Articles

Obesity, Weight Loss

Introduction

Obesity is defined as weight that exceeds 15 percent of normal weight for height and body type. Morbid obesity exceeds 20 percent of optimum weight. Obesity is considered a disease state. Life expectancy may be decreased in overweight and obese individuals. An obese person is at high risk for developing a number of complications, including heart disease, high blood pressure, stroke, varicose veins, psychological stress, osteoarthritis, hyperlipidemia, and diabetes. (1) , (2) However, weight is not the only factor in the development of disease. Body composition, the measurement of body fat and lean muscle mass, is now recognized as an important determinant of health. Body fat has important functions, including providing readily accessible energy during short periods of fasting. Fat is a structural component of organs, the nervous system, and skeletal muscles.

The distribution of body weight is also important. Recent studies have demonstrated that excess abdominal fat increases the risk of some diseases. "Apple" shaped women with waist to hip ratios of 0.8 or more, or waist measurements of 30 inches or more, appear to have a greater risk of developing heart disease and diabetes than "pear" shaped women. (3) The type of fat most insidious to health is the deep visceral fat that cushions the abdominal organs. Increased visceral fat is associated with higher levels of LDL cholesterol and lower levels of HDL cholesterol. It is possible that excess fat metabolism stresses the liver, rendering it less effective in metabolizing cholesterol. Visceral fat is also associated with insulin resistance and increased risk of diabetes. (4)

Obesity is influenced by a number of conditions. Basal metabolic rate, or the amount of energy burned at a resting state, is the major determinant of body weight. The ability of the body to convert energy (in the form of calories) to heat determines the basal metabolic rate. The basic law of thermodynamics states that heat expended must equal energy consumed. An imbalance on either end will result in weight loss or weight gain. Exercise is another determining factor. As lean muscle mass increases, so does the basal metabolic rate. A safe and effective weight-loss program is one that considers the laws of thermodynamics: energy burned must exceed energy consumed, and caloric restriction should be accompanied by exercise to maintain lean muscle mass.

Obesity can be caused by some metabolic disorders of the endocrine or pituitary systems. The pituitary, the thyroid, and the adrenal glands are important regulators of metabolism. Disorders such as hypothyroidism, hypopituitarism, and Cushing’s syndrome can alter metabolic function and contribute to obesity. Insulin resistance, impaired glucose tolerance, and hyperinsulinemia can increase fat deposition and decrease lean muscle mass, influencing basal metabolic rate.

Some theories suggest that the origin of obesity is genetic. In fact, two obese parents are at greater risk of having children with adult weight problems. (5) This may be due, in part, to learned habits and poor dietary choices in childhood. (6) , (7) Many people with overweight parents successfully manage their weight with diet and exercise once they reach adulthood. Given the astonishing number of overweight Americans, the more likely causes of obesity are behavioral. Overeating and lack of exercise are the principle behavioral factors that lead to obesity. As technology and transportation dominate the 21st century, lifestyles have become increasingly sedentary. (8) Societal pressure to produce and succeed leaves less time to plan and prepare wholesome meals. Advertising promotes processed, high fat, high-sugar, junk foods.

The recent discovery of the adipose-derived hormone leptin has led to advances in understanding the physiology of obesity. Plasma leptin levels correlate with fat stores, linking adipose tissue status with a number of nervous system components. (9) Leptin appears to be an important anti-obesity hormone, as well as regulator of certain neuroendocrine and immune functions. (10) When leptin receptors are stimulated, appetite is suppressed. A deficiency in leptin, or a blockage of leptin receptors has been associated with obesity. Recent animal studies indicate the potential of synthetic leptin or leptin receptor agonists in the treatment of obesity. (11)

Statistic

National Center for Health Statistics, 2002.

  • 64% of adults age 20 years and over are overweight or obese (129.6 million Americans)
  • 30% of adults age 20 years and over are obese (61.3 million Americans)
  • 15% of adolescents age 12-19 years are overweight
  • 15% of children age 6-11 years are overweight

Signs and Symptoms

[span class=alert]The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.[/span]

Obesity is a continually growing problem in most industrial nations. Obesity is also difficult to diagnose due to the lack of any specific, definite definition of the disorder. The body mass index (BMI) is a widely used formula to calculate obesity because body fat is considered within the calculated result. To calculate body mass index for a given height and weight, use the following formula:

BMI = weight in kilograms (pounds divided by 2.2) divided by the square of the height in meters (inches divided by 39.4).

Guidelines created in 1998 state that the BMI must be 24 or less in order for one's weight to be considered healthy. An individual with a BMI 25 to 29.9 is considered overweight. Obese individuals have a BMI greater than 30. (12) Body mass index is associated with overall mortality. Studies have indicated that the greater the BMI in the individual, the greater the risk of death from all causes. Smoking and the presence of heart disease, cancer or other disease increases the risk of death even more in both men and women. (13)

Treatment Options

Conventional

Every year, billions of dollars are spent on gimmicks, diet plans, surgery, and drugs for weight loss. Losing weight, for some people, is a lifelong obsession. Weight loss is extremely difficult for many people. Given a healthy pituitary-endocrine function, weight loss should begin with the fundamentals: consuming less energy than one expends and increasing lean muscle mass through exercise. If there is reason to suspect a fundamental alteration in endocrine or pituitary function, these underlying issues must be addressed. As more discoveries are made about the physiology of obesity, hope improves for the millions who struggle with obesity. The following medications are generally reserved for the morbidly obese, although the desire for a "magic bullet" for weight loss has pressured some health care providers into prescribing them inappropriately.

    Stimulants (Amphetamines) have been prescribed for many years to increase basal metabolic rate and expedite weight loss. However, these drugs have a number of unpleasant side effects, including dry mouth, nervousness, insomnia, and hyperactivity. More serious effects include hypertension, arrhythmias, and dependency. Today, use of amphetamines has been strongly discouraged through various state laws. Sibutramine is a selective serotonin and noradrenaline re-uptake inhibitor that aids in weight loss by increasing appetite-suppressing neurochemicals. In clinical trials, sibutramine has proven effective in improving weight loss, reducing body mass index, and decreasing waist size. (14) Side effects reported, include dry mouth, constipation, and tachycardia. A serious risk factor associated with taking sibutramine is hypertension. At the recommended dose, some patients experienced an increase of greater than 15 mm Hg (systolic) and greater than 10 mm Hg (diastolic) pressures. (15) This agent should be used with extreme caution in those with hypertension. Orlistat is a gastrointestinal lipase inhibitor that works by binding with lipases and preventing the breakdown of ingested fat. The undigested fat is removed in the feces. Orlistat can inhibit up to one third of the fat ingested, substantially reducing absolute fat uptake. A recent clinical trial reported that after one year of treatment, patients receiving orlistat lost an average of 8.5 percent of body weight. (16) In addition to body weight, orlistat patients demonstrated significant reductions in total serum cholesterol, LDL cholesterol, and VLDL cholesterol. Because orlistat blocks fat, there is reduced absorption of the fat-soluble vitamins (A, D, E, and K). Fat-soluble vitamin supplementation is required to prevent depletion of these nutrients. Side effects include increased frequency and urgency of bowel movements, oily discharge, fatty stools, and bowel incontinence.

Nutritional Supplementation


Conjugated Linoleic Acid (CLA)

Conjugated linoleic acid (CLA) is a type of fat that helps to reduce body fat, which has prompted researchers to suggest that it is an obesity-preventing agent. (17) CLA is necessary for the transport of dietary fats into cells where it can be utilized to build muscle or to produce energy. Animal and human studies indicate that the reduction in body fat could be significant. (18) , (19) , (20) These results from these studies indicate that CLA reduces body fat by several mechanisms, including a reduced energy intake, increased metabolic rate, and increased utilization of fats for energy.

Formerly, beef and dairy products contained approximately 3 percent CLA. However, there has been nearly a 70 percent reduction in the amount of CLA in the food supply in the last 40 years, due to changes in how cattle are fed, and people switching from whole milk to low fat or skim milk. Some researchers suggest that the disappearance of CLA in the food chain is one of the reasons why Americans have continued to become fatter.


5-Hydroxytryptophan (5-HTP)

5-HTP (5-hydroxytryptophan): Serotonin is a neurotransmitter that influences appetite and eating behavior. Some diet drugs exert a serotonergic effect. 5-HTP, which is the immediate precursor to serotonin, reportedly has been used successfully to decrease carbohydrate intake and promote weight loss. In one study, 19 obese female subjects were given 5-HTP. The results showed a decrease in food intake, and weight loss during the period of observation. (21) Another human study shows that the use of 5-HTP may improve compliance to dietary requirements in non-insulin dependent diabetes mellitus. (22)


Pyruvate

Calcium pyruvate: Pyruvate is a short, 3-carbon acid that plays a critical role in both the aerobic and anaerobic pathways for the generation of energy in the body. Pyruvate itself is relatively unstable. When combined with calcium, the resulting salt calcium pyruvate is both stable and well absorbed. The largest amount of pyruvate is utilized in the mitochondria in the Krebs cycle.

Pyruvate occurs naturally in the body as the end product of glycolysis, which is the metabolism of sugar or starch. In the mitochondria, pyruvate is then decarboxylated to form acetyl CoA, the starting substance in the Krebs cycle, in the process of energy production. Thus, pyruvate plays a primary role in the production of energy because it "fuels" the energy production cycle. Supplementation with pyruvate can increase cellular respiration or the amount of energy the mitochondria (the cells’ metabolic furnace) uses. The more energy used, the less the body stores, which explains why pyruvate has been used successfully in weight loss programs.


Chromium

Chromium is a mineral that plays a role in the metabolism of carbohydrates and fats as well as in the production of insulin. Chromium enhances insulin’s ability to transport glucose into energy producing cells, which reduces the amount of glucose that gets converted into body fat. (23) In addition to its effects on glucose, insulin, and lipid metabolism, chromium has been reported to increase lean body mass and decrease the percentage of body fat, which may lead to weight loss in humans. Claims that chromium improves lean body mass in humans remains controversial, but this effect has been reported in animal studies. (24) Note that if no chromium deficiency is present, chromium will not have any additional benefit for weight loss.

Herbal Supplementation


Garcinia

The use of garcinia cambogia has been growing rapidly in the United States due to the increased desire of people to lose weight. Unlike appetite suppressant drugs, garcinia has no reported CNS stimulant activity. Research indicates that it may modulate blood fat levels and have a positive effect on energy and metabolism. (25) , (26)

The appetite-suppressant mechanism of garcinia is thought to be due in part to the production of glycogen in the liver and small intestine. (27) The conversion of carbohydrates to fat requires the enzyme, adenosine triphosphate citrate lyase. Garcinia temporarily inhibits this enzyme. (28) At the same time, the liver produces more glycogen. and this sends a satiety signal to the brain. Obese individuals have less glycogen storage and more triglyceride storage than thin individuals. The storage mechanism for glycogen in the peripheral muscle tissue is thought to be defective in the obese and in patients with type 2 diabetes. Studies have reported that individuals using garcinia, combined with niacin-bound chromium and a reduction in dietary fats, had three times the weight loss of those on diet alone. (29) Obesity is often seen in individuals with diets high in refined foods and saturated fat. A recent study reported no benefits in the management of obesity in human subjects when given 1,500mg of garcinia per day. (30) A higher dosage may be required. To date, evidence is not convincing for the use of garcinia alone.


Guggul

Guggul oleoresin has been used in the Indian (Ayurvedic) medical system for centuries as an anti-arthritic, carminative, antispasmodic, diaphoretic, and aphrodisiac. (31) It has also been described as an agent for treating obesity and other eating disorders including "coating and obstruction of channels." (32) In the early 1960's, researchers began to explore the ancient Sanskrit description of guggul being used by Ayurvedic physicians in the management of lipid disorders. After years of research and scientific studies, guggul was approved for marketing in India in 1986 as a lipid-lowering drug. (33) The lipid lowering effects of guggul may be explained by four proposed mechanisms of action. (34) , (35) First, guggul reportedly inhibits the biosynthesis of cholesterol in the liver, interfering with the formation of lipoproteins (LDL, VLDL). Secondly, it may increase the fecal excretion of bile acids and cholesterol, resulting in a low rate of absorption of fat and cholesterol in the intestines. Thirdly, it is claimed to stimulate the LDL receptor binding activity in the liver cellular membranes, reducing serum LDL levels.

Guggul reportedly stimulates thyroid function, which may lead to blood lipid lowering and weight loss. (36) In addition to its lipid lowering effects, guggul has been reported to prevent the formation of atherosclerosis and aid in the regression of pre-existing atherosclerotic plaques in animals. (37) Guggul has also been reported to inhibit platelet aggregation and have fibrinolytic activity, as well as being an excellent antioxidant, preventing the heart from being damaged by free radicals. (38)


Bladderwrack

Fucus, or bladderwrack, consists of the entire thallus of the marine plant Fucus vesiculosus. The fronds are dried as soon as possible after collection in preparation for use as dietary supplements. Bladderwrack is a rich source of iodine, and is traditionally used in weight loss and hypothyroidism. (39) , (40) The low incidence of goiter in maritime people has been attributed to the iodine content in bladderwrack. (41) Bladderwrack also contains potassium, magnesium, calcium, iron, zinc, and other minerals. (42) Historically, bladderwrack has been used in the dairy and baking industries, due to the gelling properties of the constituent algin. Bladderwrack is thought to stimulate the thyroid gland, thus increasing basal metabolism.

Overdosage of iodine may lead to symptoms of hyperthyroidism, including weight loss, fatigue, and frequent soft stools). These symptoms were reported in a 72-year-old female following six months of ingesting a commercial kelp product. (43) Another report of a 24 year old woman developing thyroid goiter after taking a proprietary product, which included 0.4-0.5mg/day of iodine for three months. (44) Use products where the iodine content is assayed to avoid potential iodine toxicity problems.


Ephedra/Ma-Huang

Ephedra has been used traditionally for thousands of years in China, with its uses including acute nephritis, asthma, and other lung problems, colds and flu, fever, chills, lack of perspiration, headache, nasal congestion, wheezing and cough among others. (45) , (46)

Ephedra supplements have been under intense scrutiny in the past few years due in part to the irresponsible use of ephedra products by some individuals, and also due to the inappropriate advertising of ephedra products by some manufacturers. Some ephedra- containing products exist on the market that should not be recommended by healthcare professionals, including those for sexual enhancement, increased energy, and herbal "ecstasy". A recent laboratory animal study of one of the "herbal ecstasy" products reported that this ephedra product might actually produce an amphetamine-like stimulus. (47)

Ephedra was actually banned in Texas in 1996 in lieu of approximately 500 reports of adverse events in persons who consumed dietary supplement products containing ephedrine and associated alkaloids (pseudoephedrine, norephedrine, and N-methylephedrine) for a almost a two-year period. (48) Many State Boards of Pharmacy have impending action against the sale of ephedra-containing products. Some of these reported adverse events were due to abuse as stated, yet some were also from healthy individuals and individuals with pre-existing health problems. Ephedra has been used for thousands of years without significant health problems and when used responsibly, ephedra can be a useful clinical agent. Individuals with pre-existing healthcare problems should only use ephedra-containing products under the supervision of a physician. Individuals should also have regular check-ups with their doctor when taking this supplement. Be aware of the potential for abuse with the use of this dietary supplement.

The effects of ephedra are attributed to the alkaloids, including ephedrine and pseudoephedrine. (49) Ephedra alkaloids are potent sympathomimetic agents, stimulating b-1 and b-2 adrenergic receptors and the release or norepinephrine. The biological effects of ephedra at various dosages may include CNS stimulation, peripheral vasoconstriction, elevation of blood pressure, bronchodilation, cardiac stimulation and increased pulse rate, decrease in intestinal tone and motility, mydriasis, and tachycardia among others. (50)

Products containing ephedra and the alkaloids ephedrine and pseudoephedrine are reported to increase weight loss due to appetite suppression and a thermogenic activity. In combination with methylxanthines such as caffeine, ephedra and its alkaloids may improve fat loss by dual actions: a central suppression of appetite and peripheral stimulation of energy expenditure covered by fat oxidation. (51) , (52) In a comparative trial, the weight loss produced by ephedrine and caffeine was similar to that of dexfenfluramine. (53) A laboratory animal study reported that the administration of ephedrine and caffeine promoted weight loss through an increase in energy expenditure, or in the more obese animals, a combination of an increase in energy expenditure and a decrease in food intake. (54) Also, the addition of aspirin to ephedra weight loss formulas may markedly potentiate the thermogenic properties of ephedra alkaloids, effects that led to a normalization of body composition of the obese to that of the lean. (55) More research on sympathomimetics and methylxanthines should be carried out to identify combinations with improved efficiency and safety. Of interest is that in one study, ephedrine plus caffeine produced a decline in total cholesterol levels and maintained HDL levels. (56) These clinical studies are conducted with the isolated constituent ephedrine, but the herb ephedra contains this alkaloid in levels of 30-90%, and a standardized dose should provide approximately 8mg of alkaloids. (57)

Acupuncture & Acupressure

Acupuncture
One study treated 68 cases of obesity by applying acupunture treatment to Tien Shu (St 25), Zhong Wan (Ren 12), Qi Hai (Ren 6), Tai Yuan (Lu 9) and the otopoint Shen Men (H 7) and those related to the large intestine. The study reported a total effective rate of 94.1%. (58)

Another study treated 26 cases of obesity by applying acupuncture on the following bilateral acupoints: Qu Chi (LI 11), Tian Shu (St 25), Zu San Li (St 36), Yin Ling Quan (Sp 9) and Tai Zhong (Liv 3). The reducing maneuvering method was used and the needles were retained for 30 minutes after insertion. Ten daily sessions constituted one course of treatment. The results: after 4-8 courses of treatment, 5 cases were cured, 11 significantly improved, 6 improved, and 4 cases did not respond to the treatment, with a total effective rate of 84.6%. (59)

Otopuncture
In treating 50 cases of obesity, one study applied otopuncture to Shen Men (H 7) and otopoints related to the following areas: endocrine, spleen, stomach, muscle point, tri-jiao, subcortex, and ovary. The needles were buried in the otopoints and fixed with adhesive plaster. Moreover, 15 minutes before meal, 3-4 otopoints were selected and pressed with fingers about 50 times. The otopoints picked for pressing were alternated between the ears and changed every 2-3 days, and one course of treatment last 16-24 days. The results: 7 cases significantly improved, 35 cases improved, and 8 cases did not respond to the treatment, with a total effective rate of 84%. (60)

Otopoint-plastering and -pressing therapy
In treating 45 cases of obesity, one study applied a plaster made with vaccaria seeds (Semen Vaccariae) to Shen Men (H 7) and otopoints related to the large intestine, constipation point, endocrine and tri-jia. In addition, otopoints related to the sympathetic system, small intestine, spleen, stomach, mouth, esophagus, brain point and adrenal gland received supplemental treatment. A new plaster was used every three days, and one course of treatment lasted one month. The results: 30 cases significantly improved, 10 cases improved, and 5 cases did not respond to the treatment. (61)

Similarly, another study treated 54 cases of obesity by applying a plaster made with vaccaria seeds (Semen Vaccariae) to otopoints related to the mouth, stomach, spleen, tri-jiao, lung, large intestine, endocrine, muscle point and subcortex. In addition, the constipation point and points related to the abdomen and the hip were treated as points directly related to the condition. Each otopoint was pressed for 50-60 times 30 minutes before meal. A new plaster was used every three days, and one course of treatment called for the application of 10 plasters. The results: 6 cases significantly improved, 42 cases improved, and the remaining 6 cases did not respond to the treatment, with a total effective rate of 88%. (62)

Treatment with laser radiation on acupoints
One study followed TCM’s differentiation treatment theory in treating 384 cases of obesity with acupoint laser radiation. Patients with spleen insuffiency and accumulation of dampness due to qi deficiency were treated on Qu Chi (LI 11), Lie Que (Lu 7), Shui Fen (Ren 9), Tian Shu (St 25), Guan Yuan (Ren 4) and San Yin Jiao (Sp 6), supplemented with treatment on otopoint related to the spleen, lung, abdomen, and tri-jiao; patients with yang-ming interior heat and obstruction of dampness were treated on Qu Chi (LI 11), Zhi Gou (SJ 6), Fu Jie (Sp 14), San Yin Jiao (Sp 6) and Nei Guan (P 6), supplement with treatment on otopoints related to the lung, tri-jiao, large intestine, and the lower section of rectum; and patients with dysfunction of Chong, Ren, and Dai Meridians were treated on Qu Chi (LI 11), Guan Yuan (Ren 4), Si Man (K 14), Dai Mai (GB 26) and San Yin Jiao (Sp 6), supplemented with treatment on otopoints related to the kidney, spleen, endocrine, uterus, and the lower section of rectum. The radiation treatment was administered daily, twelve sessions constituted one course of treatment, and the patients were rested for 7-10 days between courses of treatment. The results: after three courses of treatment, 38 cases were cured, 219 cases significantly improved, and the remaining 127 cases improved, with a total effective rate of 100%. (63)

Traditional Chinese Medicine

Obesity, Weight Loss

Extensive information regarding the treatment of this health condition using Traditional Chinese Medicine is available through the link above.

Diet & Lifestyle

    Including aerobics and even more specifically weight training routine to build muscle mass. Muscle mass burns more calories per gram of weight. Try to live an active lifestyle; take stairs instead of escalators when possible. Drink a minimum of eight glasses of water daily. High fiber diet. Reduce or eliminate high refined sugar and refined carbohydrate intake. These foods tend to be calorie dense and nutrient poor. Eliminate trans fatty acids from the diet. Do not over indulge in carbohydrate rich foods. Eat plenty of fresh fruits and vegetables. Chew food thoroughly. Stop eating when the first feeling of satiety takes place. Try not to eat large meals before bedtime.

Clinical Lab Assessment

Some of the following laboratory testing can provide information necessary for diagnosis and treatment. In addition, the tests listed may also give insight to functional metabolism and functional nutrient status in the body.

Adrenal Function Profiles

Stress activates the HPA axis and has impact on the immune system, particularly through the adrenal hormones. In assessing the HPA axis, adrenal functional abnormalities are relatively simple to identify and address (e.g. when compared to hypothalamic dysregulation or pituitary imbalance).

Amino Acids

Deficiencies or imbalances in amino acids can indicate fundamental reasons for dysfunctional carbohydrate metabolism. Amino acid malabsorption syndrome or imbalanced amino patterns reflect abnormal organ and glandular processes that have critical bearing on optimal function. Methionine, homocysteine and key amino acid components of the energy production cycle (CAC) are particularly important factors in maintaining optimal liver detoxication capability, cardiovascular performance, emotional stability, and physical activity. In addition, in diabetic individuals, amino acids do fluctuate with insulin administration and supplementation may be indicated. Carnitine deficiency results in impairment of fatty acid oxidation and the failure of gluconeogenesis, resulting in hypoglycemia.

Allergy and Food Sensitivity Response Assessment

The severity of allergic response correlates with an increase in stress levels. (64) Allergies may have considerable impact on inflammatory processes. Direct correlation of impaired digestion or food allergic response is controversial, though some case studies manifest improvements on food elimination diets. Alternative methods of addressing allergic sensitivities begin with thorough assessment of sensitivity responses. The aspects of mineral uptake and utilization, critical to immune response, compel thorough evaluation of influences on digestive function, including food sensitivity response.

Cortisol

Plasma or salivary cortisol measurements can be used as a marker in the evaluation of stress syndromes and dysglycemia that may relate to excessive weight gain or impaired weight loss. Inversions in the circadian pattern of cortisol production can reflect a stress-induced disorder of carbohydrate metabolism. This pattern has been observed in psychiatric outpatient diabetics. (65)

Dehydroepiandrosterone (DHEA)

DHEA may have significance in the weight control processes. Serum or saliva provide useful monitors of these values.

Glucose

Blood glucose levels vary in response to food intake, stress, physical exertion, and various disorders. Elevations of serum glucose should lead to confirmatory testing such as fasting, insulin, serum phosphorus, magnesium, hemoglobin A1c, and/or fructosamine.

Hormone Assessment

Insulin: This hormone lowers blood glucose and promotes glucose storage by stimulating the synthesis of glycogen and fatty acids. Following a meal, carbohydrates stimulate the pancreatic cells to release insulin. Insulin is used in the synthesis of fatty acids and ultimately triglycerides. Stress produces an increase in cellular insulin resistance. This results in an increased production of insulin secretion and interference with optimal function. (66) The two major pathways of glucose formation in the liver (glycogenolysis and gluconeogenesis) are regulated by insulin. Glucose and insulin levels generally vary in parallel; thus a measure of fasting insulin will offer information regarding carbohydrate metabolism. In insulin insensitivity syndromes, insulin will provide a more sensitive marker of carbohydrate metabolism abnormalities than fasting serum glucose. As beta cells release insulin, an equimolar amount of metabolically active C-peptide is also produced. Measuring C-Peptide provides an index of beta cell activity independent of insulin concentration that is elevated by the administration of exogenous hormone.

Clinical Notes

Weight loss is a complex and dynamic metabolic process. Check organic acids, improve the gut integrity, and then look to subclinical hypothyroidism and food allergies. Taking the steps to limit refined sugar and carbohydrate intake and then following a low antigen diet will achieve some results for many individuals. The evaluation of the metabolic process related to Syndrome X, meaning cortisol (stress), hyperinsulinemia, hyperlipidemia, is of primary health concern for the obese.

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