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I am posting a composite profile of a chronic dieter who doesn't seem to get anywhere from both my own experience and others.

I've read about BMR, calories, and I get it. Fewer calories in, more calories burned. Since my BMR is about 2400 calories, I should be able to lose close to two pounds a week if I cut down to 1600 calories. And if I work out I should be able to lose even faster.

So I did that "Mediterranean" diet where you eat like people in the Mediterranean do. You've never seen a fat person there, right? I'm eating 1600 calories a day and I'm just evil to be around. I have no energy, I can barely form a coherent thought, and I get paid to use my brain. This just isn't working.

It's been three months since I did the Mediterranean diet and I'm heavier now than I was then. What gives? I'm eating the 2400 calories a day to maintain, but I'm steadily getting heavier.

This seems to be the plight of many calorie counters out there. A friend of mine was actually told by her doctor that she was exercising too much and eating too little. The "Mediterranean" diet was my own experience. There's got to be some magic formula to this right?

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Vote to close: This question seems to be posted only as a chance to begin the detailed Q&A discussion below and to lead to the "Ideal Protein Diet" line of weightloss products. –  J. Winchester May 6 '11 at 22:01
    
Not as a chance to lead to the "Ideal Protein Diet", however under the direction of Ivo to summarize a barrage of comments I had in another question. The principles behind controlling the pancreatic function are sound, and a feature of several comparable plans (such as the Atkins). –  Berin Loritsch May 7 '11 at 20:10

3 Answers 3

So there are a few problems with blindly cutting calories. The first is you don't quite understand what your body needs, and how to address the problems causing you to be overweight.

A common ailment in western food is the over-abundance of carbohydrates, sugars, and fats. So what problems does that cause?

  1. The pancreas gets overworked producing insulin. In the worst cases it never has a chance to rest.
  2. When the pancreas is overworked, it produces low quality insulin and too much of it. The net affect is that the insulin locks away more sugar as fat than it should. Your brain asks for more, but because you are overloading your pancreas you are in a never ending cycle.
  3. Your pancreas is also responsible for secreting a second hormone (can't remember the name right now), which is responsible for burning fat. If the pancreas is always dealing with the sugar rush, it will never secrete this other hormone.

While cutting carbs is a good start, you do have to be smart about it. Basically your body pulls energy from three major stores:

  • The sugar in your blood. Your body contains enough to fuel your brain (the only organ that only uses blood sugar for energy) for up to three days--or about 300g of sugar. Note: diabetics may have higher or lower amounts which are hyperglycemia or hypoglycemia respectively.
  • The fat stored all over your body. When muscles have oxygen, they can burn fat directly.
  • Your muscles and organs. Yes, in dire situations (such as famine) your body can cannibalize itself to preserve your life.

One thing just about everyone agrees on: muscles burn fat. The more muscle mass you have the more fat you can burn.

So what happens when you cut out all the carbs/sugar/fat?

  • Your body will use up all the sugar in the blood first for energy. During this time you may feel lethargic, or become very irritable (evil).
  • Next it will take from both the fat stores and your muscle mass and turn it into sugar.

This is called ketonic acidosis. Ketonic acidosis is a very bad thing. Your body thinks it's in a famine situation, so it holds on to the fat more earnestly and willingly burns its muscle--which is what you need to burn fat. This is bad.

So how do you protect the muscles from getting turned into sugar?

Glad you asked! Protein. Your body needs enough protein to protect your muscles from ketonic acidosis.

There is a healthy state called ketosis where your body burns fat, and not muscle. To get into this state you need the following:

  • Enough protein to protect your muscles. For sedentary people you need .5g protein per pound of lean body weight (fat free mass). For athletes or to gain muscle at a reasonable pace you need 1g protein per pund of lean body weight.
  • Less than 40g of carbohydrates/sugars. Maybe even fats.

If my pancreas is overworked, can I fix it?

Yes. If you put your body into ketosis the pancreas rests. While it rests it secretes that hormone that burns fat (yay!). If it rests for three weeks or more it will return to a very healthy state.

An added plus of being in ketosis is that every calorie not in your food will be taken from your fat stores. That means you can have 900 calories a day, assuming you found highly absorb-able protein sources, and burn fat even faster! I personally used Ideal Protein which originated in France from a Dr. Tran. They supply 97% absorb-able protein with their plan meals, so you can get those low calorie numbers. There's four phases to the diet, and its monitored. Probably not a bad idea. If you don't have something similar (like a Lindora), then doing the Atkins diet is perfectly acceptable. Just watch how much fat you take in and don't overdo the protein.

Wait, can I stay in ketosis forever?

It's not recommended. One of the side effects of having so few carbs is the fact you are likely not getting enough dietary fiber. Your body needs a bare minimum of 21g of fiber a day to stay "regular". If you have less than that you will have problems with constipation. I can speak from experience that it is not fun.

You will have to reintroduce carbs at some point. But be careful how you do it. The problem with going straight back into eating carbs after your body has been in ketosis for so long is that it's not used to processing them anymore. When your body isn't used to processing food, it turns it into fat. Not what you want.

To reintroduce carbs safely you should give your body at least two weeks of this:

  • Spike the body with carbs once a day. You want something from every representative source of carbs: dairy, grains, fruit. No more than 30g from any source and less than 100g total. Less is OK as long as it is there.
  • No more carbs until the next morning. The body is learning how to process them again. Six hours after you have the carbs, your body will go back to fat burning.
  • After the two week reintroduction, limit your carbs to breakfast and dinner. It takes 12 hours for your body to process complex carbs and when it does you get a rush of energy. If you have them at noon, you will get your rush of energy at midnight--when you should be sleeping!

So is that it, just no carbs and protein?

Well no. Even when you are on an unbalanced diet (like I just described), you need:

  • Vitamins and minerals. Use supplements, at least a multivitamin. Omega-3 supplements help, but are technically optional.
  • Lots of water (at least 2L a day, more if you exercise)
  • Lots of vegetables (western diets don't have enough of these). Be careful, if you are trying to limit your carbs, some vegetables have a lot (like carrots). Stick with green veggies and sweet peppers while you are trying to lose weight.

When you are on a balanced diet:

  • A reasonable amount of carbs. Your brain only needs 100g a day. Do you really need the 300g/day that Kellog's thinks you should have? NOTE: anaerobic workouts (i.e. without oxygen) burn sugar, not fat. You will need carbs 12 hours before your workout.
  • Fruits
  • At least 21g of Fiber a day. Increase this until you consistently have a bowel movement a day. NOTE: it took me two weeks after the unbalanced diet to return to normal, and close to 30g of fiber a day.

Balanced/Unbalanced? Are you nuts?

Understand what each is for:

  • An unbalanced diet is only for the purpose of weight loss. That means it is temporary. You use it to get to your target weight, and then start re-introducing the foods you need slowly for a balanced diet when you are done.
  • A balanced diet is what you will eat every day and maintain your weight. If you eat more than your BMR, you will gain weight. If you eat less than your BMR, you will lose weight. But be warned, your BMR changes over time. The more muscle you have the higher your BMR, the less muscle you have the lower your BMR will be.

If you still want to lose weight healthily, but maintain a balanced diet your progress will be slower. That's OK. Just remember that there are two inescapable realities:

  • If you don't have enough protein you will lose muscle mass.
  • If you lose muscle mass you won't burn fat as quickly--and your BMR goes down.

Imagine for a moment chasing the ever decreasing amount of calories to support your weight loss progress as you slowly lose muscle mass. All too often with diets like that, you lose muscle mass and then start eating the same as you did before the diet. The problem is your BMR is different now. You will not only gain back the weight you lost, but you'll gain more.

That's why you don't compromise protein when you are cutting carbs/sugars/fats. Fiber is also important for your own comfort, but not quite as important as protecting your muscles.

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Pretty much my diet the last two months. 2 Litres of water a day, a steady stream of green tea and nothing but protein and fats - with a ton of vegetables. –  myol Sep 17 at 9:05

There is no diet which has been shown, through clinical trials, to provide long term weight loss. Those that have been designed well and show short term weight loss (See the AtoZ study), have minimal weight loss which is consistently regained over the course of a year. People who have lost significant weight and have kept it off are anecdotal and usually have crafted their entire life around keeping the weight off by exercising multiple hours a day, and restricting food in a way that would otherwise be diagnosed as an eating disorder.

While is it possible that some sort of diet and exercise combination might cause successful weight loss and weight maintenance, no such diet or exercise has yet been proven to exist by science. And that is why following any currently known diet should be done with the lowest of expectations. It has not worked for any clinical trial yet, so there is no reason to expect it will work for you.

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That's not entirely true. The Ideal Protein diet (whose principles are outlined above), has hundreds of case studies of people who have both lost a significant amount of weight and been able to maintain that weight loss. For those that failed to keep it off, 9 times out of 10 it is because that person cheated while re-introducing carbs and did not successfully condition their body for it. Is there a formal study? Probably not. However there are hundreds of cases well documented by the plan practitioners. –  Berin Loritsch May 6 '11 at 20:00
    
Successful maintenance requires monitoring and providing corrective actions while the problems are still small. For example, gained a pound or two after a cruise? Lose it after you are back before it turns into 20. There's no set it and forget it mode for maintenance unfortunately. –  Berin Loritsch May 6 '11 at 20:01
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Case studies are by definition anecdotal. Without a properly designed study, it is not supported. In every study, there are some people who do really well, and even keep off the weight, but not a statistically significant number. If the diet you propose can hold up to a prospective study, imagine how rich the creator would become. And why isn't that study being conducted now. Look, I think a successful diet exists, and I have my own opinions on how it is going to look when it is found, but it has not been proven to be found yet. And that is a fact. –  michael May 6 '11 at 20:17
    
I think the problem is not the proving of a "diet" (i.e. a plan of eating that works) but rather of human behavior; there are many possible good diets, but few people who care enough to consistently follow one. Those people who do care enough are not likely to be fat in the first place, so they are never candidates for weight loss. You might reverse the problem and ask what diets are clinically shown to provide weight GAIN, and just counsel people to avoid those diets. –  J. Winchester May 6 '11 at 21:39
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You must not know many people who diet. People have ridiculous amounts of self control, yet still fail. As far as diets that gain weight, it is just as hard to gain and keep weight on, as it is to lose it. See this study ncbi.nlm.nih.gov/pmc/articles/PMC292021 (discussed in detail here junkfoodscience.blogspot.com/2008/10/…) where lean people tried to gain as much weight as possible, tripling their calories and becoming sedentary. They had a hugely difficult time gaining, and lost it all quickly when the study ended. –  michael May 6 '11 at 21:55

Any diet you'll adopt just to lose fat (in given time) eventually will fail.
The only way out of this is to work on your own habits which include both food and lifestyle changes, not temporary but for good!

Your body needs calories, but needs the right type. Mediterranean diet (or lifestyle) includes multiples of good (vegetables) and bad food (e.g. pasta - simple carbs) and surely it can be adopted if you like it and can introduce few changes e.g. pasta => brown rice.
Your body needs exercise - a walk outside where lungs can enjoy with fresh air is beneficial to overall health and/or whatever other activity you're enjoying most.
With new sport your body will require more food, give it what it asks for and do not worry about it too much. If you supply it with good food, saturation will come naturally (this under assumption you do not treat eating as a reward / comforting activity and recognize that the only purpose of it is to fuel your body with nutrition it requires to live).

Word of caution on protein diet, as it is proven to increase acidity in your body which body will try to balance by flushing it using your calcium reservoir.
Generally, any awesome diet works wonders in a limited time but the real worry is - what collateral, internal damages where done in that time?

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The net calcium effect of protein is beneficial, actually. ncbi.nlm.nih.gov/pubmed/20717017 –  JohnP Sep 17 at 17:14
    
Amount of protein consumed in protein diet exceeds by far margin the amount used in the paper. 0.8g / kg consumption? What meal that would be, two chicken breasts for a whole day? Dude.. –  RobDBob Sep 19 at 11:24
    
Reading comprehension. You're doing it wrong. –  JohnP Sep 19 at 14:40
    
Real life knowledge, that's something you could improve on. Bodybuilders on bulking phase are eating on average 1.5-3g / lbm protein. Keep in mind that this is not a protein diet and includes other foods. Protein diet might contain even higher amounts. –  RobDBob Sep 29 at 12:42

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