Weight Loss: A Functional Medicine Approach

Significant numbers of people have difficulty losing weight when they don’t have a plan to follow or advice from an expert.

A Functional Medicine health practitioner will work with you to look for the root causes(s) of weight gain and offer you a path to weight loss that is designed especially for you.

The figures for obesity are worrisome:

In 2017–18, 2 in 3 (67%) Australians aged 18 and over were overweight or obese (36% were overweight but not obese, and 31% were obese). That’s around 12.5 million adults.

Men had higher rates of overweight and obesity than women (75% of men and 60% of women), and higher rates of obesity (33% of men and 30% of women).

Obesity is more common in older age groups – 16% of adults aged 18–24 were obese, compared with 41% of adults aged 65–74. [1]

If you feel you fall into one of these categories and have tried to lose weight on your own, it may be time to look for guidance and support.

Let’s find out more about how hormones and gut health impact weight and how Functional Medicine can help you to reach your goals.

What causes people to be overweight?

We know that too much food, poor nutrition and not enough exercise are top reasons that many people put on weight and find it difficult to lose. But there are other factors that contribute to weight gain which aren’t always easy to control. These include:

• Genetics contribute to up to 70% risk for obesity.
• Not getting enough and/or poor-quality sleep can make it difficult to control your appetite.
• Depression is predictive of developing obesity and obesity also increases the risk of depression.
• Some medical conditions can cause obesity. These include hypothyroidism, also known as an underactive thyroid, and Cushing syndrome which occurs when your body has too much of the hormone cortisol over time.
• Some medications such as corticosteroids, diabetes medications, epilepsy medications, antidepressants, and medications for schizophrenia, can all contribute to weight gain and obesity.
• Toxins may also play a role in the obesity epidemic since there is evidence that low concentrations of some chemicals have powerful weight-promoting actions. [2]

There are also two significant factors in weight gain and loss – the state of your gut microbiome and your hormones – that you may be able to take action to impact and assist you in losing weight.

Gut health and your weight

The gut microbiome is where beneficial, and not-so-beneficial, bacteria live and help us to maintain a healthy gut. Your gut health, in turn, affects your weight and metabolism as some bacteria extract more energy from food, leading to weight gain, while other bacteria will extract less energy from your food, leading to weight loss.

Research has shown that your gut bacteria can also affect how different foods are digested and produce chemicals that help make you feel full.

In one study, researchers examined the gut bacteria in 77 pairs of twins, one of whom was obese and one of whom was not. Those who were obese had obesity had different gut bacteria than their twins without obesity. Obesity was associated with lower gut bacteria diversity.

Other studies have shown that if the gut bacteria from people with obesity are put into mice, the mice gain weight. [3]

There are several other different factors that tell us how good gut bacteria can promote weight loss:

• Gut bacteria digest fibre so a diet rich in fibre can lead to weight loss. If you have more of the bacteria Prevotella in your gut, you are likely to have less body fat as it digests carbohydrates and fibre.
• Gut bacteria impact the way in which dietary fats are absorbed by the body and how they are stored.
• Gut bacteria digest antioxidants such as flavonoids which are associated with weight loss.
• Gut bacteria can produce lipopolysaccharide (LPS) which causes inflammation, which in turn can cause weight gain.

Great foods for your gut bacteria include whole-grains, a good variety of fruits and vegetables, polyphenol-rich foods such as dark chocolate, green tea and red wine, fibre-packed nuts and seeds and fermented foods such as sauerkraut, kefir, kombucha and yoghurt.

It’s also essential to ensure you are getting enough prebiotics and probiotics for a health gut microbiome. Examples of prebiotics includes asparagus, dandelion leaves, Jerusalem artichokes, onions and garlic, while you can find probiotics in the form of supplements, as well as the fermented foods listed above.

There are also foods that are best to avoid to keep your gut and weight healthy. These include foods high in sugar, artificial sweeteners and unhealthy fats.

Hormones and your weight

Your hormones have a huge impact on your weight. If you have estrogen dominance, adrenal fatigue, thyroid issues, low leptin levels or insulin resistance your ability to lose weight will be very difficult.

Let’s look at two of the big ones – leptin and insulin.

Leptin

A diet that consists mainly of inflammatory foods that are ultra-processed, saturated fats, sugar, food additives and refined grains and lacking in fresh, whole and natural foods can create a permeable gut lining. This is known as leaky gut as toxins are leaked into the whole body creating a state of inflammation.

This inflammation can also affect the hypothalamus in the brain which can lead to leptin resistance.

Leptin is a hormone produced by your fat cells that helps your body maintain your normal weight on a long-term basis. Its purpose is to relay the message to your brain to burn fat for energy and to stop eating because you are full. With leptin resistance, the brain doesn’t get the message so you store fat and stay hungry. [4]

If you have leptin resistance, your body will enter starvation mode and your brain will decrease your energy levels and make you use fewer calories when you are resting.

Although more research needs to be undertaken to fully understand leptin and its impact on weight loss, there are helpful ways to increase your leptin levels. These include eating a nutrient-dense diet with very little highly processed foods, getting enough exercise, tracking your progress, setting up a healthy food environment, eating mindfully, and taking steps to manage stress. [5]

Insulin

Insulin is a hormone that is produced in the pancreas and regulates how the body absorbs sugar, also known as glucose. If your body is experiencing insulin resistance, then your body stops responding to the insulin and does not convert glucose for use by muscles and tissues. The body continues to produce insulin which in turn causes elevated insulin, thus the name insulin resistance. [6]

If you have insulin resistance, you are at risk of developing type 2 diabetes or becoming pre-diabetic so it’s important to manage this hormone not just because of the likelihood of weight gain, but serious health implications.

Elevated levels of insulin can result in weight gain, especially belly fat, which, in turn, makes insulin resistance worse. Although there are genetic factors that predisposes people to developing insulin resistance, a good diet, regular exercise, plenty of antioxidants and probiotics, in addition to the support of Functional Medicine health practitioner are good ways to ensure you manage insulin resistance.

Balancing your biochemistry

Balancing your biochemistry is key to losing weight if you are having trouble shedding kilograms, despite your best efforts.

In addition to hormone imbalances or issues, there are underlying biochemical reasons you may be holding onto excess fat. These include:

• Mineral deficiencies which can make you fatigued and more prone to eating foods that give you quick energy like carbs and sugar and caffeine. They also make you crave salty foods, as salt has minerals.
• Chemical and heavy metal toxicity poison your body’s ability to lose weight.
• Neurotransmitter (serotonin and dopamine) deficiencies can be major source of ’emotional’ eating. [7]

These need to be assessed at the same time as your hormones and insulin production to balance the overall body and reset the system to allow you to start losing weight again.

So, what should I be eating to help me lose weight?

There’s no ‘one diet fits all’ answer to this question. Each individual has different needs and will find some foods work well for them, and others don’t work well.

As a general rule, however, the following are some guidelines to keep the weight off:

• Eat whole, unprocessed, unrefined foods with lots of fibre and cut out sugar and refined carbohydrates.
• Eat lots of plants and a wide variety of them to support your gut microbiome’s diversity.
• Eat good fats such as omega-3 fats and monounsaturated fats, such as extra-virgin olive oil, avocado oil and coconut oil.
• Use supplements when needed. These may include omega-3 fatty acids and probiotics.
• Add fibre-rich foods such as nuts, seeds, legumes and pulses.
• Add fermented foods to your diets. Sauerkraut, kimchi, tempeh, and miso contain good amounts of probiotics so your healthy gut bugs can be fruitful and multiply. [8]

How we can help

At Advanced Functional Medicine, we recognise that losing weight can be extremely difficult for many people. If your stress levels are low and you’ve been eating well, getting plenty of exercise and good quality sleep, but still finding it hard to make progress, you may need some assistance in understanding some of the reasons behind your challenges in losing weight.

After a thorough investigation into what’s behind making losing weight so hard, we can work with you to balance your biochemistry and create a personalised plan to reset your hormones, manage your insulin and balance your biochemistry. Contact us now to find out more.