Scott Rollins, M.D.INTEGRATE YOUR HEALTHGrand Junction Free Press Health & Wellness Columnist

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January 10, 2013
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ROLLINS: Making hunger hormones work for weight loss

Control your appetite and control your weight. By understanding some of the hormones involved in hunger control, we can more effectively lose or maintain ideal weight.With names such as leptin and ghrelin, our hunger hormones sound more like Elven characters from J. R. R. Tolkien's legendarium, but these strange sounding little chemicals have a big impact on how much and how often we feel compelled to eat.Satiety is the feeling of fullness - similar to satisfied or satiated. Hunger needs no explanation. Our satiety hormones include insulin, leptin and cholecystokinin (CCK), while our hunger hormones include ghrelin and glucagon. These are the "feast or famine" hormones that tell our brain when to eat and when to stop eating. Insulin is a "storage" hormone produced by the pancreas in response to a meal. It responds to high blood sugar levels by opening up muscle and liver cells so that glucose may leave the bloodstream. It encourages excess glucose to be stored as energy that can be burned later. During and immediately after exercise, insulin helps turn on protein-building in muscle. During rest, insulin encourages fat storage.Leptin is a hormone that is made by fat cells. When we have a full stomach or an extra few pounds, leptin increases and sends a signal to the brain that we are full. It also speeds up metabolism.CCK comes into play as the stomach is distended with food, especially fatty or high fiber foods, causing the release of bile from the gallbladder and enzymes from the pancreas. CCK also slows stomach emptying and informs the brain we are satiated.Ghrelin is made by an empty stomach and increases appetite while slowing down metabolism. Sleep is a very important suppressor of ghrelin, and poor sleep will increase ghrelin levels leading to increased appetite the next day. Interestingly, ghrelin helps us get into a good sleep cycle, so going to bed with a full stomach and low ghrelin can interfere with sleep. Glucagon is another hormone from the pancreas and is considered as the opposite of insulin. It responds to low blood sugar or a high protein meal by stimulating the release of stored glucose from the liver.

When all goes well our hunger hormones are an elegant system of appetite and metabolism control. During times of feast, leptin signals the brain we are full and turns up metabolism, CCK helps with digestion and turns down appetite, and insulin stores the excess calories.During famine, ghrelin alerts our brain to get moving and find something to eat, while glucagon breaks down stored glucose to provide fuel for the energy to hunt down that next meal.Problems arise because we no longer live in a feast or famine world. In our modern culture we are blessed with all feast and no famine so our hunger hormone system gets pulled out of alignment. Starting with high calorie and nutrient-poor foods, coupled with lack of exercise and topped off with an aging metabolism, we tend to store calories and weight goes up. Once the extra weight builds up, insulin and leptin both become less effective. We keep making more and more but our helpful satiety hormones just quit working as our body becomes more resistant to their effects. As an example, Type 2 diabetics have insulin resistance. Once fat starts building up in muscle and liver tissue, insulin resistance sets in and we can't handle the glucose in the bloodstream. This starts a vicious cycle since high blood sugar leads to high blood triglycerides, while high insulin levels encourage more fat storage. Even the first 10 pounds of extra weight will cause some degree of insulin resistance.Leptin resistance also occurs with weight gain. Similar to the insulin in the diabetic, we make more and more leptin as we gain weight, but it quits working to signal the brain that we are full, thus leading to a cycle of persistent hunger pains.

Help insulin work by cutting out insulin-spiking foods such as sugar and high-glycemic carbohydrates. Eat more complex carbohydrates including greens and other colored vegetables and fruits. Exercise increases insulin sensitivity so take a 15 minute walk after eating. Insulin is hard at work in muscle tissue so include a bit of resistance or strength training. Include protein at every meal for good metabolism, to help stabilize insulin spikes, provide building blocks for muscle and to encourage glucagon release. This means lean meats and fish, eggs, milk, cheese, yogurt and beans.Don't skip breakfast! If you don't take in some calories first thing in the morning, as a "break from the overnight fast," then your body will go into emergency mode, releasing the stress hormone cortisol and breaking down stored glucose for fuel. This causes a quick insulin spike and leads to irregular sugar/insulin balance throughout the day. Insulin spikes lead to insulin resistance whereas the smooth release of insulin from the intake of complex carbohydrates and protein is much more efficient.Try a "wake-up" protein if you don't get to breakfast right away. Whey protein isolate or concentrate in plain water, or mixed in a smoothie, is an excellent complete amino-acid source. I have a serving at 5 a.m., then again in a workout drink about 7 a.m., and finally I get to breakfast about 8 a.m. Studies show that eating breakfast, and especially including protein at breakfast, leads to less hunger and less weight gain.Fats are good! Include healthy fats with every meal to increase CCK activity which will help with feeling satisfied. Cook with heart-healthy oils such as olive and coconut oils. Use unsaturated vegetable oils in salads. Ditch the unhealthy trans-fats and hydrogenated oils. Add nuts such as walnuts, almonds and pecans to cereals or salads, and snack on nuts instead of chips.Target the hunger hormones with supplements. Boost insulin sensitivity with goldenseal, cinnamon, seaweed extracts, alpha-lipoic acid, or chromium. Prescription diabetes medications can help with weight loss. Get leptin working with Irvingia gabonensis, an extract from the African Mango plant. Studies show weight loss starting after about six weeks with this supplement. Also include essential fatty acids in the form of fish oil capsules, a good fiber supplement, a multivitamin, and pancreas enzymes. Last, get plenty of sleep and don't eat a big meal right before bedtime.I resist the use of prescription appetite control drugs due to side effects. Instead, my patients find great success in working with nature's own hunger control hormones.Scott Rollins, M.D., is board certified with the American Board of Family Practice and the American Board of Anti-Aging and Regenerative Medicine. He is founder and medical director of the Integrative Medicine Center of Western Colorado (www.imcwc.com). He is also medical director of Integrative Weight Solutions, a holistic, physician-supervised HCG weight loss program that incorporates expert evaluation for hormone and digestive health imbalances, health coaching, and behavioral support for a powerful and balanced journey to weight loss. For more information see www.integrativeweightsolutions.com or call 970-245-0373 to arrange a free consultation.


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The Post Independent Updated Jan 10, 2013 02:51PM Published Jan 10, 2013 02:49PM Copyright 2013 The Post Independent. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.