Obesity is often triggered and perpetuated by metabolic and hormonal
imbalances that create a viscious cycle of chronic dysglycemia, reduced
thermogenesis, and altered fat production. This type of chronic metabolic dysregulation can make it very difficult to lose weight effectively without first addressing key functional imbalances.

Glucose and insulin are primary players in the etiology of obesity. The balance between glucose and insulin in the blood can influence levels of leptin, the "hunger hormone" believed to play a strong role in regulating human appetite and metabolism.1 Insulin is released in response to rising blood glucose, and transports glucose to cells, where it can be used for fat production. So it comes as no surprise that upper body fat and abdominal obesity are strongly associated with "insulin resistance," a condition that arises when cell receptors resist insulin's attempt to deposit glucose, resulting in hyperinsulinemia, a state of chronically high levels of insulin.

In fact, some researchers have suggested that consistently high insulin
levels, both fasting and after eating, may actually instigate the metabolic process associated with obesity by increasing lipid levels in the blood.2-4

Glucose levels are also very important. Disruption of glucose metabolism
can lead to bouts of hypoglycemia (periods of low blood sugar), which are often accompanied by intense cravings for foods and sweets. This imbalance may then promote an unhealthy pattern of binge and/or over-eating that encourages obesity and further perpetuates more glucose imbalances.

Chronically high levels of glucose, which may arise from overeating carbohydrates, including sugars and alcohol, or from poor glucose control, can cause a reaction which alters the normal structure of proteins in the blood. This process, called glycation, creates potentially degenerative products that are believed to underly the development of diabetes, accelerated aging, and neurodegenerative disease. Hemoglobin A1c and fructosamine are two markers of this process, and monitoring their levels is crucial for effectively preventing the cascade of physiologically destructive events that may either trigger or arise from chronic obesity.

The hormones cortisol, DHEA, and IGF-1, serve as important endocrine markers for preventing and treating obesity. Imbalances of these hormones are closely linked with insulin dysregulation. They are also directly linked to changes in the body's fat production. Optimal DHEA and IGF-1 levels promote increased lean body mass, increased energy production, and decreased fat.5-8 Excess cortisol levels, on the other hand, are known to stimulate increased blood sugar production, stimulating fat deposits in the face, neck and trunk regions, and an "apple-shaped" obesity.9-11

The balance between the adrenal hormones DHEA and cortisol also
ensures that the body is adapting to stress in a healthy manner. Monitoring adrenal balance is particularly important when addressing obesity linked to stress-related eating disorders.12,13

The Metabolic Dysglycemia Profile includes fasting and 2-hour post-prandial analyses of glucose and insulin tolerance, salivary assessment of
bioavailable DHEA and cortisol, and fasting blood assays of hemoglobin
A1c, fructosamine, and IGF-1. The profile is also available with an optional add-on lipid profile. By evaluating these crucial parameters of glycemic metabolism, the Metabolic Dysglycemia Profile can serve as a powerful tool in both the prevention and treatment of obesity and its related health disorders.

References

1 Havel PJ. Leptin production and action: relevance to energy balance in humans. Am J Clin Nutr 1998;67(3):355-358.

2 Lamarche B, Tchernof A, Mauriege P, et. al. Fasting insulin and apolipoprotein B levels and low-density lipoprotein particle size as risk factors for ischemic heart disease. JAMA 1998;279(24):1955-61.

3 Sheen AJ, Letiexhe MR, Lefebvre PJ. Effects of metformin in obese patietns with impaired glucose tolerance. Diabetes Metab Rev 1995;11:S69-80.

4 Ruderman N, Chisholm D, Pi-Sunyer X, Schneider S. The metabolically obese, normal-weight individual revisited. Diabetes 1998;47:699-713.

5 Bird CE, Masters V, Clark AF.
Dehydroepiandrosterone and androsterone sulphates, androstenedione and urinary androgen metabolites in normal young men and women. Clin Invest Med
1984;7:119-122.

6 Cleary MP, Zisk JF. Anti-obesity of two different levels of dehydroepiandrosterone in lean and obese middle-aged female zucker rats. Int J Obesity
1986;10:193-204.

7 Gansler T, Meller S, Cleary J. Chronic administration of dehydroepiandrosterone reduces pancreatic B-cell hyperplasia and hyperinsulinemia in genetically obese zucker rats. Proc Soc Exp Biol Med 1985;180:155-162.

8 Porch JV, Jain K, Reilly A, Valdez C, Mazariegos M, Ziegler TR, Solomons N, Smith RJ. Aging, physical activity, insulin-like growth factor I, and body
composition in Guatemalan women. Am J Clin Nutr
1997 Oct;66(4):874-9.

9 Miller JE, et al. Characterization of 24-h cortisol release in obese and non-obese hyperandrogenic women. Gynecol Endocrin 1994;8:247-254.

10 Maarin P, Darin N, Amemiya T, Andersson B, Jern S, Bjaorntorp P. Cortisol secretion in relation to body fat distribution in obese premenopausal women.
Metabolism 1992;41(8):882-6.

11 Ljung T, Andersson B, Bengtsson BA, Bjaorntorp P, Maarin P. Inhibition of cortisol secretion by dexamethasone in relation to body fat distribution: a dose-response study. Obes Res 1996;4(3):277-82.

12 Pasquali R, Anconetani B, Chattat R, Biscotti M, Spinucci G, Casimirri F, et. al.
Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in women with visceral and subcutaneous obesity: Effects of the corticotropin-releasing factor/arginine vasopressin test and of stress. Metabolism
1996;45(3):351-6.

13 Women's high-fat snacking during stress due to hormones? Arizona Republic 1998;April 5:A3.

Call to set up a nutritional consultation so that tests can be performed and a comprehensive strategy of lifestyle, dietary modification and nutrient supplementation can be implemented to aid you in reversing this disorder.

For an appointment, contact our office at: 800-956-7083 and go to lab tests and click on appropriate test for information.

Dr. Rispoli, Ph.D., L Ac. has had a clinical practice for over 25 years. Her programs work because she is so thorough in testing and providing a nutritional approach. Remember that the body can heal itself if given the proper nutrients.

The information herein is not intended as diagnosis, treatment or a cure. Should you have a medical condition please seek the advice of your medical doctor.