Episode 202: Discover Your Obesity Phenotype and What Really Works for You

[00:00:00] Welcome back to the Back on Track Achieving Healthy Weight Loss, where I help you get on track and stay on track with your weight loss journey. I'm your host, Dr. Alicia Shelly. So let's get started.

[00:00:28] Welcome back to the Back on Track Achieving Healthy Weight Loss podcast. I'm your host, Dr. Alicia Shelly, and I'm so glad you're here with me today. Have you ever wondered why some weight loss strategies work for others, but maybe not for you? If so, this episode is for you. Because today we are diving into the fascinating world of obesity phenotypes. Now I know that sounds like a mouthful, but trust me, it's a game changer.

[00:00:57] Especially when it comes to understanding your weight loss journey. Because sometimes I do find, especially when patients, clients, and even myself, may try one particular diet, may try one particular medication, and it just doesn't seem to work. We may have talked to other people, we may have looked on social media and see how it works for everybody else. But when we try it, it's like, this is not working. And it may be that we just haven't found what was the best obesity phenotype for you and what medication works best for you.

[00:01:27] But first, let me slow down. Let's talk about what are obesity phenotypes. So, in simple terms, a phenotype is how your body expresses certain traits based on your genetics, environment, and behavior. When we talk about obesity phenotypes, we're referring to the different patterns or types of obesity that explain why someone may gain weight or struggle with losing weight.

[00:01:54] And here's the truth. Obesity is not one size fits all condition. It is more than just eat less and move more. Each person's journey is unique, and the phenotypes help us personalize treatment plans so they actually work. I see many patients who get discouraged because one particular diet or medication is not allowing them to lose as much weight as someone else did.

[00:02:19] And I always tell them that you are unique and that, number one, you shouldn't compare yourself to somebody else because their story is unique too. We have different reasons or different factors that play a role that cause us to either gain weight or make it difficult for her to lose weight. And the person you're comparing yourself has those same factors too. And we just need to find what works best for you. And that's how understanding your obesity phenotype will be helpful in finding what treatment works best for you.

[00:02:49] So, let's dive in. The four main obesity types that I often see in my practice are, number one, the hungry brain. This is basically abnormal satiation or basically the person feels is difficulty feeling full. You may eat large portions and still feel like you can keep going, like you're just not full. And sometimes you may find the brain takes longer to register that you've eaten enough. So, you may eat a plate.

[00:03:17] Then maybe an hour later, you may not feel full. You'll eat some more because you just don't feel full. And if you experience this, some medications that tend to help people who have these type of traits are going to be your GOP-1 receptor agonists, which can help you feel full. And then when you eat, you feel full as well. And you don't feel quite as hungry throughout the day, which can help with that hungry brain. And it can be very helpful.

[00:03:42] The second main obesity type is going to be emotional hunger or hedonic eating. This person eats in response to emotions, stress, sadness, even boredom. Sometimes can cause people to want to go and snack on something even after they've eaten. And if you're drawn to like more comfort foods, especially those that are high in sugar or fat, especially when you're going through a rough time or just like you have a deadline you have to make. You're like, well, let me go eat something.

[00:04:12] Then the best treatment for you is going to be number one, behavioral therapy to kind of help with overcoming these cravings when it comes, allowing you to kind of take a beat, think, am I truly hungry? And if I'm not hungry and I want to eat a snack, is it because I'm bored or is it because I'm sad? Is it because I'm stressed? So it kind of helps with having a plan when you're experiencing these cravings. Also, stress management can help.

[00:04:38] So finding ways to reduce your stress, whether it's doing meditation, prayer, mindfulness, whatever it is that kind of helps you to be able to de-stress, making sure to implement that in your daily walk. I might also recommend taking time out for you so that you can have a little bit more boundaries around your sacred times that you can be able to be de-stressed and be less stressful. And then also in mindful eatings can be key here as well. So making sure to ask yourself before you eat, am I hungry right now?

[00:05:08] Or is there something that I can do that can help with reducing my hunger? Like maybe if I drink some water or do something else that kind of clears up my brain so that I'm not thinking about what to eat. Some other medications that can be helpful here too can be the GLP-1. Sometimes that can help reducing some of those cravings, but you just have to watch like when you're going through a high stress moment, we can actually overdo it.

[00:05:33] We can override the GLP sensation that it feels that you feel hungry and still eat. So, but it is important. It can help with reducing your day-to-day type cravings. The third main obesity phenotype is going to be your hungry gut. This is abnormal satiety. You feel full after eating, but then a short time later, you're hungry again. So it's kind of like I eat, I feel full. And then now a few hours later, I'm like, man, I just ate a few hours, but now I'm hungry again.

[00:06:03] Again, this can be linked to how your gut signals hunger and fullness. And so sometimes what I recommend for people in this case is that they eat high fiber meals that are a little bit slower and getting digested. Also, high protein can be helpful too, so that it takes longer for the body to digest it. And so you're not as hungry a little bit few hours later. Also, another technique may be small frequent meals that you can eat throughout the day.

[00:06:30] So I wouldn't focus on fasting at the moment or skipping meals because then you'll be really, really hungry just a few hours later. Also, there are certain medications that can slow the gastric emptying, such as the GLP-1s, which can make it slower so you feel more, less hungry throughout the day. And then also the fourth is your slow burn, which is a decreased energy expenditure.

[00:06:56] This phenotype has a slower metabolism and you may be doing all the right things, eating while exercising, but you can still struggle to lose weight because your metabolism has decreased. And so a mix of activity would help with treatment of slow burn. In fact, sometimes that makes that activity that builds muscle, because what happens is muscle burns more calories than fat does. So by having extra muscle or toning your muscle, it can actually help with increasing more calories being burned even at rest.

[00:07:25] Also, you want to focus on medications that can boost metabolism and giving you a little bit of a stimulant like phentamine. That may be helpful. And this particular phenotype to kind of help with burning more calories for the most part. And then also close monitoring can help as well. Now, the one thing I didn't mention is that with all these phenotypes, they do overlap. So sometimes people may have a combination of hungry brain, emotional hunger or slow burn or hungry gut. It just depends on your body because like I said, everyone's unique.

[00:07:54] Now, you might be thinking, identify with more than one. That's fine. There's always a blend, but you may sometimes have a dominant phenotype that can point you toward the most common effective strategies. So understanding your phenotype can change the game. Instead of trying random diets, exercises or even certain medications, you can focus on what actually matches your body's biology. And it also helps to take away that shame and guilt that many people feel when their efforts don't lead to weight loss.

[00:08:23] Because remember, this is not about willpower. It's about biology and behavior. And so hopefully with figuring out what your phenotype is, this will help you with getting the results that you're looking for. If you would like more help with trying to find out what is your obesity phenotype, then they do have a genetic test that can be done. And so I do recommend seeing an obesity medicine specialist like myself that can help with getting this test for you.

[00:08:52] It's made by Phenomics Science. You can find them online. We'll put the website in the show notes where you can get more information about obesity phenotypes. Because obesity phenotypes was created by doctors at Mayo. And so they've created this particular platform in order to test to see where you are. Because once again, it's about working with your body and not against it.

[00:09:16] And so I do want to kind of give you a real life example of how you can utilize obesity phenotypes. So we'll just do the example of a patient named Sarah who came to me after trying like several diets with no success. She noticed that she had never felt full no matter how much she ate. And after evaluating her behavior and responses, we determined that she likely had a hungry brain phenotype.

[00:09:42] And so once we stared at her on a GLP-1, adjusted her meals for more volume, high protein and fiber, she began to see real progress without feeling like she was starving. So that's the power of finding that personization and what works best for you in your body. And if you are feeling stuck in your weight loss, I encourage you to dig deeper. Remember, think about which phenotype may describe you the best and talk with a provider,

[00:10:06] an obesity medicine specialist who can help you with getting to that next goal and that next weight loss goal too. And just remember, you're not broken. You just need the right plan. Thank you so much for listening to today's episode of Back on Track. If this episode helped you, please share it with a friend or leave a five-star review on Apple Podcasts or wherever you look at your podcasts. And just remember, until next time, stay strong, stay committed and stay consistent. And I'll see you next time.