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What’s the Number One Obesity Mis-diagnosis?

The number one mis-diagnosis we see in our weight management program is chronic stress/high cortisol. We see people who come in and swear that they cannot lose weight, despite managing their nutrition and exercise. Invariably we find that some non-dietary factor is responsible for weight gain. Anything from medications increasing insulin, through to chronic pain syndromes and sleep deprivation.

Well, no wonder dietary changes didn’t make any difference. That wasn’t their problem. It was the cortisol/ stress pathway all along.

If I’m honest – these problems are harder to fix. While there are time tested ways of reducing stress and cortisol levels, most patients simply do not take our advice to look into mindfulness/mediation/prayer/yoga/acupuncture/religion/massage.

‘People come to a diet clinic and get advice on how to meditate. They look at me like I have two heads!’

There is, however, good evidence that things such as mindfulness mediation can have an effect on weight loss.

At the University of California, San Francisco, a trial was done with mindfulness meditation and showed that they could reduce cortisol levels. This is no surprise since meditation has been done for thousands of years as a stress relieving method. This decrease in cortisol was closely paralleled by a decrease in abdominal fat.

The important thing to know about it is that meditation does not change the actual stressor. For example, suppose your boss is driving you crazy. You will be under a lot of stress. Meditation won’t change that one bit. What it will change is your body’s response to the stress. In the end, that is what is important. By decreasing the cortisol response, there is a decrease in abdominal fat. Your boss is still the jerk he was before. You have only changed your body’s response to this stressor.

One final thought about stress relief. It’s always a little amazing to me how far organized religion is ahead of the game. Think about the practices they preach. Prayer (similar to meditation). Belief in a higher power/ confession (stress relief). Weekly ceremonies, like mass (sense of community and continuity – important for stress relief). Small group session (friendship and sense of belonging – stress relief). Fasting. Yes, fasting. All of these practices that are so important for good health have been established thousands of years ago.

Dr Nasr Al-Jafari is a Dubai-based Family Medicine Consultant and Functional Medicine Practitioner. He graduated from The University of Nottingham and completed his consultant training at The University of Manchester, UK. He has pioneered the use of obesity theory in the UAE for weight loss and type 2 diabetes reversal at DNA Health Medical Center where he is Medical Director.


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