A third of UK adults suffer from obesity (with a further third being overweight). Obesity shortens lifespan by an average of 14 years and significantly reduces the quality of life. Your weight gain and any associated health problems are not your faults. There are genuine reasons behind every case of obesity. Knowing the underlying cause will help you lose weight effectively and effortlessly.
Millions of people go through a series of diets for decades without achieving their goals. This is because they start from the wrong impression and implement the wrong solution. The false belief that obesity results from overeating, lack of physical activity and self-control has dictated the wrong solution: eat less and exercise more.
In this blog, I will share with you over 40 years of experience as a physician dealing with thousands of obese and overweight patients. The medical approach of a thorough history, clinical examination and relevant laboratory tests will find the reasons behind your obesity. This will motivate you to implement a personalised action plan, transform your life and achieve your ideal body weight. Saving time and thousands of pounds spent on fruitless generic dieting.
“To my amazement, he was full of lead”
This obese 50-year-old painter and decorator presented with painful hands and was diagnosed with rheumatoid arthritis. He was advised to use a drug called Methotrexate to suppress the immune system. I did a battery of tests, and, to my great amazement, he had a very high level of lead (used in old paints).
I gave him some nutritional support and specific treatment to rid his body of lead. With falling lead levels, his arthritic symptoms resolved, and he was delighted to lose 25 kg of weight in the bargain.
I also encounter heavy metal toxicity in people with high mercury – either leaking from multiple dental silver fillings or, as a result, of high consumption of big fish, like tuna.
Obesity is a problem for farmers exposed to agricultural toxins such as pesticides and herbicides. Eating processed food, heavily sprayed by agricultural toxins, can also result in obesity.
I met many obese people who carry loads of biological toxins like mycotoxins (yeast toxins) simply because they lived in mouldy houses.
Toxicity causes obesity because the body stores toxins in fat. Having a bigger load of toxins, your body must make more fat to store them. This makes eliminating toxins a logical solution in some obese cases.
Let’s have a moan about hormones
This 55-year-old lady presented with a history of increasing lethargy and weight gain. She was also noted to be irritable and forgetful, with mood swings. She complained bitterly about nocturnal symptoms of hot flashes and excessive sweating, disturbing her sleep, and having to visit the toilet several times. I suspected that hormones were playing their part in her metabolism.
She had gained nearly two stones in weight; her blood pressure was high at 145/90, and her blood sugar was in the prediabetic range (6.2). Her lipid profile reported high cholesterol, high triglyceride, and low protective HDL (the good guy.)
This lady had reached a state of energy imbalance, with increased appetite and reduced energy expenditure. A fall in the female hormone, oestrogen, slowed her metabolism. She was eating energy-dense snacks to cope with the stress associated with this stage of life. She gained weight in the middle; her waist measurement was high at 39 inches, and her hip at 41 inches, giving an abnormal waist-hip ratio of 0.95. I worked with her to resolve these issues.
The underactive thyroid
The underactive thyroid is a common cause of a slow metabolism. Imagine the thyroid hormone is like the accelerator pedal in your body. You will not consume energy if you cannot push it. Patients with underactive thyroids usually present with fatigue because their thyroid hormone (thyroxine) and its active form (T3) are too low to accelerate metabolism that converts calories in food into energy and vitality.
They divert these calories to be stored as fat, resulting in weight gain, but lethargy, cold intolerance, and an abnormal lipid profile with high cholesterol.
Therefore, sorting out your thyroid status may be crucial to normalising your metabolism and resolving obesity. Eating less or exercising more will not sort out the problem.
The middle age crisis is also known to alter body shape and composition. From the early 30s, you start losing muscle mass (5% every decade) and gaining fat. The process reaches a peak level around the mid-40s, manifesting as significant fat and weight gain. This is associated with interesting hormonal changes – the bad guys, like insulin and cortisol high in the sky, while the good guys, like growth hormone, oestrogen and testosterone levels, are falling.
We rarely encounter Cushing’s syndrome (high cortisol) and acromegaly (high growth hormone) in clinical practice. However, 3% of the Western population is on long-term steroids for various medical conditions, making them insulin resistant and at risk of obesity.
Other causes of obesity?
Obesity runs in families – people can inherit multiple obesity genes but more commonly inherit poor lifestyles. Your genes are not your destiny – control 15% of your health and well-being; you need unhealthy lifestyles for obesity to manifest.
Chronic stress leads to comfort eating, particularly palatable energy-dense foods. Again, high cortisol causes accumulation of fat in the middle resulting in visceral adiposity, which lays a strong foundation for obesity and metabolic diseases.
One study found, after 11.5 years of follow-up, that a woman who experienced dissatisfaction in her marriage had a three times higher risk of developing obesity and metabolic syndrome.
Another study demonstrated that adverse childhood experiences increased the incidence of obesity in adult life.
Even earlier stress during pregnancy, powered by high maternal cortisol, leads to intrauterine growth retardation and small babies. The resultant low birth weight increases the risk of developing obesity in adulthood.
Obesity is more prevalent in low socioeconomic groups due to consuming unhealthy, cheap, processed and fast foods and limited access to recreational facilities.
Also, the marketing and advertising of processed calorie-dense foods and increased portion sizes can contribute to the development of obesity.
Our ‘modern diet’ gave them pre-diabetes in two days!
Eating a Western diet, rich in simple sugars and processed carbs, pushes your insulin sky-high so that your calories are stored as fat rather than used to fuel your body.
One study demonstrated the damaging effect of the modern diet. The participants were given a diet of sugar and processed carbs equivalent to 6,000 calories per day; They were not allowed to exercise; instead, they were advised to watch TV!
The diet resulted in a 3.5kg (7.7lb) weight gain in one week. The terrifying result was that participants developed insulin resistance (pre-diabetes) in only two days.
Leptin is a hormone produced by fat tissues in response to energy storage. It travels in the blood to act on the hypothalamus (appetite centre) to reduce appetite and prompt you to stop eating. When your leptin is low, the food tastes good, and you want to eat more of it.
With fat accumulation, your body produces large amounts of leptin, but your brain does not sense it (leptin resistance). You lose control and continue to eat beyond your needs. Resulting in more weight gain and worsening obesity.
The best approach to leptin resistance is to reduce your sugar and refined carbohydrate intake and take more real whole foods with fibre and nutrients to lose weight.
Ghrelin is a hormone produced in the stomach to stimulate the appetite centre in the brain to prompt you to eat. Ghrelin is produced when the stomach is empty; the level goes up to give you hunger pains and higher to make you eat more. Ghrelin levels are not necessarily high in obese people.
There is growing evidence that a gluten-free diet has now become a common cause of obesity. The gluten-free products, mainly of sugar and refined carbs, resulted in higher rates of obesity among coeliac disease patients. Making it necessary to explain this effect when a gluten-free diet is prescribed.
The lack of beneficial bacteria
The diversity of your microbiome is key to your overall health and ideal body weight. The lack of beneficial gut bacteria, such as Lactobacillus and Akkermansia, contributes to weight gain. Eating fermented food is one way to increase the diversity of the live bacteria in your gut to facilitate weight loss.
How do we know we have a problem?
A high BMI indicates you have a weight problem simply due to calorie overconsumption, but it does not assess your disease risk. High BMI is common among healthy obese people. Those with bigger muscle mass, like the athletes, and those with bigger fat mass, stored around the hips. Just like our cavemen ancestors who stored fat during the feast season to use during a famine.
WHR is a useful tool to assess disease risk. High WHR indicates overconsumption of the wrong calories (sugar and processed carbs) to be stored within and around abdominal organs such as the liver and pancreas. This causes disease because fat accumulation makes these organs lose their vital function and become fat stores.
According to the World Health Organization (WHO), a healthy WHR is 0.9 or less in men and 0.85 or less in women. WHR is an accurate tool to predict life expectancy in middle-aged and elderly people.
Another way of looking at this is that a waist size of over 40 inches in men and 35 inches in women is strongly associated with a high risk of diabetes and heart disease.
Neck size could replace waist size as a tool to assess obesity and vascular risk, with over 32cm in females and 38cm in males indicating obesity.
Common problems in obesity
Obese people are 3.5 times more likely to have high blood pressure. Other complications include diabetes, heart disease, stroke, chronic kidney disease, dementia, cancer, sleep apnoea, arthritis, gout, and depression.
Excess body weight puts pressure on the pelvis, back and knees, causing the pelvis to be pulled forward and the lower back to become strained, resulting in chronic back pain. Acid reflux is another common symptom among obese and overweight people. Obese people also have receding gums and dental fillings (because of their sweet-based diet, which alters the mouth microbiome.)
Gout is a type of arthritis triggered by a high uric acid level, initially affecting the joint at the base of the big toe. The liver processes fructose into uric acid; hence eating processed food and drinking commercial juices sweetened by High Fructose Corn Syrup (HFCS) result in excessive weight gain, obesity, and gout.
Being overweight or obese increases the amount of cholesterol in your bile, which increases the risk of gallstones. 30% of morbidly obese people have gallstones. Rapid weight loss also increases your risk of having gallstones.
The fast way to get back in control
Hippocrates’s approach to obesity was a 24-hour fast and eating more fat. It has a lot of truth as it points out that sugar and carbs are the culprits and that eating healthy fat is a better option for losing weight and preventing disease.
Intermittent fasting (IF) refers to time-restricted feeding. The most popular routine is 16/8, an effective way to lose weight. IF lowers insulin levels to facilitate fat burning, triggers growth hormone surge to preserve and grow muscles, activates cellular repair to slow the ageing process, preserves the immune system and brain function and prevents dementia.
The Mediterranean diet
The Mediterranean diet is high in fibre, vegetables, fruits, legumes, beans, nuts and seeds, and whole grains, high in monounsaturated fats such as avocado and olive oil, and low in saturated fat in red meat and dairy.
It has more seafood, especially small oily fish, rich in omega 3. High in potassium and B vitamins necessary for energy generation and vitamin C, the antioxidant. The diet represents a healthy way of eating for a sound heart and ideal body weight.
Research has shown that the transfer of microbiota (stool transplant) from lean donors to obese individuals increased insulin sensitivity, resulting in weight loss within six weeks. This is promising but at early stages and must be replicated in larger and longer studies.
Beyond that, my friends eat whole, organic, locally grown fruit and vegetables, less commercial meat and poultry and more small fish, beans, seeds and nuts. Consider intermittent fasting. Reduce toxins loads by consuming organic food, taking the Brassica family of vegetables (broccoli), exercising, and having infrared saunas to sweat the toxins out of your body.
Exercise regularly, including cardio and muscle-building exercises, together with yoga for relaxation. Enjoy the open air, and sunshine is the natural way to gain vitamin D and reset your circadian rhythm. Lower your stress by changing your perception or response.
You can also use stress-relieving techniques such as deep breathing, meditation, prayer and listening to your preferred music and humour. Value your loving relationships and supportive communities, and practise unconditional love, forgiveness, and gratitude. And end every day with 7 to 8 hours of restful sleep.
As always, please ask any questions in the Comment section below – and please do subscribe to the newsletter so that you don’t miss further vital information. Thank you!
Gluten sensitivity and Metabolic syndrome
Hormones and Metabolic Syndrome
Class 3 obesity, formerly known as morbid obesity
Obstructive sleep apnoea and metabolic syndrome
Neck circumference as an anthropometric Indicator of central obesity in patients with