The essence of our Metabolic Rejuvenation Program is identifying and eliminating the root cause of your weight loss resistance. When eating a healthy diet and minimal exercise alone is not enough to get to a healthy weight and body composition, we find that patients have weight loss resistance. In the image below, the ? represents weight loss resistance. From our perspective, the body is always trying to achieve balance and that includes achieving a healthy weight.
How do we identify each patient’s reasons for weight loss resistance?
We identify the reasons for weight loss resistance through a combination of conventional and advanced lab testing. In our practice, the top 6 reasons for weight loss resistance are listed below:
- Insulin Resistance. It is well established that there is a strong correlation between insulin resistance and weight gain. When there is excess insulin and blood sugar in our blood stream, it signals our body to put that excess sugar in storage. We can store some sugar in our liver and muscles, however, when these are full our body starts to store the extra sugar as fat. This mechanism causes weight gain.
- Food Sensitivities. Food sensitivities don’t directly cause weight gain, but they trigger a mechanism of action starting with inflammation. Staring with inflammation, the mechanism works to create insulin resistance and in many cases weight gain.
- Leptin resistance. Leptin resistance results in a decrease in the ability of leptin to suppress appetite or increase your body’s energy use. We see this frequently from mold exposure, but there are other reasons for leptin resistance, as well. It is well documented in the medical literature that patients in a moldy environment often will develop leptin resistance and because of that, they can gain 30-50 pounds in a very short period of time with no change in diet or exercise.
- Hormone Imbalance. Both low estrogen and low progesterone that occur as women approach menopause is associated with weight gain. Low progesterone in particular acts to decrease metabolism and increase insulin levels. In men and women, low testosterone is associated with increased fat levels and less muscle.
- Thyroid imbalance. Many patients are slightly hypothyroid but it has never been diagnosed as conventional doctors look only for very elevated TSH. In some patients, however, even slight elevations in TSH combined with hypothyroid symptoms may indicate a need for supplemental thyroid medication. Absent a high-functioning thyroid, many patients will experience weight gain.
- Toxic Burden. The toxic burden comes from toxins in our food, the air and water and the environment. Herbicides, pesticides, plastics byproducts and petroleum byproducts are just a few of the non-metallic toxins that overload our bodies and create toxic burden. All of these toxins need to be processed by the body and eliminated in a safe manner. The trouble is that our body becomes over loaded and toxins build up in the liver and digestive system. This leads to weight gain, hormone imbalances, and loss of energy.
All of the top 6 except food sensitivities and toxic burden can be diagnosed with conventional lab tests that are typically covered by insurance. Diagnosing food sensitivities and toxic burden requires specialized testing that is not typically covered by insurance.
Once the reasons for the weight loss resistance have been determined, then we work to put together an individualized treatment plan for you.
The plan will address each area that is not optimal based on the laboratory testing. For the food sensitivities, patients will need to avoid the highly and moderately sensitive foods for 6-12 months to allow the body to reset. Then they can be added back in moderation.
What about Gluten sensitivity?
With gluten sensitivity, your body has trouble absorbing the gluten that is found in wheat, barley, and rye. As you continue to eat these foods you may develop multiple digestive problems and weight gain tends to be an indirect consequence of this particular sensitivity. We will uncover this sensitivity with the food sensitivity testing. Note that you do not have to have celiac disease in order to be gluten sensitive. In fact, many patients have gluten sensitivity that do not have full blown celiac disease.
Putting it all together
Your individualized plan will address all areas of imbalance and weight loss resistance. Our treatment plans incorporate prescription medications when indicated, medical foods, nutritional supplementation and bioidentical hormone replacement as needed. From the start, we will measure your body in detail using our Inbody 570 advanced body composition monitor.
This monitor provides precise accounting of your fat, muscle and water. This is important since our goal is not to reduce weight in general, but specifically to reduce fat. By comparing subsequent measurements to the baseline, we can ensure that you are losing fat and not muscle as will occur with many of the “diets” in the market today.
What about dieting and exercise?
Eating a healthy diet in the proper proportions and at least mild exercise is needed to support any weight loss program, but as discussed above, they are not enough. Nonetheless, our program does provide appropriate counsel for healthy eating and proper exercise.
- Healthy eating. Patients should strive to eat balanced meals consisting of whole foods, organic as much as possible, without eliminating any food group. Eliminate processed foods to the extent possible and simple carbs, but complex carbs are healthy and will support weight loss. The Mediterranean diet is the closest to a healthy diet in general. Calories should be 200-300 calories below your basil metabolic rate, a measure that you get from our Inbody machine, unless you exercise aggressively. In the latter case, we will work with you to determine the appropriate caloric intake.
- Effective exercise. To lose weight, patients need 30 minutes of mild to moderate anaerobic exercise 3-4 days per week. Note the emphasis is on mild to moderate as heavy, risky exercise is not needed for weight loss. Anaerobic exercises include high-intensity interval training (HIIT), weight lifting, circuit training, Pilates, yoga, and other forms of strength training such as using exercise bands. The latter is highly recommended. The point that is now supported by multiple studies is that anaerobic exercise is much more effective in promoting weight loss than aerobic exercises like running and cycling.
As the last point is somewhat counterintuitive, check one of the studies supporting this view.
High-Intensity Intermittent Exercise and Fat Loss
The effect of regular aerobic exercise on body fat is negligible; however, other forms of exercise may have a greater impact on body composition. For example, emerging research examining high-intensity intermittent exercise (HIIE) indicates that it may be more effective at reducing subcutaneous and abdominal body fat than other types of exercise.
Select medications that we use to support weight loss. We evaluate each patient, their reasons for weight loss resistance and apply medications as indicated for each particular patient. This is just a sample of some of the more novel medications that we utilize to achieve sustainable weight loss in our patients.
- Semaglutide. This medication is FDA approved for weight loss in patients with insulin resistance. It may be covered by some insurance plans based on indication. Semaglutide, sold under the brand name Ozempic among others, is an antidiabetic medication used for the treatment of type 2 diabetes and long-term weight management. Semaglutide acts like human glucagon-like peptide-1 (GLP-1) in that it increases insulin secretion, thereby increasing sugar metabolism.
- CJC1295/Ipamorelin. This is a combination of two growth hormone releasing hormones (GHRH) that both act to increase growth hormone levels in the body. This product supports healthy weight loss in two ways. The main benefit of Ipamorelin is that it has been shown to increase fat burning metabolism, whereas CJC1295 is similar to Ipamorelin, but it is a 29-amino acid peptide hormone that offers many anti-aging benefits including improvements in energy and strengthened immune system.
- Tesofensine. Tesofensine is not currently FDA approved but it has been studied extensively. Tesofensine is a novel centrally acting triple monoamine reuptake inhibitor (MRI) . Results from recent clinical trials show that tesofensine effectively produces a substantial weight loss in obese patients. When corrected for placebo and diet effects, long-term tesofensine treatment produces a maximal weight loss of 10.6% in obese patients, which is twice that achieved by other anti-obesity agents. The robust weight loss produced by tesofensine is explained by the stimulation of satiety, suggesting that tesofensine predominantly acts as an appetite suppressant.
- 5-Amino 1MQ. 5-amino-1MQ is a small, selective, membrane permeable molecule that is an inhibitor of nicotinamide N-methyltransferase (NNMT), a cytosolic enzyme that plays a role in cellular metabolism and energy homeostasis. NNMT has been found to be up-regulated in white adipose tissue (fat tissue) compared to other tissues, thus, NNMT is an ideal target for anti-obesity medication. The results of studies validate NNMT as a practical target to treat obesity and related metabolic conditions and support the development of an NNMT inhibitor therapeutics to reverse diet-induced obesity.
Ready to get Proactive Wellness engaged to help you lose weight?
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