“Hey doc, is it my thyroid or am I just lazy?”
“Hey doc, is it my thyroid or am I just lazy?”
Mr. John asked me with a fading smile hiding behind a feeling of guilt and disappointment. This is a familiar question I am often asked by patients who are trying to understand how the pounds started to pile up over a few years or even a few months span.
My interest in weight management peaked after seeing many of my patients I care for their diabetes or thyroid disease fall into the trap of “crash dieting”, a diet that will fail them by design. Weight gain is not about laziness or lack of willpower. Obesity is a chronic disease just like diabetes and blood pressure. There is a long list of factors behind its etiology! Genetics, ethnicity, family history, other diseases or medications that promote weight gain, lifestyle, culture, eating habits, level of physical activity, stress and sleep hygiene are such factors just to name a few. If we have a look at first-degree relatives of diabetics for example, they would, by default, have insulin resistance, which means that they handle sugars differently than someone without a family history of diabetes.
Obesity As A Disease
Obesity is for sure the disease of the modern times. According to the WHO, its prevalence tripled between 1975 and 2016. This is likely as we increased our focus on low fat diet to allow for more refined carbohydrates intake. Today, about 65% of Canadians are overweight and 40% of them suffer from obesity.
Obesity is not a character flaw or a manifestation of laziness or lack of willpower, it is just like hypertension, a chronic disease. The Obesity Medicine Association provides an encompassing definition for obesity - a chronic, relapsing, multifactorial and neurobehavioral disease where an increase in body fat promotes tissue dysfunction and abnormal physical stress to the body because of fat mass. This causes metabolic, biomechanical, and psychosocial health consequences.
Obesity increases mortality such that for every 5 units increase in BMI, there is a 30% increase in mortality. People with a BMI of 30-35 kg/m2 would have a reduced life expectancy by 2-4 years, whereas those with a BMI of 40-45 kg/m2 would have a reduced life expectancy by 8-10 years (which is comparable to the effects of smoking!).
Obesity affects every single organ in our body, leading to complications like obstructive sleep apnea, PCOS, infertility, diabetes, hypertension, heart disease and stroke. It is a major cause for joint pain and osteoarthritis and it is linked to a long list of cancers.
Why Do We Gain Weight?
Although our body is designed to maintain its weight and is stringently controlled by many gut hormones that communicate to the brain information about energy that is readily available or stored to prevent overeating and promote fullness, many factors can override this system such as social events, emotions, memories, stress, lack of sleep or hormonal changes during the menstrual cycle.
On the other hand, the food industry has spent millions of dollars to discover the most satisfying level of crunch in a potato chip or the perfect amount of fizz in a soda or the precise combination of salt, sugar and fat that excites our brain and keeps us coming back for more and more. The result, of course, is that we overeat because hyperpalatable foods are more attractive and even addictive to the human brain just like drugs.
The fast paced life we live in today is another major contributing factor that needs not to be ignored. As the industrial revolution needed more manpower, the entire fast food industry was created in a way workers can spend the least amount of time on nutritional breaks. As we rush to catch our morning train, we grab the coffee and bagel (or any calorie-dense item) on our way and gobble up the whole thing in a few bites, not realizing the unfortunate fate we are writing for our weight trajectory.
In fact, from the moment we take our first bite, the body starts sending hormonal signals to the brain to indicate energy resources started to replenish, decreasing hunger and slowing down eating. It takes about 20 minutes for those satiety hormones to reach your brain and tell you that you are full however, and it is only a matter of time before you overeat and the scale catches up.
Our Nutrigrative Approach
Although we may not be able to change the genes or ethnicity partly responsible for weight gain, we have a highly experienced team that can help you tackle all modifiable factors that ganged against you to prevent you from maintaining a healthy weight.
In our Center, we work with you to “rewire your neurons” and re-engineer your habits to promote sustainable weight loss and prevent bouncing back to your original weight. Our Nutrigrative program is a 12-month long program as we strive to endorse changing habits for life and we do not believe in quick fix or crash diets, something designed to fail.
Our Nutrigrative approach facilitates cognitive behavioural therapy and nutritional counselling under the medical supervision of a highly trained specialist and a Diplomate of American Board of Obesity Medicine and American Board Certified Endocrinologist, providing a unique empowering experience. The addition of pharmacological agents, if seen necessary, can also add an edge to weight loss and help with cravings.
Weight loss is not a marathon that you’re done when crossing the finish line, it is rather a life-long journey that we will guide you through. We designed a holistic and comprehensive program that utilizes a state of art approach that would transform the notion of weight management, and we welcome you aboard!