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Ep.39 – Weight Loss & IBS – challenges
5 Mar, 2024

Episode Intro

Are you trying to lose weight with IBS but really struggling because whatever you eat just seems to set off your digestive symptoms like bloating, rushing to the loo and feeling pretty terrible? There are lots of reasons why it's harder to lose weight with IBS and in this episode I'm going to talk through some of the reasons that are additional to IBS that might also be making it much harder including why diet foods aren't always the best if you've got a sensitive digestion, what about meal timing and does that make a difference to weight loss, and then talk through some other complications like your hunger hormones that can be different in people who've got IBS.

Podcast transcript

So this episode is part two, go back and listen to part one. If you want my little introduction first, but let’s go.

Hello, welcome to episode 39 of the inside knowledge for people with IBS. I’m Anna Mapson.

Reminder to only consume this content if you are keen to learn weight loss techniques

As I said at the beginning of the last episode, weight loss topics are not suitable for everybody so you may find you want to skip this week if you are not into weight loss and IBS. It’s not for everybody.

But, I do get a lot of people who do want to lose weight and are finding it increasingly hard because of the diet restrictions that come with managing your IBS.

Challenges for weight loss with IBS

This week I’m going to be talking a little bit more in a bit of a deep dive into hormones, other situations that might make it harder.

So yes, last week we talked about calorie deficit is really important. That is still true, but there are other complications that may make it a little bit more tricky. I’m going to talk through a couple of things about going on a diet, and what that entails, and mentally and literally physically with your gut, what kind of changes happen when you are going on a diet.

I’ll talk through a little bit about fasting through the night or timing of your last meal, and whether that has any impact on weight loss. And then a couple of. tips at the end of things you can do to focus on, including some really practical, simple, free things that don’t involve too much extra work. So that’s what we’re going to cover today.

The impact of genes on your weight loss, and IBS

When I’m thinking about the things that make it harder for my clients to lose weight, one of the things we have to take into account is genetics. So for example, does a larger body size run in your family? Is it to do with the way you’ve been brought up. And what food you’ve been eating, and your food and eating patterns.

Genetic mutations and individual impact

Of course, that does have an effect. But now we’re finding out a little bit more about DNA profiles and our genetic code. We are able to learn a little bit more about certain SNPs, they’re called single nucleotide polymorphisms. That’s basically like just a little mutation on a gene that can leave you with a predisposition to gaining weight.

There are thousands of these different genetic make ups and different points.

The problem with doing genetic testing where you can research what your actual genes are is that you can have a gene. For a health condition. Or for a predisposition to something like being in a larger body and being more likely to store a lot of fat. It doesn’t mean that those genes are switched on.

So it doesn’t mean that they’re going to be enacted in your body. And this is where it’s really challenging. Just knowing your genetic makeup doesn’t necessarily mean we’ll be effective for you.

Genetic SNPs can affect weight gain

Lots of pathways that might be affected would include like your appetite. Sometimes people have upregulated appetite or hunger hormones, just by their genetics.

Sometimes people have variations in the way that their insulin responds. Could be to do with your blood pressure. These kind of things sometimes do run in the family and they can impact on your body size over time.

I’ve seen some estimates that the heritability. That’s the likelihood that you will inherit these genes from your parents is somewhere between 40 and 70 percent.

So it’s quite likely that a lot of this stuff does run in the family, but it doesn’t lock you into that predestined body size. There are still things that you can do to reduce down your body weight if that’s what you are trying to do.

Hormones affect weight loss and IBS

Other things that may make it a lot harder when you’re focusing on weight loss are female sex hormones.

PCOS can influence body weight and IBS

And particularly people who have polycystic ovarian syndrome. There are four subtypes of PCOS and within that there are some subtypes that find it’s a lot harder to lose weight. It’s down to the androgen sex hormones. That’s like the testosterone, the male sex hormone. That can be upregulated, so particularly people who have problems with a lot of dark body hair overgrowth, and sort of male pattern hair loss, may find it harder to lose weight.

And so getting on top of the PCOS is one of the situations that can help. Again, some of that can be done through diet, but it just makes it, it’s like another layer.

And there is also an overlap between people who have PCOS and people who have IBS as well.

Socioeconomic status can’t be ignored

Other things that make it much harder to lose weight when you’ve got IBS include your socioeconomic status. So that means basically how wealthy you are. How much free time you have. And where you live. That may very well dictate what food you have access to. How easy it is for you to get this fresh food that everyone’s saying is good for you.

Actually, you might be working two different jobs. Really struggling to make ends meet. So your time for engaging in healthy dietary practice might be reduced.

Plus, your your headspace to engage in that as well is massively under pressure.

So there are lots of things that are more societal that we just don’t even mention a lot of the time when we’re talking about how hard it is to lose weight.

Because there isn’t really an easy answer and it’s not something that you can fix. But it is good to understand because it puts you in a more compassionate mindset about yourself.

Mindset matters

I wanted to talk a bit as well about the mindset of going on a diet and how this actually influences your ability to lose weight. So when you typically go on a diet and you’re like, ‘right, I’m not having any chocolate. No more crisps, no more meals out. No more alcohol, no more sugar. You know, everything gets cut out, gets very simplified.

You’re like healthy rice and vegetables and lean chicken.

That becomes rather boring after a little while! And there are many reasons why a kind of on a diet mindset doesn’t really work in the long term.

Don’t over-restrict your energy intake

It’s not just mindset. If you don’t eat enough food, our hunger hormone ghrelin is stimulated when the body doesn’t have food in your stomach.

So ghrelin comes in peaks and troughs and it will get stronger and stronger. That rumbly tummy feeling. Now that can be measured.

A mindset of deprivation can reduce weight loss

And there was a brilliant study in 2011 taken two groups of people. It was quite a small study, but two groups of people were given two different milkshakes.

  • One group was given a 620 calorie indulgent shake. So the packaging was really luxurious and they were told it was going to be really, filling and just a treat basically.
  • And then another group of people were given a 140 calorie, milkshake and told it was kind of, dieting. It was like for fat loss and it was to help them lose weight.

Now the interesting thing was that both of these milkshakes were exactly the same. It’s just the communication about it and the packaging was the thing that was different. Now what, the brilliant thing about this study is it measured the ghrelin. That’s that hunger hormone.

Your hunger hormone can be affected by your expectation of meals

So it was measuring how much ghrelin was produced after drinking this milkshake. They, measured it at the baseline. They measured it just before they had the shake. And then they measured it after.

And also during this time they were kind of asked to talk about it. To rate the milkshake and what was so interesting is that you saw a huge decline in ghrelin after consuming the indulgent shake. That one that they thought was going to be filling. Whereas the people who thought they were having a healthy, sensible milkshake did not have such a decline in ghrelin.

So they still felt a bit hungry.

Part of it is our mindset around diet foods

So when you think that you’re depriving yourself, it’s more than likely you are still going to feel very unsatisfied. Even if you’re getting the same amount of calories. That’s what’s so interesting to me. It’s a lot about our perception of the food.

Do we feel like this is going to be a really warm, healthy, filling meal that is nourishing us? Or do we feel like it’s a really thin, basic, gruelly kind of milkshake? So something for you to think about definitely is thinking about which foods are actually going to help you to feel good about eating. And a lot of that comes down to taste.

Diet foods can be tricky in IBS

So, is it fat free? So, this is the other thing I wanted to move on to, is dieting products. You can get low calorie versions of lots of foods out there now, low fat versions or diet versions.

Now, this is going to reduce down your overall energy intake, and these less energy dense foods, or sometimes they’re zero calories, don’t taste the equivalent of the full fat or the full sugar versions.

There are additional things added to make the food more palatable.

These aren’t always good for people who’ve got IBS.

So when you switch to low calorie foods or diet products, sometimes you can find an increase in your digestive symptoms. That’s not to say for everybody they’re not suitable. Just if you’ve got IBS and you’re trying to eat healthy. Trying to go on a low calorie diet, sometimes using foods that are low calorie aren’t always good for your IBS.

High FODMAP low sugar sweeteners

So, for example, some foods are sweetened with xylitol. Which is a high FODMAP sweetener. Or inulin, which again is a high FODMAP sweetener, and this can cause a lot of bloating and gas. Just makes it really tricky if you don’t know what is causing your symptoms.

Thickeners in fat free foods

The other thing is some of the thickeners for things like yogurts and low fat dairy products are emulsifiers. And sometimes those can be a little bit challenging on your digestive system when you’ve got a really sensitive digestion like in IBS.

Those two things hand in hand. Firstly, your expectation that this food is not going to be as nice and as filling and as comforting as the full fat version. Then secondly, the fact that you might get symptoms from it often mean that these products aren’t the best for helping you to lose weight when you’ve got IBS.

Don’t do OMAD if you have IBS

The other thing about going on a very restrictive diet, so i’ve seen people promoting One meal a day diet, which is sometimes called omad.

I mean, I think it is a little bit mad if I like to say omad is just basically one meal a day.

There is literally no way you are going to meet all your nutritional targets in one meal a day. And if you have IBS, trying to cram all your fibre targets, your protein targets, into one meal is going to leave you very bloated. Very upset tummy, or really hungry.

I mean, if you’re not eating enough meals, then you’re going to really struggle to feel like You’re having a normal diet. And that is where people go on the dieting bandwagon and then flip off and just think I cannot do this. You just go back to eating normally because. Eating one meal a day means basically you’re cutting out two meals a day. That’s quite significant.

How to address weight loss with IBS

So let’s come on to now think about some of the things that you can do.

  1. You can manipulate in your own diet to help if you do want to lose weight. So bear in mind, as I mentioned in the last episode, some of the key things would just be to cut out, you know, your biscuits, chocolate, like, a lot of the typical high energy density foods that you know aren’t great for you, but you just eat because you love them. Now try and cut down on those, those are going to reduce your calorie intake.
  2. Then also going through the low FODMAP diet process in order to understand your particular triggers. Now the low FODMAP diet is not meant for you to lose weight, it is just a diet for you to get a better handle on your digestion.
  3. And I also mentioned the third thing is to increase your daily movement, so that non exercise movement that’s just literally Getting up from your desk, moving around, taking the stairs a bit more than the lift, just generally increasing your day to day movement.

So all of those things, yes, they still stand, but let’s get a bit more specific within the diet.

Does the timing of your food influence whether you’re going to put weight on or not?

Well, generally we know that it’s mostly about your overall calorie intake. Meal frequency isn’t as important for weight loss as some people would have you believe. Eating after nine is not necessarily going to make you put on weight. Your overall energy balance is what’s important.

The impact of eating late at night

But there are some associations with late eating and weight loss.

So eating a later dinner, and they’re talking at like, 9, 10 o’clock at night. Has been shown to decrease your glucose tolerance and keep your blood glucose at a higher level. And this is because we are more able to process glucose in the morning. The later that you eat your insulin resistance gets decreased.

So this could potentially lead to changes in weight if you’re repeatedly eating dinner Right before you go to bed at like 10 or 11 o’clock at night.

Late meals also might increase your cortisol levels over the 24 hours, which can reduce your fatty acid breakdown. There is a potential mechanism. But your overall balance of energy throughout the day is still really, really important. It’s not only about eating late.

Eating late at night may make you hungrier the next day. 

Another thing to bear in mind is that eating late at night has also been shown to double the likelihood of being hungry the next day, which then means you might eat more the following day. You’re less likely to feel full, more likely to feel hungry. No matter what you’re eating, and this has been shown in studies.

If you’ve listened to my podcast before, I do really suggest eating three good meals a day. And this is in order to spread out the key nutrients that you need that are important for IBS, and, well, for everybody.

But if you’re cramming them all into a very short period of time, it’s really difficult to hit your key nutrition targets.

An overnight 12 hour fast

But, I do suggest people have a little bit of a break overnight from eating. Ideally about 12 hours. Now, this is not what we would call intermittent fasting. It’s basically just not eating after dinner.

This helps your digestion because it allows you to digest your food before you go and lie down for eight hours. 

What are you snacking on late at night? 

And also if you think about the foods you’re eating at night, I mean it’s not normally like Broccoli and fish or things that you’re snacking on, is it?

It’s going to be snacking on things that are palatable. We want a little reward at the end of the day and these foods just tend to be higher in energy. Often they’re snack foods that have been produced to have a perfect mix of fats and sugars and salts. They just keep you wanting more because they’re produced in that way.

Don’t go to bed hungry, eat more during the day

So, thinking about what you’re eating during the day will help you to be less hungry at night. I’ve said before, lots of times, I don’t want you to go to bed hungry. I’m not saying that if you have a real need for food before you go to bed that you shouldn’t eat.

Obviously do eat if you’re hungry. But if you’re repeatedly hungry after dinner, I suggest that you’re probably not eating enough in the day.

So you need to eat a bigger lunch, a bigger dinner, and just try and really bulk up on the protein, fibre.

Eating sufficient protein for weight loss

I’m going to go through a little bit more about each of those now. So, protein is one of the key elements that are brilliant for IBS. In that, they don’t have any starches that are fermentable, so they tend to cause less symptoms. Also, if you’re eating lean protein, such as chicken, fish, turkey, eggs. And then vegetarian things like tofu as well, these are really good at helping you get full. And feel like you’ve got enough energy to keep going without getting too many of the IBS type symptoms that you’re trying to avoid.

So do make sure you are eating enough protein throughout the day. That hopefully will reduce the need to want to snack later in the day. But as I said, if you’re hungry, you got to eat. But try to choose things that are including protein that are going to give you a little bit of, the goodness that you’re hungry for, rather than just snack food that like your brain is hungry for, if that makes sense.

Fats are still important, even in weight loss diets

So I mentioned a little bit about low fat foods and trying to cut down on fats, to lose weight. Now we still need fats in our diet. I did a whole episode on, dietary fats, episode 23, and that breaks down a lot about the different fats and how you can digest them and some of the difficulties you might have.

So, we don’t wanna have loads and loads of fatty food when you’ve got IBS because it can really trigger symptoms.

However, you do need to have some level of fats in your diet and think about the Mediterranean diet. It’s got lots of plant based fats like nuts, seeds, olive oil, avocados. I know some of those are higher FODMAP foods and might give you problems, but generally they will have fats that we want to include in our diet. Now the final two pieces of advice, around weight loss with IBS.

Slowing down to eat helps weight loss and IBS

The first one is slowing down to eat. Slowing down over your meal times has a really big impact on your ability to digest your food because your teeth are doing some of the digestion work for you.

If you’re not eating properly and you’re just swallowing down big lumps of food. This happens if you are eating in a rush. If you’re eating distracted, either watching telly or working at your desk, this can have negative consequences on digestion. So you want to slow down to eat and chew your food really well.

People who eat slower may improve weight loss

There is also research that shows that eating slowly can help improve weight loss. There is a research study that showed, some lean men and some men with obesity, who both chewed their food 30 times. And they ate, I think it’s like 11 or 12 percent less food, and they consumed less energy than people who chewed less than 30 times.

Slow eating allows for digestion

So, literally just by slowing down, You’re going to eat less, or you’re potentially going to eat less. Part of the way that that works is that your brain has two ways to know that you are full. One is the stretch receptors in your stomach are full as the food expands in your stomach. The second is like a chemical digestion process that sends messages back to the brain to say, Hey, I’ve got fats. I’ve got proteins. I’m happy. You can stop eating.

That can typically take up to 20 minutes. So if you eat your food really, really fast, sometimes you may get stretch receptor messages. You can feel that there’s food in your stomach, but you want to carry on eating because your brain hasn’t actually registered that there is some of this food being digested yet.

So slowing down just gives your body time to get that process sorted.

Stay hydrated

The other thing is just making sure that you are well hydrated. Now I am not someone who says, if you’re feeling hungry, just go and have a glass of water. Because that’s not really going to help your hunger. However, you can sometimes confuse feelings of hunger with being thirsty.

So, in order to get away from that, so don’t Drink when you’re actually hungry, but at the same time don’t let yourself become really really dehydrated. 

Make sure that you are just looking after your body in lots of ways.

Not just focusing on what you’re cutting out also thinking about what you’re putting in. You need to put in the liquid. You need to put in enough of the antioxidants, nutrients, protein that are going to help your body as you try to change your body shape.

Bearing all of those things in mind if you feel like you need some help with any of this then you can work with me over three months.  I have a lot of people who want to deal with weight loss alongside dealing with gut health and digestion.

Come and join my gut reset if you are interested in doing that working one to one with me or I also have a group gut reset where we do group coaching sessions and you still get time with me one to one but also group sessions. Okay, that’s it for this week. I’d love to hear from you with your questions.

If you’ve got a topic you want me to pick apart in the Inside Knowledge, then let me know. But otherwise I will leave it there for this week and thank you for listening. Bye.

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