First published June 24
If you are overweight, or obese, you probably blame yourself, right?
Well, maybe you shouldn’t entirely.
Ultimately the principles of maintaining a healthy weight are not altered by facts in this article, but there is some hidden information that might be causing you to be fatter than you’d like to be.
The basic principles of maintaining a healthy weight are:
• Controlling portion size and total calorie intake
• Avoiding processed white carbohydrates and eating the right amount of fat, protein, fresh fruit and vegetable
• Employing an eating pattern known as ‘intermittent fasting’
• Avoiding comfort eating
• Having healthy low calorie snacks at hand for moments of weakness
• Avoiding junk food
• Getting enough aerobic and strength building exercise (although exercise only contributes 10% to weight maintenance, 90% of it is still what you put in your mouth)
• Eating home cooked food, avoid food produced outside the home (it’s hard to know exactly how much carb, oil, and food additives are in bought food)
• Incorporating incidental exercise into your daily routine
• Avoiding fad diets, adopting healthy permanent lifestyle changes that incorporate healthy eating practices.
So now for the additional factors that contribute to unwanted body weight …
Prescription Medications and Over-the-Counter Medications
Did you know some commonly used medications can cause you to have an increased appetite, or can alter your metabolism resulting in extra weight gain?
As a general rule, medications that cause you to slow down, generally slow down your gut and metabolism as well.
Even over the counter medications are offenders. It’s worth asking your doctor whether any medications you are on, or any new medications you are prescribed cause weight gain. If there is a safe alternative it would be worth sticking with that instead.
While some medications only cause mild weight gain it’s still worth noting. I’m not suggesting that you stop taking your prescription medication. DO NOT STOP YOUR PRESCRIPTION MEDICATION, without consulting your doctor - that will just cause you other health problems. You do need to be aware that weight gain can be an unwanted side effects of medications and understand it might be hard for you to control your appetite at times.
Following is a list of medications that contribute to weight gain:
• Benzodiazepines and sleeping pills
• Some antidepressants, antipsychotic and antiepileptic medications
• Chronic pain medications like amitriptyline, gabapentin, pregabalin and opioids
• Reflux medications such as proton pump inhibitors, ranitidine and related antihistamine medications
• Dibenhydramine (Benadryl) and other first generation antihistamines which are used for colds, allergies and insomnia
• Medications used for contraceptives including the oral contraceptive pill, Implanon, Depo provera and other medications containing oestrogens and progesterones
• Medications such as cyproterone acetate used for treating polycystic ovarian syndrome and syndromes of excess androgens
• High blood pressure medications such as beta blockers, ace inhibitors and spirinolactone
• Steroids such as prednisolone used to treat autoimmune disorders and systemic inflammation
• Diabetes medications such as insulin and sulfonylureas
• Highcholesterol medications called statins
• Certain antibiotics have been linked to weight gain
As you can see this is a list of commonly prescribed and consumed medications. If you are taking more than one of these obviously the possibility of weight gain increases.
The Human Microbiome
In the last decade a lot of research has been produced focusing on the incredible diversity of bacteria and microorganisms that inhabit our guts. In fact, if you’ve read a book called 10% Human by Alanna Colleen, then you know that 90% of our body is made up of microorganisms that are non-human!
It’s hard to believe!
This complex microbiome plays a huge role in the development of pathologies such as inflammatory bowl disease, other autoimmune diseases, maintaining a healthy immune system, mental health (90% of serotonin is produced in the gut not in the brain) and our metabolisms.
There is so much material in the medical literature revealing a link between our microbiome and obesity that it is hard to ignore the fact you might be inhabited by bad microorganisms contributing to your weight gain! What to do about this? Well, faecal transplants are still in their infancy in Australia and might not be appealing, or feasible, so ultimately, it still boils down to willpower, self control and portion size, amongst other things. It’s possible to eat foods that alter your gut microbiome which is greatly influenced by diet. For example, there is emerging material in medical research exploring how foods like kefir alter the microbiome.
It’s worth doing some online searching to find out more!
If your life is miserable because you aren’t coping due to chronic stress this could be a major contributor to being overweight.
Our body’s stress response consists of many chemicals that are interpreted biologically as ‘stress’. A chronically overactive sympathetic nervous system that has its fight or flight response turned on all the time, has become attuned to producing too much cortisol and other chemicals that contribute to altered metabolism centralised obesity, peripheral muscle wasting, fluid retention and bowel dysfunction.
Your body will hang onto fat, because this is part of the evolutionary stress response.
It is easy to see why chronic stress is so bad for health. If you can re-engineer your life to manage chronic stress better, or eliminate stressors, (which is not always practical) this could also contribute to maintaining a healthier weight, if you are someone who is dealing with chronic stress.
Shift work disturbs our circadian rhythms and our body’s metabolic processes. People who are shift workers are at an increased risk of gaining weight because of altered biological processes. If there is nothing you can do about being a shift worker you need to get smart about introducing some of the basic principles of maintaining a healthy weight into your daily (and nightly) routine.
Drugs such as marijuana can cause significant weight gain.
Abuse of prescription medications such as those already listed can cause weight gain.
Polycystic Ovarian Syndrome
People with an underlying undiagnosed medical condition need to be especially careful with maintaining a healthy weight. It is essential to recognise and treat the underlying disorder as well as practice all the basic principles of maintaining a healthy weight. If you feel unwell, or not yourself, or recognise any of the symptoms of the above disorders you should see a good doctor.
Our Entire Food Culture
Most of our social activities centre around food in some way, or another. We are surrounded by food everywhere, but most of it is high in calories, white carbohydrates, fats and chemicals that will all contribute to weight gain. From supermarkets, to cafes, fast food outlets to classy restaurants, bars, takeaway shops, corner stores, even health food shops … every time you put your hand out when you’re hungry and want to eat something – it’s very hard to eat the right thing, or eat in a way that can maintain a healthy weight.
Even our drinking culture is responsible for loading people with too many extra unnecessary calories. Until we change our food culture and the kind of food that’s available, or unless we are dedicated enough to develop incredible will power, the battle to maintain a healthy weight will be that much harder!
Failure of Some Medically-Managed Weight loss Interventions
Some forms of medically-managed weight loss are not as successful as you might think. Pharmaceutical intervention with medications belonging to the substituted amphetamine class, do not always produce successful weight loss in the long term.
Dangerous side effects make this medication not suitable for many patients.
Bariatric surgery has its place in the management of obesity, but is not without significant risks.
Finally, the following diagram is taken from the Royal Australian College of General Practitioners online publication at http://www.racgp.org.au/afp/2013/august/obesity/ in an article written by Mariee Grima and John B Dixon. It compares varies weight loss strategies. The results are self-explanatory. I thoroughly recommend reading this article, if you want more detailed information on weight loss.
References available upon request
*Dr Anonymous is known to the Editor
• Mike Bolan in Comments: … Good to read such an informative and relevant article ...