As a dietitian studying the impact of hormones, I see remarkable success when a woman is treated holistically as an individual. The weight loss equation is not about calories in/calories out. Some of the most renown hormone specialists in North America are revolutionizing the way we look at weight loss. In her recent book, A Smart Woman’s Guide to Weight Loss, women’s health expert, Lorna Vanderhague M.S., outlines “seven factors that make us fat”. Lorna points out that scientists have shown our battle of the bulge involves a complex intermingling of factors: hormonal, biochemical, genetic, physical, and lifestyle.
- Basal metabolic rate
- Hormones regulating weight
- Food choices
- Lack of exercise
- Liver dysfunction
(For a thorough explanation of each I encourage you to purchase Lorna Vanderhague’s A Smart Woman’s Guide to Weight Loss) http://healthyimmunity.com/
For the purpose of this post I will discuss the top three issues I address as a dietitian when a client is struggling with the “Belly Fat Blues”, a term I coined recently in a seminar.
The top three concerns I look for in my initial assessment with a client are symptoms that may indicate: 1) hypothyroidism (underactive thyroid), 2) chronic stress, and 3) blood sugar imbalance (insulin resistance).
Now I’m not a diagnostician, nor am a a doctor, so I always recommend clients get a full medical work-up before seeing me a second time. Often the symptoms I notice are tell-tale signs of a condition that a blood test can confirm. Recently I had a client suffering with stubborn weight gain, depression, constipation, and hair loss. When I sent her to have her thyroid tested it was clinically low. Her symptoms were indicative of hypothyroidism yet she assumed they were part of her post-partum experience.
The questions I ask a client shed light on what might be contributing to stubborn weight gain. Many women I see are following a standard 1500 kcal, high carbohydrate/low fat diet and killing themselves at the gym. They all say the same thing, “My weight will not budge, and it’s all located around my belly!” It’s at this point they come to see me. Often by the time a woman arrives in my office she is absolutely frustrated and ready to throw her hands up in defeat. I then start digging.
During an assessment I watch for possible indicators of hormone imbalance. First I look for symptoms of hypothyroidism. These may include, depression, dry skin, weight gain, inability to lose weight, lethargy and fatigue, sensitivity to temperature changes, recurrent infections, hair loss, and head aches. Low thyroid function affects 20-25% of the population. Some researchers suggest another 10-30% may have sub-optimal thyroid function. Many women I see come to me with hypothyroid symptoms although their thyroid numbers are deemed “normal” by North American standards. As Lorna Vanderhague points out, “Standard blood tests used in North America determine ‘normal’ too broadly” . What does this mean? It means there are many women walking around with symptoms of hypothyroidism who are not receiving proper treatment. If my clients have not had a physical examination within a year it’s the first thing on the agenda.
The second indication that a client may be dealing with a hormone imbalance is the presence of chronic stress in her life. Over and over I hear clients say they are so stressed and fatigued they can barely make it through the day. Research now shows that chronic stress causes fat cells, particularly those around the belly, to become resistant to shrinkage. It’s interesting to note that belly fat, or fat cells found in the abdominal wall, have four times the cortisol receptors on their cell membranes. Stress isn’t just stress; it can wreak havoc, hormonal havoc to be exact, on the body, on the immune system, on your thyroid hormone, and on your adrenal glands. Some physical symptoms which may indicate an elevated cortisol level include: hair loss, high blood pressure, high insulin, anxiety, low sex drive, depression, poor immune function, and that weird “wired and tired” feeling.
Stress is caused by many factors: constant noise, crowded cities, pollution, negative emotions, toxic relationships, poorly managed blood sugar, caffeine abuse, unresolved trauma, negative self-talk, to name but a few. When a client reveals that she is overly stressed we discuss referrals to practitioners who specialize in diagnosing elevated cortisol (integrative medicine specialists such as Dr. Cara Flammer M.D. who are able to order blood or saliva tests) and practices such as mindfulness, meditation, yoga, acupuncture, bio-feedback, etc. Of course I also recommend diet guidelines which normalize blood sugar and support adrenal health. If you are “stressed out” please don’t accept it as a normal part of life. There are many clinically proven techniques and diet tips to lower the stress response in your body. Nutrition counseling teaches you how to eat to lower your stress levels and how to balance your blood in a way that doesn’t force your body into consistent over-drive. The provision of proper nutrient balance is crucial to balancing your stress levels.
The third sign that a client might be dealing with a hormonal imbalance is insulin resistance symptoms. A reliance on a highly refined carbohydrate diet not only makes you fat it increases your risk of heart disease, diabetes, and ultimately cancer. Scientists have shown that refined carbohydrates and sugars trigger the secretion of dozens of hormones which tell your brain you are in need of more food. Not only that, when you bombard your system with refined carbohydrates like white bread, white rice, many of your favorite cereals, mashed potatoes, and high fructose corn syrup, your body’s ability to deal with this overload of sugar becomes sluggish. When you eat foods high in refined carbohydrates, as most North Americans do, insulin levels increase in order to remove sugar from the blood and deposit it into your cells. This works well for the most part but if insulin spikes too often, from a diet rich in refined carb foods, your cells respond by decreasing reactivity and the number of cell receptors to the insulin. Eventually this prevents glucose from getting into your cells, depriving your cells of their energy source. This is why many women with insulin resistance experience carb cravings, fatigue, and weight gain. A woman’s cells may be starving for energy, even though she may have just eaten a plate of pasta. Eventually her cells send her another message, “feed me I’m hungry”. It’s a cycle I see many clients endure until I can help them balance their sugar levels throughout the day – utilizing the naturally occurring sugars from dairy products, vegetables, and whole starchy carbohydrates, balanced with a proper amount of healthy fats and protein.
So now you have it, the top three indicators I look for in your initial nutritional and lifestyle assessment. I also look at your food choices, the symptoms of low serotonin (a brain chemical), liver dysfunction, and other potential hormone imbalances. Women come into my office seeking solutions to insomnia, early waking insomnia, anxiety, depression, fatigue, and stubborn weight loss. I am associated with hormone integrative medicine specialist Dr. Cara Flamer, and with pharmacist Ilde Iles, so that together we may provide you with answers to your complex hormonal issues.
For the month of November I am offering FREE assessments for first-time clients at my clinic located in the Beaches at Fallingbrook and Kingston Road. For details see Facebook/Nutrigal or visit Nutrigal.ca
In the meantime be kind to yourself in work and in deed and have a spectacular day!
In health and peace,
Kelly Greer BASc RD
Vanderhaegue, L., and Pettle, A. “A Smart Woman’s Guide to Hormones”. Vancouver BC: Library and Archives Canada Cataloguing in Publication, 2011.
Vanderhague, L. “A Smart Woman’s Guide to Weight Loss”. Vancouver BC: Library and Archives Canada Cataloging in Publication, 2010.
Barclay, A., et al. 2008. Glycemic index, glycemic load, and chronic disease risk — a meta-analysis of observational studies. Am. J. Clin. Nutr., 87 (3), 627–637. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/18326601 (accessed 09.26.2008).