Obesity

How You Can Help Your Patients Navigate This Health Crisis

By Jaime Hunt, BA, editor

Most practitioners recognize that obesity is a growing health concern. With 17 percent of adults having a body mass index of 30 or higher — the standard set by the National Institutes of Health for obesity — an increasing number of patients seeking health care will have extra weight as a possible contributing factor.

In addition to increasing a patient’s risk for a number of diseases and conditions, including fatty liver disease, diabetes, certain cancers, and osteoarthritis, obesity can complicate treatment. An obese patient is more difficult for a person with an average or small frame to adjust and longer needles are required when using acupuncture.

In light of growing obesity concerns, “Northwestern Naturally” interviewed a doctor of chiropractic, an acupuncturist, and a naturopath about their viewpoints on obesity and how they treat it in their practices.

A Body-Mind-Spirit Approach

The traditional Chinese medicine perspective of obesity is quite different from the Western perspective. According to Barb Gosse, MSOM, LAc, associate dean of the Minnesota College of Acupuncture and Oriental Medicine, obesity is caused by an accumulation of “damp,” or phlegm.

“Fat may begin as an accumulation of dampness in the digestive system, and as it progresses pathologically, it may become the consistency of phlegm and turn into fat tissue,” says Gosse.

According to Gosse, an accumulation of damp can be caused by eating incorrectly or by a malfunction in the body’s ability to metabolize fluids. Dietary counseling along with traditional Chinese medicine may help people who are struggling with their weight.

About 50 percent of her patients are struggling with being overweight, says Gosse, although weight typically isn’t their primary complaint when visiting her office. The number of overweight patients doesn’t surprise her given the difficulty Americans have eating in a way that doesn’t result in a build-up of damp.

“Generally American’s eat very processed foods,” says Gosse. “These foods contain many chemical preservatives and have generally cooked the original nutrition out of the product. The product then must be fortified. It is my belief that eating a diet of unprocessed, organically grown, and hormone-free foods allows the body to utilize nutrition more efficiently.”

For each patient she says, Gosse does a traditional Chinese medicine assessment and provides dietary counseling based on traditional Chinese medicine theories. As part of that assessment, she may determine if acupuncture or herbal medicine would help with the weight problem.

For example, if a patient has a psychological addiction to food, Gosse can use auricular therapy — that is, needling the ear — to help the person overcome their cravings. Additionally, Gosse often prescribes herbs or other traditional Chinese medicine therapies based on an individual’s needs.

“Chinese medicine can provide a natural way of losing weight,” says Gosse. “The body-mind-spirit can’t be separated and Chinese medicine address body-mind-spirit together to help people lose extra weight.”

Gosse believes that the United States is poised to see a backlash against the food industry and a surge in healthier food, both of which could help bring an end to the growing obesity problem.

“We will begin to see the side effects of the gastric bypass surgeries within the next five years,” says Gosse. “People will begin seeking treatments for obesity that are more natural.”

What’s Your Dosha?

That’s what Amrit Devgun wants to know when an overweight or obese person walks into her treatment rooms. Devgun, ND, practices both naturopathic and ayurvedic medicine at Northwestern’s Woodwinds Natural Care Center. She believes that ayurvedic medicine has a unique approach to obesity.

According to ayurveda, each person has a unique mix of three mind/body principles that create specific mental and physical characteristics. The three principles are called “doshas.”

Devgun says that in her practice, she tailors her weight loss recommendations around her patients’ doshas.

“Two people struggling with their weight could have two totally different recommendations based on ayurveda,” says Devgun. “According to a person’s body type [dosha], that determines what type of exercise they should do and what time of day they should exercise.”

According to Degun, people with the Kapha body type, which is most prone to being overweight, may need to exercise more than once a day at specific times and for longer periods. Additionally, because that body type often has a hard time absorbing liquids, they need to be careful not too consume too much water with their meals. Devgun recommends fewer than four ounces.

She also recommends to Kapha patients that they include a large amount of ginger in their diets to improve their digestive fire. However, patients who do not have a Kapha body type would suffer from heartburn if they consumed too much ginger, making it important to have a correct dosha identified.

In addition to making recommendations based on ayurvedic medicine, Devgun offers these suggestions to overweight patients:

• Combine food properly. Protein and carbs should be combined with vegetables, but should not be combined with one another. “Proper food combinations are important,” she says. “If you are at a restaurant, order your carbs first, then order your entrée with protein and vegetables.”
• Eat thoroughly. Never take a bite without completely chewing and swallowing the previous bite.
• Be with your food while you are eating. Don’t watch television or work while eating. Instead, says Devgun, focus on being present with the meal. Breathe in its scents, which stimulates the digestive functions, preparing the stomach for the presence of food and ensuring the food will be digested.
• Give your body visual clues that you are full. Use smaller plates and wait five minutes after eating before deciding to have a second helping.

‘Five Pounds or 50’

Link Larson, DC, who teaches a section on obesity in his endocrinology class, says he believes that the same weight loss approaches can be used whether a patient is five pounds or 50 pounds overweight.

“One thing people should consider is eating six small meals a day: three meals and three snacks,” says Dr. Larson. “They need a nice, even level of blood glucose. Most diet programs force you into that model. Those diets create the structure people need.”

Dr. Larson also encourages his overweight patients to exercise. Simply walking a few times a week can be enough to ramp up a person’s metabolism, he says.

For Dr. Larson, however, it is not the number on the scale that determines whether a patient needs to lose weight, but the impact the weight has on their lives. Patients who are unable to do the things they used to do are the ones who need intervention.

“A person can be overweight and be healthy,” says Dr. Larson. “It’s all about how a person feels. Maybe someone wants to lose 50 pounds so they look like they did in high school, but after losing 30, they may feel great.

Resources on Obesity

MedlinePlus, A Service of the U.S. National Library of Medicine and the National Institutes of Health: http://www.nlm.nih.gov/medlineplus/obesity.html

The Obesity Society: http://www.obesityresearch.org/

The American Obesity Association: http://www.obesity.org