With my bias against almost all diets, and with bias against a focus solely on weight, I feel a need to address the myth that eating less and exercising more always leads to weight loss. We might have been taught that scenario in medical school, but it is a paradigm of an older era. Worse, it is an oversimplification of the complexity of the human body. For proper health and appropriate weight, we need to redirect our focus to the key factors that shape our health and weight, including the correct alignment of our hormones.
For example, let’s take the example of that patient who presents to the physician with complaints of weight gain, physical fatigue, and depression. One physician might tell the patient to eat less and exercise more. Another physician might test the patient’s thyroid, determining that it’s low and starting a thyroid medication like T4. Another physician might assess the patient’s depression as the key factor and start an antidepressant. After all, depression is becoming the world’s most common diagnosis. Today one in ten Americans take an antidepressant medication. So, that’s three different treatment approaches for the same patient.
But what have they each missed? What if the patient is extremely stressed and has a high cortisol level? A high cortisol can lead to reduced thyroid function. Treating the thyroid will do nothing to correct the primary problem with the patient’s stress and cortisol level. What if the patient has a poor diet with reduced minerals? Low levels of copper, zinc, and selenium can slow down the thyroid. A low level of Vitamin D can also slow down the thyroid. Can you see my point? Treating the thyroid is the wrong level of treatment. The best treatment should aim at correcting the causes of the reduced thyroid with reduced stress, more sunlight (Vitamin D), and improved food selection with more nutrient rich, mineral rich foods.
Now, what about the physician who selects depression as the primary diagnosis? What’s the quickest solution? An antidepressant. The physician might even have written a prescription for the antidepressant, then recommended less eating and increased exercise. But is that approach treating the root of the cause? Not really. Maybe the person needs to talk to someone (therapy) and make some changes to reduce the level of stress. Maybe the person needs to change their eating approach for healthier foods. The problem with that antidepressant? Many antidepressants cause weight gain. So, once again, the patient and the physician are left with a wrong (and much too superficial) approach.
Let me explain some basic information that relates to weight and the distribution of fat in your body. For a woman and her health / weight, the top three hormones are cortisol, estrogen, and thyroid. For men, the top three hormones for his health / weight are cortisol, testosterone, and thyroid. In addition, for men and women, there are two other hormones of significance: insulin and leptin. Insulin directs the flow and controls the deposit of your sugar. Leptin controls the deposit of fat and the sense of hunger. To tell the patient to eat less and exercise more does nothing to address the imbalances that might exist between these hormones. Eating less (or eating the wrong food in an effort to eat less) may further disrupt the hormonal balance, leading to weight gain, regardless of the fewer calories.
So, what is my point? What can we do? We can stop viewing our weight as an isolated physical state. We can start viewing weight as part of a larger puzzle, which needs to be teased apart, carefully inspected, and then put back together. In the end the patient and the physician are faced with the same picture (the same symptoms of increased weight, fatigue, and depression), but now they have a much clearer view of what needs to be changed as you reassemble the pieces. From my own vantage point, the solution does not lie with reduced eating and increased exercise. It does not lie with another pharmaceutical drug. You need to realize that you have another option. The best solution involves taking a nutritional approach.
My recommendation for the patient is don’t eat less. Just change what you eat. Isn’t that my approach for improved health, increased vitality, and greater longevity? But here is the key. The nutritional approach varies for each age, each individual. For women, there is premenopause and menopause, plus the menstrual cycle and PMS. For men, there is andropause (when men produce less testosterone). Do you want to take a pill for each of these conditions? No. You want to gain an understanding of how your nutritional needs change. How eating style can change the hormonal balance, helping you to avoid fat deposit. Am I worried about weight? No.
But I am concerned how fat produces toxins that are bad for your health and bad for your brain (and its cognitive function). So, I do not want you to focus on calories and weight. For me, our society is overly concerned about our physical appearance and our society offers too many wrong solutions. Take stock of your stress and your cortisol level. Take stock of eating style and how it might be impacting your thyroid function and your overall metabolism. Take stock of your age and your likely levels of either estrogen or testosterone. Then follow Hippocrates advice to “Let food be thy medicine.” Hippocrates did not argue for you to eat less; he argued for you to eat better. That is my reframe. With these blogs, you will learn to eat better. With these blogs, weight will become less of an issue. Our focus will remain on health, not weight; and our solution will stay geared toward nutrition. That is our frontier. That is what we need to learn. Agreed?