Weight Loss - When Diet and Exercise Just Aren't Cutting It

Weight Loss - When Diet and Exercise Just Aren't Cutting It

By Quilla Watt, Integrative Naturopath

 

The secret to a healthy body weight is as simple as making “calories in” equal to “calories out”, right?

And for weight loss, just eat less, exercise more, and you’ll see those kilos drop away. Right? Well… No. Not always. What about those people who constantly eat healthy, follow a rigorous exercise regime, and struggle to see any results?

We like to view weight loss through a much wider lens than the old “eat less, exercise more” view. While diet and exercise are essential, we also look at key players like thyroid function, stress levels, gut microbiome, and a little hormone called leptin.

But first, let’s start with a little disclaimer. When we talk about healthy body weight, we’re not talking about the zero-body-fat-with-a-six-pack fitspo idea of “healthy”. We’re talking about falling in the healthy BMI range of 18.5 to 24.9, and having a healthy waist circumference (less than 94cm in men, and less than 80cm in women). Orthorexia, which is obsessive behaviour around “clean” or “healthy” eating, is an emerging form of disordered eating, and one we need to be mindful of. When it comes to diet and weight loss, we need to practice moderation, not restriction.

Ok, now onto those key players we mentioned earlier…

 

Thyroid

Your thyroid is a little like the accelerator on your car. It helps determine how fast your metabolism runs. When it comes to difficulty losing weight, we check for hypothyroidism. With an underactive thyroid, you take your foot off the accelerator, your metabolism slows, and you don’t burn through fuel the way you should. Autoimmune hypothyroidism, called Hashimoto Thyroiditis, is the most common cause of hypothyroidism in Australia. To make thyroid hormone, you also need adequate iron, iodine, selenium, zinc, and protein intake. We can check for hypothyroidism, and work to optimise thyroid function by making sure your body has the building blocks it needs to make thyroid hormone.

 

Stress, cortisol, and insulin

We all know when we’re stressed, when life is just flat out, we sacrifice our self-care. Less exercise, less mindful eating, relying on takeaway, and grabbing sugary snacks on the run. It’s not hard to see how stress can lead to weight gain, and difficulty with weight loss.

But the story is a little bigger than that, and we take a deeper approach by also looking at the hormonal effects of stress. When we are stressed, our hypothalamic-pituitary-adrenal axis (HPA axis) gets activated. We release cortisol from our adrenal glands. And cortisol is a fantastic hormone. Without it, we would have zero ability to deal with stress. The down side is that when we are under chronic stress, our HPA axis goes haywire, and we pump out way too much cortisol. Chronically high cortisol can be accompanied by increased insulin. Together, cortisol and insulin tell our body to store more fat, and burn less. Not a great combo for weight loss.

 

Leptin resistance

Leptin is your “satiety hormone”. It is released by your fat cells. Leptin tells the brain that you have plenty of fat stores, you are full, and you don’t need to eat any more. Leptin sounds great, right?

The problem is, your body can become leptin resistant. Leptin resistance is a key player in weight gain and difficulty losing weight. In fact, leptin resistance is now believed to be THE main issue in obesity.

So what’s happening in leptin resistance? Your fat cells produce more and more leptin, but your brain does not listen. Your brain doesn’t register the high leptin levels, and mistakenly thinks your body is starving. So your brain goes into survival mode, and tells the body to eat more, and hold on to fat stores.

How you do you know if you have leptin resistance? If you are always hungry, and carry fat around your middle, it’s likely you have some degree of leptin resistance, and we can do a blood test to confirm it. To reverse leptin resistance, we need to look at diet, exercise, inflammation, sleep hygiene, and stress (there’s that high cortisol again!).


 

Microbiome

There has been an explosion of interest in the microbiome (those bugs in your gut) in the past decade. With all this research, we’re beginning to understand the impact these bugs have on our immune function, our mood, and our weight.

Our gut bacteria can alter how much energy we gain from our food, the way we store fat, and how much insulin we release in response to glucose.

Where the gut microbiome is concerned, diversity is key. Lean people tend to have a huge diversity of species in their microbiome, while obese people tend to have far fewer. Diet, including prebiotic and probiotic foods, is key to developing and maintaining that diversity.

 

Weight loss is so much more than diet, exercise, and white-knuckle willpower. If you’re struggling with it, you’re not alone. And if you want to address some of those key players we’ve mentioned, please get in touch.

Clinical Psychologist, Simon DuBois, offers 5 self-empowering tools that can make a positive impact on YOUR Relationship...  

By Simon Dubois  DipCouns, Grad Dip Psychology
 
DON'T LET ANXIETY RUIN YOUR RELATIONSHIP...
Here are 5 self-empowering tools that can make an impact on your relationship
 –-->>FOR THE POSITIVE
1. TAKE RESPONSIBILITY FOR YOUR STUFF

First and foremost work out what's your responsibility to sort out, that will improve the way you participate in relationship. Identifying your own faults and working on them is a much better starting point then pointing out your partners.

For example, John has a habit of getting cranky when his partner gets home late from work. His mind can start running with insecure ideas that she doesn’t like him and might be meeting up with someone else. When she walks through the door he gives her a mini lecture on time keeping and respect in a curt tone. OK, so his partner is a bit late and not given him the heads up, but feeling insecure is John's stuff. If he wants to get anywhere in the relationship (and perhaps encourage his partner to keep him in the loop with where she is), he needs to own his stuff and take responsibility for it. 
2. LET GO OF CONTROL BUT BE GOOD AT COMMUNICATING REASONABLE EXPECTATIONS

Knowing where your partner is and what they're doing all the time is NOT a good way to manage anxiety. Letting go of control and certainty is the only way the relationship will flourish. Never the less, being able to communicate the reasonable issues you have is important. It's ok to request a courtesy call if your partners going to be home late, especially if you’re a bit vulnerable to insecurity. Learn how to make these requests in a way where they are most likely to be heard and respected. 
3. KEEP CALM WHEN YOU HAVE AN ISSUE TO RAISE
 
Often, aggressive communication is fuelled by anxious worries. Unfortunately, if we communicate aggressively our important issue or concern is lost in our poor delivery of the information. If we're upset because our partner has arrived home late without letting us know, make sure you have calmed down first and you're clear how you'll communicate your issue respectfully. 

4. KNOW WHAT YOUR TRIGGERS ARE AND PREPARE FOR THEM

Identify clearly the sorts of things that bring up your anxieties. Make a list of them. Then have a clear plan in place for calming yourself down when these triggers have been activated. 

This skill is called self-soothing. If your partner is going away with her girlfriends for the weekend and you know you'll experience some insecurity, get your plan ready!! This may include phoning a friend or keeping yourself busy with some jobs around the house, or activities with friends. 
5. BECOME AN EXPERT AT NOTICING YOUR ANXIETY MONSTER AND KEEP IT IN CHECK

Mindfulness is a psychological technique that helps you to notice the anxiety monster. It’s a simple process that can be taught in just a few counselling sessions and with practice you'll get on top of the sorts of anxieties that can turn to anger. Anger is the most destructive force in a relationship.  Your anxieties deserve care and consideration rather than being ignored because anger has got in the way. 
 

Why an MRI could actually make your back pain worse

by Simon Sullivan BHSc MOstMed

Back pain is the most common reason that people visit an Osteopath, it is so ubiquitous that 80% of us will experience back pain sometime in our lives.

So it makes sense that we should get all the information we can about our backs so we can make the best possible treatment choices and what better way than the magic of Magnetic Resonance Imaging that allows us to see inside us with unprecedented detail, the same can be said for CT scans and X-rays as well.

Well this is wrong for all but a few cases - 

Australian (and American and everywhere else) guidelines clearly state that unless there is serious neurological impairment or signs of underlying pathology imaging is not needed. Worse, a large study in the US has shown that that getting a MRI early on in acute episodes of low back pain, even cases with nerve compression pain such as sciatica and controlling for severity and age led to significantly worse outcomes, such as $13,000 more in medical costs and more time off work - All by getting a better look at their spine.


So why does this happen?
Well there a couple of really important reasons...


Firstly, MRI’s are really sensitive, they can pick up many different changes and abnormalities in your spine and the soft tissues around it. Words like degeneration, loss of disc height, annular tears, disc bulges, disc herniation, osteophytes, calcification, and stenosis might be used. Problem is that these things probably have very little to do with why you are in pain. MRI anyone’s back over a certain age and you are likely to find some or all of these “findings” whether they are in pain or not.

The correlation between MRI findings and back pain is almost so poor it is non-existent. They are regularly false alarms. 

The cause of back pain is often due to functional problems relating to muscle imbalances, joint movement and lifestyle choices that will never show up on a MRI but are what Osteopaths look for and treat every day.

Now go back and re read that list of MRI findings… If they showed up on a scan of your back how would you feel?
Concerned, fearful, despondent? Some common things I hear are…. “I have the back of an 80 year old”… “My back is stuffed” … “My disc is bulged/slipped/popped/blown/gone” … “My back will never be good”.  - Unfortunately this type of thinking is a powerful driver of pain and it is heavily reinforced by often unrelated MRI findings.
Pain is more than the nerve impulses being sent to the brain from an area in trouble, it involves our thoughts, emotions, environment and the map we have of our body in our brain and if all this is telling us our back is broken and can’t be fixed than the chances of that pain becoming chronic is much more likely.


So what should we do about this?

Well the good news is that for large majority of people pain levels tend to reduce substantially over the first 4-6 weeks of an episode even if you do nothing. But this often leaves people with a low level annoying pain that can hang around many months. 

As an Osteopath my approach would be to get in early if possible and treat the myofascial and joint dysfunctions that may exist to restore as much function and movement as possible. At the same time working to identify as many of the underlying factors that may have predisposed and maintained these dysfunctions as possible to create lasting change.

Just before we finish I would just like to put in one caveat. Remember I said that an MRI and most imaging is unnecessary in all but a few cases? Well in these cases it’s vital and includes conditions like cancer, fractures and underlying inflammatory and autoimmune conditions. Thankfully these are rare and tell-tale symptoms should be picked up on examination by your health professional.
So next time you have an experience of back pain just remember that you are more than your MRI findings and get the help you need to live without pain.
 
Some light reading…
Iatrogenic Consequences of Early Magnetic Resonance Imaging in Acute, Work-Related, Disabling Low Back Pain
Barbara S. Webster, BSPT, PA-C,* Ann Z. Bauer, MPH,† YoonSun Choi, MA,* Manuel Cifuentes, MD, MPH, ScD,*†and Glenn S. Pransky, MD, MOccH*
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235393/
Evidence-Based Management of Acute Musculoskeletal Pain
https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp94.pdf
Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. 
Brinjikji W, Luetmer PH, Comstock B, et al. 
AJNR Am J Neuroradiol. 2015 Apr;36(4):811–6. PubMed #25430861. PainSci #53872.
The prognosis of acute and persistent low-back pain: a meta-analysis
Luciola da C. Menezes Costa, Christopher G. Maher, Mark J. Hancock, James H. McAuley, Robert D. Herbert, Leonardo O.P. Costa
Osteopathic manipulative treatment for nonspecific low back pain: a systematic review and meta-analysis
Helge Franke, Jan-David Franke and Gary FryerEmail author
BMC Musculoskeletal Disorders201415:286

 

Simon Sullivan

BHSc MOstMed Cert IV Remedial Massage

Simon provides individualised holistic osteopathic treatment and care to support patients to overcome pain and restore mobility and wellbeing.  Simon has worked in the health industry for over a decade and has a background in sports and remedial massage. Simon has successfully worked with top sporting teams including the Queensland and New Zealand rugby league and New South Wales cricket teams. 

Simon holds a Masters in Osteopathic Medicine and a Bachelor of Clinical Science from Southern Cross University.  He has also completed post graduate training in the osteopathic treatment and care of babies. 

Simon is passionate about the treatment of acute and persistant pain, sports injuries and supporting expectant mothers.  Simon offers a holistic, integrative approach which is tailored to individual needs and supported by current evidence and research in musculoskeletal medicine, sports medicine, neuroscience, pain and brain-body interactions.

How Reine DuBois, Clinic Director & Naturopath, Manages Insomnia

As the clinical director and senior naturopath of The Health Lodge I find myself wearing many hats.
In my clinical practice I treat women like myself all the time – busy with lots of expectations - I call this capable woman’s syndrome.
When I have lots on my mind attempting to rest my busy brain after another 12 hour day can bring fear into an already exhausted body - as an inability to sleep is often a challenge I am faced with.
Other factors such as the shift of my hormones combining with the effects of the moon can make  some nights feel more like a nightmare……here are

7 sure things that guarantee me a blissful deep sleep and are wonderful practices that everyone can easily adopt 

1.       No blue light after 7pm – with apps like flux and nightshift on all my devices I am very careful not to expose my pineal gland to the stimulation of blue light of screens after dark. The evidence around this is stunning and taking this first step is simple.
2.       No caffeine after 2pm – need I say more.
3.       Regular exercise – the Byron Bay lighthouse walk is my church. Moving the blood flow around my body clears my head and leaves me inspired. I always sleep better after exercise.
4.       Regular osteopath and acupuncture sessions – supporting my nervous system and my hormone levels.
5.       Herbal and nutritional support – I love passionflower, magnolia, zizyphus and phellodendron. Melatonin is also a sure thing if I am struggling with a full mind/moon/PMT.
6.       Clean diet – avoiding chemicals in my food – too much salt, sugar and preservatives will always leave me sleepless. Excessive alcohol inhibits our capacity to enter deep sleep and I often find it will cause me to wake  feeling terrible. So I choose to limit my alcohol intake to nights where I know I can sleep in the next day.
7.       Marry a psychologist – understanding the things that trap my busy mind in a loop is deeply helpful for a restful night’s sleep. My husband happens to be an amazing psychologist (and a total dreamboat) but you don’t have to be married to a psychologist to see one. Engaging quality professional support and learning tools for managing my mind have been perhaps the best investments I have ever made.
Dealing with insomnia is an essential step in treating chronic health conditions. Many of our patients that we work with coordinating a team approach find that once we solve the underlying causes of their sleep issues many of their other complex health conditions resolve themselves.
If you are interested in learning more, or wish to engage with some of the services mentioned, please leave a comment below or call me directly at The Health Lodge.