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Alan S. Weiss, MD
A New Year, A New Start
Annapolis Integrative Medicine
. http://www.annapolisintegrativemedicine.com/

A New Year, A New Start

A New Year, A New Start

The beginning of a New Year is a natural opportunity to take stock of many things, including our relationships, finances, goals and dreams, and our health. One of the most common resolutions is to exercise and lose weight.

When it comes to weight loss, diet is about 80% the key and exercise around 15%, though there are other factors.

Many of us inherited a metabolism which is geared towards survival, and storing fat helped primitive humans survive, but in this modern world it makes it easier to gain than to lose weight. Our brains are wired to crave foods that are calorie dense, which is why we are more likely to crave ice cream and pizza than broccoli! While this was useful for survival thousands of years ago, that same metabolic wiring does not really serve us in this modern world of unlimited food choices. Recognizing this gets out of the cycle of blaming ourselves for our “weakness” and allows us to take actions that make a difference.

There are many strategies that can work for weight loss and it is not one size fits all.

The first step is a full medical evaluation to look at possible underlying factors that slow down our metabolism. These include thyroid issues, sleep issues including sleep apnea which is underdiagnosed and very impactful, menopause, testosterone deficiency in men, chronic stress, medication side effects and other issues as well.

It is clear that people are under stress with financial issues and a 24/7 news cycle. I see patients every day who are chronically tired, in some degree of physical discomfort, often not sleeping well and cannot seem to lose weight. An effective approach to getting patients like this well includes working to restore the sleep cycle, promote digestive health, and investigate the health of the thyroid and adrenal glands.

Evaluating and treating digestive issues is also critical. Inflammation of the intestinal tract is very common, presenting as heartburn, bloating, pain, diarrhea and constipation. Often chronic infections can be at the root of this, including overgrowth of yeast, as well as deficiencies of digestive enzymes. Food allergies and intolerances can also play a role in intestinal dysfunction. Addressing this from a systematic, functional medicine perspective can powerfully restore health.

It is important that people get connected to the reality of what they are eating. I encourage my patients to keep a food diary and use an app like Carb Manager to document what they are eating. Many people find out that they are eating way more carbohydrates then they believed. Carbohydrates often stimulate insulin secretions and high levels of insulin encourage fat creation and storage. Reduction of carbohydrates and sugars can help many people get on the road to weight loss.

There are many medications and supplements that can help with weight loss. Most notably now available is a class of drugs call GLP-1s, like Ozempic and Mounjaro. While not for everyone I have seen these medications make an enormous difference in people being able to lose weight.

Regarding exercise, there are a multitude of health benefits available. When it comes to weight loss the effect of exercise is more in terms of improving metabolism over the long term rather than immediate loss from an exercise session. My advice to patients is that exercising and not exercising are both habits. When you are in the habit of not exercising it simply means that you would have to put some effort and structure and thought into exercising until it becomes a habit! Finding a friend or trainer to support you in this often can help!

Finally weight loss is possible for anyone, you just need to find the barriers to it and create a plan!

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