Are you struggling to lose weight? Maybe it seems that you’re doing everything “you should be doing,” but somehow, you’re stuck at a weight that doesn’t feel healthy. Excess weight can be more than just a discomfort and annoyance. Being overweight increases your risk factors for health issues like high cholesterol, heart disease and cancer. It’s important to take the long view when approaching weight loss. In fact, the best approach is often to focus on your health and wellness and let the weight loss happen naturally. Focusing on a number on scale can lead to frustration and/or fixation and can ultimately be counterproductive. If you’re still with me, let’s talk about some factors to examine that might be barriers in your weight loss journey.
Weight is influenced by many factors, including hormones, stress, environment, brain chemistry, microorganisms, and so much more. These factors are, in turn influenced by a variety of behavioral and lifestyle factors. What are the most important factors to address? Well, that varies person to person. However, the following focal points are what I’ve found to be most influential across the board.
Stress is the number one barrier to weight loss that I see with clients. Stress affects so many aspects of health. Short-term stresses, such as meeting a deadline, public speaking, tests, etc. can be positive, by stimulating alertness, providing psychological reward and so on. However, chronic stress takes a toll on the body. Under stress, we lose some of the healthy bacteria (pro-biotics) in our gut. This dysbiosis contributes to poor digestion, often worsening conditions such as IBS and IBD1. Under stress, we make poor food choices. Stress also contributes to depression and anxiety. Individuals who are depressed and/or anxious also make poor food choices and tend to be less physically active.
To summarize, stress:
· Worsens IBS, IBD and digestive complaints
· Leads to poor food choices
· Contributes to depression and anxiety
· Leads to reduced physical activity
It’s easy enough to see that stress can be a roadblock to weight loss. But, how do we manage it? Stress, unfortunately is part of the modern fabric of life. However, we do have control over many contributors. One indirect way to combat the effects of stress is to nudge the microbiome. We can shift the make-up of our microbiome in a number of ways. One way is to take probiotics. There are so many on the market these days. You can check out my online dispensary for the strains and brands that I recommend. Another way to improve our microbiome is time in nature. Healthy bacteria that in the soil, make their way into the air you breathe while walking through the woods, for instance.
And of course, stress reduction itself benefits the microbiome. So, here are some key strategies for stress management:
· Reduce screen time
· Limit social media exposure and online chatting
· Exercise regularly
· Socialize with friends and family members
· Work with a professional therapist or counselor
· Get adequate sleep
Find an approach that works for you and stick with it. You’ll need a few weeks or more to start to see the results!
Speaking of sleep, are you getting enough restorative sleep? Fitful, disrupted sleep doesn’t count. If you’re waking up not feeling rested, that’s a good sign that you’re not getting sufficient rest. If you experience daytime sleepiness, you likely also need to address your sleep. Why is adequate sleep so important? Well, there is strong evidence linking short sleep duration and poor sleep with weight gain and increased fat mass2, not to mention increased risk for autoimmune disease3, poor food choices and poor metabolic health4.
All these negative consequences will likely motivate you to improve your sleep. But, how? Start with the foundation. Improve your diet and your gut health. From there, you can move on to the sleep hygiene habits, such as:
· Reduce blue light (screens) in the evening
· Keep sleeping environment cool, quiet and dark
· Establish and stick to a consistent bedtime and wake-up time
· Reduce caffeine intake, as needed
· Incorporate a relaxing activity around bedtime, such as: journaling, meditation, reading, etc.
· Stop eating at least 2 hours before bed
Meal Timing and Frequency
This brings us to the third factor to address to optimize weight loss. When and how often are you eating? And why does it matter? Let’s start with frequency or how often you eat during the day. It’s been shown that fasting between meals and overnight improves what is known as the migrating motor complex (MMC). MMC basically controls the movement of your gastrointestinal tract, and thus the regularity and quality of bowel movements, which in turn impacts the health of your microbiome5. Our GI tracts have cycle through phases of peristalsis, which is the wave like movement that propels food through the GI tract. We reach the phases with the strongest and most frequent contractions in the fasting state6. And simply put, you can reach the fasting state if you’re grazing all day!
Frequent eating also impacts blood sugar and insulin levels. As you move from the fed state (after a meal) into the fasting state (4 hours or more after a meal), your metabolism shifts. In the fasting state, our insulin levels drop, which means that we have the opportunity to draw fat out of our fat cells (and liver) for energy. In case it’s not obvious, the is a very good thing. The only way to lose fat, is to use it for energy! Again, here is another reason that fasting between meals and overnight is beneficial. I usually recommend keeping snacks to once per day, plus before or after workout, and not eating within 2-3 hours of going to bed.
There are individuals who need to eat smaller, frequent meals. For those of us who are otherwise healthy, we can consider spacing out meals, letting ourselves feel hunger and reaping the benefits of lower insulin, better peristalsis and optimized digestion.
In terms of timing, we do have evidence that skipping breakfast is associated higher risk for obesity as well as deficiencies in key nutrients7. Morning fasting is also associated with a lower rate of physical activity in the morning hours. Admittedly, not everyone is ready to eat first thing in the morning. However, an early meal can prevent poor choices later in the day and set you up for success in meeting your nutritional needs and help protect against obesity.
This, of course, brings up the question of intermittent fasting (IF). IF has been demonstrated to be effective for weight loss. Beyond that, it’s been shown to improve metabolic markers, such as insulin levels, cholesterol, and blood sugar. If you are interested in trying this approach to weight loss, I recommend doing an early in the day version for best results. In this version, you would eat between rising and about 4 pm or so. I recommend ending your eating period with a light post-lunch snack. Then fast between ~4pm and your morning meal. This topic will be discussed in more detail in a subsequent post. IF is not for everyone and you should consult with a dietitian and/or your doctor before using this approach.
*Pro tip: stay tuned for an upcoming post that will look at what we know about intermittent fasting.
The path toward weight loss is often indirect, always gradual, and sometimes fraught. Be patient with yourself and get help! Head to my Get Started page to, well, get started.
1. Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World journal of gastroenterology, 20(39), 14126–14131. https://doi.org/10.3748/wjg.v20.i39.14126
2. Cappuccio, F. P., Taggart, F. M., Kandala, N. B., Currie, A., Peile, E., Stranges, S., & Miller, M. A. (2008). Meta-analysis of short sleep duration and obesity in children and adults. Sleep, 31(5), 619–626. https://doi.org/10.1093/sleep/31.5.619
3. Hsiao, Y. H., Chen, Y. T., Tseng, C. M., Wu, L. A., Lin, W. C., Su, V. Y., Perng, D. W., Chang, S. C., Chen, Y. M., Chen, T. J., Lee, Y. C., & Chou, K. T. (2015). Sleep disorders and increased risk of autoimmune diseases in individuals without sleep apnea. Sleep, 38(4), 581–586. ,https://doi.org/10.5665/sleep.4574
4. Nedeltcheva, A. V., & Scheer, F. A. (2014). Metabolic effects of sleep disruption, links to obesity and diabetes. Current opinion in endocrinology, diabetes, and obesity, 21(4), 293–298. ,https://doi.org/10.1097/MED.0000000000000082
5. Deloose E, Janssen P, Depoortere I, Tack J. The migrating motor complex: control mechanisms and its role in health and disease. Nat Rev Gastroenterol Hepatol. 2012 Mar 27;9(5):271-85. ,doi: 10.1038/nrgastro.2012.57. PMID: 22450306.
6. Takahashi, T. (2012). Mechanism of interdigestive migrating motor complex. Journal of Neurogastroenterology and Motility, 18(3), 246.
7. Fanelli, S., Walls, C., & Taylor, C. (2021). Skipping breakfast is associated with nutrient gaps and poorer diet quality among adults in the United States. Proceedings of the Nutrition Society, 80(OCE1), E48. ,doi:10.1017/S0029665121000495