The Functional Medicine Approach to Weight Loss
Remove the Metabolic Hurdles
If weight loss was a track event, it would be the hurdles. You line up at the weight loss starting line. Pow! The gun fires and you start down the track towards the finish line. You clear the first couple of hurdles, but then you trip on the 3rd and 4th. You can see the finish line, but there are so many more hurdles in front of you. You’re left wondering “Why can’t I lose weight,” and “What are the medical reasons that may be stopping me from losing weight?”
Why Weight Loss is Often Unsuccessful
95% of all weight loss patients are unsuccessful at long term weight loss. Many will lose some of the weight, others will lose none despite their best efforts, and then the remaining will reach their goal only to gain it back. The usual reason for unsuccessful weight loss efforts is simple—the metabolic processes and fat burning engines of the body were not functioning optimally. So, what should you do? How do you remove these metabolic process hurdles? Everyone is different, and the number and difficulty of weight loss hurdles is unique to each patient.
The Functional Medicine Approach to Weight Loss
Unfortunately, most doctors don’t even mention these hurdles much less work towards removing them. They are not trained to think that way, but Functional Medicine doctors are. We uncover and address the root cause(s); we remove the hurdles. Our Functional Medicine clinicians and health coaches work together to identify and remove the barriers.
With all of the different hurdles weight loss patients face, this conversation could get real long, real quick. Here are some of the most overlooked weight loss hurdles that we address & remove from patients every day. Remove these hurdles and weight loss becomes easy.
Medical Reasons You May Not Be Losing Weight
- Suboptimal thyroid health
- Poor gut health
- Hormonal Imbalances
- Too little or too much exercise
- Nutrient deficiencies
- Chronic emotional and mental stress
- Inadequate sleep and sleep quality
Suboptimal Thyroid Health
“But my PCP said my numbers were in the correct range.” We hear this so many times it’s become clichéd. Just because your numbers are “normal” does not mean your thyroid gland is functioning optimally. If your thyroid function is suboptimal, your attempts at weight loss will be futile. Thyroid function is impacted my many, many things–diet and gut health, food intolerances, nutrient deficiencies, high toxin burdens, STRESS and high cortisol levels, medications, fluoride consumption, heavy metal toxicities, poor sleep, etc.
I think it’s safe to say that most conventional medicine physicians are not addressing these lifestyle behaviors and environmental exposures. Conventional medicine physicians simply were not trained to think in terms of root causes. Their approach of a “pill for an ill” is not working. Thyroid dysfunction, hypothyroidism, Hashimoto’s, Graves disease, etc. are all SYMPTOMS that the body is not working as it should. A thyroid condition with abnormal or suboptimal thyroid labs is only ONE piece of evidence of the dysfunction. Lifestyle behaviors and environmental exposures play HUGE roles in thyroid function and health, and must be addressed to ensure the thyroid gland is functioning optimally. What’s good for your thyroid health is good for your overall health, and vice versa.
Poor Gut Health
Gut health is a lot more complicated than taking a handful of probiotics. I agree with Hippocrates. All disease truly does start in the gut. In fact, many researchers feel that 90% of chronic disease, including obesity and weight loss difficulties, can be traced back in some way to the GI tract. The GI tract is much more than a “food tube”. Your GI tract is a major part of your immune system. 80% of your immune cells reside in, near, or along your GI tract. What you put into your mouth matters. The foods you choose to consume can either promote inflammation or prevent it. And inflammation is at the core of most of our chronic diseases. Inflammation will make you fat, and fat will make you inflamed.
Your GI tract also houses about 3-4 pounds of microbial inhabitants which directly and indirectly impact metabolic pathways in ways we haven’t even begun to appreciate. Your GI microbiome plays vital roles in immune function, detoxification processes, thyroid function, nutrient status, hormone metabolism, to name a few. When your microbial inhabitants become out of balance (dysbiosis) the GI tract is at risk for becoming “leaky.” Gut permeability, or “leaky gut” (caused by stress, a poor diet, medications, toxins, infections, and more) can lead to chronic systemic inflammation and sabotage weight loss efforts. “Heal your gut to lose your butt” is one of our classy mottos. 😉
These signaling molecules work best when they are in balance. Your body functions best when your hormones are in the “Goldilocks Zone,” neither too high nor too low. Hormonal issues are most often downstream symptoms of upstream problems. Many well-intentioned physicians will prescribe hormone pills, creams, injections, and pellets to correct “imbalanced” hormone lab values without ever addressing, or giving thought to, WHY the imbalances are occurring.
Prescribing hormone replacement without addressing the root causes often makes a mess of things. Initially, symptoms may improve, but more times than not, other symptoms develop or existing issues worsen. I see it time and time again. Women will gain weight, complain of “puffiness,” feel fatigued or irritable. There is a complicated “metabolic dance” occurring among the different hormones, and these hormonal interactions should be addressed with care. The production, transport, signaling, and detoxification of hormones are all crucial for optimal metabolism. And each of these important “steps” is impacted by gut health and function, nutrient status, stress and cortisol levels, thyroid function, and many other things. Always look upstream.
Too Little or Too Much Exercise
“If I just work out harder I’ll lose weight, right?” Not always. Physical activity is not optional. It’s a must, but it must be done correctly. Patients often get into trouble with exercise when they “over exercise.” Too much and too strenuous activity can backfire quickly. Those extra miles on the treadmill or bike can prevent fat loss if you are placing excessive strain on an already overburdened body. Strenuous activity and “over exercising” will increase cortisol levels. Cortisol is one of the “fight or flight” hormones released during acute stress. Some stress is good, but too much is not. Excessive cortisol production interferes with thyroid function, hormone metabolism, gut motility, digestive enzyme function and production, mitochondrial function, immune function, and detox abilities. Elevated cortisol levels are like kryptonite to weight loss and fat burning.
The “Goldilocks Zone” applies to exercise also. I find that most people spend way too much time on cardio, and way too little time engaging in activities that build muscle. Weight training should comprise the majority of one’s exercise prescription. Muscle is more metabolically active than other tissues, like bone and fat. Thus, the more muscle you have the higher your metabolic rate, even at rest. A combination of HIIT (high intensity interval training), cardio, weight training, and stretching is ideal.
It’s important to note that exercise and physical activity provide much more benefit to one’s body than reduction in fat stores. Physical activity is good for the following: detoxification processes (sweating is good for detoxing), mitochondrial function, cognition and mood, stress reduction, improving sleep quality, and bone density.
There are tens of thousands of reactions occurring daily in your body. These reactions require nutrients in order to occur. If you are nutrient deficient, your body will not work optimally. All of the nutrients must be present in the right amounts, and these nutrient amounts will vary from person to person. Stress, environmental exposures, activity levels, genetic polymorphisms, gender, and age affect one’s nutrient needs. These needs can vary from day to day and over the course of one’s life.
Nutrient deficiencies can occur for a few different reasons–inadequate consumption, inadequate absorption, and excessive utilization (stress, chronic disease and infections, over exercising, medications, etc). Chronic stress often increases our need for B vitamins, vitamin C, magnesium, omega 3 fatty acids, and zinc. Medications also increase our need for certain nutrients, as can high toxin burdens and chronic exposure to chemicals. A “leaky gut,” dysbiosis, and suboptimal GI function impair the body’s ability to absorb nutrients. Also, dysbiosis can impact nutrient production–your GI microbiome is responsible for making nutrients such as vitamin B12 and vitamin K.
With regards to inadequate intake, this appears to be an issue for most everyone, even those who are eating according to sound nutritional principles. Despite the fact that we live in one of the most wealthy countries and have access to food like no other time in history, most of us are walking around with nutrient deficiencies. The food we have access to is very different than that of our grandparents. Current big farming practices are producing foods that are less nutrient dense. Many of our fruits and vegetables have significantly less nutrients compared to the same varieties of 30-40 years ago. Combine that with the fact that our diets are comprised of too many processed foods devoid of adequate nutrients and it’s a perfect storm for developing nutrient deficiencies. It’s why I always recommend a quality multivitamin. Key word here is QUALITY.
Chronic Emotional & Mental Stress
Who doesn’t have stress, right? Life can have its challenging moments. And some stress is okay, even necessary for our survival. But too much stress or a poor response to stress, will eventually cause a lot of problems. Some of us do a better job at managing our stress than others. I find that the majority of my patients underestimate the amount, source, and effects of their stress on their health. They are walking around with cortisol levels that are either through the roof, or they have completely burned out their adrenal system.
Cortisol, which your adrenal system produces, is necessary for life, but too little or too much can also cause a lot of problems–immune dysfunction, hormonal issues, weight gain, thyroid dysfunction, GI issues, detox inefficiencies, and mitochondrial dysfunction. It really does impact everything! Furthermore, when we are chronically ill and overweight, we don’t handle stress as well as we could if our bodies were operating optimally. We must give up the illusion of control and allow ourselves to be imperfect.
Inadequate Sleep and Sleep Quality
Sleep deprivation is used as a form of torture, yet many of us think we can reach our goals by shortchanging ourselves on sleep. This will bite you on the backside every time! Well rested people have far less chronic health issues, including weight problems. I cannot say enough about how important quality sleep is for your health and for reaching weight loss goals. Some of you are trying to sleep in combat conditions–pets in the bed, TV blaring, smartphones in your hands, blankets being stolen by small children, spouses sawing logs.
Sleep is when your body repairs itself. It’s when your body “takes out the trash.” Despite what many say, humans do best with 7-8 hours of uninterrupted sleep. And it isn’t just about the length of sleep time. Quality matters, too. Just because your eyes are shut doesn’t mean you are getting quality sleep, getting into those deep stages where repair occurs. Things like blue light exposure, caffeine, stress and high cortisol levels, nutrient deficiencies, inflammation and leaky gut, poor sleep hygiene, and many other things can impact the quality of your sleep. We can help you get the sleep you need!
We Can Help Remove the Barriers
Life will always have hurdles, but your weight loss efforts don’t have to. Working with a Functional Medicine team can help you remove and/or clear the metabolic hurdles. We can help you cross the finish line in a leaner, healthier body that is functioning optimally, ensuring long-term weight loss success.
You can sign up for an online Initial Health & Medical Investigation here. During this 60-minute video consultation we will work with you to identify the barriers you are facing and develop an individualized treatment plan. Treatment plans may include behavior and lifestyle changes, nutraceuticals, therapeutic nutrition/weight loss plans, stress management techniques, health coaching, and/or advanced diagnostic testing.