Weight loss. The topic everyone is talking about. The condition everyone is a self-proclaimed “expert” in.
"Losing weight is easy, you are just eating too much”
"Calories in versus calories out”
"Maybe you need to do more cardio”
"Decrease your calories and you will lose weight”
These are just a few messages that I have seen quickly get shot at someone struggling to lose weight. Not helpful. What these words actually say is: "it is your lack of self-control”, "it is a defect in your character”, "it is because you are lazy”. As an actual expert in nutrition (I have a degree and credentials to prove it), this is one of my biggest pet peeves. So get ready for some massive snark or if you can’t handle it, maybe go make some bomb protein pancakes from my previous blog post (Power Pancakes).
So here it goes: I will say it once, and I will say it a million more times, Calories are only one part of a very big picture. If you are focusing on calories alone, you are setting yourself up for either immediate or long term failure.
Before I go into all of the reasons you may not be losing weight (aside from eating too much), let’s talk about why it might be a good idea to work with an expert in nutrition to support your weight loss endeavors. Nutrition experts know what they are talking about. They have undergone rigorous studies and supervised training (https://www.resultsdietetics.com/about/). You wouldn’t take your car to the first hack shop you could find, right? Don’t you think your body deserves as much expertise as your car does? As an experienced RDN, I can spot myxedema across a room and suggest a client get a thyroid panel. I can identify if a person suffers from dysbiosis, insulin resistance, vitamin/mineral deficiency etc. This is called a Nutrition Focused Physical Exam. I can review your medication list and know right off the bat if you are on a medication that causes appetite stimulation and/or weight gain. This is part of an expert’s training.
Unless you are an RDN, LDN, CDN, or specialized PHD/MD you are not an expert. You are an enthusiast. If you would like to become an expert, go for it. Here is what you need to do: (http://www.eatrightpro.org/resource/about-us/become-an-rdn-or-dtr/high-school-students/5-steps-to-become-a-registered-dietitian-nutritionist).
I am not discounting "nutrition enthusiasts”. I have seen many women and men be encouraged and given the push they need to meet their goals with the help of a plan, group, or devoted support. However, the idea that all you need to do is starve to get results is asinine and needs to stop.
Moreover, you can be a knowledgeable enthusiast. Let’s use myself as an example. I have been exercising pretty much my entire life. I’ve done many different forms of exercise including (but not limited to) six years of competitive swimming, yoga, cycle, running, powerlifting, kickboxing, high-intensity interval training, p90x, insanity and even ZUMBA!! (I only accentuate Zumba because anyone who knows me personally will know that I have zero acumen for rhythm, coordination or dancing). And because I am, who I am, I’ve studied exercise. I’ve taken college level classes on exercise physiology, read the NASM textbook and perused the ACE study manual. But does this make me an expert?? NO!!! This makes me an enthusiast who knows what exercise is right for ME to do. I share with others what works for me and I have a comprehensive knowledge of our muscle groups, the difference between fast/slow twitch muscle fibers, and how different types of exercise affect our bodies and goals (ie. HIIT vs steady state cardio). However, if you are pregnant, injured, have heart problems or whatever else, I am not your go to girl for exercise advice. Because I am not an expert, I am an enthusiast. I am your go to girl to advise you on how to get the most out of your workouts and how to increase your exercise/sports performance with nutrition. But that is a topic for a different time. We are here to talk about weight loss and why focusing only on calories is self-sabotage.
There are many hormones that affect weight regulation such as insulin, glucagon, thyroxine, ghrelin, leptin, cortisol, serotonin, estrogen and testosterone. Hormonal imbalance is a major cause of weight gain and inability to lose weight. Hormones are all interdependent; some work together and some work opposite of each other.
The main hormone duo I want to discuss is Insulin and Glucagon. Insulin is a hormone that is secreted by your pancreas. Insulin has a few jobs including the one you are probably most familiar with: blood sugar regulation. Insulin is also in charge of delivering essential amino acids (protein) to your cells, storing and creating fat, and is one of the hunger stimulating hormones. In a healthy person, insulin is secreted by your pancreas in response to food consumption in order to deliver glucose (sugar) from your bloodstream into your liver to be converted into fat and into your muscle to be stored as glycogen (the storage form of glucose). "Insulin resistance” occurs way before a diagnosis of prediabetes or type 2 diabetes and is a very common symptom of polycystic ovarian syndrome. Insulin Resistance occurs when your insulin receptor cells start to "tune out” the excessive insulin your pancreas is pumping in response to food choices and/or other metabolic/hormonal actions (discussed later). It’s like when you were a kid and your mom was yelling at you to clean your room. Eventually, you stopped hearing her. Pretend your insulin is your mom, glucose is the toys all over your floor, and the toy box is your insulin receptor sites in your liver. Insulin starts to build up at this point. And let’s not forget the other functions of insulin. Insulin increases our hunger and stores fat. Even though your pancreas is secreting insulin, your cells are not receiving nutrition because the insulin is ineffective. As far as your body is concerned, you are starving. To recap: chronically high levels of insulin in response to high quantity/low-quality food and other metabolic factors eventually becomes ineffective which leads to cellular starvation. This signals to your central nervous system that you need more food. While this is all happening your "fat burning” hormone Glucagon is in a time out because, again, your body thinks it is starving. Oh right, Glucagon, we forgot about you.
Glucagon is also secreted by your pancreas and responsible for utilizing fat and carbohydrates as energy. While your insulin is busy ramming its head against the proverbial wall, your buddy glucagon is patiently waiting his turn to come out and play. Remember, these hormones work opposite of each other, so when insulin is elevated, glucagon is suppressed. So what now? You are storing fat, you are unable to burn fat, and you are hungry all the time. Will eating less help you? No, your cells are already starving. At this point you need to evaluate your diet quality and the types of carbohydrates you eat. Unprocessed, plant based carbohydrates ideally paired with a fat and protein absorb slower in your body and prompt a lower insulin response. Exercise is also crucial in increasing receptors for glucose on the muscle and stimulating glucagon (more on that later). Again, change what you eat…not just how much you eat.
Cortisol is another hormone that wreaks havoc on your weight loss potential when secreted in excess. Cortisol has the opposite job of insulin and increases blood sugar by pulling from your protein stores. Cortisol is produced in response to abnormal blood sugar, psychological stress, and sleep deprivation.
Sleep Deprivation and Psychological Stress
Sleep deprivation is something that we often discount when it comes to weight loss. How many times have we been advised to cut our sleep short in order to make it to the gym before work? Lack of sleep has been shown to increase ghrelin (the hunger hormone), decrease leptin (the hormone that says we are full), decrease insulin sensitivity, while increasing cortisol production. Psychological stress is another factor that increases cortisol production. Cortisol is known as the "fight or flight” hormone. Psychological stress is something that our bodies are able to deal with in short bursts without too many negative repercussions. However, our culture of long commutes, stressful jobs, high cost of living, and sleep deprivation fosters continuous environmental stress. Chronic stress means increased cortisol production. High levels of cortisol promotes secretion of its counterregulatory hormone, insulin, which increases hunger (remember how one of insulin’s jobs is hunger stimulation?) and deposits fat. Not only does persistently high levels of Cortisol make you hungry but it also suppresses thyroid function and eventually can lead to functional hypothyroidism. Your thyroid hormones are a very complicated set of hormones. But all we need to know for the purpose of this blog post is that the primary symptoms of suppressed thyroid function are weight gain and difficulty losing weight.
Additionally, the constant surplus of cortisol production leads to impaired gut integrity which leads to dysbiosis and systemic inflammation. Which you guessed it…Also, leads to weight gain.
Your intestines (or gut) house trillions of microorganisms. These microbes are involved in energy metabolism, fat deposition, and immunity. When there is a shift in the microbiome from a balance of bacteria to a majority of "bad bacteria” this is called Dysbiosis. Dysbiosis is a direct result of a poor quality diet. The "bad bacteria” thrive on sugar. I briefly talked about food cravings and the mind-gut connection in my last post about Flexible Dieting (https://www.resultsdietetics.com/does-iifym-work/). But to summarize, dysbiosis triggers food cravings, increases ghrelin and promotes chronic inflammation. Chronic levels of inflammation lead to weight gain, cardiovascular disorders, and insulin resistance. The combination of increased ghrelin and food cravings create an environment for continued weight gain, continued dysbiosis, leptin suppression and resistance, chronically elevated cortisol, decreased glucose control and infection. So again, calorie restriction without guidance on how to improve food quality and correct dysbiosis will not lead to successful weight loss.
Relatively low muscle mass is associated with increased risk for obesity, insulin resistance, and metabolic syndrome. Muscle mass requires more energy at rest than fat mass. When you move your muscles, not only are you expending more energy than if you had low muscle mass but more importantly, your muscle is able to directly receive glucose to be used as energy without the help of insulin. When you move your muscles, glucagon is stimulated (remember our fat burning buddy from above). Not only are you improving your insulin sensitivity and decreasing insulin resistance but because muscle is so needy, glucagon is called into play to break down stored fat to provide your muscle with fuel. A person who has low muscle mass should never be instructed to "just eat less”. This will just cause a continued decrease in lean muscle mass which increases the risk of insulin resistance and creates a situation where you keep having to eat less and less in order to keep up with the decrease in energy expenditure. Instead, focus on optimizing insulin sensitivity and nutrient intake to support muscle building.
As you can see, there is a lot more to weight loss than merely cutting your portion sizes in half. So many men and women struggle with their weight and feel like failures because it has been drilled into their heads that weight loss is as easy as "calories in versus calories out”. While portions sizes certainly do matter, weight loss can be a complicated cascade of hormonal imbalances and metabolic factors. The focus should be on improving your hormonal balance, muscle mass, and nutrition status first and foremost in order to set the stage for successful weight loss. Working with a Registered Dietitian Nutritionist can help determine the cause of your stalled weight loss or unexplained weight gain. Visit my services page to book an appointment.
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