It is so frustrating! You are doing everything “right” – exercising, watching what you eat (whole foods, limited refined carbohydrates and processed foods) and drink (getting ½ your body weight in lbs. in ounces of water each day and avoiding caffeine and alcohol.) But the pounds are still there and the number on the scale even continues to creep up!!! What is going on!?!! UGH!
Let us explore some possible culprits… There is a lot more to losing weight than the number of calories you consume.
First, we need to understand that you did not get here overnight. And when it comes to restoring health and wellness there is no such thing as a quick fix. But the good news about the functional approach is that the goal will not just be weight loss; it will be improved health and wellness, which encompasses so much more of who you are.
Physiologic Hormone Restoration
- Estrogen and progesterone imbalances result in weight gain in hips and thighs, water retention and sluggish metabolism. Such imbalances also occur in men as aromatase activity increases with adipose tissue accumulation resulting in elevations in estrogen.
- Too much estrogen relative to progesterone makes it tough to lose weight.
- Excesses of estrogen and cortisol inhibit thyroid function, leading to stalled weight loss.
- Low androgens (testosterone and DHEA) lead to decreased lean muscle and increased body fat, decreased metabolic rate and abdominal obesity.
- Chronic stress triggers blood sugar imbalances and weight gain – belly fat in particular.
- High cortisol results in insomnia, anxiety, sugar cravings, feeling tired but wired and increased belly fat.
- Low cortisol causes chronic fatigue, low energy, food and sugar cravings, poor exercise tolerance or recovery and low immune reserves.
- Vitamin D3 deficiency is associated with hyperinsulinemia and increased belly fat.
- High TSH/Hypothyroidism results in low metabolic rate and obesity.
- High insulin is indicative of insulin resistance, metabolic syndrome, and abdominal obesity.
Inflammation
When inflammation is present, even those with the most disciplined eating and exercise habits may find they can make little progress losing weight. The reason stems largely from changes seen when the body gains weight or is carrying excess weight, many of which are cyclical and build on one another.
Inflammation in the body may lead to:
- Decreased T4 to T3 conversion leading to a state of thyroid resistance
- Increased insulin resistance leading to weight gain
- Low testosterone and increased expression of aromatase (leading to increased estrogen levels)
- Increased leptin levels leading to weight gain
- Increased appetite
Weight gain is associated with increased inflammation in the body. Levels of a key inflammatory marker in the blood known as C-reactive protein (CRP) increased as weight increased. This inflammation appears to be triggered by hormonal and metabolic changes and remains until excess weight is lost.
Furthermore, inflammation in the gut can affect the hypothalamus, which is the part of the brain in charge of hunger signals. When this happens, your ability to know when you are actually hungry and stop eating when you are full is impaired.
Gut Health
The health of the gut determines the way we digest food – how many calories get absorbed and how many nutrients simply pass through. The gut really controls whether we gain weight, lose weight, or maintain our weight. Our gut microbiome plays a huge role in weight management. Studies have shown that gut microbes in people that are overweight are different from those found in people of healthy weight.
In addition, the bacteria in our gut also have the powerful ability to increase or decrease cravings, which means the microbes living in our gut essentially tell us what to eat! Thus, if you have too many microbes that like to feed off sugars and simple carbohydrates, when you try to eat less of them, you will crave them even more!!
Food Sensitivities
Food allergies are often a trigger for inflammation. If you are consuming foods that you are sensitive to then this will provoke an inflammatory response and it is next to impossible to lose weight when inflamed. What makes the Food Intolerance Testing (FIT) available through MD Custom Rx stand above the others is that it is a multi-pathway test that detects both IgG 1-4 and C3d, which helps to indicate not only food exposure but simultaneously indicates which foods are likely involved in inflammation and leaky gut. This is vastly different than most of the food sensitivity tests out there, which are just single-pathway tests that detect only the IgG which indicates food exposure but NOT necessarily food that causes inflammation. The net result is that IgG only tests are non-specific and not identifying those foods causing inflammation.
(Cost $475/176 foods, $375/132 foods, $200/22 foods)
Genetic Makeup
Yep, that is right, your genes may be making it difficult to fit into your jeans! Each body has a unique genetic makeup that can identify the nest approach to achieve your ideal weight goals. Wellness and developing a healthy lifestyle should be at the core of any diet & wellness goal. Confronting genetic shortcomings for diet, wellness, and beyond can help optimize your journey by placing less stress on your body during the process. Genetic testing can provide you with a customized path to weight control, weight maintenance, and a healthy lifestyle that works!
Who could benefit from genetic testing?
Patients who:
- Have made dietary improvements and are not seeing results.
- Want to target their supplementation using their DNA results.
- Desire weight management.
- Have cholesterol or sugar sensitivity issues.
- Want to address inflammation caused by dietary sources.
- Are experiencing confusion about which diet would work best for them.
Customized Solutions Through Prescription Compounding
The following treatments can help in your weight loss journey and require a prescription. We would be happy to discuss these options more with you and your healthcare prescriber, please contact us.
- “The Triple Combination” – Phentermine + 5-HTP/Carbidopa
This combination has been shown to lead to greater weight loss, with fewer psychomotor side effects than each drug alone and has resulted in a 20% body weight loss after 3 months of use.
- Low Dose Naltrexone (LDN)
- Naltrexone reduces insulin resistance
- Naltrexone may increase growth hormone in certain patients
- Growth hormone in turn helps to not only build and maintain lean muscle mass, but also helps to increase fat burning, both of which can help with weight loss. As weight increases, growth hormone decreases and as insulin increases, growth hormone decreases.
- Naltrexone significantly reduced basal insulin concentrations and augmented the growth hormone response to growth hormone releasing hormone.
- Naltrexone modulates appetite
- Naltrexone acts as an anti-inflammatory agent
- Naltrexone may help improve sleep & sleeping patterns
- Lack of sleep leads to inflammation and weight gain.
- Naltrexone improves thyroid function (including Hashimoto’s Thyroiditis
- Naltrexone can help to increase total T3 levels and improve T4 to T3 conversion
- LDN can help to improve the immune system and reduce autoantibodies in some autoimmune conditions.
- Metformin
Metformin has been used to help treat insulin resistance in the diabetic population for decades. We are beginning to see applications of using metformin to augment health in patients without a diabetes diagnosis.- Metformin improves and increases the efficiency of mitochondria energy production.
- Metformin reduces gluconeogenesis and reduces insulin resistance. Patients who take metformin with insulin resistance tend to lose weight.
- Metformin has been demonstrated to be an effective drug to reduce weight in patients without diabetes.
- Metformin modulates appetite.
- Metformin may improve muscle mass, energy production and therefore metabolism
Although effective, the use of metformin is often limited due to the gastrointestinal (GI) upset it causes. At MD Custom Rx, we can compound metformin into a cream allowing it to be absorbed across the skin and bypassing the gut all together, thereby eliminating this side effect.