Tackling Obesity's Hidden Causes
by Lisa MarshallEat less, move more. These words have been the cornerstone of diet advice for decades, leading millions of Americans to greet the new year with vows to cut calories and hit the gym. In all, one in five U.S. adults are dieting at any given time, according to the international market research firm The NPD Group, and 57 percent would like to lose 20 pounds or more. Yet few will reach that goal.
One survey of 14,000 dieters published in the International Journal of Obesity found that only one in six had ever been able to lose 10 percent of their body weight and keep it off for a year. Another study, published in the last year in Obesity, followed up with 14 contestants from the 2009 TV reality show The Biggest Loser and found that despite efforts to keep their eating and exercise habits on track, 13 had regained significant weight since the competition. Four are heavier now than before participating on the show.
Diet experts say the battle of the bulge has been exceedingly hard to win for one clear reason: We’re oversimplifying the solution and underestimating the saboteurs. “We’re learning that it’s not as simple as calories-in and calories-out,” says Dr. Pamela Wartian Smith, an Ann Arbor, Michigan, physician specializing in functional and nutritional medicine and author of Why You Can’t Lose Weight.
Research reveals that everything from food allergies to hormone imbalances and disruptions in gut bacteria can subtly undermine the best-laid weight management plans. Working out too much or eating too little can also backfire. Even a mean boss or a cold workplace cubicle can factor in.
Certainly, diet and exercise are key, experts emphasize. Yet, if we’re doing all the right things and still seeing disappointing numbers on the scale, there’s still more we can do. Here are some common weight-loss saboteurs and what to do about them.
Bite into a food we’re sensitive to and our body switches into “fight-or-flight” mode. It stores fat and water, releases histamines that widen blood vessels and inflame tissue, and cranks out stress hormones like epinephrine and norepinephrine that make us want to eat more of that food.
“You literally get a high so that you crave more,” says Smith. She notes that unlike true allergies, which can prompt an immediate reaction, food intolerances often manifest subtly over several days. When we are repeatedly exposed to a food we’re sensitive to, we feel bloated and sluggish, regardless of the calorie count.
Allergy medications can also prompt weight gain, in part by boosting appetite. One study by Yale researchers found people that regularly ingested antihistamines like Zyrtec and Allegra were far more likely to be overweight than those not using them.
What to do: First, cut out the most-craved foods. “If someone tells me they just cannot live without cheese, I assume they are allergic to it,” says Smith. Or, try an elimination diet. Ban common allergens like milk, eggs, peanuts, tree nuts and gluten (if possible, try sticking to only rice and lamb—two hypoallergenic foods— for four days). Then reintroduce other foods slowly and monitor the results. To combat seasonal allergies naturally, try vitamin C, quercetin and butterbur supplements.
The thyroid serves as a key metabolism regulator, dictating how efficiently the heart beats and muscles contract, how quickly the body turns nutrients into energy, and how well we burn off stored fat. When thyroid hormone production falls, metabolism can also decrease by as much as 40 percent.
Yet as many as four in 13 women suffer from a thyroid hormone deficiency, says Toronto naturopathic doctor Natasha Turner, author of the new book The Hormone Boost. “You can diet and exercise until you are blue in the face, but if your thyroid is out of balance, you won’t achieve the body you’re looking for,” she says. “It’s a common cause of weight gain.”
What to do: Get tested for levels of thyroid stimulating hormone (TSH) and, if possible, T4 (thyroxine) and T3 (triiodothyronine) also. TSH signals the thyroid to make more T4, the inactive form of thyroid hormone that is converted into T3, the form the body is able to use. Abnormal blood levels of any of these can impact metabolism adversely, and a TSH test alone may be unable to identify a problem, caution Smith and Turner.
The trillions of microorganisms in our gut have a profound impact on our ability to maintain a healthy weight, says Dr. Raphael Kellman, a New York City physician practicing functional medicine and author of The Microbiome Diet. “The gut bacteria are the gatekeepers of the calories that enter our body,” he explains.
Research shows that certain species of bacteria aid in the metabolizing of carbohydrates, while others help break down fats and protein. Some turn on genes that fight inflammation; others influence how well the body responds to insulin. Diversity and balance of helpful bacteria species are keys to health.
“If changes in the percentages of certain bacteria occur, the microbiome loses its ability to help us maintain a healthy weight,” says Kellman. In one landmark 21st-century study by University of Colorado researchers, swapping the gut bacteria of a skinny mouse with that of an obese one made the skinny mouse gain weight.
What to do: Go easy on antibiotics, which can wipe out gut bacteria diversity. Load up on fermented foods like kim chi, sauerkraut, kefir and yogurt. Eat lots of inulin-containing plant fiber to give desirable bacteria something to chew on, and consider taking a probiotic supplement until weight loss and health goals are achieved.
As The Biggest Loser contestants learned, losing too much weight too fast can bring metabolism to a screeching halt; the body, coaxed into starvation mode, moves to conserve fuel and store fat.
“If you try to lose weight by drastically slashing calorie intake and going crazy on the cardio machines, you’ll do more harm than good,” says Turner. Performing intense cardiovascular exercise such as running, cycling or swimming for more than 45 minutes can make cortisol levels surge, accelerating muscle loss and impairing the immune system. That’s counterproductive because muscles burn calories at rest, too. Consistent over-exercise can also prompt the stressed body to respond in a fight-or-flight fashion, storing more belly fat and leading to the “skinny but fat” body composition common among models and marathon runners, she says.
Skipping meals can prompt the key thyroid hormone T3 to fall off too, further slowing metabolism. Plus, six weeks into a restrictive weight-loss program, levels of the feel-good hormones dopamine and serotonin also start to decline, killing motivation and fueling cravings. The result is a weight plateau or even weight gain.
What to do: Unless walking, limit workouts to 40 minutes, advises Turner. Instead of slogging away at a steady pace on the treadmill, try intervals (short, high-intensity efforts separated by brief rest periods), which have been shown to boost both fat burning and cardiovascular fitness. For example: five-minute warm-up, one-minute run at fast pace, one-minute run at moderate pace, repeat 10 times, five-minute cool-down. Also, incorporate strength training into three workouts each week.
Include some fat, protein and carbohydrates with every meal. If insisting on counting calories, shoot for 450 to 500 per meal and 150 per snack for women; 500 to 600 per meal and 200 to 300 per snack for men. Every week to 10 days, enjoy a carb-loaded “cheat meal” such as pancakes or pasta; it supports any languishing thyroid and feel-good hormones, gives associated neurotransmitters a jump-start and keeps us from feeling deprived.
Dark, Cold, Stressful Workplaces
Alan Hedge, Ph.D., a workplace design researcher with Cornell University, in New York, says women, who tend to have less muscle and body hair to provide natural warmth, are at particular risk of packing on pounds due to an overly cold environment. “When the body is cold, it adapts by laying down insulation, which is fat,” he says. Even without eating extra calories, if we’re constantly cold at work, as 31 percent of women are according to a recent CareerBuilder survey, we tend to gain about a pound or two per year, says Hedge.
Other research, conducted at Northwestern University, in Illinois, shows that workers exposed to more light in the morning weigh about 1.4 pounds less on average than those toiling in windowless cubicles. The suspected reason is that morning light triggers a cascade of hormones that positively impact appetite and metabolism. Another study, by Ohio State University researchers, found women that experienced a stressful event at work or elsewhere and then ate a fatand calorie-laden meal the next day burned 100 fewer calories from that meal than non-stressed workers.
What to do: At work, move the desk toward a window or at least take a walk every morning. Bring a space heater, extra sweater or hot tea fixings. After an ultra-stressful workday, eat especially healthfully that night. Lisa Marshall is a freelance health writer in Boulder, CO. Connect at LisaAnnMarshall.com.