If you’re in a hurry, make sure to come back and check out the videos.  There is some great info there!

Dr Walsh, for those readers who don’t know who you are could you please introduce yourself and give us a little background?

Thanks, Mark.  I’m a Naturopathic Physician practicing in Maryland.  I was involved in the fitness industry for many years, but made the leap to become a physician and now specialize in a few things, most notably finding the underlying reasons people can’t lose weight.

One of my biggest frustrations is the misunderstanding that people have about health and more specifically, weight loss.  We’re told that all we need to do is diet and exercise, and weight loss should be easy.  But it’s not.  Thousands of people will tell you that from experience. 

The fundamental thing I try to teach people is, diet and exercise will only work to the degree that your physiology will allow them to.  Put another way, your body dictates how well diet and exercise works for you.  If your thyroid is sluggish, if your guts aren’t working,  if you have hormone imbalances or if you have adrenal issues, weight loss will be next to impossible.  Yet we are constantly fed the same line that all you need to do is diet more and exercise harder.  That simply isn’t true.

You recently wrote about the idea the too little hydrochloric acid in the stomach could lead to suboptimal digestion and a harder time improving our body composition.  After testing for this you also suggested that HCL supplementation might be necessary to increase these values back to normal.

Unfortunately, I’ve encountered a growing number of people who rely heavily on proton pump inhibitors to prevent HCL production due to severe heartburn when they’re not taking them.  Does reducing HCL with these medications prevent proper digestion and possibly affect their physiques?

I hate proton pump inhibitors.  They are making people worse, not better. 

Many people are put on them because of gastric reflux symptoms, otherwise known as heartburn.  But the truth is, it is very rare to find someone who has too much stomach acid.  In reality, it’s the opposite.  Most people do not have enough stomach acid.  But what happens is, the valve that goes from your esophagus to your stomach – called the esophageal sphincter – doesn’t work, so the little acid they do have goes up into the esophagus and creates a burning sensation that people usually fix with PPIs or antacids.  They are making themselves worse.

Hydrochloric acid is VERY important for our health.  One, it sterilizes our food to help kill any microbes we eat and prevents infection further down our GI tract.  Two, is starts the digestion of protein, which of course is required for a number of processes in our body.  Lastly, acid is responsible for triggering important digestive processes further down the tract, such as telling the pancreas to secrete digestive enzymes and the gall bladder to release bile. 

Without adequate amounts of stomach acid, we are more prone to gut infections and poor digestion.

Low stomach acid impacts so many systems in the body, it can indirectly impact one’s physique from many different levels – hormonal, digestive, improper anabolism or amino acid balance, cortisol, etc.

Many doctors state that once you’re on a proton pump inhibitor you’re on it for life.  Assuming they have tested negative for H Pylori bacteria, is there anything people can do so that they don’t have to continue taking these medications forever?

People should always be tested for H. Pylori infections if they have hyperacidity issues, or especially if they have a history of ulcers.  Your gut will never be healthy if you have an H. Pylori infection.  The urea breath test is the best test for that.

And to answer your question, people on a PPI are most certainly not on it for life.  I’ve helped many people get off of it, but it requires fixing whatever issues caused the hyperacidity symptoms in the first place.  You often have to supply the person with more acid and give nutrients to heal the stomach lining.

Should these people avoid HCL supplementation?

Not necessarily, but like I said, they need to fix whatever was causing the gastric reflux symptoms in the first place.

Assuming someone has a fairly solid diet and exercise regime, what other physiological factors can prevent someone from losing fat or gaining muscle at the ideal rate?  Can you elaborate on this?

This is too much to cover here and is why I created Fat Is Not Your Fault to teach people what can stop them from losing weight.

There are so many things that can do this.  Thyroid dysfunction is a big one and something most doctors don’t know much about.  Your thyroid is your metabolism gland and if there is a defect in that system, you will have a hard time losing weight.

Hormones can also wreak havoc on your body’s ability to lose weight.  We see a lot of people, both men and women, that have hormonal imbalances.  If your hormones are not working properly, you can pretty much forget about losing weight.

I mentioned gut health, but it can’t be overstated.  You are only as healthy as your digestive system.  Everything from infection, to food sensitivities, to inflammation, each of these things will cause systemic effects in your body that will make losing weight difficult.

One of the most common and basic things we find in people are blood sugar imbalances and adrenal dysfunction.  They usually go hand in hand.  On a fundamental level, if you have blood sugar and adrenal issues, nothing will work properly in your body.  It’s the number one problem we see in people, even supposedly “healthy” individuals who follow a great diet and exercise program.

Even neurotransmitters can impact weight loss both directly and indirectly.  Neurotransmitters are chemical messengers in your brain, such as serotonin and dopamine, that have intimate connections with hormones, the immune system and even thyroid physiology.  They also impact mood, motivation and cravings.  On a basic level, if someone has issues with neurotransmitter balance, they might not even have the willpower to diet and exercise, and can have pretty intense cravings for sugar and fat despite how hard they are working at being healthy.

It cannot be overstated – your body dictates how well diet and exercise will work for you.  If your physiology is off, so will be your weight loss efforts.

It seems that there has been a distinct rise in the number of cortisol products on the market.  How much of a role does stress really play in preventing fat loss and what can we do about it?

Cortisol can absolutely stop people from losing weight.  There are two problems with the products though.  One, they suck.  The research they site for rationale in using their product is valid, but the doses and potencies won’t do anything to lower cortisol.  They are totally a marketing ploy and a waste of people’s money.

The second issue is that they never address why cortisol was elevated in the first place.  It might have been a gut infection, food sensitivities, or a blood sugar issue, to name a few.  Even if these products did work, which they don’t, the second you go off of them your cortisol could go right back to where it was in the first place. 

And finally, if you could only do 5 tests that you think all trainees should do what would they be and why?

I don’t even think people need five.  By far the most important test someone can do is a good blood chemistry test.  By good, I mean with adequate markers to really see what is going on in the body.  Blood chemistries that most doctors run today are a waste of time because they only have a few markers on them. 

The second thing is – and this is too big of a topic to go into here – to have your blood chemistry read from an “optimal” or “functional” perspective.  The reference ranges people see on a lab are created using a sick population and are designed to look for pathology, not health.  If your results are within the reference range, it’s saying that you are as healthy as 95% of the people who go to the doctor, which are sick people!  That’s not health. 

The next most important test is a salivary adrenal hormone profile.  The adrenal glands are so important with a variety of systems in the body, if they aren’t working properly, nothing will. 

Other than that, tests should be run based on symptoms.  If someone has GI symptoms, you should get a good GI stool panel.  If someone has hormone issues, you should get a good salivary hormone profile.  If you have a lot of thyroid symptoms, you should get a good thyroid panel done.

Tests are great, but only after someone gets the basics done with a good blood chemistry and adrenal test. 

Thank you so much for taking the time out to do this interview.  Where can my readers learn more about you or your products?

They can learn more by going to fatisnotyourfault.com or www.drbryanpwalsh.com

Thoughts?  Comments?  Leave them below.