Monday, September 13, 2010

“Doctor, why can’t I lose weight?"

That is a question I hear every day; it is always followed by “I eat a good diet and I exercise.”

What is going on with them? How is it that counting calories and working out does not help them shed unwanted pounds? If you scroll down previous blogs, you will see many emerging reasons for this. For example, research is demonstrating that some of us are colonized by toxic microbes in the gut that mess up our metabolism, thereby messing up the brain-gut connection that drives our thermostat.

Another problem is that many cannot come to terms with their addiction to sugar. Unfortunately, this concept is not being readily accepted by mainstream dieticians, even though the research involves sound science; I often hear that the addiction is “behavioral,” not “chemical.” In other words, many of my colleagues feel food itself is not addictive; people “behave” as if it were. Granted, the science of addiction is not straight forward, a fact widely recognized by psychologists and doctors. Yet, it seems that the pharmaceutical industry has escaped such controversy; their pharmaceutical approach to addiction is never questioned the way food addictions are.

Fortunately, “early adapters” are already helping many patients by pointing out the science behind food addiction. But, no sooner open minded practitioners embrace a new concept that another one comes along to challenge them.

The concept that toxins like pesticides and chemicals used in plastics are a factor in obesity, diabetes and their common denominator, insulin resistance, is the new challenge facing the medical and paramedical professions. It sounds hard to believe, but don’t shoot the messenger. Let me get out of the way and give you the raw data:

J. Obesity (2010) doi:10.1038/oby.2010.133

Obesity and Persistent Organic Pollutants: Possible Obesogenic Effect of Organochlorine Pesticides and Polychlorinated Biphenyls
Published online 17 June 2010.

Abstract:

“Persistent organic pollutants (POPs) are endocrine-disrupting chemicals associated with the development of the metabolic syndrome and type 2 diabetes. In humans, little is known about their role in the potential origin of obesity. This study aims to assess the associations between serum levels of POPs and the prevalence of obesity in a cohort of obese and lean adult men and women. POP serum samples were investigated cross- sectionally in 98 obese and 47 lean participants, aged ≥18 years. Serum samples were analyzed for the presence of polychlorinated biphenyl (PCB) congeners 153, 138, 180, and 170 and for the organochlorine pesticides, dichloro-diphenyl-dichloroethylene (pp-DDE), and β-hexachlorocyclohexane (βHCH). We established a significant negative correlation between BMI, waist, fat mass percentage, total and subcutaneous abdominal adipose tissue, and serum levels of PCB 153, 180, 170, and the sumPCBs. For βHCH, we demonstrated a positive correlation with BMI, waist, fat mass percentage, and total and subcutaneous abdominal adipose tissue. PCBs 180, 170, and the sum of PCBs correlated significantly negative with homeostasis model assessment for insulin resistance (HOMAIR). βHCH correlated significantly positively with HOMAIR. A strong correlation was established between all POP serum levels and age. We established a positive relationship between high serum levels of βHCH and BMI and HOMAIR, whereas serum PCB levels were inversely correlated with BMI and HOMAIR. Combined, these results suggest that the diabetogenic effect of low-dose exposure to POPs might be more complicated than a simple obesogenic effect.”

“Minireview: The Case for Obesogens,” J. Molecular Endocrinology 2009;23:1127

“Obesity and obesity-related disorders, such as type 2 diabetes, hypertension, and cardiovascular disease, are epidemic in Western countries, particularly the United States. The conventional wisdom holds that obesity is primarily the result of a positive energy balance, i.e. too many calories in and too few calories burned. Although it is self-evident that fat cannot be accumulated without a higher caloric intake than expenditure, recent research in a number of laboratories suggests the existence of chemicals that alter regulation of energy balance to favor weight gain and obesity. These obesogens derail the homeostatic mechanisms important for weight control, such that exposed individuals are predisposed to weight gain, despite normal diet and exercise. This review considers the evidence for obesogens, how they might act, and where future research is needed to clarify their relative contribution to the obesity epidemic.”

So, what can you do?

You could continue the pharmaceutical approach at your own risk. The New England J. of Medicine just published an article showing that Sibutramine increases the risk of “non fatal” heart attacks.”1 Oh, good, “non fatal;” well that should makes us feel better….

Instead, try to avoid chemicals as much as possible. Eat a good diet full of antioxidants to maximize detoxification pathways in your body. Eat lots of fiber to optimize bowel function. Take probiotics, the amino acid N-acetyl Cysteine, the B vitamin derivative SAMe, and supplement whey protein: they all raise your levels of glutathione, the master antioxidant that works best to detoxify. You need more of it for sure if your liver enzyme GGT is elevated.

Also sweat a lot (sauna, exercise,) and get massages.

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