As the weather warms up and the holiday season approaches, many people renew their focus on their excess weight and what is needed in order to correct this problem. Most people understand that healthy eating and increasing outdoor exercise is essential for achieving their goal. This is often done with the mission in mind of losing some kilograms and is as much influenced by the variation of season as it is our desire to shape up. We are more than conscious of the fact that summer clothing exposes our extra kilos.
There is no shortage of information when it comes to weight loss plans and products. The weight loss industry is estimated to be worth over $30-50 billion in the US alone. But with Australians spending $827 million on weight loss in 2012, and over 60 percent of Australian adults currently being classed as overweight or obese (a Body Mass Index of greater than 25 as measured by weight divided by height squared), something is clearly amiss. With each generation, Australians are getting fatter. Being overweight or obese has more impact on our health than we may realise. Obesity as a risk factor for most other chronic diseases is, according to the Australian Institute of Health and Welfare (2010), the major preventable cause of disease – it has even overtaken smoking in recent years. Excess weight can therefore be seen to be a major cause for mortality and reduced life spans in individuals – cardiovascular disease, cancer and type 2 diabetes can all be attributed to obesity. The good news is that by losing as little as five percent of your body weight (if overweight) you can significantly improve your risk factor profile. We know that weight is a more complex arrangement than just energy in and energy out, and that the body is a highly adaptive and complex system of interrelated parts and functions. In order to deal with all of the factors that are responsible for increased weight, an integrative approach is essential. Within the integrative medicine model, health creation is a major focus with an emphasis on why the problem has arisen. When a patient is overweight, one of the first considerations is to review their lifestyle, behavioural and socioeconomic factors to determine what might be causing weight gain or weight retention. There is more to each person’s weight story than just food and exercise. Recent research is pointing us to a range of factors, including biomedical, environmental, motivational and genetic influences, that affect how food is processed and the way our bodies utilise energy. There are many lifestyle factors that impact on our body’s ability to function in a peak way (i.e. at optimal weight). Recent research is offering us some major insights into the role of stress, sleep disorders and personality factors and highlighting new strategies for managing weight from a total lifestyle perspective. One of the most important findings has been the value of pleasure in life, which is clearly related to stress but also to our general sense of wellness and our sense of joy and aliveness in the world. The less pleasure you derive from other aspects of life, the more likely you may be to consume excess food for pleasure. The stress effect Chronic stress and anxiety can have direct effects on the body that can result in weight gain. Whilst we may eat more, or make poorer food choices when we are stressed, there is also a series of biochemical responses that come into play when the body is experiencing persistent stress. Stressors actually increase our intake of palatable (rather than bland) high fat and high sugar foods as a means of activating a pleasure response in the brain in an attempt to reduce stress, e.g. desserts. The ‘flight or fight’ mechanism which is associated with stress results in increased cortisol, which not only increases our appetites, but leads to increased fat storage as a result of biochemical changes. Fat cells then produce the hormone adiponectin, which then in turn affects the cells’ response to insulin causing insulin resistance, which promotes weight gain. The cycle of stress is clearly one that could offset our best efforts with diet and exercise. In contrast, feel great and seek pleasure and the body will create biochemicals that support our weight management endeavours. The pleasure effect is the stress effect in reverse. Endorphins are powerful neurotransmitters in the brain that create feelings of pleasure and delight by acting on the opiate receptors, also in our brain. Exercise is one way to create endorphins in the brain, but there are also many other opportunities for us to seek pleasure and pleasurable activities in life that will benefit our weight loss plans. Research shows endorphins are a powerful appetite suppressant, especially when combined with elevated oxytocin levels. Oxytocin has a number of functions including the binding of humans to one another as well as improving our feelings of contentment. The journal Science recently found that obese people may have fewer pleasure receptors in the brain, which diminishes their ability to experience the pleasure of eating. Overindulgence may result in an attempt to boost their satisfaction – or dopamine levels – which is a hard-wired program in the brain designed to reward the body for consuming life-sustaining nutrition. Overeating and high fat food has also been shown in some studies (in mice) to disrupt a complex network of genes related to the fatty tissues. In a recent study in the Journal of Obesity, mastering simple mindful eating and stress-reduction techniques helped prevent weight gain without even dieting. As the stress hormone cortisol is linked to eating behaviour, anything we can do to manage stress will have far reaching benefits on the body and mind. Managing stress through meditation and body awareness gave participants a deeper understanding of the signals their body was giving with regards to fullness and vitality. Poor sleep can make you fat If you are regularly getting less than six or seven hours sleep each night, your body will respond by decreasing the sensitivity of your insulin receptors. This means your insulin levels will increase and with that compromise your body’s ability to burn and digest fat. Sleep deprivation will alter metabolism and stimulate appetite. Behaviourally, you may look for high energy (high calorie) low-nutrition snacks to get through the day. Biomedically, a lack of sleep will reduce leptin, the hormone that signals fullness, to the brain, and decrease ghrelin which makes you hungry. The rate of obesity is higher in those who are sleep deprived. Include adequate sleep in your weight loss plan. Waking up grumpy does more than cloud your day. Personality and a tailored approach US researchers from the National Institute of Ageing found people who are impulsive (by far that most prevalent characteristic), cynical, competitive or aggressive were more likely to be overweight. This long-term study suggests that behavioural therapies are vital for people facing the weight loss challenge. By understanding these traits with the help of a counsellor or other health professional, achieving a more profound and lasting lifestyle-orientated change to eating habits may be possible – and a psychological robustness that has positive effects in other areas of life. A study in the American Psychological Science journal, found that women who write for 15 minutes each day about their most important values (relationships, children, music, and so on) lost more weight that those who did not. Self-integrity and how we feel about ourselves can have a significant effect on weight. Feeling good and seeking pleasure is a weight loss strategy that can have many beneficial effects. Real pleasure comes from treating the body with upmost respect and supporting it to function at its optimal level. Looking after the body by eating well and exercising can foster a sense of joy and create a positive spiral upwards that is both sustaining and supportive of your weight loss goals. Research shows a happy person tends to make better food choices overall and treating life as a source of pleasure is a wonderful way not only to enjoy a healthy weight, but also make the most of each day. Healthy food need not be boring; dark chocolate consumed regularly leads to a healthier weight. What you eat occasionally such as foods of the festive season need not be a problem, provided you have a healthy diet generally. Enjoyment can be viewed as a necessary part of any weight loss program, and integral to a healthy lifestyle. Professor Avni Sali is Founding Director of the National Institute of Integrative Medicine (NIIM) niim.com.au
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