The Childhood Obesity Cost Effectiveness Study estimates obesity rates will climb significantly by 2030. Currently, nearly half the adult population is obese while most others are struggling to lose that “last 10, 20 or 30+ pounds” that seems to accumulate with age. Whether you’re overweight or obese, figuring out why you struggle with weight loss and following a comprehensive weight management plan are both critical to reaching weight loss goals and keeping the weight off.
In this article we will discuss:
- Why people struggle to lose weight.
- Why hormone balance is critical for weight loss and maintenance.
- Why stress management and gut health are also key to maintaining a healthy weight.
- How stress and weight management help facilitate long-term disease prevention and overall health.
- How GLP-1s, like semaglutide, should and shouldn’t be used to support weight loss.
- What to include in a comprehensive weight management plan, so you can keep weight off.
Why do so many people struggle with weight loss?
You may have heard that the key to losing weight is calories in vs. calories out. Guess what? Weight management is a lot more complex than that. The truth is, several metabolic factors can play a role in weight gain and weight loss. These include:
- Inflammation
- Insulin resistance
- Chronic stress
- Thyroid hormone disruption
- Sex hormone imbalance (estrogen, progesterone, testosterone)
- Gut health (leaky gut and gut dysbiosis)
- Toxicity (drugs, metals, pesticides, chemicals like sweeteners, dyes, preservatives, etc.)
- Nutrient deficiencies (obese people are commonly deficient in vitamins A, C, D, B1, B12, folate and biotin, as well as minerals zinc, selenium and chromium)
If you really want to lose weight and optimize your health, it’s vital to find out which of these factors are factors for you. Since so many of these metabolic processes are interconnected, most overweight and obese individuals need to address multiple factors.
How do you figure out what factors are standing in the way of your losing weight? An integrated, functional medical practitioner (those who are committed to uncovering the root cause of disease) can perform a series of lab tests along with a symptom review with you to determine what’s amiss.
What role do hormones play in weight management?
As the title of this article suggests, hormones do in fact play a big role in weight management. For one, hypothyroidism (low levels of thyroid hormone in the body) can make it difficult to lose weight or keep it off. Stubborn belly fat, even in non-overweight individuals, can also be associated with hormone imbalance, not to mention inflammation and insulin resistance.
A study published in the journal Translational Psychiatry revealed that both premenopausal and post-menopausal women who were overweight, tended to have higher free testosterone levels than women who were not overweight. In addition, research published in the journal Climacteric has shown that women who accumulated belly fat with age, along with overall fat mass, were able to address those issues with estrogen therapy.
Your integrated, functional medical practitioner can run lab tests to determine whether your thyroid and sex hormones are imbalanced or not. She can then prescribe hormone replacement therapy (HRT) and/or medical grade nutraceuticals to support hormone balance.
Controlling stress and inflammation is also key to weight management and overall health
Cortisol is another hormone that factors big time into weight management. Stress raises cortisol levels in the body. Chronic stress along with chronic cortisol elevation can lead to hypothyroidism (low thyroid), increased fat deposition, muscle wasting, alteration of sex hormones, sleep issues, mental health issues and more. Again, these metabolic processes are all intertwined.
Chronic cortisol elevation is also associated with chronic inflammation, which contributes to a variety of disease states. According to the National Institutes of Health, the diseases associated with chronic inflammation are many and include cardiovascular disease, diabetes, malignancy, auto-immune disease, chronic hepatic and renal disease, and more.
Then there’s metaflammation, which the Clinical Kidney Journal describes as a “paradigm” focused on “metabolism-induced (high fat or fructose-based diet or excessive calorie intake) chronic inflammation.” In other words, the traditional, high-fat, high-sugar, highly processed, high calorie Western diets many obese Americans ascribe to not only make them fat, they are making them sick. That’s because metaflammation is closely associated with chronic kidney disease and chronic heart disease, among other health issues.
Which leads us to insulin resistance and type 2 diabetes …
Insulin is another hormone directly associated with weight management. And get this, the aforementioned chronic stress and obesity are both linked to insulin resistance. The most common causes of insulin resistance are excess body fat—especially belly fat—and lack of exercise.
So, what is insulin resistance and what role does it play in type 2 diabetes (T2D)?
Insulin helps control the levels of sugar (glucose) in the blood. When someone has insulin resistance, their body’s cells don’t respond normally to insulin. Consequently, glucose can’t enter their cells as it should, and it builds up in the blood instead. Chronic, elevated glucose levels can eventually turn into type 2 diabetes.
How GLP-1s like semaglutide help people lose weight and manage T2D
If you’re looking to lose weight or treat type 2 diabetes, chances are you’ve heard of GLP-1s like semaglutide (Ozempic, Rybelsus, Wegovy brand names) and tirzepatide (Mounjaro and Zepbound brand names). Some are prescribed only for T2D, while others, more commonly semaglutide, may be prescribed for weight loss.
There is no question that GLP-1 (glucagon-like peptide) agonists are very effective weight loss medications and they work remarkably well as a treatment for T2D. So how do GLP-1 agonists work? They mimic the natural GLP-1 hormones our bodies make in the small intestine that are responsible for:
- Triggering insulin release from the pancreas.
- Blocking the release of glucagon, a hormone the body uses to increase blood sugar levels.
- Slowing digestion so the body releases less glucose into the bloodstream.
- Promoting satiety, feeling full.
When patients take GLP-1 agonists, hunger pangs diminish and insulin resistance is reduced. In addition, their bodies use food as fuel, instead of storing it as fat because most people eat considerably less while taking GLP-1 agonists.
You should only take GLP-1s under the guidance of a qualified medical practitioner. While GLP-1 agonists are generally considered safe for most people, these drugs have only been on the market for a short period of time. In addition, people who consume excess amounts of alcohol, are at risk for or have had medullary thyroid cancer (MTC), kidney disease or diabetic retinopathy, have had past or current eating disorders or are currently pregnant should not take GLP-1 agonists.
In addition, EVEXIAS Health Solutions and our medical providers generally do not recommend using GLP-1s as a “lifestyle drug,” meaning, you shouldn’t plan to stay on the medication forever. We may recommend them as part of a comprehensive weight management plan, where the patient commits to other critical lifestyle changes in order to lose weight and keep it off in a healthy way.
Special attention should also be paid to gut health when struggling to lose weight
Maintaining a healthy gut should truly be the cornerstone of any plan to reach optimal health. Since many of the hormones our body produces are “born” in the gut and the vast majority of our immune system resides there, gut health should be a top priority for all of us.
Hormone imbalance is just one sign of poor gut health. Digestive issues, heartburn, food sensitivities, autoimmune diseases and brain fog are some of the many others. And no surprise here, chronic stress, toxicity and poor dietary choices (diets high in unhealthy fats, sugar and processed foods) are also tied to leaky gut and gut dysbiosis, which both lead to insulin resistance, weight gain and obesity.
Leaky gut refers to increased intestinal permeability that allows undigested food particles, toxins and other harmful substances to “leak” into the bloodstream. Leaky gut can trigger an immune response and cause inflammation throughout the body, the key trigger of all chronic disease processes, as noted above.
When the gut is in a state of dysbiosis, the composition and diversity of the gut microbiota may be altered, causing an overgrowth of harmful bacteria and a reduction in beneficial bacteria. When this occurs, digestive issues, inflammation, a weakened immune system and weight gain can result, among other issues.
What does a comprehensive weight management plan look like?
Once your practitioner has determined why you are overweight or have trouble losing weight, They can prescribe a comprehensive weight management plan for you. GLP-1s are not a good option for all patients, so ask your practitioner if these medications may benefit you. Depending on your individual health issues and weight loss goals, your plan may include:
1). GLP-1 agonists like semaglutide. (Injectable and oral options are available). Our practitioners typically prescribe GLP-1s to help kick start weight loss. You shouldn’t expect to remain on GLP-1 medications for life. We find patients have the best results if they amp up their dosage gradually, and then wean off their dosage slowly.
2). Lifestyle changes (diet and exercise). Loss of lean muscle mass is common for patients who take GLP-1s or lose weight quickly in other ways, so it’s very important to truly make a lifestyle change and follow a diet that is high in protein and healthy carbohydrates, especially non- starchy vegetables, like the Mediterranean Diet. If you keep following or return to an unhealthy Western diet, you will more than likely regain the weight you lost—in fat, not muscle—once you stop taking GLP-1s.
Another way to combat the loss of lean muscle mass is to commit to a regular exercise routine, at least three times per week. Strength training, weight bearing exercises and lifting weights are great ways to both maintain and strengthen muscles.
Dropping the weight may be easy with GLP-1s but you do have to make permanent lifestyle changes like these (and potentially others) if you don’t want to gain the weight back.
3). Hormone replacement therapy (HRT). If lab tests reveal that your hormones are not in balance, your practitioner can prescribe HRT. Depending on your specific needs, the therapy may involve an oral prescription or pellet therapy. You can learn more about the EvexiPEL® method of hormone replacement pellet therapy here.
4). Stress management. Since stress plays a key role in the metabolic processes mentioned above, getting a handle on stress is very important for any weight management program. Your practitioner can discuss options with you, like therapy, meditation, exercise, yoga and more.
5). Gut health therapy. If you suffer from leaky gut or gut dysbiosis, your practitioner can discuss dietary changes, as well as prescribe nutraceuticals for nutritional support and probiotics to get you gut microbiome back to a balanced state.
6). Medical grade nutraceuticals. Most people who are overweight or obese are deficient in some or all of the vital nutrients listed at the beginning of this article. In addition, patients with certain conditions like hormone imbalance or poor gut health may benefit from nutraceuticals to promote hormone imbalance or pro- and prebiotics to support a healthy gut.
7). Ongoing guidance and support. Our medical providers pride themselves on being an ongoing resource to patients throughout their weight loss journeys. Having regular check-ins and follow ups with your practitioner throughout the process can help keep you on track or get you back on track when you struggle. They can also monitor your progress and make adjustments to your weight management plan as needed.
These are just some of the steps you might expect in your weight management plan. Some patients may also need to deal with mental health challenges impeding weight loss, detoxification when toxicity is an issue and other aspects specific to their unique needs.
We can help you kick start your weight loss journey—for real!
Our EvexiPEL Certified Providers can determine what roadblocks are standing in the way of your weight loss goals and develop a comprehensive weight management plan just for you. Contact a provider today to get started on your health and wellness journey.
