Functional Medicine: Weight Loss
From a clinician’s perspective, the New Year presents an ideal opportunity for making the most out of working with patients who, at this time of year, are highly motivated to make behavioural changes. The majority are driven by their resolution to lose weight and/or fat.
No-one can argue that ditching unhealthy foods and booze and replacing them with meals high in fruit and vegetables is a good thing to do. However, there is a potential dark side to the more extreme forms of detoxing that are often flouted on social media websites.
Intensive and sudden detoxing comes with some well validated warning signs from science. With any quick weight-loss strategy we have to accept that there may be some degree of increased toxic assault as our fat cells decrease in size and release their potentially harmful passengers into our circulation.
This can lead to increased toxicity which can compromise health. In-fact the more overweight and unhealthy you are the greater the potential levels of toxicity.
Exploring the scientific literature on this subject gives much food for thought. There are very strong links between high levels of Persistent Organic Pollutants (POPs), obesity & related metabolic diseases (in particular type 2 diabetes). Despite this scientific evidence most nutritional guidelines on these diseases ignore these links.
High levels of POPs in our body are associated with increased body mass index and waist circumference. The mechanism by which this occurs is via disruptions to our hormonal system leading to increased insulin resistance which in turn predisposes us to weight gain.
Weight loss induced toxicity also decreases the ability of our muscles to use fats. A 2002 paper in the Journal of Toxicology Science found that organochlorines released into the blood during weight loss are associated with a reduction in thyroid efficiency and a reduction in the number of calories our body burns.
On the other side of the coin…weight ‘gain’ can lead to decreased levels of POPs! And here you see the catch 22, or what I like to call the “toxic weight loss paradox.”
So, it seems, for some, weight loss is dangerous and weight gain is protective. Does this mean that the body finds storing these POPs in fat cells safer than having them floating around? Some scientists may believe so.
Reducing our levels of and exposure to POPs is essential, but and it’s a big BUT, we must do this as safely as possible.
Where can we find these hormone-disrupting chemicals? Frankly, they are everywhere. Food, makeup, skin products, scented candles to name a very few sources and the exposure to them is significant. BPA is one of the more commonly known ones and is used to make protective coatings and linings for food and drinks cans. Just one exposure to BPA from this type of source, e.g. drinking a soya milk coffee using soya milk from a BPA lined carton increases BPA levels 10-fold (JAMA 2011).
So how does our body perform the job of detoxification? It’s mainly carried out at the liver, whose job it is to transform fat like molecules (i.e. most environmental pollutants) so that they can be excreted safely out of the body. It does this in two phases: To simplify it, Phase 1 is responsible for the start of transforming the toxin. Phase 2 is where conjugation occurs, i.e. the toxic compound is joined with another compound in the body to detoxify and make it more water soluble. Once in this state the compound is easier to eliminate from the body via the kidneys & urine as well as out of the stools.
Some toxins can also be excreted in sweat. Another good reason to exercise…sweating is good for you!
Do we all detoxify the same way? No. Scientific testing is, however, allowing clinicians to test patients for alterations in genes involved with detoxification. This can help to identify patients more at risk of increased toxicity from detoxification.
- Go slow!! Feeling awful suggests that your detoxification pathways may not be keeping up. The more you consider yourself unhealthy and overweight the less intensive your detox should be if used at all.
- Rather than an intensive detox, try concentrating on providing your body with the nutrients it needs from foods slowly over time. This may allow your own detox pathways to do their job more effectively.
- Reducing exposure is the best way to reduce toxicity. Think of the bigger picture on environmental chemicals. It’s not only foods but household cleaning products, make-up, perfume etc. Think about what you breathe in, consume, and place on your skin in terms of the toxic load over time.
- Detoxification is an energy and nutrient heavy process. If you choose a detox product make sure it provides vitamins, minerals, anti-oxidant’s and proteins in abundant levels to allow your detoxification pathways to work effectively.
- Once you liberate toxic chemicals from fat cells you need to get rid of them. Make sure your exit routes are clear. Pooping well through this period is vital.