Weight Management
Weight Management
How do we approach weight management at Crafted Balance
By: Dr. Madeleine Clark, ND
Weight management is something that many patients seek support from health care providers for. It can involve investigation around recent weight gain, wanting to focus on maintaining a healthy weight, wanting to engage in healthy weight loss, or wanting to learn more about how their habits and health plan can support them long term.
We address weight with patients if they bring it up as a goal of their care plan. We do not prescribe weight loss to patients. We do encourage all patients to be active, manage their stress, and eat in a health promoting way as part of overall health.
What is a healthy weight?
Determining what weight is healthy depends on the individual. Measurements like body mass index (BMI) scale are commonly used in research as a measure to classify weight. However, BMI is not perfect, and can result in classifications that do not make sense for the patient depending on their height, background, and muscle mass.
Is weight loss appropriate for everyone?
Not always. Losing weight if you are already underweight, have struggled in the past with restricted eating, are currently pregnant and underweight, or are a healthy weight and trying to get pregnant may not make sense. Talk to your health care provider about your health goals and your individual case.
Why does weight gain occur?
Weight gain can occur for many reasons which include; metabolic, mental-emotional, hormonal and physical (injury or inability to stay active).
When we work with patients we provide an investigation into all of these areas to see how they may be impacting a patient's recent weight gain. Some of the things you may want to rule out with your practitioner include:
Hormonal Concerns
Thyroid
Polycystic Ovarian Syndrome
Perimenopause/Menopause
Pregnancy
Diabetes Mellitus
Cardiovascular Health
Mental Health
Stress
Emotional factors that change diet and appetite
Lack of sleep
Medications
Injury or Change to Mobility
Environmental Factors
Access to nutritious food
Access to parks, sidewalks and affordable gyms
Things that can change your weight in a day/week
If you are monitoring your weight, it is important to note some factors that may play a role in a changed number of pounds on the scale. It is common to have weight fluctuations of up to 2-4lbs within a day and 1-2 lbs day to day.
Some of the factors that can cause an increase in weight on the scale include:
Heavy exercise the day before which can cause fluid retention
Drinking lots of water
Being in your PMS phase or luteal phase (two weeks before your period)
A late night meal
A high salt meal the day before
A low fruit and vegetable intake the day before (impacting potassium intake)
Overeating the day before
Alcohol intake the day(s) before
Not having a bowel movement
Factors that can cause a decrease in weight on the scale
Bowel movements
Emptying your bladder
Undereating the day before
Eating lots of fruits and vegetables (high potassium intake) the day before
Being dehydrated
Eating lower carbohydrate foods the day before
What is successful in weight management?
There are a variety of health behaviours that have been found to be successful in managing weight in research. These factors may not be what you think! They include:
Adopting a flexible eating style
Meal regularity (timing of our meals, eating three meals throughout the day with snacks)
Our eating behaviours (taking time to sit, eat undistracted, rest)
Food choices (opting for fruits and veggies, limiting fatty foods and sweets)
Physical Activity
Coping with stress (and managing emotional eating)
Having rigid dietary control, or restricting food quantity was not found to be related to the success of weight loss or maintenance over the long term.
As you can see from this list, there are many lifestyle habits we want to focus on maintaining consistently in order to achieve results. The more of these behaviours maintained, the greater the weight reduction is, and the higher the likelihood that this weight reduction was maintained after three years in research.
What do I need to know about food?
Typically when we structure a conversation about food with patients we focus on education around the three different macronutrients; carbohydrates, fats, and protein.
When the calories taken in during a day outweigh the calories burned (from exercise and our body running itself as normal) in a day, we are in the territory of weight gain. And while technically this calories in vs. calories out equation is the chemical basis of weight loss and gain, different types of foods can make us feel more satisfied or full (and others more hungry!).
Types of Food
While calories at the end of the day do matter, the type of food we eat can also change our hunger cues.
Protein, a macronutrient made of amino acids and abundant in meats, dairy products, nuts and legumes, takes longer to digest than other macronutrients, and can reduce levels of our hormones involved in hunger signals (called ghrelin). Ensuring that all your meals (and sometimes snacks) contain protein is important to maintain hunger cues and help us feeling full.
Fibre, a component of many fruits and vegetables, can have a similar effect in improving hunger cues by delaying gastric emptying and helping us feel full for longer. Fibre rich foods are also beneficial for our overall health - as they are low calorie, help improve digestion, blood pressure and provide us with antioxidants (think: fruits and vegetables).
Processed foods, such as packaged goods, fast food (or many of the things in the aisles at the grocery store - not the perimeter!) can impact our hunger and taste cues as they are designed to encourage us to eat more.
In one study, when ultra-processed foods (foods and drinks that are primarily made from processed ingredients we don’t typically find in our home kitchens - think; doritos, sodas) led to overeating by about 500 calories per day. Being mindful of our daily intake of these foods can help prevent us from over eating.
Eating Regular MEALs
Eating regular meals in addition to having them be well balanced in macronutrients is an important part of our food and weight discussion. When we eat regularly, we avoid over compensating or overeating later in the day. Depending on our age and gender, our body can see a lack of food as a stressor. For menstruating women, this can contribute to hormonal change that impact our menstrual cycle and stress response.
Typically we may see patient who don’t eat breakfast regularly because they don’t feel hungry. In these situations we may strategize on how to craft a light but nutritious breakfast that feels appetizing to them, or chat about strategies to create the time and space to eat (sometimes we don’t feel hungry if we are in high stress state or not in tune with our bodies!).
Movement
Movement or exercise is an important part of weight management (but also mental health & overall health in general!).
Within the realm of exercise we want to be meeting minimum guidelines recommended by the Canadian government. This includes at least 150 minutes of moderate-vigorous intensity activity, two strength bearing exercises using major muscles groups per week, and limiting sedentary time as much as possible (including a maximum of 3 hours of recreational screen time). If we are over 65 years old, the recommendations also include physical activity that works on our balance.
How vigorous/intense should our activities be?
The intensity at which we preform our activities (or calculate what is “intense” for us) depends on a few factors, including how trained or sedentary we are already, and how challenging the activity feels for us. We want to ensure we are getting enough intensity for our training - which often means that we need these minutes to at least feel out of breath or sweaty.
Exercise is important for increasing the calories we “spend” in a day, but also to create a body composition that is supportive of long term physical health.
When we build muscle, we increase our resting metabolic rate (the amount of calories our body naturally burns in a day). This combined with our daily movement increases the overall calories burned in a day. Therefore, the fitter we are and the more we move the more we push this number.
Muscle is heavier tissue than other components of our body, which is an important nuance to keep in mind when we are watching the scale. We may not see much movement in the number, but we may be changing body composition which in turn is supporting our health and our caloric spend.
Building and maintaining muscle is also important in the context of aging, where we lose muscle mass naturally over time. We want to preserve this for quality of life as we age (losing muscle mass as we age can put us at risk for losing the ability to live independently!), preserving bone density, and keeping us metabolically healthy.
What are the barriers to exercise?
The most common barriers to exercise are time and money. We often talk to patients about how they can incorporate exercise into their week in a time efficient and affordable way, alongside with things they enjoy.
One of the most time efficient types of exercise is high intensity interval training - which only requires a watch and some running shoes to get started. Using running intervals can be a great way to quickly complete a work out in under 30 minutes. Youtube or community classes can be another great way to find access to new forms of exercise on your own schedule and for a reduced price.
It’s also important to remember that the research we have in terms of weight and exercise focuses on reducing visceral fat mass (fat located in our midsection and surrounding our organs), and improving or maintaining our muscle tissue. When patients are worried about building too much muscle we may engage in a conversation about body image.
Body Image
How we feel about our bodies can impact how we approach weight. Shifting the conversation from wanting to look a specific way, to encouraging patients to prioritize health metrics including how they feel can be a powerful way to approach weight. This might involve reflecting on why weight loss is a goal, or even if loss should be a goal we strive for (rather than maintenance and optimal performance).
Often, this may require additional support from mental health practitioners, like psychotherapists, and working with a team that recognizes this goal to reach a place of body neutrality or positivity.
Other aspects of your health to consider
Sleep
Under sleeping (getting less than 7 hours of sleep per night) can be a physical stress on our body. When we are underslept, hormones controlling our appetite (ghrelin and leptin) are impacted, leading to an increase in hunger signals which can cause us to overeat. When we get appropriate sleep, we allow our body to recover from exercise, manage our stress responses and improve our energy to feel able to engage in healthy habits to manage weight.
Stress
Mental and emotional stress can chronically activate our sympathetic nervousness to put us in “fight or flight” mode. Chronic stress responses can increase pain, tight muscles, mobilize blood sugar and cortisol in our bodies. Mental and emotional stress can increase overeating or emotionally eating. Managing our stress, may involve a varied approach depending on the sources, how long it has been occurring and our own ability to cope.
Managing other health concerns
As part of the overall plan - we want to manage any symptoms or health concerns that get in the way of you feeling well enough to engage with the daily lifestyle habits that will contribute to your success. This may include managing mental health, hormones, digestion as part of a comprehensive health plan.
I have more questions!
Want to learn more? Book a complimentary meet and greet appointment with one of our naturopathic doctors to learn more about how we can support your overall health goals.