Wait Out The Weight?

Is weight gain (or lack of weight loss) the bane of your existence? Do you find yourself at times being told to simply “give it more time”? Weight management was right up there with fatigue for me for many years. One of the many things I love about BHRT is getting to the “root cause” of the problem. There is no doubt that fixing fundamental hormonal imbalance is a key in managing a person’s weight. Sometimes weight gain can actually be good. These patients many times are adding muscle mass to their frame. In my practice, we preach how muscle mass is the currency of aging and how preventing sarcopenia is critical to a healthy life.

But why is it that my patients still can not lose body fat despite the fact that I have fixed their hormonal imbalance, improved their nutritional status, and got them moving at the gym? The answer may be still hormonal imbalance. The hormone we must check in these patients is insulin. A fasting insulin level is an inexpensive yet vital lab to check and follow in your patient base. In my practice, all patients have this lab monitored just like I will with their testosterone levels.  Did you know 1 of 3 Americans are actually prediabetic? Finding early insulin resistance, while the glucose is still normal but the insulin is elevated (>8 fasting) is crucial to your patient’s overall health. Insulin resistance is a disease and must be treated as such.

So what is an effective way besides nutrition and exercise to treat my patient’s body fat issues? We should attack that “root cause” issue again. My practice is largely based on hormonal balance combined with peptide optimization. Peptides are chained amino acids that act as signaling agents. One of my favorite peptides for weight loss is Semaglutide. Semaglutide is a GLP-1 agonist that truly treats the root cause of insulin resistance. Semaglutide increases intracellular AMP (cAMP), improves AMPK signaling, and improves GLUT4 translocation to the plasma membrane. In essence, we are reversing the insulin resistance issues. This will allow our patients to finally lose the body fat they need to shed but at the same time removing major future obstacles with their health journey.

It is essential for the success of any weight management program to have objective data to measure changes in body composition. I have found the Inbody 570 provides our office with the ability to monitor fluctuations in a patient’s weight, muscle mass, and percent body fat that occur visit to visit. By regularly reviewing this information with our patients, we can adjust their weight loss program and keep them motivated to achieve their goals.

The following is an example of “typical” patient journey that begins with an elevated fasting insulin. A 44-year old mother of two children who is an avid exerciser and consumes a relatively healthy diet, but despite proper BHRT she could not lose body fat. The patient’s success, after adding Semaglutide, speaks for itself below. 

 

Note: This article by Dr. Wusterhausen was shared from Biote Medical. 

 

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