip down into their bathing suits, but for many, it brings insecurities about weight.
According to Healthline data, in the United States, 36.5 percent of adults have obesity. Another 32.5 percent of American adults are overweight. In all, more than two-thirds of adults in the United States are overweight or have obesity.
The CDC breaks down these numbers even further:
Adults:
Percent of adults aged 20 and over with obesity: 42.5% (2017-2018)
Percent of adults aged 20 and over with overweight, including obesity: 73.6% (2017-2018)
Children:
Percent of adolescents aged 12-19 years with obesity: 21.2% (2017-2018)
Percent of children aged 6-11 years with obesity: 20.3% (2017-2018)
Percent of children aged 2-5 years with obesity: 13.4% (2017-2018)
That’s right, a whopping 2/3 of the adults in the United States are overweight or obese. And that’s not even counting the children. In all, these numbers are concerning, so it’s no wonder weight loss is a primary goal of many the patients we see at EmpowerMed.
For some, despite their best efforts with diet and exercise, weight loss remains elusive. That’s why we have developed this list to help those that are frustrated with stubborn weight to understand the reasons why the body holds onto fat, and what you can do about it.
Top 5 Reasons Weight Loss Isn’t Working (That Have Nothing To Do With Eating or Exercise)
1. Your hormones are Out of balance
Hormones are chemical messengers that travel throughout the body. Nearly every single cell in your body has a hormone receptor site. We commonly think of hormones as the chemicals that make us have male or female characteristics, but in reality they do much more than this.
There are a few key hormones to consider in the context of weight loss.
For men: testosterone
Testosterone is a complex hormone, and is actually important for both men and women. However, in the context of stubborn weight loss, low testosterone is of higher concern for men as it plays many protective roles. Testosterone not only helps to reduce fat mass and grow muscle tissue, but it can protect against insulin resistance, diabetes, and cardiovascular diseases. It also supports the brain, bones and mood in both men and women.
For women: estrogens and progesterone
Estrogen and progesterone exist in a delicate balance throughout a woman’s monthly cycle. But have you ever noticed that at some points during the month you feel more “bloated” and at others you feel more “slim”? This is because of your estrogen to progesterone ratio. The role of estrogen is tissue proliferation - meaning it has a plumping effect by making the body retain fluid (particularly in the breasts and abdomen). In contrast, progesterone has a diuretic effect on the body, helping you to release stored water. An imbalance in the ratio of estrogen to progesterone can results in a chronically “bloated” abdomen.
For everyone: thyroid and growth hormone
There are two major thyroid hormones: T3 and T4. While T4 is the most abundant in the body, T3 is the most active. Healthy amounts of thyroid hormone help to increase blood flow, heart rate, metabolism, energy levels, cognitive abilities, and keep cholesterol levels in check. Thyroid levels tend to decline as we age, with low activity levels, and with low calorie diets. When thyroid is low, people tend to have weight gain all over, or feel a sense of “puffiness”.
Growth hormone is one of the major anabolic (tissue building) hormones in humans. During puberty, it helps us to develop our skin, hair, bones and internal organs into adult-sized versions. In adults, growth hormone helps to maintain skin tone, muscle and bone. Growth hormone also helps to repair vital tissues like the heart, liver, lungs and neurons of the brain. Growth hormone also tends to decrease with age. Because of its muscle-building and skin-tightening effects, people with low growth hormone tend to have sagging skin, stretch marks and abdominal obesity.
2. Blood sugar swings are making you store fat
Before we even dive into this topic, it’s important to note that carbohydrates and sugars are not bad. Like most things we eat, drink, or do, they exist without any inherent morality to them. Carbs are sugar are a tool that your body uses to make or store energy - that’s it. When you understand some of the simplicities behind this, it’s much easier to understand why the context in which you consume carbs and sugar matters more than the carb itself.
It all comes down to a little thing called Glycemic Variability (GV). GV refers to the intensity with which your blood sugar fluctuates throughout the day. A sharp rise in blood sugar after eating a donut (or even “healthy” foods like bananas and potatoes) is an example of an increased GV. Now even this isn’t necessarily a bad thing, but it's the next step that is absolutely crucial.
What does your body do with the extra blood sugar?
When there is an excess of sugars in the blood, there are two possible outcomes. Either that sugar is shuttled to muscles and liver or it becomes stored as body fat.
In other words, if your daily activity level and baseline muscle mass is not enough to use up the extra sugar, guess what? Now, all that sugar is fat.
Your best bet, aside from avoiding these foods altogether, is to have a buffer system in place.
Here are some simple hacks to help extra blood sugar become fuel, not fat.
Fasted morning cardio: yep, thats means a moderate intensity workout before eating anything.
Strength training: remember that muscle mass = a better sugar buffering system.
Go for a walk after you eat, do some activity, or at the least stand for 2 hours after your meal.
Use herbs and spices like berberine, cinnamon and bitter melon. Your doctor can help you determine the right blend and dose.
3. There are infections and inflammation in your gut
Unless you’ve been living under a rock, you’ve by now likely heard someone mention the importance of gut health for overall wellness. While naturopathic doctors have known about the importance of gut health for many decades, the mainstream scientific world is just now picking up on the gravity of gut health for humans.
The “gut” is a term used to describe the tube-like connection between the mouth and the… other end. It includes the esophagus, stomach, small and large intestines as well as the liver, gallbladder, pancreas and other organs that excrete digestive enzymes and hormones that regulate appetite, digestion and satiety. Recently this definition was expanded to include the vast network of bacteria living inside of our gut called the microbiome.
Research is finding new connections between the microbiome and metabolic health all the time. We know that obesity can be induced in lean rats when we give them a microbiome transplant from an obese rat. Simply put, the bacteria living in your gut play a major role in your metabolism.
Just as the microbiome can protect us and be good for health, a microbiome that is out of balance can promote medical disorders, too.
Because everything that we ingest must go through the gut, the lining of your must be primed and ready to fit infection at any moment. Things like stress can drastically decrease the ability of your gut’s immune front-line, called secretory IgA, to respond to bacterial or viral threats. Additionally, stress can impair the normal function of our digestive tract, which is a major reason why most digestive disorders such as IBS or UC/ Crohns worsen during periods of high stress. If the immune protection portion of the gut isn’t working well, this can lead to undesirable bacteria, parasites, viruses, and yeasts such as Candida setting up shop as permanent members of the gut flora.
A poor diet can also lead to an unhealthy microbiome. The good bacteria inside of our gut feed specifically off of soluble fiber, short-chain fatty acids, and polyphenols. These nutrients are found mostly in whole, natural foods like fruits, vegetables, and high-quality meats. Without these nutrients, the good bacteria inside of the gut simply cannot live. Once again, this gives an opportunity for less desirable microbes to become residents within the gut.
When an undesirable type of bacteria, virus or yeast becomes a resident of the microbiome, they cause large levels of inflammation as your body tries to get rid of the invader. Additionally, some of these pathogens are known for their ability to produce toxins like LPS, which trigger an even larger inflammatory response.
This kind of inflammation inside the gut, while creating blasting and water retention in the abdominal area, also means that your body is likely not absorbing nutrients correctly. Poor nutrition absorption means that he will lack the ability to mobilize stored fat for energy. Yikes! Inflammation can also lead to the development of food sensitivities, which creates an even bigger gut misery snowball effect.
For general gut health support, the following tips can be highly effective:
Fast 12-14 hours per day and leave at least 3-4 hours between meals without snacking
Ditch processed foods and gluten - they’re an inflammatory nightmare
Eat more soluble fiber and resistant starch - your microbiome uses these to make short-chain fatty acids that feed the gut lining and brain
Don’t eat on the go or when stressed. If you can’t avoid it, take a digestive enzyme with those meals
If you have ongoing gut symptoms (or even "non-gut" inflammatory symptoms like allergies, acne, rashes, autoimmunity, depression, anxiety) get functional testing sooner rather than later. The longer these issues go on the harder they are to treat!
For those who have ongoing gut symptoms, at EmpowerMed we highly recommend determining what the source of those issues is.
Using simple tests, we can determine:
Your food sensitivities
The composition of your microbiome
Whether undesirable bacteria, viruses, yeast, or parasites are present
If you have leaky gut
The health of your immune system inside the GI tract
How well your digestive organs are working
If there are any other sources of inflammation inside the gut
4. Your stress levels are out of control
Stress is probably the most common concern I see in my office day in and day out. Most of us think of stress as the mental/emotional type, but the term can also include internal stressors such as pain, inflammation, and infections.
Here are some of the most common stressors my patients experience:
emotional or traumatic events, such as the loss of a family member, job stress, financial pressure, overworking, caring for children or elderly parents
spiritual disconnection
dietary stressors like skipping too many meals, restrictive dieting, overconsumption of processed foods and alcohol, blood sugar swings
inflammation from infections in the gut, heavy metals, or environmental toxins like pesticides
injuries, past or present
concussions
ACEs (adverse childhood experiences)
sleep deprivation
excessive exercise
Many of my patients are surprised to learn that many of the items on this list are in fact stressors that can impact your cortisol levels. I would guess you probably feel the same.
No discussion on stress is complete without talking about cortisol. So, let's dive into the basics of cortisol.
Cortisol is one of the end products of the stress response. The creation of cortisol is largely determined by something called the HPA axis.
HPA stands for hypothalamic, pituitary, adrenal.
Essentially this is how your brain responds to and interprets the stressors that are present in your life, whether emotional, inflammatory, or dietary. The brain communicates to the adrenal glands via neurotransmitters, and the adrenal glands are then pressed to create cortisol.
In short-term stressful scenarios, cortisol is actually very helpful. It signals your liver to create glucose and bring it into the blood so that you can fuel your muscles. It's also a potent anti-inflammatory, which is helpful if you have experienced an injury as a result of a stressful situation, such as a car accident. It also regulates the electrolyte balance within your blood and mobilizes fats and proteins for energy.
In an ideal world, once the body the adrenal glands have created enough cortisol to get you through the stressor, the system shuts off.
But many of us do not live in this ideal world. We are subject to ongoing stressors, Dayton and day out, that keep the HPA axis running constantly. This means that cortisol is being produced at a significant rate outside of what we were designed to endure.
When cortisol is chronically produced, it becomes catabolic. That means it breaks tissues down. You might think that this would be beneficial for weight loss, but in fact, it's actually the opposite. What we see with excessively high stress levels overtime is the breakdown of muscle for energy and the storage of fat as a security measure. Essentially, the body is hoping that by increasing fat storage, it will have enough energy to respond to the stressors of the future. Additionally, high cortisol shuts down proper thyroid production, another hormone that is critical for a healthy metabolism.
If left unchecked, this constant stimulation of the cortisol-producing HPA axis leads to chronically elevated levels of cortisol, and then to HPA axis dysfunction as the problem continues.
So what's the solution? First of all, you need to understand how advanced the level of HPA axis dysfunction is. This can be accomplished with a simple four-point salivary test. Your doctor will help you to interpret the results of this test and determine which stage of HPA axis dysfunction if any, your body is experiencing.
To reset the HPA axis and reduce cortisol levels, your doctor may use a combination of options. At EmpowerMed Clinic we use prohormones called DHEA and pregnenolone along with amino acids, vitamins and minerals, and herbal adaptogens.
But the most important thing is for you to start to begin to address the root cause of your stressors. If you have ongoing gut health issues, seek testing to determine why and have it treated. If overwork is the source of stress, begin to cut back or become more efficient within your current work schedule. In some cases, working with a counselor or therapist is recommended to address the source of stress.
However, there are cases where nothing can be done about the stressor. For example, caring for elderly parents is a stressor that will be ongoing for many years. In cases like this, we provide ongoing support for the HPA axis to ensure healthy production of cortisol levels and keep the system from becoming imbalanced.
5. You’re not being exposed to enough cold
In the modern world, we live very comfortable, temperature-regulated lives. Think about it. How often are you in a situation where you are either way too hot, or way too cold? If you're like most Americans, the answer is rarely, if ever.
And now reachers are actually finding that living a temperature-regulated life could be part of the modern world’s obesity problem.
As with most things health-related, the type of fat your body carries exists on a spectrum. Believe it or not, we have "good" and "bad" fat.
The bad fat is exactly what you might expect it to be. This is the fat that tends to accumulate on the abdomen, thighs, hips, and waist. This fat is known as white adipose tissue (WAT) and is essentially just stored energy sitting, waiting for your body to use it.
Good fat is known as brown adipose tissue (BAT). This fat accumulates primarily around the rib cage and sternum. Its function is to create heat using your stored white fat to keep your internal organs warm. This is called "cold thermogenesis”. Typically, our body will use the stored white fat to create ATP a.k.a. energy. In this case, that is used to create heat itself. This is pretty amazing and means that you can have the same fat-burning effect as working out by just exposing yourself to cold.
Then there's another type of fat called beige fat. Beige fat is white fat that becomes brown after being exposed to cold. The space fat now has the exact same function as brown fat in that it creates heat for the body rather than functioning as stored energy.
All of this means that you have the capacity to make your brown or beige fat burn white fat by simply exposing yourself to cold. This means that one of the best fat-burning daily activities is anything that promotes cold thermogenesis.
Here are a couple of simple techniques that you can do at home:
daily 2-5 minute cold showers at no more than 55 degrees
weekly cold soaks for 20 minutes
“contrast hydrotherapy”, going back and forth between sauna and cold showers, multiple times, always ending with cold
Next Steps
If you've had difficulty losing weight, but have a great day and exercise habits, then these tips are for you.
At EmpowerMed Clinic in San Diego, we work closely with our patients to determine which factors are most appropriate for them to address, and perform high-level testing to assess underlying causes such as high cortisol levels, infections, and food sensitivities. Your doctor will interpret your results and develop a personalized treatment plan which addresses all our findings in a succinct and effective way.
If you are ready to get to the root cause of stubborn weight, reach out to the EmpowerMed team of naturopathic doctors today. We take a collaborative approach to natural medicine, partnering with patients to help them achieve their unique health and wellness goals.
Contact us today at 760-456-7501 or use our booking link to schedule. We offer a complimentary 15-minute consultation for every new patient.
EmpowerMed Clinic is located just off the I-15 and Carroll Canyon within the Fitness Quest 10 Wellness Center of Scripps Ranch, San Diego County, CA. We serve the communities of North County San Diego, Poway, Rancho Bernardo, 4S Ranch, Mira Mesa, Ramona, Scripps Ranch, Santee, and more.
Written by Dr. Carleigh Golightly