What’s Really Making You Fat?

Many obese people suffer for years trying and failing at diet after diet, but what they don’t know is that there may be an underlying medical condition that is thwarting their efforts. If they address that challenge, weight loss can be achieved.

I recently visited with Jared Zeff, ND, LAc, a naturopathic doctor and adjunct professor of naturopathic clinical theory at Bastyr University in Seattle, who told me that he sees four common medical problems over and over that lead, directly or indirectly, to uncontrollable weight gain. In fact, he said, he sees these problems not only in people who are obese, but in many who are simply overweight. Here’s what they are…

Food intolerances mess up digestion. Dr. Zeff said that just about all the obese patients he has treated have malfunctioning digestive systems, most often associated with an intolerance to one or more common foods, such as milk protein (casein)… eggs… potatoes… certain fruits… soy… wheat… and meat. When you eat foods that your body doesn’t tolerate well, it ends up affecting your ability to digest other foods that wouldn’t normally be troublesome and interferes with nutrient absorption — the resulting undernourishment leaves people so hungry that they remain ever on the prowl for more food.

Dr. Zeff’s advice: You can identify your intolerances by temporarily following this strict diet — it’s tough but worth it. What you can eat: Fish (only the kind that has fins, not shellfish or other types)… most vegetables (but no potatoes, corn or soy — or products made from them)… brown rice… and the grains quinoa and millet. Walnut oil and other nut oils are okay (assuming that you aren’t allergic to nuts), but avoid olive oil as it’s from fruit. Avoid everything else including wheat… eggs… dairy products… animal meats… all fruit… alcohol… and all added sugars aside from a bit of pure maple syrup, which you can use as a sweetener. You can expect some digestive discomfort, such as bloating and bowel changes, for the first few days, but within 10 days or so, you’ll feel better. In fact, you are likely to feel quite wonderful!

At about two weeks, you should start to add back the foods you eliminated, one at a time — a new one every three to four days. Foods that bring digestive distress are the ones you are intolerant of, and you’ll need to give them up permanently.

Sluggish thyroid slows metabolism. Another biological problem that leads to obesity is a sluggish thyroid gland, which may be your problem if you have such symptoms as excess weight, tiredness, feeling cold, depression, and coarsening hair or having your hair fall out. This often goes undetected even after thyroid testing, since doctors may not factor in the subtleties of hormone test results.

Dr. Zeff’s advice: Noting first that treatment must be individualized, Dr. Zeff said that a typical strategy might be to start by enhancing iodine nutrition with a daily dose of seaweed powder (one-half to one teaspoonful mixed in water or juice or sprinkled on foods as a seasoning). Caution: Do not do this if you are allergic to iodine. Then Dr. Zeff might prescribe weekly acupuncture and/or a variety of approaches to stimulate thyroid function.

Adrenal fatigue affects blood sugar. Often the result of too much stress for too long, adrenal fatigue is characterized by exhaustion (especially in mid-afternoon), low blood pressure and a tendency toward low blood sugar — leading to overeating and sugar craving. Adrenal fatigue is diagnosed through a variety of blood tests. A tip-off: Dr. Zeff says people with adrenal fatigue often feel more comfortable wearing sunglasses much of the time because their pupils dilate too easily.

Dr. Zeff’s advice: Again, treatment varies, but Dr. Zeff told me that he commonly treats adrenal fatigue with different products that help rebuild and strengthen the adrenal glands. Specifically, he often recommends a blend of licorice root, ginseng, Eluthrococcus (also known as Siberian ginseng) or other similar adrenal support… or he may give adrenal gland substance in pill form, either a pure adrenal tissue extract or one combined with nutrients that the adrenals need to function well (vitamin C, certain B vitamins and zinc). It may take six weeks to three months to normalize adrenal function, says Dr. Zeff, adding that it is important to correct life stress factors as well so that you don’t start the same cycle again.

Overeating as self-medication. It’s no surprise that there often are psychological issues behind obesity, leading people to “self-medicate” with food — perhaps trying to dull emotional angst from a difficult childhood or an unsatisfactory marriage. Dr. Zeff said that the big reason people do this is that it not only fills an emotional void, it also works physiologically. Having food in your gut encourages production of serotonin (much of which is manufactured in the intestine), the brain chemical that increases a sense of well-being. But of course, it eventually backfires as weight — and health problems — pile on.

Dr. Zeff’s advice: Happily, there is a way to get the feel-good effect without over-eating. Tryptophan, an amino acid, also increases serotonin and enhances satiety. For some people, the 5-HTP version of this amino acid works better — your doctor will determine which is right for you. Dr. Zeff cautions that these supplements should be taken only under the supervision of a knowledgeable health-care professional and should not be taken with Prozac or other SSRI antidepressants.

…And Then What?

While there are other, less common biological problems behind obesity, these are the principal ones, says Dr. Zeff. He says that patients are encouraged when they see weight beginning to come off as these problems are addressed and treated and, of course, they continue to lose even more when he puts them on a diet of mostly proteins, vegetables and a bit of fruit. He advises avoiding grains, particularly wheat, potatoes, sugars and other simple carbs that produce a lot of insulin. As for exercise, patients start with whatever they can tolerate, adding longer and more intense workouts as they lose weight and gain more energy.

Obesity is a complex issue, to be sure, says Dr. Zeff, but he has seen time and again that it can be effectively addressed with strategies such as these. You can find a naturopathic physician at www.Naturopathic.org, the Web site for the American Association of Naturopathic Physicians.