the natural doctors’ guide to weight loss
Dr Jess: Losing and maintaining weight have been a personal battle for Xandra and I…we LOVE food and have both struggled with emotional eating and fluctuating weight. Xandra was a size 22 when younger and I was a size 18 by the time I left hospital work. As we have worked through natural health, we have learned to maintain a size 12, which feels comfortable for us. One of the top questions I get asked regularly is how a patient can lose (or maintain) weight and if there are any herbs or natural remedies that can help with fat burning. My answer is always that weight isn’t as simple as calories in and calories out and there are a lot of things you can do to improve weight loss but it isn’t that one size fits all. Working through the list below will help you work out which factors are stopping you losing weight. I also always tell my patients that being overweight isn’t because you eat too much, are lazy or are uncommitted. Like any health condition, weight gain has its root cause(s) and once we address these, it is easier to achieve your goals.
the natural doctors’ perspective
There are many factors that can make it much harder for you to lose weight or to control appetite or cravings. The good news is that, depending on the root cause(s), there are lots of things that can really help. The current multi-billion pound food and diet industry sets us up to fail to maintain our weight, encourages sugar addiction and there is a massive amount of marketing and messaging to constantly encourage us into the wrong choices. At The Natural Doctors, we want to empower you with the right information.
Whilst there is no magic bullet for instant weight loss, our personal journeys and experience supporting thousands of patients have taught us so much about food, lifestyle, health and the many barriers that stop us losing weight.
It is helpful to understand that, like stopping smoking, positive changes occur even within a few hours of eating the right foods for your body. These foods can improve your blood sugar and inflammation within hours and in a couple of weeks, you have made a massive difference to your overall health. Equally, studies show that just one highly processed meal has the power to trigger the rise of inflammatory markers in your blood, creating an instant negative impact on your body that can peak within hours.1
The emotional component of weight gain should also never be underestimated and the social pressure upon us to look a certain way is immense for both women and men. This creates a huge amount of unnecessary stress and can destroy self-esteem. Our aim with The Natural Doctors is to have a community of support, not condemnation that enables positive changes and behaviour in manageable steps. With 2 in 3 of us overweight or obese,2 but even many people with a ‘normal’ BMI struggling with chronic health problems, we need to leave judgement behind and use the right information and support to end the obesity and health crisis.
what is my ideal weight?
The traditional method of assessing weight is by calculating your body mass index (BMI). Calculate your height in metres squared (i.e. if your height is 1.6m it would be 1.6 x 1.6 = 2.56) and then divide your weight in kg by this number (70/2.56 = 27.3). Over 18.5 and less than 25 is considered ideal.
While a BMI can be a reasonable guide for your ideal weight, it doesn’t assess muscle mass or take into account your natural build. A body builder could have a high BMI because muscle weighs a lot. Whilst you can use the range as a general guide, sitting just above the range can be healthy for certain individuals and studies show that women whose BMI is 25-27 live longer.3
We find the most useful way to assess and monitor weight (and health) can be to do regular body measurements, particularly the ratio between your waist and hips. Use a tape measure around the smallest part of your waist, just above your belly button and divide this by the measurement around the widest part of your hips/buttocks.
Your waist hip ratio can be an excellent predictor of your long term health and risk.4,5 This value should be 0.8 or lower in women and 0.95 or lower in men. Optimising your waist hip ratio is a much more important goal as it shows you are carrying less weight around your mid-section, a more dangerous place to store fat. If your BMI is over 35, then a waist-hip ratio is not accurate and we would recommend bringing down your BMI first.
For many patients, I encourage choosing a clothes size at which you have felt good in the past or a size that feels realistic and setting this as a goal. We find a set of scales can be daunting and frustrating for many people, generating unnecessary stress. I often choose to stick with sequential body measurements (waist, hips, arms and legs) every 2 weeks, diet monitoring and general health symptom questionnaires (these are all part of the Refresh programme too).
I encourage my patients to enjoy the process of their body changing, feeling stronger and healthier and stop being end-goal focused. Whilst staying on track is important, getting hung up on the number of pounds can be very stressful. It is also important to realise that many celebrities that people aspire to look like are underweight or have used surgery or medications to achieve quick results. It doesn’t matter how long it takes you to reach your goal (or if you have blips which are part of being human) as long as you stay focused and are going in the right direction.
why am I struggling to lose weight?
For many of us, the answer to this question begins with our diet. Not just because diet changes help us lose weight but also because the right food nourishes our microbiome. This ecosystem in our gut controls a lot of our general health and also helps us with food cravings6 and weight maintenance.7,8 80% of weight loss is diet so it really is the key to successful weight maintenance. Exercise has a huge number of benefits and can really help you stay on track with your diet by reducing stress levels and suppressing appetite but if you don’t change your diet, you can struggle to maintain a healthy weight.
Weight loss is not linear, it doesn’t always come off at the 1-2lbs/0.5-1kg per week but eating the right diet for your body and feeling healthier means it’s OK to plateau (not lose weight for 3-4 weeks at a time) as your body readjusts. All the changes you make to improve your health are also improving your risk of disease and often your weight will catch up over time. Plateauing can also happen as your body is concentrating on detoxifying (fat cells store a lot of toxins)9 and also with hormonal ups and downs (many of us experience weight gain just before the period or mid-cycle at ovulation).10
it is important when you eat
As the day goes on, our blood sugar tends to become less stable and so processed, high carb bedtime snacks can have much more impact on our insulin levels and on our ability to lose weight. As well as timing, keeping your eating within an 8 hour window can make a real difference to your body to get into a fat burning state. Intermittent fasting is an important tool for health and can really help you get your blood sugar levels more stable and optimise your weight loss. Basically by skipping breakfast (you can drink water or herbal, black tea or coffee) and fasting for 16 hours every day, you are making a simple change to both boost your health and make it easier to maintain your weight. Read more about the benefits of intermittent fasting here.
what you eat
The myth of calories in and calories out has persisted for the last 70 years and many people have become frustrated with their inability to lose and maintain weight on a low fat and calorie-controlled diet. This model is radically out of date and just plain wrong; a handful of walnuts and a Mars bar may contain the same number of calories on paper but they each have a very different process and impact on the body. We are far more complex than the simple physics model of calorie burning.
Multiple biological, metabolic and hormonal processes mean that sugar calories have a different impact when they are with complex fibre and healthy fats and proteins affect our hunger, cravings and storage of fat. Insulin is the most important hormone for both long-term health and weight maintenance and eating a diet that avoids continuously spiking insulin and blood sugar levels is much more important that the calculated energy value of a food in calories. Inflammatory oils like sunflower, rapeseed, corn and canola can also sabotage our weight loss and our health.11
the right diet…
For the majority of people, eating a whole food diet high in nutrients and low in processed carbs like our Refresh programme will be right for you to lose weight. The recipes are carefully balanced to supply maximum nutrients and to keep blood sugar stable. If you aren’t losing weight despite eating well and following Refresh, it may be that you have individual factors affecting your weight loss. I have listed the most common barriers to weight loss that I experience in practice below.
barriers to weight loss on refresh
- Not being in ketosis – the first 2 weeks of Refresh take you into nutritional ketosis, a fat-burning state but hidden sugars can knock you out and affect your ability to lose weight. You can test whether you are in ketosis with ketone urine testing strips available on Amazon. Test at night and as long as there is any colour change to match the chart, you are in ketosis.
- Not drinking enough water – make sure you are drinking at least 2 litres of water or herbal/green tea a day. Fruit juice, fizzy drinks, tea or coffee do not count.
- Being constipated – your body struggles to lose weight if it can’t get rid of waste! See our constipation article here and consider working through our gut health & digestion toolkit to optimise your digestion and help weight loss
- Your gut health – conditions like SIBO (small intestinal bacterial overgrowth),12 ‘leaky gut’, dysbiosis and poor gut health13 can make weight loss difficult for many patients. Equally for some patients, they can be a root cause for an inability to gain weight and keep up to a healthy weight. Studies show your gut microbiome can influence food cravings, metabolism and how easy it is for you to lose weight.14 Transplanting the microbiome of a thin mouse into an obese mouse helped it quickly shed excess weight. Conversely, a thin mouse quickly gained weight on a similar calorie level when it was transplanted with an obese mouse microbiome.15 If you are struggling with chronic digestive issues, resolving these and improving your gut health can really help you maintain a healthy weight.
- Food intolerances – when I see a patient in practice and they are struggling to lose weight despite doing the diet correctly, food sensitivities and intolerances are the first area we investigate. It is shown that IgG antibody levels to foods are much higher in those with inflammation and obesity.16,17 We often do this with a food intolerance/ allergy blood test looking at IgE (allergy) and IgG (intolerances) reactions against 90 common foods. Genova Diagnostics and Doctors Data offer this testing for around £250. If you suspect any issues with food, you can keep a diet diary for a few days and see if you note any reactions, which can occur up to 72 hours after food. These can present as digestive upset, nasal congestion, headaches, skin reactions or you may notice bloating and weight gain. If a food seems to trigger these reactions, completely eliminate it for 3 months (this has to be absolute to be able to try reintroducing it). When you are unsure of any reactions, start with the most common triggers by completely avoiding gluten and dairy (checking all packets) for 3 weeks and see if your weight goes down during this time. If you are still struggling, then consider seeing a functional medicine practitioner or health coach to help you work through this. Aside than dairy and gluten, other common reactions I have seen in practice include eggs, fish and nuts so you could try excluding these groups individually for 3 weeks after dairy and gluten. The main difficulty with exclusion can be multiple reactions and knowing if and how to reintroduce foods so you may need support.
- Hormones – many people have their thyroid checked when they can’t lose weight but there are more in-depth tests that can show you if you are having an issue with your thyroid function (despite it appearing normal on the standard NHS test) which can cause you to struggle losing weight. Read more about hypothyroidism here. The other important hormone to consider with weight loss is cortisol, the stress hormone. If you are always busy, burnt out, struggling with trauma (past or present), can’t relax or are dealing with anxiety, depression or mental illness, then you may have cortisol levels that are either too low, too high or not following the normal daytime rhythms. Cortisol responsiveness and levels have a big impact upon appetite, diet and weight loss.18 You can have these tested with a 24 hour salivary cortisol test or consider building in more mindfulness, meditation, yoga or just time for things you enjoy! Read our article on stress here. Finally issues with our sex hormone balance (often low testosterone for men,19 imbalances in oestrogen, DHEA or progesterone for women20) can cause us to struggle with our weight. Hormonal symptoms, period irregularities, conditions like PCOS and endometriosis make it likely that this could be an issue for you. Visit our hormone & sexual health toolkit or see a functional medicine practitioner if you think this could be an are you need to work on.
- Toxins & Moulds – are a highly under-diagnosed block to weight loss. As mentioned above, fat cells store a lot of toxins and modern life has an abundance of toxins which are unfortunately not considered in your standard medical assessment. These include heavy metals like lead and mercury, aluminium, flame retardants, VOCs, endocrine disrupting chemicals like pesticides, phthalates, plasticisers like BPA and the hidden household toxins from moulds. All of these can cause issues with weight loss21 and learning how to minimise and detox correctly is part of a long term healthy lifestyle and weight maintenance. This may sound unlikely to you but there is a wealth of medical evidence and after testing many of my patients with a high toxic burden, we have achieved weight loss of several stones using detoxing protocols. Avoiding chemicals includes taking a regular assessment of any work and home exposures, personal care products, cleaning chemicals, building work, household items, damp or mould patches and non-organic food high in pesticides. Regular saunas (15-20 minutes 2-3 times a week) can really help you detox22,23 as can a healthy gut microbiome (visit our gut health and digestion toolkit). Much more information can be found in the excellent book ‘Staying Alive in Toxic Times’ by the wonderful Dr Jenny Goodman (see The Natural Doctors’ webinar with her here).
- Sleep – not sleeping for long enough or having poor sleep quality can stop you losing weight and significantly increase your risk of being obese as well as multiple other chronic diseases. If you are regularly going without sleep, you can sabotage your weight loss results and if you are struggling with sleep issues, visit our better sleep toolkit for support.
- Not having the right nutrients – Vitamin A,24 Vitamin B2,25 Vitamin B12,26 Vitamin C,27 Vitamin D,28 Vitamin E (tocotrienols),29 chromium,30 iodine,31 magnesium,32 selenium33 and zinc34 deficiency have all been shown to influence metabolism, obesity, and the diseases associated with it. The Refresh programme is designed to provide high levels of nutrients and you may also wish to consider a high quality multivitamin (like our one.), vitamin D with K supplement (you can have your vitamin D levels checked by your doctor) and magnesium supplement. Multiple studies have shown a small but significant impact on weight loss when taking chromium supplements which can also help stabilise blood sugar.35
traditional chinese medicine tips for weight loss
In traditional Chinese medicine, the balance of the Chinese spleen and stomach (equating with our digestion) is a focus for weight loss. Strengthening the function of the spleen and stomach and reducing dampness and phlegm is seen to help promote weight loss and this can be done using herbs, acupuncture and diet. Chinese food therapy believes that to reduce ‘damp’ and phlegm which can promote weight gain and damage the spleen and stomach, food should be cooked and not raw (like salad). Damp, greasy foods should be avoided including fried food, too many dairy products and heavy or refined starches. They encourage regular drinking of oolong, green and pu’er tea, which are all rich in polyphenols that nourish the microbiome. Spleen and stomach nourishing foods include sweet potato and damp relieving foods include mung beans (which are great sprouted), fresh ginger and dried orange and lemon peel in hot water as a tea.
Acupressure points that can traditionally support weight loss by harmonising the spleen and stomach, reducing damp and helping hunger and fat breakdown include:
Massage each point for 30 seconds twice daily.
hunger ear point:
the emotional side of weight gain
Most of my patients trying to lose weight can see the huge impact of stress and our emotions on our eating, motivation and weight loss. There is a wealth of evidence to show the impact upon our ability to lose weight.36
This can be even more important for some of us. The first patient who ever made me think about this differently we’ll call Sarah. She said something during her first consultation that really gave me a different perspective on why we might prefer to be overweight. She had an extremely traumatic experience of sexual abuse as a teenager, had been extremely overweight most of her life and had yo-yo dieted for many years but always self-sabotaged when she reached a size 16. Sarah said that at that point she realised she received positive male attention and it frightened her so much that she preferred the anonymity of being overweight and would abandon her diet and go back to the ‘protection’ of being bigger.
I have since then seen many cases where people talk about weight as a form of protection, sometimes from abuse, from avoiding their sexuality, as diversion from other forms of attention, because it is part of their larger than life persona and they feel unlovable without it, because it protects them from having to act on other desires or goals they may fail at and be judged for, because they believe food is the only love they deserve or the only reward in their life….and many other reasons. We encourage you to take some time to reflect on any barriers to losing weight that you think may be within you. Examine them carefully: Are those beliefs true? Are they helping you or harming you? Are you ready, with some support to let them go? Examining our negative self-talk and deciding to challenge it can be one of the most important conversations we have with ourselves. We are big believers in both the importance of challenging the negative beliefs imposed on us by others and using positive affirmations and being your own cheerleader for change. Some books that can we have found really helpful are:
Bessel Van Der Kolk – The Body Keeps Score (for understanding trauma)
Louise Hay – You Can Heal Your Life
top 7 herbal supports and food supplements for weight loss
Whilst diet and lifestyle are the bedrock of weight loss, there are some supplements with reasonable evidence and a history of traditional use which you could consider for support.
Green Tea Extract – one of the most well known supplements to support weight loss. There is reasonable evidence that green tea extract supplements can reduce body weight, improve waist to hip ratio, improve blood sugar control and reduce body fat as part of a diet plan.36 It does however seem important to have the caffeine intact – not decaffeinated and EGCG is likely one of the main active phytochemical components. It has been shown that green tea can inhibit an enzyme involved in the absorption of fat (which is how the weight loss drug orlistat works), it also seems to inhibit the enzymes that digest and absorb carbohydrate and sugar.
Green tea has been shown to be high in polyphenols which have a positive effect on the gut microbiome37 and its production of beneficial short chain fatty acids (compounds that are great for our health).38 It is also very safe with very few side effects and has an array of other health benefits including a reduced risk of cardiovascular disease, cancer and neurodegenerative disease.39 We recommend drinking high quality green tea and our favourite is the Dragon Pearl Jasmine from Mei Leaf but if you want to take a supplement, The Pretty Smart Food Co Organic Matcha Green Tea are a nice brand (https://www.prettysmartfood.com/products/matcha-green-tea-capsules).
White Kidney Bean – white kidney beans consumed throughout South America have been shown to interfere with carbohydrate metabolism affecting pancreatic amylase in order to cause a small but significant amount of weight loss when taken for up to 3 months. This is supported by both animal and small human studies.40 White kidney bean extract may also improve blood sugar and cholesterol markers and increase good bacterial concentrations in the gut microbiome. Dosages in human studies range from 1000-3000 mg per day with no side effects found.40 Natrol White Kidney Bean Extract Carb Intercept Phase 2 has trial evidence supporting its benefits for weight loss.
Organic Whey Protein: Whey protein is the water soluble part of milk so may not be suitable for those with a dairy intolerance. Taking regular whey protein has been shown to increase feelings of fullness and may help reduce body fat whilst preserving lean muscle mass. These improvements may be particularly noticeable when combined with resistance training exercise.41 Quality of whey protein is important. We would only recommend an organic, grass fed source. Garden of Life does a nice range of flavoured whey protein powders.
Psyllium Husk: a water-soluble prebiotic fibre from Plantago ovata seeds is a popular Ayurvedic herb for gut health. Psyllium husk has been shown to improve body fat over 6-12 months when combined with diet and lifestyle and may reduce BMI when taken for longer than 10 weeks.42
Aloe vera: There are several animal studies and a handful of human studies showing the benefits of aloe vera on weight loss.43 It has been shown to have anti-inflammatory properties in those who are overweight and has also been shown to influence the gut microbiome, improving beneficial SCFAs and reducing appetite in animal studies.44 A study of obese prediabetic and diabetic patients showed aloe vera significantly improved weight loss and body fat loss whilst preserving muscle mass in comparison to placebo.45
Flax seed: Consumption of whole flax seed (30g/day) was shown to produce significant weight loss in an analysis of trials of patients who were overweight and obese over 12 weeks. It was shown to reduce body weight, BMI and waist circumference.46 Flax seed is a water soluble fibre that is a beneficial prebiotic improving gut health and the balance of the microbiome.
Gymnema sylvestre: Dr Jess uses Ayurvedic herb Gymnema in tincture form (2 drops as needed) regularly in practice following its traditional use to help control appetite and sugar cravings. She has found it very helpful to support weight loss when dieting. Gymnemma has been shown in small studies to improve blood sugar regulation and insulin sensitivity47 and improved body weight and VLDL cholesterol in a small study of patients with metabolic syndrome.48
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