Tuning Metabolism: Melatonin’s Role in a Rapid Weight Loss Program

Most individuals following a medically guided weight loss program will lose weight. However, the operative word here is following. The number one reason why programs fail is poor compliance. The old adage frequently attributed to Benjamin Franklin applies “Failure to plan is planning to fail.”

Practitioners hear the excuses, “I’m too tired…”, “I’m too stressed….”, or “I’m too busy….” to plan and coordinate the right foods and exercises into my lifestyle to stick with the program. Even the simplest plans can end in failure due to a poor night’s sleep or perceived decreased energy during the day.

Programs can focus on reduced calories, increased activity, detoxification, or hormone balance. The best ones have a contribution from all of these and will also pay particular attention to the stresses that are placed on a body that is decreasing in total mass!

Most weight loss patients expect to feel better when starting a “get healthy plan,” but more times than not one or more predictable yet overlooked stresses derails a well-meaning patient and frustrates a well-intentioned doctor.  Most people feel a bit worse before they feel better.

Stresses on the weight-loss body include

• Changes in circadian rhythms 
• Oxidative stress 
• Toxic release from adipose (fat) tissue

Waking up early, going to bed earlier, or staying up later to accommodate a new lifestyle can be disastrous to the normal diurnal cycles that the body clings to for natural adaptation and survival. Any change (even healthy ones) to the status quo causes additional stress to the body in an attempt to restore homeostasis. Melatonin is the most commonly suggested therapeutic for entrainment of circadian rhythm. Most often studied in shift work disorders, jet lag, changes in season, and among the blind, little doubt exists between the connection between this powerful hormone and daily cycles. A 3 milligram dose is often used over the short term to correct for changes and ease the body into adapting to the new healthy patterns. If not addressed up front during a weight loss programs, many patients will seek conventional medical intervention for sleep such as prescription hypnotics. However, this can have potential ill results as reported in the British Medical Journal which associated these medicines with increased mortality. [1]

With melatonin’s reputation as a sleep product, many practitioners forget that melatonin is a powerful antioxidant that crosses the blood-brain barrier. Most patients have never even been introduced to this concept. Rapid weight loss patients may experience increased oxidative stress due to exercise, increased protein intake, and even reduced calorie intake can be seen by the body as an oxidative stress event. In fact, even healthy fats including fish oils which support the reduction of systemic inflammation can increase an individual’s need for antioxidants. Oral melatonin has the potential to reduce this oxidative stress load.[2] Melatonin at 0.3 milligrams can effectively be used for long-term support in the event that a rapid weight loss program is expected to take a longer time frame. For example, individuals needing to lose more than 30 pounds may require three or more months and low, physiological-dosed melatonin (0.3 mg) is appropriate for supporting this process.

Toxins, whether environmental or excess intermediate metabolites from normal metabolism, are often sequestered in adipose tissue to protect vital tissues and organs from free radical damage. During rapid weight loss, adipose tissue decreases in size (the desired outcome of the program), yet this eliminates valuable storage for these toxins. Weight loss releases these toxins into the blood stream and must be handled effectively. Fecal elimination must be supported as well urinary excretion. Liver support, antioxidant support, and bowel and kidney support are all necessary to safely and effectively master a rapid weight loss plan. When dietary antioxidants and alkalization are not enough, simple supplementation of pH-supporting greens and melatonin can be useful. In fact, melatonin has been used to support bowel motility among those with those further into the dis-ease state of irritable bowel syndrome[3] and pain in those with inflammatory bowel disease.[4]  

In the context of weight-loss, it is rare to find a patient seeking this type of support without other comorbid conditions. Addressing these personalized needs are key to success. Sleep challenges are pervasive affecting up to 30% of the population. Gastrointestinal disturbances and hormone and/ or stage-of-life related conditions also affect a majority of weight loss patients. Thus, using a combination of interventions to support hormone balance, gastrointestinal health, and healing sleep is simply good lifestyle medicine and prudent to support compliance in a medically supervised weight loss program.

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[1] Kripke DF, Langer RD, Kline LE. Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open 2012;2: e000850.
[2] Reiter RJ, Tan DX, Osuna C, Gitto E. Actions of melatonin in the reduction of oxidative stress. A review. J Biomed Sci. 2000 Nov-Dec;7(6):444-58.
[3] Lu WZ, Gwee, KA, Moochhalla, S, Ho, KY. Melatonin improves bowel symptoms in female patients with irritable bowel syndrome: a double-blind placebo-controlled study. Aliment Pharmacol Ther 2005; 22: 927–934.
[4] G H Song, P H Leng,K A Gwee,S M Moochhala, K Y Ho. Melatonin improves abdominal pain in irritable bowel syndrome patients who have sleep disturbances: a randomised, double blind, placebo controlled study. Gut 2005;54:1402-1407 doi:10.1136/gut.2004.062034