Why Am I Struggling To Lose Weight?

Dr. Julie George: Hi, welcome to Restoring Your Health. I am Dr. Julie George. Today I would like to talk to you about something that is extremely frustrating for a lot of people, and that is weight loss. Weight loss can be challenging when we are dealing with chronic health conditions. I totally understand what it's like to battle the weight because I have battled it my own fair share. See, if our body is in an inflammatory response, we can have a harder time shedding weight. Okay. So things that I want to make sure that I'm looking at for my patients is their whole health history, especially around those environmental exposures. That could be something that's hiding and interfering with our ability to lose weight. So on that initial intake, I ask a lot of questions regarding exposures in the workplace, in your home, where you've lived, where you've You spend a lot of time, hobbies, you know, different types of things that you've put on your body or in your body, all of that can play a role. And so a lot of times if we have a high level of exposures, then the body could be having like a cell danger type response and not wanting to shed excess weight. So that is something to really pay attention to. That's a lot of people are not factoring in. Another thing that I like to look at for patients is the thyroid function. How well is the thyroid doing? And so I will measure TSH, which is thyroid stimulating hormone. I will measure free T4, free T3, sometimes a reverse T3, and then oftentimes I'll run the antibodies thyroid globulin antibody and thyroid peroxidase antibody just to make sure that the thyroid is functioning optimally. The TSH has a very wide reference range. Okay. Most of the time if you're lower on the TSH you're not going to be struggling with weight loss as much. But if you're at the higher side of TSH or outside of the upper limit you could potentially be struggling with weight loss and so you have to take the TSH you have to look at where the free T4 and the free T3s are coming in within the reference range to determine if the body needs some thyroid medication. Typically you're going to prescribe a medication based off of those numbers and office symptoms. And that's very unique and individualized for every single person. But sometimes people can have a normal TSH, a normal free T4, a normal free T3, and have their antibodies elevated. And so when the antibodies are elevated, they potentially could have Hashimoto, and that would mean that the body is attacking the thyroid. And whenever you have antibodies against your thyroid, and your thyroid is being attacked. Then there might be a weight loss problem. And so we might have more struggles with losing weight over time. We might be struggling with energy, we might have other inflammatory conditions going on that needs to be investigated. But definitely paying close attention to thyroid is very, very important. After thyroid, and sometimes at the same time, I would Look at cortisol and cortisol function. The best way of measuring cortisol is an A.M. cortisol blood test, and an AM cortisol blood test should be done between 8 a.m. and 9 a.m. I typically like it done at 8, but 9 would be the last hour of the day. I would want that to be taken, drawn at, and that helps us determine what the morning cortisol level is like. See, cortisol helps us, it's a stress hormone, but it has many benefits in the body. It should go up in the morning to wake us up, and it should spike around an hour. Two hours after waking, and then it should gently fall down, slowly go down over the time of the day, and then be lower in the evening when it's bedtime, and then again start rising right before it's time to wake up, and then spike in that morning. So we can trail it by measuring our different cortisol levels at different times of the day. So we usually start with that morning cortisol to see where it is. If we're speculating that there are problems with cortisol or stress response throughout the day, then usually we'll go to more advanced cortisol test. And there's many of them out there on the market. I will sometimes use the Dutch test to measure cortisol. They have their own cortisol test. sometimes I'll use US biotech to measure it, depending on People's budgets and options, I might use a different company as well. But cortisol is very, very helpful to track and people that are struggling for with weight loss. After cortisol, after thyroid, I will measure inflammation markers. There are numerous inflammation markers out there that can be checked, but typically I'm going to start with a C-reactive protein. And I'm gonna see where that level is at. And if it is elevated, we might have a challenge. We might need to start working on inflammation as a whole and the body. We may need to add other inflammatory markers to our blood test. other things to think about glucose, fasting glucose, very important. If our blood sugar is elevated, then that can make it harder to lose weight. cortisol can spike that glucose too, so they they go together in that factor as well. But looking at glucose is important. There's something called a hemoglobin A1C, which is a measurement of Over three months of how well your blood sugar is doing. And that can be really good to track to see where those levels are at. Because again, blood sugar can definitely impede, if it's high, it can definitely impede weight loss over time. I will go further sometimes and look at fasting insulin levels because that can interfere if we're looking at more of a metabolic. Issues coming on, pre-diabetes issues. So definitely that can't play a role. After those markers, I'll go back to some of those environmental concerns. Do we need to look at the mycotoxin levels? Do we need to look at heavy metal levels? Do we need to look at toxicant levels that we can measure and see where they're at? that you know potentially causing some inflammation. Do we have fungus in the body, yeast in the body that is making it harder for us to lose weight. Okay, so making sure the body is in balance and we're looking at things that can be throwing the body off is is important. Very, very important. Okay. So that is where I like to go in the blood you know wise area now whenever those areas check out we're optimizing if we need to with medications or nutrients supplements then i'll come in and sometimes give different items that can help with metabolism can help with supporting metabolism, can support the body ability to to process different, you know, sugars and and such. So we can do that. I will optimize the diet at at that point too. I'll start interfering with someone's diet a little bit more aggressively. Sometimes we'll check for food sensitivity. Sometimes we'll do some eliminations. We'll make sure that their gut microbiome is healthy and then come back in with the calorie calorie restriction or calorie reduction at that time. And so there that's one of the most important things is through all of this we still need to be looking at our macros. We still need to be looking at our proteins. We need to look at our fats and we need to look at our carbohydrates. And a lot of times these That we can use can give us a pretty good idea of where to start with, but some people don't metabolize or don't process fats as well as others, so we might have to dial back the fats a little bit. Some people don't handle carbs as well, so we might have to alter, you know, what where a micro sorry where a carbohydrate count would be, and so it's it's really trying. To optimize it for each and every person, and so at while being in a calorie restriction, we also have to remember that we don't want to do calorie restrictions for a long time. We want to do a calorie restriction probably for about 10 to 12 weeks and then take about a month off in maintenance mode. We don't want to go back to eating how we used to. We want to be in a maintenance calories and then go back into another calorie restriction. So that way our body can come back into equilibrium on a cycle and we can keep having it respond to. The weight loss journey that we're trying to decide. As far as calorie restriction, that's gonna be dependent on the person. So I'm not gonna tell you how many calories you need to eat right now. I'm not gonna tell you how much you need to cut because that's dependent on a lot of factors for you. It's dependent on your age, it's dependent on your body size, it's dependent on. On size, meaning your height, your weight. it's dependent on how active you are. it just there's a lot of factors there, but some of these calculators that you can use, the apps, are really helpful for dialing it in and helping you figure out a good starting point. So typically, once we can figure out what your maintenance level is for your current activity, then we're wanting to cut the calories just by a little bit. Maybe 200 to 500. We never want to go below 1200 calories for someone with a low calorie intake, as it is. Okay, so we don't want to cut a tremendous amount of calories, we just want to do a little bit at a time. At the same time, we want to really hit and focus on making sure we're getting adequate protein. That's really important throughout this whole journey is protein. A lot of the gurus in this field are are focusing on higher protein amounts. And I for some people that may be okay. Usually it's about 0.7 to 1 gram per ideal body. Weight. And so again, if you're way off from where your starting point is, your ideal, you don't want to drop it that far. You want to go in smaller decreases, and that's what I talk to my patients about. for some people, that protein amount might be too much. People with kidney concerns need a lower amount of protein, and so they really need to be working with a nutritionist that can help them go through their kidney journeys, but for that The average person usually a 0.7 to one gram of protein per ideal body weight is a good level. fiber, not everyone can handle fiber. Fiber is something that you hear that we all need this amount of fiber. That is a good thing to have fiber if you can handle it. But a lot of my patients that are chronically ill can't handle fiber. And so, or they can't handle the amounts that. That we're told we need. So if you're doing well, and if you can get to it, 25 grams for a female of fiber is an ideal amount of fiber. Not everyone can do it. That's okay. And I think they say the average person sets around eight grams of fiber per day. So there's a big window to increase, but we don't want to increase that quickly. That's a huge problem. If you take on too much fiber too quickly, you can get a lot of GI disruption as well as some constipation. Also, too, when you're having fiber on board, you need to make sure that you're drinking lots of water. Lots and lots of water. So the more fiber, the more water. But protein and fiber, two big things to focus on. We want to make sure that we are getting in In antioxidants every day, which comes from colorful fruits and vegetables. We want to make sure that we're getting lots of good colorful vegetables and just in general. There's in school we learn that the person needs about 30 different plant foods per week to keep their GI system healthy. And so just aiming to have a variety of different plant foods in. But it comes back to tracking. We must track our food. we need to measure our food. It is so easy to make mistakes while we're trying to lose weight or trying to maintain weight. It's so easy to say that, you know, this I just put a splash of oil on my salad. I just put a teaspoon of oil without measuring into the skillet to cook. The food. I have a little bit of extra yogurt on my spoon. I'm going to lick it off. I was making sandwiches and I'm licking off the nut butter off of the spoon, or I grabbed a handful, and they taught me a handful was the serving size. So I grabbed a handful. Well, guess what? Our eyes can be deceived, and we can actually take too much. And so, or we can also Take too little, so it's really helpful to measure, and measuring can become tricky too because not all measuring cups are equivalent, not all measuring spoons are equivalent. So we really need to get a good quality skill and make sure that we're measuring our foods. we don't have to measure. Every single vegetable, you know, there's certain vegetables like lettuces and greens that are very low in calories and I don't feel like they're gonna cause that much issue, but you may need to measure that. Years ago, I did the Weight Watchers program and I really enjoyed their point system. And there are multiple apps out there that use a point system. And so if counting calories is too hard, you might resonate more with a system that measures points. And then there when you're on these point systems, depending on what program you choose, there are some free foods that you can eat. So you don't even have to count those foods. But for some of us that have been at this for a long time, it's usually best to count the majority of things coming into your body just because there can be foods that are deceiving, you know, like it's very deceiving how many nuts are serving size. It's very deceiving to know how much oil and the calories and the oil that we put in our food whenever it's just like a splash to to brown something in the skillet. So paying attention to that. so if we're counting our calories and we're tracking our macros, so that's the proteins, fats, and carbohydrates, and we're still not getting results. That's where the macros might need to be altered, okay? but we need to really focus on all of those inflammatory conditions and hormones that I talked about. And Then we go into exercise. It's really important to move the body. We must move the body every single day. Stretching is really important. I recommend that we stretch for at least 10 minutes a day. You don't have to stretch all at one time. Like while you're listening to me right now, you can just roll your head around and get some stretches. You can do some arm circles. Just get the stretching in as much as you can. walk. Walking, if you can walk, we want to walk, and that's really important. Walking is something that we want to do as As like the basics, okay? Like that's something basic. We want to walk every day. If you're not walking, then start walking around your house inside your house to stay safe. If you can walk a little bit further, add a few more minutes each day. If you are outside walking and you're Walking, you know, for 30 minutes, great. Maybe for every 10 minutes you get your heart rate up just little bit faster for a minute or so and then come back down. But walking is really, really important. Resistance exercises are also very important. There's multiple ways of doing resistance style exercises. I, if you've never done it, I really recommend that you meet with a trainer and you work with a trainer that can keep you safe. You don't want to learn how to work out and have pro improper form that could be causing some problems. But I also don't want you to be too scared to start either. So we want to do some resistance exercises two to three times. A week is usually pretty sufficient to get started, but we have to be careful too with cortisol. If our cortisol levels are really high andor really low, we want to make sure that our workouts aren't very stressful for us. And so that may mean that we do lower. rep counts that might mean that we've decreased the weight a little bit and we have more rep counts that might mean that we have more breaks in between our reps. It's just we have to figure out what's best for the person. I really like yin style yogas. I like tai chi classes, qigong classes for people that are struggling just because it does help with some of the inflammation that can be going on. And then through all of this, I don't want to forget about adjunct therapies. Adjunct therapies are really important when it comes to weight loss. Okay. I like to use the sauna, I consider that an adjunct therapy. Saunas are really good at helping you mobilize toxins, they're good at helping your Heart rate speed up, they're good at potentially burning some calories. So There's a lot of winds in it. So I really like a low temperature far infrared sauna. I think that's fantastic. I think that going and getting some acupuncture from an acupuncturist can help and be a tremendous support. They can support your meridians, support the stress response, support your organs, just very, very important when we're going through these processes. Vagus nerve is something I talk about a lot with my patients. The vagus nerve is really important for your nervous system being regulated, and so there's multiple ways to do that from deep breathing to some massage type work that you can do on yourself to buying a vagus nerve type stimulator. Multiple, multiple ways from something that's free to something that's That can potentially be an investment, but that can be helpful. Other adjunct therapies to support stress would be biofeedback. Emotion code, body code, maybe some hypnosis work with a qualified person, neurofeedback is fantastic. Again, I talked about exercise, so working with a trainer would be a great adjunct therapy. but really supporting the stress responses as much as we can. there's lots of frequency style machines out there that can be helpful, PEMFs that's helpful, hyperbaric oxygen therapy. Can be a great resource that we use. So we can't forget about adjunct therapy while we're going through with weight loss, while we're trying to balance hormones, while we're trying to lower inflammation, while we're working on environmental. concerns, you know, that stress component is huge here. And then and something I didn't mention that I should have mentioned, if we are prone to having a lot of food noise, we're prone to having some level of Emotional eating, overeating, binging. We might want to work with someone that focuses on that, and that can help take down that level of noise. You know, you hear about it all the time with these GLPs out on the market. You hear about it with, you know, other types of drugs, drug support out there, but ultimately, you know, at the end of the day, we probably need to figure out work with a qualified person. person, why are we having that noise and what can we do to turn off the light for it? Okay, so I hope this gave a little bit of insight, things that I consider, things that I talk about. You know, I I I want people to lose weight too. I want people to be able to maintain it. And I didn't even go into the maintenance. That's where the real work starts. Maintenance is for life. that is something that you have to do for life. If you do all of these weight loss strategies and you get everything balanced and you don't learn from it and you don't keep them inflammation low. you don't keep up with how much food you're gonna eat and adjust it as you lose weight, then you will gain the weight back. So maintenance is the the harder part of this whole thing. And maybe we'll talk about that on another episode, how to maintain some strategies, some support for for maintenance. But you know that's where the real work begins is when we get to the maintenance stage. If you have any questions, please let me know. Again, I'm just sharing things that I do in practice, that I see in practice. I'm not trying to diagnose you or treat you here. If you have questions, please schedule an appointment with us or reach out with your healthcare professional. Thank you.