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The 'Lose Weight / Fit into the Swimsuit' Ad Season is Almost Here

While the New Years' flurry of weight loss ads is over, patients will soon start to see the "slim down for summer swimsuit season" weight loss ads.  But why is there seasonal weight gain in the first place, and what evidence-based approaches are available for encouraging weight loss?

Dr. Betul Hatipoglu, an endocrinologist at Cleveland Clinic writing for the Health Essentials newsletter,1 explained that humans, like all animals, have a natural seasonal cycle which increases the body's insulin-resistance as cold weather approaches, slowing metabolism and enabling animals to survive when food is naturally scarce. "As a result, our liver can increase fat production, and our adipose and non-adipose tissues can store fat to get ready for winter," Hatipoglu states, explaining that it is a "... survival mechanism (that) has been preserved for almost 400 million years of evolution ..." 

Per Dr. Hatipoglu, the brain, controlling hypothalamic dopamine activity, is the key player for the insulin-resistance state in humans. A low level of dopamine activity also has been found to be associated with obesity and Type 2 diabetes. (Diabetics may notice this seasonal rise in their blood-sugar levels in the autumn.) While, for many, the annual insulin resistance cycle reverses back to an insulin-sensitive state around late winter or early spring to prepare for the anticipated abundance of food in the summer, humans today don't typically experience food scarcity due to seasonal factors like our ancestors did or wild animals do.

measuring tape on belly

According to the NIH2 70 percent of adults in the United States are overweight or obese, and tend to gain weight each year. As referenced in ACPM's lifestyle article "The Holiday Weight Gain is Real and Persistent,"3 a 2016 article published in The New England Journal of Medicine4 found that study participants gained on average 0.6 kg each year.

With summer approaching, patients will soon see "quick and easy, lose 30 pounds in 30 days" diet ads. But these are seldom evidence-based. Worse, they may carry significant health risks. However, clinicians can coach patients to lose weight by adopting lifestyle changes they can prescribe. According to the evidence-based Lifestyle Medicine Core Competencies Program,5 behavior change and weight loss coaching should include:

  • Prescribing a healthier diet, including writing food-based nutrition prescriptions promoting diets mostly consisting of plant-based whole foods,
  • Guiding physical activity increases, and
  • Depending on the patient and his/her lifestyle, other weight loss strategies may include coaching to obtain better sleep patterns, reducing stress that can prompt poor eating habits, and reducing alcohol use (which cuts more risks than just unnecessary calories).

For patients, the NIH offers a guide to "Choosing a Safe and Successful Weight-loss Program."6 Noting the need to focus on lifestyle habits and overall health, this guide includes tips for preparing for a visit with a health professional, including questions to ask themselves and the provider, plus tips for evaluating weight loss programs and warnings of programs to avoid.

By coaching patients to adopt healthy lifestyle changes and providing psychosocial supports, health professionals can help patients avoid the typical yo-yo weight loss/gain pattern and achieve a healthy, sustained weight loss.

  1. How the Seasons Can Affect Your Body’s Metabolism. Chronic Conditions Team, Health Essentials. Cleveland Clinic. December 15, 2015.
  2. Understanding Adult Overweight & Obesity. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed August 11, 2108.
  3. The Holiday Weight Gain is Real and Persistent. American College of Preventive Medicine. Accessed April 11, 2018.
  4. Weight Gain over the Holidays in Three Countries. Elina E. Helander, Brian Wansink  and Angela Chieh. The New England Journal of Medicine. September 22, 2016.
  5. Lifestyle Medicine Core Competencies Program. Course 2B, Nutrition Prescriptions, Basic Curriculum, slides 7, 10-22; Module 3A–3D Nutrition; Module 4A–4B, coaching behavior; Module 9A–9B Advanced Weight Loss curriculum.
  6. Choosing a Safe and Successful Weight-loss Program. National Institute of Diabetes and Digestive and Kidney Diseases. Updated July 2017.
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