Obesity clearly poses a danger to health, having been associated with numerous health problems including heart disease, high blood pressure, diabetes, and certain types of cancer. However, diets for weight loss have been shown to be ineffective and even damaging to health. A well-balanced diet which avoids fat-building foods, regular exercise, drinking adequate amounts of pure water, and stress reduction can help maintain a healthy weight compatible with one body type.
Weight loss has become a national obsession in America. As many as 40 percent of women and
24 percent of men in the United States are trying to lose weight at any given time through such
diverse methods as diets, exercise, behavior modification, and drugs.’ While this obsession is often
fueled by psychological needs (the urge to con- form to an artificial standard of beauty fostered by
media, fashion, and peer pressure) rather than physical needs, the underlying fact is that one-quarter
to one-third of Americans are overweight. 2 Even more troubling, according to Joseph E. Pizzorno,
N.D., President of Bastyr College in Seattle, Washington, is the fact that the number of severely obese
children in the United States nearly doubled between 1965 and 1980. This trend, if it continues, will only lead to an even greater frequency of adult obesity as these children grow up.
This is even more alarming because excess weight has been linked to a number of health problems, including high blood pressure, heart disease, diabetes, gallbladder disease, respiratory conditions, as well as breast and endometrial cancer in women, and cancer of the colon and rec- tum in men. Obesity has also been shown to re-suit in a decreased lifespan for both women and men.3 The answers to weight gain and weight loss though. are not always simple and easy. Under controlled settings, most people trying to lose weight are usually able to lose about 10 percent of their total body weight, but one-third to two-thirds of that weight is regained within a year, and almost all is regained within five years. Oftentimes. excessive dieting and weight loss regimens can actually lead to increased weight gain.
Causes of Obesity and Weight Gain
Obesity is indicated by an abnormally high proportion of body fat, but, according to Timothy Birdsall, N.D., of Sand point, Idaho, “Although it is commonly assumed that obesity is due to over eating, there is, in fact, a complex interaction between one’s culture, environment, exercise habits, and eating styles, as well as one’s genetic makeup, biochemical individuality, and physiological “set point.”
The set point theory states that one’s size and body fat are determined by genetics, eating patterns and calorie intake at certain key times in life such as early adolescence. “These patterns
are relatively fixed.” says Elson Haas, M.D., Director of the Preventive Medicine Center of Marin in San Rafael, California. “Attempting to arrive at a weight above or below one’s set point range causes physiological mechanisms which ultimately force behavioral changes and a return to one’s previous weight. A good example of this is the rapid weight gain that can happen after coming off a diet, especially a low-calorie starvation diet. The body reacts to what it perceives as a threat, quickly regaining the weight to once again reach its natural set point.”
There are also cases where excess weight is gained because of conditions such as food allergies and nutritional deficiencies which are often treatable. Other times weight gain may be due to a sluggish metabolism, chemical toxicity, insulin imbalance, impaired thermogenesis (the mechanism by which fat is burned to produce heat), excessive dieting, or psychological factors. In rare cases obesity occurs as a signal that a more serious disease is present, such as hypothyroidism or Cushing’s syndrome (hypersecretion of adrenal cortex, in which excessive glucocorticoids are produced, disrupting protein and carbohydrate metabolism).
“Thin people have higher metabolic rates and burn calories at a much faster rate than their obese friends.” says Majid Ali, M.D.. Associate Professor of Pathology at Columbia University in New York. Metabolic rate can be understood as being the rate by which the body utilizes energy. The basal metabolic rate (BNIR), which varies tremendously between individuals, is the minimum amount of energy needed to maintain normal body functions. Age, sex, body size, and fat to muscle ratio are all factors that influence how efficiently an individual burns calories. Even when individuals are matched for all of these factors, they can exhibit a 30 percent difference in BMR.4 The types of food a person eats may also affect metabolic rate. According to Dr. Birdsall, carbohydrates are most effective in raising the metabolic rate. He points out that while fats can also increase the metabolic rate, they contain more calories per gram than carbohydrates and are therefore much less effective. “Fats have a negative net effect because, while they may increase the metabolic rate somewhat, they don’t increase it enough to offset the added calories.”
An inefficient thyroid gland (hypothyroidism) can be the cause of sluggish metabolic rate, according to Dr. Birdsall. And while it is possible that laboratory tests will not indicate the existence of hypothyroidism, other tests, such as basal body temperature, and symptoms, such as chronic constipation, fatigue, feeling cold, and a tendency to gain weight, may point to subclinical hypothyroidism. Correcting this problem can often lead to weight loss, adds Dr. Birdsall.
The body contains two types of fat tissue—white adipose tissue which stores fat, and brown adipose tissue (BAT), which burns up fat to produce heat in a process called thermogenesis. Evidence indicates that an impairment of the thermogenesis system in BAT may lead to obesity.5 If fat from the diet is not burned up by BAT, it is stored as fat in white adipose tissue, thus contributing to excess body weight. Chronic dieting can alter BAT’s responsiveness, lowering diet-induced thermogenesis and causing increased hunger, according to Dr. Birdsall.
Fat-Stored Chemical Toxins
For the past ten years, Zane R. Gard, M.D., of Beaverton, Oregon, and his partner and wife, Erma Brown, B.S.N., P.H.N., have been studying the effects of environmental toxins and detoxification on health. “Although humans adjust well to a changing environment, exposure to harmful chemicals is now occurring at a rate faster than the human body is able to adapt,” says Dr. Gard. He notes that most environmental toxins are stored in fat tissue, and he refers to the accumulation and storage of these poisons in the body as “toxic bioaccumulation.” He points out that one physical response to subtoxic chemical exposure is obesity and possibly a higher fat to muscle ratio.
“Many cases of obesity are due to an imbalance of the hormone insulin,” says David K. Shefrin N.D., of Beaverton, Oregon. Insulin allows the body to utilize glu¬cose (sugar) and carbo¬hydrates. Factors such as genetic predisposition, food allergies, eating habits, and stress may interfere with glucose and carbohydrate utiliza¬tion, resulting in a condi¬tion known as glucose intolerance. Excessive sugar consumption fined carbohydrates) may also contribute to glucose intolerance and obesity.6
“If insulin is not rapidly cleared from the bloodstream after a meal, it will cause an individual to feel hungry,” says Dr. Shefrin. “Usually insulin will signal the body to stop eating, but if a person has chronically elevated glucose levels due to inefficient insulin, he may eat more.” Thus, the more refined carbohydrates a person eats, the hungrier he or she may become.
Research also shows that overweight individuals burn up sugar less effectively than individuals of normal weight, and that dieting only makes this problem worse. The same research concludes that this trait is a part, not a consequence, of obesity.’
“When an overweight person becomes more obese, the insulin problem becomes worse as well, because the individual becomes more unresponsive to the action of insulin,” says Gus Prosch, M.D.. of Birmingham, Alabama, an obesity specialist. “In such a person. the simple carbohydrates are triggering the release of increasing amounts of insulin, but the body cannot use it efficiently. This is why we see high insulin levels in overweight people. Apparently the insulin receptors on their body cells are blocked from doing their function. This prevents insulin from stimulating the transfer of glucose to the cells to give them energy, which explains why so many overweight people feel tired so often. To make matters worse, since the insulin is not converting the glucose to energy, more glucose is then moved into the fat cells to create more fat.”
This imbalance in insulin hormone functioning can cause other See Diabetes. dependent and related hormones to Hypoglweinia• function abnormally and less effi-ciently as well, according to Dr. Prosch. “Ultimately, either the insulin receptors or the pancreas itself wears out or becomes exhausted, in which case diabetes can result,” he says.
This excess insulin in overweight people can lead to other problems and complications, Dr. Prosch points out. These include:
· Increased salt and water retention
· Sleep disorders caused by insulin interference with neurotransmitters
· The production of more LDL, or bad cho-lesterol, by the liver due to insulin stimulation
· Interference with the thyroid hormone thyroxine, thereby aggravating low metabolism
· Decreased cell wall permeability, which can cause an increase in cell size
· Hypoglycemia, hunger, and a further craving for simple carbohydrates
“These factors illustrate why simple carbohydrates are so detrimental to the health of America,” says Dr. Prosch. “The number of overweight and obese people in this country is constantly increasing, and the problem will continue to get even worse until our health leaders learn the truth and fulfill their responsibility to inform citizens of these facts.”
Low-calorie diets and exercise have been the typical solution to losing weight. With thousands of diets and a multimillion dollar industry dedicated to weight control, shedding a few pounds should be easy. Unfortunately, the weight lost by dieters is almost always regained. As a result, many dieters fall into the “yo-yo trap”—a repetitive cycle of weight loss and gain.
Susan Kano, a national speaker and author on dieting and eating disorders, tells a story about a friend who had not only been trying to lose weight for years, but was also in the dieting business. Initially she struggled to get from 165 pounds down to 120. After a while, her weight returned to the 165 mark. Over the years, as she tried one diet after another, her weight yo-yoed up and down. Today she continues to diet and weighs over 200 pounds.
There are several reasons why this happens and why food restriction for the purposes of weight loss should be avoided. “We have gotten fatter as a cul- ture over the last few years,” says Kano, “partly because of dieting.” Whenever the body is deprived of food, whether from famine or dieting, it ensures survival by decreas- ing the metabolic rate in order to compensate for fewer calories. Energy is stored so efficiently in adipose (fat) tissues that someone of normal y-eight can survive for two months without eat-
mig. The desire to binge after food restriction, though disheartening to dieters, is another built- In survival mechanism intended to click on after a famine.9 “Our innocent cellular metabolism has no way to tell the difference between self-imposed starvation and life-threatening famine,” says Nancy Dunne, N.D., of
“Dieting can be a cause of obesity, and not the way to lose weight,” adds Dr. Ali. “Dieting not only slows down the metabolic enzymes, but leads to the emaciation of muscle cells, bloating of fat cells, accumulation of toxic fats in tissues, and fatigue. The more rapid the weight loss, the higher the risk of heart complications from muscle loss as well.
“An obese person needs to gain muscle mass and increase the amount of fat-burning tissue,”continues Dr. Ali. “This usually means a slight initial weight gain, or at least absence of weight loss. This happens because muscle tissue is heavier than fat tissue. Only then can someone hope to increase the rate of burning, and losing, fat,” says Dr. Ali.
Weight Loss Medications
Weight loss medications work in several ways, principally by either stimulating the nervous system or by suppressing appetite. All weight loss drugs have side effects though, according to Dr. Ali, and therefore he does not recommend anyone use them. Some of the more common problems associated with these drugs include adverse effects on the heart and blood pressure, an increased level of toxic fat in the tissues, as well as a variety of degenerative diseases.
Food is an intricate and tightly woven part of social activities, childhood memories, and psyches. Food is used to help celebrate almost all major holidays and events. In the United States, birthdays are marked by cakes and ice cream; Halloween is centered around candy and other treats; July 4th celebrates with picnics; and Thanksgiving, with its traditional feast of turkey
stuffing, and gravy, isn’t complete without a thick slab of pumpkin pie and whipped cream. Even romantic dating centers around eating.
Dieting can make a person feel down, like he or she is actually depriving him- or herself of something, and eating can temporarily curb feelings of loneliness and depression. While many. people eat “comfort foods” under stress, problems can emerge when unhappiness leads to chronic overeating. When someone eats for reasons other than hunger, especially if this is done frequently, professional help may be required.
The National Institutes of Health (NIH) has outlined a specific protocol for modifying unhealthy eating behavior brought on by psychological factors. First of all, each individual needs to identify the eating or related lifestyle behaviors to be changed, then one needs to set specific behavioral goals, modifying the psychological determinants of the behavior to be changed. and thus, reinforcing the desired behavior. According to the NIH, “The goal of behavior treatment is to modify eating and physical activity habits, typically focusing on gradual changes. Behavior modification can be undertaken through group or individual sessions under the guidance of professional or lay personnel, and alone or in conjunction with other approaches.”
Dr. Birdsall believes that proper diet and exercise are the most effective ways to lose weight. However, he feels that it is not a matter of how much a person eats, but what the person eats that is important, and that one’s diet must be high in complex carbohydrates. Other approaches to treating obesity include detoxification, stimulat
ing thermogenesis, and correcting any underlying condition affecting one’s weight such as insulin imbalance or hypothyroidism. Herbs and nutritional supplements may also prove beneficial in some cases.
The typical American diet includes more refined and processed foods than the diet of any other nation. When food is refined and processed, not only is fiber removed, but simple sugars often replace complex carbohydrates. A diet low in fiber and high in simple sugar can be a major contributing factor to excess weight gain. Fiber, on the other hand, can have a major impact on weight gain as evidenced by the almost complete lack of obesity in cultures that consume a diet high in fiber.” Fiber has been shown to not only reduce serum cholesterol, but to also pull dietary fat from the body into the feces. Other benefits of roughage include increasing chewing time, thus slowing down the eating process and inducing satiety, preventing constipation, and stabilizing blood glucose levels.”
A whole foods, whole grain, high-complex carbohydrate, low-fat (less than fifty milligrams daily), high-fiber diet is recommended by Dr. Birdsall. He suggests a maximum of 25 percent of the daily food intake be in the form of fat. In general, this amounts to forty-five to fifty grams per day, which represents about 450 calories. He believes lowering dietary fat and exercise are the two key factors to weight loss.
Dr. Haas points out that certain people will do better on different types of diets, with the one consistent factor being that the diets be low in fat. “For instance, some people will do better on a low-carbohydrate diet, instead of one that is high in carbohydrates,” he says. “As long as the fat content of the diet remains low, the overweight person can have success.” This was verified by a Cornell University study which showed that when women were allowed to eat as much as they wanted, with the only restriction being that they had to consume low-fat foods (only 20 to 25 percent of calories as fat), they lost weight.I5 This is due to the fact that fat contains more than twice as many calories per gram as protein or carbohydrates. A Swiss study also revealed that, unlike carbohydrates, approximately 90 percent of extra fat consumed during a meal is converted to body fat.16 Very fatty foods may also encourage overeating because more needs to be consumed in order to maintain the body’s natural storage of glucose.” Weight loss should therefore be directed toward a change in eating habits rather than dieting.
Alcohol should also be avoided or minimized, since it has been found to act like a fat in the body and promote weight gain. J. P. Flatt,
Ph.D., from the University of Massachusetts Medical School, estimates that one ounce of alcohol represents one-half ounce of fat in the diet.t8 Cigarettes, which are used by many people to manage their weight, also appear to steer extra fat to the abdomen. In addition, both of these substances should be especially avoided by those who are prone to glucose intolerance.
Chromium plays an important role in sugar and fat metabolism. Over the years, research has demonstrated that chromium deficiency impairs glucose tolerance, increases circulating insulin levels, boosts blood sugar levels, allows’ sugar to spill into the urine, and elevates serum triglycerides and cholesterol.’9
Zinc is needed for normal taste acuity and enhances the effectiveness of insulin. If a person overeats in part because food has no flavor, then zinc may be the answer.2° A zinc taste test, performed by your physician, will determine if you have a zinc deficiency.
According to James Braly, M.D., Medical Director of Immuno Labs, Inc., in Fort Lauderdale, Florida, other essential nutrients for weight loss and weight management include vitamin A, beta-carotene, vitamin B3, vitamin B6, biotin, vitamin C, and vitamin E.
Dr. Braly also recommends daily supplementation of essential fatty acids with evening primrose oil and MaxEPA (a fish oil), as well as two multiple amino acid capsules taken one half hour before each meal.
Obesity is almost always associated with toxicity, as many toxins are stored in fatty tissue, according to Dr. Haas. “When we lose weight we reduce our fat and thereby our toxic load. However, during weight loss we release more toxins and thus need protection through greater intake of water, fiber, and the antioxidant nutrients such as vitamins C and E, beta-carotene, selenium, and zinc.” He adds that L-cysteine can also be used, as it helps liver and intestinal detoxification processes.
Michelle Pouliot, N.D., from Torrington, Connecticut, recalls a woman in her mid-forties who sought help for a weight problem. The woman had many surgeries and an extensive history of prescription drug use. Dr. Pouliot helped to stabilize the woman’s health then put her on a detoxification program using a whole foods diet,
an occasional two-day vegetable juice fast, mild exercise, and meditation.
To help the woman release toxins through her skin, Dr. Pouliot instructed her to soak in an Epsom salts bath and do dry brush massages three times per week. Drinking eight glasses of water per day supplemented with cranberry juice extract helped her kidneys flush out poisons. Fiber supplements moved waste out of her colon and milk thistle helped her liver detoxify substances more effectively. Finally, deep breathing exercised her lungs. After three weeks, she had lost seventeen pounds.
Dr. Gard and Erma Brown have developed the BioToxiel Reduction Program to detoxify individuals suffering from chemical toxicity. The program includes heat, physical therapy, nutritional supplements, and other treatments. Although people use the treatment program for detoxification, about 75 percent of the patients who are overweight end up losing weight. However, it is not wise to deliberately attempt to lose weight while going through a detoxification program since this makes it difficult to keep nutritional supplementation in proper balance.21 Brown also cautions that such a program
should only be undertaken with proper medical supervision.22
Correcting Insulin Imbalance
According to Dr. Pouliot, the insulin imbalance theory seems particularly applicable to women who have twenty pounds or less to lose. “A lot of women who are in this twenty pound range,” says Dr. Pouliot, “have a history of yo-yo dieting and their bodies are very resistant to weight loss. With most women first I will try decreasing fat intake to thirty grams per day and increasing exercise. For some women that’s enough to get them losing weight, and for others, not at all.” For these women Dr. Pouliot uses a special plan that addresses insulin imbalance.
In one such case, a thirty-year-old fabric salesperson came to see Dr. Pouliot when she developed asthma after moving into a moldy basement apartment. Because the asthma, along with medications that were prescribed to treat it, restricted her activity, she also gained about thirty pounds. After Dr. Pouliot stabilized her health with various herbs and nutrients, and gave her ephedra and yohimbine, herbs which encourage the burning of fat (see Herbal Medicine section of this chapter). Dr. Pouliot also put her on a diet designed to rebalance her insulin and told her she could eat one meal a day containing unlimited amounts of carbohydrates, but the other two meals could not contain more than four grams of carbohydrates each. She also had her exercise every other day, when able. Not only did the woman lose the extra weight, but her asthma improved markedly.
“Food fuels the furnace of metabolism; exercise stokes its fire,” says Dr. Ali. Yet, almost as important as exercise, is what kind of exercise one does. Exercise that causes sweating and heavy breathing is sugar-burning exercise. Overweight people need fat-burning exercise, which requires slow, sustained activity. Dr. Birdsall recommends forty-five to sixty minutes of vigorous walking every day, if possible. Exercise such as walking possesses many health benefits including lowering the set point and increasing the metabolic rate.” The key is finding an activity one likes and then changing exercise plans periodically to alleviate boredom.
For weight-loss programs, herbs are usually broken into two groups. The first group is taken to correct a condition that contributes to weight gain. For example, plantain for reducing absorption of fats and creating a feeling of fullness, fennel seed for digestion, burdock or dandelion root to enhance liver function, and kelp and bladder-wrack to correct a sluggish thyroid gland. 24
The second group of herbs is given to directly promote weight loss. Ephedra sineca, also known as ma-huang, has become a popular ingredient in natural weight-reducing formulas. Its effectiveness and ability to enhance the burning of fat, especially when taken with green tea or coffee, is due to the ephedrine in ephedra. Many people, particularly women who have a history of chronic dieting, can benefit from this herb as it helps to stabilize and enhance their metabolic rates.
Some people, however, will experience side effects like irritability, anxiety, insomnia, and hyperactivity. Used alone, ephedra can lead to rapid weight loss, but the pounds usually return once the herb is discontinued. For best results, ephedra should be part of a comprehensive program that includes permanent lifestyle changes, including diet and exercise.
Corynanthe johimbe, another herbal stimulant popular for weight loss, contains the fat-burning alkaloid, yohimbine. This herb works especially well for women with lower body fat, such as on the hips and thighs, by blocking fat-accumulating sites, called alpha-2 receptors, found predominantly on the breasts, buttocks, and thighs. These receptors become even more concentrated during pregnancy, low-calorie diets, and with normal aging. Like ephedra, yohimbine is useful for yo-yo dieters. These two herbs can also be used together.
Although both these herbs can have adverse side effects, Dr. Birdsall says they are rare and only short-term. In eight years of practice, he has only had three patients who had to discontinue ephedra. He finds both herbs to be highly effective, but cautions that they should only be used under professional supervision.
Caution: Ephedra and yohimbine should be used only under medical supervision. Ephedra should not be used by anyone with heart disease,high blood pressure, thyroid disease, diabetes, or benign prostate hypertrophy. If using antidepressant drugs or medication for hypertension, avoid ephedra. Pregnant women should also avoid taking this herb. Additionally, yohimbine’s side effects can include panic attacks, hypertension, heart palpitations, and increased heart rate, especially among individuals who are prone to anxiety. Yohimbine should not be used by people with kidney disease, pregnant women, or people on antidiuretic medication.
According to Virender Sodhi, M.D. (Ayurveda), N.D., Director of the American School of Ayurvedic Sciences in Bellevue, Washington, the Ayurvedic approach to weight management includes both dietary considerations, such as watching the intake of sweets, dairy, and fats, and various herbal remedies. He recommends the herb guggul for lowering cholesterol and burning fat, Garcinia cambozia for suppressing appetite and aiding digestion, and the herbs boswellia, garlic, ginger, cayenne, black pepper, and fenugreek to help increase metabolism. To address carbohydrate indigestion (which can lead to the transformation of undigested carbohydrates into triglycerides), Dr. Sodhi recommends black pepper, long pepper, cayenne, ginger, and hot lemon juice before meals.
Lauri Aesoph, N.D., from Sioux Falls, South Dakota, recalls a woman in her early forties who decided to investigate weight loss after her husband left her because he thought she was too fat. Over a series of visits, the woman was instructed in how to select foods that were healthy for her, and was encouraged to exercise regularly.
Midway through her program it was discovered that she had been sexually molested as a young woman. Eventually the woman came to understand that she may have gained weight to protect herself from sexual intimacy. To help her open the door to her feelings, she was given weekly guidance concerning the physical and emotional changes that were taking place in her life. The homeopathic remedy Calcarea carbonica, which fitted her constitutional symptoms, was prescribed. As the remedy began to work, her fears and apprehensions around sex and being thin surfaced, but as she continued to openly discuss her feelings and fears, her weight dropped until she reached her desired goal. At that point she felt that she no longer resisted feeling sexually attractive, and, according to Dr. Aesoph, she began to enjoy her new lifestyle and body.