Overweight & obesity – how nutritional counselling can help you lose weight

Übergewicht & Adipositas – wie Ernährungsberatung beim Abnehmen helfen kann

The obesity pandemic….

The topic of obesity & overweight divides the nation. Or to be more precise, it divides the nation into three: there are those of normal weight, those who are overweight or pre-obese (BMI 25-30) and those who are obese (BMI >30). Obesity has been categorised as a disease by the WHO since 2020.

But how bad is it really to have a little too much flab on your ribs? And to what extent can nutritional counselling help you lose weight?

According to the RKI, overweight and obesity affect a total of 53.5% of the population in Germany (46.6% of women and 60.5% of men). Obesity is present in 19.0% of adults.

BMI calculators for the body mass index help with the initial categorisation of your own weight.

The same applies to abdominal circumference: it becomes critical for women from 80 cm and for men from 94 cm.

Do you suffer from obesity?

You may already know from painful experience that being overweight or obese can cause you health problems: increasing breathlessness, joint wear and pain, heartburn or increased sweating are just a few examples. In addition, those affected often face considerable social problems and social exclusion: obese people are seen as lazy, comfortable, inflexible and sometimes even uneducated.

After an unsuccessful odyssey to combat the risk factor of obesity, you are now seeking competent medical help.

It is possible that secondary diseases such as type II diabetes mellitus or high blood pressure have already developed as a result of the increased body weight. You feel your health spiralling downwards and would finally like help with losing weight.

Now you are looking for competent and, above all, targeted nutritional counselling to help you finally shed the pounds.

An important note at this point:

Nutritional counselling and nutritional medicine may sound confusingly similar, but their services differ significantly. ‘Nutritional counsellor’ is not a protected professional title and therefore the qualifications of the counsellor can vary greatly.

The aim of nutritional counselling is primarily to prevent illness and provide general advice on healthy eating.

In contrast, ‘nutritional physicians’ have completed a degree in medicine and specialised training in nutritional medicine. Nutritional physicians can (and are allowed to) offer more comprehensive and in-depth help with nutrition-related illnesses than nutritionists. They are able to make medical diagnoses, prescribe medication and co-operate with other doctors.

At THERA Praxisklinik in Berlin, we have Dr Ralf Hilbert, a recognised expert in our team for solving problems associated with overweight, obesity and obesity. As an experienced nutritional physician, Dr Hilbert can offer you his help with overweight & obesity with confidence.

Together you will develop a strategy to escape the negative cycle.

How does overweight or obesity develop?

How does obesity come about? And what factors lead to more and more people suffering from obesity today?

Many causes can be listed here. To summarise, you could say that we eat differently, more often and more, are more stressed and move less. But perhaps the devil is in the detail. Let’s take a closer look.

Sedentary behaviour has actually increased significantly. Food is available everywhere and in abundance all the time, and this has a not insignificant influence on our eating behaviour.

The more food we have in front of us, the more we eat. But even more important than how often and how much we eat is undoubtedly WHAT we eat. And what we drink.

We all know that the trend towards convenient food, soft drinks and unbalanced diets has an impact on our health.

So what happens in our bodies when we eat one (or more) white flour toast with margarine and cheese every day, or alternatively a doughnut or yeast plait?

To answer this question, let’s take a brief excursion into the topic of metabolism.

‘The human organism realises life processes with processes that are summarised by the term metabolism.’

Dr. Ralf Hilbert

What does metabolism actually mean and what effects does metabolism have on weight?

Metabolism means: substances are ‘exchanged’. This metabolism takes place in our body cells at all times and serves to generate energy (>90%) and synthesise building materials (<10%).

For a well-functioning metabolism, we need nutrients: macronutrients (carbohydrates, proteins, fats) and micronutrients (vitamins, trace elements, etc.), which are then converted into energy and building materials via complicated conversion processes.

So at this point it remains to be said:

It is not a good idea to simply stop eating or to eat far too little.

How could the process function without starting substrates? Since substances are exchanged during the so-called metabolism and ‘waste’ is also produced in the process, it requires not only the supply of nutrients, but also the export of ‘residual substances’ or end products.

If both processes function optimally, this inevitably leads to health.

Unfortunately, in today’s diet and lifestyle, a high-quality supply of nutrients is rarely available.

There is also another disruptive factor:

Too many carbohydrates, too many accompanying substances and toxins.

What to do with this ‘too much’? At some point, the cells are ‘saturated’ and refuse to absorb any more sugar. The stores in the liver and skeletal muscles are then filled. If these stores are also fully utilised, the fat cell is the last to step in. The fat cell converts glucose into fats (triglycerides).

And now watch out:
The storage capacity of fat cells is unlimited. And at some point the liver is also overloaded with the breakdown of toxins. Where do we put the excess toxins? Exactly: the fat cell readily absorbs them.

So if we want to prevent fat build-up, it makes sense to reduce our intake of carbohydrates and toxins. In this context, it becomes clear why both nutritional counselling/therapy and detoxification therapy make perfect sense.

Bisphenol A exposure is associated with abdominal obesity

Various scientific studies indicate that the risk of abdominal obesity increases significantly with increasing bisphenol A exposure.

Bisphenol A (BPA) is used in the production of plastics and resins and can be found in many everyday products such as drinking bottles, Tupperware and tins or till receipts. In April 2024, Stiftung Warentest tested 58 tinned food products for BPA. BPA was detected in almost all samples.

You can find out how to detox properly in our specialist article ‘Detoxing with a doctor: How to detox properly’?

Countering cravings with nutritional counselling – Do you suffer from food cravings?

Insulin is needed so that glucose (sugar) can enter the cells. This means that whenever glucose enters the bloodstream, insulin is released by the pancreas. This is important to know:

The faster a glucose level rises, the more insulin is released.

And if (too) much insulin is released quickly because we eat white flour toast with jam, for example, then after the glucose level has normalised, excess insulin remains in the blood and continues to prompt cells to eliminate glucose.

As a result, glucose levels fall below normal and the nervous system reacts with ALARM. The result: cravings, nervousness, restlessness, lack of concentration, tiredness.

And what do people logically do? Exactly, they compensate by eating carbohydrates again. A vicious circle.
The logical thing to do would be to avoid a rapid and sharp rise in glucose levels.

This is where the often-mentioned glycaemic index or glycaemic load comes into play. There are various tables on the internet that show exactly how much the consumption of a certain food affects the glucose level.

The short summary of these tables is as follows:

If you want to prevent or combat overweight and obesity, consistently avoid white flour and industrial sugar, favouring wholemeal flour and whole cane sugar instead.

Disturbed hunger-satiety regulation

In addition, a deficiency of certain nutrients (e.g. omega-3 or fibre, protein deficiency or B-vitamin deficiency) can also lead to cravings.

This makes it increasingly clear why it is sometimes difficult or even impossible to free oneself from the overweight or obese state alone and without medical support. At the THERA Praxisklinik in Berlin, we work with the best laboratories to analyse your personal nutritional status.

Stress as a factor favouring obesity

And there is another factor that promotes obesity to a large extent: Stress.

More precisely, permanent stress. If we are constantly stressed, e.g. under great pressure or suffering from persistent anxiety, then more cortisol is released and the liver is constantly encouraged to break down glucose reserves (glycogenolysis). The glucose ends up in the blood and, as with the consumption of white flour, this also leads to an increased release of insulin (-> cravings). Cortisol also likes to dock onto abdominal fat cells and thus inhibits the breakdown of fat (lipolysis). In short: as long as there is a lot of insulin and cortisol circulating, fat burning will not work.

Excursus mTOR

mTOR is a cellular enzyme that promotes proliferation and growth. It promotes anabolic (anabolic) cell metabolism. When mTOR is activated, all switches are set to growth, thus promoting the synthesis of lipids, among other things. At the same time, catabolic processes such as autophagy are downregulated. It is interesting to note that mTOR is mainly activated by the following substances: Insulin and branched-chain amino acids (especially leucine, predominantly contained in animal products). mTOR can be inhibited or regulated by calorie restriction or secondary plant substances.

10 factors that favour or cause overweight and obesity

  • Constant stress and chronic lack of sleep
  • Environmental toxins (storage in fat cells and shift in hormonal regulation)
  • Overeating and incorrect nutrient ratio (lots of sugar and white flour)
  • Frequent consumption of dairy products (leucine, casein, oestrogens, IGF-1)
  • High meal frequency
  • Disturbed microbiome
  • Genetic predisposition
  • Taking certain medications such as antidepressants, antidiabetics, glucocorticoids, beta blockers
  • Chronic illnesses such as hypothyroidism, Cushing’s syndrome, depression (hormonal changes) or joint problems/arthritis (restricted mobility)
  • Consumption of industrially manufactured products with additives and trans fatty acids

How harmful is being overweight or obese really?

Both overweight and obesity are the prime suspects as the cause of most chronic diseases. Even if overweight is initially only a variant of normal physiology (and serves as a precursor to obesity), obesity can certainly be considered a life-threatening disease. Nevertheless, in conventional medicine obesity is often seen more as a secondary diagnosis. However, impaired metabolic regulation and high fat mass have immense physical consequences. Overweight and obesity multiply the risk of dying prematurely from a secondary disease.

Specifically, a lot of belly fat also means a lot of inflammation. This is because a lot of fatty tissue is inflammatory to a certain extent, partly due to the adipokines (= proteins) released, which have pro-inflammatory properties, especially when weight is gained. Proinflammatory cytokines are produced, which can not only be partly responsible for silent inflammation, but also further promote insulin resistance.

Ultimately, being overweight means that all organs have to work harder all the time and the joints and bones have to carry more weight.

What consequential damage can possibly be prevented with nutritional counselling?

Consequences of overweight and obesity can include:

  • Cardiovascular diseases: High blood pressure, heart failure, circulatory disorders (heart attack, stroke, intermittent claudication/pAD), sleep apnoea
  • Metabolic diseases: Diabetes mellitus type II/insulin resistance, gout, lipometabolic disorders, metabolic syndrome
  • Digestive system: non-alcoholic fatty liver, gallstones, reflux disease, irritable bowel syndrome
  • Hormonal disorders: Testosterone deficiency, PCOS, reduced fertility or fertility
  • Tumour diseases (increased risk)
  • Joint damage (especially knee joints due to increased strain and premature wear of the spine)
  • Psyche: depression and anxiety disorders

Nutritional counselling & nutritional therapy: for a healthier life

Nutritional counselling or nutritional therapy can be useful for various reasons. Everyone wants to feel good and healthy in their own body.

It is important to understand that our diet has a significant impact on our well-being and health.

But what is the right diet? It is often difficult to find your way through the jungle of contradictory information. As described above, in addition to selecting good and biologically valuable foods, it is also important to consider individual circumstances: risk/environmental and social factors, lifestyle, existing illnesses and symptoms, micronutrient deficiencies and toxin exposure.

Dr. med. Ralf Hilbert

Nutritional medicine at the THERA Praxisklinik under the direction of Dr Ralf Hilbert offers precisely this possibility of an all-encompassing approach. Taking into account the latest scientific findings, an individualised nutrition and therapy plan is developed which, in addition to weight reduction, always aims to improve the overall level of health.

In concrete terms, this means that you will not only receive a nutrition plan in the sense of a change in diet, but also

We also carry out targeted research into existing imbalances and potential obstacles to weight loss.

This may mean that we carry out one or more of the following examinations:

  • Detailed blood test
  • Test for heavy metal exposure
  • Measurement of heart rate variability (HRV measurement)
  • Measurement of body composition (BIA measurement)
  • Resting metabolism measurement
  • Stool examination
  • Blood pressure measurement

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