It’s that time of year again… sunny weather is here and you’re ready to rock the summer with confidence. Like many of us, you know that you need to make a few changes if you want to shed those extra winter pounds, but you’re not sure where to start. Maybe you have already cleaned up your daily habits and thought you would have seen some results by now, but unfortunately, that hasn’t been the case. Could your hormones be playing a role? Or your diet, your exercise level… or even stress? What’s your next step? In this article, we take a look at Functional Medicine and Weight Loss
We’re going to tackle some of the most prevalent weight loss myths that are getting in the way of your healthy weight management goals and long-term health.
The premise of “CICO” is that to lose weight you must consume fewer calories than you burn a day. For example, if you are currently sustaining on 3,000 calories a day and want to lose weight, you need to either reduce your caloric intake by 500 calories or increase your physical activity to burn those 500 calories off.1
This concept, while seemingly logical, doesn’t take into consideration the quality of the calories you’re consuming or their effect on your body depending on where they come from. For example, 200 calories worth of sweet potatoes is going to have a very different effect on your insulin response levels than 200 calories of milk chocolate (plus, it’ll fill you up longer).
When your insulin levels spike, you’re more prone to energy crashes, lethargy, and hypoglycemic reactions, which often lead to cravings and quickly sabotage your weight goals. While CICO may work in the short term when followed properly, it may not be the most effective long-term strategy.
The idea that all calories are created equal when it comes to weight loss is inaccurate, at best2. This idea quantifies calories without taking the many varied qualities of each macronutrient into account. Foods are metabolized differently (i.e., sweet potatoes vs chocolate), which can have a significant effect on your hunger and hormones.
While reducing or eliminating fat from your diet can result in short-term weight loss, it is not a healthy strategy for the long term. People who follow low fat and no fat diets generally regain the weight they have lost within six months to a year, as these diets are incredibly difficult to sustain and cause cravings, poor food choices, and binge eating. Fat calories help you feel full and can contribute to long-term sustainable weight management.
Long-Term Effects of Low-Fat Diet
Fat intake is crucial to your metabolic health and nutrient absorption, and the long-term effects of a diet too low in healthy fats affects the whole body, from cellular health to hormone production. While it is important to avoid overconsumption of saturated fats often found in red meat, or unhealthy trans fats from dairy and processed foods, eating enough healthy, high-quality unsaturated dietary fats and oils is necessary to maintain a healthy body.
The Processed trans fats often found in commercially prepared snacks and baked goods are the worst culprits. Look out for anything labeled as partially hydrogenated and skip it. Opt for a moderate intake of saturated fats and prioritize monounsaturated fats and polyunsaturated fats found in olive oil, avocados, soy products, and nuts.4
Grocery store aisles are filled with processed foods meant to entice, often touting labels used by the diet industry: “diet”, “low fat”, “healthy” and “no fat” are some of the most common. We recommend avoiding these foods as they’re often lacking in nutritional value. Not to mention that “diet” foods often compensate for the flavor of fat by loading up on excess salt, sugar, and additives. Refined sugars such as high fructose corn syrup are often used in these types of products. And the sodium? Nothing like high sodium levels for feeling bloating and holding on to extra pounds of water weight.
Integrative Approaches to Healthy Weight Management – Functional Medicine and Weight Loss
Now that we have covered some of the weight loss strategies that don’t work, keep reading to discover the ones that do with functional medicine and weight loss
If your gut microbiome is out of balance, meaning you don’t have enough of the “good” bacteria and too much of the “bad” bacteria, your ability to metabolize food will be compromised, as will your weight loss goals. An imbalanced gut can mean inflammation and increased insulin resistance in the body. Over time, poor gut health can lead to irritation and food sensitivities that can trigger your gut’s immune system to go into overdrive – your body begins to prioritize combatting what it sees as an attack, and your ability to metabolize your food and absorb nutrients can become compromised. In comparison, when your microbiome is operating efficiently, the “good” bacteria help to protect the gut wall for optimal absorption, they help to fully digest and get the most out of your meals, and they support natural waste elimination.
To increase the “good” bacteria, increase your fiber intake and consider taking a probiotic.
Contributors to bad bacteria include processed foods, refined sugars, antibiotic overuse, and stress. While it’s not always easy to manage stress, try to make time for yourself every day, get at least 30 minutes of physical activity, and try mindfulness, journaling, and/or meditation. Also, note that reducing processed foods and refined sugars contributes to stress management – you’ll have fewer insulin crashes and increased mood stabilization.
Imbalanced hormones, especially insulin, leptin, and cortisol, can have dire effects on your weight loss goals over both the short term and the long haul.9 This can happen even if you’re doing everything you think is right, including eating a balanced diet and getting at least 30 minutes of daily physical activity. Additionally, a hormonal imbalance can influence what you eat and when.
If you’ve noticed that you’re experiencing hormonal changes and weight fluctuations, it’s important to act and talk to your doctor about it. Strategies they may suggest to help bring balance your hormones include:
- Good sleep hygiene
- Stress management (journaling, meditation, mindfulness, time management, and saying “no” when you feel like you’re overextending yourself)
- Regular exercise
- Avoiding sugary foods
- Increasing your intake of healthy fats and protein
A balanced diet can help reduce cravings, insulin spikes, inflammation, and weight gain. It provides the nutrients needed for healthy hormone production and supports your mood, giving you the energy and motivation to stick to your weight loss goals. As every individual is unique, there is no single “best” diet for weight maintenance. The best diet is one that an individual can maintain over the long term.7 We recommend focusing on food that is nutrient-dense, low in sugar, and high in probiotic foods. It includes:
- A lot of vegetables, especially dark, leafy greens and low starch carbohydrates like sweet potatoes
- Whole grains and legumes
- Hormone-free meats, eggs, and dairy
- Fish and seafood
- Fermented foods such as kimchi, sauerkraut, kefir, Kombucha and yogurt
- A reduction or elimination of refined sugars. Try maple syrup, honey, blackstrap molasses, agave, or stevia instead.
- Little to no processed foods
Intermittent fasting is the process of introducing periods of not eating at regular intervals. It includes limiting eating to a short window of time daily (for example 6 or 8 hours out of 24)6. Intermittent fasting is best done under the supervision of your healthcare practitioner and may not be appropriate for everyone. When done in a way that is appropriate for your unique body and circumstances, it can help reduce and manage weight by decreasing your caloric intake, giving your body time to fully digest the food you have eaten, and helping to bring balance to your hormones8. It’s also a simple technique that doesn’t involve counting calories, but please note, when intermittent fasting, we recommend continuing to eat a nutrient-dense whole foods diet.
Regular physical activity is a vital component in any integrative weight loss strategy5. It reduces stress and improves the quality of sleep – both of which help you make wiser food choices and not overeat. Additionally, when you exercise and build muscle mass, that muscle helps burn fat at a greater rate.
30 minutes of daily, moderate exercise is recommended at a minimum, with increased levels for greater weight loss goals, but don’t overdo it. For some people, working out too hard and/or for long durations, especially in highly aerobic activities, increases cortisol and sabotages weight loss goals. Find an activity that works for you and always listen to your body.
If you’re struggling to get your weight under control, as a Functional Medicine practitioner, our office can run the right laboratory tests to make sure that you are approaching your weight management in the best way for you and we will work with you to create a tailored plan that will set you on the right path to reaching your weight management goals.
If you are interested in personalized treatment, you can sign up for a free initial virtual consult here.
1Belfort-DeAguiar, R., & Seo, D. (2018). Food Cues and Obesity: Overpowering Hormones and Energy Balance Regulation. Current obesity reports, 7(2), 122–129. https://doi.org/10.1007/s13679-018-0303-1
2Benton, D., & Young, H. A. (2017). Reducing Calorie Intake May Not Help You Lose Body Weight. Perspectives on psychological science : a journal of the Association for Psychological Science, 12(5), 703–714. https://doi.org/10.1177/1745691617690878
3Bhandari P, Sapra A. Low Fat Diet. [Updated 2022 Feb 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553097/
4Hall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y., Chung, S. T., Costa, E., Courville, A., Darcey, V., Fletcher, L. A., Forde, C. G., Gharib, A. M., Guo, J., Howard, R., Joseph, P. V., McGehee, S., Ouwerkerk, R., Raisinger, K., Rozga, I., … Zhou, M. (2019). Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad 6Libitum Food Intake. Cell metabolism, 30(1), 67–77.e3. https://doi.org/10.1016/j.cmet.2019.05.008
5Institute of Medicine (US) Subcommittee on Military Weight Management. Weight Management: State of the Science and Opportunities for Military Programs. Washington (DC): National Academies Press (US); 2004. 4, Weight-Loss and Maintenance Strategies. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221839/
6Kang, S. H., Park, Y. S., Ahn, S. H., & Kim, H. H. (2020). Intermittent Fasting: Current Evidence in Clinical Practice. Journal of obesity & metabolic syndrome, 29(2), 81–83. https://doi.org/10.7570/jomes20022
7Kim J. Y. (2021). Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance. Journal of obesity & metabolic syndrome, 30(1), 20–31. https://doi.org/10.7570/jomes20065
8Rynders, C. A., Thomas, E. A., Zaman, A., Pan, Z., Catenacci, V. A., & Melanson, E. L. (2019). Effectiveness of Intermittent Fasting and Time-Restricted Feeding Compared to Continuous Energy Restriction for Weight Loss. Nutrients, 11(10), 2442. https://doi.org/10.3390/nu11102442
9Schwarz, N. A., Rigby, B. R., La Bounty, P., Shelmadine, B., & Bowden, R. G. (2011). A review of weight control strategies and their effects on the regulation of hormonal balance. Journal of nutrition and metabolism, 2011, 237932. https://doi.org/10.1155/2011/237932