By Dr. Sarah LoBisco, ND

Happy 2011! Picture this, as the Cinderella clock rings 12 am, you stand glittering in your glass slippers (or grounded in your Uggs or manly Nikes’), excited and filled with hope that, “This will be my year; I will finally do it right! I will attain this goal! And FINALLY, the fairy godmother of abundance will pay me out in dividends for my reward!”  

However, the 6 am reality alarm clock comes all too soon, and along with it, the fading of the twinkle in the eye. The soft spoken words of encouragement that danced in the world of possibility is drowned out by that stern, internal, determined voice ready to whip its current victim into shape. Many talk of the power of positive thinking or motivation in order to create change. However, motivation without inspiration usually produces less than optimal results and the ideals of a fairy tale fantasy that existed at the stroke of twelve fade away.

One of the rewards of my profession is the honor of witnessing others’ reflections on what has and hasn’t worked in their journey to health. Many of my patients over the years have expressed that extreme methods from that of panacea pills that shut down biology, fade starvation diets, and hamster wheel workouts to the complete life-change-makeovers based on determination and nose to the grindstone methods, have and can create change. Still, the end result of these external motivations does not create the inner transformation necessary to make these resolutions and outer improvements stick.  In other words, you can hit that exhausted horse all you want, but unless you unleash your hold, let it rest, and take time for reflection on how to do it differently, your new resolve will be to do it more, better, or harder in 2012, 2013, 2014……As stated on the Tesco Diet webapage:

John Miles, business development director at, said: “Unsurprisingly health top[s] the list [of New Year’s resolutions]. A new year presents us with a new start and an opportunity to look forward.” Mr. Miles said that despite the majority of people making resolutions, the survey revealed that 86 per cent of people fail within the first six months of the year to stick with their plans.

In health, it is no surprise that one of the biggest resolutions for change is weight loss. Unfortunately, as stated above, it is also no surprise that the method in which many go about in order to obtain this goal has a lousy track record of maintained success. Any change, especially in health, requires integration of the whole person, and unless one is ready to deal with all aspects of their life that will be affected with the shifts in self-destructive habits, change can create angst.

As Brad Lamm, author of Just Ten Pounds, Easy Steps to Weighing what you Want (Finally), says, “Change is uncomfortable.”   This presents a problem in our hyperactive, pill-panacea popping culture. Our society is one in which entertainment and busyness is used distract ourselves from feeling anything but elation, or at least numbness, but never an absolute “negative” feeling.  Alas, it’s unfortunate, because contrary to popular belief, feelings won’t kill you, but not feeling will have consequences in all areas of your life.

Instead of slowing down and assessing how and why to do things differently, we run to the latest expert to find out what is wrong with us, how we can most easily and most comfortably “correct” it, while expending the least amount of effort and the least amount of change. Or, we sway to the other extreme and vow to change everything all at once. With weight loss, the change expected is usually such an extreme makeover, that most people can’t cross that bridge, much less even walk to it.

Well, as one of my mentors explained me, “Sarah, the truth usually lies somewhere in between two extremes.” For my patients, I always want to honor what brings them joy and as we make shifts to help alleviate suffering. This does not entail a “diet Nazi” mentality or another tough love rendition of a motivational speaker  jumping on stage shouting encouraging words that at the end of the day leave one feeling empty and unmotivated when the words fade.

Enter in, the world of integrative medicine. What’s not recognized in conventional weight loss plans, or in many weight loss methods, is the importance of balancing the biochemistry and addressing the “whys” when embarking on a path for change. For example, according to Dr. Amen, low activity in the cingulate gyrus, a portion of the brain responsible for “shifting gears”, aka changes in habits, could account for why one gets stuck in self-defeating behavior. One treatment option for this issue is to supply the body with serotonin precursors and nutrients to create more momentum in this critical area of the brain. Furthermore, as a Naturopathic Doctor, for me addressing why the serotonin is low to begin with is important. Therefore, due to the fact most neurotransmitters are produced in the gut, I always look at gastrointestinal function and stress response if adjustments in neurotransmitters are called for.

Furthermore, in weight loss resistance, certain hunger cues can be imbalanced. Unless this is regulated, willpower will be in a boxing match with biochemistry, and we know who will win that fight. A study in the J of Clinical Investigation suggested that leptin resistance may be a key player in maintaining weight loss.

Specifically, hypothalamic activity and activity in areas of the brain involved in emotional (cingulate gyrus; Brodmann area [BA] 24, 32) and cognitive (middle frontal gyrus) control are commonly engaged in states of leptin sufficiency and leptin repletion (9, 1113). The pivotal role for leptin in the CNS-mediated responses to the maintenance of reduced weight is also demonstrated by the neural activity observed during the state of relative hypoleptinemia following weight loss relative to subjects at usual weight and leptin levels (Table 4). The regions include insula, cingulate gyrus, medial frontal gyrus, precuneus, middle occipital gyrus, superior frontal gyrus, and superior temporal gyrus (Table 2), suggesting that functions such as enteric regulation, emotional control, decision, and executive functions as well as high-level perceptual systems are influenced by the relative reduction of leptin in the weight-reduced state.


One last piece of biochemistry was explored in the Yale Journal of Biological Medicine. Researchers studied the effect of how foods affect the reward center in the brains of overweight volunteers vs. control subjects.  It was found that following ingestion of a sugary treat, obese individuals tend to have less activation in the reward potion of their brain than thin control subjects. This may offer an explanation for compulsive eating, as it seems the brain responds differently to satiety and satisfaction cues in those who have excess pounds.  In the study, researchers also specifically assessed how artificial sweeteners rebound in weight gain and food cravings. This article supported how our biochemistry is affected by what we eat and that our brains in return affect our future choices which can further compound making healthy decisions. Looking at the patients overall and systemic biological patterns, sugar as blood sugar balance and proper nutrient balance can help with this pattern.

Here is an excerpt on the effect of artificial sweeteners on the brain for those interested:

On the functional level, sucrose ingestion, compared to saccharin ingestion, was associated with greater activation of the higher gustatory areas such as the insula, orbitofrontal cortex, and amygdala [53].

These pilot investigations are consistent with a revised hypothesis: Sweetness decoupled from caloric content offers partial, but not complete, activation of the food reward pathways. Activation of the hedonic component may contribute to increased appetite. Animals seek food to satisfy the inherent craving for sweetness, even in the absence of energy need. Lack of complete satisfaction, likely because of the failure to activate the postingestive component, further fuels the food seeking behavior. Reduction in reward response may contribute to obesity. Impaired activation of the mesolimbic pathways following milkshake ingestion was observed in obese adolescent girls [45].

Lastly, artificial sweeteners, precisely because they are sweet, encourage sugar craving and sugar dependence.

As I’ve written in my previous blogs, stress plays a big role in biochemistry.

For the conculsion of this article and references, click here.