Have you exercised or reduced calories and still not lost weight? You most likely have medical problems that are managed with lifestyle and medical treatments.
Once your belly reaches a certain size or BMI (basal metabolic index) is 30, you have a combination of insulin resistance, abnormal CRP (C reactive protein) and/or leptin resistance which are medical problems diagnosed with simple blood chemistry tests. These treatable conditions regulate appetite, fat cells, metabolism and more (immune functions, circulation and much more). Specific treatments are often needed to address each portion of the combination.
Appetite and weight regulation are largely controlled by the pituitary and hypothalamus. Pituitary and hypothalamus functions are affected when insulin or glucose, CRP and/or leptin is abnormal. Other issues can be involved, such as abnormal but treatable serotonin or dopamine, but here we’re focused on specific weight chemistry.
The chemistry of weight problems were discovered in the last 10 -15 years so most people have never heard of these. Many clinicians do not test these or have no experience in treating these.
A mother recently brought in her overweight 11 year old son. The boy did not lose weight despite exercise and a healthy diet. Her pediatrician who did some testing, but not the blood chemistries of weight problems. My evaluation showed insulin resistance, abnormal CRP, abnormal leptin, abnormal ECG (heart evaluation), abnormal metabolism and abnormal cholesterols. Unless he’s lucky or managed with medical treatments, weight will not go down and he may progress to immune problems, high blood pressure, circulation problems, metabolic problems, diabetes and/or other degenerative conditions sooner rather than later.
Insulin resistance is mostly due to a combination of genetic risks, insufficient exercise and too many calories. Many people will not lose weight until insulin resistance is diagnosed or treated. A four hour glucose tolerance test is the best way to diagnose and manage this. There are limited drugs but plenty of lifestyle changes and alternative medicines to control insulin resistance.
Abnormal CRP means immune and circulation damage is present (also known as vasculitis). It also means the normal appetite centers and weight control mechanisms can be out of control. Many people will not lose weight unless CRP is normalized. There are alternative medicines and approaches to normalize CRP to treat or prevent circulation problems and help with weight and appetite control. One statin drug has been approved to suppress CRP, but side effects can develop, especially heart disease and diabetes.
Leptin resistance is created when you have too many fat cells, especially around the belly. When leptin is normally functioning, as your stomach fills up, leptin signals the brain it’s time to stop eating. With leptin resistance, the signal is disrupted, so you don’t feel full and keep on consuming calories or hold onto fat cells. Many people will not lose weight until leptin resistance is diagnosed and treated. There are no drugs for leptin resistance but there are plenty of alternative treatments to help out.
I hope you now understand the basic chemistry of weight problems and seek treatment from an experienced clinician. Weight loss is key to managing and preventing many degenerative conditions.
David Overton, PA-C works at Natural Medicines & Family Practice providing integrated conventional and alternative treatments under the supervision of Dr. Richard Faiola, MD, ABFM.