Weight Management

Apple cider vinegar may help with weight management

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two bottles of apple cider vinegar next to a bucket of red apples
New research in adolescents and young adults suggests that apple cider vinegar could aid weight loss. Image credit: SKC/Stocksy.
  • Several food choices and lifestyle habits contribute to healthy weight management.
  • Researchers are seeking to understand specific foods that may help people maintain an appropriate weight.
  • A recent study found that regular consumption of apple cider vinegar may have several benefits, including reducing weight, body fat ratio, cholesterol, and blood glucose levels.

Maintaining a healthy weight can be challenging. People may utilize a number of strategies to assist with weight loss.

One such strategy of interest is the regular consumption of apple cider vinegar. Apple cider vinegar has many potential health benefits, and it is a highly popular item, used by consumers in foods and even in hair and skin routines.

A study published in BMJ Nutrition, Prevention & Health found that apple cider vinegar appeared to have weight management benefits among young adults with overweight or obesity.

Participants in the intervention group experienced a greater reduction weight, in waist-to-hip circumference, body mass index, and body fat ratio.

They also had lower blood sugar, triglyceride, and cholesterol readings. The results point to the potential benefits of apple cider vinegar in weight management.

Future research must confirm these findings and see how apple cider vinegar consumption may help individuals in other groups.

15 ml of apple cider vinegar a day may bring the most benefits

The study was a randomized, double-blind, placebo-controlled study that included Lebanese adolescents and young adults between the ages of 12 and 25. Participants were not on medications and did not have any chronic diseases.

Researchers recruited a total of 120 participants with overweight or obesity, and divided them into four groups. One group received the placebo, and the other three received a specific dose of apple cider vinegar — either 5, 10, or 15 milliliters (ml) diluted in water daily.

Other than this intervention, participants continued their normal diets and recorded what they ate.

Researchers collected data on body measurements and blood samples every 4 weeks. The study intervention lasted 12 weeks.

The study found that all amounts of apple cider vinegar improved weight components. Overall, all the intervention groups experienced weight, body mass index (BMI), waist-to-hip circumference, and body fat ratio reductions.

The intervention groups also had lower blood sugar, triglycerides, and total cholesterol levels, with the group receiving 15 ml of apple cider vinegar showing the greatest reductions.

The results did appear to be influenced by dose, with the group receiving the highest dose of apple cider vinegar showing the most significant reduction in weight and body mass index.

However, all intervention groups experienced similar reductions in waist-to-hip and body fat ratios. Participants did not experience any adverse or harmful effects because of the intervention.

The results point to a potential intervention to assist with weight loss. Study author Dr. Rony Abou-Khalil, head of the Biology Department at the Holy Spirit University of Kasik — Lebanon, explained to Medical News Today:

“The results of our study suggest that incorporating apple cider vinegar into the diet could be a beneficial adjunctive therapy for weight management in adolescents and young adults with overweight and obesity. Healthcare providers may consider recommending [apple cider vinegar] supplementation as part of a comprehensive weight loss program, alongside dietary and lifestyle modifications. However, further research is needed to confirm these findings and determine the optimal dosage and duration of [apple cider vinegar] supplementation.”

Adolescent bodies change: Would the findings apply to older adults?

The research did face certain limitations, which the authors acknowledge. Firstly, the researchers focused on a specific population, meaning we may not be able to generalize the results.

Secondly, study also only lasted 12 weeks, so future research could have a longer follow-up timeframe and include more participants.

Finally, some data relied on participants’ reports, which are not always precise. Blood sugar measurements involved looking at fasting blood sugar levels rather than an a1c testTrusted Source, so more research may be required to determine the long-term effect of apple cider vinegar on blood sugar.

Registered dietitian and nutritionist Karen Z. Berg, not involved in this research, commented on the findings for Medical News Today. According to her, this is “a strong study since it’s a double-blind placebo controlled study, and researchers nor participants knew which dose of [apple cider vinegar] they were taking.”

“To me the only negative of this study is the age group,” said Berg. “The ages of participants were 12–25 years […]. That is a very transformative time in one’s life, where the body is changing a lot, growth spurts are happening, and the metabolism functioning pretty quickly,” she cautioned.

“But since the placebo group and intervention group had similar ages, and they could compare people who got [apple cider vinegar] and the people who didn’t and saw no changes in the placebo group, that’s good to note,” Berg added.

Reflecing on potential areas for continued research, Dr. Abou-Khalil noted that “[f]uture research […] could investigate the mechanisms underlying the effects of [apple cider vinegar] on weight and metabolic health, explore potential differences in response to [apple cider vinegar] supplementation based on individual characteristics, such as age, gender, and baseline metabolic status, and assess the long-term safety and sustainability of [apple cider vinegar] use for weight management.”

“Additionally, studies comparing [apple cider vinegar] to other weight loss interventions or examining its efficacy in combination with other dietary supplements could provide valuable insights into its role in obesity management,” he said.

Why is managing weight important for health?

Maintaining a healthy weight is a critical component of well-being. It helps reduce the risk for certain chronic conditionsTrusted Source, such as high blood pressure and diabetes. People can seek to maintain a healthy weight by exercising regularly.

Diet is another critical component of weight management. People can follow certain dietary patternsTrusted Source that assist with weight loss, although effectiveness can vary. The focus is often on limiting calories and focusing on the type and quality of food consumed.

Kalyn True, a registered dietician with Memorial Hermann in Houston, TX, not involved in the current study, explained to MNT that “[w]eight management is important for a variety of reasons, including both physical and mental health benefits.”

According to her, this is because a healthy weight:

  • “Reduces [the] risk of chronic diseases: Being overweight or obese increases the risk of developing many serious health conditions, such as heart disease, type 2 diabetes, stroke, some cancers, and sleep apnea. Maintaining a healthy weight can significantly lower risk of these diseases.
  • Improves physical health: [Weight management] leads to increased energy levels, improved mobility and flexibility, and reduced stress on the joints.
  • Boosts mental well-being: [It] can improve self-esteem and body image and reduce symptoms of depression and anxiety.
  • Better overall quality of life: [People with a healthy body weight] find it easier to participate in physical activities and have more energy for work, family, and social activities.”

As for using apple cider vinegar for weight loss, Berg explained that, while it may bring some health benefits, we are still a long way off from confirming its potential as an alternative weight management aid.

“Apple cider vinegar is a type of vinegar that is made by fermenting apple juice,” Berg said, pointing out its “natural ingredient” appeal.

“Apple cider vinegar has long been thought to help with weight loss and digestion, but research in humans has not been strong enough to make definite correlations or recommendations,” she cautioned.

How Can Cognitive Behavioral Therapy (CBT) Help With Weight Management?

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Can your thoughts and feelings be linked to your weight? 

Experts say yes. Cognitive behavioral therapy (CBT) is a popular form of talk therapy that focuses on how your thoughts, feelings, and behaviors are connected. It’s effective for a wide range of issues. Those include helping you reach and keep a healthy weight. 

In the WebMD webinar “How Can Cognitive Behavioral Therapy (CBT) Help With Weight Management,” Rachel Goldman, PhD, explained to more than 2,200 attendees how CBT techniques can be key in managing your weight.

“These are also referred to as lifestyle modifications, behavioral interventions, or behavioral weight control,” said Goldman. “They provide people with a set of skills to achieve a healthier weight while learning how to handle barriers and potential challenges along the way.”

Viewer Polls and Questions

In a viewer poll during the webinar, almost half of the respondents said stress is the most likely emotional trigger for overeating. Another poll showed 28% of viewers interested in how CBT can help manage that stress and curb comfort eating. 

Question: It seems like an emotional trigger for overeating is:

  • Stress: 47%
  • Boredom: 33%
  • Loneliness: 6%
  • Sadness: 6%
  • Something else: 5%

Question: I’m interested in how CBT can help someone:

  • Better control what they eat: 37%
  • Manage stress to avoid eating for comfort: 28%
  • Get motivated to exercise: 18%
  • Improve how they feel about their body image: 13%
  • Something else: 2%

Goldman also answered viewer questions during the webinar. Those included:

“Why do people eat out of stress?”
“How can CBT be used to stop the habit of snacking at midnight?”
“How can you avoid or control snacking in social settings that revolve around food?”

Eating in response to an emotion like stress is common, Goldman explained. Maybe it became a habit to overeat or eat unhealthily on stressful days. When we eat certain foods, the reward center of our brain activates and it makes us feel good — and makes us want it again. If we’re feeling stressed, the immediate satisfaction we get from food is what we go to. This can become an issue if it’s your go-to coping mechanism for stress.

When we snack at midnight, we might think we’re hungry but we’re actually thirsty or tired. First, pause before you grab a snack. Ask yourself, are you just automatically grabbing the snack? If you’re actually hungry or if you just want to enjoy it, eat it. But first pause and identify what you’re doing. 

If you don’t need or want it, substitute the behavior. Have a glass of water, some herbal tea, hot water, or just go to bed.

Social eating may be something you want to prepare for. Don’t walk into events super hungry. It may be helpful to eat a little bit before you go somewhere. But remember, social eating is OK if you want to and if you feel in control.

“How can someone find a therapist skilled in using CBT for weight management?”
“How can you create accountability during a weight loss journey when you don’t have access to a registered dietitian?”
“How can you avoid getting discouraged during a weight loss journey?”

You can find a therapist through the Obesity Action Coalition (OAC), Psychology Today’s “therapist” button, or with a simple Google search of providers in your area, Goldman suggested. 

But if you don’t have access to a professional, you can make use of self-monitoring to stay accountable. The key, Goldman said, is to be consistent, patient, and persistent. Be kind to yourself.

You can also create a team of supportive people in your life. Find a friend who you can be accountability buddies with.

She also pointed to apps or social media experts that can provide information that’s less costly than a dietitian.

“Is weight loss possible after menopause?”
“What are the weight loss challenges associated with being postmenopausal?”

Weight is not all about calories in, calories out, Goldman said. There’s more that goes into that, like hormonal changes. During menopause, it’s first important to be mindful of your sleep.

To understand your body during menopause, she said, you might seek help from your doctor and get lab work done. This will help you understand what’s going on with your hormones. Regulating your hormones is important because they play a role in weight management. 

Another tip is to think about what worked for you when you were premenopausal, Goldman said. What did you do differently (in terms of your eating, sleeping, or other habits) when you felt good about your body and your weight?

What Is CBT for Weight Management?

Before CBT was a part of treatment for weight management, experts only focused on how your behaviors affected your weight.  But as time went on, CBT became recognized as an effective part of some weight management plans. 

Now, doctors understand that your weight is affected by many more things than just your behaviors. Today’s treatment of obesity and weight management is more complex. It focuses on many areas including your past experiences and present-day lifestyle changes.

How Does CBT Help in Weight Management?

The way you understand and think about something can affect how you feel and behave. CBT techniques shift your thoughts and emotions. 

These tools include:

Goal setting. CBT focuses on both long and short-term goals. “Define your long-term goal and then think backwards. Ask yourself how you’re going to get there,” Goldman said. Create short-term goals that lead to your main goal. Focus on small steps that relate to your behaviors.

You’ll create your goals with the “SMART” goal-setting tactic. These are:

  • Specific
  • Measurable
  • Attainable/achievable
  • Relevant/realistic
  • Timely

But it’s important that you avoid specifics like weight goals, or the words “less,” “more,” or “better,” she said. 

Self-monitoring. You can self-monitor almost anything. With CBT, you may focus on your food, emotions, activity, sleep, weight, or feeling of fullness. These are all data points that can help you in your weight management journey.

You can monitor the food you eat through a food diary. This can help keep track of the type of food you consume, the time you eat, and how much. You can do this through a diary you create or with a phone app like MyFitnessPal, FitDay, or SparkPeople.

But it’s not a good idea for everyone. “Food can be unhealthy to monitor for someone with a history of an eating disorder or disordered eating,” said Goldman.

Mindful eating habits. This can help you be more aware of food in general. Mindful eating isn’t a diet. It’s a tool that can help you learn your own habits around food. You might pay special attention to times you eat out of emotion, when you eat, the quality of your meals, or feelings you have about different foods.

Mindful eating can remind you to savor moments and slow down during meals.

Cognitive restructuring. Our thoughts are powerful. “Some thoughts are helpful, but others aren’t,” Goldman said. “The key of cognitive restructuring is that we identify, challenge, and change or tweak our unhelpful thoughts.”

With weight management, unhelpful thoughts may hold you back. Goldman pointed out some harmful thoughts:

  • “All or nothing thinking,” which makes it hard to find a happy medium. For example, if you can’t work out for a full hour, you might give up on an exercise for that day completely.
  • “Overgeneralizations,” which include defeating self-talk like “I can never reach my fitness goals,” or “I’ll never be able to lose weight.” 
  • “Jumping to conclusions” assumes things that may not be true. You might decide you’re already doomed before you even start.
  • “Should statements” might make you feel that you “should” go to the gym for a certain amount of time each day or that you “should” be able to lose a certain amount of weight. But these comments put you in a negative mindset. Focus on small steps that are doable in your life right now.

Behavior changes. Since your thoughts and emotions shape your behavior, it’s important to avoid negative ones. If you can rewire your thinking, you’ll have more success with weight management.

But this can be difficult. Maybe you’ve had negative, automatic thoughts for years. To help overcome them, Goldman suggests you:

  • Be compassionate with yourself and validate your feelings. Stay away from toxic positivity, too. Weight loss is hard and it’s OK to admit that.
  • Become more aware of your thoughts and practice mindfulness. Ask yourself if your thoughts are helpful, how they make you feel, and what purpose they serve.
  • Accept your thoughts for what they are, challenge them, and replace them with helpful thoughts. Remember, not all thoughts are facts.
  • Speak kindly to yourself. Your self-talk creates your reality. Frame your words in a healthy and realistic way. 

Future planning to avoid relapses. To continue your success with weight management, you need a plan. Find things that motivate you.

There are two types of motivation: external (like a friend’s kind comment) and internal (feeling good about your own health). 

“External motivators typically get people to make the first change,” Goldman said. “But eventually, when we make behavior changes that feel good, most people become motivated by internal feelings.”

To plan ahead, be ready to problem solve as well. There’ll be moments when weight management is hard. Expect challenges and face them with a healthy mindset. 

“We all lose sight of our goals,” she said. “When this happens, it’s important to go back to your ‘why.’ Why do you want to make these changes? Why are you going to set those goals?”

Your plan might not always work out perfectly because life happens! Outside stressors, other people’s actions, or the reactions of your peers are out of your control. But you do have control over your own reactions, thoughts, and behaviors.

Weight Management For T2DM Remission

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Type 2 Diabetes Mellitus (T2DM) is considered as a lifestyle disorder and obesity is one of the key risk factors that predispose to this metabolic syndrome. Several studies have proved that lifestyle and therapeutic interventions are beneficial in reducing weight that in turn improve insulin sensitivity and glycemic control. Individuals with body mass index (BMI) > 25 Kg/m2 and > 30 Kg/m2 are considered as overweight and obese respectively. Increased caloric intake and sedentary lifestyle are two most important factors that lead to increased body fat content that predispose to poor insulin sensitivity which in turn often progresses into T2DM.

Effect of obesity on insulin resistance Insulin resistance has different manifestations based on the location of the action. In muscles, insulin resistance leads to poor glucose uptake and reduced muscle glycogen synthesis; in the liver, it leads to impaired suppression of gluconeogenesis while maintaining the stimulation of fatty acid synthesis; in adipocytes, reduced insulin sensitivity results in decreased glucose uptake and impairment in the inhibition of lipolysis. Cumulative research over decades has revealed that obesity can cause insulin resistance through diverse mechanisms as discussed below: Glucose transporter type 4 (GLUT-4) Receptor abnormality: GLUT-4 receptors are responsible for glucose uptake. These receptors are present in the cytoplasm and translocate to the plasma membrane of the cell to import glucose molecules inside. In obese individuals, it has been often observed that GLUT-4 has reduced expression in adipocytes, leading to reduced glucose uptake despite normal insulin secretion. On the other hand, the expression of GLUT-4 remains unchanged in skeletal muscles of obese people, however, the fusion of these receptors to the plasma membrane is impaired leading to less glucose uptake despite normo- or hyperinsulinemia. Visceral adipocytes functionality: Research has confirmed that insulin resistance related to obesity depends on the location of the fat storage.

In fact, lipid accumulation in subcutaneous adipose tissue reduces the resistance to insulin. On the other hand, lipid accumulation and thereby increase in the visceral adipose tissue decreases insulin sensitivity. These adipose tissues are more lipolytically active that lead to increased intraportal free fatty acid levels resulting in insulin resistance and impairment of beta cell function. Enhanced lipid accumulation in these adipose tissues also increases the secretion of adipokine hormones that further increases insulin resistance in liver and muscle. Immunological factor of insulin resistance: Adipocytes are known to secrete inflammatory molecules such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) that can alter insulin signaling and reduce GLUT-4 expression leading to poor insulin sensitivity in the target cells. In obese individuals, hypertrophic adipocytes release chemoattractant molecules such as monocyte chemoattractant protein-1 (MCP-1) which leads to infiltration of macrophage and other immune cells in the adipose tissue resulting in secretion of more inflammatory molecules that further impair the action of insulin. Lifestyle modification for weight reduction and improvement of T2DM Lifestyle modifications are one of the earliest physician recommendations to overweight and obese patients with insulin resistance to prevent T2DM. Even in T2DM patients, lifestyle changes besides medications are extremely useful. Physical activity and maintaining well-planned diet are necessary steps for weight reduction.

Regular exercise helps in maintaining the energy balance in the body and helps offset excess caloric gain through food intake. Regular aerobic exercises are related to the reduction in visceral fat leading to improvement in glucose tolerance, insulin sensitivity, and glycemic control. Many studies have confirmed the insignificant effect on weight reduction through physical exercise if caloric restriction is not maintained. Low-fat and low-carbohydrate diets are highly beneficial dietary interventions in weight management. For T2DM patients or obese individuals with insulin resistance and risk of T2DM, the low-carbohydrate diet preferentially includes foods with low glycemic index. Several studies have shown that patients on low-carbohydrate diet are able to reduce significantly more weight compared to patients on a low-fat diet for initial 6 months. However, in long run, weight loss with both types of diets are similar. The benefits of lifestyle modifications in weight reduction are evident from clinical studies. The Diabetes Prevention Program randomized more than 3200 participants with insulin resistance to receive placebo or metformin or lifestyle modification and followed them for 2.8 years. The lifestyle modification included low-fat diet (1200-2000 Kcal/day depending on weight) and 150 min/week physical activity with a goal of 7% weight reduction from the baseline. After 2.8 years the lifestyle intervention group reduced an average 5.6 kg body weight, while the metformin and placebo groups lost 2.1 kg and 0.1 kg only. Pharmacological management for weight reduction In overweight and obese people with insulin resistance or T2DM, pharmacological management for weight loss can be considered only if lifestyle modifications are ineffective or inadequate.

The FDA has approved several drugs for weight loss: Intestinal lipase inhibitor Orlistat effectively decrease fat deposition in the body. Multiple randomized clinical trials have shown that Orlistat reduces an average 8-10% of initial weight which is 4% more reduction in weight compared to that of placebo and lifestyle change combination. Lorcaserin reduces appetite by activating serotonin receptor 5-HT2c. As per clinical studies, Lorcaserin reduces on average 5-6% of initial weight compared to 2-3% in Placebo treatments. Phentermine-Topiramate combination causes early satiety and thereby reduces dietary intake. The combination drug is found to reduce 8-10% of initial body weight compared to placebo (1-2%) as observed in randomized trials. Bupropion-naltrexone combination is found to reduce 5-6% of initial body weight compared to 1.3% that is achieved with placebo treatment. Besides the conventional drugs for weight loss, several antidiabetic drugs have also shown the promise. Since these drugs serve both the purposes (weight loss and glycemic control), patients need to take fewer medications. Selective sodium glucose co-transporter 2 (SGLT-2) inhibitors are effective drugs for T2DM management. However, Empagliflozin, an SGLT-2 inhibitor also effectively reduces body weight. In a randomized double-blind clinical trial with 3300 T2DM patients (HbA1c >7% – <10%), Empagliflozin (10mg and 25mg) significantly reduced (P<0.001 compared to placebo) body weight, waist circumference, estimated body fat, index of central obesity and visceral adiposity index.  Other studies also reported 2.2-4.0 Kg weight loss with Empagliflozin monotherapy or combination therapy (Metformin or insulin).

Besides Empagliflozin, other oral antidiabetic drugs such as Glucagon-like peptide 1 receptor agonist (GLP-1RA) Liraglutide & Exenatide, insulin-sensitizing drug Metformin, Dipeptidyl peptidase-4 inhibitors are also known to reduce body weight. Surgical management for weight reduction and its impact on T2DM remission For extremely obese patients (BMI > 35 Kg/m2), pharmacological therapy is often insufficient to achieve recommended weight loss and related glycemic improvement. For these patients, bariatric surgery has shown tremendous efficacy. It is now established that laparoscopic Roux-en-Y gastric bypass surgery leads to normoglycemia in more than 75% of these T2DM patients. Few other proposed mechanisms that are related to gastric bypass surgery and T2DM remission are as follows: The surgery stimulates the secretion of incretin peptides such as GLP-1 from L-cells resulting improved insulin secretion in a glucose-dependent Moreover, other incretins such as a gastric inhibitory peptide (GIP) also increases post-prandial insulin secretion. The surgery reduces the secretion of anti-incretin hormones resulting in improved blood glucose level. Adipocyte-derived hormone leptin causes insulin resistance while adiponectin improves insulin sensitivity.

Gastric bypass surgery reduces leptin level and improves adiponectin level. Moreover, clinical findings have shown the benefit of gastric bypass surgeries especially that offers caloric restriction in reducing body weight and T2DM remission. In a study with 1160 morbidly obese patients, Roux-en-Y gastric bypass surgery resulted in a normal level of fasting glucose and HbA1c levels in 83% cases and improved in remaining 17% cases. The surgery also reduced the need for oral antidiabetic drugs and insulin in 80% and 79% cases respectively. The remission of T2DM after the surgery was 95% in patients who had T2DM for less than 5 years, 75% (T2DM 6-10 years), 54% (T2DM more than 10 years).

Overall, more than 90% of the T2DM patients are either overweight or obese. BMI above normal is also associated with people with insulin resistance. Since obesity is an established predisposing factor for T2DM, effective remission of the disease requires thorough lifestyle management, pharmacological as well as surgical interventions to reduce body weight besides targeting better glycemic control.

 

References

Olga T. Hardya, Michael P. Czech, and Silvia Corvera, What causes the insulin resistance underlying obesity? Curr Opin Endocrinol Diabetes Obes. 2012 April; 19(2): 81–87. Barbara B. Kahn and Jeffrey S. Flier, Obesity and insulin resistance. The Journal of Clinical Investigation, August 2000, Volume 106, Number 4. Thomas A. Wadden, PhD, Victoria L. Webb, BA, Caroline H. Moran, BA, and Brooke A. Bailer, PhD, Lifestyle Modification for Obesity: New Developments in Diet, Physical Activity, and Behavior Therapy. Circulation. 2012 March 6; 125(9): 1157–1170. George A Bray, Patient education: Weight loss treatments (Beyond the Basics). UpToDate. 2015. Retrieved on 5th January 2018 (https://www.uptodate.com/contents/weight-loss-treatments-beyond-the-basics) Ian J Neeland, Darren K McGuire, Robert Chilton, Susanne Crowe, Søren S Lund, Hans J Woerle, Uli C Broedl, and Odd Erik Johansen, Empagliflozin reduces body weight and indices of adipose distribution in patients with type 2 diabetes mellitus. Diab Vasc Dis Res. 2016 Mar; 13(2): 119–126. Fábryová Ľubomíra, Weight Loss Pharmacotherapy of Obese Non-Diabetic and Type 2 Diabetic Patients. Lubomíra, J Obes Weight Loss Ther 2015, 5:5. Mahmoud Attia Mohamed Kassem, Michael Andrew Durda, Nicoleta Stoicea, Omer Cavus, Levent Sahin, and Barbara Rogers, The Impact of Bariatric Surgery on Type 2 Diabetes Mellitus and the Management of Hypoglycemic Events. Front Endocrinol (Lausanne). 2017; 8: 37. Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, Eid GM, Mattar S, Ramanathan R, Barinas-Mitchel E, Rao RH, Kuller L, Kelley D, Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003 Oct;238(4):467-84; discussion 84-5.

Slow Down Diet Helps with Weight Management

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Story at-a-glance–

  • Most people eat too fast, which causes stress and cuts you off from your body’s innate intelligence; slowing down the pace at which you eat is an important part of reestablishing this natural connection
  • Stress and fear results in sympathetic nervous system dominance, increased insulin, increased cortisol, and increased stress hormones — all of which deregulates your appetite and makes you eat more
  • Eating a very low-fat diet may prevent weight loss. One of the signs of essential fatty acid deficiency is weight gain or inability to lose weight.

Many people have a problem with their relationship with food. Some overeat, others unde reat, and many struggle with their weight despite doing everything right “on paper.”

“Sonoma State University allowed me to do an independent study for my master’s degree in Eating Psychology. I put an ad in a newspaper that said, ‘Graduate student looking to start Eating Psychology study group.’ That was the beginnings for me of learning on the job.

I had a group of 20 plus people — a handful of anorexics; a handful of some of the most obese people I’d ever seen; a beautiful model who had an eating disorder; and a handful of women in their 50s who looked fine to me but [spent their] life chronically dieting.

That was my beginnings of starting to understand eating psychology, counseling psychology, and coaching psychology. I looked at all the different modalities, started doing clinical practice, and said, ‘OK. What works and what doesn’t?'”

Why Does Dieting Oftentimes Fail?

Gradually, over the course of about 15 years, David developed a number of strategies that effectively address weight, body image, overeating, binge eating, emotional eating, and endless dieting.

The key was to distill the science and psychology down into simple, clear, and straightforward strategies that could empower people to take action and get desired results.

For example, many people diet and exercise yet don’t lose weight. Why is that? Oftentimes there are secondary complaints that can offer clues.

“Maybe they have digestive issues. Maybe they have mood, irritability, or fatigue. Maybe they have dry skin and dry hair. Then I look at their diet and find that they’re eating extremely low-fat.

Now, why are they eating extremely low-fat? They’re [doing it] because they have what I call the ‘toxic nutritional belief’ that ‘fat in food equals fat on my body.’ That’s a piece of nutritional information that they’re practicing, using, and abiding by.”

The problem with believing and following this myth is that lack of dietary fat may actually be part of why you can’t lose weight. One of the signs of essential fatty acid deficiency is weight gain or inability to lose weight.

This seems counter intuitive to many, but the proof is in the pudding, as the saying goes, and if you’re not losing weight even though you’ve cut out nearly all fat, then perhaps it’s time to reassess your belief system.

“Then I have to do what I call an intellectual intervention,” says. “This is my opportunity to deliver information… and let them know that ‘here is where your belief is impacting the goal that you want.’

[I’ll tell them] ‘let’s do an experiment because you’ve been doing it this way for a dozen years. So now we’re going to include more healthy essential fats in your diet for the next several weeks. Then we’re going to see how you feel.'”

More often than not, adding healthy fats back into your diet will result in more regular bowel movements, an increased sense of well-being, improved appetite control, and, eventually, weight loss.

Reconnecting to Your Body’s Innate Intelligence

Part of the challenge, David notes, is that most people have lost their connection to body intelligence. “There’s a brilliant wisdom that’s activated once we start to clean up our diet and eat healthier food,” he says.

Most people also eat too fast, and this too cuts you off from your body’s innate intelligence, so slowing down the pace at which you eat is a very important part of reestablishing this natural connection.

If you’re a fast eater, you’re not paying attention to the food you’re eating, and you’re missing what scientists call the cephalic phase digestive response (CPDR).

Cephalic phase digestive response is a fancy term for taste, pleasure, aroma, and satisfaction, including the visual stimulus of your meal. Researchers estimate about 40 to 60 percent of your digestive and assimilative power at any meal comes from this “head phase” of digestion.

“In other words, you look at a food and your mouth starts to water,” David explains. “You think of a food and your stomach starts to churn. That’s digestion beginning in the mind. When we are not paying attention to the meal, our natural appetite is deregulated. On top of that, eating very fast puts your body in a stress state.”

Stress Effectively Hinders Weight Loss

When you put your body in a stress state, you have sympathetic nervous system dominance, increased insulin, increased cortisol, and increased stress hormones.

Not only will this deregulate your appetite, you’re also going to eat more, because when your brain doesn’t have enough time to sense the taste, aroma, and pleasure from the food, it keeps signaling that hunger has not been satisfied.

You’ve undoubtedly experienced this at some point: You quickly gorge on a huge meal, but when you’re finished, your belly is distended yet you still feel the urge to eat more. At the heart of this problem is eating too quickly, which causes stress. As David explains:

“I want to steer people towards more soulful eating,” David says. “Be present. Feel good about what you’re doing. Get pleasure from that meal. Taste it. Stress is arguably one of the most common causative or contributing factors to just about any disease, condition, or symptom we know of.

When I can start to help a person slow down with their meal and get in a relationship with their food, first and foremost, what’s happening is they’re stepping into parasympathetic nervous system dominance.

If you take five to 10 long, slow deep breaths before a meal, or five to 10 long, slow deep breaths before anything you do, you are training your system to drop into the physiologic relaxation response. When I can help somebody drop into that place, magic starts to happen. People start to go, ‘Oh my goodness, I paid attention to my meal. I was present and I slowed down. I’m not overeating anymore.'”

In David’s experience, a person’s problem with overeating or binge eating can disappear within days when they get into right relationship with food and life, which means being present to it. Being present and mindful can actually affect your physiology in a very direct and profound way.

So if you typically reserve five minutes for breakfast, make that 15 or 20 minutes. If you’re taking 10 minutes for lunch, take 30, 40, or better yet, as much as an hour or an hour and a half, which is common practice in many European countries.

Approaching Food from a Place of Inspiration Rather than Fear

Many people also suffer from what David calls a “high fact diet,” meaning they have amassed a great deal of nutritional information, but they don’t have the expertise to determine fact from fiction, and thus they get inundated with minutia and overwhelmed by contradictions. “From that place, they can easily go into breakdown. They can easily go into ‘Oh, screw it. I don’t know what to do,'” he says.

Others eat very healthy foods, but are motivated to do so not because of the health benefits they get, but because they fear they’ll end up diseased or dead if they don’t. You might think that the end result would be the same, regardless of the motivation driving their food choices, but doing anything from a place of fear can set you up for failure.

“Start to notice… ‘What are the thoughts that are serving you and what are the thoughts that aren’t serving you?’ Living in a constant state of ‘I’m no good, I’m not eating the right diet, I know I’m supposed to eat paleo but I didn’t do it perfectly so now I have to punish myself,’ [will cause] people to quit a great nutritional program because they made one little mix up!

I’ve helped so many people who were following a healthy diet out of fear. Follow a healthy diet out of inspiration. What do you want to do when you’re healthy? Who do you want to be when you’re really healthy, when you have all this energy, and when you have the perfect weight?”

The strategy David recommends here is to turn eating into a meditative act; to slow down, and become aware — of your food, and of how your body responds to the food.

“It becomes a meditation of ‘What am I thinking about when I eat? Am I present? Am I tasting the food? What does this food taste like? Am I full? Do I need to eat more?’ Then it becomes a meditation after the meal. I ask people to check in 20 or 30 minutes later. ‘How’s your body feeling now? Are you noticing anything? Are your sinuses clogged?’ They might say, ‘Yeah, I’m noticing I have a little head congestion.’ Does that connect to what I ate then in terms of how I’m feeling right now?’ It’s all about awareness. It’s all about questioning.”

Why Intermittent Fasting Might Not Work for Some People

Most people who seek to lose weight are insulin resistant, and in over 35 years of experience in clinical medicine, I’ve not discovered a more effective intervention than intermittent fasting, where you skip either breakfast or dinner, thereby restricting your eating to a narrower window of time each day. Restricting your calories to a six to eight hour window is a powerful intervention that will jumpstart your metabolic systems to start burning fat for fuel.

David agrees, but notes that many people who skip meals from a fear-based place with the intention to cut calories often still fail to lose weight.

“I’ve seen hundreds of these clients,” he says, adding that, “there is a huge subset of people who have been taught that weight loss is calories in and calories out, period. From that understanding, they are trying to limit their number of calories. Oftentimes that is done from a place of fear and anxiety, i.e. ‘stress.’

And one of the factors that creates weight loss resistance is the constant state of stress that we live under. Because if you’re not losing weight on a weight loss strategy where you’re undereating for years, that creates stress and upset. To me, that low-level and that chronically elevated insulin and cortisol impacts the body and the sympathetic nervous system.”

In essence, what’s happening in such a situation is that even though skipping meals should improve your ability to lose weight, the fear and stress overrides the process by upregulating your sympathetic nervous system. Also, from a stand point of bio-circadian nutrition, some people find it easier to lose weight when they’re eating the bulk of their calories in the first half of the day as opposed to the latter part, so maybe you’d do better eating breakfast and skipping dinner (or vice versa).

Are You on a Sumo Diet?

Dr. Lee Know’s book “Life – The Epic Story of Our Mitochondria,” really brought home the importance of meal timing for me. Most people eat their biggest meal at night, which could be a massive mistake because your mitochondria — the powerhouses inside your cells — are responsible for “burning” the fuel your body consumes and converting into usable energy.

When you add fuel close before bedtime — a time when you actually need the least amount of energy — you end up generating metabolic complications, caused by free radicals and an excess of electrons produced in the process.

In a nutshell, late-night eating tends to generate excess free radicals, which promotes DNA damage that contributes to chronic degenerative diseases and promotes accelerated aging. To avoid this, stop eating at least three hours before bedtime. David also notes that, according to the concept of bio-circadian nutrition, your ability to metabolize food is related to your body temperature.

Your body temperature is highest right around solar noon, and that’s when your body is metabolically operating at peak efficiency, burning the most calories. Moreover, he says that:

“Historically, the one place I could find that this was being put to use was in the traditional sumo wrestler community. You ask yourself, ‘How did all those Japanese guys get so big?’ As it turns out, back in the 1400s and 1500s when they didn’t have cookies and ice cream, they were eating more food than their average countrymen, and they would wake themselves up in the middle of the night and eat the bulk of their food when everybody else was sleeping.

The sumo community, the sumo wrestlers, discovered that if we want to gain massive amounts of weight, just eat it all in the middle of the night! So if you’re eating the bulk of your calories late at night, you’re on the sumo diet. This is a very simple piece of nutrition information, which is so crucial and so key.”

Exercise, but Choose Something You Love

David often recommends yoga, especially to people who have been eating right and exercising yet still fail to lose weight. Part of the problem here, he says, again goes back to stress — in this case, engaging in exercise you hate, or feeling that exercise is a form of punishment for eating or punishment for being overweight. By doing something you can’t stand, you enter into sympathetic nervous system dominance, which cancels out many of the benefits of exercise.

He noticed that simply by switching to a form of exercise they found enjoyable was enough to provoke a shift, allowing them to start losing weight.

“When you put people on exercise that they love, or movement that they love, something happens. They get happy. They get more in love with their body. They get more present. People who are weight loss-resistant will start to lose weight finally. So that’s an observation. I believe that it has to do with, once again, the person’s kind of metabolic posture, the state that their nervous system is in. If you’re doing exercise you can’t stand, you’re probably going to be locked in sympathetic nervous system dominance,” he says.

Minding Your Posture While Eating

David has also found that when it comes to addressing overeating, binge eating, emotional eating, and endless dieting, your posture can play a role. Are you sitting up straight when eating, or are you slouched over your plate? People who slouch while eating tend to eat more quickly, but it also affects how you relate to your food. David xplains:

“We have a different relationship with food when we’re upright. First of all, there’s more of a sense of dignity. There’s a sense of authority. When I’m slouched, I’m more energetically collapsed. This posture has an emotional kind of texture to it and the texture tends to be one more of subservience, defeat, or I’m making myself small. [Sitting upright makes] people feel more empowered and more dignified about their own self, their own body, and their relationship with food.

Also, when sitting upright, it will make breathing easier. It will make the breath more full. The breathing pattern of relaxation is regular, rhythmic, and deeper. The breathing pattern of distress response is arrhythmic, shallow, and infrequent. If you’re hunched over, you will breathe more as if you’re in sympathetic nervous system dominance. You’re going to be breathing shallower. When you’re upright, when your chest is expanded, you can breathe more regular, rhythmic, and deep.

Just adopting the breathing pattern of parasympathetic nervous system dominance will put you in that place in less than two minutes easily, which will then put you in the optimum state of digestion and assimilation. It will put you in the optimum state of being aware of your own appetite. So, one simple shift in the body can be very profound.

Also, when we start to become more erect, what we’re doing is we are changing our personality. We are really stepping into our own personal growth program where we’re claiming a sense of empowerment. Yes, it is good, structurally. But it’s good for who we are as human beings inside as well.”

If You’re Stuck, Go Back to the Basics

The more I study and the more I learn, the more I realize how simple it is. Health and weight loss are not nearly as complicated as we’ve been led to believe. It comes down to understanding and applying some very basic principles, because your body was actually designed to stay healthy. It wants to be healthy. It does not want to be diseased or to rely on medications. Once you give your body what it needs, it will go into self-repair mode and heal quite efficiently.

Besides a healthy diet and physical activity that you enjoy, the ability to self-reflect and grow may also play a more important role than most people suspect.

“There’s a subset of people who, until they do work on their self, they don’t get the body to shift where it naturally needs to go. What I’m saying is, in my observation, there’s a connection, oftentimes, between personal growth and metabolic potential. I like to use the formula: personal power equals metabolic power. Meaning, as I become the person that I’m meant to be; as I do work on self; as I become better in my character, and as I look at what life is trying to teach me, how do I learn my lessons? How do I become a better person?

How do I fulfill my mission in the world? How do I deliver my gifts? As I do that, I’ve noticed that my body has the best chance to step into its metabolic potential. Do I need to eat all the right foods? Of course I do. But as I’m stepping into my personal potential, I naturally gravitate towards the information, the kinds of foods, or the kinds of practices that serve me. That, I think, is a missing piece in the conversation around weight, or even the conversation around health in general.”

By Dr. Mercola

Many people have a problem with their relationship with food. Some overeat, others unde reat, and many struggle with their weight despite doing everything right “on paper.”

“Sonoma State University allowed me to do an independent study for my master’s degree in Eating Psychology. I put an ad in a newspaper that said, ‘Graduate student looking to start Eating Psychology study group.’ That was the beginnings for me of learning on the job.

I had a group of 20 plus people — a handful of anorexics; a handful of some of the most obese people I’d ever seen; a beautiful model who had an eating disorder; and a handful of women in their 50s who looked fine to me but [spent their] life chronically dieting.

That was my beginnings of starting to understand eating psychology, counseling psychology, and coaching psychology. I looked at all the different modalities, started doing clinical practice, and said, ‘OK. What works and what doesn’t?'”

Why Does Dieting Oftentimes Fail?

Gradually, over the course of about 15 years, David developed a number of strategies that effectively address weight, body image, overeating, binge eating, emotional eating, and endless dieting.

The key was to distill the science and psychology down into simple, clear, and straightforward strategies that could empower people to take action and get desired results.

For example, many people diet and exercise yet don’t lose weight. Why is that? Oftentimes there are secondary complaints that can offer clues.

“Maybe they have digestive issues. Maybe they have mood, irritability, or fatigue. Maybe they have dry skin and dry hair. Then I look at their diet and find that they’re eating extremely low-fat.

Now, why are they eating extremely low-fat? They’re [doing it] because they have what I call the ‘toxic nutritional belief’ that ‘fat in food equals fat on my body.’ That’s a piece of nutritional information that they’re practicing, using, and abiding by.”

The problem with believing and following this myth is that lack of dietary fat may actually be part of why you can’t lose weight. One of the signs of essential fatty acid deficiency is weight gain or inability to lose weight.

This seems counter intuitive to many, but the proof is in the pudding, as the saying goes, and if you’re not losing weight even though you’ve cut out nearly all fat, then perhaps it’s time to reassess your belief system.

“Then I have to do what I call an intellectual intervention,” says. “This is my opportunity to deliver information… and let them know that ‘here is where your belief is impacting the goal that you want.’

[I’ll tell them] ‘let’s do an experiment because you’ve been doing it this way for a dozen years. So now we’re going to include more healthy essential fats in your diet for the next several weeks. Then we’re going to see how you feel.'”

More often than not, adding healthy fats back into your diet will result in more regular bowel movements, an increased sense of well-being, improved appetite control, and, eventually, weight loss.

Reconnecting to Your Body’s Innate Intelligence

Part of the challenge, David notes, is that most people have lost their connection to body intelligence. “There’s a brilliant wisdom that’s activated once we start to clean up our diet and eat healthier food,” he says.

Most people also eat too fast, and this too cuts you off from your body’s innate intelligence, so slowing down the pace at which you eat is a very important part of reestablishing this natural connection.

If you’re a fast eater, you’re not paying attention to the food you’re eating, and you’re missing what scientists call the cephalic phase digestive response (CPDR).

Cephalic phase digestive response is a fancy term for taste, pleasure, aroma, and satisfaction, including the visual stimulus of your meal. Researchers estimate about 40 to 60 percent of your digestive and assimilative power at any meal comes from this “head phase” of digestion.

“In other words, you look at a food and your mouth starts to water,” David explains. “You think of a food and your stomach starts to churn. That’s digestion beginning in the mind. When we are not paying attention to the meal, our natural appetite is deregulated. On top of that, eating very fast puts your body in a stress state.”

Stress Effectively Hinders Weight Loss

When you put your body in a stress state, you have sympathetic nervous system dominance, increased insulin, increased cortisol, and increased stress hormones.

Not only will this deregulate your appetite, you’re also going to eat more, because when your brain doesn’t have enough time to sense the taste, aroma, and pleasure from the food, it keeps signaling that hunger has not been satisfied.

You’ve undoubtedly experienced this at some point: You quickly gorge on a huge meal, but when you’re finished, your belly is distended yet you still feel the urge to eat more. At the heart of this problem is eating too quickly, which causes stress. As David explains:

“I want to steer people towards more soulful eating,” David says. “Be present. Feel good about what you’re doing. Get pleasure from that meal. Taste it. Stress is arguably one of the most common causative or contributing factors to just about any disease, condition, or symptom we know of.

When I can start to help a person slow down with their meal and get in a relationship with their food, first and foremost, what’s happening is they’re stepping into parasympathetic nervous system dominance.

If you take five to 10 long, slow deep breaths before a meal, or five to 10 long, slow deep breaths before anything you do, you are training your system to drop into the physiologic relaxation response. When I can help somebody drop into that place, magic starts to happen. People start to go, ‘Oh my goodness, I paid attention to my meal. I was present and I slowed down. I’m not overeating anymore.'”

In David’s experience, a person’s problem with overeating or binge eating can disappear within days when they get into right relationship with food and life, which means being present to it. Being present and mindful can actually affect your physiology in a very direct and profound way.

So if you typically reserve five minutes for breakfast, make that 15 or 20 minutes. If you’re taking 10 minutes for lunch, take 30, 40, or better yet, as much as an hour or an hour and a half, which is common practice in many European countries.

Approaching Food from a Place of Inspiration Rather than Fear

Many people also suffer from what David calls a “high fact diet,” meaning they have amassed a great deal of nutritional information, but they don’t have the expertise to determine fact from fiction, and thus they get inundated with minutia and overwhelmed by contradictions. “From that place, they can easily go into breakdown. They can easily go into ‘Oh, screw it. I don’t know what to do,'” he says.

Others eat very healthy foods, but are motivated to do so not because of the health benefits they get, but because they fear they’ll end up diseased or dead if they don’t. You might think that the end result would be the same, regardless of the motivation driving their food choices, but doing anything from a place of fear can set you up for failure.

“Start to notice… ‘What are the thoughts that are serving you and what are the thoughts that aren’t serving you?’ Living in a constant state of ‘I’m no good, I’m not eating the right diet, I know I’m supposed to eat paleo but I didn’t do it perfectly so now I have to punish myself,’ [will cause] people to quit a great nutritional program because they made one little mix up!

I’ve helped so many people who were following a healthy diet out of fear. Follow a healthy diet out of inspiration. What do you want to do when you’re healthy? Who do you want to be when you’re really healthy, when you have all this energy, and when you have the perfect weight?”

The strategy David recommends here is to turn eating into a meditative act; to slow down, and become aware — of your food, and of how your body responds to the food.

“It becomes a meditation of ‘What am I thinking about when I eat? Am I present? Am I tasting the food? What does this food taste like? Am I full? Do I need to eat more?’ Then it becomes a meditation after the meal. I ask people to check in 20 or 30 minutes later. ‘How’s your body feeling now? Are you noticing anything? Are your sinuses clogged?’ They might say, ‘Yeah, I’m noticing I have a little head congestion.’ Does that connect to what I ate then in terms of how I’m feeling right now?’ It’s all about awareness. It’s all about questioning.”

Why Intermittent Fasting Might Not Work for Some People

Most people who seek to lose weight are insulin resistant, and in over 35 years of experience in clinical medicine, I’ve not discovered a more effective intervention than intermittent fasting, where you skip either breakfast or dinner, thereby restricting your eating to a narrower window of time each day. Restricting your calories to a six to eight hour window is a powerful intervention that will jumpstart your metabolic systems to start burning fat for fuel.

David agrees, but notes that many people who skip meals from a fear-based place with the intention to cut calories often still fail to lose weight.

“I’ve seen hundreds of these clients,” he says, adding that, “there is a huge subset of people who have been taught that weight loss is calories in and calories out, period. From that understanding, they are trying to limit their number of calories. Oftentimes that is done from a place of fear and anxiety, i.e. ‘stress.’

And one of the factors that creates weight loss resistance is the constant state of stress that we live under. Because if you’re not losing weight on a weight loss strategy where you’re undereating for years, that creates stress and upset. To me, that low-level and that chronically elevated insulin and cortisol impacts the body and the sympathetic nervous system.”

In essence, what’s happening in such a situation is that even though skipping meals should improve your ability to lose weight, the fear and stress overrides the process by upregulating your sympathetic nervous system. Also, from a stand point of bio-circadian nutrition, some people find it easier to lose weight when they’re eating the bulk of their calories in the first half of the day as opposed to the latter part, so maybe you’d do better eating breakfast and skipping dinner (or vice versa).

Are You on a Sumo Diet?

Dr. Lee Know’s book “Life – The Epic Story of Our Mitochondria,” really brought home the importance of meal timing for me. Most people eat their biggest meal at night, which could be a massive mistake because your mitochondria — the powerhouses inside your cells — are responsible for “burning” the fuel your body consumes and converting into usable energy.

When you add fuel close before bedtime — a time when you actually need the least amount of energy — you end up generating metabolic complications, caused by free radicals and an excess of electrons produced in the process.

In a nutshell, late-night eating tends to generate excess free radicals, which promotes DNA damage that contributes to chronic degenerative diseases and promotes accelerated aging. To avoid this, stop eating at least three hours before bedtime. David also notes that, according to the concept of bio-circadian nutrition, your ability to metabolize food is related to your body temperature.

Your body temperature is highest right around solar noon, and that’s when your body is metabolically operating at peak efficiency, burning the most calories. Moreover, he says that:

“Historically, the one place I could find that this was being put to use was in the traditional sumo wrestler community. You ask yourself, ‘How did all those Japanese guys get so big?’ As it turns out, back in the 1400s and 1500s when they didn’t have cookies and ice cream, they were eating more food than their average countrymen, and they would wake themselves up in the middle of the night and eat the bulk of their food when everybody else was sleeping.

The sumo community, the sumo wrestlers, discovered that if we want to gain massive amounts of weight, just eat it all in the middle of the night! So if you’re eating the bulk of your calories late at night, you’re on the sumo diet. This is a very simple piece of nutrition information, which is so crucial and so key.”

Exercise, but Choose Something You Love

David often recommends yoga, especially to people who have been eating right and exercising yet still fail to lose weight. Part of the problem here, he says, again goes back to stress — in this case, engaging in exercise you hate, or feeling that exercise is a form of punishment for eating or punishment for being overweight. By doing something you can’t stand, you enter into sympathetic nervous system dominance, which cancels out many of the benefits of exercise.

He noticed that simply by switching to a form of exercise they found enjoyable was enough to provoke a shift, allowing them to start losing weight.

“When you put people on exercise that they love, or movement that they love, something happens. They get happy. They get more in love with their body. They get more present. People who are weight loss-resistant will start to lose weight finally. So that’s an observation. I believe that it has to do with, once again, the person’s kind of metabolic posture, the state that their nervous system is in. If you’re doing exercise you can’t stand, you’re probably going to be locked in sympathetic nervous system dominance,” he says.

Minding Your Posture While Eating

David has also found that when it comes to addressing overeating, binge eating, emotional eating, and endless dieting, your posture can play a role. Are you sitting up straight when eating, or are you slouched over your plate? People who slouch while eating tend to eat more quickly, but it also affects how you relate to your food. David xplains:

“We have a different relationship with food when we’re upright. First of all, there’s more of a sense of dignity. There’s a sense of authority. When I’m slouched, I’m more energetically collapsed. This posture has an emotional kind of texture to it and the texture tends to be one more of subservience, defeat, or I’m making myself small. [Sitting upright makes] people feel more empowered and more dignified about their own self, their own body, and their relationship with food.

Also, when sitting upright, it will make breathing easier. It will make the breath more full. The breathing pattern of relaxation is regular, rhythmic, and deeper. The breathing pattern of distress response is arrhythmic, shallow, and infrequent. If you’re hunched over, you will breathe more as if you’re in sympathetic nervous system dominance. You’re going to be breathing shallower. When you’re upright, when your chest is expanded, you can breathe more regular, rhythmic, and deep.

Just adopting the breathing pattern of parasympathetic nervous system dominance will put you in that place in less than two minutes easily, which will then put you in the optimum state of digestion and assimilation. It will put you in the optimum state of being aware of your own appetite. So, one simple shift in the body can be very profound.

Also, when we start to become more erect, what we’re doing is we are changing our personality. We are really stepping into our own personal growth program where we’re claiming a sense of empowerment. Yes, it is good, structurally. But it’s good for who we are as human beings inside as well.”

If You’re Stuck, Go Back to the Basics

The more I study and the more I learn, the more I realize how simple it is. Health and weight loss are not nearly as complicated as we’ve been led to believe. It comes down to understanding and applying some very basic principles, because your body was actually designed to stay healthy. It wants to be healthy. It does not want to be diseased or to rely on medications. Once you give your body what it needs, it will go into self-repair mode and heal quite efficiently.

Besides a healthy diet and physical activity that you enjoy, the ability to self-reflect and grow may also play a more important role than most people suspect.

“There’s a subset of people who, until they do work on their self, they don’t get the body to shift where it naturally needs to go. What I’m saying is, in my observation, there’s a connection, oftentimes, between personal growth and metabolic potential. I like to use the formula: personal power equals metabolic power. Meaning, as I become the person that I’m meant to be; as I do work on self; as I become better in my character, and as I look at what life is trying to teach me, how do I learn my lessons? How do I become a better person?

How do I fulfill my mission in the world? How do I deliver my gifts? As I do that, I’ve noticed that my body has the best chance to step into its metabolic potential. Do I need to eat all the right foods? Of course I do. But as I’m stepping into my personal potential, I naturally gravitate towards the information, the kinds of foods, or the kinds of practices that serve me. That, I think, is a missing piece in the conversation around weight, or even the conversation around health in general.”

Source:mercola.com

A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management — NEJM

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Background

Obesity is a chronic disease with serious health consequences, but weight loss is difficult to maintain through lifestyle intervention alone. Liraglutide, a glucagon-like peptide-1 analogue, has been shown to have potential benefit for weight management at a once-daily dose of 3.0 mg, injected subcutaneously.

Methods

We conducted a 56-week, double-blind trial involving 3731 patients who did not have type 2 diabetes and who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of at least 30 or a BMI of at least 27 if they had treated or untreated dyslipidemia or hypertension. We randomly assigned patients in a 2:1 ratio to receive once-daily subcutaneous injections of liraglutide at a dose of 3.0 mg (2487 patients) or placebo (1244 patients); both groups received counseling on lifestyle modification. The coprimary end points were the change in body weight and the proportions of patients losing at least 5% and more than 10% of their initial body weight.

Results

At baseline, the mean (±SD) age of the patients was 45.1±12.0 years, the mean weight was 106.2±21.4 kg, and the mean BMI was 38.3±6.4; a total of 78.5% of the patients were women and 61.2% had prediabetes. At week 56, patients in the liraglutide group had lost a mean of 8.4±7.3 kg of body weight, and those in the placebo group had lost a mean of 2.8±6.5 kg (a difference of −5.6 kg; 95% confidence interval, −6.0 to −5.1; P<0.001, with last-observation-carried-forward imputation). A total of 63.2% of the patients in the liraglutide group as compared with 27.1% in the placebo group lost at least 5% of their body weight (P<0.001), and 33.1% and 10.6%, respectively, lost more than 10% of their body weight (P<0.001). The most frequently reported adverse events with liraglutide were mild or moderate nausea and diarrhea. Serious events occurred in 6.2% of the patients in the liraglutide group and in 5.0% of the patients in the placebo group.

Conclusions

In this study, 3.0 mg of liraglutide, as an adjunct to diet and exercise, was associated with reduced body weight and improved metabolic control.

Cardiovascular-Risk Indicators Eleva.ted in Overweight, Obese Children

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Overweight and, particularly, obese school-aged children show significant increases in measures of cardiovascular risk relative to their normal-weight peers, a BMJ meta-analysis shows. Editorialists remind readers that although the results are “worrying,” it is unknown whether those risks follow the children into adulthood, independent of adult weight.

The analysis looked at 63 studies including almost 50,000 children aged 5 to 15 years from highly developed countries. Average systolic blood pressure was 4.54 mm Hg higher among overweight children and 7.49 mm Hg higher among obese children, compared with their normal-weight peers. Obese children also had increased total cholesterol, fasting glucose, fasting insulin, and insulin resistance, as well as a 19-g increase in left ventricular mass.

The editorialists liken childhood obesity to climate change, which “is at times in danger of inciting an ennui borne out of a repetition of problems without answers.”

Source: BMJ