How to Lose Weight
Updated 11/20/2013
Do you have trouble losing weight? Or would you like to lose it faster? Here are
the 17 best tips for you.
For
some people losing all of their excess weight is easier said than done.
But there are many common errors people make. Correcting them can
restart or speed up your weight loss.
Based on a decade of
experience treating obese patients, reading studies, going to obesity
conferences and discussing this topic with the world’s biggest experts,
here’s my best advice for maximizing your weight loss.
Start at the top of the list (most important) and go down as far as you need. Perhaps you only need the first piece of advice?
How to Lose Weight
- Choose a low carb diet
- Eat when hungry
- Eat real food
- Measure your progress wisely
- Be patient
- Women: Avoid fruit
- Men: Avoid beer
- Avoid artificial sweeteners
- Review any medications
- Stress less, sleep more
- Eat less dairy products and nuts
- Supplement vitamins and minerals
- Exercise smart
- Achieve optimal ketosis
- Get your hormones checked
- coming soon
- coming soon
1. Choose a Low Carb Diet
If you want to lose weight you should start by avoiding sugar and starch (like bread). This is an old idea: For
150 years or more
there have been an infinite number of weight loss diets based on eating
less carbs. What’s new is that at least 17 modern scientific studies
have proven that, yes,
low carb is the most effective way to lose weight.
Obviously
it’s still possible to lose weight on any diet – just eat less calories
than you burn, right? The problem with this simplistic advice is that
it ignores the elephant in the room: Hunger. Most people don’t like to
“just eat less”, i.e. being hungry forever. That’s dieting for
masochists. Sooner or later a normal person gives up and eats, hence the
prevalence of “yo-yo dieting”.
The main advantage of low carb diets is that they cause you to
want
to eat less. Even without counting calories most overweight people eat
far fewer calories on low carb. Sugar and starch may increase your
hunger, avoiding it may decrease your appetite to an adequate level. If
your body wants to eat a suitable number of calories you don’t need to
bother counting them. Thus:
Calories count, but you don’t need to count them.
A 2012 study also showed that people on a low carb diet
burned 300 more calories a day – while resting! According to one of the Harvard professors behind the study this advantage
“would equal the number of calories typically burned in an hour of moderate-intensity physical activity”. Imagine that: an entire bonus hour of exercise every day, without actually doing it.
Bottom
line: A low carb diet reduces your hunger and makes it easier to eat
less. And it might even increase your fat burning at rest.
Study after study show that low carb is the smart way to lose weight and that it
improves important health markers.
How to do it: LCHF for beginners
Inspiration: Weight loss stories on low carb
2. Eat When Hungry
Don’t
be hungry. The most common mistake when starting a low carb diet:
Reducing carb intake while still being afraid of fat. The problem is
that carbs and fat are the body’s two main energy sources. It needs at
least one.
Low carb AND low fat = starvation
Avoiding
both carbs and fat results in hunger, cravings and fatigue. Sooner or
later people can’t stand it and give up. The solution is to
eat more natural fat until you feel satisfied. For example:
- Butter
- Full-fat cream
- Olive oil
- Meat (including the fat)
- Fatty fish
- Bacon
- Eggs
- Coconut oil, etc.
Always eat enough,
so that you feel satisfied, especially in the beginning of the
weight-loss process. Doing this on a low carb diet means that the fat
you eat will be burned as fuel by your body, as your levels of the fat
storing hormone insulin will be lowered. You’ll become a fat burning
machine. You’ll lose excess weight without hunger.
Do you still fear saturated fat? Don’t. The fear of saturated fat is based on obsolete theories that have been
proven incorrect by modern science.
Butter is fine food. However, feel free to eat mostly unsaturated fat
(e.g. olive oil, avocado, fatty fish) if you prefer. This could be
called a Mediterranean low carb diet and
works great too.
Eating when hungry also implies something else:
If you’re not hungry you probably don’t need to eat yet.
When on a LCHF diet you can trust your feelings of hunger and satiety
again. Feel free to eat the number of times per day that works best for
you.
Some people eat three times a day and occasionally
snack in
between (note that frequent snacking could mean that you’d benefit from
adding fat to your meals, to increase satiety). Some people only eat
once or twice a day and never snack. Whatever works for you. Just eat
when you’re hungry.
3. Eat Real Food
Another
common mistake when eating a low carb diet is getting fooled by the
creative marketing of special “low carb” products. Remember: An
effective low carb diet for weight loss should be based on
real food, like this:
Real
food is what humans have been eating for thousands or (even better)
millions of years, e.g. meat, fish, vegetables, eggs, butter, olive oil,
nuts etc.
If you want to lose weight you’d better avoid special “low carb” products that are full of carbs. This
should be obvious but creative marketers are doing all they can to fool
you (and get your money). They will tell you that you can eat cookies,
pasta, ice cream, bread and plenty of chocolate on a low carb diet, as
long as you buy their brand. They’re full of it. Don’t be fooled.
Here are three examples of what to avoid:
- Atkins’ Fairy Tale Cookies
- Julian Bakery’s High Carb Low Carb Bread
- The Dreamfields Pasta Fraud
These
three companies are not unique. There are thousands of similar
companies trying to trick you into buying their “low carb” junk food,
full of starch, sugar alcohols, flour, sweeteners and strange additives.
Two simple rules to avoid this junk:
- Don’t eat “low carb”
versions of high carb stuff, like cookies, bars, chocolate, bread, pasta
or ice cream – unless you are SURE of the ingredients (perhaps by
making it yourself).
- Avoid products with the words “net carbs” on them. That’s usually just a way to fool you.
Focus
on eating good quality, minimally processed real food. Ideally the food
you buy shouldn’t even have a list of ingredients (or it should be very
short).
4. Measure Your Progress Wisely
Tracking
successful weight loss is sometimes trickier than you think. Focusing
only on weight and standing on the scale every day might be misleading,
cause unnecessary anxiety and undermine your motivation for no good
reason.
The scale is not necessarily your friend. You may want to
lose fat – but the scale measures muscles, bone and internal organs as
well. Gaining muscle is a good thing. Thus weight or
BMI are imperfect ways to measure your progress. This is especially true
if you’re just coming off a long period of semi-starvation (calorie counting), as your body may want to restore lost muscles etc. Starting weight training and gaining muscle can also hide your fat loss.
Losing
fat and gaining muscles is great progress, but you may miss it if you
only measure your weight. Thus it’s smart to also track the
disappearance of your belly fat, by measuring your
waist circumference.
Here’s how to do it:
- Put the measuring tape around your middle, like in the picture above, slightly above your belly button (to be exact: at the midpoint between your lowest rib and the top of your hipbone, at your side).
- Exhale and relax (don’t suck in your stomach).
- Make sure the measuring tape is snug, without compressing your skin.
- Measure
Compare your result to these recommendations:
I
recommend aiming for “excellent” but it’s not always realistic. Young
people can usually achieve it, but for some middle-aged or older women
it may be a major victory to get all the way to “decent”.
Measuring progress
I
suggest measuring your waist circumference and weight before starting
and then perhaps once a week or once a month. Write the results down so
that you can track your progress. If you want you can measure more
areas: around the buttocks, the chest, the arms, legs, etc.
Note
that your weight can fluctuate up and down several pounds from day to
day, depending on fluid balance and stomach contents: Don’t worry about
short term changes, instead follow the long-term trend.
If you can, try to
check other important health markers when starting out, like these:
- Blood pressure
- Blood sugar (fasting blood glucose and/or HbA1c)
- Cholesterol profile (including HDL, triglycerides)
These
markers are almost universally improved on a low carb diet, even before
major weight loss. Re-checking these health markers after a few months
can be great for your motivation as
they’ll usually show that you’re not just losing weight, you’re gaining health too.
PS: Don’t have a measuring tape at home? Try these options:
- Use
any piece of string. Wrap the string around your waist and clip off the
extra on day one. This string could magically appear to become longer
and longer every week you wrap it around your waist.
- Comparing how an old pair of jeans fit is also a decent option.
5. Be Patient
It
usually takes years or decades to gain a lot of weight. Trying to lose
it all as quickly as possible by starving yourself rarely works well
long-term, that’s just the recipe for “yo-yo dieting”. To succeed you
need something that works long term.
What to aim for
It’s common to lose
2-6 pounds (1-3 kg) within the first week on a strict low carb diet, and then on average about
one pound (0.5 kg) per week as long as you have a lot of weight remaining to lose
. This translates into about 50 pounds (25 kilos) per year.
Every 5 pounds of fat loss roughly equals 1 inch lost around the waist (1 kilo = 1 cm).
Young
males sometimes lose weight quicker than this, perhaps twice as fast.
Post-menopausal women may lose it at a slightly slower pace. People
eating a very strict low carb diet may lose weight quicker, as well as
those who exercise a lot (a bonus). And if you have an enormous amount
of excess weight to lose you could start out much faster.
As you
get closer to your ideal weight the loss slows, until you stabilize at a
weight that your body feels is right. Hardly anyone gets underweight on
a low carb diet – as long as they eat when hungry.
Examples:
Weight loss stories.
Initial stalls
Are
you coming off a period of semi-starvation (calorie counting)? Focus on
your waist circumference and health markers (see advice #4) at first as
it sometimes takes several weeks before weight loss is apparent.
Weight loss plateaus
Expect
weight loss plateaus: Days or weeks where nothing seems to happen on
the scale. Everybody gets them. Stay calm. Keep doing what you’re doing
and eventually things will start happening again (if not, check the
other 16 tips).
How to lose weight forever
Losing a lot of weight long-term and keeping it off forever won’t happen unless you
change your habits forever.
If you lose weight and then return to living exactly the way did when
you gained weight, don’t be surprised when the excess weight returns. It
will.
Maintaining weight loss requires long-term change and
patience. If this doesn’t seem possible for you, then you’re perhaps
more interested in
one of these magical diet scams.
Forget
quick fixes: If you lose some weight every month, eventually you’ll get
rid of all your excess weight. That’s inevitable progress. That’s what
you want.
PS: Long-term change is only hard in the beginning, especially during the first couple of weeks. It’s like quitting smoking. Once you develop new habits it becomes easier and easier every week. Eventually it comes naturally.
How to lose weight faster
Keep reading these tips!
6. Women: Avoid Eating Fruit
This is a tip that goes for men as well, of course, but eating fruit is a more common obstacle for women trying to lose weight.
This
advice is controversial as fruit has an almost magical health aura
today. People may believe that fruit is nutritious but unfortunately
fruit contains a lot of sugar – around 10% by weight (the rest is mostly water). Just taste an orange or a grape. Sweet, right?
Five
servings of fruit per day is equivalent to the amount of sugar in 16
ounces of soda (500 ml). Contrary to what many people believe the sugar
is more or less identical (about 50% glucose, 50% fructose).
Sugar from fruit can shut down fat burning. This can increase your hunger and slow your weight loss. For best results avoid fruit – or enjoy it occasionally as a treat.
Bottom line:
Fruit is candy from nature.
7. Men: Avoid Drinking Beer
This applies to women too, but men drink more beer on average.
Beer contains rapidly digested carbs that shut down fat burning. That’s why beer is sometimes referred to as “liquid bread”. There’s a good reason for the term “beer belly.”
Here are
smarter alcoholic options for losing weight:
- Wine (red or dry white)
- Dry champagne
- Pure spirits like whiskey, cognac, vodka (avoid sweetened cocktails – try vodka, soda, lime instead)
These
drinks hardly contain any sugar/carbohydrates so they’re better than
beer. However, large amounts of alcohol might slow weight loss somewhat,
so moderation is still a good idea.
8. Avoid Artificial Sweeteners
Many
people replace sugar with artificial sweeteners in the belief that this
will reduce their calorie intake and cause weight loss. It sounds
plausible. Several studies, however, have failed to show any positive
effect on weight loss by consuming artificial sweeteners instead of
plain sugar.
Instead, according to scientific studies, artificial sweeteners can
increase appetite and maintain cravings for sweet food.
This
could be because the body increases insulin secretion in anticipation
that the sugar will appear in the blood. When this doesn’t happen, blood
sugar drops and hunger increases. Whether this chain of events
regularly take place is somewhat unclear. Something odd happened
when I tested Pepsi Max though, and there are well-designed studies showing
increased insulin when using artificial sweeteners.
Furthermore,
artificial sweeteners can maintain an addiction to sweets and lead to
snack cravings. And the long term effects of consuming artificial
sweeteners are unknown.
By the way, Stevia is marketed as a
natural alternative to artificial sweeteners. That’s marketing talk.
There is nothing natural about
a processed super-sweet white powder like Stevia.
If
you’re having trouble losing weight I suggest that you completely avoid
sweeteners. As a bonus you’ll soon start to enjoy the natural sweetness
of real food, once you’re no longer adapted to the overpowering
artificial sweetness of junk food and “diet” sodas.
9. Review Any Medications
Many prescription drugs can stall your weight loss. Discuss any change in treatment with your doctor. Here are the worst three:
- Insulin injections,
especially at higher doses,are probably the worst obstacle for weight
loss. There are three ways to reduce your need for insulin:
A. Eat less carbs,
which makes it a easier to lose weight. The less carbs you eat the less
insulin you need. Remember to lower your doses if you can.
B. If
this isn’t enough, treatment with Metformin tablets (at a dose of 2
grams – 3 grams/day) can decrease the need for insulin (at least for
type 2 diabetics).
C. If this is not
enough to get off insulin (again, for type 2 diabetics) you could try
newer promising drugs like Victoza or Byetta. These reduce the need for
insulin and cause weight loss.
Other diabetes medications. Insulin-releasing
tablets (e.g. sulphonylureas) often lead to weight gain. These include:
Minodiab, Euglucon, Daonil, and Glibenclamide. Tablets like Avandia,
Actos, Starlix and NovoNorm also encourage weight gain. But not
Metformin. The newer drugs Victoza and Byetta (injectable) often lead to
weight loss, but possible long-term side effects are still unknown. More on diabetes- Cortisone
as an oral drug is another common culprit (e.g. Prednisolone).
Cortisone often causes weight gain in the long run, especially at higher
doses (e.g. more than 5 mg Prednisolone per day). Unfortunately
cortisone is often an essential medicine for those who are prescribed
it, but the dose should be adjusted frequently so you don’t take more
than you need.Asthma inhalers and other local cortisone treatments, like
creams or nose sprays, hardly affect weight.
These other medications can also cause problems:
- Neuroleptics/antipsychotic drugs, can often encourage weight gain. Especially newer drugs like Zyprexa (Olanzapine).
- Some antidepressant medications
can cause weight gain, especially the older tricyclic antidepressants
(TCAs) such as Tryptizol, Saroten, and Clomipramine; as well as newer
drugs such as Remeron (Mirtazapine). Lithium (for manic-depressive
disorder) often leads to weight gain. The most common antidepressants
known as SSRI’s (for example Citalopram and Sertraline) usually don’t
impact weight significantly. More on depression
- Some contraceptives often
contribute to slight weight gain, especially those that contain only
progesterone and no estrogen, for example the mini-pill, the
contraceptive injection, or a contraceptive implant. More on fertility
- Blood pressure medicine, in the form of beta blockers can cause weight gain. These drugs include: Seloken, Metoprolol and Atenolol. More on high blood pressure
- Epilepsy drugs may cause weight gain (e.g. Carbamazepine and Valproate).
- Allergy medicines called antihistamines can cause weight gain, especially at high doses. Cortisone is even worse (see above). More on allergies
- Antibiotics can
possibly lead to a temporary weight gain by disturbing the gut
microbiota and increasing the amount of energy we absorb from food. This
is still speculative for humans but it’s another reason not to use antibiotics unless you truly need it.
10. Stress less, sleep more
Have
you ever wished for more hours of sleep, and a less stressful life in
general? Most people have – and that can be bad news for their weight.
Chronic
stress may increase levels of stress hormones such as cortisol in your
body. This can cause increased hunger and result in weight gain. If
you’re looking to lose weight, you should
review possible ways to decrease or better handle excessive stress in your life. Although this often demands substantial changes, even altering small things –
such as posture – may immediately affect your stress hormone levels, and perhaps your weight.
You should also make an effort to
get enough good sleep, preferably every night.
Strive to wake up refreshed of your own accord, independently of the
alarm clock. If you’re the kind of person who always gets brutally woken
up by the alarm ringing, you might never be giving your body adequate
rest.
One way to combat this is to go to bed early enough for your
body to wake up autonomously before the alarm clock goes off. Letting
yourself get a good night’s sleep is another way of reducing stress
hormone levels.
Sleep deprivation, on the other hand, comes hand
in hand with sugar cravings. It also has an adverse effect on
self-discipline and makes it painfully easy to give in to temptation
(it’s no coincidence that induced sleep deprivation is a common
interrogation technique). Similarly, sleep deprivation weakens your
resolve to work out.
Sleep issues?
Do you have trouble sleeping even if there’s ample time for it? Here are five tips from
an expert:
- Stick to a certain bedtime every evening. In the long term, this will help the body prepare for sleep at that time.
- No coffee after 2 pm. Just don’t – and remember that it takes time for caffeine to leave the body.
- Limit your alcohol intake three hours before bedtime. While booze might make you woozy, it worsens the quality of sleep.
- Limit exercise in the four hours before bedtime. Physical activity can perk you up and make it difficult to get to sleep for several hours afterwards.
- Get 15 minutes of sunlight every day. This is good for your circadian rhythm (your “body clock”).
Finally, make sure that your bedroom is dark enough, and stays at a pleasant temperature. Sleep well!
Difficult, but worthwhile
Many
may find the above guidelines difficult to follow, perhaps because of a
lack of time (or the equivalent – small children!). But stressing less
and sleeping more doesn’t just feel good. It can also play a part in
helping you get thinner.
11. Eat less dairy products and nuts
Can
one eat as much as one likes, and still lose weight? Yes, it tends to
work just fine with a low-carbohydrate diet, as appetite regulation
happens effortlessly.
However, despite the fact that a
low-carbohydrate diet generally makes it easy to eat just enough, there
are foods classified as low carb which become a problem in larger
quantities. If you find yourself having a hard time losing weight on a
low carb diet, you could try to be more careful with:
- Dairy products (yoghurt, cream, cheese)
- Nuts
Dairy
products all contain a varying amount of lactose (the milk sugar),
which slows down weight loss. What’s more, part of the protein in milk
generates a significant
insulin
response, which can have the same effect. Consequently, cutting back on
dairy products may accelerate weight loss. This applies especially to
dairy products typically lacking in fat, such as regular milk and
different yoghurts, but be careful with full-fat dairy such as cream and
cheese all the same. And don’t forget whey protein powder, which is
pure milk protein.
Exempt from all these dairy product warnings is
butter, which is almost pure fat. Butter may be consumed liberally as desired.
Nuts,
which are the second food to watch, contain a fair amount of
carbohydrate, and it’s very easy to unwittingly scarf down large
quantities.
Cashew nuts
are among the worst carb-wise – you’ll find that they contain around
20% carbohydrate by weight. For someone following a strict LCHF diet
with a 20 grams of carbs per day allowance, this means that consuming
100 grams (which happens in a flash!) will have filled their daily
quota.
Peanuts tend to be around 10-15% carbohydrate – not putting them in the clear either.
So,
for those of you having trouble losing weight: use nuts sparingly. When
in a situation where nuts are an absolute must, know that the most
harmless ones carb-wise are
macadamia nuts (usually around 5% carbs), or
Brazil nuts (around 3%).
12. Supplement vitamins and minerals
Your
body needs a certain amount of essential vitamins and minerals to
function properly. What happens when you don’t get enough of them? What
happens when you eat too little food, or when the food you eat isn’t
sufficiently nutritious? Perhaps our bodies catch on and reply by
increasing hunger levels. After all – if we eat more, we increase the
chances of consuming enough of whatever nutrient we are lacking.
On
the other hand, reliable access to vitamins and minerals could perhaps
mean decreased hunger levels and decreased cravings, thereby promoting
weight loss.
The above is, of course, speculation. But now there are well-performed studies which suggest it might not be far from the truth.
Vitamin D
A
lack of vitamin D is probably the most common deficiency in northern
countries such as Canada, or most of the US. Three recent studies
indicate that, when compared to a placebo, a vitamin D supplement can
decrease your fat weight or waist measurement [
1 2 3].
In one of the studies,
77 overweight or obese women received either a supplement of 1000 units
of vitamin D, or a placebo, every day for 3 months. Those who took
the vitamin D supplement decreased their body fat by 2,7 kg (6 pounds) – significantly more than the placebo group, who hardly decreased their fat weight at all.
Multivitamins
A study from 2010
involved around a hundred women with weight issues, separating them
into three groups. One group received a daily multivitamin supplement,
the other a daily calcium supplement, and the last group only a placebo.
The study carried on for half a year.
Unsurprisingly, the results
showed that nothing had happened to the weight of the women receiving
calcium or the placebo. However,
the group which took the multivitamin lost more weight
– about 3 kg more – and improved their health markers. Among other
things, their basal metabolic rate (the rate at which the body burns
calories when at rest) increased.
Furthermore, another earlier study found that subjects
decreased hunger levels by taking multivitamin supplements during starvation diets, compared to a placebo.
Conclusion
Nutrient-dense,
good food is certainly the foundation of weight loss. But an adequate
amount of vitamin D can be difficult to ingest via food. In the case of a
lack of sun (such as during the darker months of autumn and winter),
it’s wise to supplement for multiple health reasons – and perhaps even
for your weight.
If you’re overweight and not entirely sure that
your diet provides enough nutrients, it may be worthwhile to take a
multivitamin pill. Unfortunately, they still contain only minimal doses
of vitamin D, so you need both for the full effect.
13. Exercise smart
Do you wonder why this weight-loss tip doesn’t show up until number 13 on the list? It’s because few things are so
overrated for weight loss as exercise is.
Have
you ever watched “The Biggest Loser”? The participants take leave from
their jobs (and family) for months. They are allowed only small portions
of food, and work out as though it was their full-time job – 40 hours a
week, sometimes more. This method is clearly unsustainable for your
average person in the long run.
Just taking the stairs instead of
the elevator, or getting off the bus one stop earlier, isn’t going to
change the numbers on your bathroom scales.
It’s a myth.
Sorry about that. Studies show that if you just start exercising,
you’re going to need at least one hour of tough workouts every single
day to noticeably lose weight.
Basically, the
effect of exercise on our weight is vastly overrated.
That’s why it’s only number 13 on this list. There are other things you
need to take care of first. It’s not a good idea to eat bad food, drink
sugar water (so-called “sports drinks”) or be on medications which
force you to train for hours daily just to compensate. Metaphorically
that’s like digging a hole, into which you put your ladder, on which you
stand and paint the ground level windows of your house.
Exercise cannot compensate for other issues in your life. Those must be addressed first.
The good news
If, on the other hand, you’ve already taken care of
steps 1-12,
you should have a rested and recharged body which is already happily
burning fat. In this case, increased activity will accelerate your
weight loss, and act as an nice bonus. You’ll be burning even more fat
from the very first step.
For example, you could take long walks (golf), cycle, dance, or play any sport you’re happy and comfortable with.
Exercise
also burns the body’s glycogen stores, which are essentially
carbohydrate. This means that after a workout, you can eat a little more
carbs than you otherwise can permit yourself, without negative effects
on
insulin or fat storage. Also, don’t forget that the non-weight-related health effects of exercise are quite impressive.
Hormonal effects
For
even more impressive effects on body composition: aim for exercise
forms which elicit a positive hormonal response. This means lifting
really heavy things (strength training), or
interval training.
Such exercise increases body levels of the sex hormone testosterone
(primarily in men) as well as growth hormone. Not only do greater levels
of these hormones increase your muscle mass, but they also decrease
your visceral fat (belly fat) in the long term.
As a final bonus, exercise can both make you feel and look better.
What kind of activity suits you?
14. Achieve optimal ketosis
Warning: Not recommended for type 1 diabetics, see below.
We’ve
now arrived at tip number 14. If you’re still having trouble losing
weight, despite following the 13 pieces of advice listed above, it might
be a good idea to bring out the heavy artillery: optimal ketosis. Many
people stalling at weight plateaus while on a low carb diet have found
optimal ketosis helpful. It’s what
can melt the fat off once again.
So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet
lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy. This tends to cause you to
want
to consume less calories than you expend – without hunger – and lose
weight. Several of the tips mentioned above are about fine-tuning your
diet to better this effect.
How do you know you’re getting the
maximum hormonal impact from your low-carb diet? You do that by achieving what’s known as “optimal ketosis”.
Ketosis
Ketosis
is a state at which the body has an extremely high fat-burning rate.
Even the brain runs on fat, via ketone bodies. These are energy
molecules in the blood (like blood sugar) which become fuel for our
brains after being converted from fat by the liver.
To encourage
ketone production, the amount of insulin in your bloodstream must be
low. The lower your insulin, the higher your ketone production. And when
you have a well-controlled, sufficiently large amount of ketones in
your blood, it’s basically proof that your insulin is very low – and
therefore, that you’re enjoying the maximum effect of your
low-carbohydrate diet. That’s what’s called optimal ketosis.
Measuring ketones
Today,
there are reasonably-priced gadgets available for measuring ketone
levels at home. One needle prick of the finger, and in just a few
seconds you’ll know your blood ketone level.
Blood ketones
are best measured on a fasted stomach in the morning (before breakfast,
that is). Here are a few pointers on how to interpret the result:
- Below 0.5 mmol/L is not considered “ketosis”. At this level, you’re far away from maximum fat-burning.
- Between 0.5-1.5 mmol/L is light nutritional ketosis. You’ll be getting a good effect on your weight, but not optimal.
- Around 1.5 – 3 mmol/L is what’s called optimal ketosis and is recommended for maximum weight loss.
- Values
of over 3 mmol/L aren’t neccessary. That is, they will achieve neither
better nor worse results than being at the 1.5-3 level. Higher values
can also sometimes mean that you’re not getting enough food. For type 1
diabetics, it can be caused by a severe lack of insulin, see below.
Ketones in urine
Ketone levels can also be measured in a more old-fashioned way, with urine test sticks (sold prescription-free in pharmacies or
on Amazon).
Ketone sticks give less reliable results for several reasons, and the
above recommendations can’t be straightforwardly applied to them. They
are, however, much cheaper.
My personal experience
Feel free to read my accounts of a two-month personal trial:
- Experiment: Optimal ketosis for weight loss and increased performance
- Four weeks of strict LCHF and ketone monitoring
- Final report: Two months of strict LCHF and ketone monitoring
Although
I was quite happy with my weight before these trials, they resulted in a
further loss of 4.5kgs (10 pounds) and 7cm (3 inches) around my waist –
without additional exercise or even the slightest resemblance of
hunger.
How to achieve optimal ketosis
Many who firmly
believe they are eating a strict low-carb diet are surprised when they
measure their blood ketones. They may be at around only 0.2 or 0.5 –
quite far off from the sweet spot! Why?
The trick here is not only
to avoid all obvious sourced of carbohydrate (sweets, bread, spaghetti,
rice, potatoes), but also to be careful with your protein intake. If
you eat large amounts of meat, eggs and the like, the excess protein
will converted into glucose in the body. Large amounts of protein can
also raise your insulin levels somewhat. This compromises optimal
ketosis.
The secret to getting around this is usually to eat your fill with
more fat.
For example, if you have a bigger helping of herb butter to your steak,
you might not feel like having a second steak, and instead feel
satisfied after the first one.
A popular trick people use to
ingest more fat is “fat coffee” (sometimes called “Magic Bullet Coffee”
or MBC). It involves adding one tablespoon of butter and one tablespoon
of coconut oil to your (morning) coffee, and requires a food blender for
the right texture.
More fat in your food will fill you up more.
This will ensure you eat less protein, and even less carbohydrate. Your
insulin will drop and, hopefully, you’ll be able to reach optimal
ketosis. And that’s when many a stubborn weight plateau is overcome.
If it doesn’t work
Being
in optimal ketosis for a prolonged period of time (say, a month) will
ensure that you experience the maximal hormonal effect from eating a
low-carb diet. If this doesn’t result in noticeable weight loss, you can
be certain that too many carbs are NOT part of your weight issue and
not the obstacle to your weight loss. There are, in fact, other causes
of obesity and being overweight. The next three tips in this series
might help you.
Try it
Order a ketone meter online and start measuring. There are a few different models, take a look at
this one and
this one.
More
Watch my video interview with the American doctor Peter Attia, on a strictly ketogenic low-carb diet:
Very Low Carb Performance
A word of warning
If you have type 1 diabetes,
you should not follow the above advice on optimal ketosis – it may be
risky. If you have ketones in your blood at all, you must be sure that
your blood sugar levels are normal. If they are, you’re in normal
ketosis – just like the ketosis of healthy people who stick to a strict
low carb diet.
High blood sugar levels coupled with high
blood ketones, on the other hand, will mean that you have a
pathologically low level of insulin – something non-diabetics do not
suffer from. This can lead to ketoacidosis – a potentially
life-threatening condition. If this happens, you’ll need to inject more
insulin; if you’re at all unsure of what to do, contact a medical
professional. Coveting really high blood ketones for weight control is
not worth the risk for type 1 diabetics.
15. Get Your Hormones Checked
So
you’ve followed the previous tips, implemented major lifestyle changes
and established that neither medication nor vitamin deficiency is an
issue. You’ve even tried being in optimal ketosis for a while (ensuring
low insulin levels). And you still can’t hit the normal weight mark?
If
this applies to you, it’s high time to consider the possibility that
hormonal imbalances are the cause of your troubles. There are three
common problem areas:
- Thyroid hormone
- Sex hormones
- Stress hormones
Thyroid hormone
Some
people, especially women, suffer decreased metabolism as a result of
thyroid hormone deficiency – hypothyroidism. Common symptoms are:
- Fatigue
- Cold intolerance
- Constipation
- Dry skin
- Weight gain
In these cases, weight gain resulting from decreased metabolism usually do not exceed fifteen pounds.
Your
doctor can easily arrange for you to take a blood test to measure the
concentration of thyroid stimulating hormone (TSH). If the test comes
back and everything looks good, your thyroid gland is probably fine. For
a more exact diagnosis, you can ask them to measure the actual levels
of thyroid hormone in the blood (T3 and T4).
Two ways to avoid becoming deficient in thyroid hormone:
- Make
sure you consume enough iodine, which is a building block of thyroid
hormone. Good sources are fish, shellfish and iodised salt (or sea
salt).
- Very low levels of thyroid hormone usually indicate an
autoimmune reaction to the thyroid gland itself. This means you’ll have
to take thyroid hormone supplements orally, usually the stable form T4
(Levaxin), which your doctor can prescribe for you. Your body will
transform this into the active T3 hormone when necessary. The supplement
dose should be adjusted so that you reach normal hormone levels (TSH,
T3, T4) and sufficiently alleviate symptoms – though a few people feel
best when keeping TSH slightly below normal.
Some people
feel better supplementing the already active T3 (sometimes prepared from
pig thyroid glands), as it can give a stronger effect than the T4
hormone, but its effect is often harder to control. Swedish healthcare
rarely prescribes or offers such T3 treatment, as it often lacks
advantages and may pose a risk when doses are high for an extended
period of time.
“Hypothyroidism Type 2″
Some alternative
health coaches will diagnose you with the condition “hypothyroidism type
2″ if you’re experiencing symptoms of fatigue etc., despite normal
blood levels of thyroid hormones, and will recommend supplementation
anyway. Be skeptical of this. You’ll likely end up trying to mask other
health issues (i.e. the real causes of your symptoms) by slathering your
system with overdoses of thyroid hormone.
Of course, some people
will certainly feel more lively and alert (at least in the short term)
running on an overdose of thyroid hormone. On the other hand, many
people feel more lively and energetic when using amphetamine, too. That
doesn’t mean their fatigue was caused by a lack of amphetamine!
Sex hormones
Sex hormones also affect your weight:
Women:
Women can suffer from the endocrine disorder PCOS – polycystic ovarian
syndrome – which elevates testosterone and insulin levels. This can mean
weight gain and menstrual disorders (very common), infertility, acne
and male pattern hair growth (such as facial hair). A
low-carbohydrate diet is a good treatment for this.
More on PCOS.
During
menopause, a woman’s level of the female sex hormone estrogen drops.
This often causes some weight gain, especially around the gut (so-called
central obesity). Any excess weight gained after menopause will tend to
be less femininely proportioned, less curvy.
Men:
From middle age and onwards, men experience gradually declining levels
of the male sex hormone testosterone. This leads to slight weight gain,
also typically around the gut, and decreased muscle mass.
What can you do about sex hormones?
Testosterone deficiency can be at least partially treated naturally by engaging in
smart exercise routines,
conscious body language and
supplementing vitamin D.
Of
course, you can also affect testosterone levels by getting your doctor
to prescribe a testosterone supplement (a blood test will confirm any
deficiency). Women can use estrogen supplementation for climacteric
problems.
It’s important you take into account, however, that
supplementation of testosterone or estrogen for years on end, in doses
that are abnormally large for your age, will increase the risk of
prostate cancer (in men) and breast cancer (in women).
It may be
wise to accept that you don’t (and shouldn’t!) have the body of a
20-year-old when you’re several times that age. A better option might be
to try and focus on a healthy lifestyle instead, and to be as happy and
grateful as you can for the body you have.
Stress hormone
The
final possible culprit behind stubborn weight issues may be the stress
hormone, cortisol. Too much cortisol will increase hunger levels,
bringing along subsequent weight gain. The most common cause of elevated
cortisol is chronic stress and
lack of sleep (see
tip #10), or
cortisone medication (
tip #9). It’s a good idea to try your utmost to do something about this.
In
rare and extreme cases, you could be dealing with a specific kind of
tumour that drives cortisol production. The condition is called
Cushing’s syndrome. If you suspect you’re suffering from this, consult your doctor and they will run the appropriate tests.
Feel free to Comment
