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3 Considerations for Weight Loss Beyond Calories and Exercise

Intentional calorie deficits are based on the theory of energy balance, more commonly known as calories in/out. This is a simplified and largely ineffective method for helping clients reach their weight loss goals in the long term. Science has identified, studied and concluded that the picture is far more complicated and intricate. We are seeing studies surface, confirming what we teach in the integrative space, showing that there are additional factors that promote weight gain and retention regardless of the amount of calories ingested. Three major factors to look at and incorporate into any weight regulation plan are the stress response, the gut microbiome and quality of sleep.

The Stress Response

The level of stress experienced and perceived by our clients is intricately related to their ability to regulate weight.

Several aspects are at play here, as the stress response influences a wide range of metabolic processes. A major way in which stress interacts with the biology of weight is through its relationship with insulin.

Cortisol increases insulin production and secretion, and chronically elevated cortisol, as is the case in stress, is a contributing factor to insulin resistance.

Since insulin is anabolic and decreases lipase activity, its presence in weight loss is an uphill battle. Addressing stress often results in a natural reduction (or regulation) in weight that is long-term in nature.

To learn more about stress and weight, visit this blog - where we dive into the inner workings of this relationship.

The Microbiome

The composition of the microbes in the GI tract influences metabolic processes directly related to weight loss.

The main mechanisms through which this occurs are:

  1. Bacteria regulate substrate metabolism

  2. Bacteria are involved in calorie ‘extraction’. This means that depending on the dominant strains, they can either make calories more or less available

  3. The composition of the gut microbiome is either inflammatory or anti-inflammatory. If it promotes inflammation, we typically see a metabolic cascade that favors fat storage and lowers energy production

An important concept to be aware of is bacteria and fungi that live in the GI tract communicate via chemical metabolites. If dysbiosis is present, these metabolites send signals to the brain that translate to us as sugar cravings, as sugar is their main fuel source and survival is their main goal.


Like stress and the microbiome, the quality of sleep is an important factor to consider when working with weight loss clients. Sleep influences weight directly and indirectly.


The quality of sleep largely determines the hormonal landscape. When sleep quality is compromised we see sustained rises in cortisol, which we know impacts insulin.

Beyond this connection, poor sleep influences leptin and ghrelin. These are the hormones which are responsible for hunger and satiety.

Next, sleep and melatonin also share a connection. Insufficient melatonin production impairs sleep, and impaired sleep impacts melatonin synthesis. This relates to weight because melatonin perseveres muscle, regulates adiponectin and has a crucial role in fat oxidation.


When sleep is compromised, so is the function of the amygdala. The amygdala is the part of the brain that is responsible for decision making and essentially, how we perceive the world.

Research shows when the amygdala is negatively affected, the individual tends to perceive more negative events and experience negative emotions. This correlates with a reduced frequency of working out or engaging in health-oriented behaviors and with an increased reliance on food as a coping mechanism.

The research shows that through direct and indirect factors, poor sleep is significantly associated with obesity. Independent of other factors.

In Conclusion……

We can see that the calories in/out equation is largely incomplete and that implementing it in the true sense of intentionally creating a calorie deficit without utilizing other interventions cannot yield long term success.

If you are curious to dive deeper into these concepts in relation to weight loss and how to implement them in a clinical setting, check out our course ‘A Functional Medicine Approach to Weight Loss'

Over 4 Lectures We cover:

-The Stress Response

-The Microbiome


-Why Quality of calories over quantity of calories is a better strategy

We provide theory as well as clinical applications and we discuss how to have these conversations with your clients for the fastest and most sustainable results.

Check it out!

Author: Lisa Kowalyk, Co-Founder Fiore

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