Weight loss is the number one topic I discuss with women who come to see me. Almost every woman I know has struggled to lose a few pounds at some point in her lifetime. Weight is such an emotional issue for women – whether they have ten pounds or 100 pounds to lose. I know this, so I approach weight loss from a holistic angle, exploring every aspect of the issue with each patient so that we can find the best solutions together.
Weight loss struggles are nothing new. In over 30 years of practice, it’s consistently remained a top priority among my patients. What is new, however, is what we know about the ways in which excess weight impacts health. Losing weight isn’t a vanity issue – and it isn’t as easy as it was long made out to be! The calories in, calories out model just doesn’t work. There are far too many factors that impact weight to think something so simplistic would be the answer.
There are many interventions and treatments that can be effective for weight loss, and the right treatment isn’t the same for every woman. When I see patients, I get a comprehensive overview of what’s going on in their life. I run many tests to be sure I have the full picture. That includes testing hormone levels – including DHEA.
What is DHEA and How Does it Relate to Weight Loss?
Dehydroepiandrosterone (DHEA) is a natural hormone secreted by your adrenal glands, which sit just above your kidneys. DHEA is produced in much greater amounts in young people, with levels at their highest between the ages of 30 and 40. After that, production declines at a rate of approximately 5% each year. By the time we reach 70, most of us have very little DHEA in our systems.
This is a natural decline, and in general, nothing to worry about. But for people experiencing serious unexplained symptoms, increasing DHEA levels might be the answer. For decades, claims have been made about the amazing benefits of DHEA – and much controversy has also surrounded the use of DHEA supplements.
DHEA has been touted as a “miracle” pill that can boost energy and athletic performance (in fact, it’s banned by major athletics associations), slow aging, build bone and muscle strength, improve mood and memory, boost your immune system, and aid in weight loss.
In fact, DHEA was first sold as an over the counter weight-loss pill, until the FDA required that it be sold by prescription only. It resurfaced on the shelves in the mid-90s when, re-classified as a dietary supplement, it could be sold over the counter once more.
Research results have been mixed when it comes to the purported benefits of DHEA supplementation, and it’s certainly not the answer to every health problem (no pill is). But I’ve seen enough people improve their health and jumpstart weight loss when using small doses of DHEA (under my close supervision) to know that for some people it provides just the extra boost they need to get back on track.
What We Know About Weight and Health
Reaching a healthy weight is about so much more than how we look. There is clear scientific evidence that being overweight or obese carries greater risk of developing many major health problems.
These can include heart disease, Type II diabetes, stroke, high blood pressure, metabolic syndrome, sleep apnea, fatty liver disease, gallbladder or kidney disease, osteoarthritis, and certain types of cancer. Being overweight or obese can also cause problems in pregnancy, and be at the root of emotional/mood disorders due to feelings of rejection, shame or guilt.
Weight gain is associated with a heightened inflammatory response. When you have more fat cells, more cytokines are released into your body. Cytokines are part of your immune response, and are intended to be natural protectors of your cells. But when too many are floating around in your blood, chronic inflammation can result and they do more harm than good!
What we also know is that these health risks aren’t limited to obese individuals only. Even those whose weight is in the “normal” range can be at increased risk if fat accumulates in certain areas – particularly the belly region. That’s why the number on the scale isn’t the only thing a skilled healthcare professional looks at.
Let’s take a look at measures of healthy weight, some of the risks that come from being overweight and/or having a high body mass index (BMI) or waist circumference, and how lifestyle changes and targeted supplements – like DHEA – can help with weight loss and maintenance.
How is Weight Assessed in Relation to Health?
The number on the scale gives your healthcare practitioners a little information, but not nearly enough to give us an accurate picture of your health and risks for disease. We need to look at the complete picture, not just the view through a tiny viewfinder.
There are three main components to discuss when talking about weight and health: Body mass index (BMI), waist circumference, and other risk factors you may have for diseases associated with obesity. Only be examining all three can we determine what a healthy weight for each individual is.
BMI looks at the proportions of lean muscle mass to fat mass. The goal, of course, is to have more muscle tissue than fat tissue. BMI is calculated using your height and weight, through a BMI calculator or BMI Table. While BMI can be a useful measure, there are some limitations in the calculations. By simply looking at height and weight, there’s a very real possibility that fat will be over or under-estimated, depending on the build of the individual.
Waist circumference is important because it can let you know if you are carrying most of your fat in your mid-section. Excess fat in the abdominal region is associated with a higher risk of heart disease and Type 2 diabetes. Risk increases with a circumference greater than 35 inches in women. That means that even if you have a weight in the “healthy range,” if your waist size is too large you could be at higher risk for serious health issues.
Other Risk Factors
In assessing a healthy weight, your healthcare professional should also ask about certain risk factors. These include: high blood pressure, high LDL or low HDL cholesterol, high blood sugar, high triglycerides, a family history of early heart disease, physical inactivity or smoking cigarettes.
Knowing where you stand in terms of these measurements can help you make an informed decision on whether or not weight loss is necessary. But knowing is only the first step. Often, what prevents us from being healthy isn’t what we know – it’s what we do!
Why is Losing Weight So Hard?
As we gain more information we also have come to understand that women are struggling to lose weight not because they don’t have the right amount of “willpower,” but because there are complex internal processes that impact each woman individually. With this knowledge comes a great deal of power. Women no longer have to beat themselves up, blaming and shaming themselves for being unable to shed those stubborn pounds. In fact, those feelings of guilt and shame might be one of the factors keeping the weight on!
Lifestyle choices make a huge difference for many people. Good nutrition, quality sleep, and plenty of movement are all important in maintaining a healthy weight. But even when you’re doing all that, if there are internal imbalances you’re unaware of, dropping those pounds can seem impossible.
Stress is one great example. With chronic stress comes elevated cortisol levels. Your body is in a constant protective state, which makes it hold on to any excess fat as if actual survival depends upon it. For our ancient ancestors, it often did!
Inflammation, adrenal fatigue, imbalanced thyroid hormones, unhealthy overgrowth of bacteria in your gut — there are so many different factors to look at! And even if you’re “skinny” according to the number on the scale, if you have excess fat deposits, especially in the belly, you have increased risk for health issues.
Abdominal fat sends more free fatty acids into the body than other fat tissues. When free fatty acid levels are high, the liver is impacted, sending blood sugar and insulin levels spiraling. Most people know the connection between blood sugar and diabetes, but what you might not know is that insulin can also promote growth of cancer cells.
Can DHEA Help You Get Healthy?
One National Institutes of Health (NIH) study out of the Washington University School of Medicine in 2004 showed promising results in controlling the impact of obesity with DHEA supplements. While participants didn’t lose a significant amount of weight in the six-month study, women shed about 10% of their abdominal fat, and men dropped about 7%.
The researchers believe that the reduction in abdominal fat comes from the activation of the PPAR-alpha receptor. This receptor prompts a sophisticated series of events improving how the body metabolizes fat, thus avoiding the build up around the belly.
While this study was too small to be used as conclusive evidence, it raises interesting questions and deserves further exploration.
A Healthy Weight is Possible When You Have All the Facts
I don’t want to make light of the struggles women go through when trying to lose weight. It’s probably one of the hardest things to manage, especially when societal expectations and judgements are taken into account. It’s hard enough to make good choices for ourselves without worrying about everyone else’s opinions!
Here’s the good news — it’s ALL within your control, even if it doesn’t seem like it. When you know what’s going on inside your body, when you have all the information you need, you can make the best choices for yourself. That’s my role here – to serve as your guide in finding the answers you are looking for.
The rest is up to you, and the choices you make. What will you put on your fork – food that makes you feel lousy, or food that makes you feel great? Are you willing to do the hard work, embrace a healthy lifestyle, and step outside the conventional medical model and explore options? If so, a DHEA supplement just might be able to provide the short-term boost your metabolism needs.
Reviewed by Dr. Mark Menolascino, MD