04/23/2013 06:06 pm ET Updated Jun 23, 2013

Losing Weight: You Can Gut It Out

Last month, the New York Times reported on a new study that says having proper gut microflora might aid weight loss. The story quickly rose to the most-emailed article of the day, which highlights just how eager we all are for that holy grail of weight management. The medical community has observed the power of probiotics for everything from immune system enhancement to the treatment of inflammatory bowel disease and even cancer prevention. The National Institutes of Health launched the Human Microbiome Project to pinpoint the microbial communities found at various sites on the human body and to investigate the role of these microbes in human health and disease. The far-reaching health impact of the microbiome, as the microbial environment of the digestive tract is known, has been discussed lately in mainstream publications like the Wall Street Journal and The New Yorker. Who knew the gut would become such a hot topic? We holistic doctors have always considered the digestive tract to be the seat of health. In fact, I can count on two hands the number of patients I've seen who do not have some sort of gastrointestinal imbalance. But is a healthy gut truly the key to lasting weight loss? While there are myriad variables when it comes to successful weight loss, it's fair to say that healthy digestion just might create a good groundwork.

The new study correlating intestinal health with weight loss looked at humans who had undergone gastric bypass surgery, in which the stomach is divided into a lower and upper pouch and the intestines rearranged to attach to both. Up until now, it wasn't exactly clear how patients lost up to 75 percent of their body weight through this surgery, but the scientists behind this current study believe that 20 percent of such results could be attributed to a shake-up of gut flora. It was not clear to the authors of the study whether the change was from the surgery itself or the subsequent weight loss, and if the microbial shift had any distinct effect on its own.

So, using mice as subjects, they created three groups: one that received gastric bypass surgery, one that had a simple abdominal surgery while staying on a heavy diet, and a third that also had a sham surgery but ate lightly. The bypass group was the only to both lose weight and experience a change in microflora. When their new intestinal bacteria were implanted in other mice, those subjects, too, quickly lost weight.

How this works isn't clear, even to the researchers themselves. An earlier study hypothesized that certain microbes decrease the body's metabolism. Another proposal is that an unfavorable gut bacteria profile might inhibit fat oxidation, thereby impairing a body's ability to burn fat. Still another review suggests that the byproducts of bacterial breakdown might impair the body's ability to regulate appetite. In my practice, I've observed that adverse bacteria clearly cause inflammation (manifesting as irregular bowel movements, gas and bloating), which can make it more difficult to lose weight.

The mind-body connection comes into play, too. How terrible do we feel when our gut, our second brain, isn't working right? Grumpy, out of sorts, irritable? You bet. Among my patients, those kinds of feelings often lead people to reach for the cupcakes to get a quick feel-good spike, which becomes a vicious circle. Conversely, a healthy gut often equates to a happier person and the less depressed we are, the easier it is to lose weight and avoid temptation.

The evidence is mounting: Get your gut back to equilibrium, and health will follow. But how does one go about this, exactly? There are over 400 types of bacterial species in the human intestine. Balancing these critters takes time, but natural medicine is highly effective at implementing these shifts so that they bring about lasting and noteworthy change. The first step is finding out just what's going on in your gut.

Get a comprehensive stool analysis and have your practitioner evaluate it. It will show how well you're digesting and absorbing, as well as enumerate the presence of both good and bad bacteria, as well as any yeast or parasites. Other ways of diagnosing are through hydrogen or methane breath test (two gases bad bacteria typically give off) or applied kinesiology (a form of muscle testing that uses the body's feedback mechanisms to evaluate the state of health). Once small-intestine bacterial overgrowth is diagnosed, the treatment for gut imbalance will involved one or more of the following:

  • Take a good probiotic, with food. The jury is out as to which strains of bacteria work for the best for weight loss. Your best bet are pharmaceutical grade probiotics that have the GMP ("Good Manufacturing Practice") seal of approval. Look for probiotics that have at least seven strains and at least 5 billion active cells.
  • Eat fermented foods. They're high in probiotics and they're delicious: kimchi, sauerkraut, kombucha, kefir and yogurt are a few. My favorite online source for these is Wise Choice Market.
  • Avoid things that will imbalance your gut: antibiotics, chlorinated water, antibacterial soap, agricultural chemicals, pollution. If you're trying to balance your gut, take a break from eating out; restaurants can have higher-than-normal bacteria in their kitchens and that translates into the food.
  • Make some diet changes. Fiber is integral to clearing out bad bacteria. I typically suggest three meals a day with nothing in between so that the small intestine's cleaning function can take place without the burden of digestion. Eliminate sugars and any forms and artificial sweeteners. Foods like milk, soy, legumes and lentils should be eliminated because they leave behind residue in the small intestine that's hard to move out. Limit wheat due to its potential thyroid-interrupting properties. Don't forget lots of water: half your body weight in ounces.

If you're struggling with your weight, by following some or all of these, not only will your gut be pleased, you'll inevitably -- and likely effortlessly -- drop stubborn fat.

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