Bulldog Weight Loss The Impact of Physical Therapy on Weight Loss
Why Does Therapy Help You Lose Weight?
Why Does Therapy Help You Lose Weight?
Nearly 70% of adults in America are considered overweight or obese. With the number of overweight individuals growing every year in this country, it is becoming more obvious that the traditional routes of weight-loss (diets, exercise, etc.) are not cutting it. But the issue with being overweight is not simply aesthetics in terms of body shape and size. Being overweight is a serious health risk as it can lead to other medical problems such as diabetes, high blood pressure, sleep apnea, kidney disease, certain types of cancer, and many more. Not only does being overweight increase the risk for medical/physical problems, but also mental health problems. In general, people who are overweight tend to struggle with low self-esteem, increased anxiety, and depression. Clearly, being overweight can significantly impact a persons life, and seeking a non-traditional approach to weight loss might be the key to success.
Weight loss therapy is a form of cognitive behavioral therapy (CBT), which is an approach to psychotherapy used to treat a multitude of issues. Cognitive behavioral therapy helps people increase awareness to, and eventually challenge and change, the negative cognitions (or thoughts) that often drive the unhealthy behaviors. CBT can also help people get to the core of the problem, as the relationship with food is often just the symptom of a deeper issue.
Recently, the scientific and medical communities have begun to sing the praises of CBT for weight loss benefits. Several large profile studies have detailed the effectiveness of cognitive behavioral therapy as a supplement to traditional diet and exercise. The studies have shown that patients using CBT in addition to diet and exercise showed more dramatic and long-lasting changes to their overall body composition than those that used just diet and exercise, or just cognitive behavioral therapy.
While CBT can be a great addition to ones weight loss journey, it is not necessarily a substitute for healthy lifestyle decisions such as getting appropriate amounts of exercise or choosing foods that support the weight loss goals.
Methods Used in Weight Loss Therapy
Upon the initial meeting with a weight loss therapist, they will likely conduct an assessment. An assessment typically consists of questions about physical and mental health history, relationship to food, and lifestyle choices.
Long-term goals for weight loss and food/exercise will also be established in the initial session. In subsequent meetings, the long-term goals will be broken down into smaller steps to create a sort-of action plan as to how the goals will be achieved. Through a series of lifestyle changes including meal planning (which is individually tailored to the client and their specific goals), and following an exercise program, weight loss can be achieved. In addition to lifestyle changes, working with a weight loss therapist can help increase ones understanding about their relationship to food, and identify any underlying issues that might contribute to weight gain, overeating, negative body image, etc.
Although all therapists are different, CBT for weight loss typically involves one or many of the following approaches or strategies:
- Goal setting
- Self-monitoring
- Feedback and reinforcement
- Increasing personal motivation and belief in self
- Incentives
Upon achieving weight loss/body composition goals, the therapist may continue to guide you on healthy lifestyle choices, and tools and skills to help with maintenance.
Post-Pandemic Impact on Weight Loss TeleTherapy
The pandemic and subsequent lockdown required everyone to find creative ways to connect and continue working, attending school, and engaging in daily life.The same can be said for mental health and medical services. Shifting from in-person meetings to online left many skeptical about the efficacy of telemedicine appointments, especially when it came to modalities like weight loss therapy. Yet, post-pandemic research indicates much of the skepticism was unwarranted.
In fact, many benefits were found with using telemedicine includingease of access and increased weight loss. Tele-therapy proved essential for those in more rural communities; as well as allowed for the possibility of longer-term interventions; participation in groups; and for many was the preferred format.More significantly multiple studies showed participants in weight loss therapy were more likely to lose up to 5% of their body weight when participating in telemedicine sessions when compared to regular, in-person sessions. More research continues to emerge, but initial studies show weight loss therapy delivered via telemedicine can lead to clinically significant weight loss, greater access to services, and an overall increase in participation.
Why Hire a Therapist?
Many who struggle with extra weight or obesity have a significantly difficult time losing weight, likely trying multiple methods, such as programs like Weight Watchers and Jenny Craig, or through attempts at following a diet and exercise plan. Trying to lose weight can be a frustrating and overwhelming process, but you do not have to do it alone. Asking for the support of a weight loss therapist might be the next step.
Finding a qualified therapist can help to hold you accountable and assist you in achieving your goals.
In addition, if you struggle with body image issues or your relationship to food, therapy is vital. Issues such as emotional eating are difficult to conquer alone. Emotional eaters may rely on food for a variety of reasons, from seeking comfort to using food as a way to cope with difficult feelings, or even using food as a way to punish themselves. Emotional eaters, whether they recognize it or not, use food to satisfy some deeper-rooted emotional issue(s), and are essentially feeding their emotional hunger rather than physical hunger needs. Unfortunately, many emotional eaters end up feeling powerless over food, and thus, find it near impossible to make any change without outside help.
What to Look for When Finding a Therapist
When searching for a therapist, its important to look for one that is the best fit for your needs. Meet with more than one therapist if they exist in your area, and choose the one that you are happiest with and that you believe will be the biggest asset in helping you lose the weight, for good. Search TherapyTribe to find a weight loss therapist near you.
References
- Castelnuovo, G., Pietrabissa, G., Manzoni, G., et. al. (2017). Cognitive behavioral therapy to aid weight loss in obese patients: Current perspectives. Psychology Research and Behavior Management. 10, 165-173.
- Miller, W., Koceja, D., & Hamilton, E. (1997). A meta-analysis of the past 25 years of weight loss research using diet, exercise, or diet plus exercise intervention. International Journal of Obesity. 21, 941-947.
- van Strien, T., (2018). Causes of emotional eating and matched treatment of obesity. Current Diabetes Reports, 18(6), 35.
- Ufholz K., & Bhargava, D. (2021) A review of telemedicine interventions for weight loss. Current Cardiovascular Risk Rep. 15(9):17
Hormone Replacement Therapy and Weight Loss: What Should I Know?
Hormone Replacement Therapy and Weight Loss: What Should I Know?
Medically reviewed and edited by
Dr. Danielle WeissNovember 29, 2022 4 min
Research has shown a link between estrogen levels and obesity in menopausal women.
Postmenopausal women those who have been through menopause experience higher rates of obesity than men of the same age.
Hormonal imbalances are responsible for many of the changes women experience during menopause, and hormone replacement therapy may be able to help.
In this article, we'll discuss hormone replacement therapy, how it is linked to weight loss, its benefits and risks, and alternatives.
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How Do Hormones Affect My Weight?
Hormones regulate almost all the functions in the human body. They are essential for ensuring healthy growth and development, and they also regulate our mood and sleep cycles.
As women grow older, hormones that are essential for controlling weight, such as estrogen and testosterone, decrease. So it becomes increasingly difficult to get rid of excess weight and body fat especially abdominal fat.
All hormones are important and a hormonal imbalance can cause many health problems, including decreased bone mass, insulin resistance, high blood pressure, and weight gain.
Estrogen is one of the main hormones that regulate weight, but there are many others that also play an important role when it comes to weight loss.
Testosterone
Although testosterone is generally thought of as a male hormone, women also produce it.
It is essential for preventing fat storage in the abdomen. Low testosterone is associated with sugar cravings and insulin resistance.
Estrogen
Falling estrogen levels can result in weight gain as estrogen is responsible for regulating glucose and controlling where fat is stored.
Decreased estrogen can cause increased belly fat even if you dont have weight gain elsewhere.
Insulin
If your insulin levels are high, your body is unable to burn fat. And instead, it stores it in the body.
So when your insulin level increases due to insulin resistance which can arise because of low estrogen levels weight gain occurs.
Progesterone
While progesterone doesnt directly impact weight gain, when there is an imbalance of estrogen and progesterone, the body may retain more fluid this can result in a bloated appearance.
Cortisol
Together with adrenaline and noradrenaline, cortisol is the main hormone that controls the bodys response to stress.
It is essential for survival, but it also increases your appetite especially cravings for sweet, salty, or greasy foods.
What is Hormone Replacement Therapy (HRT)?
Hormone replacement therapyalso called menopausal hormone therapy or estrogen replacement therapyis a treatment that relieves the symptoms of menopause.
The two main hormones used in HRT are estrogen and progesterone.
Both hormones are typically administered during therapy, but estrogen-only therapy may be prescribed for those whove had a hysterectomy (womb or uterus removal).
Testosterone may also be prescribed in HRT as it aids fat loss, improves sex drive, and increases muscle mass.
How Does Hormone Replacement Therapy Work?
When menopause begins, the body produces less estrogen and progesterone, which causes several bodily changes weight gain is often one.
To reduce some of the effects of menopause, you can ask your doctor about starting hormone therapy. Hormones used in HRT may be synthetic or bioidentical hormones.
What are the different types of hormone replacement therapy?
There are many forms of HRT, and they all have their own advantages and disadvantages. Your doctor will talk you through the different options before you start treatment.
Some ways HRT may be administered include:
- Tablets
- Skin patches
- Estradiol gel or spray
- Implants inserted under the skin
- Vaginal estrogen, such as a cream or ring thats inserted
- Testosterone gel
Your age, the regularity of your period, and other risk factors will be considered when deciding which hormone therapy is best for you. An endocrinologist (hormone specialist) can best advise you.
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How long does it take for hormone therapy to work?
It may take a couple of weeks before you start to feel the effects of hormone replacement therapy.
Your doctor may recommend a 3-month trial with HRT, and your dosage may be adjusted based on your bodys response.
Key Point: What is Bioidentical Hormone Replacement Therapy?
Also called natural hormone therapy, bioidentical hormone replacement therapy uses plant-based hormones that have the same structure as our own hormones.
Synthetic hormones that are traditionally used in HRT, have been chemically altered and do not resemble natural hormones.
The FDA has approved certain brands that use bioidentical hormones, and some evidence shows that some bioidentical hormones may be safer than synthetic hormones. For example, progesterone may be safer than progestin.
Why Should I Consider Hormone Replacement Therapy for Weight Loss?
If you've tried to lose weight the traditional way by exercising, reducing calories, and eating a balanced diet and nothing seems to be working, you may benefit from HRT.
Hormone replacement therapy can be a great weight loss solution if:
- You gained weight when you started menopause
- You have excess abdominal fat
- You have any of the other symptoms that accompany menopause, such as night sweats and hot flashes
- You stopped menstruating at an early age
Key Point: What About Hormone Replacement for Men?
Men, much like women, also experience menopause which is sometimes called male menopause or andropause.
Andropause is characterized by low testosterone levels which may be rectified with testosterone replacement therapy (TRT).
However, this treatment is not approved by the FDA for use in men who experience a decrease in testosterone due to age.
TRT is only approved to treat other causes of hypogonadism, where the body cannot produce enough testosterone due to a genetic disorder, medication, injury, infection and other causes.
What Are the Benefits of Hormone Replacement Therapy?
Hormone replacement therapy can rebalance your hormones and help your body to function normally again. Simply put, HRT can help you feel like yourself again.
Those who start hormone replacement therapy can expect to:
- Experience less severe symptoms of menopause
- Have an improved sex drive
- Experience less vaginal dryness and discomfort
- Lose weight and reduce body fat especially belly fat
- Feel less anxious and have fewer mood swings
- Sleep better
- Experience less chronic pain
- Have a reduced risk of heart disease and dementia
- Enjoy softer, smoother, and more youthful skin
- Improve or protect bone health
- Reduce colon cancer risk
What Are the Risks or Side Effects of Hormone Replacement Therapy?
Although hormone replacement therapy offers several potential benefits, like any other treatment it also comes with risks and side effects.
Some initial side effects of hormone replacement therapy that may pass within the first three months of treatment include:
- Indigestion, stomach cramps, or bloating
- Headaches and nausea
- Feeling sick
- Swollen or tender breasts
- Skin irritation
- Irregular menstruation
Women who use hormone therapy typically stay on the treatment for five years or fewer.
Long-term usage of HRT carries an increased risk of the following side effects:
- Heart attacks
- Strokes
- Blood clots
- Breast cancer
Key Point: What is the Link Between Cancer and Hormone Replacement Therapy?
An observational study conducted by the Womens Health Initiative found that:
- Estrogen-only HRT lowers the risk of breast cancer.
- Combination HRT which uses estrogen and progesterone or progestin slightly increases the risk of breast cancer depending on type or hormone, length of treatment and other factors
Women with a family history of breast cancer should not consider hormone replacement therapy and should consult their doctor about alternate treatments.
What Are Some Signs of Hormone Imbalance?
If youve been struggling to lose weight and the scale wont budge no matter how hard you try, you may be experiencing a hormonal imbalance.
Here are some symptoms to watch out for:
- Irregularities in the menstrual cycle, such as missed periods
- Sleep disturbances, such as struggling to fall asleep or waking frequently
- Acne that wont go away
- Excessively dry skin
- Difficulty remembering things
- Bloating, nausea, constipation, diarrhea, and other digestive problems
- Stomach cramps or back pain during a period
- Chronic fatigue
- Depression
- Mood swings
- Chronic headaches
- Low sex drive
- Vaginal dryness and changes in the shape and density of breast tissue
- Joint pain and/or fractures
Do I need to check my hormone levels?
You can have your hormone levels tested at a doctors office or with an at-home hormone test kit. However, if youre already displaying symptoms of menopause, it isnt necessary.
According to the North American Menopause Society, hormone levels tested during perimenopause (usually the period between ages 40 and 45) are not typically accurate, as hormone levels fluctuate too much.
However, a hormone test may provide useful fertility insights when menstruation stops too early.
What Else Could Be Preventing Me from Losing Weight?
If youre struggling to lose weight, your hormone levels may be responsible for those extra pounds or it might be those late-night snacks or all those Frappuccinos with extra cream.
Below are some other reasons why you may be gaining weight:
- Youre not eating a balanced diet
- Youre consuming too many calories
- Youre drinking too many sugary drinksor consuming empty calories
- You arent getting enough quality sleep
- Your stress levels are too high
- Youre not getting enough physical activity
- You have a medical condition such as depression or hypothyroidism thats making you gain weight
Before seeking hormone replacement therapy, determine whether a few simple lifestyle changes can help you lose the extra pounds.
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Who Should Not Have Hormone Replacement Therapy?
While hormone replacement therapy can be really beneficial to some women, a doctor may advise against this course of treatment for those who:
- Come from a family with a history of blood clots, or ovarian, uterine, or breast cancer
- Have uncontrolled high blood pressure, or liver or heart disease
- Are currently pregnant
- Experience unusual vaginal bleeding
- Are smokers
What Are Some Alternatives to Hormone Replacement Therapy?
If youre someone who's not a suitable candidate for HRT, but you still want to regulate your hormones for weight loss and other benefits, you may want to explore the following options:
- Alternative medicine treatments, such as acupressure and acupuncture
- Herbal medicines, such as essential oils
- Medical treatments that can rebalance hormones, such as antidepressants
- Lifestyle changes, such as a healthy diet and increased exercise
- Homeopathic remedies
When Should I See a Doctor for Weight Gain?
If youve experienced sudden or unintentional weight gain, you should seek medical attention.
Maybe you've just been snacking more often due to stress in which case, more mindful eating and a good meal plan may solve the problem.
However, if your hormones are causing weight gain or you have a more serious underlying medical issue, only a healthcare professional can help.
If eating moderately or incorporating more exercise into your routine doesn't change the way you look and feel, get in touch with a doctor.
Dr. Weiss earned her MD from NYU School of Medicine, completed her residency at Scripps Mercy San Diego, and an endocrinology fellowship at Stanford University. Shes Board Certified in both Internal Medicine and Endocrinology, Diabetes, and Metabolism.
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