All You Need to Know to Lose Body Weight Without MedicationProf. Bellamkonda K. Kishore, M.D., Ph.D., MBA

Many people are frustrated for not being able to lose body weight without medication despite trying every possible approach – such as dieting, avoiding junk foods, exercising and sleeping well, etc. All these cannot help unless one understands the rational science behind gaining weight. This article explains that in a simple and mathematical way.

Obesity or increase in body weight, mostly due to fat accumulation, is the result of “deranged energy homeostasis or balance.” Energy homeostasis is like the balance sheet of a corporation – with revenue, expenditure, assets and liabilities, etc. Just like how the “net balance” of a corporation at the end of the year depends on these line items, so also the net gain or loss in body weight depends on defined parameters. The food we eat (solids and liquids) is the source of energy for our body. It is comparable to the revenue of a corporation from all sources or products it sells. When food is digested and absorbed in the stomach and gut and metabolized in the body, it is converted into energy measured in calories. The energy thus produced is utilized for the functioning of the body and internal organs and also builds structural components (comparable to the expenditure line of a corporation). Excess calories which the body cannot utilize become fat (comparable to the assets of a corporation). In this context, 3,500 calories (revenue) are equivalent to one pound of human fat (asset). So, if a person saves 100 calories as excess energy every day, in about 35 days, he/she will gain one pound of fat. In one year, it will be 10 pounds. To give an idea how much 100 calories are, a can of Coke contains 140 to 150 calories. To burn those calories, one has to run for about 15 min or ride a bike for about 25 min. It is all simple math.

To burn 3,500 calories, an average 160-pound person would need to run for 6 hours at a steady pace of 5 mph or walk about 70,000 to 100,000 steps, which equates to roughly 35 to 50 miles walking. Human body is very efficient in using energy as compared to internal combustion engines of automobiles. So, burning the excess calories is not an easy task.

That is about intake of energy in the form of food and beverages. Now, let us examine the methods by which the consumed calories are burned or expended. As shown in the following scheme, energy expenditure is the sum of BMR, physical activity and adaptive thermogenesis. Let us examine each of these components.

BMR or Basal Metabolic Rate: It is the number of calories required to keep the body functioning at rest. It is similar to the gasoline consumed by a car while it is parked and the engine is idling. Just like the consumption of gasoline by an idling car depends on the size of its engine (V4, V6 or V8), so also BMR depends on the size of our body, or more precisely the skeletal muscle mass, where most energy is utilized at rest. As we age, we gradually lose our muscle mass, and so the BMR keeps falling. When that happens, even if we do not increase calorie consumption, we will still be in positive energy balance. To prevent age-associated loss of skeletal muscle mass, one has to do resistance or tension exercise or lift weights.

Physical Activity: Unlike BMR, physical activity is directly under our control. Physical activity can be in any form, such as brisk walking or jogging or riding a bike or climbing stairs, or just doing household chores, etc. While these types of activities burn calories, they do not match tension exercise or weightlifting in increasing the volume and strength of the skeletal muscle mass or preserving it as we age.

Adaptive Thermogenesis: It is regulated production of heat in response to external conditions, such as cold weather or some types of foods, resulting in metabolic inefficiency. In this process, heat is produced by burning metabolites, which could have otherwise generated ATP, or the energy currency of the body. It is similar to a car engine losing its efficiency and burning gasoline as heat, without giving enough mileage or giving lower mileage than expected. Central to thermogenesis is the brown fat, a specialized fat tissue rich in mitochondria, thus giving it a brownish color. Brown fat burns glucose and other metabolites, such as fats, and produces heat, instead of ATP, the energy currency of the cells. Infants and children have significant amounts of brown fat in their bodies. But as we age, we gradually lose brown fat mass. In addition, individual habits such as overeating and eating refined foods, gaining weight, sedentary life, poor sleeping habits, and alcohol consumption and tobacco smoking will decrease the amount of brown fat in the body. This is one of the main reasons for gaining weight as we age, despite controlling the food intake. So, loss of adaptive thermogenesis is like increasing the assets of a corporation by cutting down the unnecessary expenditure, despite no increase in revenue. This is becoming a significant problem as we age, resulting in frustration.

Under certain circumstances, white fat cells can be induced to change to brown fat cells, the so-called “browning of fat.” Certain foods, such as chili peppers (containing Capsaicin), green tea (containing Catechins), turmeric (containing Curcumin), grapes and alcohol-free red wine (containing Resveratrol), and cinnamon have been shown to induce browning of white fat in adults. Browning of white fat increases adaptive thermogenesis and it is within the reach of anyone by consuming specific food items as above.

Take Home Message: In order not to gain weight, daily energy intake in the form of food and beverages should equal the energy expended daily. The latter has three components as shown in the image. Of these three, only physical activity can be computed accurately. BMR can be improved by increasing skeletal muscle mass and strengthening it by doing tension exercises and weightlifting. Loss of brown fat can be combated by healthy lifestyle. Consuming foods listed above can promote browning of white fat. So, losing weight is not all about eating less food and doing exercise. It is more than that and calls for a holistic healthy lifestyle.

Prof. Bellamkonda K. Kishore – a distinguished physician-scientist, innovator, entrepreneur, author, and community leader. He lives in Sandy, Utah.