It’s that time of year—weight is atop most minds. Here’s how to help your clients gain wellness and esteem while losing fat pounds.
It is almost always the top resolution each year—“I will lose some weight and get into better shape.” But typically, resolutions are abandoned before Feb. 1, with holdouts quitting before March.
People tend to gain several pounds starting in the autumn as the colder weather drives us inside and encourages us to eat comfort foods (more calories in, fewer out). But for those who hold onto the cold-pounds each year, they may suddenly have a revelation: “how did I gain so much weight?” They seek to lose anywhere between 10 and 40 pounds, depending of course on the individual.
It appears so incredibly simple: just cut out bad foods and down on portions, while adding in a little bit of exercise. Right? Well, according to Celine Torres-Moon, senior scientist for Illinois-based Protocol for Life Balance, “Losing weight is very difficult to achieve. While all of us are well intentioned and try to alter our diet and increase exercise, very few individuals succeed in maintaining their resolutions, and after a few weeks, revert to their usual lifestyle.”
Sandy Robertson, RN, MSN, CHTP, CMIP, agreed, relating that many individuals believe that losing weight is a short-term process, and isn’t difficult to do. However, frustration sets in after a few weeks and often when a plateau occurs. “By week five or six, they give up,” she stated. Many of her clients tend to underestimate sedentary time per day and misjudge the amount of food they consume. Further, many don’t realize that they numb their emotions and stress through food. Mindful eating can help, she said.
But if they are successful for several months, they may often have setbacks, according to Robertson. “Research suggests that approximately 80 percent of people who shed significant amount of body fat will not maintain that level of loss for 12 months; and, according to one meta-analysis (Engber 2023), on average dieters regain more than half of what they lose within two years.”
That stated, according to Dayna Dye, education content writer, Florida-based Life Extension, published statistics concerning how soon people give up dieting and exercise are scarce. Catherine Champagne, PhD, RD, professor at Louisiana State University’s Pennington Biomedical Research Center, stated that people typically last approximately six months on a diet.
Don’t Give Up
No matter what, your patients who are serious about losing 10 to 50 pounds all have one thing in common—they are coming to you for guidance, especially if they just can’t seem to keep on track and have become discouraged.
Torres-Moon advised, “helping patients maintain a positive attitude around their body image regardless of the number displayed on the scale can help keep them engaged. The worst outcome would be to enter a ‘yo-yo’ vicious cycle where the patient loses some weight, gives up, feels terrible about their perceived ‘failure,’ regains more weight, and repeats this cycle over and over.”
Robertson suggested considering the state of the gut flora with specific tests. If the client has been dealing with chronic stress, it can affect their cortisol levels. Another question to ask is about sleeping habits, because lack of adequate rest may affect metabolism and heighten cravings for unhealthy foods such as sweets and carbs.
She added, “Tools for behavior change can guide your clients to set goals that are “SMART”—Specific, Measurable, Achievable and Time-based. Outlining goals that are aligned with the client’s values and reflect what matters most to them will help them be motivated to take action.”
Very busy lifestyles may also hamper a client’s ability to commit to exercise. According to Vanessa Pavey, ND, education scientist, Life Extension, individuals with hectic lifestyles tend to have difficulty engaging in regular exercise, maintaining healthy circadian rhythms, and obtaining adequate sleep, which all impact the ability to maintain a healthy weight. “Practitioners can guide their patients and help encourage them to schedule consistent exercise into their daily routine until it becomes habituated. Research has found that it takes a minimum of six weeks to establish an exercise habit when exercising at least four times per week.”
She added that one obstacle clients may mention that interferes with developing an exercise habit for those new to regular exercise or getting back in shape is delayed onset muscle soreness (DOMS). Muscle soreness is most frequently felt a day or two after the muscles are challenged through a workout. This is caused by microdamage to the muscle tissue, exercise-induced oxidative stress and inflammation. Waiting for muscle soreness to subside may impede the client’s ability or desire to continue routine exercise. In this case, Dr. Pavey noted that anthocyanins, such as those from tart cherries, help inhibit inflammation, and thus promote more rapid muscle recovery, according to clinical studies.
The “Berber-Zempic” Factor
We cannot truly discuss successful weight reduction without mentioning the trends of consuming berberine or using Ozempic to drop some pounds. And it may benefit your consultation to find out if any or both were tried out by your client.
Berberine, an herb used in traditional Chinese medicine, is a compounded supplement based on elements found in several plants, according to Robertson. Its recent rise in popularity is due, in part, to it “blowing up” on TikTok and being regaled as “Nature’s Ozempic.”
“Studies have shown that berberine can lower blood sugar, help with weight loss and have benefits for heart health. It may also help to improve your gut health, by increasing ‘good bacteria’ which can reduce risk for certain cancers, and cardiovascular diseases,” said Elizabeth Bradley, MD from the Cleveland Clinic.
“As far as I know there is no robust scientific evidence that berberine supports weight loss,” countered Torres-Moon. “I would not recommend it to my patients. Losing weight is difficult, so adding a product with no clinical evidence can only makes things worse and reinforce the feeling of failure that the patient may feel when no or little weight loss happens.”
Dye noted that berberine is helpful for the treatment of obesity as it has been shown to exert several mechanisms of action, such as spurring production of AMP-activated protein kinase (AMPK), an enzyme that declines during aging that encourages fatty acid oxidation. Many studies, including clinical trials, have associated health benefits with berberine use. “However, concerns resulting from preclinical findings have been raised about long-term use of berberine. If one chooses to use berberine, it is recommended for short-term use only. Extracts of Gynostemma pentaphyllum and hesperidin are alternative AMPK-activators that can be used to help burn fat and support healthy metabolism,” she stated.
Ozempic (semaglutide) is a pharmaceutical originally created to help promote reduction of blood sugar in diabetic individuals, as it helps the pancreas create more insulin. Basically, semaglutide mimics a hormone that signals the brain that you’re full. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA). Wegovy is the same semaglutide that is prescribed for weight loss; like Ozempic, it is also an injectable.
While semaglutide may cause some weight loss (often about 15 percent during two years), it is only a short-term solution and does not take into account changing dietary and lifestyle habits. It is also highly expensive (approximately $900 per month) unless covered by insurance. Maintaining a healthy weight is like an ultra-marathon, not a sprint, and no intervention like berberine or Ozempic can be enough by itself,” commented Torres-Moon.
As many of your clients enter middle-age, you may hear more complaints about how it is harder to keep off pounds, or to shed some. The quaint term, “middle-age spread,” is not welcome, nor is it accepted as a consequence of aging. Your patients are resolved to find the solutions that work to trim down.
According to Torres-Moon, middle-age is a very important phase in life for both men and women as weight gain is often accompanied with conditions such as high blood pressure, type 2 diabetes, atherosclerosis, osteoporosis and low testosterone.
And, it isn’t solely about the scale and clothing sizes: “body composition tends to change in middle age with a slow decline of muscle mass and often an increase in visceral fat,” she said. “So even if weight is not increasing a lot, it is important for practitioners to pinpoint these changes in body composition along with evaluating hormonal imbalances.”
The hormonal changes experienced by men (andropause) and women (menopause) are considerably responsible for redistribution of weight as well as reduced muscle mass. In women, Robertson pointed out, “insulin levels may increase because estrogen levels have fallen, causing the body to want to hold onto fat. The protection from insulin spikes that estrogen has provided is no longer present.”
Supplement Solutions for Weight Control
Patient One MediLean, from New York-based MediNutritionals Research LLC, supplies a synergistic combination of three clinically supported ingredients—Meratrim, Capsimax and chromium picolinate—in a convenient one capsule dose, according to Kathy McIntee, vice president. This multi-functional formula supports lean muscle mass and reduced body fat by promoting lipolysis from improved adiponectin levels, thermogenesis and insulin-modulating activity. “The natural ingredients in MediLean promote healthy weight management without the use of stimulants,” she commented.
Meratrim is a blend of Sphaeranthus indicus flower heads and Garcinia mangostana fruit rind. Meratrim demonstrated positive weight management outcomes in three randomized, double-blind, placebo-controlled human clinical studies. An 800 mg daily dose for eight weeks resulted in statistically significant reductions in body weight, BMI (body mass index), waist and hip circumference that exceeded those achieved via diet and exercise alone.
Capsimax is a concentrated extract of capsaicinoids that targets several key areas of weight management, including appetite control, breakdown of fat stores, resting energy expenditure (metabolism) and thermogenesis. Lastly, an essential mineral, chromium picolinate provides chromium that is bound to picolinic acid, which facilitates its absorption. In a study, chromium picolinate supplementation helped reduce carbohydrate intake and mood fluctuations.
Another aspect of healthy weight is addressing support of the gut microbiome, according to Pam Conboy, health care practitioner support and education for Omni-Biotic (AllergoSan USA). She explained, “Gut microbiome shifts can result in changes in food-to-energy conversion, secretory adipose tissue functions, carbohydrate and lipid metabolism in the liver, as well as activity centers in the brain which influence appetite.”
Conboy pointed to research suggesting that the intake of probiotics can influence metabolic efficiency through several mechanisms including:
• SCFA production which plays a sole in energy homeostasis as well as insulin sensitivity, fatty acid oxidation and lipid accumulation;
• Inflammation modulation which protects against obesity and related diseases;
• Reduction in the LPS which increases cytokine production and insulin resistance;
• Production of specific hormones (GLP-1, PYY), which play a role in appetite suppression; and
• Increased levels of ANGPTL4 which may lead to decreased fat storage.
Omni-Biotic Hetox was developed specifically to support the gut-liver axis, detoxification and metabolism, according to Conboy. She reported that randomized clinical trials demonstrated that Hetox supplementation for six months resulted in a significant decrease in circulating levels of endotoxin by almost 70 percent, as well as additional reductions in glucose (38 percent), insulin (38 percent), HOMA-IR (64 percent), triglycerides (48 percent), total cholesterol (19 percent), total/HDL-cholesterol ratio (19 percent), TNF-α (67 percent), IL-6 (77 percent), CRP (53 percent), and resistin (53 percent), while a significant increase in adiponectin (72 percent) was seen as compared with baseline. “Moreover, health care practitioners have seen reduction in these markers as well as overall weight loss with Hetox supplementation in as little as three months,” she noted.
Dr. Pavey explained that when calorie consumption is reduced the body compensates by reducing its resting energy expenditure (REE), an adaptive mechanism to resist changes in weight. REE can increase through regular exercise. To further support REE, she said, the metabolite of DHEA, 7-Keto DHEA, acts as a thermogenic to increase energy expenditure. In a study with overweight adults on a calorie-restricted diet, those who took 7-Keto DHEA saw a 1.4 percent increase in REE compared to the placebo group who saw a 3.9 percent reduction in REE during the seven-day study.
Another option for supporting energy expenditure, thermogenesis and lipolysis is capsaicin. To enhance the bioavailability and reduce gastrointestinal discomfort, capsaicinoids can be combined with galactomannan fiber from fenugreek seeds, Dr. Pavey noted. In one study, 24 overweight subjects took 200 mg of this blend (providing 4 mg of capsaicinoids) or placebo once daily for 28 days. The capsaicin group experienced a 2.1 percent decrease in body weight and a 2.2 percent decrease in BMI compared to placebo.
However, if appetite and cravings are your client’s obstacle to achieving weight loss goals, the botanical combination of lemon verbena and hibiscus shows promise. Preclinical research suggests the mechanisms behind this herbal combination include inhibiting triglyceride accumulation in adipocytes and increasing fatty acid oxidation. In one clinical trial of overweight and obese women who supplemented with 500 mg of the lemon verbena-hibiscus blend and a 30-minute walk daily for two months saw significant decreases in body weight, BMI and body fat, compared to the placebo group. Weight loss averaged 7.7 pounds versus 4.6 pounds for the placebo group. And subjective hunger scores were significantly lower in the lemon verbena-hibiscus group.
In Torres-Moon’s viewpoint, ingredients that can support a healthy weight-loss program include 7-Keto DHEA, CLA, Phase 2, glucomannan (konjac root), carnitine and green tea extract. She explained, “If a patient decides to start a specific type of diet, for example, vegan, keto, low fat, very low calories, intermittent fasting, it is important to discuss the potential nutritional gaps some of these diets can trigger and recommend vitamins and other nutrient supplements to ensure that these shortfalls don’t develop. Weight loss should never come at the cost of nutritional deficiencies.”
Boiling it all down there is one basic way of gaining weight (eating more calories than is burned), there are several ways to approach weight and fat loss. And there’s no “bad time” for your client to start this healthier journey than today!
Facts About Weight Loss
By Dayna Dye, Education Content Writer, Life Extension, Florida
Areview of 15 studies that examined what it takes for successful weight loss maintenance identified specific challenges. These include:
• Work and personal stress, such as stressful meetings, residential relocation, lack of time to engage in exercise
• Emotion, stress or boredom
• Life events, including pregnancy, illness or injury
• Social issues
• Major life events (deaths, divorces, job losses, changes to living arrangements)
• Trigger foods and temptations
• Celebrations, such as weddings and birthday parties
• Relationship changes that impact routines or require emotional stamina
• Obesogenic food environments in which hyperpalatable, high calorie and inexpensive foods are readily available
• Unsupportive peers who discourage, tempt or pressure those who are attempting to lose weight
• Cultural norms concerning portions or types of foods consumed or alcohol consumption
Individuals who regained weight in various studies reported:
• Difficulty tracking food intake and setting aside time to exercise
• Eating due to stress or boredom or using food as a coping mechanism or reward
• Finding it challenging to resist temptations
• Giving in to social pressures
• Not wanting to waste food
• Feeling deprived
• Experiencing weight fluctuations and stressors that reduced motivation
• Lack of motivation leading to overeating
However, adhering to positive determinants of weight loss, including self-regulation/monitoring, external monitoring (such as joining a weight support group), motivation (improved self-image, self-confidence, health or social opportunities), encouraging experiences, resisting challenges and enduring discouraging experiences help support adherence to a weight loss program.1
In an investigation of motivation and limiting factors for weight loss intervention adherence, obese patients identified barriers to adherence to diet and exercise plans as:
• Insufficient motivation (67.5 percent)
• Not having a prescribed diet (27.8 percent)
• Experiencing joint pain (17.7 percent)
• Becoming tired of dieting or bored (14.8 percent)
• Feelings of laziness (11.5 percent)2
1 Spreckley M et al. Perspectives into the experience of successful, substantial long-term weight-loss maintenance: a systematic review. Int J Qual Stud Health Well-being. 2021 Dec;16(1):1862481.
2 Trujillo-Garrido N et al. Motivation and limiting factors for adherence to weight loss interventions among patients with obesity in primary care. Nutrients. 2022 Jul 17;14(14):2928.
Healthy Take Aways
• Research suggests that approximately 80 percent of people who shed significant amount of body fat will not maintain that level of loss for 12 months.
• Body composition tends to change in middle age with a slow decline of muscle mass and often an increase in visceral fat.
• Gut microbiome shifts can result in changes in food-to-energy conversion, secretory adipose tissue functions, carbohydrate and lipid metabolism in the liver.
• When calorie consumption is reduced the body compensates by reducing its resting energy expenditure.