045. Why Weight Gain is a Hormonal Issue and 5 Action Steps to Address It Now. Insulin, Cortisol, Time Restricted Eating, Fiber, Vinegar, Protein, and Healthy Fats

In this episode, Ann Tsung explores the intricacies of weight loss in the context of hormonal issues, shedding light on the obstacles many individuals face. She delves into the pivotal roles played by insulin and cortisol levels and their impact on our bodies’ ability to shed excess weight. Ann’s insightful discussion goes beyond conventional weight-loss approaches, emphasizing the importance of understanding and addressing these hormonal factors.

Moreover, Ann generously shares a roadmap for action, guiding listeners through practical steps to reset their cognitive approaches and embark on a successful weight-loss journey. She emphasizes that true weight loss transcends the mere tallying of calories; it hinges on a transformative shift in one’s mindset and approach to wellness. Join us in this episode as we unlock the keys to sustainable weight management, grounded in a profound understanding of the hormonal intricacies at play.

Key Points From This Episode:

  1. When you consume anything refined, it will be converted into glucose or sugar, and your body will secrete insulin.
  2. Insulin is what helps your body absorb glucose; it also signals the body to store fat.
  3. When you reduce your calorie intake, your metabolism will actively decrease to match that reduced calorie intake.
  4. The consumption of artificial sweeteners can still stimulate an insulin response.
  5. Obesity is a hormonal issue; that’s why it’s difficult to lose weight when you’ve been obese for an extended period.
  6. Cortisol increases your blood sugar levels, which in turn increases your insulin levels.
  7. Fiber and vinegar can reduce the absorption of carbohydrates.
  8. The significance of micro habit stacking

Tweet This:

  • Engage in activities you love and find joy in; they can help reduce stress levels.”
  • “What’s one action you’re going to take now to contribute to your weight-loss journey?”

Listen to the previous episodes here


The Cancer Code: A Revolutionary New Understanding of Medical History by Dr. Jason Fung

The Obesity Code: Unlocking The Secrets of Weight Loss by Dr. Jason Fung

Dexcom Continuous Glucose Monitor 



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45 - Why Weight Gain is a Hormonal Issue and 5 Action Steps to Address It Now. Insulin, Cortisol, Time Restricted Eating, Fiber, Vinegar, Protein, and Healthy Fats

00:06 Announcer If you’re struggling with your vitality, energy, mood, focus or sleep, this podcast is for you. Your host Dr. Ann Tsung, ER doctor and aerospace flight surgeon, will help you reach for the stars and remove the barriers or blockades that have been holding you back from living your best life. If you’ve been challenged by your health, relationships or productivity, then it’s time for a breakthrough. So here’s your host Dr. Ann Tsung.

00:43 Dr. Ann Tsung Hello. Welcome to It’s Not Rocket Science Show. I am your host Dr. Ann Tsung. In this episode, I’d like to talk about why it is so hard to lose weight. It’s because of the hormonal issues that we experience like insulin and cortisol. That is why when we want to lose these few little pounds, or we try all these diets, it just doesn’t work. We’re going to talk about why insulin level is important, why cortisol level is important, and the action steps you can take to actually reset your brain set point for your weight. That’s really the main thing. It’s not about calories at all, whatsoever. So let’s go ahead and dive in.

01:25 In episode 32, I talked about intermittent fasting. And in Episode 33, I talked about why eating healthy fats can actually get you fuller and help you lose weight. In this episode, I’m going to be tying everything together and give you the reasoning why those things actually work, okay? A lot of people, even me myself, I have done low fat diet. You probably have done some sort of calorie restriction to lose weight or maybe a low sugar diet, Paleo, Keto. There are all various forms of diets, and there are so many out there. Usually, it works for a while. Then after a few weeks or a few months, then you plateau and nothing else happens. Or, you gain your weight back. Or, perhaps you know somebody who is actually severely overweight and it is so hard. No matter what they do, what they try, the weight just won’t come off.

02:23 I read this book by Dr. Jason Fung, The Obesity Code and The Cancer Code. I absolutely love the book. It just explains everything from a hormonal standpoint in terms of obesity, from hormonal standpoint instead of from calories and different diets. It really gives you the real cause of why people gain weight and can’t get it off. Obesity is a hormonal issue, not a calorie issue. Essentially, what that means is obesity is caused by insulin level. It’s very, very simple when you actually dial down to it.

03:07 When you have high insulin level, when you have glucose or sugar, basically, when you ingest glucose or carbohydrates, a lot of people actually have a misconception. Like, “I don’t drink anything sweet. I don’t eat anything sweet or add a sugar.” Maybe you’re eating refined carbs like pasta, anything white like white flour, rice. Then it will be converted into sugar or glucose. So when you ingest it, usually, your body will secrete insulin so that the cells can take the glucose into the cells to be utilized. When you ingest those refined carbs, you have a very sharp rise in your sugar level in the body, and then you have a very sharp rise of insulin to kind of combat that. The insulin stays high for a very long time too when your sugar is that low. I have personal experience with that because I’ve been wearing the Dexcom, the continuous glucose monitor, for many years now. And I can tell my body responds. If I eat nuts, lean protein, olive oil, avocado, my sugar goes from 80 to maybe 110, 120. That’s it. Then it goes back down within usually two hours. But I’ve had also pizza, or I’ve had rice like rice noodles, oh my goodness, that increases my glucose to about at least 190s or sometimes 200s if it’s pizza. It stays up. It doesn’t start going down to baseline for four hours. So I have a really sharp peak and long duration.

04:45 Insulin is what helps you take the glucose in, and it’s a fat storage signal. You take the glucose in, and it signals your body to store more fat. All these excess energy needs to be stored as fat. So it’s very, very simple. You can see as an example, a medical example, type 2 diabetics. Typically, they do secrete insulin but they have insulin resistance. So their body is not actually able to take in the glucose as well, so the body secretes more and more and more insulin. Anyway, you see that a lot of type 2 diabetics are overweight or obese. But if you look at type 1 diabetics, their issue is that their body actually cannot produce insulin at all, whatsoever. There’s a low level of insulin, and they’re actually very skinny. They’re usually thin. I thought that was just an incredible way to explain the root cause of obesity. This is why when you try to decrease your calories intake usually, well — so your brain already has a set point for your weight. When you try to decrease your calories intake, your brain will actually decrease your metabolism. You might lose weight initially for a bit, but your brain will decrease your metabolism to match that caloric intake so you stay at the same weight. And then you plateau.

06:13 The second thing that happens that’s very important is, if you take in artificial sweeteners — even though it doesn’t increase your actual body sugar level or glucose level — it will still stimulate insulin response. So you may not have an increase in glucose, but you will still increase your insulin. Again, an insulin is a fat storage signal and a hormone. And so a lot of times, you don’t usually see people who are drinking a lot of diet products or diet soda, many of them are actually not that thin.

06:53 The other thing with the hormones is that increased stress increases your cortisol. Cortisol is a fight or flight hormone, essentially. When you’re stressed out, then you need more glucose. You need more sugar, energy, right? So when you have increased cortisol during stress — that can be due to work stress, stress from family. It could be lack of sleep. That’s a form of stress. It could be working night shifts — then you increase the sugar in your body level. Then that therefore increases the insulin again and that increases fat storage. That is why obesity is a hormonal issue. You have to address essentially the peak or the level or sharp rise of insulin that occurs when you eat refined carbs or sugar. Also, the duration of it, how long you’ve been exposed to and when you’re stressed out, that basically worsens your insulin level and insulin duration.

07:56 The other thing is, when you have been overweight for some time or obese for some time, your brain is already at that set point for that specific weight. Because of the duration, if you’ve been overweight for a long time, 10, 20, 30 years, it’s even harder to lose weight. Because, usually, there’s some sort of insulin resistance going on. So it’s not just the level, the peak and trough of insulin. By how long you’re exposed to that high level of insulin, that plays a role as well. Because that leads to insulin resistance when you have a high level of hormones. Then your body basically will not respond to that hormone as well. So you need higher, higher, higher level of insulin for your body to actually respond to it. It creates something called insulin resistance. That is the reason why it’s so difficult for somebody who has been obese for so long to not be able to lose weight. That is why time-restricted eating pattern comes into play. Because if you set a time-restricted eating pattern — as in you only eat from 12 to 8 PM, or you only eat 10 hours of the day instead of eating all day or snacking all day — then you decrease the duration of time your body is exposed to the rise and fall of insulin.

09:24 Again, I want to summarize. Obesity is the hormonal issue. It is caused by increased insulin. And when you have a long duration of insulin exposure, then it leads to insulin resistance, okay? Cortisol increases your sugar level, which increases your insulin level. That exacerbates the whole cycle as well. That’s why when you see nightshift workers, a lot of times, they’re eating during the day. They eat before they go to sleep. They eat not very healthy food at night. They’re stressed out at night. Their body is not sleeping well. They should be sleeping at night, but they’re not. A lot of shift workers are overweight or obese.

10:09 And so the action that you can take now in order to address the weight issue, to decrease your insulin level, is number one, you go to your pantry right now and you read all of the labels. You have to be very careful. It’s going to be minimally processed food. Whole foods will be best. If you have something with packages or a label, you want to look at the ingredients. Look up 50 different names for sugar, because they have dextrose and sucralose and fructose and even various forms of syrup that doesn’t have sugar syrup. We found that Hershey’s chocolate syrup, actually, the cacao is actually the last ingredient. Then the first ingredient is high fructose corn syrup. Whatever comes first has the highest amount, and whatever comes last has the least amount. So I will go to your pantry and look at all of the packaging. Look for anything with added sugar and take something. Also, if you have any diet products, again, those stimulate insulin too. Just pick one thing or two that you know that you can remove from your everyday diet. It has to be something that’s feasible for you.

11:26 Then number two, you want to increase the amount of fiber, especially whole foods with lots of fiber, and vinegar into your diet. Because fiber and vinegar will decrease the absorption of carbohydrates. It will kind of slow down the absorption, and so you won’t have that sharp rise of insulin. Just like Italians when they eat bread, they usually eat it with olive oil and balsamic vinegar. The oil will also decrease the absorption of the carbs as well. Again, if you can incorporate like chia seeds, or flax seeds, or any sort of vegetables, greens, high fiber, whole foods, minimal processed, natural fiber. Don’t blend it. A lot of fruit smoothies are blended. Basically, you lose. It leads to a very, very sharp rise in your sugar instead of eating whole fruits.

12:25 Then what you want to do is, you want to set a time for eating, an eating schedule. Currently, what time do you eat from? Do you eat breakfast at 7 AM, and then you stop by 8 PM? Okay. So currently, you’re eating duration is about 13 hours. And so maybe you can start by cutting back one hour or cutting back two hours. Say, instead of stopping eating around 8 PM, you can do 7 PM. You can do 6 PM, whatever you want to do. Or, you can eat later. You can delay your breakfast time or not eat breakfast. It’s just what I usually do, until 10 or 12 and see how you do. And so you take in the same amount of calories. You just decrease the duration that your body is exposed to the rise and fall of insulin level. That is going to address the insulin resistance portion so that you can basically change your brain set point.

13:23 Essentially, obesity is a brain issue. We don’t address the brain issue. The brain has that set point and also produce signals to hormone secretion, cortisol, insulin, et cetera. It’s very, very important. Then next, you want to have some moderate protein intake and increase your healthy fats. So if you want to go dive deeper into what are healthy fats, go to Episode 33. Lots of olive oil, nuts, raw — raw nuts are better than roasted nuts — and avocado, et cetera.

13:58 As a summary, obesity is a hormonal issue. It is usually due to insulin level peaking. Also, the duration of it causes insulin resistance. So if you don’t address insulin level — not just calories. It’s not sugar level. It’s insulin level — then you’ll have a pretty difficult time to lose weight because you can’t really change your brain set point. And you also want to address your cortisol level, your stress level. Assess your sleep. Are you sleeping okay? Are you sleeping enough? Perhaps increase your recovery. So you need to have the grit to recover because that’s a productivity hack, too. If you don’t recover, you can’t produce. Your brain is not going to be able to focus as much if you do not recover and back off. Meditation or some sort of visual imagery, 6 phase meditation, I love that. I do that every morning. Sensory deprivation float tanks, that’s what I do as well. It’s fantastic. It takes away all stimulation and just lets your body and your brain rest to go to a creative side or meditative state. Perhaps there’s yoga, spending time with others, family, and just doing things you love, something you find joy in, spending time with your pets, your children. All of those can decrease stress level. So I would say the most important is sleep.

15:24 Now, I want to challenge you right now just to take one action. I know I talked about a lot of things that you can do. But just take one action. What is one thing that you’re going to do now? Either you’re going to address your added sugar. You’re going to address the time that you eat, the feeding window, or you’re going to address your sleep, your stress level. Just pick one thing. I don’t want to overwhelm you with so many things. Write it down. “For the next week, I will go to bed at 8 PM or 9 PM.” Or, “For the next week, I will stop eating at 7 PM,” or, “I’ll start eating later like 10 PM, et cetera.” That’s it. If you can sustain it for one week and then keep going and then stack another action item on top of that, it’s called micro habit stacking. If you get too overwhelmed, too many things that you have to do, there’s too many things you have to think about. So it’s more likely you will fail. You may not, but you may. So think about the micro habits and just one action after this episode, okay?

16:32 I wanted to thank you so much for your attention and your presence. If you want to see the links in the show notes that I talked about, go to itsnotrocketscienceshow.com. And if you go to my Facebook, Anne Tsung MD, and join my private Facebook group, I have uploaded the Seven-Day Master Class on Productivity. It’s essentially all of the tips and the tricks and my planning, my routine, on how I get the most out of my day so I can do multiple ventures like real estate, podcast, working full-time and part-time in the ER, ICU, et cetera, and also spend time with my loved ones. So please go check it out. Go to my Facebook Ann Tsung MD. Join the private Facebook group. Alternatively, go to itsnotrocketscienceshow.com. Go to the bottom, and you can sign up for that master class. So again, thank you so much. And remember, everything you need is within you now.

17:33 Announcer That’s it for today’s episode. Head on over to iTunes and subscribe to the show. One lucky listener every single week that posts a review in iTunes will win a chance in the grand prize drawing to win a private VIP Day for a health and life makeover with Dr. Ann Tsung herself. Then be sure to head on over to itsnotrocketscienceshow.com, and pick up your free gift from Dr. Tsung. Then join us on the next episode.