Beyond Calories and Carbs: A Broader Approach to Weight Loss By Antonio Reale, ND
diet. If you're like most patients, choosing the right diet can be confusing, overwhelm- ing, and understandably stressful. With so many diets to choose from, it can be diffi cult to determine which program is best for you. While each one likely has its benefi ts, I often tell patients there is no single diet that is universally best for all of us. We are genetically and biochemically unique, which means the approach to weight loss should be specifi c to your body type, age and activity level. Understanding the differ- ent approaches to weight loss helps put into perspective the many possibilities when it comes to addressing weight loss goals.
N The Caloric Defi cit Equation Let's start with the basics. I joke with
my patients that weight loss comes down to a very simple, yet sobering, mathemati- cal equation. Calories are a measurement of energy and we lose weight as a result of energy expenditure; that is, "burning" calo- ries beyond what our bodies need to sus- tain everyday activities. One pound of fat is the equivalent of 3,500 calories and if we divide this number by seven (for each day of the week), we need to create a defi cit of 500 calories per day to lose one pound per week. I ask my patients to complete a diet diary, which not only helps me get a better understanding of their diet, but is useful in helping patients recognize "hidden" calo- ries – calories that may be keeping them from creating a caloric defi cit. We can then construct a personalized meal plan based on the appropriate caloric intake when accounting for age, gender, height, weight and activity level. It's not only how many calories we consume, but the types of calo- ries that play a role in weight gain. As we discuss a patient’s personalized meal plan,
ow that summer is in full swing, it's hard to go too long without hearing a conversation about the next best
I make it a point to review the breakdown of macronutrients (the relative proportions of fats, carbs and fats) to optimize effi cacy.
Thyroid & Metabolism: Getting the Full Picture
A healthy diet is an essential part of
any weight loss program, but so is a fully- functioning metabolism. Our metabolism is controlled by the thyroid, the gland respon- sible for the production of hormones that affect everything from energy levels and weight loss to supporting healthy mood and libido. The thyroid is the powerhouse of the body and when sluggish or operating at suboptimal levels, can make it more diffi cult to lose weight. Most primary care doctors test TSH as part of a yearly physical, which works well as a screening tool, but some- times can miss the bigger picture. In many cases we fi nd normal TSH levels, but the hormones produced by the thyroid gland itself, T4 and T3, are either low or low-nor- mal. This happens when the body is under stress, whether emotional or physical, as the body converts T4 to reverse T3, instead of T3. Essentially, the body tries to save for a "rainy day," preventing the conversion to T3, which is necessary for a fully-functioning
metabolism. Testing the full panel of thyroid hormones provides a more complete picture of the state of your metabolism. Fortunately, there are herbs that help improve the con- version of T4 to T3 that can in turn promote weight loss, when necessary. Since the herbs affect hormone balance, it's important to run blood tests before supplementing and thyroid-supporting herbs should only be used under the supervision of a physician.
Herbs & Supplements: Garcinia Cambogia & 5-HTP
You've probably heard this before: there is no magic pill for weight loss. There is, however, research supporting the use of one herb, Garcinia cambogia, to optimize weight loss in patients who already adhere to a healthy diet and exercise program. While research is mixed, some studies show that regular supplementation with Garcinia as much as doubled weight loss in partici- pants already following a diet and exercise regimen when compared to subjects taking a placebo. So how does it work? Widely used in southeast Asia, a component in Garcinia called hydroxycitric acid (HCA) binds to and inhibits an enzyme called ATP- citrate lyase, which converts carbohydrates
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