I would like to share this blog by Dr. Pam Svendsen with some of you who may be interested in her work. I know Dr. Pam and have recently started reading up on her health blogs - boy can I relate to some of them! They are on her business website and fb page, short and sweet, and make you think about actually taking steps to better health. She discusses many timely health subjects particularly for women (though not only for women). She teaches us to take control of our lives for better health, to avoid preventable disease and conditions.
Why cant I lose weight?
Posted on February 12, 2011 by navarrewellness
This has to be everyones favorite topic! I hear this question more times in a day than you can imagine. The simple answer is that its all about calories in and calories out, right? Wrong! I know of many patients who eat a well balanced diet and exercise regularly who cant seem to drop weight. Now granted, they are not in the majority, but those folks exist. Weight loss goes way beyond calories in and out.
Lets look at the typical woman I see in my office. Shes in her 40?s, 5 feet, 6 inches tall, 185 pounds with a BMI of 30. She is married, works full time and has 3 adolescent children. Her mother has adult onset diabetes. She tells me that she feels old, tired, shes having hot flashes at night, shes anxious, has some puffiness in her ankles and has headaches. She has gained weight around her waist and hips her muscle tone is decreased. Her sex drive is diminished.
Here is a typical day in this womans life. She skips breakfast because shes not hungry and doesnt have time to eat. She usually just grabs a coffee and pastry on her way into work. She has lunch at a fast food restaurant but tries to have something healthy. She eats out 1-2 times a week, usually take out. She prepares a sit down meal with her family 2-3 nights a week but it usually comes from a package. She rarely makes a meal from scratch. She drinks 1-2 diet soft drinks a day and has 4-6 cups of coffee daily. She snacks on chips or a chocolate bar for snacks.
This lady does not sleep well, usually 5-6 hours a night. She tells me that some nights she just cant get her brain to shut off and she has trouble falling asleep. Most nights she can fall asleep but wakes up throughout the night, sometimes for an hour or two. She tries to sleep in on the weekends. She rarely dreams.
For exercise, she rides her bike occasionally and works in her garden. She rarely feels relaxed and most days wakes up feeling nervous and rushed. She has sex 1-2 times a month.
This woman has been to her primary care doctor who tells her that her blood pressure and cholesterol are too high, her blood sugar is a little high and that she is probably depressed. He wants to start her on a statin drug for her cholesterol, a blood pressure pill for her hypertension and an antidepressant pill. He tells her to lose weight. Her friend tells her that her hormones are probably not well balanced. This is when I see her in my office. Do you know this woman? I bet you do!
This lady, and many others just like her, has metabolic syndrome, which includes any 3 of the following symptoms: abdominal obesity, elevated triglycerides, low HDL (good cholesterol), hypertension and elevated blood sugar. What does this mean for her overall health and what can she do to change things?
Generally speaking, people with metabolic syndrome have an increased risk of diabetes, cardiovascular disease including stroke and heart attack, arthritis, osteoporosis, cancer, a decreased quality of life and a shortened lifespan. Thats why it is crucial for us to address these issues and correct them. Statistics are projecting that by 2020, half of all adult Americans will have Type 2 Diabetes! Half! If that doesnt scare you, nothing will. And remember, just because you take a pill to control your diabetes or hypertension or cholesterol doesnt mean that the disease process is gone. Its still there, just working at destroying your body a little more slowly than it would if it was untreated.
So how can I help this lady? Well, what I usually recommend is that we take the traditional path of prescribing medications for cholesterol and blood pressure until we can make some real change in her life. Most of the recommendations I make are very simple but not very easy!
First of all, this woman needs to start an exercise program which will start slow and gradually increase to a high intensity program over time. She needs to improve her sleep by making some change in her diet. If she snacks on sweets and carbohydrates at night, she will have a high blood sugar at night which suppresses her growth hormone secretion which has a direct impact on the quality of her sleep. She can take a hot bath or sauna before bed to improve her sleep or take some DHEA or growth hormone secretagogues (stimulators) to help increase her growth hormone levels. Oral progesterone at night helps improve sleep. She can also supplement with melatonin and 5-HTP, Vitamin B6 and magnesium to help increase her melatonin production. She should also have a sleep study to ensure she does not have sleep apnea. Over time, exercise and improved sleep will help Jane lose weight and maintain her weight loss.
Now lets look at her diet. In a nutshell, her diet has low antioxidants, high saturated fat, high trans fats, high refined sugar, high fructose, high refined salt, low monounsaturated fat, high sodium, low potassium, low selenium and low magnesium. Her diet promotes what is called oxidative stress or the production of free radicals, those cell damaging molecules that I have written about earlier. Her diet needs to change to one which includes fresh fruits and vegetables, preferably organic to avoid pesticide exposure, lean meats, preferably free range to avoid hormones and antibiotics, decreased sugar consumption including sweets, breads, rice, pasta and cereals. She can replace the grains in our typical diet with whole grains such and quinoa. This is referred to as a low glycemic index diet and there are plenty of websites which describe what this is all about. Her caffeine consumption must decrease. In general, with these changes, she will consume fewer calorie, still feel satisfied and lose weight.
What about her stress level? I dont need to tell you that this lady is stressed out! She works full time in a high stress job, comes home to a husband and children, eats poorly, sleeps poorly and doesnt exercise. This day to day stress causes the release of stress hormones, namely cortisol and epinephrine. Overtime, she has had to oversecrete insulin to counter these other hormones which has lead to her obesity and insulin resistance. My previous blogs have talked about ways to counter stress and decrease cortisol levels. Decreasing her stress will eventually lead to weight loss.
This woman is so similar to many people who come to my office. Our lives in 2011 do not generally promote health, so we need to make changes in our daily living to promote health and wellness. Weight loss will happen gradually for this lady if she makes appropriate changes to her life. If not, she will go on to develop chronic health problems and will experience a shortened life with a decreased quality of life. So, while it is certainly is about calories in and calories out, theres a lot more to weight loss than that. Its really about being healthy.
About navarrewellness
Dr. Svendsen is the owner and medical director of The Wellness Center at Navarre in Navarre, FL. She is board certified in Family Practice and has completed a fellowship program in Anti-Aging and Regenerative Medicine. She is a Diplomate of the American Academy of Anti-Aging and Regenerative Medicine.
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