Episode 51 Shownotes - The Math and Science of Weight Loss
Well, hey, my friends. I did a recent webinar on Weight Gain after Cancer treatment, and people loved it, so I thought I might do a little recap as a podcast in case you missed it. I am kicking off my next Cancer Weight Loss group in June, and if you are interested in learning more about it, you can get more information in the link in the shownotes or request a minisession on my website, www.bestlifeaftercancer.com to schedule a time to meet with me and discuss if it might be helpful.
Weight gain is really common after cancer treatment. There are so many reasons – changes in metabolism, hormonal changes, maybe being less active, or eating to feel better (either physically or emotionally). Why is weight so important? There is no fat shaming going on here. All human bodies are beautiful – we are all created perfectly imperfect. This is important because obesity increases risk in many cancers. First, this is because our fat directly increases hormonal levels (our fat cells actually create estrogen!) – this is important in hormonally sensitive cancers like breast, uterine and possibly some ovarian cancers. Also, obesity is proven to directly increase risk in colorectal, kidney, esophageal and pancreatic cancers with evolving data in thyroid, gallbladder, liver, ovary, aggressive prostate cancer and NHL! Body fat has been shown to be a source of inflammation, which can alter many of our body’s normal processes. There is also evidence that fat is metabolically active and may alter cellular processes. Though not yet confirmed, research is being done to understand this. The elevated levels of body fat in the body may directly increase the mutation rate of cancer cells, or may create changes in cellular signaling pathways, which means that cells may not get messages to stop growing or get incorrect messages to grow more. It may create changes through inhibition of programmed cell death, when cells self-destruct when something is wrong with them, or by increasing angiogenesis, which is the stimulation of growth of new blood vessels. Ok - come back to me if you drifted away during all that technical mumbo jumbo, the bottom line is we need to care about obesity because it can increase cancer risk.
I want to take a minute here to tell you a few things. If you are gaining weight after treatment, you are not alone. So many patients struggle with this. You are not broken or weak just because you haven’t figured out how to lose weight to date. You just haven’t had the right knowledge so far. Most people are capable of losing weight just by following the suggestions in my podcasts and in the Facebook group for FREE. If you want this to be quicker and easier, I do offer a weight loss group coaching program.
Ok – we know and accept that weight can increase risk. For so long, we have been taught it is all calories in and calories out – that it is just math. Each calorie has a certain value and that is all there is to it. We were told that 1000 calories of salad would cause the same weight loss or gain as 1000 calories of candy bars. This is strikingly inaccurate. All calories are not created the same. This is because DIFFERENT FOODS AFFECT OUR BODIES DIFFERENTLY! This all boils down in its most simplified way to how WHAT and WHEN we eat triggers insulin. Insulin is triggered by glucose levels in our bloodstream predominately. It is most strongly triggered by sugar in all its forms – this includes all types of sugar, but also includes honey, maple syrup, and other types of sweetners with calories. In order of strong to weak stimulation following sugars is simple carbs, then complex carbs, protein and fat. Our digestive system first breaks down foods into parts small enough for the body to absorb and use. Both simple and complex carbohydrates break down into simple sugars. Proteins break down into amino acids. Fats break down into fatty acids and glycerol. As these smaller parts are absorbed into our bloodstream, our blood glucose level goes up and this triggers the release of insulin from our pancreas. Insulin is secreted by in varying levels in response to the amount of sugar detected in the bloodstream. The first thing insulin does is provide glucose to all of our muscles. When our muscles have all they need, it drives the storage of excess sugar that we don’t need in the moment. First, the nutrients are stored short term in the liver for quick use. When the liver is full, insulin drives the excess glucose into our fat cells. HERE IS WHERE YOU NEED TO REALLY PAY ATTENTION. As long as our insulin is high, our fat cells are in storage mode. They CAN NOT release the fat in them into the bloodstream to use for energy. Many Americans’ insulin levels are elevated for all but a few hours a day when they are sleeping. Let’s think about this: you get up, and have a bagel. This is rapidly broken down into sugar, raising your insulin levels. 2-3 hours later, all of that sugar is stored, and your insulin level just starts to drop. But about that time, you start to feel hungry and have a mid-morning snack. Insulin peaks again. Then it is lunch time. More sugar and more insulin. Then midafternoon, you start to feel tired. Maybe now it is a sugary starbucks drink to boost your energy. Then a glass of wine and a few bites here and there while making dinner, then dinner, and 2 hours after dinner, a bowl of ice cream. About 3-4 hours after the ice cream, your insulin levels finally start to drop. This means your body is only in fat burning mode maybe 4 hours in the middle of the night. You can see how this would make it very hard to lose weight. The worst part is that people’s bodies get used to this constant influx of glucose, and then lose the drive to burn fat even when there isn’t much sugar around. It is like the difference between picking up a Big Mac and cooking a burger and making fresh fries from scratch. Our bodies like easy, just like our brains do. So, our body hits the “Easy” button, and makes us lightheaded and “hangry” to get us to give it a neverending supply of sugar. The more we do this, the worse we feel when our blood sugars drop. This creates more sugar cravings, which dysregulate our insulin more, which prevent accessing our fat even more, which drive more sugar cravings, and around and around we go, right down the drain.
Here is where my first suggestion comes in. From my standpoint, this is the absolute easiest way to lose weight. We can lower our insulin levels by shortening the number of hours we are eating each day. This is fully outlined in the books “The Obesity Code” and “The Diabetic Code” by Dr. Jason Fung. If you are diabetic, you should first, speak with your doctor, and second, read the book, before you make changes to your routine, as fasting can be quite dangerous for people on injected insulin. When we shorten our eating window, we DO NOT have to reduce the number of calories. We can eat the same number of calories, just over a shorter time. Instead of eating from 6 am to 9 pm, you can eat from 10:30 am to 6:30 pm. This means no snacks, juice, soda, alcohol, sugar in coffee and so on outside of this eating window. By doing this, it takes you from 15 hours with high insulin to 8 hours with high insulin, adding 7 hours that your body can normalize its insulin levels and let our fat cells come out of fat storage mode and into fat burning mode.
You might think “If I am eating the same number of calories, how can that possibly help?” Great question. This is because of our body’s weight set point. What is that, you ask? It is the place our body thinks it should be in terms of weight. This is why when we lose 5 pounds with the flu, pretty quickly we gain it back, and why when we go on vacation and gain 10 pounds, when we come back and get back to our regular eating, it drops back down without too much fuss. The simple explanation is that our weight set point is tied to our insulin levels. As our insulin levels drop, all of a sudden, our body is able to “see” the fat stores, and realizes we have more nutrition stored than we need, and it resets to a lower weight. The way this happens for many people is that they will change their eating window, and weight stays the same for a few weeks, then in a whoosh, we suddenly lose a few pounds. That is our new set point. The great thing about this is that our body is not always fighting us trying to get back to the original weight – this is the new place your body thinks it should be. Awesome!
Once you have accomplished this, you likely will be pretty thrilled seeing the weight start to come off, and may be ready to take the next step. The next step is to continue to lower your insulin. There are lots of ways to do this, and I will tell you my favorite 3. First is to stop snacking between meals during your eating window, so even during that 8 hours, there are times when your insulin drops. Don’t eat in the morning until you feel hungry, sometimes extending the time you start eating closer to noon. Another option is to cut out or significantly limit your processed carbs and sugar from processed sources. Let me be very clear - I am not suggesting a keto diet here. I’m saying cut out the manmade carbs and sugar. These are rapidly broken down and cause huge surges in our insulin levels. Cut out or limit the bread, pasta, cereal, cupcakes, pies, candy, soda during the majority of your life. I personally do 16:8 eating window and limit my manmade carbs to 2 servings on the weekend, planned in advance. I still eat starchy veggies like squash, peas and corn, brown rice, and occasionally white rice or white potatoes (though I more commonly eat sweet potatoes). The third way to continue to move the scale down is to stay where you are in terms of what you are eating and when, and add daily light exercise like walking. I think the very best is to do this in the morning before you have started eating so your body is forced to get the calories from exercise from your fat stores.
One thing I want to point out here – as you remove carbs, you need to replace the calories with something to avoid feeling like you are starving all the time. Remember – the goal is not to eat less calories, it is to reduce your insulin levels. As you decrease carbs, you need more fat in your diet. I know – this is the exact opposite of what the AHA told us for years. If this seems counter-intuitive, watch the movie “That Sugar Film” available on amazon prime for free. It is brilliant and truly life changing. Add fatty salad dressing, avocado, cheese. All the things that taste delicious and make us feel satisfied. Please note – I am not recommending a free for all – don’t eat more fat, and then decide to eat every 2 hours TOO and expect that you will lose weight!
Ok – we are eating less often, and most people, as their insulin levels drop, feel much less hungry and definitely less hangry. But sometimes people still are feeling pretty hungry between meals. First, we need to look for hidden sugars or carbs in what we are eating. Check labels for sugars – these hide in flavored yogurt, anything that says flour (including almond and rice flour – anything that you grind to a powder will be absorbed extremely quickly and raise insulin levels), and in ketchup and other sauces. If you are feeling hungry with these, they have to go. If you don’t find any hidden sugar, you can try eating more fiber. Green leafy vegetables clearly are one way to get more fiber. Fiber is digested slowly, so sticks around longer, leaving you feeling full longer. Adding protein or fat to your meals does the same thing. There are a lot of studies that show that people who eat eggs for breakfast instead of cereal, pastries or bagels lose weight faster with no other changes to their diet. You can also just have coffee with heavy cream for breakfast – this raises the insulin very little and is a really satisfying start to the day for many people.
Finally, you need to address the brain drama that comes when you are not eating to feel better. Many people have no idea that they are eating to suppress negative emotions, but they can’t understand why they can’t stick to their plan. Often this is because feelings start to come up and they are so uncomfortable, we just eat to push them down without even a whole lot of thought. Sometimes, we think we are hungry, but our stomach isn’t growling, and the feeling isn’t in our belly – many people feel emotional hunger in their chest or throat. EMOTIONAL hunger you will learn is like feeding a gremlin after midnight. You feed it, and it will continue to rear its head and demand snacks, alcohol, chips and more. I often tell my kids – if the hunger is for a candy bar and a plate of eggs, or a salad, or a chicken breast won’t satisfy it – it isn’t physiological hunger. This reminds me of a time we were hiking – it was my oldest son’s first hike – he was probably 2 ½ at the time. He was really slow, and my husband went on ahead with other family, and the pack with fool. Trey started to get hungry, and I had nothing to give him. He was a trouper, but he went from “I want fruit snacks” to “I want a sandwich” to “I’ll eat leaves” and ripping them off trees as we walked by and shoving them in his mouth. This degenerated into “I’ll eat rocks, when a stranger on the trail offered him a smashed and half eaten whoopee pie, and I let him eat it and was hugely grateful. So, if it is hunger for Cheetos, wine, a candy bar, or what is on the counter at work that looks good, ask yourself if a dry chicken breast would fit the bill. If the answer is no, likely it is emotional hunger to avoid an uncomfortable emotion. You need to work on really getting in touch with what your true hunger feels like, and what your brain wanting to stuff something down feels like. When you don’t stuff things down, you will have to deal with the emotions that come up. I have a number of podcasts about dealing with emotions – this is CRITICAL here. If you aren’t able to deal with the emotions, you are using willpower to resist the food, and eventually our will power ALWAYS runs out.
Speaking of brain drama – here is as good of a place as any to mention this. Another technique we use in our home to convince our brains it is all good is the small plate technique. We eat all of our meals off the salad plates. This is built in portion control, and your brain is happier with a full plate than an empty one. It turns out our brains doesn’t really care if it is a big full plate or a small full plate – it just wants to look at the plate and have it be full. Veggies go on first, then protein, then any starches. I often have a big bowl of salad on the side, as well. Drinking water as you eat helps to fill up space and can help you feel full quicker. If you are a very fast eater, especially if you finish eating and feel good, and then 20 minutes later, feel really too full, setting down your fork between each bite will help you to eat more slowly and give your body time to send the “I’m full” signal.
Ok, my friends. That is it. The math of weight loss is that calories in – calories out does not equal our weight loss. There are other factors affecting this, most notably insulin levels.
The science of weight loss is that as our insulin levels normalize, our body will reset to a lower weight set point, and we will lose weight almost easily. But if the brain drama is what is holding you back, if you keep eating even though you planned not to, you may need help with that. Coaching is AMAZING for this, and my students will tell you that the program was not a diet, it was a full life overhaul! The next session starts in early June if you are interested.
