Why Eating Less And Exercising More Is A Recipe For Weight Gain

so often it's the sleep apnea that's causing the weight gain yeah [Music] hey everyone it's dr. Mark Hyman welcome to the doctors pharmacy this is a special episode called house call part of a little mini episode series that I'm doing with my colleague and friend dr. Elizabeth boham who's the medical director at the ultra Wellness Center in Lenox Massachusetts which started a long time ago we've been working together for a few decades now and she's an exceptional doctor who has a big heart and brilliant mind and knows a lot about health and how to fix people so today we're going to talk about a problem that almost no one has waking recent data is pretty striking seventy-five percent of us are overweight in America 42 percent are obese one in 10 are severely obese it's getting worse and worse and worse and is it all about eating less and exercising more well mark first thank you so much for having me and no that's not it's not all about that there's so many more things going on than just that it's so true you know I think we've been all been brainwashed by the food industry the government nutritionists doctors that the best way to lose weight is just cut down your calories and get more energy expenditure through exercise the problem is it's so much more complicated than that yes and you know I've written like I don't even know a dozen books about this already and I think that that what I've come to learn and been humbled by as a functional medicine doctor is working with these patients seeing the vast array of things that actually caused them to gain weight yes that have nothing to do with you know eating less and exercising more it has to do with things like sugar and insulin it has to do with things like environmental toxins like BPA right has to do with your gut flora know your microbiome it has to do with hormone imbalances like thyroid or estrogen yeah it has to do with mitochondrial issues that are your energy factories so it's really important to to understand that yes sometimes it is you eat too much or don't exercise enough but and that clearly plays a role but it's not the whole story and it's why people struggle so much if it was that simple we'd all just eat less and exercise more why can't we do it right away and it's so you know it I really like working with this patient population I mean I love working with all my patients but but with that functional medicine approach it really helps us identify for that individual person where we need to focus yeah and and look at what's imbalanced in their body where we can have significant impact yeah man there's one woman she was like 30s she was a trainer mm-hmm she had 40 extra pounds on her she exercised all the time she ate a healthy diet yep and I know she wasn't lying right right she was trying not like it yeah we did a little digging and you know through her history I found out she ate a lot of fish she had a bunch of fillings we checked her mercury it was super high yeah and I detoxified her from the mercury and she lost 40 pounds like that right and I saw her a few years later I can even recognize her yeah that high toxic load which can prevent us from from losing weight I mean there are a whole category thing it's called OB so Jen's which are environmental toxins that cause obesity yeah and so that's a big factor in diabetes obesity we don't talk about that right I mean we know we know that men that went to Vietnam and were exposed to Agent Orange right they got diabetes at a much lower weight than men that didn't get exposure to Agent Orange right because we know that those toxins that being Agent Orange being one of them you know damages our mitochondria which damage how well the body can take our food and turn it into energy yeah so so in functional medicine you know traditional medicine is pretty simple you know eat less exercise more that's a solution count calories you know counting your steps I mean it's just not working so what do we do differently in functional medicine you know so first of all we get a really detailed history right we find out from that person their timeline when did when did weight become more of an issue for them was it was it just this slow progressive increase over the years or was there a time where they had this big spike in weight you know it that really impacts how we think about what could be that underlying cause for them right if all this sudden somebody gains weight then you go and okay maybe there's something going on with their thyroid maybe something shifted there right you know if it's that slow progressive weight gain then maybe it's a combination of of you know just getting you know the wrong foods and not you know not sleeping enough or not exercising enough right so is so it you know how they gain did when they gained the weight really gives us information yeah so everybody's different sweets all this is what functional medicine is it's personalized medicine personalized health yep and we actually dig into your individual imbalances and correct them and that leads as a side effect to weight loss I never get people to lose weight I mean I never say lose weight I never say we're putting on a diet I say here's the things that are out of balance let's get them back and bounce I'll cross their fingers and see what happens yeah you know and it's often a miracle what you seek yeah and it just comes off yeah people you know there are weird cases of things like I remember a case where there was a doctor who came to see me a woman who had gained a hundred pounds in a few years mm-hmm and her colleagues were like oh you're just eating too much you know don't need so much to get a gastric bypass this and that she's like no something's wrong I'm like well she showed me your driver's license picture she looked like completely different no I'm like well what's going on with this and I and I just look it's probably something weird let's check things like her cortisol level and we checked her cortisol levels off the chart and she had a tumor on her adrenal gland that was causing high levels of cortisol which makes you hungry yeah and fat yeah and yeah you know and stress makes you fat in the same way so you could be I mean this woman who was and so we had her adrenal gland tumor taken out and she lost hundred pounds like that right right another patient I remember years ago was struggling and she'd gained 40 pounds and her daughter lived in Israel Mitch was so stressed cuz it was during the time of the conflict there and constant bombings and terrorist attacks and she was constantly stressed yeah and as soon as her daughter came home she lost 40 pounds right right right or or you know I think the I think there's a really interesting connection with the gut and food sensitivities and weight right so when we put people on elimination diets like you know somebody does like your 10-day reset or yeah they you pull away inflammatory foods and they lose weight so quickly right that's a sign that they're eating a food that's causing their body inflammation right and what is inflammation after you with weight gain oh well when there's inflammation that causes us to hold on to water and that causes weight gain and inflammation also damages the mitochondria and that impacts weight gain so it is you pre-diabetic yes so you could be eating the same things but if you're right stressed yeah they're actually raising cortisol yep and if the insulin goes high then you're gonna gain more weight from the food that you eat yeah so it's complicated but in functional medicine we really have a map to diagnose each person's dysfunction and bounds with your thyroid or mercury or cortisol or the gut microbiome or your mitochondria yeah there are all sorts of things that go wrong that most doctors overlook and so and the problem with medicine today is that we sort of blame the victim like if you're overweight it's because you're eat too much and you're don't have self-control and you're not taking personal responsibility and we blame the victim yep and we don't actually have a way for helping these people figure it out so you know I think this is really important people understand that that we now know a lot about metabolism and weight and all the various factors that go into affecting it and how to fix them where we necessarily didn't know a lot before yeah but now the more and more we're knowing we can actually figure out how through food and various strategies help people lose weight so I want to talk to you about a few cases you had that were interesting about how we saw these patients at the ultraviolent Center and and what exactly you did to help them figure out their issues yeah yeah yeah so the first the first person that came in was or one of the women that came in we she was 55 and she had she was overweight about 40 pounds overweight and she had noted that you know her kids had just gone off to college it was time for her to start taking care of herself but she had noted that you know over the years after her her pregnancy she just slowly started wait and you know she was exercising and taking care of herself but you know those those 30 40 pounds just slowly came on over the years and what we noted with her we we did her waist hip ratio we saw her waist hip ratio was elevated indicating that there was insulin resistance we also checked a fasting insulin we saw that it was high also indicating that insulin resistance we saw that when it's one's high you can't lose weight right as it locks the fat in the fat cells it slows your metabolism it makes you hungry and crave carbs yep and it makes your body store fat you're literally creating a total chaotic sabotage of your body when your insulin levels are high and you're eating all the starch or sugar right so we had to figure out how do we help drop her insulin levels right how do we help drop her insulin levels well you know you can do that when you shift diet because we know that when we eat fat right the body doesn't need to make insulin to use that fat so when you eat carbohydrates your body makes insulin you know and when you eat a lot of the refined processed carbohydrates you your insulin levels spike so when we when we shift when we shift the diet to one that's a little lower or a lot lower and those refined and processed carbohydrates and more healthy fats that helps with people with feeling better and and and not feeling so hungry it helps prevent those insulin spikes and it helps us not gain as much weight around the belly yeah it's so important to focus on insulin most dr. Lehmann test your insulin so we know where it is right but if you check it and it should be less than five you're good and if it's over ten it's pretty bad and it can go up to 50 100 or more and especially after you eat it and get worse right and I wish we had a little like monitor where we could quickly measure insulin like a continuous glucose monitor or continuously monitor I think it'll be more interesting I agree and I think that you know we we actually know how to fix it and you know people need to realize that without insulin you can't gain weight if you take a type one diabetic mmm-hmm whose pancreas is damaged by an autoimmune disease yep and you look at their symptoms their weight loss and hunger they're eating 10,000 calories a day and losing weight right why because without insulin you can't store the fat right so this is really important people understand it's so powerful and that's why strategies that help fix insulin are so key for weight loss for most people yeah yeah and you know we were so you know 20 years ago or so we were so programmed on that pyramid right where we were making sure we're getting enough grains and I guess 6 to 11 servings of bread rice and pasta data it seems like a recipe for disaster yeah and so it really it caused a lot of high insulin for people and it and they're having a harder time with with they're feeling hungry all the time and they're having a harder time with weight loss because of it so sometimes people get really surprised when we pull away either pull all away the the grains or keep them very minimal they are like really I thought I was supposed to eat all of these right and and that and that can help help really help with those cravings and you know so I'm getting more fat yeah and getting more so if you you think you could eat so much fat and not gain weight cuz we used to think that fat made you fat right cuz it has nine calories per gram versus four for carbohydrates or protein so if you want to cut out the calories you just cut out the fat yeah well that's what happened we cut out the fat and had a low-fat craze when low-fat salad dressing and low-fat snack well cookies and low-fat muffins and they were all full of starch and sugar yeah and and that was the worst thing that could have happened so when you eat fat you don't increase your insulin you actually you speed up your metabolism right you know is that study by our friend David Ludwig yeah we basically gave people food so he knew what they were eating and was either sixty percent carbs twenty ten percent fat or it was sixty percent fat and 20 percent carbs and on the sixty percent fat eating exactly the same amount of calories every day the the metabolism increased on the high fat diet so doing the same level of activity the people who were the most overweight and in some resistant their metabolism increased by 400 calories a day that's like running over an hour and a without getting off the couch and that would account for the entire obesity epidemic if we could fix that so right this is a really important strategy yeah and and so she then lost her numbers came down beautifully her blood pressure was a little high and it came came down her blood her insulin came down and she lost about ten pounds but she was right so she got a little bit stuck and I think that's where we shifted things a little bit and I think sometimes that's really important is that you know sometimes the body gets a little used to a certain plan and you have to change things up and I think that's where in intermittent fasting can be really helpful and so we put her on a program it's called a 5-2 program where we're two days a week she cut down her calories significantly you know it was like a 500 to 600 calories on those two days because she was really not eating very much on those two days and she could pick whatever two days she wanted and the other five days she wasn't as strict and that's when you know her her body started to kick in and her metabolism improved yeah I think probably because of the impact on the mitochondria yeah you know but it was it was impressive talking about this because you know I think there's so much information now online in the media about this whole intermittent fasting thing yeah and there's lots of different terms like time restricted eating yeah you know intermittent fasting and fasting by making diets and ketogenic diets and it turns out they all do the same thing and so you know tell us a little bit about each of these and how they work and why they're so effective right so you know time restricted eating just means that you're not eating for specific periods of the day or you are only eating for certain times of the day so a typical way that somebody will do a time restricted eating plan is say okay I'm only going to eat for eight hours in the day and I'll eat between between eleven and seven a new fast for six and then you fast for the other sixteen twelve is good most people eat all day II talked to the go to bed and then they wake up and they like you know eat again I think you're absolutely right I think that is a great place to start with everyone because if we can just get people to not eat after dinner right they will they're there things will improve because we know that the food that we're eating later in the evening that nighttime eating will cause more of an insulin spike right so we know that that that's really important to pay attention to so so saying to people okay let's try with at least not eating for 12 hours a day so you know when you move to 14 yep but it you know and and not everybody needs to go longer but there's good research with the 12 to 13 in terms of helping with longevity helping decrease risk of cancer there's some interesting research on breast cancer and not eating for 13 hours at night so I think that that that's something that we can really work with a lot of patients to do and say okay let's say at 6:00 to 7:00 at night that's when you stop and and not eat until the next you know the next 7 a.m. time or whatever whatever whatever that is for them yeah there's so much research on this now you know and they all do similar things whether your time restricted eating whether your integrand fasting like you know fasting one day a week or the five-two program yeah or whether you're you know trying a ketogenic diet which activates the same systems in the body all of it does the same thing it enhances your energy production your mitochondria health which is really important it fixes insulin resistance and gets rid of belly fat yeah it builds muscle and improve your brain chemistry in your cognitive function yeah it helps your bone density and it even helps production of stem cells it reduces inflammation and it reduces your antioxidant burden I mean it reduces your oxidative stress you get more antioxidants produced so it's a very powerful way of focusing not on what you're eating or how much you're eating yeah but when you're in your eating right and that's a very interesting angle that we really haven't focused on we always focused on how much and then we now focusing on what because not all calories are the same and now we focus on wham right and I think that's a really important thing people understand that you you there's a lot of ways to hack weight loss that have to do with the right kind of approach and and if you're not doing it right you can kind of get in trouble because but you need to know what you're doing and I think there's a lot that we can share about this and we'll share at the end about how to actually do this so yep what's the key thing so what other things you know we had this other patient you had that that was was a male who really struggled he was overweight about 40 pounds so tell us about him yeah so you know he came in and he was he was he was 55 and he was really struggling with his energy he was very low energy he was really frustrated with his his sexual function he noticed he had a low libido he was having some erectile issues he had gained he'd gained these 40 pounds around his belly but he was really having a hard time with with losing them with losing that weight and the more the higher your belly fat the lower your testosterone yes because right because that belly fat has that aroma taste enzyme which takes your testosterone and converts it into estrogen yeah they lose the hair on their body they get man boobs right yep breasts you know it's like it's a it's a real thing it's a it's a real thing and and it's it's it's a great motivator for men right we know that as your waist circumference goes up so does issues with a rect I'll dysfunction so you know but we need to give them the tools to be able to lose that weight around the belly right so so he had all these other issues and you you know you sort of figured out that he had in some resistance to I mean the first thing the first thing we did with him was put him on like that 10-day reset that that you've put together which really I think is a is a great it's a great jumpstart for people because it can help them say okay I'm just gonna I got a I gotta try this but I need the the the tools I need the map to do it yeah and and and and it's really motivating because P times because people were eating inflammatory foods before or they were eating the wrong foods at the wrong time right and they do this and they notice a significant improvement in how they feel and then they're like okay I can really shift this yeah I can make a change yeah so we did that before any time we said you know what we've been doing in our Center for decades which is an anti-inflammatory low glycemic higher fat phytochemical Ridge fiber-rich diet yeah it actually helps to reset your whole biology not just about weight but uh any chronic illnesses or assume you have it so effective right because you're pulling away the inflammatory food which for a lot of people those inflammatory foods are triggering a lot of their centers and you can you can actually get access to the free program I'd get pharmacy calm as GE T FA RM Acy calm and if you want the upgrade on it you can would get with the coaches that help you go through it with the shakes and the supplements that help enhance the program so it's all on there just going to get pharmacy calm and you can try it because a lot of times you don't really need the doctor if you can you can sort of biohack your own biology and figure out what's working what's not working and then once you figure out oh my god I lost 10 pounds this week and I feel so much better and my joint pains gone and my headaches are gone and my nose isn't running and my digestion is working and I sleep better and it's like well how did that all happen it's because your your body is so powerfully influenced by food we always talk about food as medicine not like medicine it is medicine yeah and it and it has tremendous effects on curing all kinds of illnesses if we actually used it and that's what this is it's a very medicinal diet that tastes freakin amazing yeah right so you're suffering right so and he felt really motivated he was really happy but you know he actually had a lot of other things going on so he had lost some weight but but then we also we also noted we also you know I've through questions we found out that okay this he might have some issues with sleep yeah you know he was snoring his blood pressure was a little high he had all this weight gain yeah so I said you know what we really need to get a sleep study on you and so when we did the sleep study we found out that he had sleep apnea and is so common and under diagnosed yes and sleep apnea where where people stopped breathing in the middle of the night even though they don't realize it right there snoring and then there then they have episodes of apnea where they don't get any oxygen into the body that in and of itself triggers insulin resistance so that causes high levels of insulin in the body which then as we've been talking about causes to gain weight around the belly so what you're saying is if you don't sleep you get fat even if you don't change your diet absolutely yeah when you realize because people think it's again is about what you eat and exercise and yes it is but there are other factors that have to be looked at that most doctors miss so often when somebody has sleep apnea or might have the signs of sleep apnea you know they think okay I'm just gonna lose weight and then it will go away right but so often it's the sleep apnea that's causing the weight gain yeah and you know of course it becomes a vicious cycle sure but that sleep apnea causes high levels of inflammation in the body and it causes high levels of insulin and it just causes us to put on weight and it also is one of the biggest causes of high blood pressure this absolutely I remember this one guy added was like lawyers in his 50s and he's like you know mark I have to work in my desk but I have a standing desk because this is before standing desks were popular because if I sit down I fall asleep I'm like you fall asleep driving home you fall asleep watching TV your story's like yeah yeah yeah I'm like you need up sleep apnea let's get you tested yeah we got him a CPAP machine he lost 50 pounds yep just boom like that mm-hmm putting on a sleep apnea machine every night right right because you're actually getting oxygen into the body so the body's not at stress anymore and so the insulin levels come down the inflammation comes down in the body and then the weight comes off I think when people have undiagnosed sleep apnea when it's not being treated we can do we can do all these great things with in terms of shifting their diet and and and putting them on an exercise regimen and and looking for other issues but if we don't deal with that it's it's it's almost like I always say to them it's like you're running against the wind you're not gonna get to your goals yeah and so we've we've got to deal with the sleep issues and like you said it's so common and this guy didn't just have sleep issues he had the insulin issue had sleep issue yep his thyroid wasn't right right yeah exactly we checked his thyroid and he had he had some elevated TSH he had some or low thyroid and he had some thyroid antibodies that hadn't been discovered before so then we dealt with all this autoimmune stuff going on and so we we took him off a gluten he was already off because of the reset but we kept him off a glutton and so we were working on every aspect of his health yeah and and that's when and that's when he got to his goal weight right when when we we worked on every aspect of his health and we helped him also get on a diet that he could maintain yeah forever right which is what the goal is it's so true and you know it's importantly we often joke we say we're holistic doctors because we take care of people with a whole list of problems mm-hmm and you know he's often not one thing it's many things yes and you know everything so siloed in medicine so there's a sleep doctor it's the thyroid doctor there's a wait doctor it's like forget it you know in functional medicine we take a step back and we look at the whole system and we're able to map out in and this is this one guy another guy with over who's overweight might have different issues absolutely and so we might have to look at their toxin load or their gut microbiome or their you know levels of nutritional status that affect their metabolism so you know we really really have a very sophisticated lens to look through to understand what are all the imbalances and all the systems of the body and how they affect any different disease the truth is you know we have so many different illnesses that we diagnosed in medicine but they're all connected by very common root causes mm-hmm you know just like you know you can send a man to space with with an incredibly few simple physics laws right very few laws of physics and they actually can help you do something incredibly complex the same way the human body has some basic laws of biology and follow those laws we can help people get better it's just learning how to unlock all that and that's really the beauty of functional medicine and we actually have the ability to personalize our treatments to get people better from things that often they don't get diagnosed or that traditional medicine doesn't have a great approach for so it's just so gratifying to be doing this you know it's really so satisfying every day to go to work and see patient after patient who's seen everybody done everything gone everywhere tried everything and they're not better and they come in and we sort of like a magician we find the thing and it's like it was so easy but it's so easy if you know the questions to ask right it's really fun too it's really fun to have a great team and you know we've been doing this for a long time at the eltra Wellness Center we have collective experience of over 60 years of functional medicine more than probably any other Center in the in the world and you know does not everything we can fix but most things we're really good at either totally fixing or dramatically improving and I just encourage people to seek out functional medicine in their community you can come see us at the ultra Wellness Center you can learn more about how to deal with the obstacles to weight loss and things you want to look at it a hand that we provided on our website dr. Hyman com4 slash uwc and get the information you need to really succeed in every aspect of your health and not just treat disease but optimize your health you know functional medicine is a science of creating health and and I would have everybody to have that that's our birthright and sometimes you need a little help and we're here to help you so thank you for listening to this episode of the doctors pharmacy with dr. Boehm my friend and colleague and partner on this week's episode of house call and the mini episode of the doctors pharmacy and if you liked it please share with your friends and family on social media subscribe wherever your podcast leave a comment I'd love to hear from you and we'll see you next time on the doctors pharmacy Thank You Marc

Channel: Mark Hyman, MD

Views: 18,601

Keywords: dr. elizabeth boham, dr. mark hyman, the doctor’s farmacy, health podcast. Weight, fat, how to lose weight, functional medicine, why am i gaining weight, insulin, blood sugar, intermittent fasting, time restricted eating, night time eating

Id: Ijg_2vCVXCs

Length: 27min 52sec (1672 seconds)

Published: Fri Apr 17 2020