Do You Have Excess Belly Fat? Why It’s A Problem And What You Can Do About It

the visceral adiposity that belly fat is associated with high levels of insulin in the body and insulin resistance and that means that the body isn't listening to its insulin as well as it used to and so that high level of insulin as you mentioned earlier causes us to store calories and to just gain weight [Music] hello everybody it's dr mark hyman welcome back to the doctor's pharmacy that's pharmaceutical f i won't spell it out because i got reprimanded for doing that too many times on the podcast so it's just doctors pharmacy a place for conversations that matter and if you have belly fat it matters this conversation will matter because we're all struggling with it and today we're going to talk on our special house call episode with dr elizabeth boham my colleague at the ultra wellness center is the medical director she's a world-renowned physician teaches all over the world she's helped thousands of people achieve optimal health and she focuses on nutrition her practice every day she's an rd she's an exercise physiology she's an md she's contributes to all sorts of national media and educates physicians all around the world she's just the bomb so anyway welcome liz we're gonna talk about belly fat thank you mark it's great to be with you and to talk about belly fat oh yeah my favorite topic i've written all these books on problem right well the thing about it it's a huge problem and it's so easy to fix and it's not through the ab roller or the uh time master whatever infomercial tool you can figure out to get your abs right i mean you can't get good abs through exercise i mean eventually you have to do exercise but if you just focus on exercise you won't get it straight so let's talk about this problem because for those of you listening you know we are in a staggering health crisis not just covet but the whole pandemic of chronic disease that's driven by poor metabolic health and this phenomena of being over fat uh you can be overweight or you can be over fat or you can be both we're going to talk about that today and why it's so important to think about for our own health for longevity for preventing disease and just for feeling good and actually even just getting our own lives together and managing our appetite and our metabolism and our energy and all the things that affect us so i'm so excited to talk to you about let's get my favorite topic oh yeah mine too mine too and we know we know that where your fat is in your body makes a huge impact you know we used to so always worry about pinching an inch right when we were growing up you know can you pinch an inch but now we realize that that fat that's deep with inside the belly the visceral adiposity that belly fat deep inside the abdomen is really concerning in terms of overall health and like you mentioned it is a it's a huge issue you know it is a huge pandemic it's you know in the in just the united states we know that 70 of americans are overweight or obese but 86 are over fat meaning that they have too much fat and especially you know that concerning visceral fat is a real concern and over half of our kids also are over fat and so um you know it's staggering half of our children treating half of it so much it's staggering it's sad it's sad you know and um it's creating so many health problems from just feeling crummy to tired to causing cancer increasing our risk of cancer like breast cancer and prostate and colon and lung cancer of course increases our risk of diabetes and cardiovascular disease increases our risk of alzheimer's disease and cognitive decline it increases our risk of stroke and blood clots and high blood pressure and infections as as you were mentioning earlier with covid we realized that people with with too much fat you know people who are over fat people with too much visceral adiposity have an increased risk of covid 19 they have an incre you know they've lower immune systems they have increased risk of erectile dysfunction and infertility and pcos and hair loss in the wrong places and they make it make it harder to lose weight so it's it's just it's just connected to so many things and it's unfortunately so common and so that's why we like to talk about it so often because because you know sometimes it it takes this talking about a subject m more than one time for people to really kind of put all the pieces together for themselves it almost seems too good to be true that all these problems are related to one phenomena and and and while there are many often many causes for many of these things the majority of these problems you mentioned from infertility to heart disease cancer diabetes alzheimer's are all related to this weird fat that's very different and you know when you mention pinch an inch it's not that's the subcutaneous fat it's the fat around your organs that really matters and i remember this one study i read you probably saw years ago where they it was the new england journal medicine and they did a liposuction on this very obese woman who were really was very very big and they sucked out 40 pounds of fat from her subcutaneous tissue so basically she lost 40 pounds just by sucking out all the fat but when they did a cat scan to look at the fat inside that didn't change at all and what also didn't change was all of her biology in other words if you change your diet you can change the quality of the fat and the messages that make very very quickly within days two weeks but for her even though she lost 40 pounds of subcutaneous fat there was no change in her blood pressure blood sugar cholesterol any of the markers of poor metabolic health she was just as sick as she was before even though she was 40 pounds lighter because they took out the subcutaneous fat so this belly fat is really different than the fat on your body your arms or under your gin or whatever it's very different fat so talk about this fat particularly we call it vat or visceral adipose tissue or belly fat or organ fat or whatever you want to call it but it's fat around your organs your liver your kidneys your intestines it's in that organ compartment what what's it doing that's different than regular fat yeah you know i i was also so blown away when that study came out all those years ago and it just really was an eye opener for me to say you know and i use that example for patients all the time like you can't we can't just liposuction this this away and your blood pressure is not going to come down like you think oh if i can just liposuction it away then my diabetes will go away but it doesn't it doesn't work like that right because you're not getting to that deep adiposity and that deep belly fat and that deep belly fat is really inflammatory what we realized is that deep belly fat produces all sorts of inflammatory markers um interleukin-6 and tumor necrosis factors so it actually results in increased inflammation in the body and it it is associated with increased insulin resistance and that high level of insulin and the high level of inflammation those two things and there's i'm sure there's more are really drivers for all of these processes to get out of whack in the body for the cholesterol to get out of whack for your for your uh inflammation in your arteries to get out of whack for for for cancer to like to grow um and so inflammation drives all of that fat that's absolutely absolutely and so and that and that deep fat is not just hanging out it's it is metabolically active as we've talked about before and if you always like to talk about it's metabolically active it's not just sort of sitting there it's really do you just holding up your pants no right it's actually doing things it's and it's producing all these chemicals and and and hormones and it's increasing the inflammation in your body and so if there's one thing that people can focus on like if you're you know you kind of sometimes people get overwhelmed with all these messages in in health right like oh my goodness what do i do what diet do i follow what what should i work on where do i focus and sometimes people get overwhelmed and they almost give up we see that all the time and and and this is like the basic thing that everybody can focus on you know i even for myself like i'm like you know i do i do a lot of these self-care things right i try to all the time right but you know this is an area that we can all focus on that can improve our health if we just pay attention to what's our waist circumference and what's our waist to hip ratio because that's telling us how much belly fat we have yeah so so i i think that's right i i often joke and say there's a simple test you can do to figure out if you have this problem it's called the mirror test you take up your shirt you look in the mirror you jump up and down your stomach jiggles you probably have it and the truth is 88 of americans have it it's metabolic and healthy that's because they have this visceral fat that's making them unhealthy and causing all these other problems that we see as separate right oh i have high blood pressure oh i have high cholesterol why am i blood sugar but they're all the same problem or i have low sex drive or low testosterone or i have you know pimples and poor periods and sleep apnea whatever the things are that we're suffering from we see them as all separate but they're all connected by this and with with cobit now the vulnerability of this population with visceral fat is just it's just been highlighted you know 63 of hospitalizations could have been prevented if people had poor better metabolic health and a better food so the real question is one you know let's talk we're going to talk to him about what causes it uh and how we start to diagnose it um but what are the ways we can diagnose it properly what you mentioned the waist hip ratio that's a simple test tell us about that and then let's talk about some of the blood tests that you'd see that may seem like other stuff but our clues to you having bigger belly fat yeah you know the waist tape ratio is a great measurement that we can all do and repeat on our own so what you do is you get your waist circumference and to find the right place for your waist circumference it's in between you know you find your lowest rib and you find your upper hip bone and then you put this you put the tape measure in between and that's considered your waist circumference so if you find that lowest your last rib and your hip bone and go in between the two that's considered your waist circumference it's like your belly button and then you're pretty much circumferent yeah you know some people's belly button hangs down or is in a different place so it's it's not always the belly button but it's it is around that area yeah and then and then the hip circumference is they you know it's considered over the greater trochanter but if you don't know where that is i always say to people go over the largest part of your hip because that just makes your number look bit better so you want to you know get the biggest hip circumferences you can have not that you want it you know you want to be you know way overweight but it's you pick the biggest tip circumference to to determine your waist hip ratio if you can't figure out where that greater trochanter is yeah so for for the the goal for caucasian people for caucasians is to have a waist circumference less than 35 inches for women and less than 40 inches for men for asian and indian ethnicities it's it's stricter less than 31 inches for women and less than 37 inches for men and that waist to hip ratio is a great measurement to do so for women you want to be less than 0.8 and for men less than 0.9 is the waist hip ratio you want to have so you want you know a smaller waist than hip of course and um and the neat thing this is a really simple test you can do and something you can check every month you know you can redo your waste tip ratio every month and watch your progress and say okay what am i doing what do i need to do and um it's a really inexpensive way to figure out is this a problem for me yeah that's really huge and i think i think it's also important what you said in that people who of indian or asian descent can have significant visceral fat and all the complications from it at much lower weights so they may if you look at their weight they might weight might be perfect it might be less than 25 23 in their body mass index which 25 or more is overweight but they may be full of this visceral fat and they can be diabetic it can be thin and they look thin we'll call them skinny fat so they have the same issues as someone who is overweight but they're just over fat yes or tofi right thin on the outside fat on the inside so so you know if you are a smaller person um then then that's where also that waist hip ratio can be really helpful and and and you're right you're right none no test is ever perfect for so for some people the waist circumference or the waist hip ratio isn't isn't giving us all of the information there's a lot of other biomarkers that of course tell us that somebody has too much visceral adiposity that somebody is carrying too much weight around the belly you know if we see a high c-reactive protein or marker for inflammation it makes us wonder okay do they have metabolic syndrome insulin resistance visceral adiposity if we see that fasting insulin greater than five that's when we say okay that's this is something we have to pay attention to if we see too many small dense ldl cholesterol particles we've spoken about that before you know that's a sign that somebody has insulin resistance or visceral adiposity if we see um we also check for things like oxidative stress too many free radicals being produced that's a sign if their liver function tests are high or they have signs of fatty liver that can also be because of this visceral adiposity or gout high uric acid that can also be because of this um you know or that pattern in cholesterol the high triglycerides low hdl all of these things can give us a sign you know give us information and say okay this person is struggling with metabolic syndrome insulin resistance or probably because of visceral adiposity and you often notice all these things abnormal at the same time right so you see a pattern and it's really pretty easy to diagnose when you know what to look for so you get inflammation you get abnormal high blood sugar high insulin lots of oxidative stress your liver i mean these are these are all things that seem seemingly are treated like separate problems but they're all connected to this visceral fat and what's amazing is to watch them improve when we make shifts or changes in somebody's lifestyle you know or you know there's a lot of things that can contribute to this from toxins in the environment to shifts in the microbiome to poor diet you know having a nutrient poor diet eating too many refined carbohydrates and simple sugars not getting enough exercise poor sleep too much stress can all contribute to it but what we when we shift somebody's lifestyle and when we when we make shifts in in these issues that they're dealing with we see these these markers these biomarkers improve significantly so it's really fun to watch we see it improve all the time hey everybody it's dr hyman thanks for tuning in to the doctor's pharmacy i hope you're loving this podcast it's one of my favorite things to do and introducing you all the experts that i know and i love and that i've learned so much from and i want to tell you about something else i'm doing which is called mark's picks it's my weekly newsletter and in it i share my favorite stuff from foods to supplements to gadgets to tools to enhance your health it's all the cool stuff that i use and that my team uses to optimize and enhance our health and i'd love you to sign up for the weekly newsletter i'll only send it to you once a week on fridays nothing else i promise and all you have to do is go to doctorhymen.comforwardslashpix to sign up that's drhyman.com forward slash pics p-i-c-k-s and sign up for the newsletter and i'll share with you my favorite stuff that i use to enhance my health and get healthier and better and live younger longer now back to this week's episode so so i'm going to get into you know the causes a little more deeply in a minute but there is another test that we often do which i like a lot and it's sort of the gold standard it's called the dexa body composition test and it's like a x-ray a very low-dose x-ray i mean you have to basically take 50 of these to equal one flight across the country from new york to california in terms of radiation and it measures the compartments of your body your arms your legs your belly and can tell you what the fat is where it is and and it's pretty compelling there's also mri technology that does that ct technology uh liver fat measurements so there's a lot of ways to look at this but it is really the central problem of our time and and there are many causes but the major cause is our ultra processed high starch sugar diet that's the biggest cause because that drives insulin and insulin drives all the available fuel that you've eaten into your bat cells in your belly and then it keeps the fat there prevents this breakdown process called lipolysis of your fat and it produces all these inflammatory compounds and it screws up your hormones and it makes you hungry all the time and it slows your metabolism so it's the worst possible thing and it's really driven predominantly by that so so we know that a a high carbohydrate in the sense of starch and sugar diet because you know vegetables are carbohydrates so you can use much those you want is the biggest driver of this but there are other causes right let's and you mentioned a few of them um so let's kind of go through some of the unusual things that might be driving us whether it's a microbiome toxins and other things that drive inflammation you know i i always just in the terms of the the the most common cause right i get so concerned when i i see you know a a young child maybe like eight or nine and their parents are buying them a you know a muffin and a sugary coffee drink or sugary you know beverage for breakfast and i'm like oh no you know it's just a setup it's a setup for them to have problems for their whole life you know and and i think that that it's it's it's important that people take care of those those basics like you mentioned but we always look for you know sometimes sometimes people are doing or they feel like they're doing everything right and there's there's hidden reasons for why they start to develop visceral adiposity and that belly fat when when when they're really doing a lot of things correctly and one of the things that i find that people don't realize is what what happens when they start to lose lean muscle mass as they get older so you know you know we might be exercising a good amount every day but if we're not working really hard to maintain that good lean muscle mass what happens after the age of 25 is we slowly lose lean muscle mass and and then it's just so much easier for the body to put on excessive fat and we know that having good lean muscle mass and exercising really keeps our insulin sensitive and so that's one thing that people that slowly catches up with people and they become more insulin resistant over time and and you mentioned toxins you know unfortunately there's been multiple multiple toxins associated with this visceral adiposity so that's the way i want to understand i want to underscore what you just said i want liz i want to i want to underscore what you just said yeah because you basically said something really important absolutely around muscle loss when you get older and and muscle loss is really um could be thought of as replacing muscle with fat so you could be the same weight at 65 then you were 25 maybe twice as fat and that fat in your muscles it's not um not just in your belly is also this poor metabolic fat and it leads to this increasing phenomena with all the consequences that we see of disease so i feel like this is a really important thing that people understand so exercise basically strength training building muscle and aerobic exercise even interval training will help improve metabolic function and help keep this insulin resistance at bay as we age because it is something that affects almost everybody as you age unless you do something actively about it so let's talk about toxins you do have you do have to work really hard at it you know i mean it's like so easy to maintain well i don't know if it's so easy but it's so much easier when you're younger to maintain your lean muscle mass and as you get older it's really work you know people are like i do go for a walk every day and i'm like you know it's just it's not it's not enough for you right now and getting in two days a week where you really are working on resistance type exercise there's so many ways you can do that um that you know every you know that really can make a big difference so yes so toxins you know bpa is a toxin that's been unfortunately associated with with visceral adiposity fatty liver metabolic syndrome and bpa bisphenol a is that hard plastic that is pervasive unfortunately aren't in our environment and has been associated with you know breast cancer but it's also been associated with insulin resistance so so i think it's important that we recognize that there are a lot of toxins out there that are impacting our insulin sensitivity and and possibly through how it damages our mitochondria and you know it's just really it there's more to it sometimes than than just our food intake and we always really have to dig and look for that when we're working with our patients for sure we call these things obesogens you know they're petrochemical toxins they're even heavy metals i've seen so so we really have to be alert to people are not losing weight and they're not successful doing the basics stuff of diet and lifestyle change what else is there and there are other things like the microbiome so maybe you can share a little bit about that and what we're learning oh the microbiome i think is so fascinating right i mean there's there's so much information there that we're learning and i don't and there's going to be so much more that we're going to learn over time and i don't think we have it obviously all figured out but we know that there's certain bacteria in our digestive system that are associated with less inflammation and a healthier weight and there's certain bacteria in our digestive system that are associated with more inflammation in the body and having an easier time with weight gain so um it's so it's it's fascinating the association between the microbiome and this whole process of insulin resistance and so you know when somebody comes in and we're trying to figure out what's going on with them we want to work on all angles here and you know we want to ask those questions of what's going on in your digestive system and is you know how are your bowel movements and how do you feel after you eat and are there foods that you're not tolerating because because we could work to manipulate that um to help improve somebody's metabolism yeah and also you know anything that causes inflammation right could cause weight gain so people might be having sensitivities that are causing it or they're exposed to mold in their environment or they have latent infections yeah because anytime there's inflammation it drives in some resistance independent of the cause so the biggest cause just you know not to get too down from that rabbit hole of these things the biggest cause obviously is sugar and starch those are the two biggest things that are driving inflammation but there are a lot of other things that people need to think about uh that also do it now people listening might be going okay yadda yadda okay all this great science about belly fat what it does and why it's bad and how to test for it and you know what causes it but how do i get rid of it is the big question how do you actually get rid of it and and um i think it's it's so it's it's so gratifying practicing functional medicine and in the ultra wellness center where we work it's so it's so gratifying seeing this because this is one of those kind of slam dunk idiot proof things for most people and it happens so quickly and it's so striking because people are always struggling with this i'm like well if you understand biology and how the body works and how it functions which is really the foundation of functional medicine understanding how to work with the body rather than against it you can drive these biological changes really quickly and and really change the quality of the fat dramatically and the fat and just give you a quick example and then we'll go into what to do about it one of my favorite studies that i've read recently is a study looking at gastric bypass surgery basically they said well you know gastric bypass works because it causes all these you know amazing changes and hormones and appetite blah blah blah blah blah blah there's all these theories about why it works well somebody decided maybe we should test this theory so they took a bunch of people who are really overweight and they gave me gastric bypass on half of them the other half just ate the diet that the gastric bypass people ate after they had the surgery and there was no difference but very quickly within days of changing their diet their quality of their fat changed and it went from being inflammatory fat that's driving all these problems to really shifting that and so it can happen pretty quick even if you're still a little overweight you can still have the metabolic and health benefits and of course you still need to get the weight down but i think it's just an interesting phenomenon so i kind of love that study um so let's talk about you know what what do you guys do and some case studies that you've had that really sort of illustrate the ways in which um we can use this strategy of of function and science functional medicine and the science to drive uh real change for these patients in their not only their their belly fat but all the other biomarkers and health issues and consequences that come from having this belly fat absolutely like we were talking about the visceral adiposity that belly fat is associated with high levels of insulin in the body and insulin resistance and that means that the body isn't listening to its insulin as well as it used to and so that high level of insulin as you mentioned earlier causes us to store calories and to just gain weight it makes it it makes us more hungry but it also makes it much harder to lose weight so one of the things we really we when you're talking about okay how do we we really work with our physiology is we want to prevent insulin spikes because we know that higher levels of insulin are what's really driving us to gain this visceral adiposity and so as you mentioned it's those refined carbohydrates and sugars that drive up insulin levels in the body and we know that if we just ate just fat we wouldn't secrete a lot of insulin and protein we secrete some insulin but not as much as with carbohydrates so what's really important is bringing down the percentage of calories that somebody's getting from carbohydrates especially the refined and processed carbohydrates that cause that insulin spike and so i always talk to people about that having that balance of the you know good healthy fat and some and lots of fiber and some protein at every meal and just pulling away the simple sugars and refined carbohydrates because that brings the insulin down and makes us less likely to hold on to that weight around our belly so that's really the first area we always work on and you know we can dive into a couple cases uh as examples so this is really a great point so basically the key to this is keeping your insulin levels low because as long as your insulin levels are high the body really has a one-way street of fuel into your fat cells so basically insulin locks the fat cells in your belly and prevents the breakdown we call it lipolysis they're the breakdown of this belly fat so like you said how do you cut insulin levels well you've got to cut out the starch and sugar especially if you're in an extreme case if you have a lot of belly fat you really need to be more strict like no sugar grains beans even some fruit and then as you start to become more metabolically healthy and resilient you can add things back but it's really key to be really religious about it and also there are other factors like artificial sweeteners that are driving this and there you know are other carbohydrates we might think are okay like we're eating whole grains or eating wholly bread or eating but they may not for people who are really insulin resistant uh be helpful and what you also said was so important about fat fat doesn't cause any spike in insulin and you you see this this phenomenon this is just a great story i learned from david literally who's a professor at harvard one of the greatest scientists in this field and he said mark if you would take a type 1 diabetic and this is very different than type 2 which is basically from eating sugar and starch type 1 diabetics have an autoimmune disease that damages their pancreas they cannot make insulin so the presenting symptoms and every doctor learns this in first year medical school are they're hungry all the time they're peeing all the time and they're losing weight so they could be eating 10 000 calories a day and lose weight why because there's no insulin so that's really the key and a ketogenic diet is the most extreme version but there are a lot of other approaches to eating more fat less starch and in the continuum of all that so i think that's really important protein is really important too but if you eat too much protein you can also get insulin spike absolutely right so the first patient that we're going to talk about is a woman who she was in her mid-50s and she came to see me because she had just been diagnosed with an estrogen receptor progesterone receptor positive breast cancer and it was stage one so she was uh you know she was lucky in that sense or you know she found it early in that sense so that was great she had a surgery and and radiation and she was placed on aromatase inhibitor but she said you know i i want to do whatever i can to prevent this from coming back and so we gathered all of her information her whole history and she um noted in her in her history that she had gained like 30 pounds since she had her children and it just came on slowly over the years she became more tired over time and really just you know had a harder time with losing that weight you know so she she came in about 30 pounds overweight and when we checked her waist to hip ratio it was 0.88 and remember we said for women we want that waist-hip ratio to be less than 0.8 so hers was high at 0.88 and you know not crazy off the charts overweight you know but 30 pounds higher than she needed to be and so we said okay you know i explained to her this is where we really want to focus because there's so much research here showing the connection between insulin resistance and belly fat and breast cancer so we really want to focus on lowering your waist to hip ratio and we want to focus on lowering your insulin levels because we know that will lower inflammation in the body and it will decrease your risk of getting a reoccurrence or another cancer for that matter so she was really motivated and we put her on the pegan diet um you know we really worked to lower her percentage of carbohydrates in her diet she was you know she was she was a pretty healthy eater but getting in some you know her her you know coffee drink that had added sugar in it and you know needed to really make some shifts so we we started to tighten up her diet we gave her a lot more phytonutrients we gave her a lot more fiber we worked to increase her omega-3 fats and we also did we really tried to increase her green tea intake um there's some really interesting research with green tea you know we've always talked about it from a breast cancer prevention strategy because it's got anti-angiogenic properties it's can it's a tumor it can impact the tumor suppressor gene in a healthy way and decrease risk of cancer that way um and it's an antioxidant but it also has been shown to lower insulin and help with lowering body weight so when people drink four cups of green tea a day for eight weeks they had improvement in their metabolism and their weight and their and their bmi and um and so so that was that was that was helping her on both angles we also gave her more omega-3 fats to help improve her her uh her her triglyceride hdl ratio so we added in two to four grams of fish oil and um you know there has been some really interesting research on kimchi as well at helping to improve somebody's insulin sensitivity and so we had her start to incorporate lots of phytonutrients in her diet lots of vegetables but also kimchi to help with improving her microbiome and uh and and she did really well you know she was able to to lower her weight it took a few months to get the weight down you know six months or so but she even got that waist hip ratio to that you know to less than or right around point eight which we were happy with so she's doing great that's amazing so you you see this happen you know over and over with our patients and you sort of just dial in the simple recommendations it seems that obvious but for some it's a little different and um you know i just to share a few cases of mind i remember one who had for example severe diabetes and his sugars were 250 couldn't get in control we changed his diet even put them on a ketogenic diet helped a lot but what was fascinating is we couldn't get that last mile until it was by accident really he was complaining to me of his gut and his and his bloating and all kinds of issues and gas and i was like so let's just try and experiment let's just try charcoal now now diabetes is not treated by taking charcoal pills but by understanding functional medicine and interrelationship of the microbiome and inflammation and how it affects for example the toll receptors and causes increases in tnf alpha which is a basically an inflammatory cytokine when the cytokine storm things it causes insulin resistance and i said well let's just try it he says wow i took this charcoal and my blood sugar went to normal for the first time and i was like wow it's fascinating or another another patient had was a trainer and a fitness trainer and you know ate healthy and she struggled and her she had high mercury and we got rid of the mercury and she was able to lose weight so i think you know most of the time it is really about the diet and then you know i think adding the exercise too we didn't really talk about that but adding the exercise even though you can't exercise your weight of a bad diet you can exercise your way into better health and fitness and increase metabolism so it's really important to actually as you're losing the belly fat to maintain your muscle that's where you talk about the strength training and exercise um what about the next case you were going to share about who was a guy who had high blood pressure and bad cholesterol and uh tired all the time yeah i mean this is yeah we see this all the time you know somebody comes to us because they he had just gone to his physician he's 47 and he had just gone in for his routine physical and all of a sudden his doctor wanted to put him on blood pressure medication and he wanted to put him on cholesterol medication and you know so he was he was like oh no this is not this is not what i want to do and he it sort of woke him up a little bit and he said let me just exp explore this a little bit and and look into it and look at this a little differently i don't want to just treat all my symptoms with a medication i want to see what's going on here so you know i mean he he was um he was just struggling with his energy so he's feeling a little bit lower in energy he would put on some weight and um and and but otherwise he you know he was just kind of doing fine he didn't have a lot of other complaints and when we did his waist hip ratio his waist dip ratio was at one so again remember with men we want their waist tip ratio to be less than nine and he was at one and so this was a sign to me right away that i knew i had to work on insulin resistance and this visceral adiposity i knew that this belly fat this too much weight in his abdomen was triggering this high blood pressure was triggering an unhealthy cholesterol pattern and when we looked when we did that particle size test on his cholesterol we saw that his small dense ldls were were too high and his his hdl were too low and his oxidized ldl were um too high as well which we know when when ldl cholesterol gets oxidized that's when it can get damaging to the artery lining so that's when we said okay you know we're going to really focus on your insulin levels here and again we pulled away all the the refined and simple sugars he needed to get rid of some extra beer that he was that he was drinking we um we got in a lot more vegetables in his diet we we worked to increase his omega-3 fats in his diet you know he didn't want to take a lot of pills but he was really he was he was he was good at making shifts in his diet he was really got motivated um he also got motivated because he was we talked about how that increase in waist circumference increases erectile dysfunction and so he said you know you know that's really interesting i'm gonna i really want to lose this weight around my belly and so that really got him motivated to get right on the diet and um really worked to increase his exercise we had him get some strength training in three days a week um he he ended up working with a trainer which was really helpful for him to stay motivated and he started to add in a little bit more interval training on those other days but but that really helped him and within within three months or so we saw that that waist hip ratio come down significantly and in like six months he was at that point nine of waist hip ratio his blood pressure improved his cholesterol pattern improved his energy improved and he never needed to start medication and he's doing really well that's amazing and then you know just so many stories like that it just kind of reminds me of this patient i had it wasn't a typical so sometimes you think it was typical but she looked like the michelin woman i guess she or you know with total apple like you just round now you've seen these people it's a round and their skinny legs and big belly and i thought oh man her tests are going to be so bad and her blood sugar is going to be high and it's going to be terrible and what was fast in her a1c which is her average blood sugar was fascinating with her and this is just sort of speaks to what really happens to people is her her blood sugar was perfect in fact we even did a glucose tolerance test where you look for diabetes and we gave her the equivalent of two coca-colas and watched whether her blood sugar went up or not and it never went up i mean your blood sugar was under 100 fasting it never went up over 110 even after all that but what was really different and this is the thing people should listen to and we're going to put in the show notes the tests that you should think about doing and asking your doctor for and i've written a lot about it and in fact get then there's a great descriptions of actually how to diagnose this but what she had was very high fasting insulin like 50 which should be under five and after she took a sugar drink it should be under 30. hers was like 200 or 300. and so her insulin was so high she couldn't lose weight and within a very short time she lost like 50 pounds of belly fat just like that by shifting her diet and reducing the inflammation and dealing with this sort of starch and carbohydrate intake that she took yeah it's amazing it's amazing it's pretty amazing and it's really it's you know it's a really gratifying area and i think you know when you look at aging when you look at fertility when you look at chronic disease when you look at productivity when you look at your brain function all those things are related to this belly fat and and it's really the sort of the drum beat that i and we have been sharing for decades at the wellness center which is it's really about the quality of the food you eat the quad of your diet and it's why i spent so much time writing books like the blood sugar solution the 10 day detox diet eat fat get then pegan diet food what next today because if we can get this straight we're going to solve so many of our global issues around health and chronic disease the economy and everything else so it's kind of an exciting moment where i think this is becoming more and more recognized i literally just got off a call with a uh senator really and his team about how we begin to address history policy so i'm i'm kind of optimistic i'm always a little bit optimistic no matter what anyway but i think i'm more optimistic than ever that we actually have a moment to start to change the tide on this any last thoughts liz on on belly fat before we wrap up our podcast yeah i i agree i agree mark you know it's it is really we there's so much we can do and simple simple changes in your diet make a huge impact on how how easy it is to maintain a good healthy weight and to prevent this from happening and you know when you make those changes and cut out that extra sugar and cut out those refined carbs you're also not only having an easier time with maintaining your weight and keeping that weight off your belly but also preventing all those diseases like we spoke about so that's so great thanks for all the great work for tonight it's really exciting yeah well thank you liz and thanks for being on this week's house call i love sharing this information to all of you if you love this mini episode of the doctor's pharmacy share with your friends and family uh subscriber your podcast leave a comment however you address your belly fat we'd love to hear from you and also you know i've got this new incredible content opportunity which is called dr hyman plus and you can go to my website dr hyman.com learn more about it and it's you know ad free podcast access dollar documentary series uh and ask me anything with me where every month i answer questions through video and personally as well as dr boehm and others are from our team are doing deep dives into functional medicine so it's a really wonderful way to access a lot more content if you're a little geeky like us so dr hymanplus check it out and of course we'll see you next time on the doctor's pharmacy thank you mark you

Channel: Mark Hyman, MD

Views: 58,590

Rating: 4.8780794 out of 5

Keywords: house call, elizabeth boham, mark hyman, belly fat, visceral fat, insulin resistance, blood sugar, functional medicine, the ultrawellness center, chronic disease

Id: 5HjFefr2uSE

Length: 43min 28sec (2608 seconds)

Published: Mon May 03 2021

Reddit Comments

[u/Fluffy_Ad9373]

Been watching lots of nutrition videos lately (can be overwhelming and confusing) has inspired me to cook different meals and try new foods. So far it has been a positive experience.

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