Leptin Resistance | Symptoms, Causes, Treatment, & ReversalMar 18, 2021
Note: Reshape Physical Therapy and Wellness evolved into Weight Loss for Health, and finally Zivli. How to Lose Weight After 50 was our first course that eventually grew into Zivli. Some old blog posts or resources mentioned in this episode may have been removed.
If you struggle to lose fat, you may have leptin resistance. Learn the symptoms, causes, and treatment in this video. To lower leptin resistance so you can start burning fat for fuel, you’ll need to address insulin resistance.
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What Is Leptin?
Your adipose, or fat tissue is now recognized as an endocrine organ. It’s not just some parking lot for excess fuel. It’s metabolically active and produces many different cell signaling proteins called adipokines, including one called Leptin.
Think of leptin to your brain as your gas gauge is to your car. The gauge lets you know how much gas you have. Your leptin levels let the hypothalamic region in your brain know how much energy is stored and readily available. Your brain then regulates energy homeostasis and body weight by controlling your appetite and metabolism.
Put simply, your brain (not the volitional control of calories in, calories out) controls your weight. Your fat tissue and the messages it sends the brain have a direct impact on your hunger and metabolic rate. Your leptin tells your brain how much fat you have. The more fat you have, the more leptin you have. The less fat you have, the less leptin you have.
What Is Your Body Set Weight?
Leptin, along with insulin, are the two primary hormones in charge of your body set weight. Leptin serves as the primary signal to your brain to burn fat, and insulin as the primary signal to store fat.
If body set weight is a new term to you, let me briefly explain. Your body loves a state called homeostasis, or a stable state. You’re likely familiar with other forms of homeostasis in the body.
For example, your body likes to maintain a steady heart rate of around 70-100 beats per minute, a steady breathing rate of 12-16 breaths per minute, a body temperature of 98.7, a blood glucose of 70-100, and proper fluid balance.
You may experience elevated blood glucose after a meal, but it will come back down. You may experience an elevated heart and breathing rate during exercise, but it will come back down to your baseline.
With regular exercise, you can lower your basal heart rate and improve your blood pressure. With the right strategies, you can lower your fasting blood glucose.
The same goes with your body’s preferred level of body fat. Your body has a stable state that it likes to maintain, and leptin, that little protein made by your fat cells, signals to your brain how much you have to keep it in check.
In the absence of leptin resistance, as leptin levels rise - indicating you have enough fat storage for now - your appetite goes down, and your metabolism speeds up to use that excess energy. This is why leptin has been termed the “fat burning hormone.”
On the other hand, if you lose fat mass and leptin levels drop, your appetite increases and your metabolism slows down to replace that lost energy.
In other words, when working properly, if your fat stores go up, leptin levels go up and signal your brain that you have enough fat stores, stop eating, and speed up your metabolism to get back down to your set weight.
Conversely, leptin works against you when you lose weight. When your fat stores go down, your circulating leptin goes down. These lower levels of leptin tell your brain that you don’t have enough fat stores to stay in your body set weight.
As any dieter knows all-to-well, the body has strong hormonal mechanisms that try and prevent you from losing fat - usually stronger than your willpower.
So when you do lose some weight, this decrease in leptin works against you because you’re under your body set weight, and your body will make every effort possible for you to regain that weight. Your metabolism slows down, your appetite increases, and your satiety does down, so you eat more food and store more of it as fat.
I know this sounds a little depressing for those trying to lose weight, and hopefully eye opening for those of you who have lost and regained weight. But there are plenty of strategies that help you outsmart, and outlast your hormones to lose weight and keep it off. Stick around till the end of the video and I’ll explain where you can learn more about how to do this.
Here’s a really important key I want you to remember. When you lose weight, leptin levels drop faster than your insulin levels. The drop in leptin will signal your body to regain the weight before the drop in insulin has the chance to truly lower your body set weight.
This is why you see more weight loss in the first month or two and then it slows down. This is also why you so often regain weight you lose. Your hormones are working against you, and if you haven’t truly made these changes part of your lifestyle, if you haven’t formed new healthy habits, your hormones will win. You will regain the fat.
Losing weight is a long-term game. You can’t rely solely on your self-control or willpower. You can’t do a restrictive diet or exercise plan that you can’t maintain for the rest of your life. You have to outsmart, and outlast your hormones to lose weight for good.
Here’s a picture of how your body set weight works.
This is called your body weight thermostat, and it’s a negative feedback loop between insulin, your fat storage hormone, and leptin, your fat burning hormone. So, when you eat, your insulin levels will go up to move the energy from the food out of the bloodstream and into your cells. You’ll gain fat.
But then, those fat cells are going to increase your leptin levels. Leptin signals your brain, that you have enough fat, you’re full, stop eating. Your appetite goes down and you stop eating. Anytime you aren’t eating will lower your insulin. You can see that leptin holds insulin in check. This is how it works under normal conditions.
What Is Leptin Resistance?
Leptin resistance is when your brain becomes resistant to the effects of leptin. Your brain doesn’t sense that your body has enough fat and stops speeding up your metabolism and reducing your hunger to get the extra fat off.
This is a visual of the body weight thermostat when you have excess weight.
You eat, your insulin levels rise, you gain fat, leptin goes up, and it should lower your appetite and make you stop eating so that your insulin levels can go down.
But remember, if more and more leptin is being released because you have more and more fat cells, eventually your body becomes resistant to those appetite-suppressing and fat-lowering effects of leptin. That negative feedback loop is broken, so insulin then essentially goes unregulated by leptin.
Often, leptin can keep up with rising insulin levels for decades, but the root problem, which is insulin resistance and inflammation from poor nutrition and lifestyle habits, haven’t been solved, so insulin levels continue to rise and persistent high levels of hormones result in resistance.
Eventually, persistent high levels of leptin cause leptin resistance, and persistent high levels of insulin cause insulin resistance.
Defective cellular cleaning, or autophagy has also been implicated in leptin resistance. I’m a huge advocate of intermittent fasting, and autophagy starts after about 16 hours of fasting. Improving leptin sensitivity is just another benefit of intermittent fasting.
If you weigh more than you’d like, it’s because insulin and leptin levels are higher than what you’d like. With leptin resistance, your brain is less sensitive to the effects of leptin. It has a harder time telling when you have enough fat, stop eating, and speed up the metabolism.
Remember when things are working well if your leptin goes up, your weight should go down. But most people with excess weight actually have elevated levels of leptin because they’re resistant to its effects.
Your brain doesn’t sense that it has enough fat. To make things worse, you also have insulin resistance and higher levels of insulin will make your body store more fat. And to cap it off, because your insulin isn’t working as well, glucose has a harder time getting into your cells.
Think about how a type 1 diabetic may have dangerously high blood sugars, yet can’t gain weight. There is plenty of energy in the bloodstream, but without insulin, it cannot get into the cells, and they cannot gain weight.
Someone with untreated type 1 diabetes can eat and eat and eat and never gain weight. They have excessive thirst because of the high blood sugars.
That’s similar to what’s happening with insulin resistance, glucose is having a hard time getting in, which is why many people with insulin resistance have carb cravings. Those cells want energy and they want it fast, and refined carbs and sugars are just the ticket to get that fast energy.
These high carb foods raise your blood sugar which will raise your insulin and the sick cycle continues, all the while driving your body set weight up and up.
It’s important to note that insulin and leptin resistance are time-dependent. Like rust, a little water on some metal won’t do damage over one night, or a week, or a month. It takes a long time, and so does hormonal resistance.
Developing insulin and leptin resistance is a slow process and your body set weight increases gradually over time. Most people only gain one to one and a half pounds per year, but after 15 or 20 years, that can really add up!
This doesn’t happen overnight. And it won’t get better overnight, or even weeks, or months. It can take years of consistent lifestyle changes to really get the long-term benefits.
But if you want to reduce your risk for diseases like type 2 diabetes, cardiovascular disease, cancer, arthritis, and dementia, change you must. I want you to stop asking yourself, “How many calories, or points, or grams of fat does this have,” and start asking yourself, “How does this affect my insulin.”
How to Lower Leptin Resistance
If you want to reverse leptin resistance, learn to reduce your insulin resistance. Here are 6 tips to reduce insulin resistance.
#1: Focus on Macronutrients
The first thing that impacts insulin is your food choices. Food is made of various combinations of three different types of macronutrients - carbohydrates, proteins, and fats. Here’s a picture that shows how each type of macronutrient affects insulin.
Fat stimulates the lowest amount of insulin, protein is moderate, and carbohydrates are the highest.
As a brief overview, there are three main types of carbohydrates: fiber, starch, and sugar. Fiber doesn’t stimulate an insulin response, actually, it slows down the digestion of your food so slows your insulin response. The other two types of carbs - starches and sugars - will stimulate an insulin response. The more pure and refined the carb, the more it stimulates blood sugars and insulin.
The most common cause of excessive insulin in your blood is eating a diet that’s high in refined starches and sugars. If you’re eating things like pop, dessert, candy, other sugary beverages, bread, pasta, bagels, or you have a diet that’s high in processed foods that contain refined flour and sugar, you’re elevating your blood glucose so much, and so often, that your insulin levels are constantly stimulated.
#2: Pick Healthier Sugar Alternatives
The second thing that can stimulate an insulin response are some artificial sweeteners. You may think that diet pop, other diet drinks, or artificial sweeteners don’t contribute to weight gain because they don’t have any calories.
But remember...the calorie model of obesity was wrong in the first place. The research shows that many artificial sweeteners don’t help with weight loss and can actually contribute to weight gain.
The reason is that some artificial sweeteners, especially sucralose and saccharin, raise insulin more than regular sugar. Think of artificial sweeteners, no matter what type they are, the same way you think about sugar. Try to eat just a little at a time and not too often. If you do like artificial sweeteners and you want to include them in your diet, I recommend using stevia, erythritol, or monk fruit sweetener because these ones don’t appear to raise insulin.
You may be wondering…”How can artificial sweeteners stimulate insulin when they don’t have any carbs and have a minimal blood sugar response? I thought blood sugar was what caused insulin to be released? So how can insulin be released without an increase in blood sugar?” Great question!
The third factor that can stimulate insulin is something called the cephalic phase insulin response. This occurs when insulin is released in the first few minutes of a meal before your blood sugar levels rise.
The cephalic phase insulin response lasts for about 10 minutes and is caused by the anticipatory sight, smell, and taste of food. It’s enhanced by the chewing and swallowing of food.
This insulin response is triggered with some artificial sweeteners even though they have no calories, which is why they don’t help with weight loss.
Along with the cephalic phase insulin response, the other mechanism that stimulates your body to release insulin, even when it’s digesting things like protein and fat that don’t directly raise your blood sugar levels, are called incretin hormones.
Food in your stomach is going to trigger these two hormones, primarily glucagon-like peptide-1 or GLP-1 and glucose-dependent insulinotropic polypeptide, also known as gastric inhibitory peptide or GIP, to be released by your stomach and intestines. These hormones will raise insulin levels.
#3: Embrace Intermittent Fasting
Meal timing is a really important and commonly overlooked factor regarding insulin release. In the caloric model of obesity, when you eat doesn’t matter...it’s all about the total number of calories you consume in a day.
The truth is, the more frequently you eat, the more insulin is released. Reduce your snacking, and learn to incorporate intermittent fasting, also known as time-restricted feeding, into your lifestyle.
#4: Make Stress Management a Top Priority
Stress can be a big underlying barrier to losing weight because when your body is stressed, no matter what type of stressor, your cortisol, or your stress hormone, will go up. Cortisol causes more glucose to be released into your bloodstream, and more glucose causes more insulin to be released.
#5: Take Rest & Sleep (Very) Seriously
Sleep deprivation is another crucial piece to insulin resistance. Studies show that if you don’t get at least seven hours of sleep each night, you’re increasing your risk for weight gain and disease.
When you’re sleep-deprived, your cortisol, blood glucose, and insulin levels will all go up...just like any other stress on your body. If you aren’t losing weight, or have reached a plateau, and haven’t focused on your sleep, this may be an excellent place to start.
#6: Are Your Medications Raising Insulin?
Medications are another factor that affect your weight loss, more than you probably realize. Some medications cause higher blood sugars, which will in turn raise your insulin and make it harder to lose weight. Your regular medications actually become a contributing factor to your body set weight.
A few common examples of medications that raise insulin are corticosteroids, antidepressants, some diabetes medications like insulin or those containing sulfonylureas, some heartburn drugs, some blood pressure meds like metoprolol, atenolol, and propranolol, hormone therapy or contraceptives, and anti-seizure drugs such as Depakote.
These are only a fraction of the meds that can contribute to weight gain. Most medications won’t say if they raise insulin, but they may indicate if they cause an increase in blood sugars and if they do, you can be sure they will also raise your insulin and body weight.
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