You exercise and you count your calories. You’ve substituted your french-fries for a salad and your latte for an herbal tea. For many people, the pounds start steadily falling off the scale and all is well in the world. But, for you, the weight just won’t budge. What else could be going on?
As much as we focus on calories in and out of the body, weight management is far from such a simple equation. The entire story must consider blood sugar regulation[1], medication side effects[2], psychological barriers[3], obesogens (hormone-disrupting chemicals like phthalates)[4] and imbalanced hormones. While it’s crucial to address thyroid health for weight gain, an often-overlooked hormone is cortisol.
If you’ve seen any Naturopathic doctor, you already know that cortisol is released by the adrenal glands in response to stress. It is a great hormone in the short term to help us cope, but over the long-term chronic cortisol elevation can lead to an array of health concerns and weight gain tends to be one of the biggest issues.[5]
Elevated cortisol directly increases blood sugars and fat storage.[5] Moreover, cortisol blocks the activation of thyroid hormone, which leads to a slower metabolism.[5] As if this all wasn’t bad enough, when we’re stressed, we crave sugars and junk foods.[5]
So what does this mean for you? You not only have to watch what you eat, how you eat and how you move, but you also need to keep your stress and cortisol levels in check. Deep breathing techniques[6], laughter[7] and proper sleeping habits are all great places to start. Irregular or poor quality sleep can directly increase cortisol levels and reduce growth hormone release (which is important for healing and metabolism).[8] When we consider these hormonal alterations, it is no surprise that sleep deprivation has been linked to poor stress coping, unhealthy food cravings, obesity and diabetes.[9]
There are also specific supplements that have been studied for their ability to normalize the stress response and to balance cortisol. For example, a high quality B-vitamin complex[10] and adaptogenic herbs like Rhodiola Rosea[11] and Withania Somnifera[12] may be indicated in select weight loss cases, but it is best to consult with a Naturopathic practitioner first.
If, even after making these healthy lifestyle adjustments, the weight isn’t moving, it is likely that a more in-depth look at your hormones or more lab testing is necessary. The basics such as Vitamin D, Ferritin and Vitamin B12 cannot be overlooked but advanced testing such as the Dutch Test can be extremely helpful for pinpointing the problem.
All in all, weight loss is a difficult process for many people, and it is often unfair. There are so many factors at play and they are not always easy to identify or rectify even with targeted lab testing and a holistic approach. Just know that weight management is not simply calories out > calories in.
In Health,
Dr. Colin O’Brien, ND
[1] McMillan-Price J et al. Comparison of 4 diets of varying glycemic load on weight loss and cardiovascular risk reduction in overweight and obese young adults: a randomized controlled trial. Arch Intern Med 2006; 166:1466–1475 http://www.ncbi.nlm.nih.gov/pubmed/16864756
[2] Angelakis E et al. Abnormal weight gain and gut microbiota modifications are side effects of long-term doxycycline and hydroxychloroquine treatment. Antimicrob Agents Chemother. 2014 Jun;58(6):3342-7
http://www.ncbi.nlm.nih.gov/pubmed/24687497
[3] Pedram P and Sun G. Hormonal and dietary characteristics in obese human subjects with and without food addiction. Nutrients. 2014 Dec 31;7(1):223-38.
http://www.ncbi.nlm.nih.gov/pubmed/25558907
[4] Heindel JJ, Newbold R, Schug TT. Endocrine disruptors and obesity. Nat Rev Endocrinol. 2015 Nov;11(11):653-61. http://www.ncbi.nlm.nih.gov/pubmed/26391979
[5] Christiansen JJ et al. Effects of cortisol on carbohydrate, lipid, and protein metabolism: studies of acute cortisol withdrawal in adrenocortical failure. J Clin Endocrinol Metab. 2007 Sep;92(9):3553-9 http://press.endocrine.org/doi/full/10.1210/jc.2007-0445
[6] Kim SH et al. PTSD symptom reduction with mindfulness-based stretching and deep breathing exercise: randomized controlled clinical trial of efficacy. J Clin Endocrinol Metab. 2013 Jul;98(7):2984-92.
http://www.ncbi.nlm.nih.gov/pubmed/23720785
[7] Bennett MP and Lengacher C. Humor and Laughter May Influence Health: III. Laughter and Health Outcomes. Evid Based Complement Alternat Med. 2008 Mar;5(1):37-40 http://www.ncbi.nlm.nih.gov/pubmed/18317546
[8] Van Cauter E, Spiegel K, Tasali E, Leproult R. Metabolic consequences of sleep and sleep loss. Sleep Med 2008;9(Suppl 1):S23–8
http://www.ncbi.nlm.nih.gov/pubmed/18929315
[9] Knutson KL, Van Cauter E. Associations between sleep loss and increased risk of obesity and diabetes. Annals of the New York Academy of Sciences 2008;1129:287–304. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394987/
[10] Head KA and Kelly GS. Nutrients and botanicals for treatment of stress: adrenal fatigue, neurotransmitter imbalance, anxiety, and restless sleep. Altern Med Rev. 2009 Jun;14(2):114-40. http://www.ncbi.nlm.nih.gov/pubmed/19594222
[11] Panossian A, Wikman G, Sarris J. Rosenroot (Rhodiola rosea): traditional use, chemical composition, pharmacology and clinical efficacy. Phytomedicine. 2010 Jun;17(7):481-93. http://www.ncbi.nlm.nih.gov/pubmed/20378318
[12] Singh N et al. An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):208-13.
http://www.ncbi.nlm.nih.gov/pubmed/22754076
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