Note: this excerpt written by Robban Sica, MD is published in the book Fat and Furious by Loree Taylor Jordan, C.C.H., I.D.
What types of diets have you tried?
Most are based on calorie restriction, fat restriction, fasting, and restriction of foods to certain limited (not to mention boring!) food choices. You can maintain them, if highly motivated, for a period of time. Sooner or later, something will make you go off the diet: feeling deprived, celebrating a special occasion, etc. Then you are back on the weight roller-coaster, often gaining back whatever weight you’ve been successful in losing and usually a few pounds more.
Why do we believe that there is a “right diet” that everyone will lose weight with? Or that people only gain weight because they eat excessively?
Why diets don’t work:
· The wrong diet for a person’s unique type.
· Boredom, severe restrictions, regimentation, lack of variety.
· Calorie restriction actually causes the body to hold onto fat! When you consume an insufficient amount of calories, your body goes into “starvation mode”. In other words, your body thinks it is being starved so it tries to store whatever food it gets for future use. The body does this by converting calories into fat stores that can be broken down at a later time to produce energy.
· Dieting slows down the functioning of the thyroid gland. The thyroid gland controls the rate of metabolism and thus the rate at which calories are burned by the body. Severe dieting slows down your body’s metabolic rate, which slows down weight loss and predisposes you to gain weight more easily once you go off the “diet”.
· Most rapid weight loss achieved on calorie restrictive diets results from water loss and muscle wasting. This type of weight loss is not lasting. Losing muscle mass decreases your lean muscle mass to body fat ratio, which causes your metabolic rate to slow down even further. This means that this type of dieting predisposes you to gain weight more readily.
· Quick weight loss, through starvation, calorie restriction, laxative use, vomiting, and other diet methods, cause nutritional deficiencies and imbalances in the body which can lead to serious and long term health problems, especially cravings that lead to binging.
· Crash dieting is a stress on the body that can lead to the production of toxins and free radicals, which increases the rate of aging and degenerative diseases.
· Toxins are usually stored in fat tissue. When the body is overloaded by toxins, it increases fat stores in an effort to sequester these toxins and protect the rest of the tissues.
· Besides obesity, prolonged or cyclic (yo-yo) dieting predisposes to many chronic illnesses such as: Hypoglycemia, Fatigue, Insulin resistance, Diabetes, Thyroid disorders, Menstrual and hormonal disorders
What you really need instead is an “Eating Plan’ or “Dining Style” that you can maintain day in and day out for the rest of your life that maintains your optimal weight and health!
An effective diet has nothing to do with starvation or deprivation!
Each person – Body / Mind / Spirit – is unique. Their beliefs, goals, feelings, reasons for eating, physique, health status, biochemistry, metabolism, blood type, allergies, etc. are all individual. Every human is as unique biochemically as they are physically. Thus, biochemical and nutritional needs vary considerably among the population. Variability in nutritional requirements have been linked to genetic makeup, blood types, lifestyle factors, insulin response to carbohydrate intake, environmental pollution, food processing techniques, hormonal balance, and health conditions. These combined factors indicate that all people should not have the same diet. Therefore, their diet, exercise plan, and lifestyle choices must be unique too! One size truly does not fit all.
The most significant individual variables that affect weight issues and diet include:
· Carbohydrate sensitivity and insulin resistance
· Adequacy of trace minerals
· Optimal thyroid function which controls metabolic rate
· Hormone balance including estrogen and progesterone, cortisol and DHEA, growth hormone, testosterone
· Toxicity
· Food allergy
· Optimal digestion and absorption
· Metabolic Type
· Blood Type
· Body type
· Exercise tolerance and ability
· Age
· Emotional issues
· Belief systems about weight
· Lifestyle habits
· Stress levels
· Genetics
· Other Medical conditions
Biochemical Individuality
Each individual is as unique in their biochemistry as they are in physical appearance. Thus, biochemical and physiologic needs vary considerably among the population. Variability in nutritional requirements have been linked to genetic makeup, blood types, lifestyle factors, insulin response to carbohydrate intake, environmental pollution, food processing techniques, and health conditions. These combined factors indicate that all people should not have the same diet. While many best-selling books have touted the latest, supposedly best diet for everyone, they are destined to fail if they ignore the truth that: One diet does not fit all!
In helping a person to find the keys to their unique situation, I think of myself as a detective, seeking out the keys to unlock that individual’s particular needs. Over many years of practice, I have realized that honoring the uniqueness of each person is the way to guide them on the path to their optimal wellness. When these individual variables are addressed, we arrive at the answer: An integrated and truly individualized approach to weight loss.
Carbohydrate Sensitivity and Insulin Resistance
Warning: What you are about to read may totally contradict much of the advice given by doctors, dieticians, and diet authors. “Fat phobia” that has been generated in our society arises from a total misunderstanding of how food is handled physiologically in the body, along with the simplistic thinking that “fat makes you fat”. Contrary to the “low fat” advocates, fat (in and of itself) does NOT make you fat! Nor does it raise your cholesterol! The body is much more complex than that, as you will see.
I’ve found that the single most important factor in how you will fare on a given diet is your body’s reaction to carbohydrate. Virtually any carbohydrate intake causes the body to produce increased levels of insulin, in order to metabolize these sugars that ALL carbohydrates break down to eventually. Every dieter knows that some carbohydrates are better than others. However, for some, understanding the reason why often unlocks the mystery of dieting. Among other benefits, some fruits and veggies have a lower glycemic index vs. high glycemic carbohydrates such as sugars, grains, and flour based products. The higher the glycemic response, the more insulin has to be produced to handle the sugars. Insulin is a storage hormone: It tells your body to take everything you have just eaten and store it basically as fat. You simply cannot lose weight with that higher insulin level telling your body to go into storage mode!
This applies to everyone: Higher insulin levels take their toll many ways: weight gain, poor concentration, fatigue, impaired performance, generalized inflammation, hypertension, elevated cholesterol and triglycerides, decreased HDL, insulin resistance, adult onset diabetes, and cardiovascular disease. FOOD ACTS AS A DRUG. What we eat is profoundly affects insulin production. Insulin is the most powerful mediator of the short term chemical messengers called eicosanoids or prostaglandins, which mediate inflammation in the body (for example, arthritis), and affects serum lipids, and blood pressure. High insulin decreases the sensitivity of hormone receptor sites, causing hormonal imbalances and aging.
So What’s Wrong with the Food Pyramid?
- According to the food guide pyramid that we all had to learn in school, you need to consume 20-30% of your calories as fat, 15-20% protein and 50-65% as carbohydrates. Unfortunately, this emphasizes large amounts of carbohydrates, which is inappropriate for many and worsens weight problems. Also, the food pyramid makes little distinction in food quality. It tells you to minimize the intake of fats without discriminating between necessary fats and harmful ones.
- Many Americans do not eat a balanced diet, even those who feel they eat well. Almost 40% of the calories in the average American diets come from highly processed convenience and snack foods that are high in unhealthy fats and refined sugar, and depleted of valuable vitamins, minerals and essential fatty acids needed for health. If you are eating processed “low-fat” and “no-fat foods”, you’re still not helping yourself. These foods are extremely high in sugar (they have to get them to taste good somehow!). Sugar, which comes in many different varieties, has the strongest effect on the release of insulin. The higher the amount of circulating insulin in our blood, the more likely we are to store our calories as fat.
How much insulin is produced depends on the type of carbohydrate but also on the carbohydrate tolerance of the person who ate them! Some people produce increased amount of insulin in response to carbohydrates. This hyper-insulinemic state is also called Syndrome X, insulin resistance, and, eventually, carbohydrate intolerance, also known as adult-onset diabetes. People with this tendency are much more prone to health problems induced by insulin.
Not uncommonly, I see patients like Adam, who, at 48, had already had bypass surgery several years before and was having chest pain again. His cardiologists were recommending a second surgery. His cholesterol was 281 with a low HDL (good cholesterol) of 18, and triglycerides of over 800! And his weight and blood pressure were climbing. His conventional doctors wanted him on a very low fat diet and statin drugs immediately but he didn’t want the side effects. Since this lipid pattern is classic for hyperinsulinemia, I immediately explained to him why he needed to lower his carbohydrate intake. After only 10 days on a very low carbohydrate, moderate fat and protein diet, Adam lost 10 pounds and lowered his blood pressure significantly. His cholesterol fell to 230, HDL went up to 31, and triglycerides fell to 90! All without cholesterol lowering medications. Best of all, his energy level went up dramatically and his chest pain stopped, probably because high triglycerides make the blood thick and harder for the heart to pump among the other factors. The standard low-fat recommendations were literally killing him!
When someone tries to follow a low fat diet, they generally replace protein and fat with carbohydrates, causing them to overeat carbohydrates. Low fat diets cause another problem: Since they are less calorie dense, people will generally lose weight initially due to the calorie restriction. As the effects of the elevated insulin levels and the resultant insulin resistance takes its toll, gradual steady weight gain occurs and often exceeds the amount lost. Blood pressure, lipids, and blood sugar often rise as well. The resulting frustration is considerable!
This illustrates another misperception about diet: that all fat is bad! There are many benefits of fat in the diet, including slowing down metabolism of carbohydrate, lowering the glycemic index, which in turn slows down production of insulin. Fat signals the satiety center in the brain, telling you that you’ve had enough to eat. This satiety center is only stimulated by cholecystokinin, which is produced in response to FAT in the diet. Unfortunately, carbohydrate does not trigger the satiety mechanism that tells us to stop eating! Low fat diets, therefore, actually CAUSE overeating because of the absence of this signal. Only adequate fat content will produce a satiety response.
Think about the portion sizes at typical Italian restaurants. Often, pasta is served in an enormous bowl. This gives the impression of generous portion size but actually pasta is relatively inexpensive, as is bread. In addition, large portions have affected what people view as a normal portion size. Now think about someone trying to eat a large serving of prime rib. Halfway through, they will usually push the plate away, exclaiming that they can’t eat another bite! This is due to the higher fat content. Not so with the person who ordered the pasta dish. Most likely, they will continue nibbling until they’ve finished most of it.
Another example is the difference in fat content in types of ice cream and frozen yogurt. The expensive, gourmet ice creams have higher fat content but notice the package size is usually smaller than the low fat frozen yogurt. Most people will consume a small serving of the gourmet ice cream and savor it but will overeat on the low-fat varieties, trying to gain the same level of satisfaction. (I often tell my patients that, if they are going to “cheat”, at least get the good stuff and enjoy it!)
All fats, however, are NOT created equal! Essential fats such as Omega 3 Fatty Acids, found in fatty fish such as salmon, mackerel, cod liver oil, and flax seed oil, decrease appetite, lower inflammation by building of good eicosanoids, and many other health benefits. Unfortunately, eating too much large fish (like tuna or swordfish) can expose you to high levels of mercury, pesticides, PCB’s and other fat soluble poisons. So I recommend taking supplements of flax seed oil or Omega 3 fish oils, purified to remove these toxins, to aid in weight loss. Arachidonic Acid, found in fatty red meats, egg yolks, dairy, and organ meats, increases inflammation in the body so those on higher protein diets need to choose from a variety of protein sources. Also, excessive amounts of omega 6 fatty acids found in sunflower oil, safflower oil, and soybean oil as these can increase arachidonic acid. Monounsaturated fats are hormonally neutral, so foods such as olives, olive oil, avocado, and nuts are good for snacking as they are satisfying with minimal affect on insulin.
The good news: A diet composed of the proper balance of protein, fat and carbohydrate reduces insulin levels and results in normalization of blood sugar, blood pressure, cholesterol, triglycerides, HDL, and LDL, and energy levels. In my opinion, anyone’s diet should contain no more than 40% carbohydrates, (preferably fruits and vegetables) and approximately 30% each of protein and fat. However, the optimal balance of macronutrients is VERY individual, according to the person’s tolerance for carbohydrates. Anyone with diabetics, hypoglycemia, extremely high triglyceride levels, polycystic ovarian syndrome, or fatigue after eating carbs are very carbohydrate intolerant and need to reduce the percentage of carbohydrates in their diet accordingly. From what I’ve observed in my patients, this explains the mystery of why some people do fine on the food pyramid diet while others only lose weight on an extremely low carbohydrate diet and still others need something in between. Balancing these macronutrients and moderation of portion size to maintain this balance are the keys to losing weight and feeling great consistently.
Far too often, I am frustrated and angered when I hear from a new patient their horror story of going to doctor after doctor, seeking out nutritionists and personal trainers and diet programs, carefully following all the recommendations and not losing weight. To add insult to injury, these unfortunate people are told that they must not be following the diet, that it is somehow their fault! I hope that you have never had that experience, but I know that too many people have!
Fortunately, certain blood tests can allow your doctor to monitor your progress and determine how strict you need to be with carbohydrates. These tests include lipid profile, glucose, hemoglobin A1C, fructosamine, and fasting insulin levels. With these tools, you have the power to individualize your carb intake to insure you are successful with your weight goals.
Thyroid Function and Metabolic Rate
Ever wonder why some people have “slow metabolism”? Thyroid hormones control metabolic rate, which of course affects ability to lose weight. The Metabolic Rate, which is the rate at which your body turns food into energy, affects the health of every cell in the body; so many health problems have their roots in hypothyroidism, or low thyroid function. I could easily write a whole book on this subject but the most frustrating effects of a sluggish thyroid are fatigue and weight gain. Many overweight people suspect that their metabolism is not what it should be, yet find little help and support in solving this mystery. Often they are blamed for their inability to lose weight, yet I often see patients who are eating 1000 calories or less per day and still not losing weight! Sometimes they exercise 2 to 3 hours a day and still can’t lose.
I recently saw a 23 year old girl who gained a large amount of weight during puberty and at 15 became anorexic in her frustration to be thin. She did lose the weight but at a tremendous price. At our first meeting, Maryann was pale with puffy dark circles under her eyes. She suffered from dry skin, severe constipation, depression, and fatigue that only improve when she exercises to extremes, all signs of hypothyroidism. Her temperature was very low and she frequently felt cold, which is an indicator of metabolic rate. While she was very wary of any dietary intervention and fearful of eating more than 800 calories, as we cautiously corrected her underlying thyroid problem with natural thyroid replacement, she became free of the torture it took to maintain her weight. Her skin improved and the sallow color disappeared. Maryann now has plenty of energy and is no longer depressed. Best of all, she was able to eat more normally, although she did maintain a lower carbohydrate intake. (Most hypothyroid patients have a hyperinsulinemic tendency.)
Unfortunately, her conventional endocrinologist did not recognize or treat her thyroid problem because her blood tests for thyroid function were within the laboratory’s reference ranges, although on the lower side. These ranges are usually misconstrued to mean “normal” range but really only represent a statistical average of the last 800 tests run by that particular lab! In no way do they represent optimal function for a given individual. There are at least a dozen reasons that I know of why thyroid blood tests can miss the diagnosis of hypothyroidism. Various authors have estimated the percentage of low thyroid people in the population from 30 to a whopping 80% (Could this account, in part, for the epidemic of obesity?) and the percent of those missed by blood test from 30 to 50%! That is why I prefer to use a clinical method of diagnosing and treating hypothyroidism: looking for clinical symptoms and signs such as Maryann was suffering from. While thyroid hormone is NOT a magic weight loss pill and other factors still must be addressed, many of my patients have benefited from this approach and are living happier, healthier lives as a result.
The Delicate Hormone Balance
Besides thyroid, the balance of other hormones such as cortisol and DHEA, estrogen and progesterone, growth hormone, testosterone affect weight gain as well as percent body fat and distribution of fat. As we age, many of our hormone levels decline, causing imbalances and deficiencies. This affects our overall wellbeing and many aspects of our health, not the least of which is the tendency to gain fat and lose muscle mass. It is essential to identify individual imbalances and correct them.
Balancing Adrenal Function
Our adrenal glands help in several ways to maintain normal function under a variety of stressors. Cortisol is an adrenal hormone that stabilizes blood sugar. A low cortisol level can result in low blood sugar and the need to eat frequently. This type of adrenal deficiency can lead to fatigue after exercise tolerance, a real obstacle to losing weight and getting in shape. Cortisol is also essential for utilization of thyroid hormone, leading to the problems associated with low thyroid. Small, physiologic doses of cortisol can be helpful and actually improve thyroid function and weight loss.
High cortisol levels, a common side effect of too much stress, can also be problematic. Cortisol is catabolic, meaning it breaks down tissue. This can cause loss of muscle mass and excessive fat gain, especially around the middle! Worse yet, high cortisol suppresses the production of DHEA, an adrenal hormone that is anabolic, meaning it builds and repairs muscle and other tissues. Stress management and DHEA is the key to reversing this imbalance.
What about Female Hormones?
Estrogen and progesterone balance each other in a delicate dance. When a woman has too much estrogen relative to progesterone, she tends to gain weight, have fluid retention, and other premenstrual symptoms, including chocolate or sweet cravings. Improving this balance with magnesium, vitamin B6, the herb Vitex, or natural progesterone restores the natural balance and helps to smooth out the month.
After menopause, women who take Hormone Replacement Therapy (HRT) notoriously gain weight. But do naturally occurring hormones cause weight gain? Or is something else going on? The most commonly prescribed HRT is made from horse urine. These conjugated waste estrogens are strong enough for a thousand pound animal! Hence, they lead to estrogen dominance including increased risks of weight gain, blood clots, and breast cancer. These problems and compounded when it is combined with the synthetic progesterone derivative, which has side effects of severe water retention, bloating, and breast tenderness. No wonder so many women resist the idea of HRT. Fortunately, when natural hormones that are bio-identical with human hormones are used in a balanced fashion, a woman can realize the benefits of HRT including prevention of osteoporosis, diabetes, and cardiovascular diseases without the risks and the weight gain. I use Estriol predominately, the estrogen highest during pregnancy. This hormone actually seems to confer some protection from breast cancer and, since it is far weaker than Estradiol, has far less tendency to cause weight gain, etc. Estrogen dominance can be prevented by pairing estriol with bio-identical progesterone. Natural progesterone actually opposes the negative effects of estrogen and has some positive anabolic effect.
Sarah came to my office at age 55, on Prempro that her gynecologist had prescribed to treat her severe hot flashes. She got rid of the flashes only to suffer significant fluid retention and weight gain of 18 lbs. The resultant mood swings caused food cravings and binge eating, compounding the problem. She felt stressed and out of control, afraid of stopping HRT and having the hot flashes return but equally afraid of continued weight gain. I helped her get out of this vicious cycle by switching her HRT to an estriol and progesterone combination and adding DHEA (in the 7 keto form to prevent conversion to estrogen) to balance the stress-induced cortisol. First she noticed feeling calmer and sleeping better. As she gained control of the stress, she was able to make the necessary adjustments to her eating habits and begin exercising regularly. Her weight loss was gradual but steady, until she returned to her original weight 6 months later.
What about ‘Male’ Hormones?
Testosterone and DHEA are androgens, or anabolic steroid hormones, that start to decline sometime after the age of 45. We don’t talk much about male ‘andropause’ but it happens all the same. Although attention is often focused on diminishing sexual prowess and libido, low testosterone levels can affect cardiovascular health, carbohydrate metabolism, memory, cognitive function, bone density, and sense of wellbeing. As these androgens decrease, muscle mass starts to turn to flab and its harder to build muscle from those endless workouts! Weight gain around the waist line increases conversion of testosterone to estrogen by up-regulating the aromatase enzyme, causing increasing weight gain and gynecomastia (enlarged breasts).
Steve, at 50, was already feeling the effects of a falling testosterone level, with weight gain, diminishing muscle mass, decreased libido. He felt like something was missing in life, like “not himself”. His testosterone levels were in the low normal range, not unusual as the laboratory reference ranges are broad, encompassing the range for 20 to 80 year old men. After starting natural testosterone replacement therapy, he initially felt some increase in fluid retention with chest and abdominal swelling. Upon checking an estrogen level, we realized he was converting all his testosterone to estrogen. By using aromatase blockers, we were able to prevent this. His testosterone levels came up to normal, along with the disappearance of his symptoms. He felt like himself again! He was able to return to his individualized diet and exercise program with vigor and, in time, his physique returned as well.
The metabolites of testosterone are as important as the hormone itself in terms of libido, arousal, and optimal sexual function. Not just for men, women need testosterone too: especially menopausal women and those whose high cortisol/stress levels are suppressing testosterone. Improved libido helps with weight loss. Feeling sexy helps self esteem and sex itself is a much better stress reducer than maladaptive eating. And sex burns calories instead of adding them. Testosterone builds exercise tolerance and ability, aiding weight loss and fitness efforts.
Steroid hormones have gotten a bad rap and none worse than testosterone. A steroid hormone is, by definition, a hormone built on a cholesterol frame. Steroid hormones include testosterone, DHEA, cortisol, estrogen and progesterone. All affect every cell in your body and are absolutely essential to feel great, look great, and to prevent disease and the effects of aging. Testosterone, particularly in synthetic form, has been abused by athletes, causing excess levels and a variety of horrific side effects. However, when testosterone is properly supplemented with bio-identical hormones, the benefits can be wonderful!
Adequacy of trace minerals
Too often, cyclical starvation diets are devoid of nutrients, leaving the dieter in a nutrient depleted state. To complicate matters, the myth that multivitamins cause weight gain continues to raise its ugly head. Deficiencies of vitamins and minerals cause craving and binging on certain foods. For instance, chocolate is rich in magnesium (among other things) so when you’re deficient, your body craves chocolate. Premenstrually, the demand for magnesium and vitamin B6 sharply increases, as does chocolate cravings and weight gain. Chromium and vanadium are trace minerals, often ignored, that are necessary for normal carbohydrate and insulin metabolism. Deficiencies create cravings for sweets and carbohydrates as well as blood sugar swings, high insulin, and hypoglycemia. It a vicious cycle, that is so easily prevented. Since over 60% of the population is deficient in one or more nutrients, I believe that our food supply is significantly depleted in essential nutrients, made far worse by restrictive low calorie weight loss diets. I recommend a good quality, balanced multivitamin to all my patients, especially those interested in losing weight. And I often look for nutrient deficiencies with specific testing, allowing me to correct imbalances unique to a given person.
Digestion and absorption
Food cravings and overeating may also result from inability to digest and absorb nutrients. Malabsorption leads to subsequent deficiency of essential nutrients. Sandra was a typical patient who complained of indigestion and fullness after eating, but overate because she always felt hungry. Comprehensive digestive testing revealed that she did not produce the enzymes to break down proteins. Starved for amino acids, she overate to get the protein she craved. Once we corrected her digestive enzyme deficiency, the bloating ceased and she felt satisfied with a reasonable portion size. Unable to lose weight before without “starving”, she found she could easily follow a diet individualized for her and start to achieve her long sought after “ideal weight”.
Toxicity
One of the overlooked issues of weight loss is that fat is often a protective mechanism. Toxins are sequestered in fatty tissues to protect the other tissues from damage. The body then holds on to the fat stores to prevent release of these substances, including pesticide residues, heavy metals (mercury, lead, etc.), and other fat soluble toxins. Detoxification is essential to allow the release of this excess weight.
An example of what can go wrong when you don’t listen to the body’s wisdom is Jason, the body builder. While in the Navy, Jason’s job was to sandblast old paint from the inside of his ship’s metal hull. Since he didn’t wear adequate protection, residues of lead, cadmium, and mercury seeped into his system through his skin, lungs, and gastrointestinal tract. Being a young and other wise healthy young man, he ignored this exposure. That is until he couldn’t. Jason decided to sign up for a body building competition that meant he had to drastically reduce his percent body fat to be competitive. He put in hours at the gym and did whatever it took to get to 10 % or less body fat. He looked fantastic but didn’t feel that way. In fact, he received a medical discharge from the Navy. I met Jason four years later, completely disabled with chronic fatigue syndrome. He still looked the picture of health, so doctors ignored his complaints and told him it was in his head. They thought he was malingering. After hearing his story, I checked and found astronomical levels of the heavy metals he was exposed to back on the ship. As he lost the protective fat, the heavy metals flooded his system, poisoning his cells. Using chelation therapy, we were able to remove those toxic metals and restore Jason to health. I shudder to think what his life would have been like; if we had not found out he was toxic. Most people don’t drive to win a competition like that so, fortunately, they don’t go through the agony Jason did. But many feel the anguish of pushing against an unseen barrier to weight loss that is caused by the resistance of losing that protective fat.
Food Allergy
Food allergies are often overlooked because they don’t cause classic allergy symptoms: stuffy nose and itchy eyes. In fact, allergies to foods are most often delayed, IgG reactions that can manifest in a variety of symptoms. Sometimes, the only symptom is difficulty losing weight. You see, there is an allergy-addiction cycle with foods that we’re allergic to. The more allergic, the more we crave them because we get some relief, like a high, when we eat them. You can be allergic to almost any food, even “healthy” foods. Studies have demonstrated the food allergy-weight gain phenomenon. If your weight loss is stuck on a plateau, think of food allergy testing.
Linda had actually been a patient of mine over 10 years ago but had long since forgotten my recommendations because she was “feeling well”. Gradually over time, lack of attention to her health caught up with her. She gained over 100 lbs. and felt terrible. She was exhausted, depressed, and her allergies were getting worse. She had a sinus infection at least once a month and was taking antibiotics almost continuously. Her cholesterol and triglycerides were edging skywards and her primary care physician was harping on her to lose weight. But he couldn’t give any effective advice and she was at wits end. Then she remembered that she had seen me years before and things seemed better then. When she returned to my office, I barely recognized the young girl I knew before. After hearing her story, I started her back on thyroid medication that she had taken previously and her immune system improved significantly. But her allergy symptoms were still severe. Using antifungal medication and probiotics, we were able to stop the yeast overgrowth that was causing a great deal of discomfort and fluid retention. But she still didn’t feel well and her weight was sticking with her. Since antibiotic-induced yeast infections often cause yeast infection and damage in the gut, I suggested we test for food allergies that result in these situations. Sure enough, she had many significant allergies, including corn, dairy, tomatoes, wheat, and yeast, among others. While it was difficult for her to cut out all of them, she knew she needed to. Her determination paid off immediately: her allergy symptoms diminished and she dropped 10 lbs. in 2 weeks. We supported her immune system with allergy desensitization drops and she rapidly improved with this combined approach. She lost an additional 25 lbs. in the next two months and felt so much energy returning that she started a rigorous walking program 5 days a week. When she came back a month later, I barely recognized her in a new dress she had bought. All the puffiness was gone from her face. But she was very upset. She had been to see her primary care physician, who had insisted she lose weight when she was at 240 lbs., only to be told that she was anorexic and she should stop what she was doing! Since she felt fantastic, she decided to ignore that advice and continue to follow the allergy elimination diet (which, by the way, did NOT restrict calories!). She has gradually continued returning to her optimal weight. A year later, she has lost over 100 lbs. but more importantly, Linda has regained her self esteem and her health.
Metabolic Type and Blood Type
Dr. William Kelly and his best known protégé, Nicholas Gonzalez, MD, have long studied human variability in metabolic type. Individual differences of the autonomic nervous system (ANS) and digestive integrity affect which diet a person will thrive on and what diet will contribute to disease, particularly specific cancer types related to the metabolic type. While Kelly’s original system included over 12 types, the most common are sympathetic-dominant and parasympathetic-dominant, depending on which half of the ANS is strongest. Sympathetic-dominants have weaker digestion, and tend to be healthier on a lower animal protein diet, higher in grains and vegetables. Parasympathetics, with stronger digestion, need to eat more protein and avoid excessive grains. While metabolic type has been studied mostly in reference to cancer, not weight loss, it is a good illustration of how many factors contribute to individualization of your diet.
Probably the clearest evidence that individual genetic variation affects what foods we should eat to lose weight and be healthy comes from blood type. This work was pioneered by two naturopathic doctors, Drs. James and Peter D’Adamo. Years of observation and study of any reference in the literature to blood type, led Drs. D’Adamo to the conclusion that the lectins (sticky cell membrane proteins that differentiate the four blood types) interact differently with foods. These lectins occur not just on blood cells but on many cells in the body. I tend to de-emphasize blood type because I’ve seen patients get so fixated on the concept and, while D’Adamo’s theories are far from conclusive fact and much research still needs to be done, I have also observed dramatic differences when blood type is taken into account.
I’ll make some fairly sweeping generalizations to make a complex subject simpler. Blood type O, the most common type, stems from humanity’s ‘hunter-gatherer’ phase so the best diet is a higher protein (from hunting and fishing) with vegetables, nuts, and fruits (from gathering). The O type tends to have stronger digestion, resulting in more stomach acid problems and intestinal reactions when eating the wrong foods. Grains, the product of farming, weren’t available in the hunter-gatherer days and the O is poorly adapted to these foods. Often, an O individual complains of indigestion after eating even the smallest amount of wheat. O type does much better avoiding grains and many digestive problems disappear. They also produce more insulin to store nutrients to get them through long periods when food wasn’t available, causing increased risk of hyperinsulinemia and diabetes. Wheat and corn, in particular, contain lectins that block insulin receptors on the O type cells, worsening insulin resistance. This can prevent the O type from losing weight and getting blood sugar under control. It may take up to 6 months avoiding these foods for the insulin problems to resolve and weight loss to accelerate.
A person with A blood type, on the other hand, is much more adapted to a grain based diet, later in evolutionary development. Weaker in digestion, animal proteins are harder to digest and cause lectin interactions. A type often feels better eating more vegetarian diets and do poorly with excessive dairy and animal products. Nevertheless, some A types are still insulin resistance and need to limit dense carbohydrates. The other two types, B and AB, are the rarer types with their own unique dietary needs. I won’t go into details but I think you get the point.
Kim, in her mid 50’s, had been slowly gaining a pound or two per year over the last 10 years. She was also beginning to experience some nagging health problems, worsening allergies, skin problems, and arthritis. She stuck rigidly to an extremely low carbohydrate diet, the only way she could lose any weight at all. If she even ate 1 slice of bread or a dessert, the scale would jump up 5 lbs. or more but it would take 2 weeks for her to lose it again. Frustrated by weight gain, she traveled from Florida to Connecticut to my office. We assessed and treated her hypothyroid condition, put her on natural hormones, and tested for food allergies. Weight loss was easier but the extreme carbohydrate intolerance remained. I suggested we check blood type and was shocked to find that she was an A type. With trepidation, I sent her the diet recommendations, largely carbohydrates. Two months later, I received a distressed call that she had gained over 20 lbs. She had been so relieved that she had really enjoyed herself, but it took its toll. We explored her food choices and decided to try a lower carbohydrate diet but using A type food choices with more vegetarian protein choices, such as soy products, eggs, protein powder, beans but she continued to eat poultry and fish. Another three months went by. Kim called me, ecstatic. Not only had she achieved her pre-menopause weight, her arthritis, allergies, and skin condition virtually disappeared! Interestingly, after all those years of struggling with dieting, Kim told me that this diet was effortless for her and she was enjoying eating for the first time in years!
I experienced the relevance of individual metabolic and blood types in a very personal manner. Over 15 years ago, I was vegetarian, having been convinced that this was the healthiest way for everyone to eat. Only I felt less and less well. My cholesterol level dropped too low and affected steroid metabolism and all my hormone levels were scrambled. I felt hypoglycemic most of the time and often felt shaking chills, almost feverish. I had no idea what was wrong until a nutritionist friend of mine who had studied with Dr. Kelly suggested that my metabolic type was parasympathetic dominant and I should be eating meat. That day I went out and had a steak and immediately started improving. Several years later I met Dr. D’Adamo and realized that, as an O blood type, I was much better suited to a lower carbohydrate, higher protein diet. And I can feel the difference immediately!
The Body-Mind Connection
While I’ve left this to last, the profound connection between our mind and what happens in our bodies is critical to achieving our weight and health goals. Our individuality is most evident in the how we think and feel and what choices we make to create our unique lives.
Many emotional issues affect our ability to stick to a diet. Feeling nervous, bored, frustrated, depressed can lead to binge eating as a reward. Individual lifestyle issues like ingrained eating habits, dining out often, eating alone, eating in fast food restaurants to save time, traveling on business, high stress levels from work or family obligations, feeding children, or hating to cook also create the need for unique solutions to these diet problems. We can’t just expect that everyone can follow through with diet recommendations. By identifying which situations are most difficult for you, we can discover creative ways of adapting the diet to your lifestyle, not forcing you to adapt your life to a diet!
Most powerfully, entrenched belief systems affect every aspect of our lives and often limit our possibilities. What we’ve heard and learned in the past causes us to make assumptions that allow for only that possibility. “I’ll always be fat.” “Losing weight is hard.” “I hate dieting.” “I love desserts.” “I’m a chocolate addict.” Our bodies hear those beliefs and our subconscious mind sets out to make sure they happen. The resulting internal conflict produces increased stress, low self esteem, and self sabotaging behavior. Our beliefs determine what we allow or don’t allow in our lives. We cannot change our experience without first changing our beliefs. The difficulty often arises from the fact that many of our beliefs are unconscious. We may have picked them up as children or in response to some negative event that happened to us. It may have made us decide, “Not me, I never can have what I want.” If you’ve tried to lose weight several times before and were unsuccessful or regained the weight, you probably have some strong beliefs that losing weight is difficult, hard work, or even impossible for you. These beliefs must be released in order to make room for new beliefs that allow you to create what you want.
Rosalyn, a 35 year old woman who was divorced and had 2 children, had been overweight to varying degrees most of her life. She knew and had tried all the diets successfully but always gained back the weight. She was referred to me for thyroid evaluation but even correcting her sluggish metabolism didn’t do the trick for long. It became evident to me that she had some pretty strong beliefs about weight, so powerful that no amount of dieting could overcome them. Her belief that she’d always be fat clashed with her belief that, unless she was thin, she would not be sexy and no one would ever love her. This profound conflict led to depression and self-sabotaging behaviors like binging on cookies at night, self-fulfilling her prophecy. I convinced her to forget the diet for awhile and concentration on finding some new thoughts about herself. As she worked just accepting herself, she started to feel happier than she had in years. Then she met a new boyfriend whom she thoroughly loved and enjoyed. That convinced her that the second belief was false and opened the door for her to change many other limiting beliefs. Now she is free to diet or not, can lose weight when she chooses to, and is making different choices. No longer obsessed with her weight and diet at every moment, Rosalyn is now living to enjoy her life.
Your body is unique. No one is just like you. Your body also has the innate wisdom to know what is right for you, what is consistent with your health and happiness and what is not. You have a flawless inner guidance system. Most people have been taught by society to suppress their intuition, their feelings, and most signals from their body. You can learn to access and listen to the body’s wisdom. The body can only communicate through feelings and sensations, which often are ignored. These are often far more subtle and quieter than the negative beliefs we have picked up from others or from society. You just need to “tune-in” to this extremely useful inner wisdom.
There are only two steps to creating a new reality about weight, health, or virtually anything, in your life.
· First, intend it.
· Second, allow it.
Intending means creating in your thoughts the outcome that you desire. This sets the creation into motion. The stronger your positive feelings, the more you enjoy your visualization, the faster and more completely your goal will manifest in your life. Allowing means expecting you will receive what you want and believing that you can and will have what you desire. It is just a matter of time. Shift your picture of yourself in your mind from that of an overweight person, to that of a fit and healthy person who just happens to temporarily be in a costume, acting the part of an overweight person. All that you are and want to be is already there, just temporarily hidden underneath.
Once you’ve pictured your result, don’t allow negative thoughts, like “that can’t happen, I’m still fat”, undo your creation. Intend to feel joy in each moment and you’ll connect with that allowing state. Then, you’ll find the right keys to unlock the secrets of achieving your dreams.