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Overcoming Obesity, Naturally

Natural practitioners—and natural approaches—play a leading role in helping patients decrease their weight.

Obesity, as defined by the Centers for Disease Control and Prevention (CDC), exists when an adult has a body mass index (a calculation based on height and weight) of 30 or higher. Alarmingly, this adverse medical condition exists among approximately 34 percent of Americans over the age of 20, or more than 72 million people in the U.S. alone. And the ramifications of this epidemic are deadly serious: obesity can lead to a variety of life-threatening diseases and related health problems including heart disease, stroke, type 2 diabetes and certain types of cancer, CDC points out.

While the obesity epidemic is widespread, the primary cause of obesity is quite simple, noted Daniel Lifton, COO of Quality of Life Labs, a New York-based dietary supplement maker: it’s the imbalance between calories consumed and calories burned. Portion sizing, carb-binging, sedentary lifestyle, lack of exercise, stress and stress-related eating, and insufficient sleep all contribute to the obesity crisis in the U.S., he said.

“Obesity is like a puzzle with a variety of contributors, just like pieces to a puzzle,” added Christopher Mohr, a registered dietician and president of Mohr Results, Inc., a Kentucky-based company that helps individuals achieve optimal health. “Portions have increased over the years, physical activity has decreased, people spend too much time in front of a screen (TV, phones, computers, etc.), eat out too often, drink too many liquid calories and much more.” 

Thus, over the last 10 years or so, weight management has become a key issue for natural practitioners, said Caryn Wichmann, ND, clinical manager at the Perpetual Wellbeing Clinic in Brisbane, Queensland, Australia. “With 68 percent of Americans overweight or obese, natural health practitioners can play a leading role. The biggest issue facing the natural practitioner market is whether they can lift their profile to be seen widely as providing the most effective solutions to the obesity epidemic.”

Natural Treatment 

The goal of obesity treatment, sources note, is first to reach a healthy weight, and second to stay there. This can be approached in a variety of different ways; one of the reportedly most effective natural approaches involves reducing the absorption of fat and carbohydrates and helping control the spike in blood sugar that occurs after a meal. While everyday changes, such as more physical activity and a decrease in portions, are steps in the right direction, other strategies are also gaining favor according to Joseph Lamb,MD, director of intramural clinical research at Metagenics, a nutritional supplement manufacturer headquartered in California.

Today, many medical practitioners are turning to integrative medicine practices rather than surgery to help reduce the prevalence of obesity, offered Dr. Lamb. “Metagenics is spearheading the concept of medical foods as ‘super nutrition’ specifically formulated to manage conditions associated with certain disease states including obesity,” he said. As an expert in nutrition and lifestyle medicine,Metagenics’ Chief Science Officer Dr. Jeffrey Bland recently hosted a workshop on medical foods at Harvard Medical School, describing it as “therapeutic nutrition.” 

Metagenics’ FirstLine Therapy program, for instance, is described as a proven natural remedy for reducing metabolic syndrome and decreasing overall body fat, said Dr. Lamb. “Currently, more than 4,000 health care providers are dedicated to enhancing patient health through the program, which is formulated to be consumed under the supervision of a physician and is based on recognized scientific principles.” The program includes phytonutrient- dense products like the company’s PhytoMulti daily supplement,Wellness Essentials products as well as UltraMeal Plus 360.

In addition to therapeutic nutrition, supplementation is also very common in the fight against obesity. According to a recent survey of health care professionals conducted at the Obesity and Associated Conditions Symposium in Las Vegas, NV, more than 88 percent believe that weight-loss supplementation has become one of the many components in a successful weight management program. Metagenics’ PhytoMulti daily supplement, also known as the “Smart Multi,” targets health at the cellular level, nourishing, defending and supporting the cell. And Metagenics’ medical food UltraMeal Plus 360 is the first medical food developed, tested and demonstrated to be effective and safe for the management of conditions associated with metabolic syndrome, including the reduction of risk factors for cardiovascular disease, said Dr. Lamb.

Enzymedica, the Florida-based provider of the Enzyme Science practitioner line, will soon introduce Slender GR, a product that contains an ingredient called Glucoreductase, along with the enzymes lipase and superoxide dismutase (SOD), according to Tom Bohager, the company’s founder. “The proprietary enzyme blend Glucoreductase converts starches to form soluble fiber. This conversion of carbohydrates decreases the glycemic index of the foods consumed, helps maintain normal blood sugar levels and promotes healthy digestion,” he explained.

Also available for the natural practitioner’s weight loss arsenal is Calorie Control Weight Management Formula by Florida-based Life Extension. The weight-loss aid combines green coffee extract with many of the best ingredients for weight management into one comprehensive formula, according to the company. “It capitalizes on the proven benefits of slowing absorption of carbohydrate calories after each meal and targeting digestive enzymes to support healthy after-meal glucose metabolism,” said Dr. Kira Schmid, associate director of scientific affairs for the company.

The formula includes LuraLean propolmannan, which is reported to slow the rapid emptying of ingested food into the small intestine, reducing the surge of glucose entering the bloodstream. According to Dr. Schmid, it has been shown to significantly lower after-meal glucose surges; its white kidney bean extract (Phaseolus vulgaris) inhibits amylase, the digestive enzyme that breaks down carbohydrates to be absorbed into the bloodstream as glucose. Phaseolus vulgaris has produced weight loss of 6.5 pounds on average in 30 days and abdominal fat reductions, Dr. Schmid said.

“While supplements that focus on reducing appetite can be very helpful since they help people eat less, another approach is to focus on reducing stress levels and correcting imbalances of cortisol and serotonin to reduce binge-eating, carb cravings and help individuals avoid the cycle of yo-yo dieting,” said Quality of Life Labs’ Lifton.

Another promising class of supplements target adipokine tissue and fatcell metabolism to reduce the dangerous visceral fat that sits around our waistlines, continued Lifton. Enter Quality of Life’s Metasol product in its health care practitioner line, which contains Oligonol, a lychee-based polyphenol that has been clinically shown to reduce visceral fat by 12 percent after eight weeks, shrink waist circumference by three centimeters, cause a significant reduction in body weight and an increased sensitivity to insulin.

Beyond supplements, Perpetual Wellbeing Clinic’s Dr.Wichmann believes in behavioral change for weight loss as well. Research published in the Journal of Clinical Investigation in June 2011 showed that the most used natural approach of diet and exercise has failed to be effective in both preventing obesity and maintaining weight loss. This research also found that the pharmacological approaches had poor efficacy and serious side effects. “We believe the key to success of our approach is to work on behavioral change at the same time as correcting diet, increasing exercise and correcting gastrointestinal absorption of key nutrients,” she said.

Science Matters 

Undoubtedly, there has been tremendous differences of opinion and controversy through the years surrounding different approaches to weight management, and most especially with regard to weight-loss supplements. Regulatory agencies have focused heavily on weight-loss products recently, and companies that choose to make weight-loss claims without the scientific evidence to back them up are taking a substantial risk.

Ineffective or unsafe products are the most serious challenge in the weight management market, sources agree. It is therefore imperative for natural practitioners to recommend or prescribe products manufactured with strict quality control standards and to select effective formulas based on hard science.

According to Mohr of Mohr Results, most science on weight-loss supplements “hasn’t really panned out.” He said there is some interesting data, but not from a supplement most would think of as a “weight-loss” product. “A high-quality fish oil has been shown to help decrease body fat above and beyond diet and exercise alone,”Mohr said. “Of course, fish oil is also beneficial for virtually all the co-morbidities of obesity, so it’s truly a no-brainer for people to use a high quality, pure omega-3 product regularly.” 

While the data on fish oil is still in the infancy stages, it’s promising, said Mohr. “Some preliminary data suggests that fish oil may lower resting heart rate. That means that if someone is exercising and attempting to work up to or maintain a certain heart rate, they’d possibly have to work harder to get the same end result,” he commented.

A lot of the science with weight management is looking at the quality of the diet people are eating, continued Mohr. “Data suggests lower carbohydrate diets, but certainly high-quality carbohydrate diets may be more effective. Similarly, higher-fat diets—again, focusing the quality of the diet—is the key. And ‘quality’ in terms of fat means essential fats, such as omega-3s found in fish oil.” 

Studies have supported the efficacy of Enzymedica’s Slender GR, the company’s Bohager said. In the first in-house pilot study of the product, there were 21 participants who were instructed over a 30-day period to not change anything about their diet or lifestyle. They consumed two capsules of Slender GR with each meal, and 40 percent of the participants described unanticipated benefits including improved digestion and energy levels, while 50 percent lost an average of four pounds in 30 days. A second pilot study was later conducted with the same instructions, and this time 70 percent of participants lost an average of eight pounds, while 30 percent lost 10 pounds or more, said Bohager.

In May 2011, the results of Metagenics’ HMS-4 study carried out in three universities were published in the Journal of Clinical Lipidology demonstrating that 44 percent of people who combined a low glycemic Mediterranean-style diet with UltraMeal Plus 360 were successful in reversing metabolic syndrome, versus 33 percent of those implementing diet alone, said Dr. Lamb.

From Practitioner to Patient 

Patients rely on natural practitioners to educate them and prescribe the highestquality products to improve and maintain their health. For an overweight individual, it isn’t enough to simply say, “just eat less.” Natural practitioners need to give their patients specific tools and support to help them maintain a healthy weight.

“The patients are best served by programs that meet their specific needs,” said Life Extension’s Dr. Schmid, who offered their nine pillars of successful weight loss, an article that outlines steps that most overweight aging people should follow if they are to achieve optimal removal of surplus body fat. She said these pillars “allow a natural practitioner to customize their suggestions for the most effective weight management program.” 

According to Mohr, natural practitioners still have areas where they can improve in terms of helping patients. “Many practitioners are quick to write prescriptions, yet not investigate the actual underlying issues,” he said. “To their credit, many professionals aren’t skilled at discussing diet, exercise or the behavioral issues that are causing folks to gain or struggling with losing body weight.” 

Of course, patients are getting more sophisticated and educated, making them less likely to fall for advertising gimmicks and overblown marketing of unscrupulous marketers. There is also growing awareness of safety issues as news of FDA crackdowns on companies spiking their supplements with drugs or using unsafe natural ingredients hits the media. Therefore, consumers are more likely to turn to their doctors for advice on which supplements to take for safe and effective weight loss, said Lifton.

“This is when practitioners can help patients separate real science from marketing fluff. Explain that there is no ‘magic pill’ and that supplements, as their name suggests, are most effective at supplementing a regiment that entails dieting and exercise,” continued Lifton. “Practitioners can also encourage their patients to stay on the diet, use diaries, participate in peer groups, exercise, set goals and ultimately meet them.”

Obesity is a disease that affects 34 percent of adults aged 20 years and up in the United States—more than 72 million people.

Many medical practitioners are turning to integrative medicine practices for treating obesity.

Weight-loss supplementation has become one of the many components in a successful weight management program.

Promising data shows fish oils are an effective treatment for obesity.

Give patients specific tools and support to help them maintain a healthy weight.

FOR MORE INFORMATION:

American Society of Bariatric Physicians, www.asbp.org 

Centers for Disease Control and Prevention, www.cdc.gov 

Enzymedica, (888) 918-1118, www.enzymedica.com

Life Extension, (800) 544-4440, www.lef.org

Metagenics, (800) 692-9400, www.metagenics.com 

Quality of Life Labs, (914) 251-0981, www.q-o-l.com