Those last pesky 20 pounds. Over the years my patients are always asking how they can shed a little more weight after they have worked hard to claw their way back from significant obesity. My response is always the same–forget about your weight and focus on your health.
You might wonder about this approach when we are in the middle of a massive obesity epidemic. The reason I give this advice is because there is really no such thing as a weight problem. Obesity is defined as excessive body fat–you have too much fat in your body relative to other components such as muscle, bones, organ tissue and water. Thus obesity is a body composition issue and your weight and BMI tell you nothing about how much fat is in your body.
Make Health your End Game, not shedding those last 20 pounds
It’s also important to know that fat really isn’t a health problem in itself. Many but not all people with excessive body fat have a long list of dangerous metabolic problems that increase their risk for serious chronic metabolic problems and premature death. These metabolic problems include:
1. Elevated fasting insulin levels.
2. Fatty infiltration of the liver.
3. Central obesity.
4. Insulin resistance.
5. High blood pressure.
6. Endothelial dysfunction leading to vascular disease.
7. Elevated triglycerides and low HDL (good) cholesterol.
8. Elevated uric acid levels.
9. Increased inflammation.
10. Elevated fasting glucose.
These ten metabolic markers are closely associated with obesity. Some people with a lot of extra body fat have few of these dangerous metabolic markers whereas some thinner people with excessive fat have most or all of them. The best way to ascertain the levels of fat in your body is to measure your body composition. Although there are many high-tech ways of doing so, I recommend that you buy a scale that uses bio-electrical impedance to measure body composition.
The next important parameter to know is your waist/hip ratio. Take a tape measure and measure your waist one inch about your belly button and then measure your hips at the widest point of your buttocks and then divide your waist measurement by your hip measurement. For males anything above 0.9 and for females anything above 0.85 if considered central obesity.
If you combine the elements from the list of ten metabolic parameters with your percent body fat and waist/hip ratio, you will have a good idea of your overall metabolic health. Your waist/hip ratio will likely correlate much more with your metabolic parameters than your percent body fat. In other words if your metabolic parameters are normal, you don’t need to be so concerned about having a little extra fat in your body.
It’s also important to realize that these ten metabolic parameters are mainly driven by the excessive fructose in your diet, Most of this fructose comes from sucrose (sugar) and high fructose corn syrup (HFCS). When you add honey, fruit and fruit juice to a diet full of fructose from sugar and HFCS you make the problem worse. To avoid metabolic problems limit your fructose intake to no more than 25 grams per day–about the amount present in three apples.
Things get worse when you add high glycemic carbohydrates–especially from grains, to the picture. When you have insulin resistance and consume these rapidly absorbed carbohydrates, you end up subjecting your brain to magnifed glucose spikes. Over time these toxic glucose spikes trigger chronic brain dysfunction or “Sugar-Brain”. The medical term for this disease process is Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. When you develop CARB syndrome you may end up with up to 21 brain dysfunction symptoms that interfere with your ability to function. Because your brain plays a key role in auto-regulating the amount of fat in your body, when you develop CARB syndrome you also end up storing extra fat at any caloric intake even as you lose weight by dieting and undereating. That’s because most of this diet weight loss is lean body mass, not muscle.
Thus the best way to ensure a healthy metabolic state and reasonable body composition is to follow the CARB syndrome treatment plan outlined on this web site (https://carbsyndrome.com.) Don’t relax if your weight or BMI is normal because you can still be a metabolic mess. If you are in good metabolic shape, forget about those last 20 pounds and enjoy your improved health and quality of life. Remember, there’s no such thing as a weight problem. Be well!