Weight Loss ResistanceRomilly Hodges, MS CNS CN

Nutritionist

Disclaimer

The material presented here is for educational purposes only. It is not intended to diagnose or treat any condition. You should consult with your physician before implementing any of this information.

It is harder to lose weight today than it was 30 years ago

Brown et al. 2016. Obes Res Clin Pract.

Image: Mayo Foundation for Medical Education

Location of Weight Retention Provides Clues

Excess abdominal weight:

Waist circumference>94 cm male>80 cm female

Waist-hip ratio>0.9 males>0.85 females

Associates with elevated:

INSULIN (blood sugar imbalances)

CORTISOL (chronic stress)

Associates with elevated:

INSULIN (blood sugar imbalances)

CORTISOL (chronic stress)

How Sugar and Carbohydrates Connect to Weight Gain

Excess carbohydrate, signaled by insulin, drives fat synthesis and

storage

The Carb Continuum

Low Carb High Carb

Ketogenic Diet Paleolithic Diet Standard American Diet

Weight gainWeight loss

PROTEIN FATS CARBOHYDRATE

“CLEAN” WESTERN

PALEO

KETOGENIC

PROTEIN FATS CARBOHYDRATE

“CLEAN” WESTERN

PALEO

KETOGENIC

PROTEIN FATS CARBOHYDRATE

“CLEAN” WESTERN

PALEO

KETOGENIC

PROTEIN FATS CARBOHYDRATE

“CLEAN” WESTERN

PALEO

KETOGENIC

PROTEIN FATS CARBOHYDRATE

“CLEAN” WESTERN

PALEO

KETOGENIC

PROTEIN FATS CARBOHYDRATE

“CLEAN” WESTERN

PALEO

KETOGENIC

Still drives insulin signaling

Image: Huffington Post

Even natural non-caloric sweeteners aren’t likely to help with weight loss if you rely on them too much.

Quiz: Insulin ImbalanceDo you have one or more of the following?

Waist circumference >94 cm males, >80 cm females

Elevated waist/hip ratio >0.9 for males, >0.85 for females

Darkening at the back of the neck (acanthosis nigracans)

Skin tags

Acne or large pores on face

Cravings for sugar and other carbohydrates

Hypoglycemic episodes (need to eat now!)

High energy after eating followed by fatigue

Polycystic ovarian syndrome (PCOS)

Laboratory values

• Fasting blood glucose >90 mg/dL

• Fasting insulin >5 units/mL

• Hemoglobin A1C >5.6

• Triglycerides above 100 mg/dL

Consider purchasing a glucometer and measuring fasting blood sugar at home

Associates with elevated:

INSULIN (blood sugar imbalances)

CORTISOL (chronic stress)

Stress

Roberts et al., 2014 Eur Eat Disord Rev.Macedo & Diez-Garcia, 2014. Appetite

How Stress Contributes to Weight Gain

• Increased cortisol secretion increased blood glucose increased insulin fat synthesis and storage

• Stress also makes it very hard to make wise food choices…

https://hysterectomy4dysmenorrhea.wordpress.com/tag/health/

“Chronic stress, especially when people live in a palatable food environment, induces HPA stimulation, excess glucocorticoids, insulin resistance, which lead to inhibition of lipid mobilization, accumulation of triglycerides and retention of abdominal fat.”

Sleep Deprivation Increases the Stress Response

Sleep and Weight Gain

And worse food choices

Quiz: Stress ImbalanceDo any of these describe you?

In the past two years, any major changes to:Social activities, sleeping habits, residence, work hours, tension at work, small children in the home, living conditions, personal achievement, financial situation, difficult family or friend relationships, loss of family or friend, divorce, retirement.

Easily upset, over-reacting

Breathing difficulty, feeling of faintness

Anxiety, fear

Excessive perspiration without high temperatures or physical activity

Sadness, depression

Fatigue, low energy

Poor memory

https://tomallenagent.wordpress.com/insurance-humor/

Image: Mayo Foundation for Medical Education

Associates with

ESTROGEN excess

DETOX impairment

DYSBIOSIS

Image: Mayo Foundation for Medical Education

Associates with

ESTROGEN excess

DETOX impairment

DYSBIOSIS

Estrogen Dominance

Progesterone Estrogen

Quiz: Estrogen Imbalance Do any of these describe you?

Breast swelling, tenderness

Pre-menstrual syndrome

Irregular or missed periods

Mood swings

Thyroid dysfunction

Hair loss

Poor sleep

Decreased libido

Bloating, water retention

Headaches

Fatigue

Uterine fibroids or breast cysts

Endometriosis

Polycystic ovarian syndrome

Image: Mayo Foundation for Medical Education

Associates with

ESTROGEN excess

DETOX impairment

DYSBIOSIS

Detox Systems Can Get Overwhelmed

Tolerance is a balance between how much we’re exposed to and

how effective we are at managing or clearing those toxins.

Known and Suspected Obesogens

• BPA (Bisphenol A)

• Perfluoroalkyl compounds

• Organotins

• Dithiocarbamates

• Nonylphenol

• Air pollutants

• Atrazine

• Nicotine

• DDE (from DDT)• PCBs• HCB• Oxychlordane• Beta-hexahloro-

cyclohexane• Dioxins and

furans• Flame retardants• Phthalates

Source: Collaborative on Health and the Environment. Sept 2011

Where Are Obesogens Found?

• Plastics (including food/cosmetic containers, toys)

• Can linings

• Nonstick cookware

• Water-repellent/stain-resistant fabrics

• Cosmetics

• Household cleaners

• Pesticides – home and commercial

• Pet collars

• Tobacco smoke

• New furniture

• Children’s pajamas

Some obesogens (like DDT) have been banned but persist in the environment because they do not break down.

Source: Collaborative on Health and the Environment. Sept 2011

Do these chemicals make

me look fat?

Do these chemicals make me look fat?

Do these chemicals make me look fat?

Quiz: Detox ImbalanceDo any of these describe you?

I consumer conventional rather than organic foods

I drink unfiltered water

I heat food in plastic

I use personal care products with ingredients I don’t recognize

I have not checked the ingredients of my household cleaning products

I live in a city

I live in an agricultural area

I use pesticides, insecticides and fertilizers on my property

I work in the construction industry or have done remodeling

I have new furniture at home or work

I am intolerant or sensitive to many things

My brain is sluggish, foggy

I have poor memory

I have aches and pains

Image: Mayo Foundation for Medical Education

Associates with

ESTROGEN excess

DETOX impairment

DYSBIOSIS

Imbalance in our gut microbiome

Bad bug!

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0068596 (Poutahidis, T)

AlBad gut bugs can lead to cravings that are hard to control

Alcock et al., 2014 Bioessays 36(10):940-9

Quiz: Gut ImbalanceDo any of these describe you?

Frequent antibiotics

Recent gastroenteritis

Conventional rather than organic foods

Lack of colorful plant foods in the diet

Food sensitivities

Gas and bloating

Abdominal cramping

Constipation

Diarrhea

Reflux

Nausea, vomiting

White-coated tongue

Brain fog

Mood changes

High stress

Cravings

Inflammation

Inflammation

1. Promotes increased cortisol

2. Blocks insulin action

3. Blocks leptin’s appetite-suppressing signaling

Signs of Inflammation

Signs of Inflammation

Pain

Congestion/ Swelling

Dermatitis

Redness/ Irritation

Quiz: Inflammation ImbalanceDo any of these describe you?

Pain

Swelling

Congestion

Gum disease, gingivitis

Poor diet

Excess sugar

Seasonal allergies

Asthma

Flushing

Depression

Heart disease

Memory difficulties

Medications Can Inhibit Weight Loss

• Antibiotics: tetracyclines, vancomycin, penicillin

• Antidepressants and antipsychotics

• Beta-blockers

• Corticosteroids

• Diabetes medications: sulfonylureas (glipizide, pioglitazone), insulin (some)

• Hormone replacement therapy

• Oral contraceptives

Some other factors your doctor should be ruling out

• Thyroid dysfunction

• Adrenal dysfunction

• “Stealth” infections such as viruses and vector-borne illnesses (Lyme)

• Small intestinal bacterial overgrowth (SIBO)

• Food sensitivities

• Malabsorption

Problem Some Soutions

Insulin/glucose Low carb dietBerberine/goldensealMagnesium

Stress Stress managementAdaptogens (ashwagandha, rhodiola)Sleep hygiene

Estrogen FlaxseedCruciferous veggiesFiberMagnesium

Problem Some Soutions

Detox Reduce exposureNutrient repletionRegular poopsAlpha lipoic acid

Gut Fermented foodsProbioticsPrebiotics

Inflammation Colored plant foodsAvoid food sensitivitiesTurmeric/CurcuminBoswellia

Tools from our practice

• healthRESET 6-day detox: targeted supplements, 6 day menu plans (Paleo and vegan versions), recipes, shopping list, instructional video presentations, workbook

Tools from our practice

• IFM certified physicians – Dr. Kara Fitzgerald and Dr. Ken Litwin

• Nutrition-only consults to dive deeper into gut health, food sensitivities, hormone imbalances, blood sugar control, and more

Tools from our practice

• New Frontiers in Functional Medicine podcast

• Blogs

• Monthly newsletters

• Social media

Source: Pilates Anytime

Weight Loss Resistance Webinar

Thank you for attending today.

You can reach us at:

Dr. Kara Fitzgerald 27 Glen Rd, Sandy Hook, CT 06482info@drkarafitzgerald.com(203) 304-9502