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Your Functional Medicine Guide On How To Lose Stubborn Weight & Keep it Off For Good

How to Lose Weight & Keep it Off Dr. Will Cole

With every passing year, more Americans become overweight or obese and this metabolic epidemic accounts for 21 percent of all health care costs in the United States. The Centers for Disease Control estimates that more than 1/3 of Americans are obese and another third are overweight, meaning that less than a third of us are in a normal healthy weight range. From diabetes and heart disease to cancer to debilitating arthritis, obesity is linked with an increase in almost every chronic disease plaguing western society. For the first time ever in 2011, chronic disease killed more people than infectious disease. Is this our new reality?

Of course, there are plenty of so-called solutions out there. The weight loss industry is a multibillion dollar juggernaut, offering countless ways to “get skinny quick!” with the next popular magic plan, pill, or product. So why isn’t it working? Why does the problem keep gaining on us (so to speak)? In my opinion, the problem is the desire for a quick fix or an easy and immediate solution. Of course, the truth is that there are no magic pills that will suddenly erase excess weight and restore health.

Conventional wisdom tells us that the key to weight loss is based on the rough concept of “calories in vs. calories out.” That is, if you take in fewer calories than you burn, you will win the weight loss war. Easy, right? Just eat like a rabbit, and you can look like a supermodel. But deep down, we all know this isn’t how it really works. Experience tells us that this method brings the yo-yo dieter short-term success at best. At worst, eating a low-calorie diet may not help at all, especially in those with weight loss resistance, a condition that makes weight incredibly hard to lose.

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FUNCTIONAL MEDICINE CONSULTATIONS FOR PEOPLE AROUND THE WORLD

Are we doomed as a society to creep towards obesity? I don’t believe so. There is a missing link between lifestyle and a healthy body weight. As a functional medicine practitioner, my goal is to look at the underlying causes of chronic issues like weight gain and weight loss resistance, and what I know from years of experience with patients who have these problems is that there is no one reason for it, and no one solution either. As with any chronic condition, weight issues are multi-factorial. There are many pieces to the puzzle. But there is one key that I see in play again and again, especially when weight loss resistance is the problem. Here’s a clue: It has to do with the part of you where most of your immune system resides. Yep, you guessed it: your gut.

The gut is home to trillions of bacteria, and this community of critters is collectively known as the microbiome. Your body is comprised of 15 trillion human cells, and about 90 trillion bacterial cells. The bacteria in our bodies contain at least 150 times more genes than our human genome – in a way, you are more bacteria than human! And as it turns out, the composition of your microbiome has a distinct effect on how much you weight, and you influence that composition of bacteria every time you make a dietary choice.

For example, the standard Western diet, filled with refined grains, sugar, inflammatory fats (such as canola, vegetable, corn, and soybean oil) and food additives, can lead to inflammation in the gut, which can in turn lead to gut lining permeability (leaky gut syndrome). This increased gut permeability allows endotoxins from bacteria to escape the protective gut lining and circulate through the body, causing systemic inflammation. This systemic inflammation can also affect your brain (known as leaky brain syndrome), affecting the hypothalamus, which can lead to leptin resistance.

Leptin, a hormone produced by fat cells, is supposed to tell your brain to burn fat for energy and to tell your body when it is full, cueing you to stop eating. With leptin resistance, the brain doesn’t get the message. You store fat and stay hungry.

These are the conditions that define weight loss resistance. For some people, the struggle begins in childhood and may be triggered by a C-section birth or frequent antibiotic use. We acquire the seeds of our unique microbiomes during our trip down the birth canal, and from that moment on, our guts depend on our environments – what we eat, how often we are outside, what we are exposed to, what pets we have – to provide the diverse bacteria that keep us healthy and at an optimal weight. But when food is poor, and we are rarely exposed to the dirt and germs of the world, our beneficial bacteria may be reduced, and will be taken over by more pathogenic species. In short, our processed diets and sanitized lifestyles may come with a price tag: more chronic disease and obesity.

So always remember this: Being overweight does not cause poor health. Poor health causes weight loss resistance. Weight gain and weight loss resistance are symptoms, and weight loss alone is not the secret solution to health issues. The key to resolving weight issues is to get healthy first. Get healthy to lose weight, rather than losing weight to get healthy. This is the best and most sensible way to resolve problems like gut dysfunction and leptin resistance, which can help you finally achieve optimal health and your ideal weight.

Why You Still Aren't Losing Weight (Despite All Your Efforts)

Everyone is different with different reasons for their weight loss resistance and different things that will work for them. But, by looking at the top seven reasons why I see people fail at losing weight, maybe you’ll see yourself and change your course, breaking through your weight loss resistance and finally achieving the weight that will make you feel strong and healthy. Here’s what I’ve seen:

1. Unrealistic goals

Goals are critical to weight loss success,, but many people give up on their weight loss goals because they are not realistic. They think they can lose a huge amount of weight in a very short time, or won’t have to put in much effort or perseverance. If this was the case for you in the past, you may be left feeling too overwhelmed to try again. However, you can overcome this paralysis by analysis. Make realistic, small, short-term goals that push you just a little bit out of your comfort zone. When you reach your goal, make another one. A lot of small steps can add up to serious mileage over time.

2. Emotional eating

Eating should be enjoyable, but when the love of food is used as a coping mechanism during times of stress or sadness, it can turn unhealthy. If you’re an emotional eater, dealing with the underlying emotions that fuel compulsive eating is essential. Mindfulness meditation can help you become aware of the body’s true needs. Observing your thoughts and emotions, instead of mistaking yourself for them, allows you to break the habitual cycle of emotional eating and make rational choices.

3. Negative self-talk

You can’t heal a body you hate. I often see patients who aren’t able to get healthy and lose weight because of years of self-loathing. Think about the things you assume about yourself, consciously or subconsciously. Do you feel that you are not worthy of love or good things? These are false beliefs. You do deserve love, success, happiness, and health. To believe otherwise is to believe a lie. Get wise to your mind’s tricks and address those false beliefs head-on (sometimes a counselor or therapist can help). Believe me when I tell you that without self-love, even if you had the body you always wanted, it would never be enough.

4. Malnutrition

Are you starving yourself in an attempt to lose weight? Trust me when I tell you that this does not work, and in fact, may cause you to store even more fat. Do your body a favor and end punishing starvation diets and fat diets. What you weight is a result of countless and various physiological factors, but the bottom line is that to be nourished and to fully activate the body’s ability to balance its weight, sufficient amounts of good, healthy food are required. That may mean you will have to shift your perspective on food.

Instead of looking at how you can withhold food from your body as punishment for weight gain, ask yourself how you can heal your body with the therapy of delicious, nourishing food as medicine. It takes energy to make energy, and by chronically restricting food, you tell your body that it’s in starvation survival mode. Quit making your body so great at storing fat and teach it how to burn fat for energy instead!

5. So-called quick fixes

Do you have piles of exercise DVDs, weight loss products, and fad diet books that promise “4 minute abs” or “1 pill a day to melt the fat away” or “lose 20 pounds in a week”? The washboard abs and sculpted muscles on the covers feed the desperation to be fit, and the slim waists and tight arms feed the desperation to be thin. The problem is, these pie-in-the-sky plans don’t actually work. The minute you stop these unsustainable programs, you gain all your weight back and then some. Bodies simply don’t respond to this kind of drastic action. The simple fact is that there are no quick fixes or magic pills to buy online. The only solution is to make positive changes to your health and find strategies that work for you, then stick with them over time.

6. Weight loss prioritizing

You could seek whole-body, vibrant health, or just weight loss. These are not the same thing. Losing weight is not equivalent with getting healthy. Cancer and arsenic will make you lose weight, but you won’t be healthier. I consult with many skinny people who have high blood pressure, diabetes, and heart disease. Many people who are technically overweight are also quite healthy. Weight gain is a symptom, not a cause, and therefore, weight loss is just an attempt at bandaging a symptom without getting to the cause.

What is going on in the body and mind that is causing weight gain or weight loss resistance? The simple fact is that in order to get to your healthy body weight, you have to get healthy. You have to get healthy to lose weight, not lose weight to get healthy. Sustainable weight loss will be a natural byproduct of regaining health. If you get healthy, you will look great….as an awesome side effect!

7. Underlying physiological problems

If you are doing all the things you think are necessary to get healthy and lose weight, chances are good that the real problem is something else you are not addressing, such as an underlying hormonal imbalance, adrenal fatiguegut conditions, thyroid dysfunctions, or toxicity issues. All of these health problems can prevent the most dedicated person from ever losing weight.

When you are struggling, even the healthiest, lowest-calorie foods can cause weight gain. This is not your fault. Clinically investigating these underlying causes of stubborn weight loss resistance can help people finally find answers and make progress by addressing the underlying cause rather than the weight gain symptom.

Fortunately, functional medicine has a solution:

  1. Begin by requesting comprehensive gut diagnostics to uncover underlying gut issues so you know what you are dealing with.
  2. Use food and natural medicines to correct yeast, fungal, parasitic, or bacterial overgrowth.
  3. Repair the gut mucosa with functional foods like gut-healing bone broth.
  4. Repopulate your own gut with friendly flora by eating more naturally fermented foods such as sauerkraut and kimchi.
  5. Feed your body to restore full healthy liver function for optimal detoxification, so your body can eliminate toxins properly.

What Science Says About Successful Long-Term Weight Loss

Even though our culture is obsessed with dieting and working out, and despite having the most published diet books, exercise CDs, and fitness centers of any country, we are one of the heaviestsickest nations in the developed world. Clearly there is a disconnect, and when it comes to weight loss, I believe we’ve got it all wrong.

Functional medicine recognizes that weight gain is a symptom, not the cause of health problems. In other words:

We have to get healthy to lose weight, not lose weight to get healthy.

If you are suffering from weight-loss resistance, this should be your mantra because your weight gain and the way your body holds onto that excess weight is a sign that something else is going on underneath the surface. Fad diets may help you lose weight quickly, but that weight almost always comes back because the fad diet never addressed the underlying issue causing the weight gain.

Research shows that calorie counting and calorie restriction almost always fails when it comes to sustainable weight loss. The bottom line? We need to ditch dieting and get healthy first. That’s the best way to reach your goal weight and look great – as a side effect and a natural by-product of radiant health.

What’s the secret? Healing. Here are the four key areas (mind, emotions, gut, and hormones) you need to heal, and what you need to know to reach your health goals.

1. Heal your mind to break repetitive habits.

The first step to healing yourself is to become aware that most people spend most of their days lost in compulsive, unconscious thought. In fact, Stanford research estimates that a staggering 90 percent of our thoughts are repetitive. Think about that: Nine out of 10 of your thoughts are ones you have constantly. Are we all really so unoriginal?

The real problem with this repetitive thought process is how it can harm your health. For many people, these repetitive thoughts are not just repetitive but also negative. Negative thoughts create stress, and chronic stress can raise inflammation in our bodies and could contribute to health problems in the long term.

Further, research out of Cornell University found that we make about 200 food-related decisions each day, mostly mindless, the researchers found. In other words, we are not making conscious food choices to benefit ourselves. Instead, we are much more likely to make easy and poor food decisions because we aren’t thinking about how these decisions could be further contributing to poor health.

That’s why increased consciousness and mindfulness of thoughts – especially those having to do with food and health decisions – is the first step to healing and creating lasting health. When you take some time each day to observe your thoughts and consider them, you can begin breaking stress cycles and addiction cycles.

I recommend practicing mindfulness meditation as one way to become more aware of health choices and to eliminate negative, repetitive thought patters. Read my previous article for more practical tips.

2. Heal your emotions to heal your relationship with your body.

People tend to spend a lot of time feeling negative emotions, especially towards themselves. However, anxiety, fear, and hate flood the body with stress and stress hormones, and stress is linked to an increased risk of weight gain and many other health conditions.

You can’t heal a body you hate.

Instead of punishing your body into submission by restricting foods, make food your friend. The key is to eat it consciously and rationally. Your body is a gift and it is always doing its best to take care of you based on the conditions in which it lives and the resources it has. Love yourself enough to nourish your body with good food medicine and be kind to it.

Further, try to pinpoint what you might be holding onto from your past that’s keeping you from your goals. Forgiving yourself and others can be a revolutionary act of healing, and can finally remove the blockades to your weight loss and good health practices. I consider this emotional healing to be vital in my work helping patients overcome their health obstacles.

3. Heal your gut to make the most of the food you eat.

After dealing with the mind and emotions, the next step is to address the needs of the physical body, which can involve recovery from years of unknowingly (or knowingly) mistreating yourself.

As Hippocrates said, “All disease begins in the gut,” and that is where I like to begin, too. The health of your microbiome – the trillions of bacteria that live within you – determines many facets of your overall health, including weight. Weight gain is often related to an underlying gut problem. your microbiome could be damaged after years of junk food, toxins, stress, and harmful medications, and that is likely influencing your weight and health.

Healing the gut is a process, and I talk about that process in more detail in other articles, but herbal medicines like slippery elm, marshmallow root, and deglycyrrhizinated licorice (DGL) can be a good place to start. Nourishing bone broth and a strict limit on sugar, which feeds the more pathogenic gut bacteria, are also on my list of best ways to heal the gut.

4. Heal your hormones to use nutrients for good, not evil.

So you think your weight loss or health problems are about will power? Think again. Often, the real issue is a hormonal imbalance that has disabled your body’s ability to make rational choices about food. For example, I often see brain-hormonal connection problems in my patients who struggle with weight loss resistance, such as thyroid conditionsadrenal fatigue, and leptin resistance (when your brain doesn’t get the message from your hormones that your body is full).

Years of stress and poor diet can do a number on brain and hormonal health, further perpetuating hormonal dysfunction as well as brain inflammation, which can further aggravate your ability to make good decisions by contributing to anxiety, depression, and brain fog. healing your hormones and your brain is the final step in healthy weight loss and long-term wellness.

4 Fears That Could Be Preventing Sustainable Weight Loss

Fad diets make it all sound so easy, but they rarely work, and because so many people see short-term success but find themselves back where they started soon after, and go through this process again and again (the dreaded yo-yo cycle), they can become gun-shy. All that seeming success and ultimate failure can be deflating and humiliating. Of course it is. Nobody wants to feel like a failure. This can feel worse than just giving up and trying to forget about getting healthy. You may not be healthy, but at least you aren’t failing at your attempts. I’ve had many patients tell me, “I am never going through that again!”

But you can think about this in a different way. The truth is that the idea of being at square one (repeatedly) is an illusion. Each experience that didn’t turn out the way you hoped is a learning experience. You’re different than you were before – stronger and wiser because of that experience. If you need to lose weight, stop trying to lose weight to get healthy. Instead, get healthy so you can lose weight. There is no failure. There is only learning. Open the door to experience and start taking care of yourself, big-picture style. Maybe you need to address some underlying causes of weight loss resistance. Maybe you need to take it slow. Maybe you need to reframe habits one at a time. When you deal with these issues gently and kindly, weight loss will be a natural byproduct of getting healthy.

2. Fear of success

Wait, what? If you want to lose weight, why would you fear achieving that goal? This is surprisingly common. Some people aren’t ready to get healthy because of an unspoken fear of success. For years, they’ve found their identity in their health condition. They mistake their weight or their health condition for who they truly are. An uncomfortable or unpleasant familiarity can be less scary than a supposedly awesome unfamiliarity. This fear can make the success of healthy changes seem daunting and scary. Who would you be if you were thin, fit, and healthy? If you don’t know, you may fear the answer.

I’ve also seen many people fear that others would reject them if they lost weight. If they got healthy, they feel like they wouldn’t be able to relate to their friends anymore. But again, you can think about this in a different way. You are more than your outer form. You have a long, abundant life to live. Why cut it short? Why suffer unnecessarily? Your true self will always be there. You are only upgrading the “container,” which is your body. Train for a healthy life so you can life it to it’s fullest. When you are happy and healthy, those who love you will be happy, too.

3. Fear of admission

“I’m not really overweight.” “Everybody at my age has aches and pains.” “Of course I’m tired. I work hard.” I speak to a lot of people who are in denial about their health issues, or the severity of their issue. They compare themselves to someone who’s worse off than they are, deflecting their own issues. These people often equate how they feel with how healthy they are. They think that because they can function during the day, their health is decent enough. If this is you, you are missing out on the full spectrum of a life lived in a healthy, strong, fit body. By denying yourself this opportunity, you’re only hurting yourself and your loved ones. Instead, what if you admitted that you need to reclaim your health? What’s the worst that could happen? You might get healthier? If you try it, you may never look back, or wonder what took you so long.

4. Fear of responsibility

This one is possibly the most nefarious of them all and can feel debilitating to confront. People are terrified of fully recognizing that every bit they eat or don’t eat directly contributes to their health state. It feels much easier to pop a pill, ignore mild or moderate symptoms, and hang your hat on genetics, believing nothing can be done about it, whatever it is. But there is a better way to live.

The fact is, everything you eat will either contribute to the creation or destruction of your health. Are you choosing to feed disease or destroy it? Are you eating as if your life depended on it? Because it does. The foods we eat can turn off and turn on genes that code for diseases and chronic conditions that can compromise your quality of life drastically. I have seen the worst cases of autoimmune and chronic disease with genetic components become completely reversed with healthy lifestyle changes. So, what are you waiting for?

Franklin Delano Roosevelt said, “The only thing we have to fear is fear itself.” For your life and health, this is a deep and resounding truth. If you were waiting for the right time to finally take responsibility for your health by taking responsibility for your lifestyle choices, the time is now. Clinically, I regularly see people who have waited too long to reclaim their health and they have a much longer walk back. The sooner you start, the easier it will be. Why not today? If you aren’t sure what to do first, try out my real food challenge here.

5 Things That Can Interfere With Weight Loss

Many of my patients tell me that a chief goal of theirs is to lose some excess weight. This is easier said than done (as evidenced by the multi-billion-dollar diet industry) because weight struggles are more complex than just overeating and under-exercising. Many lifestyle habits contribute to weight gain and weight loss resistance. Often, the inability to lose weight is a symptom of a bigger underlying health problem or seemingly unrelated issue. Here are five common weight loss distruptors I see frequently in my clinic:

1. Poor sleep.

Irregular sleep cycles can lead to leptin resistance. Leptin is a hormone produced in your body’s fat cells that tells your brain to burn fat for energy and also signals your brain that you are full and can stop eating. If you become leptin resistant your hypothalamus doesn’t recognize leptin and goes into “hibernation mode,” storing fat unnecessarily. Eating less just makes the situation worse because your body already thinks you are starving, and this stressful state jacks up cortisol levels, causing adrenal fatigue. It’s a perfect storm for rapid weight gain and trouble with losing it.

2. Poor microbiome health.

What you eat can either feed your microbiome or destroy it. If you’re eating a diet full of processed foods and sugar, you are feeding the bad guys and starving the good ones. This can lead to increased intestinal permeability (leaky gut syndrome) and can also increase fat around your organs and contribute to metabolic syndrome. Studies have shown that people who eat a wider variety of fermented foods like sauerkraut and kefir on a regular basis generally have greater bacterial diversity (meaning more good bacterial in the gut), which has been correlated with lower weight.

3. High stress levels.

Mental health plays a significant part in healthy weight management and chronic stress in particular has been implicated in health issues ranging from adrenal fatigue, and autoimmune conditions to, digestive issues – all of which can impact your weight. Stress alone can actually slow down your metabolism and increase food cravings! Start combating stress with mindfulness tools like meditation, deep breathing, and gentle stretching, to start healing and jump-start the weight loss journey.

4. Toxin exposure.

We all come in contact with toxins on a daily basis, predisposing us to autoimmune, digestive, and hormonal problems that can contribute to weight-loss resistance. Some people have an even greater toxic burden than average due to workplace exposure (artists, hair stylists, people working in agriculture, etc.) If you aren’t sure about your exposure, ask your doctor about tests for toxin levels and reduce exposure when possible by using more natural personal care products and cleaning products.

5. Other underlying health problems.

Hormonal imbalances and gut issues easily discovered through basic lab tests could be playing a major role in weight loss resistance. Find out your levels so you know what to address. Here are some good tests to start with:

Cortisol: Your adrenal glands release cortisol, your body’s main stress hormone. When there is too much or too little it can lead to adrenal fatigue.

Testosterone: When this hormone is too low for men and too high for women, it leads to weight gain.

Estrogen: Men and women can have estrogen imbalance. There are three types of estrogen in your body – estrone (E1), estradiol (E2), and estriol (E3), and you need the proper ratio between each. Too much can lead to rapid weight gain.

Progesterone: This balances the effects of too much estrogen; without it, estrogen can cause more trouble.

Thyroid: Every cell in your body needs thyroid hormones to function. Autoimmune thyroid problems, thyroid resistance, and thyroid conversion problems are all possible thyroid issues.

Microbiome: Studies have shown that people who are overweight have less microbiome diversity and that people who have leaky-gut syndrome tend to be more overweight. This can lead to metabolic syndrome and can further perpetuate inflammation and hormone imbalance.

These labs can help determine your level of gut permeability:

  • Zonulin and occludin antibodies: These proteins govern gut permeability. Antibodies could indicate damage to the tight junctions that seal the intestinal lining.
  • Actomyosin antibodies: The presence of these could indicate gut lining destruction.
  • Lipopolysaccharides (LPS) antibodies: These bacterial endotoxins could indicate leaky-gut syndrome.

Finally, remember that losing weight is only part of the journey. If you have an underlying issue and are restricting calories and exercising like mad, you could be exacerbating the problem, not solving it. When health is your priority, weight loss will follow as a natural result of healing your body from within.

References

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  8. Cheng, Jianfeng, Pardeep S. Brar, Anne R. Lee, and Peter H. R. Green. “Body Mass Index in Celiac Disease: Beneficial Effect of a Gluten-Free Diet.” Journal of Clinical Gastroenterology 44, no. 4 (April 2010): 267–71. https://doi.org/10.1097/MCG.0b013e3181b7ed58.
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  12. Forsythe, L. Kirsty, Julie M. W. Wallace, and M. Barbara E. Livingstone. “Obesity and Inflammation: The Effects of Weight Loss.” Nutrition Research Reviews 21, no. 2 (December 2008): 117–33. https://doi.org/10.1017/S0954422408138732.

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BY DR. WILL COLE

Evidence-based reviewed article

Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.

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