Colleen Bush, RDN, Author at Donaldson Plastic Surgery

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Author: Colleen Bush, RDN

By Colleen Bush, RDN |

What Causes Disproportionate Fat Loss?

The Complexities of Fat Loss Patterns & How to Address the Final Hurdles

What Causes Disproportionate Fat Loss?

You’re in the gym. You’re getting good sleep. You’re following the ideal diet down to the macro. However, the pounds just aren’t coming off — or they are not coming off evenly throughout your body. As frustrating as it may be, fat loss patterns are complex and weight loss is not always proportionate due to a variety of physiological, genetic and lifestyle factors that influence how and where the body stores and burns fat.

Having a firm grasp of what causes disproportionate fat loss can help you adjust your ongoing lifestyle plan to address some of the overlooked components throughout this journey.

 

Hormonal Influences

Hormones are influential regulators in fat loss, significantly impacting where and how fat is burned in the body. For example: Insulin, cortisol and thyroid hormones play pivotal roles in metabolism, energy storage and fat mobilization. Elevated cortisol levels due to stress can lead to fat accumulation, particularly in the abdominal area, while imbalances in thyroid hormones can disrupt overall metabolism and hinder weight loss.

Gender-specific hormones like estrogen and testosterone also contribute to fat distribution, with estrogen promoting fat storage in the hips and thighs for women and testosterone fostering a more even distribution in men.

Gut Health’s Impact On Hormones & Weight Loss

Gut health plays a profound role in hormonal balance, directly influencing weight loss, particularly when a patient seems to be doing all of the “right” things. Functional medicine adopts a holistic approach to uncover the root causes of fat loss resistance, often starting with a GI Map test to identify gut imbalances.

Certain gut bacteria are more efficient at breaking down food, which can lead to increased calorie absorption and fat storage. When these bacteria are present in excess, they can create an environment where weight loss becomes challenging, highlighting the importance of addressing gut health in any comprehensive weight loss strategy.

Two women discussing genetics and their weight loss journey

Genetic Predisposition

Genetic factors play a significant role in determining fat distribution patterns in the body. Some people are genetically predisposed to store fat in certain areas (such as the abdomen, hips or thighs) and these areas may be more resistant to fat loss.

Genetic predispositions can also affect hormone levels and receptors involved in fat regulation, leading to differences in where and how fat is lost. Variations in genes that regulate appetite and satiety can also impact fat loss patterns by influencing eating behaviors and energy expenditure.

Genes Related To Fat Loss

Genetic factors that influence disproportionate fat loss include variations in genes related to fat distribution and metabolism, such as those affecting lipogenesis and lipolysis. For example, polymorphisms in the FTO gene have been linked to differences in fat storage patterns and obesity risk.

Types Of Fat: Subcutaneous vs. Visceral Fat

The body stores fat in two primary forms: subcutaneous fat (under the skin) and visceral fat (around internal organs). Visceral fat is more metabolically active and tends to be lost more quickly compared to subcutaneous fat, which is more resistant to mobilization.

Regional Blood Flow

Areas with higher blood flow, such as the face and upper body, may lose fat more readily than areas with lower blood flow, such as the hips and thighs. Increased blood flow enhances the delivery of hormones and enzymes involved in fat breakdown.

Exercise Patterns & Targeting

While spot reduction (losing fat from specific areas by exercising those areas) is largely a myth, exercise patterns can influence overall fat distribution and the appearance of muscle. For example, aerobic exercises tend to reduce visceral fat more effectively, while resistance training can help maintain muscle mass and improve overall body composition.

Additionally, muscle requires supplemental calories to maintain, meaning a patient with greater muscle mass can have a higher caloric intake vs. someone with lower muscle composition without storing extra calories as fat.

Woman performing yoga in her living room
High protein diet for fat loss

Diet & Nutrition Choices

Macronutrient composition and caloric intake can impact fat distribution. High-carbohydrate diets may contribute to fat storage in different areas compared to high-fat diets. Overall caloric deficit and nutritional balance are crucial in how fat is mobilized and burned. Working directly with a registered dietician can help patients discover a nutrition regimen that is both effective and sustainable long-term.

Benefits Of A High-Protein Diet For Even Weight Loss

A high-protein diet aids proportionate weight loss by increasing satiety, which helps reduce overall calorie intake and curb hunger. It also boosts metabolism through the thermic effect of food, which requires more energy to digest and process protein compared to fats and carbohydrates. Additionally, protein supports muscle preservation and growth, which enhances metabolic rate and promotes a leaner body composition.

Individual Metabolic Rate

Basal metabolic rate (BMR) varies between individuals, influencing how quickly and efficiently the body burns fat. Factors such as age, biological sex, muscle mass, and overall health can affect BMR and fat loss patterns.

Age

As people age, hormonal changes and a natural decline in metabolic rate can affect fat distribution. Older individuals may find it harder to gain muscle and lose fat in certain areas compared to younger individuals.

Stress, Sleep & Other Lifestyle Factors

Chronic stress and poor sleep can lead to hormonal imbalances, particularly increased cortisol levels, which promote fat storage, especially in the abdominal area. Managing stress and ensuring adequate sleep are crucial for balanced fat loss.

Weight loss patient from Donaldson Plastic Surgery

Where Do Women Lose Weight First & Last

In women, weight loss often begins in the areas with the least fat storage, such as the face, arms, and chest, due to hormonal influences. The midsection, particularly the lower abdomen, hips, and thighs, is usually the last to lose fat because these areas are hormonally protected for reproductive purposes.

The body’s reluctance to release fat from these regions is a significant factor in the perceived disproportionate fat loss experienced by many women.

Where Do Men Lose Weight First & Last

Men typically experience fat loss first in the abdomen and chest, where fat stores are more readily mobilized. As weight loss continues, the body will gradually reduce fat in other areas such as the arms and legs. However, the lower back and love handles are often the last areas to shed fat, which can be frustrating for those seeking a leaner physique.

This pattern is primarily due to the influence of testosterone and other metabolic factors that dictate fat distribution and loss in the male body.

How To Prevent Disproportionate Fat Loss

While it’s challenging to prevent disproportionate fat loss entirely, adopting a comprehensive approach to diet and exercise can help achieve a more balanced outcome. A well-rounded exercise regimen that includes both cardiovascular activities and strength training can optimize fat loss across the body. Ensuring adequate protein intake and maintaining muscle mass can also prevent muscle loss, which is crucial for maintaining a more proportionate physique.

Discussing stubborn fat loss solutions with Dr. Donaldson

How To Overcome The Final Weight Loss Hurdles:

  • Liposuction: A surgical method to remove stubborn fat deposits, refining the body’s contour and achieving a more proportionate appearance.
  • Tummy Tuck: A comprehensive procedure that removes excess skin and fat from the abdomen, enhancing the body’s natural contours.
  • Gynecomastia Surgery: A specialized intervention for men to reduce excess breast tissue, achieving a flatter and more masculine chest.
  • CoolSculpting: A nonsurgical technique that employs controlled cooling to target and eliminate fat cells, significantly reducing stubborn fat pockets.
  • Kybella: An injectable treatment that dissolves fat cells, typically used to reduce submental fat (double chin) and improve facial contours.
  • Hormone Therapy: A tailored approach that optimizes hormone levels to support metabolism and fat loss, especially when hormonal imbalances are a contributing factor.

 

About The Author

Colleen Bush, RDN, LDN, IFMNP, is a registered functional medicine dietitian in Columbus, Ohio. She creates customized lifestyle programs for her patients, designed to address their most pressing health concerns — with gut health and weight management being top priorities for many patients. She uses an education-first approach when it comes to helping these individuals understand all of the various factors that are at play while trying to lose weight evenly and with an optimized metabolic response.

Colleen Bush, RDN

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Vitamins & Minerals That Complement Each Other

Understanding How Certain Nutrients Perform Better When Paired Together

Vitamins & Minerals That Complement Each Other

While individual vitamins and minerals play essential roles in the body, their effectiveness can be amplified when strategically combined. The following are examples of specific vitamins and minerals that complement each other, which can lead to enhanced absorption of each nutrient and better health outcomes. 

A Quick Note About Getting Your Nutrition From Supplements vs. Food

While supplements help fill nutritional gaps, we often urge patients to obtain their vital vitamins and minerals from whole foods. Whole foods provide a complex matrix of nutrients, fiber and beneficial compounds that work together to promote overall health. Supplements should be seen as a temporary solution and not a substitute for a balanced diet rich in fruits, vegetables, lean proteins and whole grains — unless otherwise suggested by your healthcare provider. 

1. Magnesium & Vitamin D

  • Benefits: Magnesium assists in the activation of Vitamin D, enhancing its benefits for heart health, mood stabilization and sleep.
  • Food Combo: Blackened salmon salad with berries and pecans.

2. Vitamin D & Calcium

  • Benefits: Vitamin D enhances calcium absorption, crucial for bone health. Vitamin K2 further helps by directing calcium to bones and away from arteries.
  • Food Combo: Grilled tofu with kale and sesame seeds, a meal rich in both nutrients.

3. Vitamin C & Iron

  • Benefits: Vitamin C improves non-heme iron absorption from plant-based foods, helping prevent iron deficiency anemia.
  • Food Combo: Spinach salad with strawberries and poppyseed dressing or teriyaki steak with bell peppers.

4. Vitamin B12 & Folate

  • Benefits: Both are essential for red blood cell formation and DNA synthesis, and they work together to maintain proper brain function.
  • Food Combo: Whole grain cereal with fortified soy milk or just a few free-range eggs. 

5. Omega-3 Fatty Acids & Vitamin D

  • Benefits: Omega-3s can enhance Vitamin D’s absorption, promoting better heart and immune health.
  • Food Combo: Sardines with a side of avocado and leafy greens.

6. Zinc & Vitamin A

  • Benefits: Zinc helps transport Vitamin A, necessary for immune function and vision, from the liver to other parts of the body.
  • Food Combo: Whole grain rice with charred bluefin tuna and roasted tomatoes. 

7. Selenium & Vitamin E

  • Benefits: Selenium enhances the antioxidant effects of Vitamin E, protecting cells from damage and reducing inflammation.
  • Food Combo: Turkey avocado wrap with spinach or simply a handful of Brazil nuts which contain an ample amount of both nutrients. 

8. Vitamin C & Vitamin E

  • Benefits: These antioxidants negate free radicals damage and regenerate each other, enhancing their effectiveness in protecting cells from oxidative stress. 
  • Food Combo: Mixed fruit salad with citrus fruits and nuts.

9. Vitamin K & Calcium

  • Benefits: Vitamin K aids in binding calcium to the bone matrix, preventing bone density loss.
  • Food Combo: Creamy fettuccine with brussel sprouts and mushrooms. 

10. Potassium & Magnesium

  • Benefits: Both minerals work together to support cardiovascular health by maintaining normal blood pressure and muscle function. 
  • Food Combo: Bananas with a handful of almonds or salmon with roasted sweet potato and asparagus.

Vitamins & Minerals to Combine Sparingly

  • Calcium & Iron: These minerals compete for absorption in the intestines, which can reduce the efficacy of both; this competition can also result in constipation, diarrhea or other gastrointestinal symptoms.
  • Zinc & Copper: High levels of zinc can interfere with copper absorption and vice versa, which can lead to numbness and weakness in the arms and legs. 
  • Vitamin E & Vitamin K: High doses of Vitamin E can potentially interfere with Vitamin K’s role in blood clotting.

 

 

About The Author

Colleen Bush, RDN, LDN, IFNCP, is the lead functional dietitian at Donaldson. She utilizes the latest dynamic diagnostic testing solutions to get to the root cause of her patients’ health concerns before creating customized lifestyle plans that will help them achieve optimal health. Colleen also believes that education and understanding the core principles of nutrition are necessary for living a long, comfortable, and healthy life.

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Dietician vs. Nutritionist

Understanding The Differences Between These Two Respected Disciplines

Dietician vs. Nutritionist

In the realm of health and wellness, the terms “dietician” and “nutritionist” are often used interchangeably, leading to confusion among patients seeking guidance for their dietary needs. Both professions are dedicated to promoting healthy eating habits and improving overall well-being, but they carry some significant differences. 

What Is The Difference Between A Dietician & A Nutritionist?

The key differences between the two lie in their training, qualifications and scope of practice. Dietitians undergo extensive education, including a bachelor’s degree in dietetics, supervised internship and national examination to become registered dietitians (RDs) or registered dietitian nutritionists (RDNs). They are equipped to provide medical nutrition therapy and dietary counseling in various healthcare settings. 

The term “nutritionist” is not regulated in the same manner as “dietitian.” While some nutritionists may have formal education in nutrition, others may lack accredited training or credentials, leading to variability in expertise and reliability.

“During my internship, I worked alongside dietitians in many areas of dietetics. I was able to see, firsthand, how many interact with patients, but also got to see areas I really enjoyed working in, and areas I didn’t.” 

-Colleen Bush, RDN

Registered Functional Dietitian working in a plastic surgery office with patient

Scope Of Practice: Where They Work & What They Do

 

  • Dietitian: Dietitians are qualified to provide medical nutrition therapy (MNT) and dietary counseling to individuals with various health conditions, such as autoimmune disorders, cardiovascular disease and obesity. They work in diverse settings, including hospitals, clinics, plastic surgery practices and community health organizations, collaborating closely with healthcare professionals to optimize patient outcomes.
  • Nutritionist: Nutritionists often focus on general wellness and lifestyle interventions, offering guidance on healthy eating habits and dietary patterns. However, their scope of practice may lack the depth and specificity required to address complex medical issues or provide individualized dietary recommendations.

Regulatory Oversight: Credentials, Licensing & Accountability

 

  • Dietitian: Registered dietitians are governed by stringent regulations and standards set forth by professional organizations and licensing boards. These regulations ensure that dietitians adhere to evidence-based practices and ethical guidelines, safeguarding the public’s health and well-being.
  • Nutritionist: Unlike dietitians, nutritionists may not be subject to regulatory oversight in many jurisdictions, leading to potential inconsistencies in qualifications and accountability. Without standardized requirements, it can be challenging for patients to assess the credibility and competence of nutritionists.

Dietician and doctor working together

The Benefits Of Choosing A Registered Dietitian

While both dietitians and nutritionists offer valuable insights into healthy eating and wellness, dietitians distinguish themselves as the preferred choice for patients seeking personalized dietary advice and specialized medical nutrition therapy vs. more generalized wellness information. 

 

  • Evidence-Based Practice: Dietitians rely on scientific evidence and clinical research to inform their recommendations, ensuring that dietary interventions are safe, effective and tailored to individual needs.
  • Comprehensive Assessment: Dietitians conduct thorough assessments of patient’s medical history, dietary habits and nutritional status, enabling them to develop personalized nutrition plans that address specific health concerns and goals.
  • Continuity of Care: Dietitians provide ongoing support and education to patients, empowering them to make informed decisions about their health and nutrition throughout their lifespan. These professionals also have to keep up with continuing education to ensure they are up-to-date with the latest research. 
  • Collaborative Care: Dietitians collaborate closely with healthcare providers, including physicians, nurses, and allied health professionals, to coordinate care and optimize patient outcomes within a multidisciplinary framework.

“Dietitians and primary care physicians work great together. We specialize in two different areas but have the same goals for our patients, so I think they complement each other nicely.” 

-Colleen Bush, RDN

The Role of Registered Functional Dietitians (RFDs)

In recent years, a specialized subset of dietitians known as Registered Functional Dietitians (RFDs) has emerged, offering a holistic approach to nutrition and wellness. RFDs integrate principles of functional medicine, personalized nutrition and lifestyle interventions to address the root causes of health issues and optimize physiological function.

By employing a systems-oriented and hyper-customized approach, RFDs empower individuals to achieve sustainable health outcomes through targeted dietary interventions and lifestyle modifications.

About The Author

Colleen Bush, RDN, LDN, IFNCP is a Registered Functional Dietitian in Columbus, Ohio. As Donaldson’s leading nutrition expert, she uses her specialized training to help patients alleviate symptoms related to autoimmune disorders and address the root cause of their health concerns. Colleen also creates customized treatment plans to help prepare patients for surgery and improve their recovery experience. 

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