Functional Approach to Weight Loss
COVID-19 has had many impacts on our health. With gyms closed, work-from-home schedules, and high stress, many have noticed a loss of muscle mass and a gain in excess fat. Dr See Yunn Ho discusses the often overlooked causes of weight gain and her Functional Medicine approach to healthy and lasting weight loss.
The Common Causes of Weight Gain
The common causes of weight gain include both poor diet and a lack of exercise. But these aren’t the only factors involved in weight.
Indulging in high calorie foods and foods high in sugars, carbohydrates and saturated fats can lead to weight gain. In addition, a sedentary lifestyle lacking in exercise prevents calorie output which adds to the piling on of our weight. This is especially so during COVID-19 times when most of us are cooped up at home indulging in foods, snacks and drinks, plus not exercising, which leads to many people gaining weight while working from home.
In addition, a lack of sleep or stress can cause high cortisol and ghrelin levels and a reduction in leptin. Ghrelin is involved in sending hunger signals and leptin tells your body to stop eating. As a result, after a few nights of impaired sleep, levels of ghrelin have been shown to increase significantly leading to an increase in hunger and cravings for energy dense high glycemic index foods. (1) The increase in cortisol level due to stress stimulates the body to store fat.
Hormone imbalances, such as declining hormones like estrogen and testosterone after menopause and andropause, may lead to weight gain and fat accumulation in the belly or thighs. Testosterone is responsible for maintaining lean muscle mass in the body and that is why men with higher testosterone carry more lean muscle mass than women and less body fat. During menopause or andropause when the testosterone level declines, the body is more prone to fat deposition and middle weight gain. In women, often when we go into our forties, the progesterone level start to decline more than estrogen levels. This leads to estrogen dominance which causes storage of fat around the middle and weight gain.
Another common causes of unwanted weight gain include unchecked metabolic issues like low thyroid or insulin resistance. Insulin is a hormone that causes fat deposition. Insulin resistance means that your cells cannot respond to the glucose from food and thus the liver converts the glucose to be stored as fat. Insulin resistance is a common cause of carbohydrate addiction and uncontrolled weight gain. Suboptimal thyroid function which is common in the ageing process leads to lower metabolism in the body and reduction in fat burn. A sluggish thyroid leads to weight gain, fluid retention, fatigue, low mood which in turn causes a person to exercise less and less fat burn.
Functional Approach to Weight Loss
Once you have identified what are the likely causes for your weight gain, the initial step is to work on your diet to optimize nutrients and enhance fat burn. Weight loss is no longer just about reducing calories in the diet. Instead, work on optimizing nutrients help to rebalance your hormone and improve your metabolism. Remove foods that causes inflammation in your body like sugars, refined carbohydrates, dairy products like milk and cheese. Cut off saturated, trans-fats and vegetable oils. Instead, substitute with monounsaturated or polyunsaturated fats. It is also important to eliminate or reduce alcohol intake as alcohol contains sugars and can reduce the metabolism rate. Work with a functional practitioner or nutritionist to identify food traps and make healthier food choices.
Incorporate targeted exercise into your daily regime to improve fat burning. The American Heart Association recommends 150minutes each week of moderate intensity exercise or 75min per week of vigorous exercise. HIT exercise (high intensity exercise) involves short periods of high intensity exercise which besides helping fat-burn, also raise testosterone and growth hormone that helps maintain lean body muscle mass. Strength training helps build muscle mass which encourages fat-burn even when resting.
Detoxing your body is helps remove toxins that may inhibit weight loss. Toxins are usually hidden within the fat cells. These toxins including organophosphates and BPA are known as endocrine disruptors and may interfere with your hormones like estrogen and thyroid which also damage your cells. Toxins can also trigger adipogenesis and cause visceral fat deposition. Detoxing your body will not only improve weight loss but also benefit your overall health. Supplements like DIM or fiber helps to detoxify estrogen from the body and reduce the effects of estrogen on the body causing weight gain.
Next, if you are experiencing sudden weight gain when you reach your 40s or stubborn weight that refuses to budge no matter how hard you exercise, work with a functional practitioner to test your hormones including the thyroid and male and female hormone levels. Thyroid hormone deficiencies can lead to slow metabolism and correcting this with thyroid medications may help boost your metabolism and encourage fat burning. Hormonal imbalances like estrogen, progesterone or testosterone deficiencies that occur during perimenopause or menopause can be addressed either by hormone boosting supplements or bioidentical hormone replacement therapies.
Check for metabolic imbalance in the body like insulin resistance which could have developed from many years of indulging in rich foods high in refined sugars and high glycemic index carbohydrates. Work with your practitioners to use nutrients like cinnamon, chromium (2) and berberine (3) to control blood sugar. For patients with diabetes or diabetic risk, medications may be needed to improve insulin sensitivity and reduce uncontrolled blood sugars which may cause excess fat deposition. Nutritional supplements like Relora which helps reduce stress-induced carbohydrate cravings may also be necessary at the start to reduce sugar cravings and change your tastebuds.
Finally adding certain supplements to boost metabolism may be helpful to enhance fat-burn for weight loss. Nutraceuticals like Carnitine promotes metabolism and fat-burn for weight loss. (4) Green tea extracts help in fat oxidation and improve energy expenditure which may support weight management. (5)
Maintaining a healthy weight should be a long-term skill to manage a healthy diet and lifestyle habits. It is no longer all about counting calories or fad diets which could lead to yoyo weight management. Rather, it should be about knowing the right nutrients to take to promote detoxification, cellular repair and enhance metabolism. This is the route to optimal weight and heath management.
Dr See Yunn Ho
Dr Ho See Yunn is a Physician with more than 15 years experience. She is board certified in both Singapore and Hong Kong and received her specialization in Family Medicine from Singapore. She also received her Advanced Fellowship in Functional and Nutritional Medicine and Peptide certification from the American Academy of Anti-Ageing and Regenerative Medicine. Dr Ho is trained and certified under Dr. Walsh’s advanced nutrient therapy protocols that use personalized nutrient treatment strategies to treat patients with behavior disorders, ADHD, autism, depression, anxiety, bipolar disorders, schizophrenia and Alzheimer’s Disease.
- Ref: Schmid SM, Hallschmid M, Jauch-Chara K, Born J, Schultes B. A single night of sleep deprivation increases ghrelin levels and feelings of hunger in normal-weight healthy men. J Sleep Res. 2008 Sep;17(3):331-4
- Wang ZQ, Cefalu WT. Current concepts about chromium supplementation in type 2 diabetes and insulin resistance. Curr Diab Rep. 2010 Apr;10(2):145-51
- Hao Zhang, Jing Wei, Rong Xue, Jin-Dan Wu, Wei Zhao, Zi-Zheng Wang, Shu-Kui Wang, Zheng-Xian Zhou, Dan-Qing Song, Yue-Ming Wang, Huai-Ning Pan, Wei-Jia Kong, Jian-Dong Jiang, Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression, Metabolism, Volume 59, Issue 2, 2010, Pages 285-292
- Pooyandjoo M, Nouhi M, Shab-Bidar S, Djafarian K, Olyaeemanesh A. The effect of (L-)carnitine on weight loss in adults: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2016 Oct;17(10):970-6
- Janssens PL, Hursel R, Westerterp-Plantenga MS. Nutraceuticals for body-weight management: The role of green tea catechins. Physiol Behav. 2016 Aug 1;162:83-7