Metabolic dysfunction is primarily a disease driven by a combination of diet, sedentary lifestyle, poor sleep quality, and chronic stress.
- 93% of Americans have some type of metabolic dysfunction, meaning they fall somewhere on the spectrum between prediabetes and type 2 diabetes.
- More than one billion people worldwide are considered obese and 2 billion are overweight.
How did we get here? We tend to sit more and move less than we did in the early 1900s. Sleep quantity and quality are not valued highly enough. We are more stressed than ever. The standard American diet has changed from primarily home-cooked whole-food meals to one dominated by highly processed, nutrient-poor convenience foods such as:
- Fruit-flavored yogurt
- Instant noodle soup
- Breakfast cereals
- Mass-produced bread, cakes, cookies, and other baked goods
- Frozen meals and entrees
Food that comes in a box, bag, can, tube, carton, or jar and does not resemble food in its natural form is likely to be highly processed.
Our food system has evolved to one that drives metabolic dysfunction. Metabolic dysfunction opens the door to type 2 diabetes, heart disease, Alzheimer’s and other types of dementia, non-alcoholic fatty liver disease, among others. The state of America’s health may be vastly improved by returning to a whole-food, minimally processed diet. By making fewer trips through the drive-thru, changing the foods we purchase at the grocery store, and making time to prepare meals at home we have the ability to improve metabolic health, shed excess weight, and elevate many aspects of our health.
GLP-1 Agonists. By now most of us have heard about the latest weight loss miracle drugs, glucagon-like peptide-1 agonists (GLP-1 agonists) better known by their brand names: Ozempic, Wegovy, Mounjaro, and Zepbound. These drugs were originally developed to treat type 2 diabetes and then later repackaged for the treatment of obesity.
Why do these drugs work for both diseases? GLP-1 agonists support healthy blood sugar levels by slowing the release of glucose (sugar) by the liver into the bloodstream. When blood sugar remains within an appropriate range there is less need for insulin. Insulin is the hormone responsible for signaling the body to store excess blood sugar as fat. GLP-1 agonists support weight loss by keeping our body’s need for insulin low and therefore minimizing fat storage.
GLP-1 agonists also curb hunger and promote a sense of fullness by slowing the rate at which food leaves the stomach. This action causes us to eat less.
GPL-1 agonist drugs come with concerning side effects. 50% of people taking GLP-1 agonists experience nausea, vomiting, and diarrhea in the short term. The longest study of these drugs was conducted over 68 weeks, so we are just beginning to understand what long-term side effects might look like. A pattern of gastroparesis, bowel obstruction, pancreatitis, and death is beginning to emerge. None of these digestion-related side effects are surprising.
Digestion is a north-to-south process. This means that when some part of the process is not functioning optimally, we expect to see a downstream effect. GLP-1 agonists slow the rate at which food empties from the stomach, so it makes sense the digestive process would experience some level of impairment further along the digestive process.
As a greater number of people take these drugs for an extended period, we will get a better sense of what the long-term effects may include.
GLP-1 agonists are effective. There is no denying that many people have experienced significant weight loss. This weight loss has allowed many to reduce or stop diabetes, cholesterol, and blood pressure medications. Continued success is largely contingent on continuing to take the medication.
Success with GLP-1 agonists come at a price. Approximately 40% of weight loss is attributed to muscle loss. Muscle is essential for maintaining an appropriate metabolic rate. Think of your lean muscle mass as the fuel that stokes your metabolic furnace – the more muscle mass you have the faster your metabolism burns. The muscle mass lost during treatment with these medications sets the stage for rebound weight gain once these medications are stopped. Rebound weight gain can vary and may amount to two-thirds or more of the weight lost.
GLP-1 agonists require long-term use. This is an important detail to acknowledge. Questions you may want to consider: will my health insurance cover any of the cost, what is my out-of-pocket expense, will I be able to afford to pay for the drug long-term, will the drug supply be able to keep up with demand (counterfeit drugs have been found to be in circulation), am I prepared to take this medication for the rest of my life, as these medications are used for longer periods of time what other side effects may be revealed?
GLP-1 agonists may be a good choice for some. Talk to your doctor. Do your research. Ask questions regarding realistic length of treatment, side effects, dietary changes to optimize nutrient density and weight loss while on the drug, and ask about strategies to minimize muscle loss. Blood sugar management and weight loss are complex issues that require a multi-faceted approach.
What is the solution to metabolic dysfunction from the root cause perspective? Returning to the way our great-grandparents ate – minimally processed whole foods in the form of pasture-raised animal proteins, healthy fats from animal and plant sources, colorful low-sugar fruits and berries, and mostly non-starchy vegetables. Identify and resolve sleep issues. Incorporate movement into our daily routine. Practice stress mitigation techniques. The solution is straightforward but complex.
The solution to the obesity epidemic is both simple and complex. Diet, movement, sleep, and stress management are well understood to be powerful tools for maintaining a healthy weight and an overall healthy body. The challenge for many people is shifting habits to put these tools into practice. I often hear from clients “I don’t have time to do all these things!”. I understand. I said the same things to myself and my doctor for years until my health started to deteriorate. I had to get real with myself about whether I wanted to make time to create health or to be sick. Did I want to have the energy to enjoy life or continue eating fast food? Did I want to feel good in my body or was I willing to live with constant aches and pains?
Teamwork makes the dream work! Most of us will benefit from mapping out our health plan and finding support to help us execute it. This will look different from person to person. You may find support within your family and friends who share your goals. You may excel at self-motivation and can go it alone. For me, it involved starting with a nutrition class. I realized my diet was doing me no favors. I needed to start from scratch and learn what a healthy diet looked like for me rather than chase the latest diet trend. So I started by taking a basic nutrition class. (This class is what inspired me to become a functional nutritionist!)
I continued to struggle with consistently incorporating movement into my routine. Finally, I gave in and now workout with a trainer. I resisted doing so for years but came to realize I needed the accountability a trainer would provide. My thought was that I could either spend the money on a trainer now or spend it on medical bills later in life. I continue to experiment with techniques to improve sleep and manage stress.
Where I recommend my clients start. I tend to recommend most of my clients start with diet. Results can come very quickly which helps to keep motivation high. Everyone is different. It may make sense to start addressing sleep, movement or exploring stress management techniques. Consider what would be an easy win for you and start there. It doesn’t matter where you start. Pick something that will be relatively easy to accomplish and go from there.
My go-to tool is the RESTART® Program. In five short weeks you gain an understanding of what a healthy diet looks like, how to adjust it to meet your unique needs, how your digestive system should work and what to do if it is not working properly, how different types of food impact blood sugar, the truth about dietary fats, and how to maintain success after class ends. We meet online so you may join from wherever you are! Learn more about the RESTART® Program and reserve your spot TODAY!
Not sure if RESTART® is right for you? Contact me to schedule a free 20-minute call to discuss your goals and identify options that support your needs.
Mary is a Functional Nutritional Therapy Practitioner, Board Certified in Holistic Nutrition, and an Autoimmune Paleo Certified Coach. She helps people figure out what a healthy diet looks like for their specific needs, balance their blood sugar, and regulate their digestion to support living their most vibrant lives.
Contact Mary to discuss how nutrition therapy may be used to propel you to a higher level of wellness.
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Resources
O’Hearn, M., Lauren, B. N., Wong, J. B., Kim, D. D., & Mozaffarian, D. (2022). Trends and Disparities in Cardiometabolic Health Among U.S. Adults, 1999-2018. Journal of the American College of Cardiology, 80(2), 138–151. https://doi.org/10.1016/j.jacc.2022.04.046
Centers for Disease Control and Prevention. (2022, December 13). Chronic diseases in America. Cdc.gov. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
Shah, M., & Vella, A. (2014). Effects of GLP-1 on appetite and weight. Reviews in endocrine & metabolic disorders, 15(3), 181–187. https://doi.org/10.1007/s11154-014-9289-5
Collins, L., & Costello, R. A. (2022). Glucagon-like Peptide-1 Receptor Agonists. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551568
Wolfson, J. A., & Bleich, S. N. (2015). Is cooking at home associated with better diet quality or weight-loss intention? Public Health Nutrition, 18(8), 1397–1406. doi:10.1017/S1368980014001943
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