Amchara’s Approach To Weight Management

Programme Topics

• The Problem
• Diets & Surgery
• Personalised Weight Loss

The weight of the problem

The worldwide prevalence of obesity has more than doubled since 1980 and by 2014 was declared an epidemic by the Woorld Health Organisation.

Health Risks of being Overweight

Obesity represents a direct cause to many health problems and it is estimated that 20% of adults in the UK are likely to develop a range of life-threatening and chronic diseases purely because of their weight including:

Cardiovascular Disease

• Heart disease & stroke

Heart disease and stroke are some of the leading causes of death in the world.

Being overweight can lead to high blood pressure, blood lipid imbalances, low level chronic inflammation, atherosclerosis, angina, heart disease and stroke.

Excess fat tissue, especially around the waist, has a direct effect on heart structure and function, even in the absence of other heart disease risks.

Cancer

• Endometrial, breast, ovarian, prostate, liver, gallbladder, kidney & colon

The specific link between obesity and increased risk of certain cancers has not yet been established but research suggests the following:

• Fat tissue produces excess amounts of oestrogen which have been associated with the risk of breast, endometrial and some other cancers.
• Increased level of some hormones (IGF1) in the blood of obese people may promote the development and growth of tumours.
• Fat tissue secretes leptin, a type of hormone, which seems to promote cell division and therefore growth. Also obese people have a lower amount of a hormone called adiponectin which may have antiproliferative (inhibiting cell growth) effects.
• Fat cells may also exercise a direct and indirect influence on other molecules which regulates tumour growth (mTOR and AMP-activated protein kinase).
• Obesity leads to a chronic low level of inflammation which has been associated with increased risk of cancer and other degenerative diseases.

Osteoarthritis

• Obesity is a preventable cause of osteoarthritis in weight-bearing joints.

The earlier someone becomes overweight or obese, the greater the risk of developing osteoarthritis.

But contrary to widespread belief, obesity causes osteoarthritis through different mechanisms and not just by excessive loading of the joints.

Raised blood glucose and uric acid levels increase inflammation of the joint; the release of inflammatory molecules by the fat cells contributes to direct joint degradation and latest research also shows that dyslipidemia (abnormal lipids profile) can also contribute to the development of osteoarthritis.

Gall Stones

• Gall stones develop in the gallbladder and can cause sudden pain.

A gallbladder attack or biliary colic occurs when gallstones block the ducts of the biliary tract.

There are two types of gallstones (cholesterol and pigment stones).

Gallstone disease is common amongst the Western population, with an increased risk for women, and it is believed that obesity is the most important risk factor for the development of cholesterol gallstones, which account for 90% of gall stones.

Research supports the theory that due to increased secretion of cholesterol by the liver of obese people, the bile becomes super-saturated leading to the formation of stones.

Sleep Apnoea

• Sleep apnoea is a condition that is often associated with weight gain.

Excessive body fat increases the bulk of soft tissue in the neck, which can place a strain on the throat muscles and may result in sleep apnoea, a relatively common condition amongst overweight and obese people.

Sleep apnoea is characterised by regularly interrupted sleep, due to the walls of the throat relaxing and narrowing during sleep, interrupting normal breathing. Excess stomach fat can also lead to breathing difficulties, which can make sleep apnoea worse.

Disrupted sleep can have a big impact on quality of life and increases the risk of developing certain conditions such as high blood pressure, increased risk of stroke, heart attack and developing an irregular heartbeat.

How has obesity developed?

To protect ourselves from famines we evolved to store energy in the form of fat to sustain ourselves.

This biological adaptation causes our bodies to seek out calories, from sugar and fat, to survive.

In the Western world, especially over the last 60 years, we are surrounded by abundant and readily available sources of calories.

These sources, however, no longer resemble the diet that our ancestors had for millennia.

The bottom line is that modern food is not the food that we have biologically evolved and adapted to.

The change in our relationship to food

Humans, in a short time, have gone from:

Our genetics have not had a chance to adapt to this new diet and lifestyle.

Modern industrialised food, high in calories, chemicals, toxins and refined sugars, is typically low in nutritional value.

This, combined with the fact that we do not move as much as we used to, means that…

We are simultaneously over eating and starving ourselves towards obesity and disease

Food addictions and cravings

Industrially produced foods are noy only a nutritional disaster directly attributed to the obesity epidemic, but they are also addictive.

“Processed, refined-sugar-based food or soda drinks deliver a biochemical charge to our brain that stimulates the release of endorphins, the body’s own “feel good “chemicals which make us feel temporarily happy.”

This feeling quickly drops off and we are left unfulfilled and craving for more and the circle perpetuates itself.

Dr. Pert, one of the chief scientists who discovered the significant role endorphins play in addiction, says:

“I consider sugar a drug, a highly purified plant product that can become addictive. Relying on an artificial form of glucose – sugar – to give us a quick pick-me-up is analogous to, if not as dangerous as, shooting heroin.”

Orthodox Approaches to Weight Management

There are a number of orthodox methods to aid weight loss, some more drastic than others.

Surgical procedures like:

• Gastric Bands
• Gastric Bypass and Liposuction
• Calorie Controlled Diets
• High Protein Diets

and innumerable other fad diets all offer solutions but rarely succeed because they fail to tackle the underlying issues.

Medical intervention to weight management

There is currently only limited medical intervention for unhealthy weight and it is only typically utilised in cases of extreme obesity.

Medical intervention for the treatment of obesity is conducted by different types of surgical procedures and by pharmaceutical treatment.

It is available to treat people with life-threatening obesity where other interventions have failed.

Bariatric surgery includes:

Gastric Banding

Gastric banding – reduces the volume of the stomach to limit the amount of foods that can be hold increasing your satiety. This procedure is reversible.

Gastric Bypass

Gastric bypass – and biliopancreatic diversion reduce the length of the intestine that the food goes through reducing its absorption. This procedure is not reversible.

Gastric Balloon

Gastric balloon – insertion is carried out by inserting an endoscope in the stomach via the mouth. The balloon is then filled with liquid or air and partially fills the stomach creating a sensation of fullness. The balloon is typically removed after 6 months.

Sleeve Gastrectomy

Sleeve gastrectomy – this consists of removing part of the stomach. This reduces its volume and therefore the amount of food that can be eaten and results in feeling fuller sooner.

Liposuction

Liposuction – Using high frequency vibrations, fat cells are broken up and a suction tube attached to a vacuum machine is inserted through a small incision to suck fat out.

Weight loss surgery presents risks of complications of any surgery, such as internal bleeding, deep vein thrombosis, pulmonary embolism and infection.

It can also lead to long term digestive issues such as nausea, heartburn, vomiting and diarrhoea.

Because of the reduced food absorption, the weight loss is accompanied by a decreased absorption of micronutrients, minerals and vitamins and the consequent increased risk of disease.

The only pharmaceutical intervention to reduce weight approved to be used by NHS is Orlistat, a drug marketed under the name of Alli. It belongs to the class of drugs called fat blockers and works by preventing the actions of enzymes used in the breakdown and absorption of fat, which is then excreted in the faeces.

Common side effects are gas, cramp and diarrhea. In the long term, it may cause a deficiency of fat-soluble vitamins A, K, E and D and lead to vitamin deficient related health problems.

Diets (and why they don’t work)

There is much conflicting advice when it comes to healthy eating and weight management and there is an equal amount of complexity when it comes to our relationship with food and the body.

Obesity is on the rise and with it increasing concerns around issues such as body image, overeating, binge eating, emotional eating and unwanted food habits.

The nutrition field is filled with different type of diets which either aim at reducing calorie intake or manipulating how the metabolism work by changing ratio of fat to protein to carbohydrates resulting in high carbohydrate, low fat diets, high protein diets, low carbohydrates diets, low fats, moderate carbohydrates diets or high fat and low carbohydrates.

None of these types of diets addresses the roots causes behind the weight increase

They merely manipulate calorie intake and metabolism and aim for quick results.

Furthermore, they are not focusing the attention on the nourishment of the body or the whole person and are merely a temporary fix to look better, to allow us to lose weight in time for the summer season, a wedding, a special occasion but they do not offer a long term, healthy, sustainable solution to weight management.

Low carb and low fat type diets

Following a poorly executed single scientific study in the mid 20th Century, that was only debunked many decades later people have been led to believe that the best way to lose weight is to eat a low-calorie diet, following the principles that…

weight = calories in – calories out

…and that all calories are the same, no matter their source.

Since fat has more calories per gram than protein or carbohydrates, we have been told for decades that the easiest way to lose weight is to reduce the total number of calories, either by cutting down fat or by eating a low carb diet.

We have also been told to increase our exercise so, in simple terms, the message from the experts and from the government has been “to eat less and move more” and that the reason that we eat too much is lack of willpower.

The low calorie approach gives no consideration to the quality of the food consumed or to any other physiological and emotional factors intrinsically related to weight regulation.

Unfortunately, this rudimentary logic is still at the core of many diet plans (Weight Watchers, Slim Fast, Cambridge Diet etc.), which encourage people simply to cut down calories, often substituting foods with unhealthy products low in fats and carbs and laden with additives such as artificial flavorings, sugars, preservatives and colourings.

Following these diets, your weight eventually decreases, but so does your metabolic rate, with a consequent lack of energy making it difficult to adhere to any exercise routine or even cope with everyday life demands.

Your food is restricted, boring, lacking in nutrients, leaving you with cravings and low moods.

Restricting all kind of fats fat has negative effects on our health as it is essential for many aspects of our health.

The cells’ membrane is made of fats.

Fat is the precursor molecule for the production of sex hormones and DHEA, the “youth hormone”.

We need fat for vitamin D synthesis and for the absorption of other fat-soluble vitamins and we need it for the formation of bile.

Some fats have anti-inflammatory properties and are required for brain health, to balance mood and to stave off dementia and cognitive decline.

This incorrect conventional approach to weight loss has been commonly dispensed for decades, and as a result, government statistics show that, since the 1960s, the intake of calories per capita and the percentage of calories we eat from fat have steadily been decreasing.

However, the latest data compiled by the Health and Social Care Information Centre shows that the proportion of adults with a healthy body mass index (BMI) fell to just 34% in men and 39% in women during 2011, whilst obesity rose to 24% for men and 26% for women.

High protein low carbohydrate type diets

Another type of diet is that focusing on high ratio protein to carbohydrate intake.

The concept behind these types of diets (Atkins, South Beach Diet, Protein Power Diet, Stillman Diet) was first introduced by late Dr Atkins, is a switch to fat and protein metabolism which favours fat and proteins as the main fuel, including the body fat reserves.

The byproduct of fat metabolism is ketones which are excreted in the urine.

This process is called ketosis.

A low carbohydrates diet kick starts weight loss because the body is forced to utilise its short term stores of glucose, glycogen, which are stored in the liver and muscles.

For every pound of glycogen, the body stores 3-4 pounds of water, so the immediate weight loss is impressive but is mainly from glycogen and water losses, rather than fat tissue.

A review of all high protein/low carbohydrate diet studies concludes that weight loss is principally associated with decreased calorie intake.

An Atkins-type diet may work, but the results are due to eating less in general and this is attributed to the regulation of blood sugar.

The negative side of high protein diets, especially in the long term, apart from their unsustainability, limited variety and restriction of foods type, is that they are linked to increased risks for the development of kidney and bone problems. Also, because of their typically high content of meat and dairy products, they can increase the risk for breast and prostate cancer risk.

Fad Diets

Too many to mention, they come and go promising miracle weight loss, with no scientific background, unbalanced not only in terms of inadequate provision of macronutrients but also for their lack of micronutrients, vitamins, minerals and phytochemicals.

The common denominator in all these weight loss solutions is as a quick fix with little effort, they tend to promote weight-loss pills, shakes, meals substitution or cut out singular foods or food groups.

Needless to say that they don’t give long term results and are detrimental for metabolic rate and health.

The Personalised Approach to Weight Loss

Personalised Health addresses weight management appropriate to any individual and considers history, environment, lifestyle, mental, emotional and spiritual aspects, as well as biochemical and genetic individuality.

The root causes to unhealthy weight change are addressed not by applying a reductionist and deprivatory dieting approach, but by learning how to nourish your body and support its unique needs in a way which naturally supports weight loss and long term health.

Your unique genetic variances play a central role on your weight management by determining how you metabolise the different type of macronutrients (fats, carbs and proteins) and how you respond to different type of exercise.

A genetic test also provides you with specific information about your unique micronutrient needs, support for detoxification pathways as well as offering you insights into other aspects of your health such as inflammation, oxidative stress, bone health, heart health.

With this knowledge a highly effective plan for your diet, exercise and lifestyle can be created.

Rather than just a quick fix with a fit all approach, the aim of a functional dietary programme is adopting an eating style which works for you and is healthy, enjoyable and sustainable in the long term.

When necessary a tailored natural supplement plan will complement your dietary style.

The focus is on adding nourishment to your life, not only from a dietary perspective but more widely reflecting on other aspects which influence your health such as your relationship with food, level of stress, lifestyle, exercise, relationships.

Learning and practising mindful eating means applying mindfulness towards foods, body image and weight loss and can help you to let go of any blame related to the way you are, look and why you eat the way you eat.

Nothing productive comes from blaming your self or others – this simply encourages a repetitive, negative pattern of focus which keeps us stuck in the same bad habits.

The focus is shifted to your new health and weight loss goals and you will be encouraged, guided and inspired by newly gained knowledge about your body, and your healthy eating and lifestyle.

How to start a successful weight loss programme at Amchara

# Detox (Juice Cleansing)

Our body naturally has various means of naturally detoxifying. The key organs in the body involved in detoxification are:

• The colon
• Urinary tract including the kidneys
• Lungs, skin and lymphatic system
• The liver, the key organ of detoxification

The modern Western lifestyle of too much food, the wrong food and a stressful environment can cause our bodies to become toxic and overweight.

One approach to this modern lifestyle is to take time out and to intensively detoxify for a period of time, typically between 5-21 days.

The most extreme form of detoxification includes water fasting and total abstinence of all foods and nutrition.

This is only normally recommended in rare circumstances and normally at Amchara, we advocate juice cleansing, light fasting or intermittent fasting.

# Hypoxia (IHHT)

Hypoxia therapy, also known as IHHT (Intermittent Hypoxia Hyperoxia Therapy), creates a training effect in the body.

The client either sits in a comfortable chair or in athletes they can cycle on an indoor bike.

The patient wears a breathing mask and over a 30-minute to 50-minute period breathes in air controlled by an IHHT machine.

Periods of reduced oxygen (hypoxia) stimulate the body and move into the training effect.

This process enables the old and dying mitochondria to be eliminated encouraging the body to produce new mitochondria, healthy, strong mitochondria.

Periods of higher oxygen (hyperoxia) support the body’s recovery and furthers the production of new mitochondria.

Healthy mitochondria is key to good health, most cells contain mitochondria and these tiny pockets in the cells are responsible for our energy and thousands of general health and cellular health factors.

IHHT is available in our Malta retreat.

# Exercise & Mindfulness

Increasing exercise is known to improve health.

The challenge is most people to do not enjoy exercise that pushes them too hard. The key is to find an exercise that you can enjoy, often making exercise a social activity is a good way to improve the likelihood of encouraging long-term commitment.

For good health, most of us know what we need to do and the challenge is bridging the gap between the knowing and the doing.

Mindfulness can support someone in closing this gap.

We facilitate biofeedback practice at Amchara, using biofeedback technology and measuring our Autonomic Nervous System, sometimes referred to as the fight/flight response.

Biofeedback is built on the principles of mindfulness.

Our body is equipped with an effective and sophisticated system of organs and functions to detoxify naturally however, the problem is that we are exposed to an ever increasing number of toxins which can overburden our system.

This, together with a less than optimal nutrients intake typical of our modern Western diet, might cause the liver to become less efficient.

The average adult’s body contains over 700 different contaminants and according to the Environmental Working Group research, the average infant is born with more than 200!

Since 1940 more than 80,000 new chemicals are introduced into the environment every year.

Environmental toxins can be found in the food you eat, the water you drink, the air you breathe. Alcohol, cigarettes, medication, use of synthetic hormones, household products and personal toiletries are also adding to the toxic load of our body.

Weight gain, obesity and chronic conditions such as Type 2 diabetes, cardiovascular disease may be associated with environmental toxins in the body.

Although you might not be aware of all the toxins you are constantly exposed to, symptoms such as brain fog, fatigue, irritability, inability to lose weight, increased allergies, skin and sleeping problems might be the signs of toxic stress.

Regular cleansing programs are important to reduce your toxic load, to support your natural detoxification system and to reboot your metabolism.

Your body and mind have an extraordinary capacity to improve and stay healthy if given the right nutrition and allowed to detoxify in a stress-free environment

At Amchara we have an approach to health that balances the three strategies of detoxification, replenishment and education.

Utilising the foundation of the functional medicine model combined with careful monitoring we aim to optimise the opportunity for positive changes in your health and lifestyle.

Monica Durigon

She graduated from the Institute of Optimum Nutrition after four years of studying and clinical training and trained under Patrick Holford’s zest4life team qualifying as a weight-loss and wellbeing coach. In 2014, she was awarded the Dian Shepperson Mills Prize for “Outstanding Performance in Clinic”.

She believes in the uniqueness of each individual from a genetic, biochemical, spiritual, cultural and lifestyle perspective and therefore, her nutritional and weight-loss approach is tailored specifically to your genetic and biochemical individuality to help you reach your full potential for optimum health and ultimately lead a longer and happier life.

Monica applies the principles of Functional Medicine in her practice and is also training with the Institute for Functional Medicine to become an accredited Functional Medicine practitioner. Functional Medicine applies a science based, holistic, patient centred approach to assessment, prevention and treatment of complex health problems and chronic disorders.

The next steps

The journey to weight management and revitalising your health can sometimes just be a few simple steps.

We can support you in one of two ways: