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How Your Diet Influences Where You Lose Fat

>> Monday, March 19, 2018

In weight management, our goal is to improve overall health.  In a perfect world, it would be preferable if we could melt away the fat around and inside the internal organs (called 'visceral fat') rather than the fat under the skin, as it is this visceral fat that contributes most to health complications of obesity such as diabetes, high blood pressure, and metabolic syndrome.

A recent study suggests that what we eat actually can help us to target this visceral fat.

The CENTRAL study, published in the journal Circulation, randomized 278 sedentary adults with either abdominal obesity or high cholesterol to follow either the Mediterranean diet versus a low fat diet for 18 months.  Six months into the trial, participants were also randomized to follow an exercise program or not. They used MRI scans to evaluate fat under the skin, fat around the organs, fat in the liver, pancreas, and even around the heart.

At the end of the 18 month study, weight loss was the same between all four groups (Mediterranean vs low fat diets, with or without exercise) at -3.2%.   However, where fat was lost from, and how this influenced health, was different between groups:

  • People on the Mediterranean diet lost more fat from the liver, pancreas, and around the heart. 
  • Exercise with either diet had a greater effect on reducing visceral fat. 
Whether or not total body weight was lost: 
  • Losing visceral fat and/or liver fat improved cholesterol.
  • Losing fat deep under the skin improved insulin sensitivity.
  • Losing fat just under the skin had no effect on health and reduced levels of leptin (a hormone that tells our brains that we feel full). 
The findings that the Mediterranean diet preferentially reduces the more dangerous visceral fat may explain why it is the only diet that has been convincingly found to prevent cardiovascular events.  

These results also show us that it's not about numbers on the scale, as this does not reflect the important changes going on with fat deposit patterns inside. 

Follow me on twitter! @drsuepedersen © 2018


Why Short Term Weight Gain Can Be Easier to Lose Than Long Term Weight

>> Monday, March 12, 2018

No weight gained is easy to lose, but - have you ever wonder how Hollywood's actors can gain weight for a movie role, and the next thing you know, they are back at their usual weight for their next photo shoot?  While one may think that it’s simply the superstar access to personal chefs and trainers that gets actors back in shape, there is actually a physiologic basis that can make it less difficult to shed a quick/temporary/intentional weight gain than excess weight that has been present for the long term.

As discussed in a recent Scientific Statement on Obesity Pathogenesis by the Endocrine Society, obesity is associated with inflammation in various tissues, including muscle, fat tissue, vascular system, and liver, and this inflammation appears to be a consequence of chronic obesity.    There is also inflammation in the hunger/fullness centre of the brain, called the hypothalamus.

For a person who has been struggling with weight long term,  inflammation in these tissues causes maladaptive changes in those tissues that make them more resistant to weight loss.    It takes time for this inflammation to develop, so for a person who has had a fairly acute weight gain, it may be easier to drop pounds because they don't have this inflammation working against them.

So then you may wonder - why do some people seem to lose quickly gained weight more easily than others? (e.g. after pregnancy)?

Well, the story of the hunger/fullness centre in the brain is a little more complex.  It turns out that this inflammation may not only be a consequence of long term obesity, but may actually be present in some people before obesity develops.   Some animal studies suggest that eating a high fat diet triggers these inflammatory changes, damaging the neurons in the hypothalamus, which may then result in a disruption of sensations of hunger/fullness, lead to weight gain, plus make it harder to lose it again.

In other words, people who struggle to lose weight after a fairly quick/new weight gain may have inflammation in their hunger/fullness centre that was there before the weight gain, thus making them not only more prone to weight gain, but also making it harder to lose weight than the person without the inflammation. 

Follow me on twitter! @drsuepedersen © 2018


The Sleeping Beauty Diet

>> Monday, March 5, 2018

I was shocked and saddened to learn about yet another potentially harmful way that some people may be trying in a desperate attempt to lose weight.

The Sleeping Beauty diet involves taking sleeping pills, with the goal of sleeping through normal waking hours to avoid eating.  Also referred to as 'narcorexia', this fad is not only ineffective, but also dangerous:

1.  While it is true that not enough sleep is associated with higher body weight, so to is too much sleep.

2.  When you are sleeping, your body's metabolism is at its slowest.  When you are awake and moving around, you burn more calories.  Thus, people who sleep more than what their body needs are putting themselves at risk of weight gain by decreasing their overall calorie burn.

3.  Sleeping at unusual hours alters the body's circadian rhythm and the normal hormonal rhythm, which can has a negative impact on health from many perspectives.  Poor sleep quality caused by messing up the body's normal daily rhythm is associated with weight gain, due to alterations in the normal rhythm of hunger/fullness hormones, and an increase in craving for unhealthy foods.

4.  Most importantly: sedation induced by sleeping pills increases the risk of all manner of dangers  and problems due to impaired brain function while under the influence - car accidents, accidents at home, mistakes at home or the workplace... need I go on.

I am so terribly saddened that people out there are so desperate to lose weight that they are literally willing to sleep their life away to do it.  Yet another powerful and compelling reason why the health care profession, and society in general, needs to uniformly accept obesity as a chronic medical condition and help people get the support and care they so desperately need.

Follow me on twitter! @drsuepedersen © 2018



I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!

Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!

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