Healthy weight

Natural weight loss

A holistic approach that’s healthy, effective and lasting

by Marcelle Pick, OB/GYN NP

Over the years I’m sure I’ve lost over 100 pounds — the same 10 pounds ten times! And my patients tell me the same thing.

On any given day about half of all American women (and girls) are on a diet. We spend an estimated $30–40 billion a year on diets and weight-loss products. But 65% of us are still significantly overweight, and the long-term failure rates of fad diets and diet chains (Weight Watchers and Jenny Craig included) are said to be dismal.

Clearly there are powerful factors that push us toward excess weight and all its related health problems. But the equally important question is, why can’t women lose weight and keep it off, even when they stick to a diet plan?

I’ve worked as hard on this issue as on any other medical question in my 27 years of practice. And I think I have finally discovered a way to unravel the knot of issues that work together to produce weight gain and resist weight loss. In a nutshell, women who can’t lose weight are up against hidden obstacles in their health — core imbalances that encourage the body to hold onto weight rather than let it go. To lose weight, you must restore your health and hormonal balance — if you don’t, either the weight will come right back after you stop dieting, or it will stay put no matter how hard you try to get rid of it. Think of it as getting healthy from the inside out. Only once you’re in balance can you lose weight and keep it off.

Women to Women’s approach to weight loss

Creating a healthy, lean body depends on how well each individual woman’s body copes with the demands made on it. This is highly individual: what works for you may not work for your friend, but the important thing is that you understand what works for you.

To understand this, you need to know that almost every major system in your body relates to your metabolism and your ability to lose weight and keep it off, specifically your central nervous, endocrine, musculoskeletal, digestive, immune, and detoxification systems. Parts of your metabolic blueprint are genetically predetermined or formed in utero, while others are highly influenced by your nutrition, emotional history, stress level, lifestyle, and environment.

So this means you need to get healthy on all these levels before you can lose those stubborn pounds.

Appetite and metabolism

Healthy leanness results from burning fat and building muscle — two of the key processes of a functioning metabolism, which on the macro level includes digestion and elimination and on the micro level involves various forms of cellular “work,” such as membrane repair, cell division, and endocrine function.

A well-functioning metabolism has three jobs: 1) to convert energy from the food we eat into work and heat (on both a cellular and a muscular level); 2) to eliminate any toxins or unnecessary nutrients in the form of waste; and 3) to store glucose in the form of glycogen and extra energy as fat for future use. All of these functions are interrelated and interdependent; one cannot function properly without the support of the other two. And as research increasingly shows, our nutrition serves as the backstop for the whole game. That’s why the saying “you are what you eat” is no joke.

A well-functioning metabolism is supported by regular, good nutrition. No matter how often you hear that “a calorie is a calorie,” it is just not that simple: what, when, and how you eat do matter. And nothing shuts down metabolism faster than starvation and deprivation. Your body immediately switches into hoarding mode: conserving fat and burning the liver’s glycogen reserves for energy. Once the reserves of glycogen are depleted, your brain sends out intense hunger signals that will not be denied. This is the source of so much failed yo-yo dieting and repeat weight gain.

Adequate nutrition combined with moderate physical activity automatically keeps our bodies at a healthy set point: a predetermined body fat ratio within a 10–15-pound weight range. Your metabolism is designed to vigorously defend your set point by speeding up or slowing down if its thresholds are threatened.

One way your body signals that it needs (or wants) more calories is through hunger. A constellation of appetite signals work in your body at different times and are highly subject to stress. Hunger hormones, or signaling factors, are part of a larger global feedback system that “talks” to almost every major body function and vice versa. Our much-maligned fat cells are actually metabolically active tissue that help us sense “fullness” and regulate body heat and weight.

The amount you eat and when are governed by your brain, fat cells, and central nervous system (which are highly influenced by your environment). How well you digest your food and rid your body of toxins relies on the health of your GI tract and other organs, like your liver, kidneys, and lymphatic system. How efficiently the cells in your body convert your food to energy is affected by the health of your respiratory, musculoskeletal, endocrine, and immune systems.

The current reality for the large majority of women is that losing weight really means shifting your point of view away from the failed traditional model — calories in, calories out — and toward a more holistic approach. Your body is designed to naturally defend a certain weight that it considers normal. Our modern way of life has confused this primitive biochemistry into accepting what is essentially an “abnormal” state: being unhealthy and overweight. In order to permanently lose weight, your body has to feel safe enough to just let go.

And feeling safe means restoring balance and, importantly, a smooth flow of “chatter” among your major systems. For this your body relies on its chemical messengers, your hormones.

Hormones that regulate metabolism

New insights appear almost daily on this weight loss frontier — the relationship between hormones and how the gut talks to the brain to regulate weight — so I’ll provide just a brief overview of this complex network.

Metabolic hormones — Of course, the major player in this scenario is insulin. Insulin is a primary hormone that is directly affected by your diet. It determines whether blood sugar gets used right away for immediate energy or stored as fat instead. Any disruption in the insulin-regulating mechanism, such as insulin resistance, has an instant effect on some of the lesser metabolic hormones — the list of which grows longer each year as we uncover more of the inner workings of human metabolism.

The hunger–satiety hormone network includes:

• Ghrelin, the only “hunger hormone” identified to date, is a peptide released by endocrine cells mostly within the stomach’s lining. It counteracts leptin to increase metabolic efficiency and stimulate appetite. Its effects are somewhat paradoxical, in that it normally indicates hunger — “if your stomach’s growlin’, you’re making ghrelin” — but it can also be released after a high-protein meal.
• Leptin, which is synthesized within fat cells, works on the hypothalamus to dampen eating behavior while increasing energy expenditure. New hopes of a magic weight-loss pill based on leptin never reached fruition (magic solutions rarely do).
• Adiponectin, a mixture of anti-inflammatory peptides secreted by fat cells, helps regulate energy balance and the metabolism of sugars and fats, as well as increasing insulin sensitivity. But the paradox again, is that overweight people often have less circulating adiponectin than slim ones, so we still have much to learn about what triggers its release from fat cells.
• PYY has been shown to slow digestion, suppress appetite, and significantly reduce food consumption.
• Cholecystokinin (CCK) is released in the duodenum in response to high-fat or high-protein meals, and signals the brain to produce a sense of fullness or satiety — fatty meals are especially effective.

Other hormones

• Melatonin, the hormone that regulates the circadian rhythm, also factors into your hunger time clock. Research shows that sleep deprivation throws off melatonin production, which in turn influences leptin and ghrelin production. In one study, subjects who were chronically sleep deprived had 15% more ghrelin than those who were well-rested. There is also some evidence that lack of sleep affects your levels of human growth hormone, because “pulses” of hGH are released at night.
• Sex steroids — Let’s not forget estrogen, progesterone, and testosterone. Adequate levels of estrogen seem to help in hunger regulation, simulating the soothing “full” effect of serotonin. An imbalance in the ratio between estrogen and progesterone triggers cravings, as anyone who is familiar with premenstrual binges can attest. Add the negative effects of stress hormones and you begin to understand why women accumulate abdominal fat during perimenopause. (For more on this, see our article on weight gain in perimenopause and menopause.) If a woman is testosterone deficient, which can occur with poor nutrition or during perimenopause, she lacks the ability to build muscle mass no matter how much she works out. Testosterone production relies on adequate levels of cholesterol, the building block of all sex hormones.
• Thyroid hormones may also be playing a lead role in your unique physiology. Women often ask me if a recent increase in weight is due to a thyroid imbalance. But very often, it is an imbalance between other hormones that is affecting the thyroid.
• Stress hormones — One hormone I haven’t yet mentioned: cortisol, a primary stress hormone produced by the adrenal glands. In my experience, adrenal imbalance and excess cortisol production are at the top of the list when it comes to unwanted weight related to hormonal imbalance. Sustained high cortisol levels can lead to intense cravings and binge eating. High cortisol production can throw off any or all of the other hormones in the body, major or minor, setting off a chain reaction that puts your body into crisis mode. The simple significance of this is that no diet will succeed if you are under tremendous stress — no matter what you do. A simple saliva test can reveal whether your daily cortisol levels are in line.

So, identifying any form of hormonal imbalance is a crucial part of understanding how you can lose weight and keep it off. And so is looking at your neurochemistry.

Neurotransmitters, the brain, and weight loss

The metabolism’s first priority is to feed the brain. The brain needs a steady stream of glucose to perform, and when that stream is disrupted the body responds with a multitude of coping mechanisms, like flooding the pathways with cortisol and adrenaline. Designed to cover the brain’s demands for energy during short periods of stress, these emergency measures were never intended to stay switched on. Unfortunately, that is exactly what’s happening in many women — leading to chronic depletion in certain areas, food addiction, depression, and unhealthy weight.

In my book, The Core Balance Diet, I explain in detail the importance of adequate serotonin, the “happy” neurotransmitter, in maintaining a healthy weight and calming food binges. (For a quick overview, see our page on neurotransmitter imbalance and your weight — a Core Balance approach. Overlooking the connection between serotonin, cortisol, and food “crashes” is one of the big mistakes made by conventional diets. Other neurotransmitters, specifically norepinephrine (noradrenaline) and epinephrine (adrenaline), are also very important when it comes to metabolism.

These brain chemicals are managed by the hypothalamus and directly affect appetite. They are released (along with cortisol) as part of the parasympathetic mechanism commonly called the “fight or flight response” — and they curb hunger. Most prescription and over-the-counter appetite suppressants, like phenylpropanolomine (the active ingredient in products like Dexatrim), work along this same pathway by stimulating the release of norepinephrine.

The basic idea connecting appetite and neurotransmitters is that if you are running away from a predator, you can’t stop to graze. Natural appetite suppressants, like nicotine or the caffeine in green tea, operate on the same principle, as do some diet drugs. But Nature never intended for us to be in a perpetual state of fight or flight! Of course there are going to be health ramifications — and the older you are the more complicated these may be.

Whatever goes up must eventually come down. And when it comes to neurotransmitters, this usually results in some pretty severe cravings and mood swings. Rebalancing your brain chemistry helps calm the rest of your system by sending out signals of well-being. And if your brain feels safe, it is more likely to switch your metabolism from calorie-saving mode (diverting energy to fat, not work) to calorie-losing mode.

Not just chemicals, but feelings too

But our brains aren’t just a collection of chemicals; emotions can also be powerful contributors to weight gain, because they all produce biochemical reactions in the physical world. Some women simply can’t begin to take the necessary measures to heal their physiology without first addressing their emotional attachment to food.

Everyone holds certain associations with food. In many cultures, being fed means being nurtured and loved. During times of high stress, many women look to food for comfort. One way you can keep track of your food associations is by keeping a daily food journal. Use pages from our Wellness Diary or create your own. Note any moods, certain times of day, or certain days of your menstrual cycle that inspire you to eat when you really aren’t hungry. You may notice a pattern.

Interestingly, emotional eating and food disorders may have physiological underpinnings. It may be that your neurotransmitter balance is off, creating a serotonin depletion that interferes with your ability to handle stress. Or it may be that the cross-talk between your hunger hormones has been disrupted due to chronic lack of sleep or sleep apnea. Corticotropin, a signaling factor involved in appetite, is orchestrated by the limbic system, the part of the brain that processes emotion. Fear, anxiety, and depression all work along this axis and as such can influence how hungry you are and when.

Recognizing a pattern of emotional eating will help you to get a handle on whether or not your caloric intake is related to your body’s physical signals, hormonal situation, or — as is so common with women — to a kind of emotional black box that no amount of food can fill.

This is particularly important if, like many of us, the foods that you connect with emotionally are high in sugars or other refined carbohydrates — sweets, pasta, breads, and similar “comfort foods.” A lot of these foods can throw off not only hormonal and neurotransmitter balance (by causing wild swings in insulin and serotonin), they can also promote inflammation and digestive imbalance, including yeast overgrowth. Let’s take a look at how these imbalances also affect your weight.

Inflammation, digestion, and obesity

One of the more overlooked signs of a taxed metabolism is inflammation, especially as it relates to fat cells. Proteins synthesized in adipose tissue, also called adipocytokines, are compounds that can have both proinflammatory and anti-inflammatory effects. Which effect gets the upper hand depends on the healthy balance of all the other elements we’ve discussed — and more. We still can’t say whether inflammation is a primarily the result or a cause of obesity, but we know the two go hand-in-hand.

A stressed digestive tract is also a major source of inflammation. Many enzymes and peptides are involved in triggering hunger signals and initiating nutrient breakdown and absorption. Good digestion improves the fat-to-energy conversion rate and supports the rest of your system. Allergies, food sensitivities, parasites, yeast overgrowth, and emotional stress can all inflame the GI system. One of the first signs accompanying inflammation is digestive upset.

What’s interesting is that a diet rich in essential fatty acids (EFA’s) and other healthy fats helps combat inflammation in fat cells and lowers irritating acids such as homocysteine in the blood. It also helps the liver synthesize the proteins that build muscle. On the other hand, we know that a diet high in sugar and unhealthy fats (the typical American diet) feeds inflammation like crazy. It also promotes the growth of free radicals and encourages the body to burn sugar and not fat for fuel. This has a direct effect on a woman’s ability to make muscle and lose weight.

Building muscle and losing fat

As a species, we are meant to be active. Our ancestors had to walk, run, dig and till for their food. Over and over again, the magic pill that everyone is looking for appears to be exercise. This doesn’t mean you have to become a fanatic, but you do have to incorporate physical activity into your daily routine. The right amount or style will, again, depend on your individual circumstances and metabolic profile.

The basic premise on exercise is this: your body stores energy in two ways, as fat and as glycogen. Glycogen is glucose stored for the short term in the liver, muscles, and other tissues. Muscles store about 12 hours’ worth of glycogen as a ready supply. Regular exercise, both aerobic and anaerobic, depletes these stores at a faster rate, forcing the body to dip into fat reserves. On a calorie-restricted diet, it is not unusual to drop 5–10 pounds right away, but it is primarily glycogen and water loss and not fat. Once you resume eating regularly, those pounds reappear as quickly as they went away.

A diet high in simple carbohydrates and sugar means that your body has a ready supply of glucose and rarely has to burn fat. A balanced diet that includes more protein, micronutrients, and fiber provides more long-term fuel and helps builds muscle.

The strength of your muscles depends on good bone health and nutrient absorption, as well as making regular and healthy demands on them for work. One nutrient that often gets overlooked in this calculus is oxygen, in the form of both air and water. Remember to keep yourself well-hydrated before, during, and after exercise to prevent dehydration and boost your endurance.

Hydration is also critical when it comes to the next layer of understanding — ridding your body of toxins.

Our need for detoxification

It is amazing to me that in this day and age, when our lives are fraught with so many dangerous toxins and stressors, more attention isn’t paid to cleaning out our systems. Nature has provided us with a remarkably efficient and versatile detoxification system, but allergens, heavy metals, unhealthy bacteria, pesticides, and the cumulative effects of toxic exposure over many years directly influence how well everything else in your body functions. It is the piece that ties everything together.

How well you are coping with your “toxic load” is highly individual, but gaining weight (or being unable to lose weight) is a telling sign that demands are outweighing support. The health of your liver and kidneys, your essential detox organs, should be addressed as part of any good weight loss plan.

If you read our article on detox, you’ll see that there are many levels of cleansing. Everyone can benefit from a gentle system detox, like the Fat Flush Plan or a week-long diet of organic fruits and vegetables a couple times a year. If you are struggling with more severe issues, you may want to discuss a deeper cleanse with your healthcare practitioner. (For our own approach, see our page on detoxification imbalance and your weight.)

I can’t overstate how important this is. You cannot achieve a healthy leanness if your body is choked with digestive, cellular, and emotional debris.

Putting it all together

So now you have a better sense of the many factors that can play into your weight-loss equation. The question then becomes what to do with it all. Over the years at my practice, I have developed a basic plan that builds a foundation of support for most women. The plan is successive. Follow the guidelines sketched out in the first stage and move through the stages progressively, even if you’re not losing weight — because problems at the next stage may be blocking your weight loss.

The goal of this plan is a firm, healthy body that is glowing with health and stability. We want your body to learn to defend a new, lower set point and to recognize a balanced biochemistry as its normal state. This means a different weight for every individual, but the right weight for you. Focus on getting healthy, feeling good, and building muscle — not on attaining some magazine’s idea of the perfect body.

A healthy weight loss is no more than two pounds per week — any more than that, and you are losing muscle, not fat.

Stage One

• Follow the Nutritional and Lifestyle Guidelines we use in our Personal Program or a similar protocol. Eat three well-balanced meals a day (containing protein, healthy fats, complex carbohydrates, and nonstarchy veggies), with two snacks that include some protein. Do your best to limit carbs to 16 grams per meal and 9 per snack, and to maintain a low glycemic load in your food sources overall.
• Take a medical-grade multivitamin–mineral complex rich in EFA’s, calcium and magnesium to fill in any nutritional gaps.
• Gentle endocrine support can help you maintain a healthy sex hormone balance, particularly during perimenopause and menopause.

Stage Two

• Continue previous measures.
• Start a food journal or investigate our Wellness Diary.
• Follow a hypoallergenic diet for one week. This means removing common allergens like eggs, dairy, gluten, peanuts, and soy, as well as any others you suspect from your diet — not necessarily forever, just long enough to see which (if any) of these might be a problem for you. Each of these can be eliminated for four to six days, then reintroduced over several days to see if there are any physical responses to the food. I also suggest that women start with the foods they crave the most, since cravings are often a signal that we’re sensitive to that food.
• Consider a gentle detox and colon cleanse, like the Fat Flush Plan. Or try Women to Women’s two-week Quick-Cleanse.
• Increase exercise sessions to 5 times per week, including 3 aerobic sessions with a target heart rate of 130–150 beats per minute for 45 minutes. Add 2 anaerobic sessions such as weight-training.
• If you have issues with emotional eating, get help from a professional. For referrals, check with your friends, religious organization, or healthcare provider.

Stage Three

• Continue to follow the above measures.
• Enlist the help of a clinical nutritionist and other healthcare practitioners to run a full diagnostic work-up. At Women to Women we look at fat mass, muscle mass, cell health, BMI and work output, food sensitivities, and adrenal, GI and liver function, then tailor a specific supplement, detox, and action plan to the individual.
• Take our Weight Loss Profile to identify any of the core metabolic imbalances we have discussed that may be impeding your success.

Moving toward a new vision of weight loss

I sincerely believe that if women understand how to support the unique needs of their bodies there should be no hindrance to maintaining a healthy, lean weight throughout their lives. This means before, during, and after menopause.

It’s my hope that through the knowledge you’ve learned here you will finally be able to get off the dieting merry-go-round that leads nowhere and enjoy a whole new life — one that blooms with vigor and beauty for all the seasons to come.

Our Personal Program for Core Balance is a great place to start

The Personal Program for Core Balance helps rebalance your body to promote natural and lasting weight loss. At the heart of our Program is The Core Balance Diet, an eating plan designed to provide the body with the foundation it needs to lose pounds along with the digestive and nutritional support needed to maintain a healthy weight.

• To learn more about the Program, go to How the Program works.
• To learn if the weight loss approach in the Personal Program for Core Balance will work for you, take our on-line Weight Loss Profile.
• To start taking control of your weight today, sign-up for a risk-free trial.
• If you have questions, don’t hesitate to call us toll-free at 1-800-798-7902. We’re here to listen and to help.

Related to this article:

References & further reading on natural weight loss

 

Original Publication Date: 11/15/2005
Last Modified: 08/17/2009
Principal Author: Marcelle Pick, OB/GYN NP