I’ve been pondering about weight loss recently, and why it’s so darn hard for some people to lose weight.
Let me be clear that I don’t pretend to have THE answer.
And I don’t think there is one single THE answer, because I don’t believe that obesity is caused by any one single thing.
Yes there’s always an imbalance in calories, but the simplistic calories in – calories out meme that you hear everywhere is the equivalent of thinking the ‘Earth is flat.’
Yes, all the continents are there, but you’re missing so much of what is going on. It’s true you can’t escape calories, but you also can’t ignore the complicated systems happening all around it.
At a guess, obesity is probably a result of a combination of:
In this post I’m just going to explore the idea and scratch the surface with neurological / brain dysfunctions.
A Patient’s story
This week I met with a patient who is one of those people who just can’t lose weight. She is diligent about her food intake and her exercise (working the calories in & out equation).
Let me pause here for one second to say that the first step in losing weight MUST always be to get your diet squared away and be doing at least some exercise.
And to recognize that we’re all pretty delusional regarding how much we eat. A study I saw recently had women reporting they were eating about 1400 calories daily. When directly measured, these women were actually eating closer to 2000 calories daily, explaining why they weren’t losing weight even though they felt they were dieting.
So, first, you have to get your diet in check. And to get a good baseline you MAY even need to measure and weigh in the beginning.
Back to our story…
So despite being very diligent about her food and exercise her weight won’t budge.
We got to talking about her history. She had thyroid cancer a number of years ago, had her thyroid removed and then took radioactive iodine (standard treatment) to attempt to kill off any other thyroid cancer cells in her body.
That’s when the trouble started. Over a course of 6 months the patient gained 45 pounds, and her menstrual cycle went haywire.
Despite different doctors fiddling with her thyroid hormones over the years, none of that has helped, and today she is well-managed on her thyroid medication.
The only thing over the years that has helped her is the HCG diet.
This is a low calorie diet coupled with injections of HCG. What little science is behind this is negative, but there are scores of reports from patients and a number of doctors that I trust that provides an interesting counterpoint.
Weight loss aside, the patient says, “I feel the best I ever feel when I’m taking HCG. It’s like I’m alive again. If I could I would live on HCG all the time.”
So let’s talk about rats
Peter over at the blog Hyperlipid posted an interesting piece just the other day that sparked my thoughts on this. As a side note, if you’re a technical reader (you have some biochemistry in your background) check out Peter’s blog posts, they are always very interesting, but quite technical.
Peter was talking about rats, and how when you injure their ventral medial hypothalamus (VMH; a part of the brain) they get fat.
Injuring the VMH causes their fat cells to become very insulin sensitive which means they begin to vacuum up nutrients at the expense of the rest of the body. This triggers hunger, because the rest of the body isn’t being adequately supplied with nutrients (the fat cells are stealing them) which causes the person to begin overeating. This causes them to get fat, but it’s not the overeating that’s the primary cause, it’s the neurological dysfunction.
Does this happen in humans? And what breaks the brain? We don’t know, and we’re not sure. But it certainly sounds plausible to me.
One more thing
The other day on our Facebook page I linked to an article describing a small study (12 people) with severe, unrelenting pain that was poorly controlled by prescription painkillers. Based on some clinical evidence, the MD in charge of the study had the patients begin injecting HCG. 8 of the 12 people had noticeable improvements in their pain levels. It was theorized that HCG might change the neurologic dysfunctions involved in chronic long-term pain.
Stringing our assumptions together
For this patient, it certainly sounds like it might hold true. Taking radioactive iodine might have caused brain dysfunction/damage in her hypothalamus leading to weight gain and other hormonal dysfunctions. Her past use of HCG with her dramatic response to it, might suggest that HCG helps with this dysfunction.
We are considering doing a trial of HCG in lower dosages and less often than the ‘HCG protocol’ and with a normal diet, not the starvation diet of the typical protocol to see how it affects her weight.
These are some thoughts on weight loss, there’s a good chance they’re not quite right, and they might be totally wrong, but we need to move past the whole calories in – calories out idea and get more sophisticated. Some people may have brain damage, and if we can figure out ways to help that, we can help a lot of people.
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