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Posted: Monday, February 29, 2016

Endocrinology and Weight Loss

We’re now a few weeks into 2016, so it’s time to take stock. Have you kept your weight loss resolutions, or have you become one of the many who statistically have abandoned them by now? If you’ve dropped it, it’s never too late to pick it back up and try again. Maybe you just need a renewed perspective. For instance, did you know that there can be a variety of reasons why we weigh what we weigh? Sure, some of it is diet and exercise – or lack thereof – but for some, it’s also a hormonal issue. Sometimes, figuring out that there’s more going on than just what we’re eating or how much we’re exercising can lead to better results.

Endocrinologist Dr. Sarah Smith from the Blount Memorial Weight Management Center says endocrinology studies just that. “An endocrinologist is an internal medicine doctor who studies just hormones, which basically are chemical signals that tell the body how to work,” she said. “When we’re looking at obesity and how to lose that extra weight, we first have to determine if there are any crossed signals. If there are, we have to fix those first, then we can pursue how to lose the weight. The first aspect of what I do is to diagnose a hormonal issue. On a patient’s first visit, we take a look at whether one exists, and from there, I can perform some lab testing to get confirmation of that. Then, we also look at what we can do to treat that issue, as well as what’s being done already to treat existing issues such as diabetes, which is a hormonal disease. So, it’s essentially a two-fold process of looking for things that haven’t yet been discovered, as well as how to medically optimize issues that have already been discovered,” she explained.

Smith says, in general, hormones are underestimated. “Hormones are not the boss of anything, but they will affect everything,” she said. “A lot of hormonal issues can go undiagnosed for years and even decades because you can live with a relative deficiency of a hormone or even the absence of certain hormones, but you’re going to feel bad. Sometimes, people can develop a ‘new norm’ of feeling bad. They’re unable to exercise at their full capacity, and they don’t have the energy and drive to devote themselves to a healthier lifestyle. Sleep issues, as well, are underestimated when it comes to hormone health. I see sleep issues in almost all of my patients, and we have to treat those first before we can go forward. Stress, too, is a very powerful motivator of hormonal irregularity, and that includes all types of stress from emotional to physical to relational,” she explained.

Once a hormonal issue is uncovered, Smith says she can begin to fix it. “If the patient has, for instance, a hormonal deficiency, we can begin to replace that specific hormone,” she said. “If they have a hormonal irregularity, such as insulin, then I have a lot of different medications we can use to tackle that. We even have, in the case of diabetes, weight-reducing diabetes medications, which is pretty exciting for those patients. We also can look to weight loss drugs. We have several long-term drugs now that are approved by the U.S. Food and Drug Administration (FDA), whereas before, the drugs we used were short-term only, so we’re really looking at obesity as more than just something that happens. We’re treating it like a disease,” she explained.

“We have two programs we’re currently offering,” Smith added. “We have a physician-designed opti-fast, which is designed for people who need to lose more than 50 pounds, and is the most-intense of the weight management options. We also have a physician-designed ‘C.O.R.E.,’ which stands for ‘Create, Optimize and Recover Excellence.’ This one is for people who want to use real food and have long-term dietary changes. Both programs are multidisciplinary and involve myself, a nurse practitioner, registered dietitians, behaviorists, psychologists and an exercise physiologist. We really try to hit all aspects of the obesity disease, and we constantly revamp the plan to help specific patients with their individual needs,” she explained.

Dr. Smith sees patients in her office at the Blount Memorial Weight Management Center located in the Blount Memorial Physician Office Building in Maryville. For more information or to schedule an appointment, call 865-977-4673.


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