Scott Isaacs's Blog

The Super Bowl has become one of the largest events of all time. It boasts the largest crowds, largest parties, and most antacid sales the day after. Below are some interesting facts about the Super Bowl that you probably never knew about. The information gathered in this page are from various sources around the web at various times.

Amazing Food Stats:

No fewer than $55 million is expected to be spent on food for The Big Game
Super Bowl Sunday marks the day on which Americans chow the second-greatest amount of food. (Thanksgiving is 1st)

Almost 15,000 tons of chips and 4,000 tons of popcornSome 12 million pounds of avocado are sold in preparation for the game so that Americans may gorge themselves on an estimated eight million pounds of guacamole – California avocado commission7-Eleven claims a whopping 20 percent in sales of antacid the day after the Super Bowl36% increase in sales of frozen breaded mushrooms prior to the Super Bowl29% Percentage increase in sales of frozen shrimp$237.2 million spent on soft drinks at grocery stores during Super Bowl week30% increase in sales of proceed-cheese loaves the week before last year’s Super Bowl68% Increase in sales of flavored snack crackersFrozen Pizza is the top Super Bowl seller at grocery stores$11.8 million additional sales of beer30.4 million pounds of snack food Americans scarf down on Super Bowl Sunday, twice the average daily amountPizza Hut expects to sell 2 million pizzas on the day of Superbowl XLV which is 60% or 1.3 million more than an average day.

References:
http://bodypaintingtoronto.com/2010/02/superbowl-2010-body-painting-saints-vs-colts/
http://musubibunny.blogspot.com/
http://moneyformyhoney.blogspot.com/2011/01/neobux-onbux.html
http://www.footballtickets.com/super_bowl_tickets.html
http://www.nubella.com/content/view/1530/
http://the.honoluluadvertiser.com/article/2008/Jan/30/br/br7936501284.html
http://nfl.fanhouse.com/2011/02/03/whod-pay-990-to-park-at-super-bowl/
http://www.businessinsider.com/super-bowl-xlv-pizza-hut-sell-2-million-2011-1
http://www.associatedcontent.com/article/19089/super_bowl_sunday_partying_eating_and.html?cat=19
http://www.adweek.com/aw/content_display/news/agency/e3i8a0ffd20e4fc46d783cdde26d4429cd7
http://www.adweek.com/aw/content_display/news/agency/e3i38c60ff3da19ea86511ec2e311f86bd8

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Congratulations!  You started your New Year’s resolution diet, and so far you’ve kept it.  You’ve already noticed the crowds at your gym (jam-packed in January) are starting to thin out.  You’re noticing your clothes are looser, and you might be considering a shopping trip in your future.  You even survived the Super Bowl, and didn’t kill your diet.  What’s the next big obstacle?

Of course, Valentine’s Day.

We’ve al1l been inundated with images of happy couples, sharing boxes of chocolate, enjoying a romantic, rich and delicious dinner on Valentine’s Day, while the man gives the woman beautiful flowers and an expensive piece of jewelry.

This year, skip the first two and stick with the last two.

If you’ve made encouraging progress with your diet, the last thing you want is to derail it with one calorie-laden night.  So here are some tips to help you maintain your slimming figure, while still enjoying your holiday:

1. Encourage your sweetheart to not bring you fattening treats.

Let’s face it, one of the many benefits of losing weight is the positive response from your significant other when you’re looking better and better.  It’s so simple to remind your loved one, “Honey, I’m doing so well with my diet.  Please don’t bring me any sweets for Valentine’s Day this year.”

2. Forgo the candy.  Period.

Even if your significant other has agreed to not bring you candy, temptations are still there.  Who amongst us hasn’t walked past the Godiva store in the mall and admired those succulent Red Velvet truffles in the candy counter?  Who hasn’t gotten a hankering for those delicious smelling heart-shaped cookies at Publix?  Just remind yourself… “I don’t need this, I don’t need this.”  And keep walking by.

3. Don’t touch the kids’ candy either.

For those with school age kids, Valentine’s Day often includes a trade of candy, not just flimsy paper cards.  As you help your child prepare their Valentine’s cards, buy a candy that doesn’t appeal to you.   When the kids come home from school with a candy stash, create some limits so you’re not tempted to eat those candies as well.

4. Eat a healthy meal at home.

Perhaps eating at home isn’t the most romantic event, but it’s the best way to control your menu and ensure you’re staying within your diet.  Ask a friend to watch your kids so you can have a romantic dinner at home (celebrating on a different night to accommodate schedules is also an option).  OR, if you absolutely must go out to dinner, research the menu of your favorite restaurant and plan ahead.  If your restaurant doesn’t have healthy choices, then choose a different place.

5. Celebrate in a way that doesn’t involve food!

Go to the movies, see a play, enjoy the symphony or an art exhibit, or simply take the time to go for a walk with a loved one.  There are so many ways to celebrate your love that do not involve food.

After Valentine’s Day is over, come back and post some of the tactics you used to help stick with your diet, but still allowed you to have a sweet Valentine’s Day.

Related articlesHow to Spend a Creative Date on Valentine’s Day (genzpad.com)How to Choose Enduring Valentine’s Day Gifts (prweb.com) The post 5 Tips for Having a Sweet but Candy-less Valentine’s Day first appeared on Outsmarting Your Hungry Hormones.

If you have adiposity you are not alone. The disease of obesity affects more than 93 million Americans, and the numbers continue to increase. Plus, a number of other conditions associated with obesity such as type 2 diabetes, high blood pressure, sleep apnea, arthritis, heart, lung and liver disease and more are on the rise. These conditions greatly impact a person’s quality of life and overall health, both physically and mentally.

However, treating obesity can be a challenge. If you are overweight or obese, you probably know how difficult and frustrating weight loss efforts can be.

It is very difficult to achieve long-term weight loss from diet and exercise alone. In fact, most patients who lose weight on a diet gain back most or all the weight within a few years. Even with intensive exercise, long-term weight loss is difficult to maintain. What few understand is that weight regain occurs because of adaptive changes in the hormones that regulate appetite and metabolism. When you lose weight, your hormones change to increase appetite and lower metabolism, driving weight back up. These metabolic changes persist for years.

The hormonal regulation of appetite is very strong. Willpower alone is not sufficient to overcome these biological drives. Thus, medications are increasingly being used because they can help overcome some of the biological changes that drive appetite. And there are more obesity medications available today than ever before.

This can be empowering, but also intimidating and confusing. Therefore, here are important things you need to know about prescription weight-loss medications and their role in helping you succeed in losing weight.

Weight-Loss Medications Require a Healthy Lifestyle

Taking a medication for weight loss means committing yourself to long-term lifestyle changes. Lifestyle modification is the cornerstone of any weight-loss program and includes:

A healthy, reduced-calorie meal planPhysical activitySelf-monitoringAdequate sleepStress reduction

For most people, weight loss can be achieved with a 1,200-1,400 calorie-per-day meal plan. You can work with your physician or dietitian for more precise calorie recommendations based on your individual requirements. Studies have shown that the makeup of the diet is less important than sticking to the diet, so it is recommended you follow a common-sense, reduced calorie meal plan that you can stick to for the long term. For example, a strict vegan diet may work for some people, but for others, the rigidity of the diet can cause feelings of deprivation and rebound cravings or even binge eating. Try to have regular meal times and make meals a family affair – socialize, discuss the day’s events, make the shared meal an enjoyable activity for all.

Physical activity is also a critical component of any weight loss program. Without physical activity, you can still lose weight on a low-calorie meal plan, but for every 10 pounds you lose, three will be muscle. However, with regular physical activity, for every 10 pounds you lose, only one is muscle. A minimum of 150 minutes of moderate intensity physical activity is recommended each week. Resistance training with weights or bands may be added in. Start slow and gradually, and increase the duration and the intensity of the activity. Schedule physical activity on your calendar like you would other important tasks. And ask a friend or your spouse to exercise with you.

Examples of moderate intensity physical activity include:

Brisk walkingBike ridingSwimmingActive play with childrenHouseworkYardwork

Self-monitoring with food and exercise logs, regular self-weighing and using tech gadgets such as pedometers and activity monitors can help modify behaviors that contribute to weight loss. Even though weight loss is more complicated than calories in and calories out, these gadgets are useful tools that help you better understand your own body.

Adequate sleep is also crucial to achieve effective weight loss. You should aim for seven to nine hours of restful sleep each night. If you have excessive daytime sleepiness, you should discuss the possibility of having sleep apnea with your physician. Effective sleep apnea diagnosis and treatment aids in weight loss, which then improves sleep apnea symptoms.

Stress reduction is also an important component of any weight loss program, so don’t be afraid to ask for help. Support from friends and family is vital for helping you stay on track. The more support you have the more likely you’ll succeed.

It’s important that you don’t expect to change your behaviors overnight by keeping focused on long-term results, making small but gradual changes to improve your daily routine. It will take time, but as you stick with your lifestyle changes, you will see your weight and health improve. This can be highly motivating to keep the weight loss going.

The Lowdown on Medication-Assisted Weight Loss

Medications for weight loss can be considered when lifestyle modification does not produce acceptable weight loss or medical complications are not adequately controlled. Antiobesity medications (AOMs) are indicated for patients with obesity defined as a body mass index (BMI) above 30 kg/m2 or overweight with a BMI above 27 kg/m2 with at least one complication of excess weight such as diabetes, high blood pressure or abnormal blood lipids.

Before you decide on any weight-loss medication, it is important to work with your healthcare team to decide which option is best for you. Prescription weight-loss medications work by helping you eat fewer calories. These medications work on the appetite and reward centers of the brain to reduce hunger and cravings and to increase the feeling of fullness as you eat.

Currently, there are eight medications approved by the Food and Drug Administration (FDA) for weight loss. They are:

Phentermine (Adipex-P®, Suprenza®)*Phendimetrazine (Bontril®)*Benzphetamine (Regimex®, Didrex®)*Orlistat (Xenical®, alli®)†Phentermine and Topiramate ER (Qsymia®)†Naltrexone HCl and Bupropion HCl (CONTRAVE®)†Liraglutide injection (Saxenda®)†

*Approved for short-term use
†Approved for long-term (chronic) use

Although everyone hopes for a magic weight-loss pill, medications only work when combined with a reducedcalorie meal plan and increased physical activity. These medications are not a substitute to lifestyle modification, but rather a tool to enhance these measures. Taking a medication without lifestyle changes does not result in successful weight loss. It should also be noted that none of the AOMs should be taken while pregnant.

Weight-Loss Medications for Short-Term Use

Approved for short-term use several decades ago, phentermine, phendimetrazine and benzphetamine are weight-loss medications that contain a mild stimulant that is like an amphetamine and work on chemicals in the brain to decrease appetite. These medications can be taken once or several times a day depending on the formulation. Tolerance usually develops after a few months, resulting in an increased appetite and cessation of weight loss. Thus, it is prudent to have a plan for ongoing weight loss or weight maintenance, such as changing to an AOM approved for chronic use, as regaining weight is typical once these medications are discontinued.

These older AOMs are typically used for 12 weeks, although some patients may experience increased weight loss by prolonging the treatment by taking the medication every other day for 24 weeks. Side effects of these AOMs can include an increase in blood pressure and heart rate as well as insomnia, dry mouth, anxiety and agitation. These medications cannot be used if you have certain heart conditions, uncontrolled high blood pressure, a history of stroke, glaucoma (increased eye pressure), or an overactive thyroid. Consequently, you must be monitored closely by a healthcare professional who has experience prescribing these medications.

Medications for Long-Term Use

Since obesity is a chronic disease, the up-to-date approach to AOMs is to treat them like any other medication used to treat a chronic disease. This means that AOMs are intended for long-term chronic use.

The newer anti-obesity medications result in an average weight loss of 5 to 15 percent from the patient’s starting body weight over 6 to 12 months, with weight maintenance if the medication is continued. If the AOM is discontinued, patients tend to gain back the weight that was lost while taking the medication.

Weight loss should be assessed after taking the full dose of an AOM for 12 weeks. It is recommended that the medication be discontinued if at least a 5 percent weight loss has not been achieved at this point, as additional meaningful weight loss is unlikely. An alternative AOM can be substituted, as a person’s response to one AOM may not predict the response to another due to different mechanisms of action. Due to lack of data, combining AOMs is not recommended, with some exceptions discussed below. If a 5 percent weight loss has been achieved and there are no unacceptable adverse reactions, then the same AOM should be continued long-term.

Orlistat (Xenical®, alli®)

Xenical® and the lower potency over-the-counter version alli® contain the medication orlistat. This medication comes as a capsule that is taken before each meal and works by blocking the absorption of about one-third of fat in the meal. This fat gets passed out of the digestive tract in the stool. Orlistat is the only AOM that does not work by decreasing appetite. Side effects of orlistat include oily diarrhea, fecal leakage, cramps and gas discharge that can be avoided by consuming a high-fiber diet that contains less than 30 percent fat. People who take orlistat should take a daily multivitamin as there is potential for a deficiency of some fat-soluble vitamins.

Phentermine and Topiramate ER (Qsymia®)

The combination of phentermine and topiramate in an extended release capsule was approved by the FDA in 2012 as the first new AOM in over a decade. Topiramate is a medication that has been approved to treat seizures and migraine headaches. Weight loss is a common side effect of topiramate. Phentermine is an AOM as described above that helps to decrease appetite as well. This is an exception where two medications used in combination at relatively low doses are effective for long-term weight management.

Side effects of phentermine-topiramate ER include a metallic taste in the mouth, dry mouth, a feeling of pins and needles in the What You Should Know About Weight-Loss Drugs (Continued from page 5) EMPOWERYOURHEALTH.ORG 7 extremities, constipation, insomnia, memory loss and fatigue. This medication also has an interesting side effect of making soda taste flat due to the chemical properties of topiramate. Women of childbearing age must use at least one reliable form of contraception and should have a negative pregnancy test before starting the medication and should have monthly negative pregnancy tests while continuing phenterminetopiramate ER, as it is known to cause birth defects.

Naltrexone HCl and Bupropion HCl (CONTRAVE®)

CONTRAVE® is also a combination of two medications that have been approved for other uses since the 1980s. Naltrexone is a medication used to treat alcohol and opioid dependency. Bupropion is used as an antidepressant and for helping people to stop smoking. The combination of these two medications work synergistically to reduce appetite and cravings. Side effects include nausea, constipation, headache, dry mouth, vomiting, anxiety and dizziness. There is a potential for elevated blood pressure and heart rate. Those with uncontrolled high blood pressure and a history of a seizure disorder should not take the medication. Because naltrexone blocks the body’s opioid receptor, use of opioid pain medications along with CONTRAVE is inadvisable, as the combination prevents these medications from working properly and may cause withdrawal symptoms.

Liraglutide injection (Saxenda®)

Liraglutide is an injectable medication that is a synthetic version of a hormone that works in the brain to reduce appetite and make you feel full. Liraglutide is also marketed at a lower dose under the name Victoza® for the treatment of type 2 diabetes. Liraglutide increases natural production of insulin and decreases release of the anti-insulin hormone glucagon in response to food intake. The most common side effects are nausea, vomiting, abdominal pain, diarrhea and constipation.

Medication Follow-Up

When on an AOM, frequent visits to your physician (every four weeks) are recommended for the first 12 weeks and every three months thereafter. Frequent visits with a healthcare professional provide better weight-loss results through increased support, accountability and individualized medication management. Since obesity is a chronic, lifelong problem, continued periodic follow-up is advised.

The best weight-loss results are achieved when AOMs are combined with intensive lifestyle modification. The major benefit of weight loss is improvement of diseases caused by obesity such as diabetes, high blood pressure, abnormal blood lipids and heart disease, which can be seen with as little as 5 percent weight loss.

It’s important to keep in mind that AOMs are not a magic bullet, but simply a tool to help you sustain commonsense lifestyle changes. There is no perfect medication for obesity. A medication that may work for a family member or a friend may not be the ideal medication for you. Treating obesity can be complicated, so it is best to work with a knowledgeable healthcare professional who is dedicated to working with you over the long term.

by Scott Isaacs, MD

See the original article here

To learn more about Atlanta Endocrine Associates please visit: www.atlantaendocrine.com

The post What You Should Know About Weight Loss Drugs first appeared on Outsmarting Your Hungry Hormones.

If you think losing weight is only about moving more and eating less, then think again. In fact, hunger hormones — tied to metabolism — are a significant factor in weight gain and loss. And controlling them may be the best way to safely shed pounds, experts say.

“Most people can lose weight,” says endocrinologist Dr. Scott Isaacs. “Keeping it off is the challenge.”

That’s, in part, because your body is probably working against you if you’re trying to lose weight. Here’s why: For most of human existence, losing weight was a potentially life-threatening condition. So, once you start shedding pounds, your body instinctively adapts by going into starvation mode, unleashing hormones that boost your appetite and conserve your fat.

The two primary hormones that control appetite are ghrelin and leptin. They serve as biological on/off switches. Ghrelin is mainly produced in the lining of the stomach and switches on appetite. Leptin is secreted by fat cells and turns off appetite by signaling when you’re full. It doesn’t work alone as other hormones produced in the gut also signal satiety, but less is known about them because they are more recent discoveries.

“What we know from the science is that when you lose weight, your hunger hormones go in the opposite direction,” says Isaacs, a weight-loss specialist based in Atlanta, Ga. “The hormones that make you feel full all go down while ghrelin, the only hormone that stimulates appetite, goes up.”

One of the biggest problems is leptin resistance. People who are overweight or obese have more fat, which produces more leptin. In theory, that should make them feel full. But what happens is similar to insulin resistance in that their bodies become less sensitive to the hormone.

The two primary hormones that control appetite are ghrelin and leptin. They serve as biological on/off switches. Ghrelin is mainly produced in the lining of the stomach and switches on appetite. Leptin is secreted by fat cells and turns off appetite by signaling when you’re full. It doesn’t work alone as other hormones produced in the gut also signal satiety, but less is known about them because they are more recent discoveries.

“What we know from the science is that when you lose weight, your hunger hormones go in the opposite direction,” says Isaacs, a weight-loss specialist based in Atlanta, Ga. “The hormones that make you feel full all go down while ghrelin, the only hormone that stimulates appetite, goes up.”

One of the biggest problems is leptin resistance. People who are overweight or obese have more fat, which produces more leptin. In theory, that should make them feel full. But what happens is similar to insulin resistance in that their bodies become less sensitive to the hormone.

“Leptin doesn’t work to turn off appetite as it should be because the brain has become resistant to it,” explains Isaacs. “So anything people can do to reduce leptin resistance is helpful.”

The best way to do that is to eat the right foods.

“You want to eat a diet high in antioxidants.” says Isaacs, author of the book “Hormonal Balance: How to Lose Weight by Understanding Your Hormones and Metabolism.

“You want to eat fruits and vegetables with a lot of different colors. You want to eliminate inflammatory things like sugar and proceeded foods. You want to eat consistently rather than going for long periods of time without eating. All of these things will help fight leptin resistance.”

Whereas leptin levels ebb and flow like tides, ghrelin spikes before meals and drops off rapidly afterwards. But when you’re overweight, ghrelin doesn’t drop as fast and far as it should, so your brain continues to get signals that you’re hungry.

“The best way to normalize ghrelin levels is to eat filling things,” says Isaacs, a member of the American Association of Clinical Endocrinologists.

“Eat protein and foods that have high volume but are low in calories, like vegetables, fruit, and whole grains. Crunchy and chewy things take longer to eat and digest, and that will help with ghrelin. Eat slowly, and dilute high-calorie foods with low-calorie foods.”

Isaacs adds that exercise and sleep are both vital to weight loss, in part because they help regulate leptin and ghrelin levels.

“Appetite is magnified when you are sleep deprived,” he says. “If you’re not getting a good night’s sleep, weight loss is going to be next to impossible.

“Exercise is also important, but it’s a relatively small component in weight loss compared to calorie intake. Exercise is a bigger factor when it comes to weight maintenance. But people can’t lose weight just by exercising more. They also have to reduce their calories.”

According to Isaacs, research shows that no particular diet — whether low-fat, low-carb, or something else — is more effective than others. The key is to eat fewer calories, and to find something you can stick with.

And don’t blame yourself if you fail.

“I see a lot of people who are really frustrated and have a huge amount of self-blame,” says Isaacs. “They are successful at losing weight, then they put it back on and feel like a failure. They think it’s a lack of willpower, but it’s the hormones driving their cravings. It’s not their fault. It’s just biology.”

By Gary Greenberg (NewsMax)

https://www.newsmax.com/health/health-news/hunger-hormone-weight-loss/2018/03/21/id/849930/

 

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The post How to Control Hunger Hormones to Lose Weight first appeared on Outsmarting Your Hungry Hormones.

10 Things Everyone Carrying a Lot of Extra Weight Knows

Sixty-nine percent of American adults are overweight or obese, which means most of us have at least some personal experience with the battle of the bulge. And yet, for people who are overweight—especially those who are seriously overweight—offensive comments from friends, family, and strangers abound. Remarks like, “Are you simply lazy? Clueless about nutrition? Are you even trying to slim down?” can really sting.

To gain some perspective, we talked to women who are obese (defined as having a BMI of 30 or higher), as well as a number of health and nutrition experts. You might just relate to their insights—or learn what to avoid saying in the future.

“I’m working harder than you think.”

“The biggest misconception is that we just don’t care, and if we were really trying to lose weight, we would,” says Camille, 40, who says she’s about 50 pounds over her ideal weight. “People underestimate how much we’re thinking about it, watching what we eat, and trying to be active. It’s on my mind all the time.”

“Food is my drug.”

“Overeating is far more like an addiction than it is a lack of knowledge or willpower,” says metabolic and weight management specialist Tom Rifai, MD, a clinical assistant professor of medicine at Wayne State University School of Medicine. Many obese people can’t control their eating—at least not on their own. That’s because food really can be addictive; many processed foods trigger the same reward mechanisms in the brain that drugs or alcohol do.

Breaking a food addiction is especially difficult because it’s impossible to completely abstain from eating, says Rifai. “I’ve worked with several recovering alcoholic and drug addicts, and all of them say that managing their food intake is way more difficult.”

“Being heavy can be painful—but so can being thin.”

Kaye, 40, says her weight has fluctuated from 150 to 240 pounds, and for her it’s been both an emotional and physical struggle. “When I’m thin, I feel better physically, but out of control emotionally,” she says. She’s currently about 80 pounds over her ideal weight and says she aches all over, especially in her legs, back, and shoulders. “But eating is what makes my brain feel good. I wish I could put my fat brain in a thin body.”

“Stop saying I have a beautiful face.”

“Every time someone says it, I hear, ‘Given you are so fat, it is surprising you have such a pretty face,'” says Alison, 47, who is 100 pounds over her goal weight. Try complimenting her skill set or accomplishments instead.

“Don’t complain to me about your own weight or dress size.”

Maybe it’s your way of saying you can relate. Or maybe fat talk is so ingrained in our culture that you can’t help but scrutinize your thighs in the dressing room mirror. Either way, don’ t do it. “I find it very insulting when thin friends complain about their weight or make comments about how they’re getting ‘fat,'” says Kaye. Alison agrees: “I don’t want to hear how fat you think you are when you’re 30 pounds less than my ultimate dream weight.”

“I’m very active.”

You can’t tell how often someone laces up her sneakers just by looking at her. “I’ve done three marathons and over a dozen half-marathons,” says Alison. Marianne, 44, is 5’4″ and 220 pounds, but she moves around a lot thanks to her job teaching horseback riding. “The other day, someone actually said that I couldn’t run, but you have to run pretty fast to encourage a horse to canter,” says Marianne. “She almost fell over with surprise when I took off.” Camille does cardio and weight training regularly. Mary Beth Palmer-Gierlinger, founder of Inspire Health Coaching in New York, isn’t surprised. “Many people who are overweight are exercising more than slender people,” she says. “They’re desperate not to be living in that body.”

“I’ve tried starving myself, and it doesn’t work.”

Most people who are very overweight have, at some point, tried to majorly cut calories—and failed, says Scott Isaacs, MD, a clinical instructor of medicine at Emory University School of Medicine and medical director at Atlanta Endocrine Associates. While it’s true that they’re probably eating too much, they’re doing so because they’re hungry, he explains. “Telling someone to eat less is a lot like telling them to breathe less,” he explains. “They can do it for a while, but eventually biology is going to win out.”

“I don’t need your ‘helpful’ advice.”

“When you remind someone that they said they were on a diet or ask if a food is ‘allowed,’ you are usually not helping—regardless of the tone of voice you use,” says Karen Collins, RDN, a nutritionist and advisor to the American Institute for Cancer Research. “Many, many clients I’ve worked with over the years note that following such exchanges, they switch into ‘rebel’ mode and then proceed to eat through a whole box of cookies or a dozen doughnuts.” Unless a friend has specifically asked you to help her stay on track, quit playing food police.

That rule goes double for moms who feel it’s their duty to inform their daughters that they’re getting fat. “Most overweight people know they’re overweight,” says Camille. “The more people suggest that I lose weight or try to ‘helpfully’ point out that I’ve put on some pounds, the more I want to eat.”

“Don’t sabotage my efforts.”

While nagging is a no-no, support—when it’s requested—is crucial. “Some clients get stuck in an unhealthy way of eating because their families get upset when they decide to make changes,” says Palmer-Gierlinger. Don’t throw a fit because your wife wants to toss the ice cream or wave your cheese fries in front of your coworker who just ordered a salad. “Science shows that environment matters,” adds Rifai.

“I’m not necessarily unhealthy.”

It’s true that obesity has been linked to a host of medical problems, such as heart disease, diabetes, and even cancer. But not everyone who’s carrying around excess weight is in grave danger. “I may be technically obese, but I go to the doctor regularly and my cholesterol and blood pressure are always excellent,” says Camille.

Katherine, 30, who weighs 200 pounds, says she rarely gets sick anymore. “When I was younger, I was skinny, but I ate horribly—think French fries, ramen noodles, and ice cream nearly daily—and I did not exercise often. I was also sick all the time,” she says. “These days I eat a really veggie-heavy diet and walk or bike almost everywhere that I go.”

“Don’t assume I’m trying to lose weight.”

While many overweight people wish they were thinner, some are conflicted or even opposed to slimming down. Toby Smithson, RDN, a nutritionist and spokesperson for the Academy of Nutrition and Dietetics, says that she’s counseled women who intentionally overate because they felt excess pounds would protect them from unwanted advances. “Everyone flirts with you when you’re thin, and I don’t like people in my personal space,” says Marianne. “I suppose that, in a way, being fat is easier than wanting to scream ‘get the f*** away from me’ half the time.”

Others believe that weight really is just a number, and there’s no reason at all to focus on it. “There is no right or wrong weight,” says Amy Pence-Brown, 40, a body positive activist in Boise, ID. “All bodies are good bodies, and you cannot tell someone’s health just by looking at them.”

 

 

By Barbara Brody

November 23, 2015

http://www.prevention.com/weight-loss/things-everyone-carrying-a-lot-of-extra-weight-knows

 

For more information, please read my books Hormonal Balance: How to Lose Weight by Understanding Your Hormones and Metabolism and Beat Overeating Now!: Take Control of Your Hunger Hormones to Lose Weight Fast or visit my Facebook page.

www.YourEndocrinologist.com www.AtlantaEndocrine.com

The post What Thin People Don’t Understand About Living with Obesity first appeared on Outsmarting Your Hungry Hormones.

If trying to clean up your diet just leaves you more ravenous andfrustrated, you’re not alone. Time to learn how your eating decisions affectyour appetite a.m. to p.m.

Eat when you’re hungry, stop when you’re full. Simple right? Sowhy does it sometimes feel not so straightforward?

It may be one of our most basic physiological needs but eatingfeels as if it’s become far from intuitive these days. The truth is, there’smore at play than just an empty stomach or a need for calories. Research hasfound that everything from our hormones and stress levels to our moods andother people’s attitudes toward food can impact how our mind processes ourdaily eating choices.

But it doesn’t have to be so complicated. Understanding thebiggest players that affect your appetite will help you take control of it. Andthat starts by getting extremely familiar with the smallest, most powerfulteammate of them all: a hormone called leptin.

If you’ve ever dieted in an effort to drop a few pounds, only tofeel frustrated, or worse, hungry all the time, don’t blame alack of willpower. Your body is hardwired to want to hold on to fat, saysGiles Yeo, PhD, a geneticist at the University of Cambridge. But it’s not doingit to be spiteful. Body fat is what produces leptin—and believe us, you wantleptin.

Here’s why: It’s the hormone that controls appetite and weight.Its main role is to regulate your body’s energy, which includes how manycalories you eat and burn each day, as well as how much fat you store. Theprocess evolved to keep humans from star ving or overeating, both of whichwould have made you less likely to survive back in (way long ago) day.

When the system is working properly, fat cells regularly releasehigh levels of leptin that kick-start signals in the hypothalamus, which is thepart of the brain responsible for appetite control, says Stephan Guyenet, PhD,author of The Hungry Brain. “Leptin switches off an appetite-driving neuroncalled AgRP, while another signal suppresses food intake and raises calorieexpenditure.” Translation: When you’ve had enough to eat, leptin tells yourbrain, “All set, you can stop now!” and keeps your metabolismhumming along steadily.

But when leptin levels drop too low—which, FYI, happens when yougo on a crash diet—the hormone sends a starvation alarm to the brain,increasing your appetite and slowing metabolism. For some, that response takesplace even when plenty of energy (i.e., body fat) is stored. It’s a conditionknown as leptinresistance, says endocrinologistScott Isaacs, MD, author of TheLeptin Boost Diet, and it’s believed to be one of the maincontributors to obesity.

How to HitReset

Scientists and doctors don’t quite agree on exactly how leptinresistance occurs—or, more important, what to do about it. But here’s what’sknown: There are very few people who have genetically determined leptinproblems. For most, it’s something that develops over time, in response to dietand lifestyle decisions. Which also means: You have the power to alter yourleptin levels through your everyday habits. Make these easy, practical changesto your routine to recalibrate your body’s biological signals and get back ontrack with your natural eat-stop-eat rhythm. Satiation salvation ahead!

FuelSmarter

Dr. Isaacs advises clients to base their meals on protein andfiber, both of which suppress hunger hormones. His ideal meal plan to increaseleptin levels and other key appetite regulators? Eggs for breakfast, leanchicken with greens and brown rice for lunch, carrots and low-fat hummus(low-calorie and fiber-rich) for a snack, and a dinner high in leptin boostingzinc (beef and black beans are good sources). Eating more omega-3 fatty acids—foundin fish and flaxseeds—may also help mitigate the impact of inflammation on thehypothalamus, which can make leptin’s pathways less responsive, says Guyenet.

Go to Bed

When it comes to managing your hunger and appetite, sticking to asolid sleep schedule is a must. “Leptin is mostly secreted at night, so if you’regetting less than sever hours, you’ll have lower levels,” says Dr. Isaacs. Infact, if you’re getting only five hours a night, you’ll have almost 16 percentless leptin than if you’re managing the full eight, according to research inthe Annals of Internal Medicine. Another reason to maximize your shut-eye: Insufficientsleep can result in consuming up to 400 extra calories a day, mostly ofhigh-fat, low-protein food, according to the European Journal of ClinicalNutrition. Ready to rest now?

Watch YourWhy

External cues are influential in determining what, when, and howmuch we eat. For example, researchers found that people who ate with othersconsumed up to 60 percent more than those who ate alone. Another big cause forthe munchies? Stress. While 80 percent of people said they normally atehealthy, that number dropped to 33 percent when they were stressed, a studyreveals. And the majority of those folks said stress produced an increase intheir appetite, so pin down a few nonfood coping mechanisms—deap breathing,going for a walk, venting to a friend—that you can use as soon as life getstense.

By Roisín Dervish-O’Kane

Women’sHealth March 2019

If you’re struggling to with weight loss, you need the help of an obesitymedicine specialist. If you’dlike to learn more about permanent weight loss, please feel free to call us orschedule an appointment with Dr. Isaacsusing the onlinebooking tool on his website.

The post Why Am I Always Hungry? first appeared on Outsmarting Your Hungry Hormones.

If trying to clean up your diet just leaves you more ravenous and
frustrated, you’re not alone. Time to learn how your eating decisions affect
your appetite a.m. to p.m.

Eat when you’re hungry, stop when you’re full. Simple right? So
why does it sometimes feel not so straightforward?

It may be one of our most basic physiological needs but eating
feels as if it’s become far from intuitive these days. The truth is, there’s
more at play than just an empty stomach or a need for calories. Research has
found that everything from our hormones and stress levels to our moods and
other people’s attitudes toward food can impact how our mind processes our
daily eating choices.

But it doesn’t have to be so complicated. Understanding the
biggest players that affect your appetite will help you take control of it. And
that starts by getting extremely familiar with the smallest, most powerful
teammate of them all: a hormone called leptin.

If you’ve ever dieted in an effort to drop a few pounds, only to
feel frustrated, or worse, hungry all the time, don’t blame a
lack of willpower. Your body is hardwired to want to hold on to fat, says
Giles Yeo, PhD, a geneticist at the University of Cambridge. But it’s not doing
it to be spiteful. Body fat is what produces leptin—and believe us, you want
leptin.

Here’s why: It’s the hormone that controls appetite and weight.
Its main role is to regulate your body’s energy, which includes how many
calories you eat and burn each day, as well as how much fat you store. The
process evolved to keep humans from star ving or overeating, both of which
would have made you less likely to survive back in (way long ago) day.

When the system is working properly, fat cells regularly release
high levels of leptin that kick-start signals in the hypothalamus, which is the
part of the brain responsible for appetite control, says Stephan Guyenet, PhD,
author of The Hungry Brain. “Leptin switches off an appetite-driving neuron
called AgRP, while another signal suppresses food intake and raises calorie
expenditure.” Translation: When you’ve had enough to eat, leptin tells your
brain, “All set, you can stop now!” and keeps your metabolism
humming along steadily.

But when leptin levels drop too low—which, FYI, happens when you
go on a crash diet—the hormone sends a starvation alarm to the brain,
increasing your appetite and slowing metabolism. For some, that response takes
place even when plenty of energy (i.e., body fat) is stored. It’s a condition
known as leptin
resistance, says endocrinologist
Scott Isaacs, MD, author of The
Leptin Boost Diet, and it’s believed to be one of the main
contributors to obesity.

How to Hit
Reset

Scientists and doctors don’t quite agree on exactly how leptin
resistance occurs—or, more important, what to do about it. But here’s what’s
known: There are very few people who have genetically determined leptin
problems. For most, it’s something that develops over time, in response to diet
and lifestyle decisions. Which also means: You have the power to alter your
leptin levels through your everyday habits. Make these easy, practical changes
to your routine to recalibrate your body’s biological signals and get back on
track with your natural eat-stop-eat rhythm. Satiation salvation ahead!

Fuel
Smarter

Dr. Isaacs advises clients to base their meals on protein and
fiber, both of which suppress hunger hormones. His ideal meal plan to increase
leptin levels and other key appetite regulators? Eggs for breakfast, lean
chicken with greens and brown rice for lunch, carrots and low-fat hummus
(low-calorie and fiber-rich) for a snack, and a dinner high in leptin boosting
zinc (beef and black beans are good sources). Eating more omega-3 fatty acids—found
in fish and flaxseeds—may also help mitigate the impact of inflammation on the
hypothalamus, which can make leptin’s pathways less responsive, says Guyenet.

Go to Bed

When it comes to managing your hunger and appetite, sticking to a
solid sleep schedule is a must. “Leptin is mostly secreted at night, so if you’re
getting less than sever hours, you’ll have lower levels,” says Dr. Isaacs. In
fact, if you’re getting only five hours a night, you’ll have almost 16 percent
less leptin than if you’re managing the full eight, according to research in
the Annals of Internal Medicine. Another reason to maximize your shut-eye: Insufficient
sleep can result in consuming up to 400 extra calories a day, mostly of
high-fat, low-protein food, according to the European Journal of Clinical
Nutrition. Ready to rest now?

Watch Your
Why

External cues are influential in determining what, when, and how
much we eat. For example, researchers found that people who ate with others
consumed up to 60 percent more than those who ate alone. Another big cause for
the munchies? Stress. While 80 percent of people said they normally ate
healthy, that number dropped to 33 percent when they were stressed, a study
reveals. And the majority of those folks said stress produced an increase in
their appetite, so pin down a few nonfood coping mechanisms—deap breathing,
going for a walk, venting to a friend—that you can use as soon as life gets
tense.

By Roisín Dervish-O’Kane

Women’s
Health March 2019

If you’re struggling to with weight loss, you need the help of an obesity
medicine specialist. If you’d
like to learn more about permanent weight loss, please feel free to call us or
schedule an appointment with Dr. Isaacs
using the online
booking tool on his website.

The post Why Am I Always Hungry? first appeared on Outsmarting Your Hungry Hormones.

If hormones were people, they’d be pretty boring. See, hormones prefer the status quo, and they’re always trying to maintain homeostasis and keep your body the same. But, like the friend who you can always manage to coax into trying a new restaurant, you can work with hormones and use them to help you lose weight.  Here are three hormones that play a role in weight regulation and how you can get them to work with you.

Leptin

Produced by fat cells, leptin signals to the brain how much fat is in the body, explains Dr. Scott Isaacs, medical director of Atlanta Endocrine Associates. When leptin levels are low, you tend to feel hungry, and when leptin levels are high, you tend to feel full.

But it’s more complicated than that, Isaacs adds. “As you start to develop obesity, you start to become resistant to leptin,” he explains. “So you may have high levels of leptin, but the brain isn’t registering that.” This can put you at risk for heart problems and diabetes,adds Susan Carnell, PhD, professor of psychiatry and behavioral sciences at Johns Hopkins Medicine.

Hormone hack: Some research suggests physical activity can help manage leptin levels.Although any exercise may help, resistance training appears to be more efficient at reducing leptin levels, according to a recent review of studies on overweight and obese middle-aged adults published in PLOS One. As a bonus, being more active can also help you lose weight.

Sleep is also key. “Leptin is made in your sleep. That’s one reason people with sleep deprivation are hungrier,” Isaacs explains. Research has demonstrated both acute and chronic sleep deprivation decrease leptin levels,so make good sleep habits a priority.

Ghrelin

The ying to leptin’s yang, ghrelin is produced by the stomach and often referred to as the hunger hormone. It’s highest when your stomach is empty and decreases after you eat. “It does many useful things in the body, like getting the stomach ready to process food,” Carnell explains. “We also know that if ghrelin increases, people are spurred to seek out food, and that stress can produce an increase in ghrelin.”

The combination of stress and increased ghrelin can be especially hard later in the day, according to a small recent study by Carnell and other researchers. “The evening may be a biological ‘high-risk period’ for overeating, particularly when paired with the experience of stress and if you’re prone to binge eating,” she says.

Hormone hack: Again, managing stress is key, as is making sleep a priority since deprivation can increase ghrelin levels. Additionally, Isaacs recommends eating high-fiber, high-protein foods, which will help keep you fuller longer.

Cortisol

Although it’s thought of as a stress hormone because it’s secreted to help us decide whether to fight or flight, cortisol also promotes insulin secretion. “This makes us store fat on our bodies, particularly around our waists, which is not good for our health,” Carnell explains. “And it can increase our appetite.”

Hormone hack: Managing stress and how you cope with it is key to losing weight, Carnell says. Find what works for you, whether that’s making a cup of tea when you reach your mental boiling point, going for a daily jog or enjoying some time in nature. If you tend to stress eat, it may help to keep your go-to foods out of the house, Carnell adds.

by Brittany Risher

Read the article on the MyFitnessPal Blog.

The post 3 Key Hormones for Weight Loss first appeared on Outsmarting Your Hungry Hormones.

If hormones were people, they’d be pretty boring. See, hormones prefer the status quo, and they’re always trying to maintain homeostasis and keep your body the same. But, like the friend who you can always manage to coax into trying a new restaurant, you can work with hormones and use them to help you lose weight.  Here are three hormones that play a role in weight regulation and how you can get them to work with you.

Leptin

Produced by fat cells, leptin signals to the brain how much fat is in the body, explains Dr. Scott Isaacs, medical director of Atlanta Endocrine Associates. When leptin levels are low, you tend to feel hungry, and when leptin levels are high, you tend to feel full.

But it’s more complicated than that, Isaacs adds. “As you start to develop obesity, you start to become resistant to leptin,” he explains. “So you may have high levels of leptin, but the brain isn’t registering that.” This can put you at risk for heart problems and diabetes,adds Susan Carnell, PhD, professor of psychiatry and behavioral sciences at Johns Hopkins Medicine.

Hormone hack: Some research suggests physical activity can help manage leptin levels.Although any exercise may help, resistance training appears to be more efficient at reducing leptin levels, according to a recent review of studies on overweight and obese middle-aged adults published in PLOS One. As a bonus, being more active can also help you lose weight.

Sleep is also key. “Leptin is made in your sleep. That’s one reason people with sleep deprivation are hungrier,” Isaacs explains. Research has demonstrated both acute and chronic sleep deprivation decrease leptin levels,so make good sleep habits a priority.

Ghrelin

The ying to leptin’s yang, ghrelin is produced by the stomach and often referred to as the hunger hormone. It’s highest when your stomach is empty and decreases after you eat. “It does many useful things in the body, like getting the stomach ready to process food,” Carnell explains. “We also know that if ghrelin increases, people are spurred to seek out food, and that stress can produce an increase in ghrelin.”

The combination of stress and increased ghrelin can be especially hard later in the day, according to a small recent study by Carnell and other researchers. “The evening may be a biological ‘high-risk period’ for overeating, particularly when paired with the experience of stress and if you’re prone to binge eating,” she says.

Hormone hack: Again, managing stress is key, as is making sleep a priority since deprivation can increase ghrelin levels. Additionally, Isaacs recommends eating high-fiber, high-protein foods, which will help keep you fuller longer.

Cortisol

Although it’s thought of as a stress hormone because it’s secreted to help us decide whether to fight or flight, cortisol also promotes insulin secretion. “This makes us store fat on our bodies, particularly around our waists, which is not good for our health,” Carnell explains. “And it can increase our appetite.”

Hormone hack: Managing stress and how you cope with it is key to losing weight, Carnell says. Find what works for you, whether that’s making a cup of tea when you reach your mental boiling point, going for a daily jog or enjoying some time in nature. If you tend to stress eat, it may help to keep your go-to foods out of the house, Carnell adds.

by Brittany Risher

Read the article on the MyFitnessPal Blog.

The post 3 Key Hormones for Weight Loss first appeared on Outsmarting Your Hungry Hormones.

Sleepy, Stressed, or Sick?

by Olga Khazan

When I first suspected I was suffering from hypothyroidism, I did what any anxious, Internet-connected person would do and Googled “dysfunctional thyroid symptoms,” and, in another tab, “hypothyroid thinning hair??” for good measure.

What came up sounded like someone describing me for an intimately detailed police sketch:

increased fatigueheightened sensitivity to coldunexplained weight gaindry skinmuscle weaknessa pale, puffy face (“Finally, a medical explanation for this,” I thought.)

This, combined with the fact that a close family member had recently been diagnosed with a thyroid disorder, sent me scurrying to the nearest endocrinologist’s office. They took a blood test, and two weeks later the results came back. Sure enough, the doctor said solemnly, I had hypothyroidism, which meant my thyroid was under-active. She would be starting me on thyroid medication. She couldn’t know for sure, but I might have to take drugs for the rest of my life.

I took the news well. This was, after all, exactly what I was hoping for—a pill that would act like kind of a Photoshop for real life, making me skinnier, more energetic, less puffy, and more moisturized practically overnight.

Just to be sure, though, I asked to see my blood test results. The document said I tested positive for Hashimoto’s thyroiditis, a condition in which the immune system attacks the thyroid. (Somehow knowing I have a disease named after someone made it seem worse.)

At the same time, the blood test showed I had normal levels of the thyroid hormones T3 and T4, which play a critical role in regulating metabolism.

The doctor said my levels of TSH, the thyroid stimulating hormone that tells the thyroid to make T3 and T4, were too high, however. A high TSH is the marker that most endocrinologists use to diagnose hypothyroidism. It means the pituitary gland is telling the thyroid, “Go, go! Work harder!” And the thyroid is saying, “Chilll man, I’m sooo sleepy.” Conversely, too little TSH means hyperthyroidism, or an over-active thyroid.

I studied my blood-work printout. My TSH levels were 3.5, which was, according to the lab, within the normal range of 0.35 to 5.5.

“This says the TSH is normal,” I said.

My doctor begged to differ.

“If you were pregnant or trying to get pregnant, we’d medicate you at 3.5,” she said.”

But I’m not trying to get pregnant,” I said.

“Well, a family doctor might not treat you for a 3.5, but an endocrinologist would. And that’s what we’re recommending,” she said firmly. I was to call her, she added, if the meds gave me tremors or if my hair started falling out.

I stammered, saying I didn’t really understand. I wasn’t sure I wanted to take a pill for the rest of my life to fix something that wasn’t technically broken. I mean, what if the side effects were worse than being slightly tired and puffy all the time?

“I don’t know if I’m ready for this!” I blurted, then realized I sounded like some sort of medicine-fearing anti-vaxer.

“Well, you don’t have to take it,” she said. “But it’s perfectly safe.”

She finally convinced me to take the prescription with me and think about whether I wanted to actually start on the drug.

“You know, you’re low on Vitamin D, too,” she added as I walked out the door. “You should really take a supplement. And don’t worry, it’s all natural.”

Little did I know that I had stumbled into one of the hottest controversies in endocrinology, one that touches on one of the most common diseases in the U.S. Twelve percent of Americans will develop some sort of thyroid disorder within their lifetimes, and levothyroxine, the drug used to treat hypothyroidism, is by some measures the second-most-frequently prescribed drug in the country. For some reason, thyroid disorders are exponentially more common in women than men. Hashimoto’s is hypothyroidism’s most common cause.

Many people—possibly up to 2 million—who have a thyroid disorder haven’t been diagnosed. Some might lack access to or money for doctors, but for many, it’s just that the symptoms of hypothyroidism are so vague. Who doesn’t feel tired, fat, and depressed sometimes?

“The symptoms of hypothyroidism are diverse and they mimic the symptoms of everyday life,” said Scott Isaacs, the medical director at the Atlanta Endocrine Associates in Georgia.” They could be the thyroid, but they could be something else.”

It’s the TSH levels that are the source of all the squabble among doctors. Most doctors agree that any TSH above 10, especially when combined with an abnormal T3 or T4 reading, should be treated. Many labs, like mine, consider a TSH reading above five or so to be abnormal.

However, some studies have found that only 5 percent of people have a TSH above 2.5 (though others say it’s more like 15 percent). That is to say, being above 2.5 is statistically abnormal. And abnormalities are, by and large, how medicine decides what a disease is.

People like me, whose level falls between 2.5 and 4.5, have a higher risk of developing full-blown hypothyroidism over time. That suggests, to some doctors, that the upper TSH limit should actually be lower—like four, or maybe even 2.5, as my endocrinologist said. The problem is, a 10th of Americans have a TSH level between 2.5 and 4.5, by some estimates. It’s an awfully big step to suggest that an additional 30 million-some people belong on a medication for a condition they might never have heard of.

In 2004, a group of thyroid experts came together to figure out whether they should tweak the TSH range that should be considered normal. They concluded, essentially, that there’s no compelling evidence to treat people whose TSH is below 10.

This prompted widespread consternation among patients and some doctors. Hypothyroidism feels crappy; some patients with readings of six or seven might be begging to be put on medication.

“What’s normal for me may not be normal for you,” said one prominent thyroid activist, Mary Shomon, to the New York Times in the wake of the 2004 findings. “We’re patients, not lab values.”

Last month, researchers from Oregon Health and Science University performed another meta-analysis. In 10 years, they wondered, have any new thyroid studies come out and shown that there’s a benefit to treating people with so-called “subclinical” hypothyroidism?

Their findings, published last month in the Annals of Internal Medicine, confirmed the 2004 panel’s conclusion. If a person has a TSH reading between four and 10, the authors found, there’s no evidence that taking medication improves their quality of life or cognitive functioning. These individuals didn’t lose weight when they were medicated. The authors said the data on whether it might actually be harmful to take medications for this kind of mild hypothyroidism is too poor to come to any kind of conclusion.

There’s also no real downside to letting subclinical hypothyroidism go untreated. Some experts point to studies showing a higher prevalence of thyroid cancer among people with normal-yet-high TSH levels, but others say the connection is weak.

To Martin Surks, the program director of the endocrinology department at the Albert Einstein College of Medicine and chair of the 2004 panel, the two meta-analyses are a clear signal that endocrinologists shouldn’t be too eager to scribble levothyroxine prescriptions for patients without true hypothyroidism. He wouldn’t suggest treating a patient with Hashimoto’s, normal T4 and T3, and a slightly elevated TSH, for example. With numbers like those, a person only has a small chance of developing real hypothyroidism, he said.

Once a person goes on levothyroxine, he added, they usually take it for the rest of their lives. There’s a chance it could work too well—lower the TSH by too much and make the person jittery, anxious, or worse. “Such a situation is definitely associated with adverse health outcomes such as atrial fibrillation, osteoporosis, heart failure, and mortality,” Surks wrote in an email.

Plus, Isaacs told me, TSH levels might not be as iron-clad as some think. They can vary widely over the course of a few months, or even within a single day. “A lot of people who are three, they come back and they’re one the next time,” he said.

David Cooper, a professor in the division of endocrinology at the Johns Hopkins University School of Medicine, largely agreed, but he said some individual patients who don’t meet the clinical limit might still see improvements in their health with thyroid medication. Levothyroxine is just a hormone, after all—as far as pharmaceuticals go, that’s fairly harmless.”

Just because it doesn’t help 1,000 people on average, doesn’t mean that it won’t help an individual person,” he said. If a person is tired and cold all the time, and their TSH is four, why not treat them? “Many physicians would say to a patient, ‘We’ll give you a therapeutic trial and see how they feel in six months.’ If they feel better, great. If they don’t, then we’ll take them off the medication. It’s not a foreign substance, it’s the same stuff your own body makes.”

Cooper said he doesn’t have a TSH cutoff when deciding whether to treat patients. “Even if it’s between 2.5 and four, there might be somebody I would treat who has symptoms of hypothyroidism, and someone I wouldn’t, if they feel well,” he said. “If our job as doctors is to make people feel better, I see no reason not to do it.”

It’s amazing how even the slightest brush with hormonal drama can send a hardened skeptic wandering deep into pseudoscience land.

“I feel like all the stressors and toxins in my life are just inflaming it, you know?” I found myself saying to my boyfriend three or four times per evening. “All the crap that I’ve been eating because I’ve been too busy to cook. That’s not good for the thyroid.”

The thyroid is so mysterious. The clean-eating crowd likes to think you can help it along through intricate dietary strategies, as though all the quinoa and chia seeds will form a gentle poultice at the base of the neck and nurse the ailing gland back to health. The reason Gwyneth Paltrow eats so healthily, allegedly, is that she suffers from thyroid issues and “liver congestion.” Every other yoga class I attend involves some pose “that’s good for the thyroid.”

Others act like the thyroid is like a bald tire you have to be careful driving on: A few years ago Oprah claimed she “literally blew out my thyroid” by working too much. (In reality, you can’t really prevent hypothyroidism by eating or doing certain things. Like most things in life, luck and genes largely determine its fate). “This whole topic of the thyroid is the biggest Internet-type thing that endocrinologists have to deal with,” Isaacs told me. “There’s a huge disconnect between what’s out there on blogs and the research.”

Cooper said sometimes the pressure to treat subclinical hypothyroidism comes from “angry patients who feel doctors don’t listen to them.”

When he said that, I immediately thought of Dana Trentini, otherwise known as “Hypothyroid Mom.” She’s a woman who feels that her hypothyroidism went under-treated for years by careless doctors, and now she advocates for better testing and treatment for people with thyroid issues. She’s immensely popular: Her blog gets 1.6 million monthly pageviews. She has a quarter-million followers on Facebook—more than The New Republic magazine.

I was initially wary because her blog promotes some dubious herbal remedies and treatments like oil pulling. But when I talked to her for this story, she came off as well-read and rational. More importantly, when it comes to her own case, she’s right.

Trentini was already taking medication for hypothyroidism when she got pregnant in 2009. When her doctor checked her TSH level, it would range from 5.6 and 8.6, she said—lower than the official hypothyroidism ceiling of 10. Her doctor told her the levels were normal, she says, and he kept her on the same dose of medication. Yet she felt terrible, tormented by crashing fatigue and cracking skin.

Twelve weeks into her pregnancy, Trentini miscarried.

What her doctor hadn’t picked up on, for whatever reason, is that pregnant women should have a lower TSH than other people—they are the ones the 2.5 limit is intended for. The experience left Trentini wracked with guilt and rage.

“I could feel that I was very ill, but I was the kind of person who believed doctor knows best,” she said. “I should have gotten a second or third opinion. I should have done something, but I didn’t. The blog began because I was angry with myself.”

Trentini went to see an alternative-medicine-oriented M.D., and she now takes a medication derived from pig thyroid and says she “feels fabulous.” She said she’s heard from hundreds of women who have had multiple miscarriages, preterm births, stillbirths, and other problems they believe were caused by under-treated hypothyroidism.

Trentini thinks her doctor and others are reluctant to aggressively treat hypothyroidism because of a “lack of interest” in following the proper guidelines. Doctors I spoke with said, on the contrary, they are interested, but there are few good studies on subclinical hypothyroidism because so little research funding goes toward non-life-threatening diseases. Others say they’re just being cautious. Unless a patient is pregnant, “observation and retesting without prescribing medications is not ‘ignoring the problem,’” Isaacs said.

But there’s also a tendency, it seems, for hypothyroidism to be the disease some patients want to be diagnosed with. It’s a much more satisfying explanation for fatigue, weight gain, mental fog, and depression than are the countless mental illnesses that cause many of the same symptoms. People seek solvable problems; hypothyroidism is, at least, that.

“It’s always easier to prescribe a pill for someone versus saying, ‘you need to see a psychiatrist or have a sleep study,'” Isaacs said. If you can fix a problem with one pill, he said, “that’s the Holy Grail.”

This article available online at: http://www.theatlantic.com/health/archive/2015/02/sleepy-stressed-or-sick/385256/

For more information, please read my books Beat Overeating Now!: Take Control of Your Hunger Hormones to Lose Weight Fast and Hormonal Balance: How to Lose Weight by Understanding Your Hormones and Metabolism or visit my Facebook page.

www.YourEndocrinologist.com
www.AtlantaEndocrine.com

The post What To Do About Borderline Thyroid Levels first appeared on Outsmarting Your Hungry Hormones.