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Weight Loss Pearls from Functional Medicine Science

When a new client or patient walks into your office or drops into your inbox with the phrase, “I am just desperate to lose weight”, do you wince?  Many practitioners who are savvy with other entrenched chronic dis-ease dynamics find requests for sustainable weight loss to be particularly daunting.  Because, as we all well know,losing some weight is often straightforward; it’s keeping it off that proves challenging and usually frustrating.  

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This clinical tip video is a deep cut from the archives but a powerful one I don’t want you to miss!  (It was actually my very first FB Live video.)  We don’t need data to know that overweight and obesity are skyrocketing issues; we see it in our practices every day.  Excess weight (and especially excess fat, regardless of weight) is nearly always a symptom of other dis-ease in the body, but it can also be a major contributor to downstream diseases.   A vicious cycle.

For sustainable weight loss, we have to get to the true root cause of the imbalance, blockage, and dysfunction in each unique person.  A collection of powerful hormones are usually involved as well as some curious habits that might surprise you.   But most importantly, my whole perspective on weight loss as a goal may (finally) make you excited – and confident! – about serving these particularly frustrated patients and clients.






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17 Questions for “Weight Loss Pearls from Functional Medicine Science”

  1. 10
    Julie says:

    Why isn’t chewing the flax seed, breaking them up, enough to make the phytoestrogen active?

    • 10.1
      SAFM Team says:

      That’s a great question, Julie. Theoretically, it should be possible to chew the flax seeds well enough to get the benefits of the omega 3 fatty acids and the phytoestrogens locked inside the seeds. In practice, this would mean a very thorough chewing of flax seeds in small quantities to ensure this is done properly and completely. Typically what ends up happening, clients don’t chew well enough, or eat rushed and then find whole, undigested flax seeds in the stool. While there’s some benefit to the whole flax seeds passing through the GI tract due to their external mucilaginous properties, it is a rather missed opportunity to get the full benefit of the weak phytoestrogens that are inside the seeds. Note that the typical recommended dose of ground flax seeds for the hormone balancing benefits is two tablespoons daily.

  2. 9
    Susan Carter says:

    I love listening to you and learning from you. Can you please address whether intermittent fasting is safe for those with hypothyroidism? I have read that fasting can impair T4 to T3 conversion. With Synthroid, I can see that this could be problematic.

    • 9.1
      SAFM Team says:

      This is an interesting question, Susan, with no easy answer. In a big practical picture, hypothyroidism, like many conditions, is a spectrum and whether or not someone will benefit from intermittent fasting (IF) will depend on where they are in their journey in managing hypothyroidism. If someone has major disruptions in their circadian rhythms and imbalances in blood sugar, that cause hypothyroidism or suffer from these imbalances as a result of the suboptimal thyroid function IF is likely not a good choice. However, if a person has been working on their hormone, blood sugar balance and keeps a regular sleep and eating rhythm, it may be possible for them to find an IF model that will work for their body (as you know there are quite a few IF models and varieties).
      When we look at what research says about this topic, it appears that fasting and calorie restriction affects primarily the hypothalamus-pituitary-thyroid (HPT) axis regulation. What’s fascinating, and also the primary confounding factor is that there is a so-called ‘central’ and ‘peripheral/local’ thyroid hormone metabolism that is affected differently by fasting, and that’s why some people with ‘hypothyroidsm’ could still beenfit from IF. Alas, currently available diagnostic methods don’t give us the insight to distinguish between these two, nor does the scientific evidence translate easily into practical solutions for clients. If you would like to explore some of the complexities of this fascinating topic these may be of interest:

  3. 8
    Angie says:

    In terms of introducing the concept of intermittent fasting to people, how do you go about squelching the standard of “you must eat immediately upon rising to rev up your metabolism?” (And also the concept of eating several small meals throughout the day to keep blood sugar regulated)? This has been ingrained in people’s thinking and some cannot even fathom the idea of going for 5+ hours between meals, let alone going for 16+ hours.

    I know that in my own experience with introducing this concept to people, they claim quackery and immediately dismiss the credibility of such an idea. (And they claim that it CANNOT be a healthful thing to practice).

  4. 7
    Brooke Jordan says:

    Would you clarify how DHEA can make cortisol. I am having a hard time finding this pathway. Thank you.

    • 7.1
      SAFM Team says:

      Cortisol and DHEA have a common precursor, pregnenolone, and they constitute two separate steroid hormone synthesis pathways. It’s the cortisol to DHEA ratio that is significant. Here are a couple of fascinating articles that illustrate the cortisol and DHEA interplay:
      Since in this FB live weight loss was the focus it’s important to understand that viceral obesity can cause increase of cortisol and also metabolised cortisol. High cortisol can lead to decreased amounts of DHEA.

  5. 6
    Claire Garwin says:

    Dear Tracey,

    Your kindness in sharing reinvigorates my soul.

    Thank you

  6. 5

    I was curious to know about individuals that do not have a thyroid gland due to cancer. I know they have to take thyroid medication. How can we help with balancing hormones for weight loss. I am assuming as far as thyroid there may not be much intervention but focus on the estrogen dominance ?

    • 5.1
      SAFM Team says:

      Actually, when someone is missing their thyroid, it becomes particularly important to ensure that their medication dose is *optimal* and not something that allows them to creep into the normal reference range. As we know, it’s not uncommon for a person to need 3-4 progressive medication dosage increases in order to find the optimal one (that fully alleviates symptoms!) while allowing time for hormone receptors (and downstream balance with other hormones) to adjust without risking overload. It’s also very important to still do a full thyroid panel in order to check for efficiency of converting T4 to T3, which as you know doesn’t happen primarily in the thyroid at all but in the liver, kidneys and other tissues. A person who has had cancer is more likely to wrestle with some degree of liver dysfunction that might impair that conversion. We also need key nutrients (e.g. selenium, zinc, iron) in order to fuel that conversion, and certain inflammatory cytokines impair it (so systemic health can play a role here too). So yes, taking a look at other hormone imbalance such as estrogen dominance (which becomes more likely as someone gains more bodyfat due to ongoing suboptimal cellular thyroid function!) is important. But there are many other avenues for support and optimization as well. Thanks for your question! I hope this is of service to you.

  7. 4
    Kendra says:

    Great wisdom! Love all of the information you freely give. My question is how do we determine the best way of eating for our clients? Trial and error? Thanks again for all you do.

    • 4.1
      SAFM Team says:

      You are very welcome! Indeed, no matter how much knowledge we have, all interventions (including specific diets) should be considered “experiments” and should be implemented with an attitude of discovery and anticipated adjustment. At SAFM in our Deep Dive Clinical Courses we teach about a number of considerations for diet given specific disease processes or health goals. However, the process of educating your client so that they can intuitively consider and decide what is best for them is still paramount to their ability to find wellness. It’s also true that the way of eating that best helps them to Get well (therapeutic phase) may be quite different from the one that best enables them to Stay well (maintenance phase).

  8. 3
    Pamela Schubloom says:

    I am curious how breast implants affect the estrogen balance. I would suspect those to not only cause an overflow of estrogen causing imbalance as well as a toxin overload. Can you please add your insight? And any information you have regarding detoxification after implants are removed would be fantastic.
    Thank you – this is a wonderful topic!

  9. 2
    Desirée De Vries says:

    I used to be a vegan and I gained 15 lbs, became exhausted, depressed, and just had a lackluster for life. I know firsthand that diet must be specialized for each individual and it’s a breath of fresh air that you agree! I run into so many people who think one diet is the only way for everyone and it can be so frustrating because they’re so set in their ways that they become closed off to anything else. I was exactly this way when I was a vegan, until I miraculously realized that I was wrong! Lol ????

  10. 1
    paz says:

    Your knowledge is OUTSTANDING!!
    I cant wait to have enough $$ saved to be able to start at SAFM.

    I really never heard of the intermittent fasting concept!!

    Thank you so much Tracy 😉

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