ACHIEVING OPTIMAL WEIGHT

THROUGH PHYSIOLOGICAL BALANCE

Weight gain and obesity have escalated into one of the most pressing health crises of our time, reaching pandemic proportions. Currently, 40% of the population is either overweight or obese, marking a dramatic increase over the past few decades. This surge demands a comprehensive approach to weight management, including a critical analysis and targeted approach to address all underlying factors.

THE IMPACT OF LIFESTYLE CHANGES

Twenty years ago, people led more active lives, engaging in physical labour and outdoor activities. Today, our lives revolve around screens—both for work and play—leading to a sedentary lifestyle. This lack of physical activity is a significant contributor to weight gain. Compounding this issue is the increased availability of highly processed foods, which are calorie-dense and nutrient-poor.

STRESS AND HORMONAL DYSREGULATION

Modern society is characterised by chronic stress, driven by uncertainty on multiple fronts. This stress triggers the release of cortisol, a hormone that, when elevated, increases the body’s inflammatory response and promotes fat storage.

Additionally, stress negatively impacts sleep quality, further exacerbating weight gain and metabolic dysfunction.

METABOLIC DISEASE AND INSULIN RESISTANCE

Understanding metabolic disease is crucial for comprehending the complexities of weight management. Insulin resistance, a hallmark of metabolic syndrome, leads to higher insulin levels, which are inflammatory and promote fat storage. Insulin, an inflammatory hormone, plays a critical role in how our metabolism functions. When sensitivity to insulin decreases, our metabolism changes dramatically.

Another key factor in the pathology of metabolic disease is changes in cholesterol levels. Specifically, it’s important to monitor what happens to triglycerides and HDL cholesterol, also known as good cholesterol. Diagnosing metabolic disease requires identifying insulin resistance, a decrease in HDL cholesterol below 1 mmol/L, and an increase in triglycerides above 1.7 mmol/L. These changes often lead to a cluster of conditions associated with metabolic disease, such as increased blood pressure, diabetes, and weight gain. While, not universally included, changes in thyroid metabolism and hormone levels, such as those seen in menopause and andropause (hypogonadism), are also relevant to metabolic disease.

HORMONAL BALANCE

A proper diagnosis is essential when embarking on any weight loss treatment. Understanding the driving forces behind weight gain involves examining the hormonal balance in the body. Key hormones include insulin, glucose, and thyroid hormones, which are crucial for metabolism. Insulin resistance with high glucose levels can impede glucose transport to cells, affecting thyroid metabolism and vice versa. Cholesterol levels, integral to lipid and energy metabolism, also influence hormone health. Unhealthy cholesterol levels can lead to imbalances in sex hormones like pregnenolone, progesterone, testosterone, and estrogen. Testosterone, often overlooked in women, is essential for increasing metabolism and muscle mass. A decline in testosterone can affect body composition and libido. Estrogen, vital for weight management, tends to decline with age, contributing to weight gain. Progesterone also plays a role in gut health and metabolism. Thus, maintaining hormonal balance is fundamental to managing weight effectively.

Hormonal changes, particularly in women, play a crucial role in weight management. Studies indicate that women gain an average of 700 grams per year from a decade before menopause to a decade after, primarily due to declining estrogen levels. These hormonal shifts affect metabolic processes as detailed above, leading to gradual weight gain.

THYROID METABOLISM

Thyroid hormones are essential for regulating metabolism. Subclinical hypothyroidism and Hashimoto’s disease, often underdiagnosed, can significantly impact weight. Optimal thyroid function requires adequate levels of free T3 and T4 hormones, not just normal TSH levels. Proper management of thyroid health is vital for effective weight management.

ESSENTIAL NUTRIENTS

Optimal nutritional supplementation is crucial for effective weight management, extending beyond diet and exercise. Iron, vitamin D, and zinc play significant roles in weight loss and overall metabolic health.

Proper iron levels are vital for energy production and metabolism. Iron deficiency, often difficult to diagnose due to the complexity of interpreting ferritin levels, can lead to fatigue and reduced physical activity, hindering weight loss efforts. Elevated ferritin in the context of chronic inflammation can mask true iron deficiencies, making accurate diagnosis and supplementation critical. Ensuring adequate iron intake supports metabolic efficiency and energy levels, which are essential for sustaining an active lifestyle conducive to weight loss.

Vitamin D is a prohormone crucial for regulating various metabolic processes. Recent discussions suggest that routine vitamin D screening should be limited to high-risk groups such as those with liver or kidney disease. However, given its broad impact on health, including immune function and bone health, adequate vitamin D levels are essential for effective weight management. Supplementing with vitamin D can enhance metabolic processes and support the body’s ability to lose weight.

Zinc influences metabolism and supports the synthesis of hormones and enzymes critical for metabolic function and weight regulation. Adequate zinc levels are necessary for maintaining a healthy metabolism and facilitating weight loss. Deficiencies in zinc can impair appetite regulation and overall metabolic health, making it a key nutrient in any weight loss regimen.

DR MARK OPPERMAN

After graduating from the University of Pretoria’s Medical School in 1999, Dr Opperman set off abroad to practice Medical Aesthetics in the United States. He also developed a keen interest in Advanced Integrative Medicine, and, since 2001, De Opperman has been specializing and practicing non-surgical medical aesthetics and functional medicine, with a focus on integrative anti-ageing solutions.