Weight and metabolic dysfunction

Pain Management
Mental Wellbeing
Weight Management
Hormonal Imbalance
Digestive Health

Obesity and metabolic syndrome disorders such as type II diabetes have put huge pressure worldwide on healthcare systems. According to figures from the International Diabetes Foundation (IDF) diabetes affected approximately 425 million people worldwide in 2017. And these numbers are predicted to rise to 629 million by 2045.

We now know that metabolic dysfunction can be reversed through healthy lifestyle strategies. In 2016, the World Health Organization (WHO) acknowledged diabetes reversal can be achieved through weight loss and calorie restriction. The clinical psychoneuroimmunology approach has shown that this can be done with calorie restriction using restricted carb dietary approaches that generally also includes consumption of more fat – hence them being referred to as low carb high fat. Because fats deliver 9 calories per gram compared with the 4 for carbs (and protein), calorie counters are often put off low carb high fat – despite this being one of the most helpful of dietary approaches.  

Case study: patient's health issues

Sarah came to me for weight loss.  Her BMI was 34 and she weight 94 kilograms.  Her glycated haemoglobin (HbA1c) was 55mm ol/mol.  It is widely agreed that this marker should be kept under 48 mm ol/mol and may be an indication of a pre-diabetic state.  

Her body composition markers were as follows:

  • Fat Mass was 45.5% - ideally should be below 30%
  • Visceral Fat was Level 10.5 – ideally it should be below level 9 and optimally as low as possible
  • Total Body Water was 39.1% - ideally should be over 50%
  • Waist 109cms
  • Hips 128cms
  • Thigh 80cms

Visceral fat is the adipose tissue in the abdominal cavity.  Because the space is limited in this part of the body fat mass accumulation should not get too high. Visceral fat can also move around the body getting stored in other tissues and clogging arteries. It is also linked to inflammatory conditions.

Psychoneuroimmunology approach

Sarah embarked on a three-month protocol with me.  Three months allows for sufficient time for change to happen. We eliminated foods that promote high blood sugar and upped her consumption of nutrient dense foods in the right combinations and amounts. She was slowly encouraged to eat less often with gaps between meals and we planned an exercise routine for her. Our goal is to work towards metabolic flexibility. Being metabolically flexible means that the body can use energy sources according to need including tapping into fat stores when the body has been given no other option – no easy feat.

After three months Sarah felt much better.  She mentioned the following improvements:

  • Energy was improved
  • Blood sugar levels were more stable
  • She no longer had cravings
  • She was sleeping better

Her body composition markers improved as well:

  • BMI 32
  • Weight 87 kg
  • Fat Mass 41.4%
  • Visceral fat level 9
  • Total Body Water 41%
  • Waist 98cms
  • Hips 116cms
  • Thigh 69cms

As you can see she has made tremendous progress. There is still a way to go before she meets the targets that we agreed upon at the beginning. It is important that weight loss does not occur too quickly because fat burn may not occur, and the development of metabolic flexibility is crucial. We will measure Sarah’s HbA1C marker after six months.

Fleur Borrelli

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