Weight and Weight Loss

A Holistic Approach to Weight Loss for Better Health

Generally, the population in the United States continues to gain weight as a whole, and scientific studies now place the United States as the industrialized country with the highest rates of overweight citizens (64%), and the highest rate of citizens with obesity (37%). The Centers for Disease Control and Prevention, a United States government federal agency under the Department of Health and Human Services, estimated that direct medical expenditures for obesity-related health problems reached $147 billion by 2008, with rising costs each year. By 2009, 9 states had obesity rates of 30 percent or more. This research indicates that there are a number of common health problems and diseases associated with obesity, and treatment for the now very common problem of obesity must address the whole health, not just weight loss. What this means to the patient with a weight problem is that a medical problem with losing weight, which is what obesity is, in effect, produces a variety of health problems that create serious consequences in the long run, and should be corrected at the earliest possible stage. Since the problem involves a more extensive array of health problems than just being overweight, a more comprehensive holistic approach to the correction of the problem is sensible. In fact, as research expands on obesity and overweight conditions we see that an acquired weight gain can actually create a set of systemic feedback controls that work to prevent weight loss, and that forced weight loss, as in dieting, often serves to reinforce these physiological effects to maintain excess body weight. Only a few percent of individuals that lose a dramatic amount of weight will maintain their lower weight for more than 5 years, and a new holistic approach is slowly developing concerning weight loss. Obviously, creating a healthier public diet and environment to prevent obesity and overweight conditions is the most important concern, yet the will to achieve this has been lacking.

In 2012, a prominent expert on obesity and weight loss at Rockefeller University, Dr. Jules Hirsch, explained why it is so hard for many people to lose weight: "What your body does is sense the amount of energy it has available for emergencies and daily use. The stored energy is the total amount of adipose tissue in your body. We now know that there are jillions of hormones that are always measuring the amount of fat you have. Your body guides you to eat more or less because of this sensing mechanism. This wonderful sensing mechanism involves genetics and environmental factors, and it gets set early in life. It is not clear how much of this setting is done before birth and how much is done by food or other influences early in life. There are many possibilities, but we just don't know." (New York Times, In Dieting, Magic Isn't a Substitute for Science, July 9, 2012) - Serious consideration to restoring a healthy hormonal homeostasis may be the key to weight loss with obesity, and Complementary and Integrative Medicine (CIM/TCM) may help you with this task immensely.

We might divide the problems with weight loss into two categories, a simple overweight condition and medical obesity. If you wish to lose weight, and you are able to lose weight when you diet and exercise, then you may not have a problem with medical obesity. A Licensed Acupuncturist, or Complementary Medicine physician, can offer a number of treatments that can help you with either a simple overweight condition, or a problem with obesity. The ways that Complementary Medicine can help with simple weight loss problems include nutritional supplements that have been well studied, herbal formulas that are individually tailored to your overall health profile, instruction in and understanding of healthy dietary regimens, and acupuncture. Acupuncture does not miraculously cause one to lose weight, but does stimulate improved metabolism. There is no secret point on the body that, when stimulated, causes weight loss. What acupuncture does accomplish is a stimulation of the various systems and processes in the body that need to work better to help you lose weight as you diet and exercise. Acupuncture as a weight loss treatment should be combined with a holistic multidisciplinary approach that includes simple changes in habits, individualized nutrient therapy, and herbal medicine. Since one absolutely needs to burn more calories that one takes in, and achieve efficiency in metabolizing and utilizing food nutrients, eaten and stored, to actually lose weight, one cannot continue with bad habits and lifestyle and expect some pill or acupuncture to force your body to lose weight without improving the diet and lifestyle habits that made you overweight. The first step in solving a health problem is to address the cause of the problem. This takes some level of physiological understanding, and the Licensed Acupuncturist can offer explanation and advice as well.

If you try to lose weight, and you can't, you may be suffering from obesity. Large studies in recent years have shown that a sizable percentage of patients that adopt diets to lose weight actually end up with weight gain when they stop the diet, and that 95 percent of weight loss programs either achieve less than a 5 percent body weight reduction, or see a regaining of the lost weight within 5 years. The main problem with an inability to lose weight is the phenomenon of obesity. Obesity does not translate as being fat. Obesity is defined as an abnormal increase in fat in the subcutaneous connective tissues, and is mainly associated with hypothalamic dysfunction, or poor hormonal control of the various processes that regulate storage and usage of fat. This is often highly associated with accumulation of fat in the organ tissues as well, typically called 'fatty liver'. How to reset the metabolism to counter the phenomenon of obesity is question. The hypothalamus is a small area in the center of the brain that is sometimes called the control center of the endocrine, or hormonal, system, at least the adrenal-hypothalamus-pituitary axis. This has been a poorly understood health problem for many decades, but recent research has confirmed that obesity is related to specific dysfunctions involving inflammatory mediators affecting the fat cells coupled with hormonal imbalances that create insulin resistance in these fat cells. Insulin is a steroid hormone very similar to estrogen, progesterone, testosterone, cortisone, etc. Correction of underlying hormonal problems as well as chronic inflammatory dysfunction is key to correction to the underlying causative process of obesity. Standard protocol still treats systemic metabolic dysfunction as the same problem as focal pancreatic beta cell dysfunction, or equating insulin resistance with the inability to produce insulin. This continuing neurosis clings to past beliefs with almost religious zeal, and resists the fact that a more holistic approach is needed to reverse systemic metabolic dysfunction. Of course, as with any systemic health disorder, there may be a number of contributing factors that lead to hormonal and immune dysfunction, as well as a number of metabolic concerns that contribute. All of these concerns should be discussed, understood and addressed in therapy. Allopathic, or standard medical approaches, may seek to alter just one of these health factors, and this has been unsuccessful as a whole.

In 2013, researchers at Massachusetts General Hospital, in association with Harvard Medical School, published the findings of a remarkable study that showed that the human microbiota, or symbiotic bacterial colony in the gut, may play an important role in the regulation of cellular fat stores. Dr. Lee M. Kaplan, director of the Obesity, Metabolism and Nutrition Institute, lead author of a study of the physiological effects of gastric bypass surgery, showed that alterations of the microbiota could account for more than 20 percent of the weight loss effects after this surgery. Dr. Kaplan stated that 4 subsets of symbiotic bacteria were found that were enhanced by the bypass surgery, and further research will identify how best to enhance these bacterial colonies to achieve significant weight loss without resorting to gastric bypass surgery. A second study, also published in the same week, in the Journal of Clinical Endocrinology and Metabolism, reported that in a large human clinical study, that patients with a higher level of the symbiotic bacteria Methanobrevibacter smithii were more likely to be overweight or obese, and that biotic control of this bacteria could result in less subcutaneous fat storage. Dr. Ruchi Mathur, of Cedars-Sinai Medical Center in Los Angeles, surmised that this symbiotic bacteria was useful in the distant past, when the human diet needed help to squeeze more calories out of food with more fiber, but that modern diets, richer in calories and more processed, were not appropriate for the physiological effects stimulated by this bacteria. Such research is demonstrating that even the human microbiota plays an important role in the regulation of fat storage, and that a holistic approach to treatment, including restoration of health gastrointestinal function and probiotic health, is important in the weight loss protocol. To better understand the science of the microbiota, and probiotic therapy, go to the article on this website entitled Probiotics and a new appreciation for bacteria.

By 2013, the failure of most weight loss regimens prompted renewed research into the the mechanisms of fasting. Large studies in the United Kingdom demonstrated that with partial fasting, or intermittent restriction, sometimes called 2-day fasts, or intermittent monofood fasts in the past, improved weight loss and hormonal balance, with decreased insulin resistance, and improved blood sugars and lipid profile, were achieved. The 5:2 diet was proven and promoted in 2011, and variations were proven in repeated clinical studies in 2013. This strategy, long derided in standard medicine as the promotion of many small meals was stressed for blood sugar and lipid control, was condemned as quackery promoted by "health nuts". Gradually, scientific study confirmed the benefits of partial fasting. Early in the twenty-first century, public health authorities recognized the array of health benefits from taking at least a 5 hour break from eating during the day, instead of the habit of constant small meals and snacking. This habit not only allows the body to expend its energy on something else other than digestion and assimilation of food, but promotes a habit of utilization of stored fats for energy. In a similar manner, the adoption of an intermittent fasting regimen allows the body to focus on hormonal reset and utilization of stored fat, by choosing 2 days a week and limiting the food intake to about 500 calories, which equals about one small meal, composed of fresh vegetables, a little cheese, fish or lean poultry, or perhaps tempeh or tofu. To illustrate, a healthy smoothie or a small serving of yoghurt and fruit in the morning equals nearly 300 calories. These researchers studying the 5:2 intermittent restriction diet also confirmed, like the Atkins' diet researchers, that eating a small meal composed of just healthy fat and protein, and avoiding carbohydrates and alcohol, stimulated a reflex of better utilization of stored fat on the days of restricted intake. Research in recent years has also found herbal and nutrient molecules that may stimulate increased metabolism and utilization of midsection fat stores (read below on glabrinol, chitoglucan, and green coffee extract). Integration of such strategies and natural aids to resetting the complex hormonal and metabolic controls, in an individualized manner that suits one's particular needs, may be the key to regaining the healthy homeostasis that keeps the weight down and the health up.

A study published in the United Kingdom in 2016 showed that for almost all of the study participants with a diagnosis of Type 2 diabetes with obesity, that the syndrome was reversed with short healthy hypo-caloric diet and adherence to a sensible whole food Mediterranean style plant-based diet over the next 6 months. In this study the participants were fed a healthy shake in the morning and consumed a healthy shake and only non-starchy vegetables for the subsequent meals for 2 months, and then adopted individualized diets avoiding excess meats and processed foods, as well as processed sugars. None of the patients needed medications for diabetes after this, and the endpoint measured was not weight loss, although a modest 5 percent weight loss on average did occur. The point was that the weight loss per se was not the important factor, and that we should be focused on our health, not just the weight loss. In time, patients will experience a lower natural weight when they achieve a healthier metabolism. To counter these dramatic findings, a number of experts in standard medicine immediately started a different 'spin'. One spin released later in 2016 was the book entitled Why Diets Make Us Fat: The Unintended Consequences of Our Obsession with Weight Loss, by the neuroscientist Sandra Aamodt. While this type of study presents the truth that for many patients, standard diets and even surgical weight loss programs do not work in the long term, that there has been a strong failure in the weight loss industry, and that many of these highly advertised and prescribed weight loss programs do in fact stimulate individuals with obesity to a higher weight set point, the blanket statement implied, that we should all just abandon all types of dieting, is very misleading. Once again, the allopathic one-size-fits-all approach occurs, and fails to see that more sensible and holistic approaches to our health are needed, not the belief in the quick fix or miracle pill. Research is revealing what works to make us healthy and reverse the problem, and we need to pay attention to this sensible holistic approach and avoid the industry "spin".

In 2014, a long-term study by researchers at Tulane University, headed by Dr. Lydia A. Bazzano, and funded by the U.S. National Institutes of Health, confirmed that the standard recommendations in weight loss, using a low-fat diet with frequent short meals, was indeed wrong. In this study, 150 adults were recruited who represented an equal division of men and women of diverse racial backgrounds, and divided randomly into 2 groups. One group was put on a diet consisting of low-fat calorie restriction, and the other group was put on a diet that was low in simple carbohydrates and encouraged a higher intake of healthy fats, both unsaturated and saturated, with no restrictions on caloric intake. This latter group utilized a modified Atkins diet, with increased healthy fats (no transfats allowed) stimulating increased burning of fats in daily activities and exercise. Fresh vegetables were encouraged, and some intake of beans and whole grains, as well as fresh fruit. By the end of one year, the group that had consumed a significant amount of their daily calories as healthy fats, and a predominant amount as protein, had lost on average 8 pounds more than the group on the common weight loss diet. This latter group also showed significant metabolic improvement, with triglycerides and C-reactive protein decreased, and high density lipoproteins increased, as well as the decrease in the small dense low density lipoproteins (LDL) associated with atherosclerotic inflammation and calcification. The total LDL and blood pressure was unchanged in both groups, but the group that cut out processed carbohydrates and ate a significant amount of healthy fats improved the quality of the LDL-cholesterol. This study showed definitively that the standard advice for decades in healthy weight loss was wrong. If there is no sign of an obesity syndrome, adopting a diet of whole foods and avoidance of processed foods and carbohydrates, as well as transfats and sugars, while increasing daily physical activity and going for periods of the day without eating, and even days where the total food intake was reduced to a partial fast, with less than 500 calories in total, perhaps by just eating popcorn for most of the day when hungry, or toasted seaweed snack, should result in a steady and significant weight loss over time. By avoiding binge dieting and expecting large immediate weight loss, and instead trusting that positive changes in a healthy diet and lifestyle, along with some aid from Complementary Medicine, most individuals with a simple overweight condition will be able to achieve sensible weight loss goals, and keep this weight off, while improving their metabolic health, and preventing future disease. Of course, is you have slipped into a obesity syndrome, more needs to be accomplished.

The failures of standard medicine to address weight loss in a meaningful manner and without alarming health risks has driven most thoughtful patients to seek an answer with Complementary Medicine when their own attempts have failed to produce results. Science has shown us that a calorie is a calorie, and different diets and amounts of fats, proteins and carbohydrates do not alter the inflexible physical law that energy taken in to the body must equal energy used. The challenge in each individual case of overweight or obese conditions is to find the healthiest way to burn stored energy and reset the complex hormonal mechanism that may make this difficult.

Problems with standard approaches to weight loss in modern medicine:

As time goes on, the scientific community and patient population is learning that the most common of weight loss medicines and surgical procedures has incurred unacceptable risks. In 2009, the French drug Mediator (benfluorex), used for over 30 years as a diabetic treatment and weight loss prescription to an estimated 5 million French patients, was ordered to be removed from the market for new prescriptions due to cardiovascular risks. Health authorities in France determined that as many as 2000 patients died from side effects of chronic use, and many thousands more were hospitalized with cardiac damage and pulmonary hypertension linked to the drug. In France, it was assumed that the system was so secure that no drug that posed this high of risk versus benefit would be allowed to be prescribed. The fact that the same pharmaceutical company, Servier, had pulled two drugs off the market in the wake of the Fen-phen scandal, where common weight loss drugs incurred many more cardiovascular deaths and injuries than this case (the American manufacturer of Fen-phen, Wyeth, set aside more than $20 billion to pay for patient damage lawsuits, before these lawsuits materialized), had failed to incur doubt about weight loss pharmaceuticals in the patient population. Mediator, like most of the weight loss medications today, is a type of amphetamine. Why the patient population is not more skeptical of pharmaceutical weight loss drugs is a mystery.

Standard medicine has a pretty dismal record of addressing this health problem called obesity. In the 1950s and 60s medical doctors routinely prescribed amphetamines, which were successful, but produced more health problems than they solved, and turned many innocent housewives into speed addicts. Today, 80 percent of pharmacological prescriptions for weight loss involve an analogue of amphetamine, called a sympathomimetic, with the generic name Phentermine, and the brand names of Adipex-P, Oby-Cap, Suprenza, T-Diet, Zantryl, and more. While these drugs are not technically amphetamines, they are abused as stimulants, and do create false-positive results on tests for amphetamines. Today, a similar program of supposedly benign amphetamine prescription is occurring again, this time with drugs to treat mainly children with attention deficit and hyperactivity disorders, resulting in alarming rates of amphetamine abuse by teenagers and young adults, but that is another story. We need to finally achieve a holistic weight loss program that does not depend on amphetamines and amphetamine analogues. CIM/TCM should play an important role in this holistic approach.

Over the decades, there have been few successful drugs to treat obesity with an allopathic approach. The two main drugs prescribed in the 1990s, fenfluramine (from the banned Fen-phen combo drug), and dexfenfluraramine (Redux), were recalled in 1997 by the FDA due to too many documented cases of heart valve abnormalities and other serious cardiovascular risks. The pharmaceutical companies quickly got approval for today's weight loss drugs, Meridian and Phentermine (Fentamine). Meridia is a Prozac-like drug, a selective serotonin and norepinephrine reuptake inhibitor. It works to suppress the appetite by supposedly increasing the amount of serotonin available to the cells in the brain. Phentermine, commonly called fentamine, is another variation of the amphetamine class drugs that have been banned in the past, technically called a sympathomimetic, or stimulant of the sympathetic nervous system. While the amphetamine drugs worked supposedly by increasing serotonin in circulation, which caused serious cardiovascular problems, the selective serotonin reuptake inhibitors supposedly work by increasing localized availability of serotonin and appetite suppression. Still, the number of cardiovascular complaints from side effects are high, with many patients alarmed at the level of restless insomnia, episodic racing heart rate, etc. An FDA advisory panel was split on whether to remove Meridia from the U.S market. Phentermine, part of the infamous Phen-Fen weight loss medication that was removed from the market after causing tens of thousands of cardiovascular events, such as stroke or heart attack, is now marketed as part of a new combo drug, combining phentermine with another problematic drug from the past, Topamax (topiramate). This drug received a recommendation against FDA approval from an FDA advisory panel. Topiramate has been prescribed for years, first as an anticonvulsant, and later as an anti-migraine, and neuralgia therapy, and common side effects include dryness, dizziness, decrease in energy, headaches, anxiety, peripheral neuropathy, sinusitis, gastric and intestinal problems such as constipation, insomnia, short term memory problems, and weight loss. In clinical trials, approximately 21% of patients enrolled discontinued use because of side effects.

Besides alarming increase in cardiovascular risk and numerous side effects occuring in more than 10 percent of patients selected in clinical trials, these drugs that are based on narrow clinical goals, utilizing amphetamine derivatives and serotonin modulation, have a poor record of long term weight reduction as well. In October of 2010, the maker of Meridia voluntarily took the drug off the market in expectancy of an FDA recommendation of withdrawal. This drug received an FDA advisory panel recommendation against approval when it was indroduced in 1997, and a subsequent long term clinical study showed that it produced only a 2.5% weight reduction over the long course, while consistently raising blood pressure and increasing incidence of serious cardiovascular events by 16% (see link to a NY Times article below). The main drug in Meridia, sibutramine, was also found to be a significant component of over-the-counter diet drugs, and the FDA also issued a warning advising consumers of this risk. The problems with FDA warnings is that they are largely ignored by the patient and doctor population.

This leads many patients to turn to a more benign and natural medical approach. There are many heavily advertised programs of supposedly natural weight loss products and diets, most of which promote miraculous results that appear too good to be true. This is because they aren't true, according to public health studies. Most so-called 'natural' programs for weight loss have been shown to be ineffective in the long run as well as being bad for your overall health. Large-scale studies have shown that over the course of a year, almost all weight loss programs resulted in reductions of less than 5 lbs. Simple programs like Weight Watchers have yielded the best long term results in general. Many programs emphasize quick immediate weight loss that the person regains easily. These programs either increase the metabolism or starve the body of certain nutrients. Serious health risks have occurred with long-term use of these strategies and hence metabolic stimulants such as Phen-Fen and other ephedrine supplements have been banned from use by any person not certified as a professional herbalist. Still, companies seek herbs that have similar effects and market them heavily as safe natural products. The public should be wary. Profit-driven medical advice is a bad idea. Professional holistic healthcare insures that you are not being fooled by these pure profit-driven packages.

By 2015, despite a dismal record of success with weight loss, a resurgence in the treatment of obesity and overweight conditions occurred due to a provision in the Healthcare Affordability Act that requires insurers to reimburse for nutrition and obesity screening in standard care. There are now two types of weight loss care, those utilizing no prescription drugs, only Complementary and Integrative Medicine with counseling and meal-replacement products, and those depending on the quick but not long-lasting effects of prescription drugs combined with herbal and nutrient medicine. This latter type of clinic was reviewed in the July 5, 2015 New York Times, in two articles, entitled In Health Law, a Boon for Diet Clinics Overseen by Doctors, and Popular Diet Drug is Cheap and Easy to Get. In these articles, the prominent weight loss expert, Dr. Michael Kaplan, with Obesity Management Systems, stated that any Medical Doctor could now earn more than $3000 per patient per year for each of their obese patients with this new mandated coverage. Dr. Michael D. Jensen, the director of the obesity research program at the Mayo Clinic, Rochester, Minnesota, stated that true weight loss required a persistent approach, though, and Dr. Pieter A. Cohen, of Cambridge Health Associates, and an assistant professor at Harvard Medical School, in Cambridge, Massachusetts, stated that most obese patients that came to his care have tried these weight loss programs promising a quick fix, with prescription weight loss medications, not only regain the weight they lost quickly, but actually end up heavier after this type of treatment. Dr. Kaplan stated that diet and lifestyle changes are the most important part of a treatment program for obesity and weight loss, and patients sold a 3-6 month program of drugs and supplements rarely were able to keep the weight off. These articles noted that various phentermine drugs still dominated the weight loss market, accounting for over 80 percent of the market. Phentermine, a sympathomimetic amine with the same activity as amphetamines used in the treatment for obesity, was introduced in 1959, and has a long history of adverse health effects, with increase in blood pressure, development of valvular heart disease, drug dependence, and common side effects of nervousness, insomnia, dizziness, dry mouth, constipation, itch, tachycardia, heart palpitations, and decreased interest in sex. IN 1997, the U.S. FDA issued a black box warning for the combination of phentermine and fenfluramine, called Fen-Phen, with association with serious valvular heart disease, and stressed that the FDA approval for phentermine was for short term use only, and stressed that the long-term prescription had led to many cases of cardiac valvular heart disease in young patients. The FDA asked for a voluntary withdrawal from the market of fenfluramine and dexfenfluramine, with findings that 30 percent of patients taking these medications for a prolonged period had abnormal echocardiograms. The reports mounted, and the subsequent reports of cardiac death and court settlements were astounding for Fen-Phen. Eighteen years later, we seemed to have completely forgotten this history.

The package of care in Holistic Medicine is coupled with understanding

Why are there so many different diets, programs, supplement packages and drugs to make people lose weight? Because weight loss in obesity is a complex subject with no easy fix. It is estimated that more than 119 million people are overweight or obese in the United States, out of a total population of 305 million. Clearly, present approaches are not working, and we, as a population, need to start looking at the whole picture.

Weight loss must be assessed professionally on an individual basis. The human body is complex and there is no one-size-fits-all approach to complex problems. Basic physiological principles must guide the weight reduction and underlying causes must be assessed and explained to the individual. The knowledgeable Complementary and Integrative Medicine physician is the ideal guide for an intelligent and individualized assessment and treatment protocol - or you can just believe profit-drive advertisements of miracle weight loss programs.

Professional assessment of your inability to lose weight may look at functional issues such as exposure to toxins, psychological issues, effects of antibiotics on the symbiotic flora and fauna of the gut, triggers and mediators that maintain weight gain and inhibit proper metabolism and hormonal regulation, neurotransmitter dysfunction, inflammation and free radical production, abnormal yeast and fungal overgrowth in the gut, etc. This holistic approach may be needed. You may want to coordinate your care by an M.D. weight specialist with a Complementary physician to insure quicker and better outcome and get another perspective on this sometimes complicated puzzle. With true obesity and insulin resistance, often a complicated pattern of pathological dysfunction is occurring, with subclinical liver and hypothyroid disorders most common. In these cases, tests reveal abnormal lipid and cholesterol profiles, high C-reactive protein, high circulating blood sugars, high A1C index (an advanced glycation endproduct), and a high TSH (thyroid stimulating hormone). Standard medicine usually does not explore these problems thoroughly to provide an adequate explanation of specific dysfuntions. Additional testing of active hormone metabolites in saliva and veinous blood stick samples are inexpensive and provide a more detailed analysis of the whole interrelated imbalance in the body to guide therapy in Complementary Medicine.

We must first start with the basics, though, and try to see if the problem of weight loss may be handled simply. To simplify, let's assume that there are 2 basic types of person seeking weight loss: 1) persons that have developed some degree of clinical obesity, and 2) persons that consider themselves overweight and would like to be thinner.

For the person that doesn't have a real health problem that we could term obesity and would like to look better, intake of fewer calories and increase in the burning of calories by being less sedentary and more active, both in exercise and daily routines, will effectively result in weight loss. Going without food for a period of 3+ hours each day will also help. Herbal medicine and dietary supplements, as well as dietary changes may benefit this person very much. Acupuncture will enhance this benefit. The weight loss will not occur, though, unless the person improves the dietary intake and increases the daily activities. If excess appetite is a problem, there are herbs to reduce appetite. If depression and anxiety causes binge eating, there are effective treatments to help with depression and anxiety. If the digestion and elimination is unhealthy, with bloat, constipation, heartburn etc., these problems also may be treated effectively. The patient must make clear to the physician what problems are contributing to weight gain and difficulty with weight loss. Improved diet and increased activity must still be adhered to.

For the person that is unable to lose weight or has gained weight inexplicably, there is an underlying health problem that must be addressed. These health problems that lead to unwanted weight gains and inability to lose weight we may refer to as obesity, which does not mean that the person is extremely fat. One must get past emotional reactions to the word obesity and adopt an objective view of their health if one is to succeed in solving the problem. Here are some of the common causes of obesity:

Metabolic syndrome with insulin resistance: this may be the number one cause of excess weight in the United States at present. The basic mechanism is one of a national diet that is rich in simple carbohydrates and overloads the system of assimilating simple carbohydrates. The body responds to simple carbs (including but not limited to sugar) by producing more insulin. When excess insulin is produced over time, the fat cells develop a resistance to this chemical, especially when other hormonal stresses, such as chronic inflammation or menstrual problems, also affect the insulin system (insulin is a steroid hormone). When this occurs, over time, fat accumulates around the midsection, and blood sugars fluctuate. Cholesterol and triglyceride imbalance may eventually occur. Medications to reduce cholesterol and treat chronic inflammation do not treat the underlying problems, only the manifestations of the problems. Often, chronic use of these medications will contribute to a worsening situation. Hormonal changes around menopause and pregnancy, or associated with premenstrual syndrome or other menstrual irregularities may exacerbate this metabolic syndrome and need to be addressed in therapy when they occur. Since fat cells produce inflammatory mediators (cytokines) and leptin hormone, dysfunction with insulin metabolism and insulin receptor resistance are often closely tied to these chemicals as well. Since hormone receptors are triggered by a variety of hormones, neurotransmitters, and inflammatory cytokines, problems at the receptors leading to insulin resistance often involve pathological imbalances in these other aspects of health. Treatment needs to address this whole problem in obesity.
Liver stress and inefficiency in converting fats to sugars: your body runs on glucose (sugar), yet glucose is not stored. Your liver converts sugars to fats and proteins and then converts them back to get glucose for fuel. When this system is not working well there is sudden cravings for dietary sugars and simple carbohydrate foods. To correct this situation, the liver system must be improved. In more severe conditions there is an apparent lipid imbalance showing on blood tests, with high triglycerides and low levels of high density lipoproteins (HDL). If the liver is very dysfunctional, the liver enzymes will be high and the triglyceride and HDL levels will be in the disease realm. When there is less liver stress, these levels will still be within reasonable parameters, indicating that there is no liver disease. There is still a problem when the liver is not working the way it is supposed to, even when the lab tests do not show pathological levels. There are many factors that contribute to inefficient liver metabolism. Since the liver is responsible for detoxifying the blood, it works harder when chronic use of medications occurs or when chronic use of alcohol, caffeine, nicotine, or other drugs occurs. Sometimes, the patient must consider reducing liver stress to lose weight. Often, the physiological stresses that accompany anxiety and depressive disorders will greatly contribute to liver stress and must be addressed.
Hormonal imbalances unrelated to Metabolic Syndrome or Liver Stress: often there are endocrine imbalances associated with a syndrome of chronic health problems that results in unwanted weight gain. This imbalance is usually associated with chronic pain and inflammatory conditions as well a mild hypothyroid condition that results in a slow metabolism. Since all steroid hormones are linked in the endocrine system, when there is imbalance it ultimately affects the whole system. A simple hormone saliva test will give you an accurate account of your primary active hormone levels. Once this is determined to be a prime reason for the unwanted weight, treatment can be administered that is very effective to bring the endocrine system back into balance. The length of treatment varies depending on the condition. Sometimes 5 treatments will give excellent results and sometimes it may require treatment over the course of a year. Consult with me to better understand this problem. Premenstrual syndrome, or PMS, is an indicator that a cyclical relative progesterone deficiency is occurring, and progesterone deficiency and relative excess of estrogens may affect insulin and leptin physiology in a number of ways. For instance, conversion of circulating hormones to their active metabolites in local tissues is controlled with enzymes such as 5alpha-reductase, and elevated levels of 5alpha-reductase are highly associated with obesity, as well as insulin resistance and polycystic ovary syndrome. Progesterone inhibits 5alpha-reductase in a modulatory fashion. Cyclical deficiency of progesterone in PMS contributes to a pattern of insulin resistance. The adrenal hormone DHEA increases 5alpha-reductase in this homeostatic balancing, and deficiency of DHEA is also linked to insulin resistance and obesity. This also links the high rates of breast cancer in obesity to specific hormonal dysfunctions. The adrenal catecholamines, cortisol and adrenaline/norepinephrine, also affect hormonal conversions and imbalances within a diurnal cycle contribute to obesity and insulin resistance, and leptin resistance both directly and indirectly, affecting the hormonal balance and neurological controls at night. As time goes on, the research is uncovering more and more complicated ways that hormonal imbalances affect the mechanisms of insulin resistance, leptin resistance, and inflammatory dysfunction at the fat cells and liver. The patient is not expected to fully keep up with the science, but it is important to realize that there is a complexity that must be dealt with by holistic restoration of physiological and hormonal function and balance. A knowledgeable Complementary Medicine physician, and persistence, is the key to success.
The Leptin hormone and problems with the body's regulation of appetite, metabolism and stored fat. Leptin is the main hormonal protein that regulates these, and with obesity and inflammatory mechanisms in the brown fat cells there is a high level of leptin released in the body, leading to leptin resistance. Decreased expression of leptin hormonal receptors in the hypothalamus and liver are found in studies of obesity and insulin resistance, decreasing the central controls of metabolic energy metabolism. With a combination of insulin and leptin resistance, seen in the fat cells, liver, and brain regulating centers, patients are unable to lose weight despite decreasing caloric intake, increasing exercise and caloric burning, and making healthy changes in the diet. Just as in insulin resistance mechanism, when the body is overloaded with leptin, and the fat cells become enlarged, there is a decreased sensitivity to the leptin hormone to release the body fat when the body needs more energy, such as in heavy exercise. This explains why some people are frustrated by lack of success with weight loss when they seem to be doing the right routines. The correction of this problem involves a variety of mechanisms in the body and may take some time. If the weight reduction is not successful, the patient must persist with intelligent therapy and not give up easily. In fact, this leptin hormone also acts on receptors in the brain, such as the hypothalamus, which is associated with both the endocrine system and the limbic, or emotional system. Problems with emotional stability or hormonal balance, as well as thyroid dysfunction, could all play a role in the dysfunction of the leptin regulation of appetite and stored fat. Simple inhibition of leptin is not an option. A holistic treatment approach is necessary for success.
Inflammatory disorder: researchers at the University Pierre et Marie Curie have shown that obesity is associated with a low-grade inflammation of the white adipose tissue (WAT) resulting from chronic activation of the innate immune system and which can subsequently lead to insulin resistance, impaired glucose tolerance and even diabetes. WAT is the sight of stored fat as well as an important participant in numerous physiological functions and pathophysiological processes. WAT is a site for production of certain hormones as well as the site for production of important inflammatory mediators, such as interleukin 6 & tumor necrosis factor alpha. As white fat cells increase in size there is an increased infiltration of immune macrophages that secrete excess amounts of these inflammatory mediators. Sufficient essential fatty acids, liver health & a better PGE2 ratio and hormonal health are essential to correcting this problem. Excess free fatty acids induce changes in the macrophages of WAT that create harmful inflammatory mechanisms. One of the chief sources of this excess free fatty acid is commercial palm oil and poor quality meats. Low fat milk is also a source of palmitic acid because the industry uses palmitate to keep it stable. The WHO has stated that palmitate increases cardio risk.
Poor appetite control and Ghrelin excess: for many patients with severe obesity, gastric banding is at least temporarily successful to lose weight. Research has indicated that this procedure works to a large extents because the stomach lining that produces the hormone ghrelin is drastically reduced, producing a sudden drop in ghrelin. Ghrelin is a fluctuating hormone that is expressed to stimulate a desire to eat. With chronic ghrelin excess, obese patients are often aware that they are overeating, and while consciously trying to curb the appetite, the unconscious, or autonomic brain, is still stimulating excess consumption of carbohydrates. Some simple carbohydrate foods supply a day's need of caloric intake with just a relatively small portion of food. For instance, a large bottle of soda supplies most of a full day's need of calories. Reducing total food consumption while continuing to consume snacks with a high simple carbohydrate caloric content is common in obesity, and seems to be controlled by the hormone ghrelin. Unfortunately, if underlying health dysfunction is not corrected holistically, once the gastric banding is reversed, or the stomach lining again heals and grows, the patient's pathological level of ghrelin returns, and the obesity and weight also return. Patients undergoing gastic banding will also benefit in the long run with a restoration of total health with holistic medicine.
Hormonal effects in pregnancy may result in subsequent obesity and insulin resistance: many women have found that following pregnancies, weight loss becomes more and more difficult. Slowly, a pattern of subclinical obesity and insulin resistance is occurring. What triggers this is the subject of much research, but the whole explanation is still elusive. Certainly we know that leptin levels rise during pregnancy and normally fall after childbirth. Research in the last 10 years has uncovered a number of possible explanations for the onset of obesity following pregnancy, childbirth and nursing. Lactation and nursing has been linked to diurnal changes in serum leptin and hypothalamic expression of leptin receptors. A number of factors combine, including patterns of nursing excessively at night, that may explain why daytime reduced hypothalamic sensitivity to leptin may occur. Changes in eating patterns, and binging induced by increased circulating leptin, and leptin insensitivity at the hypothalamus, may be linked to eventual chronic changes in leptin levels and leptin sensitivity. If these problems are not corrected after birth, they may grow in severity. A number of beneficial hormones are also delivered with natural birth, and are found to play a large role in normalizing hormonal metabolism. The extreme rise in C-sections, which negates the hormonal effects seen in natural childbirth, may be implicated in failure to correct hormonal patterns acquired during pregnancy, and have an effect on the hormonal regulations during breastfeeding as well. This type of research is complicated and still speculative, but is pointing to some possible explanations. Certainly, a relationship between placental hormones and leptin is obvious and being explored.

So, we see that some thought and diagnosis must go into weight loss if it is to be effective. Unfortunately, there are no magic cures or pills. If you want to try magic cures go to the internet and believe whatever the advertisements tell you. Please do not put the professional clinician in the same realm as these companies that will tell your anything to make a buck. Effective weight loss accompanies good understanding and a whole package of health improvement. The good thing is that once you commit to this package of weight loss your life and health will be improved dramatically. If you are not willing to commit yourselves frustration will continue.

Only when the routines of eating and exercising are changed, and the chemical mechanisms regulated, will weight stay off. If this is not accomplished, the body will have a strong tendency to put the weight back on after the period of weight loss is over. This is the reason why most medications, surgeries and short-term dietary regimens will ultimately fail.

You must work with a knowledgeable health practitioner to achieve an intelligent permanent weight loss. These are the various herbal formulas which I may use in the treatment. I will need to explain specific courses and routines as we progress in weight loss, and use these formulas as aids to the diet and lifestyle changes and weight loss routines. The herbal and supplement routines will be enhanced by the synergistic effects of acupuncture. Often, the underlying health problems must be addressed first or the weight reduction will be difficult. Patients are often told that weight reduction must happen before their problems of hypertension, high cholesterol and diabetes can be corrected. Actually, the opposite is often the case. Attention to the whole health is often a lot of work but necessary to achieve your goals. Ignoring the whole health aspect is a sure method for frustration and failure, as many patients have experienced.

Examples of some of the available herbal and nutrient medicines and formulas useful in designing an individualized weight loss or anti-obesity treatment protocol

Traditional Chinese Medicine has never recommended that a patient ignore the many health problems associated with obesity, metabolic syndrome and even a simple overweight condition, and just take a single herb to force weight loss. This approach would be considered malpractice in Traditional Chinese Medicine. Taking a more holistic approach to weight loss and related medical problems results in a healthier and more productive life. While it is tempting to try to just take some medication to quickly lose weight, these strategies have proven to have poor long-term benefit and many chronic side effects. Standard allopathic medicine has long promoted such unhealthy weight loss regimes as amphetamine addiction, Phen-fen, etc. while ignoring the correct holistic approaches to obesity. The results are an alarming rate of obesity. Complementary Medicine offers a sensible long-term solution, but a persistence and proactive approach is necessary.

Astra Diet Tea: suye (perilla leaf), ganjiang (aged garlic), pipaye (loquat leaf), danzhuye (bamboo leaf), ciwujia (Siberian ginseng), bohe (field mint) / TP or treatment protocol = settle the stomach, warm and dispel accumulations, promote digestion; take before meals to control appetite and improve digestion; take when craving simple carbohydrates to control these cravings; improve digestion to eliminate bloating and indigestion.
Astra 18 Diet: shanzha (hawthorn), yiyiren (pearl barley), kunbu (kombu seaweed), haizao (seaweed), houpo, gangiang, banxia, chenpi (tangerine peel) with/huangqi (astragalus), baizhu, danggui, baishao, and huangqin, zhizi, xiangfuzi, zexie, and jiegeng; Treatment principle = promote functions of the stomach, small intestine, pancreas, and liver, as well as the thyroid; dispel accumulation and stagnation. This broad Chinese formula addresses many health benefits useful in correcting obesity and metabolic syndrome.
Dr. Kang's Diet formula: jiao gu lan (gymnostemna pentophyllum or sylvestre), da huang (wild rhubarb root), lu hui (dried aloe), and sha ji (sea buckthorn berries) = stimulates increased bowel motility and digestive functions to aid in weight loss when constipation or bloating is a problem; sea-buckthorn berries are the source of an amazing medicinal oil that has been widely studied in the treatment of numerous medical conditions, and exerts a significant antihyperglycemic effect, as well as lowering excesses of cholesterol and low density lipoproteins (see study link below). Jioa gu lan, or Gymnostemna, is also studied in relation to restoration pancreatic function. This formula is especially effective for a combination of metabolic syndrome, obesity and constipation.
Chzyme: 100 mg of amylase, lipase, alpha-galactosidase, glucoamylase, cellulase, malt diastase, cere calase, protease, with the herbs shenqu, houpo, yiyiren, guya (barly sprouts), huoxiang, fuling, cangzhu, gegen (kudzu), tianhuafen, chishizhi, juhong, bohe (field mint), muxiang, and baizhi; Treatment Principle = promote food assimilation, decrease abdominal bloat and indigestion, eliminate damp, promote motility, relieve stagnation, and aid pancreatic enzyme function; take with meals or between meals, whichever is more effective for the individual. This formula may help those patients with poor digestion of dairy and glutens as well.
Gentle Senna: fanxieye, yuliren, pobuye, binglang, gehua, jinyinhua; Treatment principle = clear heat and stagnation, promote bowel movements; useful as needed when bloat and constipation affect digestion and weight loss.
Griffonex 5HTP: griffonia seed extract has been shown to reduce carbohydrate cravings, regulate serotonin, and stimulate improved gastrointestinal function; take before meals or when craving sweets; (5HTP also helps with depression and insomnia, which may have an associative effect with obesity).
Adrenosen: adrenal cortex with PAK, and the herbs taizishen, shanyao (wild mountain yam), biandou, wuweizi, guya (barley sprouts); Treatment principle = aids conversion of sugars to usable energy, improve adrenal hormone function, and help the cholesterol mechanisms; use in conjunction with heavy exercise to aid use of stored fats; use when there is an adrenal insufficiency syndrome suspect, or a subclinical hypothyroidism contributing to obesity.
Myrtle Seng: xiyangshen (American ginseng) + Queens Crepe Myrtle: nutritionally reduces blood glucose levels postprandially (after meals) and aids glucose transport; helps treat Diabetes, metabolic syndrome, and promote insulin sensitivity.
Polilipid: policosanol 10mg, gugulipid 750mg, to aid the HDL/LDL ratio and treat obesity (gugulipid) by clearing fat obstruction, lowering LDL, and aiding liver function to metabolize cholesterol and help normalize triglyceride levels; Polilipid also may stimulate thyroid function and prevent atherosclerosis and platelet aggregation, exerting an anti-inflammatory effect; both this myrrh resin (gugulipid) and policosanol, a long chain fatty acid complex from rice bran, aids arterial flow as well. This formula may help in obesity and weight loss, and provide a host of benefits for patients with related disorders.
Nuvexa FBCx Alpha-cyclodextrin: a patented fat-binding complexer derived from dextrin sugars in corn, this molecule is proven to bind to triglycerides to decrease fat storage, to decrease circulating triglyceride levels and LDL, to increase sensitivity to insulin and leptin, and stabilize free fatty acids. There is also some evidence that it may decrease preferentially saturated fats and trans-fats in blood circulation, and improve the bowel function, relieving either loose stools or constipation
Advanced Chole Clear from Dr. Kang's: this herbal formula also aids in lowering triglycerides and normalizing liver fatty metabolism, when these associated health problems are evident.
Leantain GT (with Chitoglucan, as well as a green tea extract, and acacia): helps promote weight loss by both facilitating breakdown of body fat and inhibiting lipid absorption; as well as providing a proven weight loss aid in green tea extract; and the leptin reducing effects of acacia. Such combinations of herbs provide a number of beneficial aids in one formula. The patented Chitoglucan is a combination of chitosan, beta glucan, and free fatty acids, derived from the Enoki mushroom. More than 10 clinical trials support the gentle but effective actions of Chitoglucan to facilitate weight loss.
Greenexcellent: green coffee bean extract is a relatively new find in weight loss aids, stimulating the digestive metabolism without a caffeine stimulation; this extract utilizes the healthy chemicals found in coffee beans and removes the unwanted chemicals; by stimulating an increased metabolic rate, weight loss is suddenly much easier to achieve with a little exercise and improved diet.
VFM-100 / Glabrinex, an extract from the Chinese herb Glycyrrhiza glabra, standardized with glabridin, polyphenols and flavonoid oils: medicinal licorice root has long been utilized for metabolic stimulation, but a high dosage presents problems. This new standardized extract is patented and has passed clinical trials to show that it improves fat metabolism and reduces abdominal fat, while helping to normalize blood sugars. A stimulation of fat burning enzyme activity, and increased utilization of fats, are both demonstrated in double-blinded placebo-controlled human trials.
Coriolus +: turkeytail mushrooms contain oxygenating germanium to improve the health of the cellular functions and make the metabolism more efficient
Supplements and Supplement formulas: There are now a wide variety of proven nutritional supplements and supplement formulas. A knowledgeable Licensed Acupuncturist and herbalist, or a Naturopathic physician, may help you sort through the maze of these many options, and help provide a professional quality product. Poor quality products are the source of much disappointment with nutritional medicine, and just because you may have bought a poor quality product and found it unworthy does not mean that these nutrient medicines do not work:
1. Psyllium husk: psyllium, or plantago, has been widely used in Traditional Chinese Medicine for centuries. Psyllium seed, or plantaginis, is called Che qian zi, and has long been studied in China to improve digestive problems. The seed contains a significant percentage of linoleic and linolenic acids, as well as other essential fatty acids, such as oleic, stearic, palmitic, succinic, arachidic, and plantenolic acid. Psyllium husk is from the seed pod, and has long been used in standard hospital treatment, under the name metamucil, referring to the amazingly effective mucilage found in psyllium. The outer layer of the plantago seed is ground to obtain plantago-mucilage, or metamucil, and the yield is 25% by weight of the total seed. China has been one of the major exporters of psyllium husk, and the United States has long been the world's largest importer. We see that Traditional Chinese Herbalism has had a big impact on standard therapy for digestive disease as well as weight loss.
2. Essential fatty acids: for example, conjugated linoleic acid (CLA) was studied and shown to produce a drop of .8 pounds of fat mass a month with 3.2 grams daily in scientific studies; krill oil (EPAq) is the omega-3 essential fatty acid of choice, being the most concentrated and balanced of these dietary essential fatty acids; seeds (such as the plantago seed) and nuts contain a high amount of these dietarily essential fatty acids, as do healthy cold-pressed oils, and even the dietary algaes, such as chlorella, spirulina, and blue-green algae (see information link below);
3. Chromium picolinate and L-Glutamine: to reduce cravings, support healthy blood sugar levels, promote lean muscle tissue, and improve nutritional metabolism; chromium is an essential trace element in the diet that is involved in healthy insulin function, and has been removed from many commercially produced foods; chromium picolinate is shown to have greater bioavailability in the body, and is supported by more than 35 reserach trials. L-glutamine is shown to increase the effectiveness of chromium picolinate, and is the amino acid building block for glucose in the body.
4. L-Carnitine L-tartrate: this amino acid combination significantly improves metabolic conversion of sugars, fats and proteins, and helps the body manage carbohydrate storage and utilization better.
5. L-arginine and L-lysine: also essential amino acids that may benefit the metabolism
6. Alpha lipoic acid, or ALA: this essential fatty acid is a potent antioxidant that benefits liver lipid metabolism and is essential to regulation of both glucose and lipid metabolism.
7. Choline and inositol: to help burn fat intracellularly, and move fat deposition out of the liver; this nutrient combination is essential as co-enzymes required for the healthy metabolism of fats and cholesterol. Inositol is a member of the B complex vitamin group and is a liptropic agent.
8. Niacin in the form of flush-free Inositol hexacotinate vitamin B3: to increase HDL and treat depression caused by deficiency, as well as reduce high cholesterol and improve cardiovascular health; numerous studies show that this supplement is nearly as effective as pharmaceutical cholesterol lowering drugs, sans side effects, for many patients. Bitter melon extract is now also proven very effective, as well as Red Rice Yeast extract. Some combination may help the obese or overweight patient with Metabolic Syndrome or high cholesterol greatly, and perhaps help correct the underlying condition and eliminate the future need for taking drugs and supplements.
9. Leptin X: a patented formula developed and studied at the University of Connecticut, this formula was proven to provide weight loss, fat loss, and waist size reduction in obese patients suffering from leptin imbalance and metabolic syndrome. It contains a proprietary blend of high viscosity polysaccharides (complex sugars) extracted from acacia gum (the Chinese herb Er cha), and esterified fatty acids.

Other health factors associated with obesity

Short duration of sleep is associated with hormonal changes that may lead to obesity. Study by Professor Cappuccio of the University or Warwick has shown that lack of sleep produces ghrelin, which stimulates appetite and creates less leptin, increasing appetite and slowing metabolism. Once again, this shows that only a holistic approach to weight loss will produce the optimum effects, since there is a complex interaction of body chemistry and systems in the regulation of stored fat. You may need to work with the naturopathic or TCM physician to correct problems with sleep duration and quality if the weight loss program is to be successful.

Addendum: the problems with misuse of research, and the use of study design to promote sales of weight loss medicines and discourage proven natural weight loss products

Research, especially in the realm of weight loss, has unfortunately become a tool to manipulate the market, as well as a means of discovering new useful tools in the treatment of obesity. The public must be able to judge the quality of the research and the bias involved to understand which research is to be trusted. Companies with much money at stake will spend fortunes to produce research results that destroy the competition and bolster their product.

These pharmaceutical and supplement companies will try to convince the medical establishment that the more money spent on the research equals greater confidence in the results. In fact, the opposite is more often the truth. Products that produce small profits cannot produce large money research and pay for extensive advertising, but these products are often the safest and most effective products in the weight management therapeutic protocol. Supplements and herbs cannot be patented and thus produce small profits. Patented chemicals can produce billions of dollars in profit and so pharmaceutical companies will do anything to manipulate research and increase sales of pharmaceutical weight loss medicines. The history of weight loss pharmaceuticals is dismal, though. Cases of harmful manipulation of research, such as the Merck Vioxx, GlaxoKlineSmith Avandia, and the companies producing hormone replacement therapies, are now common. A 2005 confidential survey of NIH researchers found that over 40% admitted to taking money from pharmaceutical companies to alter research findings. There is no doubt that research is often compromised by paid bias in the pharmaceutical arena. The judgment of such research by the public is a difficult proposition. Sometimes the public must find professional medical practitioners that they can trust to evaluate the studies and properly assess risk and benefit. The skeptical patient researches pharmaceutical weight loss medicines and aks their M.D. to explain the risks and side effects thoroughly.

Some misconceptions promoted with faulty research:

Conjugated linoleic acid: with the publishing of the success of this supplement in recent years, companies set out to find risks, and produced results showing that chronic use of CLA could raise levels of C-reactive protein, lipoproteins, and leptin, claiming that these were associated with risk of heart disease. When we examine this claim we find flaws in this analysis. C-reactive protein is a chemical that the liver and other tissues produce to respond to cardiovascular inflammation. The increase in CRP may be due to vessel inflammation, or it may be due to other metabolic factors. Studies show that CRP increase is a nonspecific factor on its own and increases are seen with estrogen supplementation and dialysis, as well as other medical procedures that show no link to vessel inflammation. Lipoproteins (commonly, but mistakenly, called cholesterol, since some lipoproteins carry cholesterol hormones) may be 'good' or 'bad'. Increase in HDL (high density lipoproteins) is found to be the best indicator of reduced risk of cardiovascular disease. Leptin is a protein hormone that plays a key role in regulation of appetite and metabolism, affecting weight loss and energy. While leptin levels in the obese have been found to be high and obesity is linked to cardiovascular disease, this link to cardiovascular disease with the use of CLA supplementation is a misrepresentation of the facts. Obviously, any effective natural supplement that would stimulate weight reducing mechanisms would probably increase leptin levels because this is the way that the body naturally achieves weight loss. In fact, leptin levels dramatically increase in pregnancy because leptin is produced by the placenta, yet there is no dramatic increase in cardiovascular risk with pregnancy. CLA should be taken as part of a protocol that also looks at overall hormone balance. These study findings that try to discourage the taking of natural supplements when they are found effective are now very common, and curiously, get much press coverage as soon as the first study is completed. Obviously, some fiscal encouragement is being used to create these sensationalizing news stories.

Information Resources: Additional Information and Links to Scientific Studies

Vanderbilt University offers this explanation of current pharmaceutical weight loss drugs: http://www.vanderbilt.edu/AnS/psychology/health_psychology/Meridia.htm
A common opinion of current pharmaceutical weight loss strategies is that they are only mildly effective and come with considerable risk, prompting a call for a broader integrated approach to weight loss by standard medicine: http://www.medicinenet.com/script/main/art.asp?articlekey=56559
Dietary algaes, such as blue-green algae, spirulina and chlorella contain a high percentage of essential fatty acids which are useful in restoring health and losing weight: http://www.www.a-vital-life.com/page.php?p=essential_fatty_acids
Sea buckthorn berries, or Hippophae rhamnoides (Sha ji in Chinese herbology) has been well studied and proven to lower excess blood sugars, low density lipoproteins, and lower body weight in obesity: http://www.onlinelibrary.wiley.com/doi/10.1111/j.1745-4514.2010.00337.x/abstract
New weight loss pharmaceuticals are still having a hard time passing regulatory scrutiny over safety. In 2010, the FDA rejects the latest designer weight loss drugs, Lorcaserin and Qnexa, in advisory panel reviews (see; NY Times Health, Sept. 16, 2010): http://prescriptions.blogs.nytimes.com/2010/09/16/f-d-a-panel-rejects-diet-pill-2/?partner=rss&emc=rss
An FDA panel was split on whether to recommend that the weight loss drug Meridia be removed from the U.S. market due to concerns of risk versus the small relative benefit of the drug (see: Wall Stree Journal online article by Jennifer Corbett): http://online.wsj.com/article/BT-CO-20100915-713570.html
A Drugs.com article gives the clinical study side effect reports on topirimate, part of the new combo drug prescribed for weight loss, Qnexa: http://www.drugs.com/sfx/topiramate-side-effects.html
A Sept. 16, 2010 article in the New York Times Health reports that FDA advisory panels again recommended against approving new drugs targeted weight loss and obesity - medical experts on the panel report that these drugs showed little long-term benefit versus risk; the newest drug, Lorcaserin, suppresses appetite by mimimicing serotonin: http://www.nytimes.com/2010/09/17/health/17drug.html
An October 8, 2010 article in the NY Times reports the history of diet drugs such as Meridia, which was voluntarily withdrawn from the market after another FDA advisory panel reported greater risk than benefit and threatened to withdraw FDA approval: http://www.nytimes.com/2010/10/09/health/09drug.html?hpw
The series of U.S. FDA warnings and request that the drug Fen-Phen, a combination of fenfluramine and phentermine, be removed from the market due to a high risk of cardiovascular injury and death in 1997. Click on the related information to access subsequent warnings: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm180082.htm http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm180082.htm
In 2013, two weight loss drugs banned in Europe due to alarming health risks and mild benefit, Qsymia (phentermine and topiramate), and Belviq (lorcaserin), were approved by the U.S. FDA after being rejected for these reasons in 2010: http://www.minnpost.com/second-opinion/2013/08/why-did-fda-approve-two-diet-drugs-banned-europe
A 2007 randomized controlled clinical human study at Chongqing Medical University in China found that low frequency acupuncture stimulation, as well as manual acupuncture stimulation, can effectively lower leptin levels and raise circulating adiponectin to treat obesity: http://www.nytimes.com/2010/10/09/health/09drug.html?hpw
A 2007 study of obesity at Dalian Medical University in China found that circulating leptin levels were correlated with total body fat in obesity, and that decreased expression of leptin hormonal receptors was found in the hypothalamus and liver, indicating that leptin resistance is a key aspect of obesity with insulin resistance: http://www.ncbi.nlm.nih.gov/pubmed/17611900
A 2007 randomized controlled clinical animal study at Hebei Medical University in China found that electroacupuncture significantly reduced leptin levels and the size and volume of fat cells, as well as normalizing blood lipids: http://www.ncbi.nlm.nih.gov/pubmed/17853760
A 2010 randomized controlled clinical animal study at Chongqing Medical University in China found that electroacupuncture could significantly lower serum triglyceride and total cholesterol, and the level of hypothalamic leptin expression down-regulated remarkably with 4 weeks treatment: http://www.ncbi.nlm.nih.gov/pubmed/21090330
A 2011 randomized controlled human clinical trial at the University of California at Davis found that the patented molecule alpha-cyclodextrin FBCx was effective in both obese individuals with Metabolic Syndrome (prior studies) and in this study with non-obese overweight individuals, providing improvements in fat metabolism, lowered triglycerides, increased insulin sensitivity that resulted in lowered circulating insulin, lowered apolipoprotein-B, and mild weight loss: http://www.ncbi.nlm.nih.gov/pubmed/21127475
A 2007 randomized controlled human clinical trial of FBCx alpha-cyclodextrin to treat obese type 2 diabetic patients, at the Grunberger Diabetes Institute, in Michigan, found that this patented molecule improved adiponectin levels, lowered triglycerides and total lipid cholesterols, and controlled weight gain while allowing greater caloric intake over control subjects with type 2 diabetes: http://www.ncbi.nlm.nih.gov/pubmed/17013969
A 2013 randomized controlled human clinical trial at the Wayne State University College of Nursing found that the patented molecule FBCx alpha-cyclodextrin significantly lowered blood triglyceride levels after a meal without significantly altering glucose and cholesterol levels postprandially, indicating that the effects with a fatty meal occurred due to triglyceride and free fatty acid binding, and possibly increased sensitivity to leptin and insulin: http://www.ncbi.nlm.nih.gov/pubmed/23806736
A 2009 study at the University of Strathclyde, in Glasgow, Ireland, confirmed that the herb Galega Officianalis (goat's rue) showed significant aid to weight loss in laboratory in vivo studies. This herbal extract (galegine) has also shown benefits in treating Metabolic Syndrome and diabetes: http://www.ncbi.nlm.nih.gov/pubmed/18297106
A 2012 study at the Seoul National University, Institute of Molecular Biology and Genetics, found that a standardized extract of Glabridin, a constituent of the Chinese herb Gan cao (Glycyrrizha, or Licorice root), exerted significant effects on weight loss and obesity, by promoting fatty acid oxidation, and also aided normalization of fatty liver and high triglycerides: http://www.ncbi.nlm.nih.gov/pubmed/22493094
A 2015 study of the Chinese herb Shu di huang (Rehmannia glutinosa) at Dongguk University, in South Korea, found that modest weight loss from this one herbal extract was attributed to positive changes in the gut microbiota, with increases in Actinobacteria and Bifidobacterium species: http://www.ncbi.nlm.nih.gov/pubmed/26139477 http://www.ncbi.nlm.nih.gov/pubmed/26139477
A 2011 study at the Genesis Breast Cancer Prevention Centre, National Health Services Foundation Trust, Manchester, United Kingdom, confirmed that an intermittent partial fasting regimen, or intermittent energy restriction (IER), with partial fasting for 2 days a week (5:2 regimen), was as effective as continuous dieting, or energy restriction, improving insulin resistance and other biomarkers of metabolic health: http://www.ncbi.nlm.nih.gov/pubmed/20921964
A 2013 study at the Genesis Breast Cancer Prevention Centre, National Health Services Foundation Trust, Manchester, United Kingdom, confirmed that an intermittent partial fasting regimen, in a variety of settings, not only facilitated weight loss, but reduced insulin resistance, and that a diet that reduced total daily intake of carbohydrates to less than 40 calories per day for 2 days a week proved most effective, even when the amount of fat and protein was not restricted on the partial fasting days: http://www.ncbi.nlm.nih.gov/pubmed/23591120

Related Articles