Weight Loss – A Holistic Approach
Getting to a “healthy” weight can be a struggle. Most people have tried at least one diet or new exercise regimen only to give it up after a short amount of time. It seems like there is always a new product, fad diet, or exercise gadget claiming to be the next best thing for fast weight loss. With the prevalence of obesity in the US continuing to climb, more emphasis should be placed on long-term lifestyle modifications for reaching and maintaining a healthy weight.
Body mass index (BMI), a measure of body fat based on height and weight, is used by medical professionals to define obesity. A BMI of 25-29.9 is considered overweight, while 30 and above is considered obese.1 BMI is not the only (or arguably even the best) way to measure a person’s body composition, but it is most commonly used by physicians to get a quick assessment of a patient. Other measurements, such as waist circumference or body fat percentage, may give a more accurate assessment.
Being overweight or obese can predispose a person to serious health consequences. Obesity can increase the risk of developing cardiovascular diseases such as heart disease and hypertension, type 2 diabetes, chronic kidney disease, musculoskeletal disorders like osteoarthritis, respiratory disorders like COPD, asthma, and sleep apnea, and even certain cancers.2 The good news is that even small amounts of weight loss can lead to improved outcomes for many of these conditions. In one study of overweight and obese individuals with type 2 diabetes, those who lost between 5-10% of body weight had significant improvements in cardiovascular risk factors: blood sugar regulation, blood pressure, HDL cholesterol, and triglycerides.⁹
While traditional medicine focuses primarily on diet and exercise (have you ever heard “just eat less, exercise more”?), functional medicine emphasizes a holistic approach that addresses the gut microbiome, stress, inflammation, genetics, hormone imbalances, and sleep along with proper nutrition and movement.
The gut microbiome, which plays a major role in the body, is involved with digestion, absorption, immune, and hormone functions.4 The gut naturally has thousands of beneficial bacteria but sometimes the natural flora becomes disrupted, leading to dysbiosis. This is often a result of diet, inflammation, antibiotics, or other medications.5 Dysbiosis sometimes results in gastrointestinal symptoms, but it can also have less obvious effects that lead to inhibited weight loss.4 When dysbiosis occurs, the gut becomes more permeable allowing bacteria to spread throughout the body resulting in low-grade inflammation which can lead to insulin resistance and metabolic disorders. Additionally, hormone pathways may be impacted, including hormones that help with feeling satiated after eating and slow gastric emptying.6 It is important to break this cycle of inflammation in order to make long-term weight loss possible. Human and animal studies have shown that by rebalancing the intestinal flora and decreasing inflammation, weight loss can be achieved more easily and the risk of obesity-related disease decreases.5
Resolving dysbiosis is unique to each person depending on their individual flora, but one simple way to influence the microbiota is to incorporate fermented foods into the diet.3 Some examples are kimchi, sauerkraut, cultured yogurt, sourdough or kombucha to increase intestinal flora. There are also many types of probiotics available, depending on your specific needs.3 Prebiotics can also be used to promote growth of intestinal flora and they also contain fiber.3 For more complex dysbiosis, a physician may need to prescribe antibiotics to first eliminate pathogenic bacteria from the gut.4 Bacteria is then reintroduced for optimal intestinal flora using a combination of probiotics and prebiotics.3
Stress can also have a detrimental effect on attempts to reach a healthy weight. Long-term, high levels of stress have been shown to increase obesity as well as other metabolic disorders.6 Stress can disrupt the natural balance of hormones such as cortisol, estrogen, and testosterone.6 These hormones play a role in telling the body to store fat and can impact weight loss or gain.6 There will always be unavoidable stressors in life, but it is necessary to find a healthy way to deal with these issues. Yoga, exercise, meditation, and prayer are all examples of healthy ways to manage stress.
Poor sleep is linked to increased appetite, especially sugar cravings. Sleep is also important to the body’s metabolism, allowing time for digestion and absorption.7 In addition, a hormone called leptin can be produced by the body when we get inadequate sleep. Leptin tells our brain that we need to eat more than we actually need to in order to have more energy. A disrupted sleep pattern can promote weight gain, so prioritize getting a good night’s sleep.8
When it comes to weight loss, many programs include high-intensity workouts as the main focus. Aim for at least 150 minutes of moderate exercise weekly in the form of walking, jogging, biking, weight training, or swimming.1 Find ways to add movement into your day so that you can form new habits that become a part of your routine. Exercise and daily physical activity are important, but you just can’t out-exercise a bad diet.3
A balanced diet varies from person to person, but the main components include vegetables, carbohydrates, and protein.1 Think of a plate, then cut in half. Half of the plate should contain some sort of non-starchy vegetable, while the other half is split between a protein source and a carbohydrate source. This method may seem simple, but it has been proven effective for controlling portion sizes and helping with weight loss.1 When choosing how to fill your plate, try to stick to whole, unprocessed foods as they do not contain added sugar and you can get the full nutritional benefit.3 Eating a variety of colorful vegetables can help ensure you are getting the right amount of nutrients in your diet.3 Keep in mind that carbohydrates can be found in unexpected amounts in certain foods, such as in apples or bananas, as well as the foods that are traditionally thought of as carbs such as bread or pasta. Try to stick to whole grains whenever possible, such as brown rice, quinoa, oatmeal or other whole grain products.3
Unfortunately, there is no “magic cure” for weight loss. Many overly restrictive diets are unrealistic in the long-term, leading to periods of weight loss followed by backsliding. It is important to make a plan that is sustainable for you, and don’t be afraid to modify it if something isn’t working. Invite others to make changes with you; it’s easier to keep going when you have a community supporting you. Instead of focusing on limiting yourself, find ways to challenge yourself to try new recipes or activities. Speak to your physician about the options that might be available to you such as a visit with a dietitian. Be kind to yourself if you slip up and move forward with confidence!
If you’re interested in jump-starting your weight loss journey, our next round of the 14 day detox is starting soon! You’ll get a meal plan, exercises, mindset resources, and a community of others going through the program. Find out more here.
Written by, Carly Sprow PharmD
Edited by Lindsey Dalton, PharmD
- Healthy Weight. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyweight/index.html. Published 2021. Accessed November 28, 2021.
- Obesity. World Health Organization. https://www.who.int/health-topics/obesity#tab=tab_2. Published 2021. Accessed November 28, 2021.
- Beard A. Functional Medicine Weight Loss – An Approach for Long-Term Success. Amy Beard MD. https://amybeardmd.com/functional-medicine-weight-loss-an-approach-for-long-term-success/. Published 2020. Accessed November 28, 2021.
- Cox AJ, West NP, Cripps AW. Obesity, inflammation, and the gut microbiota. Lancet Diabetes Endocrinol. 2015;3(3):207-215. doi:10.1016/S2213-8587(14)70134-2
- Nagpal R, Kumar M, Yadav AK, et al. Gut microbiota in health and disease: an overview focused on metabolic inflammation. Benef Microbes. 2016;7(2):181-194. doi:10.3920/bm2015.0062
- Carvalho BM, Saad MJ. Influence of gut microbiota on subclinical inflammation and insulin resistance. Mediators Inflamm. 2013;2013:986734. doi:10.1155/2013/986734
- Hewagalamulage SD, Lee TK, Clarke IJ, Henry BA. Stress, cortisol, and obesity: a role for cortisol responsiveness in identifying individuals prone to obesity. Domest Anim Endocrinol. 2016;56 Suppl:S112-S120. doi:10.1016/j.domaniend.2016.03.004
- Papanicolaou G. A Functional Medicine Approach to Obesity: 10 Ways to Lose Weight & Keep It Off. UltraWellness Center. https://www.ultrawellnesscenter.com/2018/04/03/a-functional-medicine-approach-to-obesity-10-ways-to-lose-weight-keep-it-off/. Published 2021. Accessed November 28, 2021.
- Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals With Type 2 Diabetes. Rena R. Wing, Wei Lang, Thomas A. Wadden, Monika Safford, William C. Knowler, Alain G. Bertoni, James O. Hill, Frederick L. Brancati, Anne Peters, LynneWagenknecht, the Look AHEAD Research GroupDiabetes Care Jul 2011, 34 (7) 1481-1486; DOI: 10.2337/dc10-2415