Traditional and Functional Medicine Approach to Obesity

According to CDC statistics from 2011-2014: more than ⅓ of adults and almost 1/5 of youth in the US are obese.1 The biggest drivers of obesity include low cost of food production and consumption, less physical activity: leading to overconsumption of calories, too many macronutrients of the wrong kind that translate to nutrient insufficiency (overweight and undernourished).2

The traditional approach to obesity, in general terms may be described as the following sequence of events: i) patient is advised to eat less and exercise more, ii) come back for check up in 3-6 months, iii) probably patient weight the same or more, iv) as last resort bariatric surgery is recommended. Shrinking the stomach to the size of a walnut may be the only option for some patients, but it does not address the root cause of obesity. Despite these drastic measures, many will regain the weight because they didn’t understand the relationship between their bodies and food. Small but powerful dietary changes will have a dramatic impact in patient’s metabolism with longer and permanent effect for their health.3

Functional medicine approach to obesity epidemics start with food because food is information that alters cellular function and gene expression. Thus, the right order to help someone with obesity is: 1) start with food, 2) remove food allergens, 3) fix the gut, 4) optimize nutrient status, 5) balance hormones, 6) support energy metabolism, 7) enhance detox, 8) mind-body balance, 9) look for hidden infections.4

When I say let’s start with food I meant switching from SAD (Standard American Diet) to healthy foods that are nutrient dense and increase balanced dietary choices: including aspects from Mediterranean and Paleo diets with emphasis on Phyto density: a whole, unprocessed, predominantly plant-based diet. The food options should included the following properties: low glycemic load, high levels of ω-3 vs ω-6, no trans fats, high levels of phytonutrients and antioxidants, healthy protein choices from plants or pasture-raised animals, low allergenic foods (no gluten, dairy, and other known allergens specific to the patient), minimize the presence of toxins in foods (no added hormones, pesticides, antibiotics or preservatives), healthy pH (balancing alkalinity and acidity of foods), healthy Na/K ratio (low in salt, high in K), and high fiber content.5 In summary, the eating tips to support a healthy and sustainable weight loss include 1) eating a rainbow of vegetables and fruits, lean proteins, healthy fats, fiber-rich foods, protein and fat with each meal, preferentially seasonal, organic and local; 2) small, frequent meals: 3 meals and 2 snacks per day; 3) starting with breakfast, eat approximately every three hours; 4) enjoy the food, eat mindfully and peacefully (not in front of the TV or in the car), share meals with family and friends. Follow these rules 90% of the time and occasionally break the rules, you won’t fell very good doing it.4   As Dr. Hyman said, “Food is by far the most powerful clinical intervention in chronic disease.”5(18)