I’m not one to judge people physically. Many people sadly play up to stereotypes and society I feel in its own way builds an expectancy of certain people in certain situations.
There is never a ‘what’ people should look like or indeed a single point in life where anyone should in my view cast judgment over the way someone looks and condemn them for it. The way someone acts is a different ballpark and it’s certainly where I feel society could do with some changes…however.
The challenge I have in writing something like this is that due to the nature of my job I largely see people who are overweight (not that a definition of ‘over’ is ever a way to discuss it but for the sake of uniformity I will use that definition) and they are typically unhappy because of that fact. Their health 99% of the time is compromised. They have poor pancreatic function, their thyroid is out of sync, their appetite hormones act like a inebriated traffic cop unsure what should be going or stopping. Their digestive enzymes are all but dysfunctional and they’re a hive of both bad bacteria and immune challenging issues. Blood pressure is often elevated, as are cholesterol levels. Despite all this the catalyst that generally brings them to me is the fact they want to look physically better. The thing about this request is that if I do my job well all the rest should by default improve.
Now I’m not saying there aren’t people out there who are overweight, in good health, feel good both physically and psychologically. They have an abundance of energy, a functional libido and all in all they’re happy and no burden to anyone in being physically of that build, I simply just don’t meet that demographic in my line of work.
To play devils advocate though medical science suggests that even a moderate level of obesity can contribute to metabolic abnormalities, dyslipidemia, hypertension, insulin resistance and glucose intolerance being some of the many problems. This seems also to be most prevalent when associated with intra-abdominal fat deposition or what we term as central obesity. Now there is very little evidence that moderate levels of obesity exists without these metabolic abnormalities existing so you can draw your own conclusions.
Right now maybe some home truths are kicking in and maybe your blood pressure is rising quantifiably and muttering under your breath ‘what does he know!’ It may surprise you but I was the fat kid in school, I was unhappy, I was teased, tormented picked on and school life ultimately sucked. I didn’t know ‘why’ I didn’t know ‘how’ I was just fat, I had no idea what food was and what I needed or indeed should or shouldn’t be eating. My parents also being of the generation they were, beyond home cooked food where also none the wiser. I still believe some of the inherent damage I did to my body back then still haunts me today, also the psychological relationship I have with food is sometimes I would say questionable. Now my qualifications have been discussed onwards.
Onto the nuts and bolts. I believe as coaches we need to run a strict ship in many respects. We need to demand a lot from the people we coach and often need to exhibit a little ‘tough love’. There is however a line between a level of empathy and just being overly lenient with someone. The fact is that if you allow them to do what they’ve always done NOTHING will change. The disparity we may also lack in understanding may also sometimes be evident. Not everyone in great shape understands the journey many people are starting and those with a naturally lean type of physique often air on an excessive amount of leniency with their clients. As something works for them it can’t be a uniform approach and simply outlines the coaches inability to adapt beyond their inherent beliefs.
I will be the first to tell someone to stop moaning, suck it up and get on with it. In life if we want something bad enough there are undoubtedly going to be times when, yes it’s hard and you’re perhaps even going to get that irritating voice telling you that you can’t do it. For some this is the fact they’ve been brought up being told something enough that they start to believe it. Negativity breeds negativity in my opinion. Guess what, YOU are often the catalyst to change that and mindset needs re-enforced.
“But it’s so hard”
No shit it is, yes it’s hard. Firstly we have a society that’s acceptant of being in the aforementioned state. I’m not talking overweight; I’m talking a compromised health status and an abundance of inherent laziness or lethargy. I’m not saying it isn’t hard and again maybe my perception and expectancies are higher than most but finding a solution to your lethargy of finding reasons why you’re unproductive might be a good start for some?
On a daily basis I witness people who are clearly comfort eating, giving themselves a ‘boost’ with some food or drink and despite the degree of judgmental embarrassment it may bring they still fail to change their choices.
Do I believe overweight people ‘just’ eat too much? Not as a general rule no. I believe they eat the wrong things as part of a chain reaction of events that stems from a catalyst that gets out of control. They may in response to this then over consume food but it’s a case of the chicken and the egg?
Most people I bear witness to are accountable as they’re in the public eye for a large part of their day. This in itself acts like a nutritional regulator in many respects and even though I feel the body is a great regulator of intake (why I use food logs instead of generic calculators to determine baselines) I also know that the systems responsible for management are compromised or ineffective. Behind closed doors these same people will have a completely different outlook and relationship with what they consume.
I’m going to make some assumptive and somewhat generalized points so if you feel you want to dismiss it and say ‘but that isn’t me’, ‘I don’t do that’, you perhaps fall under the bracket of people that despite the problems being apparent you will choose to deny theirs an issue. You’re the person that will tell me your diet is great when in fact you fail to be accountable for any of it.
If I have a client who promises change to me and then fails to even log their food for a few days perhaps the psychological stage of change they’re in is merely contemplation and far from the stage of action it needs to be in. Lying and denying key facts become second nature and a stage of change needs to occur before YOU are ready to change something as the route to something greater. Many people just aren’t ready. It’s tantamount to the person that says they can’t do something or don’t like something having never actually tried it. It’s the concept or thought of it that you don’t like, nothing more.
A day in the life……….
Society has always led us to believe many myths and norms. The world of food is no different. Our associations with foods and situations are somewhat disturbing when you consider the majority of the animal kingdom.
Food for humans is a means for achieving a number of often recreational and social, changes in conscious experience. They have underlying patterns that in order to understand our physical and psychological demands we must have a clearer understanding of what causes and instigates these.
Hear me out ok. A retort of ‘but I don’t do that’ is a cop out so just listen for a moment. Denial is sometimes someone’s biggest nemesis.
As a child almost all of the past 4 generations have started their day with some kind of cartoon character emblazoned cereal. Four generations ago this was grains that would be then covered in more than likely full fat milk. Now without getting into some grain rant this was a staple and was for the most part real food and what I class as ‘clean’ food. Now steps up to the plate food manufacturing, longer lives for food being asked for, preservatives, additives, refining and then fortifying (very evident in the grain industry). Along the way the generational taste buds changing and higher sugar cereals becoming more popular. This isn’t just bracketed to breakfast this occurred across the food industry. The humble beginnings of food now served a better purpose, profit. The goal being to capture your audience and keep them as consumers.
Those that achieved this best ultimately won as corporations.
The sweeter these companies made food, the more they refined them and the more chemicals they added meant a larger amount of sales and less waste. Fast-forward four generations. What was once seen as a treat or a once a week occurrence, sweets, soda etc. were now commonplace throughout the day with vending machines in schools, offices across the world. These manufacturers were now BIG companies with big revenues and BIG tax bills. The government wouldn’t sever the hand that feeds it so a blind eye was turned and profit rained and continues to rain in.
What did they know we didn’t?
So the child in modern society is now starting their day with a high sugar, high carb cereal with more than likely, after the victimization of fats, skimmed milk (which has the highest % of carbs and sugar). As a child, possibly no issue but going off the back of a pregnant mother who due to the erratic hormonal nature of pregnancy consumed junk on a daily basis under the premise that ‘eating for two’ was the norm. You’re not really eating for two, what you’re doing is actually influencing hormones for two. This is a whole different article but I believe that the one point in life most care should be taken over nutrition is during pregnancy. Simply look at the incidence of gestational diabetes and type 1 Diabetes in kids you may have an idea. Eating for two isn’t wise and in modern society a dangerous myth.
What we’re seeing now is that over time the cells in the body are getting overwhelmed and in some cases resistant to the relevant hormonal actions that both satiation, energy and general intake is managed.
Those that we probably need to focus on the most are Insulin, Leptin and the Thyroid hormones.
Insulin, if we talk about in a simplified manner is a hormone that is secreted after the consumption of food. Glucose (carbs and sugars) is it’s main mediator but all foods have an insulinogenic effect that would also become dependent upon other factors within the individuals diet but as not to overcomplicate things lets keep it simple for now.
In a more complicated explanation: Type 2 glucose transporters (GLUT2) mediate the entry of glucose into beta cells. This is the raw fuel for glycolysis, our standard energy-producing pathway, glucose is phosphorylated by the rate-limiting enzyme glucokinase.
You consume any foods with an element of glucose in them and your body has what’s called a GSIS (Glucose sensitive Insulin Secretion). The pancreas alongside its Beta Cells takes on this responsibility of secretion. Over time if this system is overused through either excessive consumption of foods, carbs in particular and those that are refined from their original state it becomes over stimulated, down regulated and ultimately dysfunctional. It’s a balancing act, we need to stimulate without over stimulating as much as we must focus on consumption.
If we use a ration of 1:10 on GSIS which is an average across diabetic populations. This means that every 10g of carbs we consume the body will utilize 1 unit (iu) of Insulin to manage it and carry it into cellular tissue in it’s converted form Glycogen.
Under fully functional circumstances the average human produces 24 units of insulin daily at a basal level. Each meal or feeding should we say will classically induce a further 5-6 units to be produced. This would mean an average westerner consuming three meals a day with a fully functional GSIS would produce 42 units maximum or fundamentally if norms are to be accepted the ability to take 420g of glycogen into cells. If you do the math at this stage you will realize why frequency of meals can play a role when attempting to build more lean tissue and capitalize on the benefits of Insulin.
MOST of the Western population is at a state of diminished GSIS, Insulin resistance and en-route to type II diabetes. Type II being characterized as stage 4 of Beta Cell dysfunction. Most of your clientele looking at weight loss will more than likely be at some dimished stage and very rarely at a state of efficient GSIS. This may be speculative but the demographic we deal with and reach out too will almost always be within these parameters. If you doubt the statistics, start getting blood tests done on your clientele. You will soon believe the mess we’re in.
In the process of getting to this level of dysfunction the cells that generally uptake the glycogen via insulin develop what we now term as Insulin resistance. This is like your shopping. The shopping being the carbs (glycogen) and you being the insulin that picks the bags up and takes them home. When you get home your front door is locked. The only way to get the food in the house is to post it through the letterbox. This means that the food can’t all get in and it’s slow. This, despite being one of the strangest analogies I’ve used, works to get the point across….I think?
Basically the cells now can’t take in fuel like they used too, this is brought about initially by a level of insulin resistance developing firstly in the Liver then moving on to whole-body resistance.
It is suggested that insulin sensitivity in the liver is important for whole-body insulin function. Any low level of inflammation in the body or liver can impair this function and it’s signaling even more rationale for the quality of food we take in being a factor as opposed to just a series of caloric or macronutrient based targets.
A) There is compromised fuel for tissue and numerous other consequences that obviously come alongside that. Reduction in carb ‘tolerance’ should we say and an inhibition in both performance and tissue adaptation.
B) The reduction in uptake means that the surplus must go somewhere.
This is where we start to run into problems. Serious problems.
The overweight person who consumes the carbohydrates and has the diminished GSIS and cellular uptake (resistance) now has a rapid rise in blood glucose as the glucose has an inability to either get carried or taken into cells and generally in most cases both. This means it remains in the blood as opposed to in cells. This elevation in blood glucose leads to the pancreas signaling a continuous release of more insulin (hyperinsulinemia) in it’s attempting to bring blood glucose down. As there is no space in the compromised cells this never happens (Unless activity creates increased insulin sensitivity and uses up some of what’s in the cell). The continuous elevation in circulating insulin now through various pathways signals to the hypothalamus that the individual needs to consume more food, particularly carbs to bring that level of insulin down. This creates a sense of false hunger.
If this individual continues to follow this pattern the switch that firstly turns off the food and sugar cravings will never go.
Our caloric mediator -Leptin
It is hypothesized that high circulating insulin causes Leptin resistance in the brain. Leptin is the hormone that basically manages your long-term energy balance (homeostasis). It will indicate when we require calories or not. If Leptin is compromised in its function it’s unable to regulate accordingly.
An interesting side note here is that fructose unlike glucose doesn’t stimulate insulin secretion from the pancreatic Beta cells. Because Leptin production is regulated by insulin responses to meals a diet high in fructose (not fruit but high fructose sweetening ingredients such as HFCS) the circulating levels of Leptin reduce, insulin resistance rises the signaling pathways between the leptin and the brain become compromised. In animal models high fructose consumption has been shown to induce insulin resistance, impaired glucose tolerance, hyperinsulinemia, hypertriacylglycerolemia and hypertension.
You now have an overweight person with a strong signal constantly telling the brain it needs more food and particularly carbs, you also have the inhibitor which would indicate whether to consume food or not turned OFF. You see the compromised position; you may also understand my issues with ‘lenient’ or flexible dieting approaches with most of the population. The application of it is often wrong. This is what I was referring to the level of empathy and tough love. IT is hard and as coaches we must understand that the nervous system, brain and whole endocrine system is being tricked through the consumption of poor quality calories masquerading as actual food.
Too little follicle development and too many androgens
High levels of circulating insulin and extreme insulin resistance also cause ovarian dysfunction in females particularly hyperandrogenism. This over production of androgens is classically seen in the symptomatic effects of Polycystic Ovarian Syndrome (PCOS). The management of insulin alongside LH (Luteinizing Hormone) and FSH (Follicle Stimulating Hormone) is critical if normal follicle development is expected. Those of you with clients that have lost weight in an attempt to conceive and succeeded this is a large part of what has happened.
Our internal thermostat
The last one that I won’t spend too much time dwelling on is the group of thyroid hormones. These play a huge part in the metabolic function of the human body. Turn off Leptin, create Insulin resistance and the concurrent indulgence in food food will stimulate thyroid output. Now this up-regulation much like insulin over time develops dysfunction (too many mechanisms to discuss right now), the group of hormones with only this as a factor becomes overworked and down-regulates. Compound this with a history of dieting, caloric restriction, binging etc. etc. and now the third of the major regulators is also failing to do its job.
It is hard and if your coach understands what’s going on they can support you both with intelligent nutritional strategies and psychological support. Ultimately however it still comes down to YOU!