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Author: Colleen Bush, RDN

Colleen Bush, RDN, LDN, IFNCP is a registered functional dietitian who helps patients uncover the root causes of gastrointestinal symptoms and autoimmune conditions through targeted, food-first care. She provides nutrition plans for individuals experiencing IBS, fatigue, bloating, and glucose imbalance — even in the absence of a formal medical diagnosis. With a deep belief in the power of education and sustainable habits, Colleen empowers patients to feel better in their bodies through practical guidance on diet, sleep, movement and stress management.
By Colleen Bush, RDN |

Ways To Treat Seasonal Affective Disorder

Safely & Effectively Reduce Your SAD Symptoms

Ways To Treat Seasonal Affective Disorder

Seasonal changes affect more than just our routines; they influence everything from energy and sleep to skin health and emotional resilience. Lifestyle-centered functional medicine approaches can offer meaningful support, while select aesthetic treatments provide added comfort and connection for those feeling the weight of the darker months.

This guide focuses on sustainable ways to treat seasonal affective disorder so that you can feel more like yourself throughout the year.

 

What Is Seasonal Affective Disorder (SAD)?

Seasonal Affective Disorder (also called major depressive disorder with a seasonal pattern) is a form of depression that predictably returns as daylight fades in the fall and winter and lifts in spring. A clinical diagnosis considers symptom timing over at least two consecutive years and rules out other causes.

Signature SAD Symptoms Include:

  • Low mood/energy
  • Reduced motivation
  • Oversleeping
  • Increased carb cravings
  • Difficulty concentrating & “brain fog”

What Seasonal Affective Disorder Is Not

SAD is not cured by one hack, and it’s not the same as general burnout or grief — though these can coexist. Social plans, changes to routine and skincare can elevate wellbeing during the darker months.

However, these methods do not replace evidence-based mental health care such as light therapy, cognitive behavioral therapy (CBT) tailored for SAD, nutrition improvements or medication when indicated.

Colleen Bush discussing Seasonal Affective Disorder with a patient in the Columbus, Ohio office

“Seasonal Affective Disorder isn’t ‘just winter blues.’ It’s not weakness or something you should power through, especially if you find it disruptive to your daily life. There are options that don’t just get through the day; they help you live your best life even when the sun’s only out for a few hours!”

-Colleen Bush, Registered Functional Medicine Dietitian

Nutritional Deficiencies That Can Impact Mood

Vitamin D and magnesium are among the most common nutrient gaps. This deficiency can influence mood regulation and sleep quality. Food-first is ideal (fatty fish, fortified dairy/plant milks for vitamin D; leafy greens, legumes, nuts/seeds for magnesium).

However, supplementation is often appropriate during late fall–winter or when bloodwork confirms a deficiency.

Most Common Midwest Nutrient Deficiencies

Best time to take vitamin d supplements

Impact of Caffeine on SAD Symptoms

  • How Much Is Too Much: For most healthy adults, keep total intake at or under 400 mg/day. If you’re pregnant, the limit is 200 mg/day. Track all sources (coffee, tea, sodas, energy drinks, pre-workouts, chocolate).
  • Steady Energy with Fewer Jitters: Many patients do well with tea or matcha because L‑theanine and caffeine promote calm alertness. Spreading smaller doses earlier in the day protects sleep. Avoid intake after 2 p.m.

What Works: A Functional Medicine Approach To SAD

Functional medicine looks beyond symptom management to identify and address the underlying factors contributing to seasonal affective disorder. This holistic approach helps optimize both physical and emotional well-being during the darker months by aligning nutrition, movement, sleep and environment.

Morning outdoor light advances your body clock and supports your mood. Aim for a brisk 15 – 45-minute walk soon after waking. Indirect light exposure to the eyes is the key, but you can wear sunglasses if it’s too bright after a while.

Cold exposure may be uncomfortable or prohibitive for some; simply opening up the blinds and walking on a treadmill may be a more suitable solution.

Sunlight coming through the window of a Midwest living room during the winter

Popular across social media, SAD lights (or “light boxes”) are also clinically proven to reduce seasonal affective disorder symptoms. For best results, use a device that delivers 10,000 lux of light intensity, filtered for UV safety. Sit about an arm’s length away in the morning for ~20–30 minutes to help reset your circadian rhythm.

Watch for: eye strain, headache or other forms of physical agitation.

Build meals around protein-dense foods, fibrous plants and healthy fats to increase satiety and reduce carb cravings; favor minimally processed foods. Some patients have found the Mediterranean-style diet to help improve baseline mood.

Avoid skipping carbs entirely, as this can backfire and cause even more start mood swings as blood sugar fluctuations more dramatically. Emphasize quality over restriction.

Hydration often gets overlooked in the colder seasons, but it’s just as essential (if not more so) during winter. Every breath in the cold Midwest air is a small reminder that you’re losing water with each exhale. Indoor heating only adds to the overall drying effect.

Staying well-hydrated with your 8+ glasses of water a day (and electrolytes) supports energy levels, skin barrier function and even mood regulation.

Structured programs like Mindfulness-Based Cognitive Therapy (MBCT) or Mindfulness-Based Stress Reduction (MBSR) can be especially effective during this time. These 8-week interventions are designed to train your attention and help you develop greater awareness of your thoughts, feelings and physical sensations.

Starting small is essential. Even just a few minutes of guided practice can foster consistency and build resilience.

Aim for a regular schedule with 7–9 hours of rest each night, going to bed and waking up at the same times — even on weekends. Create a calming environment by dimming lights in the evening, limiting screen time before bed and keeping your bedroom cool, dark and quiet.

However, oversleeping (more than 9 – 10 hours regularly) can actually worsen fatigue and low mood rather than relieve it.

How To Get Better Sleep

“Sleep is one of the most powerful regulators of mood. Even small adjustments can make a profound impact. A consistent bedtime & wake time reinforces our circadian rhythm, making it easier to fall asleep & get out of bed.”

-Colleen Bush, Registered Functional Medicine Dietitian  

more insight

What You Can Do in the Gym to Improve Mood

Woman performing yoga in her living room

Stretching & Yoga

Incorporating gentle mobility and breathwork into your day can modulate the nervous system. Slow, intentional movement activates the parasympathetic response, helping to lower cortisol and ease the body into restful sleep. Yoga postures can also release tension in commonly strained areas like the neck, shoulders and hips — physical hotspots for emotional stress.

 

Be mindful to progress gradually and avoid pushing too far, too fast. Repetition, not intensity, is key to long-term benefit.

Functional medicine patient running during winter months

Cardiovascular Exercise

Brisk walking, light jogging or indoor cycling are all accessible ways to elevate heart rate and, in turn, stimulate the release of endorphins and brain-derived neurotrophic factor (BDNF) — both of which are associated with mood regulation and reduced depressive symptoms. Aim for moderate-intensity movement on most days, ideally in natural daylight, to further support circadian rhythm alignment.

 

More isn’t always better. Overtraining can disrupt sleep and hormone balance. Increase volume slowly and listen to your body.

Strength Training During Winter

Strength Training

A well-balanced strength training routine — even just two to three times a week — can profoundly impact mood, sleep quality and long-term metabolic health. By improving insulin sensitivity and reducing inflammation, resistance training helps create an internal environment that supports emotional stability. For those navigating SAD symptoms, structured lifting sessions offer a sense of control and accomplishment.

 

Start light, focus on form and prioritize recovery. Consistency matters more than intensity when it comes to building strength and resilience.

Collagen Supplement

Creatine (3–5 g/Day)

Once known primarily as a sports supplement, creatine is gaining attention for its role in mental health. Research suggests that 3 to 5 grams per day may enhance brain bioenergetics and complement standard treatments for depression by supporting cellular energy in the brain. While generally well-tolerated, some people may experience mild gastrointestinal upset or water retention.

 

As always, choose a third-party tested product, and consult your clinician — particularly if you have a history of kidney issues or are taking other medications.

“Creatine is often misunderstood or overlooked. It’s safe. It’s been studied over & over. It does a lot more than we once thought! Once muscles reach saturation levels, that’s when we start seeing secondary benefits like improved bone density, enhanced cognitive function &, in some patients, better blood sugar regulation.”

-Colleen Bush, Registered Functional Medicine Dietitian  

Which Aesthetic Treatments Can Support You In Winter?

While aesthetic treatments don’t address the root cause of Seasonal Affective Disorder, they can offer physical comfort and emotional support for some individuals. Feeling more at home in your skin is valid — and for many, the confidence boost and regular, supportive interactions with their care team serve as meaningful complements to broader mood care strategies.

A happy aesthetics treatment patient
Halo Laser Skin Therapy

Laser Therapy

Fall/winter is an excellent window for many laser skin treatments because sun exposure is naturally lower. Expect strict SPF and sun-avoidance afterward; your provider will tailor settings to your skin and goals.

Lasers

Close up of Aquagold being performed

Spa Facials

Clearing buildup and winter dryness can improve texture and glow. DiamondGlow® is a patient favorite for exfoliation, extraction and serum infusion — immediate radiance with no downtime.

Facials

Dermal filler patient to achieve greater cheek definition

Filler Injections

Strategic volume restoration or refinement can provide an almost-immediate positive change in the mirror, which some patients find uplifting.

Fillers

Tattoo Eyeliner Columbus Ohio

Cosmetic Tattooing

Brow tattooing, lip blushing and permanent eyeliner can streamline your mornings and reduce decision fatigue; one less task on dark, busy days.

Cosmetic Tattooing

Daily skincare essentials

Quality Skincare

Targeted actives (retinoids, vitamin C, ceramides, SPF) address seasonal dryness and dullness. A simple AM/PM routine adds structure to the day and can help your skin feel healthier.

Skincare Products

“When your skin feels good, you feel good! But when it feels bad? It can feel horrible. Sticking to a healthy skincare routine doesn’t just provide structure but also elevates skin health — which you may not have realized was holding you back.”

-Colleen Bush, Registered Functional Medicine Dietitian  

Botox Injections & Mood-Adjacent Benefits

Using Botox to treat Seasonal Affective Disorder symptoms

“Sometimes, investing in your self‑confidence & stepping out of your day-to-day is enough to lift you up. On a more anatomic level, faster cell turnover & enhanced skin elasticity creates more comfort in your skin which can carry its own set of positive impacts — especially as dry weather rolls in.”

-Colleen Bush, Registered Functional Medicine Dietitian  

The Quick List

Lifestyle Decisions That Can Make a Meaningful Difference

  • Alcohol Intake: Scale back during winter. Even modest evening intake can fragment sleep and worsen next‑day mood.
  • Ultra‑Processed Foods: Keep convenient options on hand, but anchor meals to whole‑food protein + fiber to steady energy and cravings.
  • Light at Night: Dim those harsh overheads after sunset; use warm lamps. Block outdoor light in the bedroom.
  • Social Doses: Schedule low‑lift connections (walking and talking with a coffee, standing phone date). Brief and consistent interactions beats “all or nothing.”
  • Nature Time: Aim for daylight + movement most days. If it’s icy, get steps in a bright indoor space.
  • Too Much Sleep: Most adults do best around 7 – 9 hours. Regularly sleeping more than 9 or 10 hours, napping excessively or feeling foggy despite long sleep may warrant a check‑in.

What Doesn’t Work

  • Blue‑only lights or dim “mood” lamps as a replacement for a clinical light box and actual sunlight.
  • Random mega-doses of vitamin D without labs, clinician oversight or proper magnesium dosing to complement vitamin D increases.
  • Energy drinks instead of sleep — caffeine can’t fix circadian misalignment, and the temporary boost can create chronic crashes.
  • All‑or‑nothing New Year’s plans — extremes are brittle; small daily actions win. Root your resolutions in realism and feel accomplished as you’re able to stick with it longer.

“Doing nice things for yourself can bring light to shorter days! We just want to make sure we focus on options that don’t undermine your baseline physical or mental health. Comfort food every once in a while, is great to give you a boost, but too much can drag you down. It’s all about finding your balance!”

-Colleen Bush, Registered Functional Medicine Dietitian  

When To Seek Additional Care for SAD:

  • Your symptoms persist beyond 2 weeks, you’re withdrawing from usual activities or sleep/appetite is notably disrupted.
  • You have been diagnosed with a mental illness and notice your personal early‑warning signs of a larger mental health event.
  • You want a tailored plan: Functional medicine providers can order targeted labs (vitamin D, iron indices, B12, thyroid, magnesium), calibrate light therapy and coordinate with your therapist or PCP to help minimize SAD symptoms and address them at the root cause.

About The Author

Colleen Bush, RDN, LDN, IFNCP, is a functional medicine expert and registered dietitian in Columbus, Ohio. She uses an education-first approach to holistic care, specializing in root‑cause assessments, gut-health optimization and personalized lifestyle planning that align with each patient’s schedule — especially when colder, darker months challenge mood, sleep and skin.

Colleen Bush, RDN, Author Photo

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How To Maintain Ozempic Results 

Retain & Bolster Your Weight Loss Progress Long-Term

How To Maintain Ozempic Results

You’ve reached your weight loss goals. You feel better every day. And now you’re considering reducing or stopping your weekly fat loss injections.

As you make this decision, it’s important to take thoughtful steps to maintain the progress you’ve worked so hard for. This phase is all about reinforcing healthy habits, supporting your metabolism and embracing long-term strategies that will help you sustain your results and continue feeling your best.

Clinical Note: We reference “Ozempic” throughout this article because it is one of the most well-known GLP-1 medications. However, these tips are designed to help any patient seeking to maintain weight loss results after using a GLP-1 medication, whether brand-name or compounded, including semaglutide or tirzepatide. Article updated 12/17/2025 to include new FDA regulatory guidance and provide prescribing context for GLP-1 medications.

 

What Is It Like To Come Off Ozempic

What Is It Like To Come Off Ozempic?

Transitioning off Ozempic can bring noticeable changes to your body and mindset. Physically, you may experience an increase in appetite, fluctuations in energy levels and shifts with digestion as your metabolism adjusts. Mentally, some patients report heightened food cravings or a return of “food noise” – the near-constant mental chatter about eating.

If you’re tapering off GLP-1 therapy, consider partnering with a provider to make the transition smoother and safer. Being prepared for these shifts allows you to stay proactive and maintain the healthy patterns you’ve already established.

Remember: Fluctuations Are Natural!

Minor weight oscillation is a normal part of the process and does not mean you’re regressing. Trust the process and remember that progress isn’t linear. Try to focus on the bigger picture rather than day-to-day changes!

Quality Nutrition Is Crucial

Nourishing your body with whole, nutrient-dense foods lays the foundation for sustainable weight management. Focus on incorporating plenty of lean proteins, fiber-rich vegetables and complex carbohydrates to keep you full and energized. Eating balanced, satisfying meals reduces the likelihood of overindulgence and helps stabilize blood sugar levels.

Fat Calories Aren’t The Enemy

Healthy fats play a necessary role in hormonal balance, satiety and overall well-being. Including sources of healthy fats like avocados, nuts, seeds and olive oil in your meals can help keep you fuller for longer and reduce the urge to snack unnecessarily.

Fat is a friend, not a foe — when consumed mindfully!

Stop Post-Ozempic Food Cravings

How To Stop Post-Ozempic Food Cravings

  • Prioritize Protein: Keeps you fuller longer and curbs hunger — 30% of caloric intake coming from protein is a good goal.
  • Plan Meals Ahead: Structure your macro-balanced meals to reduce impulsive snacking.
  • Increase Fiber Intake: Helps regulate digestion and keeps you satisfied as gastric emptying returns to normal.
  • Stay Active: Physical activity reduces stress, limits emotional eating and puts your calories to work for you.
  • Distract & Delay: Engage in another activity when cravings hit – they often pass within 15 minutes, especially late at night.
  • Practice Mindful Eating: Slow down, turn your phone off and truly enjoy your meals to feel more satisfied.
  • Get Spicy With It: Spices like cardamom, turmeric, coriander, ginger and cayenne pepper can help increase satiety and reduce cravings.
  • Avoid Alcohol: Beyond the empty calories, alcohol reduces self-control and causes your body to hold onto fat.

Introduce Strength Training & Increase Protein

One of the strongest ways to support your metabolism post-Ozempic is to build lean muscle. Resistance training not only enhances your body composition but also boosts your resting metabolic rate, helping you burn more calories even at rest.

Starting a consistent strength routine while still on Ozempic ensures a smoother transition and can make maintaining your results much easier. Pair this with a higher protein intake to support muscle growth and prevent muscle loss during the transition.

The Wellness Mindset & Emotional Support

Maintaining results extends beyond physical changes – it’s about nurturing your relationship with food and your body. Mindful eating, self-compassion and the recognition of emotional eating patterns can help prevent setbacks. If you notice old habits resurfacing, pause and reflect rather than react.

“If you started a food journal at the beginning of your journey, now is a great time to break that out! Celebrate how far you’ve come — not just the number on the scale — and refocus yourself on habits that reinforce lasting confidence.”

– Colleen Bush, IFNCP

Stay Hydrated, Prioritize Sleep & Reduce Stress

Hydration and quality sleep are fundamental yet often overlooked components of weight maintenance. Dehydration can sometimes be mistaken for hunger, leading to unnecessary snacking. Similarly, poor sleep disrupts hunger hormones, increasing cravings and reducing self-control.

Aim for at least 7 hours of rest each night and drink roughly 64 ounces of water a day.

What Happens If I Start To Gain Weight Back?

Weight regain doesn’t mean failure – it’s often part of the journey.

If you notice the scale creeping up, return to the basics of balanced meals, regular exercise and self-awareness. Avoid restrictive diets or extreme measures, as they can lead to burnout and a relapse to past poor eating habits. Progress takes time, and consistency will always yield better long-term results than perfection.

Colleen working with an Ozempic patient in the office

Stay Accountable & Continue Your Education with a Functional Medicine Expert

Long-term success is often supported by ongoing professional guidance. Regular check-ins with a functional medicine dietician allow you to monitor health markers using diagnostic testing and ensure your metabolism stays on track. This accountability helps identify potential setbacks early and keeps you informed about strategies that align with your goals.

“Once you’ve reached this point, my role is to offer emotional and educational support — everything you need to keep moving forward. Together, we can reinforce the positive changes you’ve made and adjust your lifestyle plan to match this next phase.” 

– Colleen Bush, IFNCP

Cosmetic Treatments Can Help Complete The Journey

Loose and excess skin after significant weight loss is common. However, they may prevent patients from feeling like they’ve truly achieved their goals. Cosmetic treatments can provide the finishing touches necessary to move forward with confidence.

Abdominoplasty (tummy tuck) and other surgical solutions after weight loss address more extensive concerns, while non-invasive treatments like Morpheus8 tighten skin. For stubborn fat deposits that linger despite weight loss, liposuction offers a precise solution to sculpt and refine body contours. Non-surgical alternatives, such as Kybella for targeted fat reduction under the chin or CoolSculpting for freezing away fat in common trouble areas, provide effective options with minimal downtime.

Regulatory Disclaimer:

This article is for educational purposes only and does not constitute medical advice. Semaglutide, tirzepatide and other GLP-1 medications are prescription-only and may not be suitable for all patients. Any decisions about starting, continuing or discontinuing GLP-1 therapy should be made in consultation with a qualified medical professional. Donaldson Plastic Surgery does not provide brand-name GLP-1 medications such as Ozempic® or Wegovy®. We do not present compounded medications as a substitute for FDA-approved therapies. Compounded medications are not FDA-approved. They are only prescribed following individualized clinical evaluation, in accordance with current regulatory guidance.

About The Author

Colleen Bush, RDN, LDN, IFNCP, is a registered dietician in Columbus, Ohio. She pairs personalized nutrition care with weekly weight loss injections (such as compounded semaglutide, when medically appropriate), functional movement and health education to help patients achieve sustainable weight loss and improve overall wellness.

When she isn’t working one-on-one with patients, she is researching emerging holistic solutions to treat chronic illnesses and employing elements of functional medicine in her own life.

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By Colleen Bush, RDN |

Functional Medicine Dietitian vs. Conventional Dietitian

Functional Medicine Dietitian vs. Conventional Dietitian

Exploring The Different Approaches To Professional Nutrition Care

By prioritizing science-backed solutions and offering tailored dietary strategies, both functional and conventional dietitians empower their patients to optimize daily nutrition, make informed health decisions and enhance their overall well-being. Both functional medicine and conventional medicine play essential roles in the healthcare landscape, and patients can greatly benefit from understanding the strengths and limitations of each approach.

 

What Are The Core Differences?

Functional medicine dietitians take a holistic and personalized approach to nutrition care and address the root causes of health issues. They conduct targeted diagnostic tests and create tailored lifestyle interventions based on an individual’s unique biochemistry while focusing on patient education to promote long-term success.

Functional medicine dietitian reading diagnostic health test scores with a patient

In contrast, conventional dietitians typically follow guidelines for managing specific medical conditions, offering standardized nutritional recommendations within the traditional healthcare framework, where shorter consultations often limit personalized care.

“As a functional medicine dietitian, I’m not here to hand you a meal plan and send you on your way. I look at your whole lifestyle — from stress levels and sleep habits to exercise routines and your existing medical history. After all, what good is a meal plan if your body isn’t absorbing the nutrients the way it should?”

-Colleen Bush, RDN

Essential Education & Credentials

Both roles require extensive education, but the key difference lies in the additional training and holistic focus that Functional Medicine Dietitians bring to their practice.

Conventional Dietitian Requirements

  • Bachelor’s Degree: A Conventional Dietitian, also known as a Registered Dietitian (RD) or Registered Dietitian Nutritionist (RDN), must first obtain a bachelor’s degree in dietetics, nutrition or a related field.
  • Accredited Internship: They are required to undergo a supervised practice program accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND). This usually consists of 1,200+ hours of hands-on experience in various clinical, community and food service settings.
  • Registration Exam: Individuals must pass the Commission on Dietetic Registration (CDR) exam to earn the RD or RDN credential.
  • Continuing Education: Conventional Dietitians engage in continuing education throughout their careers to maintain credentials and stay up to date with developments in the field.

Functional Medicine Dietitian Education & Credentials:

  • Initial Dietitian Credentials: Most Functional Medicine Dietitians start with the same foundational education and credentials as Conventional Dietitians listed above.
  • Functional Medicine Training: In addition to their RD or RDN credentials, Functional Medicine Dietitians pursue further specialized training programs with a focus on a holistic, systems-based approach to health and nutrition:
    • Institute for Functional Medicine (IFM): The IFM offers training and certification programs to specialize in functional medicine.
    • Integrative and Functional Nutrition Academy (IFNA): This academy offers a comprehensive training and certification program designed for registered dietitians who want to specialize in functional nutrition.
  • Additional Certifications: They may also earn credentials such as Certified Functional Nutrition Practitioner (CFNP) or Integrative and Functional Nutrition Certified Practitioner (IFNCP), which provide advanced knowledge in functional nutrition principles and methodologies.
  • Holistic Focus: Functional Medicine Dietitians incorporate knowledge of gut health, genetics, biochemistry and lifestyle factors to manage chronic ailments.

Two Functional Medicine Dietitians discussing health solutions

The Role Of A Functional Medicine Dietitian

  • Adopt a holistic and personalized approach to nutrition
  • Create a comprehensive assessment of dietary habits, lifestyle and health history
  • Focus on the interplay between diet, lifestyle and overall well-being
  • Identify and address the root causes of health concerns, especially those that are difficult to diagnose or aren’t severe enough to qualify for a formal diagnosis
  • Curate tailored interventions that consider the individual’s lifestyle, along with their unique biochemical and genetic makeup

The Role Of A Conventional Dietitian

  • Use Evidence-based guidelines for managing specific already diagnosed medical conditions through diet (e.g., diabetes, hypertension)
  • Provide standardized nutritional recommendations that address acute health concerns and symptoms.
  • Offer shorter consultations that are often driven by insurance reimbursement models, which may limit personalized care
  • Operate within the framework of traditional healthcare systems

Functional Medicine Prioritizes Proactive Care

Functional medicine dietitians prioritize preventive strategies designed to achieve and maintain optimal health. By regularly monitoring relevant health metrics, they can track progress and make necessary adjustments to personalized care plans.

This approach also focuses on empowering patients through education, enabling them to adopt long-lasting lifestyle changes that promote sustained health improvements.

Dr. Weston working with a functional medicine patient in the Dublin Ohio office

Conventional Medicine Takes A Reactive Stance

Conventional dietitians often focus on addressing acute symptoms as they arise, which can be effective for some patients but may lead to a cycle of treatment without fully exploring the underlying causes of health issues for others. This approach typically involves limited follow-up, which may leave patients feeling overlooked or inadequately managed.

Additionally, there is often a high reliance on pharmaceuticals, which may not always align with a patient’s broader health goals or support long-term well-being.

“Feeling overwhelmed by daily stress? Can’t get to the gym enough? Struggling to fall asleep — and stay asleep? These issues can all manifest as symptoms like fatigue, mood swings and brain fog. If left untreated or uncorrected, they can even evolve into autoimmune conditions.”

-Colleen Bush, RDN

Colleen Bush, RDN, working with a patient

When Is The Functional Approach Preferred?

The functional approach is particularly effective for individuals seeking:

  • Comprehensive solutions for chronic health issues, such as autoimmune disorders, digestive problems, or hormonal imbalances.
  • Support in lifestyle changes aimed at enhancing quality of life and healthspan.
  • A collaborative relationship with their dietitian, where their concerns are taken seriously, and care is tailored to their specific needs.
  • Results and answers that allow you to live your fullest, most energetic and comfortable life.

When Is The Conventional Approach Preferred?

Conversely, the conventional approach may be more appropriate for:

  • Acute medical situations, such as injuries or sudden illnesses that require immediate attention.
  • Diagnoses requiring rapid intervention, where standardized protocols can provide quick relief.
  • Specialized treatment, particularly in acute care settings or emergencies, where traditional methods have been proven effective.

About The Author

Colleen Bush, RDN, is a registered functional medicine dietitian in Columbus, Ohio. She leverages her unique personal experiences and her specialized training in nutrition care to help patients alleviate symptoms related to autoimmune disorders, chronic illnesses and food allergies. Colleen believes in getting to the root cause of health concerns before curating a completely customized treatment plan that combines lifestyle interventions, functional medicine testing and dietary modifications to improve a patient’s overall well-being.

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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

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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