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Weight Managment and Hormones
The obesity epidemic and its health and economic consequences affect 200 million Americans. Causative factors include genetics, culture, poor lifestyle, maladaptive behaviors, lack of exercise, stress, excessive caloric intake, lack of portion control, poor quality food intake including excessive consumption of refined carbohydrates, fat, and alcohol, lack of nutritional education, certain medications, and various medical and psychological disorders, just to name a few.
Treatment approaches have focused on finding the ideal diet combination of protein, carbohydrate type and fat. Legions of fad diets, diet programs, government recommended diets, health institution consensus diets, etc. have been combined with various prescriptions for exercise, lifestyle modification, behavioral modification, medications, food supplements and bariatric surgery in an attempt to definitively solve the problem.
A widely applicable and highly successful solution to the obesity epidemic remains elusive.
Overweight and obese patients, unable to lose weight, commonly visit physicians asking if hormones are causing their weight problem stating they are following a healthy, low calorie diet and making recommended lifestyle and exercise changes.
Metabolic rate, buildup or breakdown of fat, hunger, and body weight maintenance are hormonally controlled. Hormones and neurotransmitters provide a communication system among the central nervous system, liver, stomach and digestive tract, muscles, and fat storage that assesses if ingested food is to be used for immediate energy or converted to fat for storage.
A person who has a healthy body weight usually achieves this by his system knowing when to increase or decrease metabolism and appetite depending on whether weight needs to be lost or gained. This is an automatic process in normal weight individuals.
There is more to the idea that bodyweight is nothing more than calories in versus calories out and that all a person needs to do to achieve proper body weight is consume a specified amount of food and engage in a prescribed amount of exercise. There are many hormones involved in weight management, including leptin, serotonin, ghrelin, neuropeptide Y, insulin, cortisol, progesterone, estrogen, testosterone, DHEA, thyroid hormone, and many others.
Malfunction of this complex system leads to metabolic errors in the body such as building up of excessive fat, inappropriate hunger signaling, reduced metabolic rate when it should be increased and improper diversion of ingested calories into fat buildup rather than immediate use for energy.
Cutting edge lab tests are now coming online to help physicians analyze errors in this complex hormonal regulatory system. This allows improved prescription of specific diets, supplements and medications to target hormonal problem areas. We can now detect and treat high cortisol and insulin levels.
The importance of stress management, mood improvement and adequate sleep to the hormonal correction process is now better understood. Reproductive hormone, growth hormone and detailed thyroid hormone evaluation can lead to helpful hormone replacement or supplementation ending weight loss and maintenance resistance.
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