How to Lose Weight

 

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

  1. Choose a low carb diet
  2. Eat when hungry
  3. Eat real food
  4. Measure your progress wisely
  5. Be patient
  6. Women: Avoid fruit
  7. Men: Avoid beer
  8. Avoid artificial sweeteners
  9. Review any medications
  10. Stress less, sleep more
  11. Eat less dairy products and nuts
  12. Supplement vitamins and minerals
  13. Exercise smart
  14. Achieve optimal ketosis
  15. Get your hormones checked
  16. coming soon
  17. 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:

  1. Atkins’ Fairy Tale Cookies
  2. Julian Bakery’s High Carb Low Carb Bread
  3. 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:

  1. 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).
  2. Exhale and relax (don’t suck in your stomach).
  3. Make sure the measuring tape is snug, without compressing your skin.
  4. 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 loseThis 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

sleep2

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:

sleep

  1. Stick to a certain bedtime every evening. In the long term, this will help the body prepare for sleep at that time.
  2. No coffee after 2 pm. Just don’t – and remember that it takes time for caffeine to leave the body.
  3. Limit your alcohol intake three hours before bedtime. While booze might make you woozy, it worsens the quality of sleep.
  4. 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.
  5. 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

snacks

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

Multivitamin

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

confused

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.

confused

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:

  1. Experiment: Optimal ketosis for weight loss and increased performance
  2. Four weeks of strict LCHF and ketone monitoring
  3. 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

Hormones

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:

  1. Thyroid hormone
  2. Sex hormones
  3. 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:

  1. 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).
  2. 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.

 

16 – 17. Coming Soon

These tips will be posted soon.

While you wait, feel free to check out my best blog posts on weight loss.

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425 Comments

  1. 2 comments removed
  2. April Green
    Your article mentions watching whey protein amounts but what about Casein protein? I'm sure this must be better but it wasn't mentioned so I thought I would inquire.
    Thank you!
    Reply: #405
  3. 1 comment removed
  4. Zepp
    Whey is often used for protein powder.. Casein is cheese!

    Dont go overborard whit cheese either.. us it in your coocking or to your meals.

  5. 5 comments removed
  6. Terri
    Hi
    Great page full of terrific free eduation.
    How many carbs should we aim for to lose weight I need to lose around 5kgs. 50-100g? Do I coutn all the carbs in green leafy veg, etc?
  7. 6 comments removed
  8. Dana
    Sometimes a woman's hormonal problems are PCOS, sometimes it's an excess of estrogen relative to progesterone. That one's a Catch-22 though. First off it's difficult to diagnose because of course your estrogen and progesterone levels change throughout the month. Secondly the estrogen excess is likely related to your excess fat, since fat secretes estrogen. So it's hard to say whether you should supplement progesterone, or just try harder to lose the fat. Some women take pregnenolone instead, which is the precursor for progesterone (and the other sex hormones, but I think it converts to progesterone first), since a body out of balance will sometimes "steal" this precursor hormone and use it for other things when it's supposed to be making sex hormones with it.

    If you're having periods but having a lot of trouble getting pregnant and you don't really have PCOS symptoms other than the obesity, this might be something to look into. Progesterone is supposed to increase after ovulation so it can help a pregnancy "catch."

    I've been pondering this in my own case because it may be an issue. My doctor won't even check it; I've debated going to an endocrinologist. But for now I think I will just work on the weight loss because right now *everything* is abnormal-ish and will continue to be til I get more of the weight off. Can't tell what needs fixing if a lot of it is the excess fat and insulin...

  9. Leo
    I have now cleaned up the comment section for this blog post. Some 100 spam entries have been removed. Thank you for your patience, and sorry fo the delay in removing them.

    /Moderator

  10. Doug
    About three weeks ago I finally went in to see my Internist for back pain, they put me on the scale and it read 239. I was sent to a Spine Center and the scale said 241. When I checked into the Surgery Center for joint injections, I weighed 244. Of course I had clothes on, but just realized it is time to do something. I am 6' tall and been athletic my whole life. I decided to go on a low carb diet after buying a good scale at BBB. In under ware I started at 237. I needed to get some kind of plan to follow and found a sight called Lose It. I does not tell you what to eat, it just tracks you daily calorie, fat, and carb intake. It also tracks your used calories for any exercise you do. After putting in all of my information I select 200 lbs as my goal. It spit out that I would get there about May by just counting calories and staying at 1650 per day. I just used that to get something into the System. The main use is to track my daily progress by weighing each morning, counting my carbs. My real goal is to lose 20-25 lbs by Feb 22, when I take an 18 day cruise.

    I found this site looking for what to do after the low carb diet as not to gain it back, like I have so often. Great advice. I have never been so determined and my results are scary good. Maybe not real safe, but I just have 6 days left before I switch to a more sustainable routine and lifestyle. In eight days I am down 14 lbs. I am only eating about 5-6 carbs a day and exercising 2 hours a day. I am using an exercise program from the old book, "Body for Life". One day cardio (5 mile treadmill at 3.3 MPH), then the next day I use weights, one time upper body, next time lower body. Today I went and purchased Atkins bars and shakes. Until I read this article I was going to use them for snacks. Not now! After reading this article, I am just going to increase by carb intake when I finish this crazy phrase of my diet. I am 67 years old and retired. I have to tell you, once you get a couple of days behind you on this Low Carb Diet, you have a great amount of energy. I do find the weight routines tiring and that is probably just my age and my upping the intensity from my more easy going routines.

  11. John
    After many years I have understood that people need individual diet plan in order to lose weight.Most programs offer only free tips.If you are serious that is not enough.Here is a great system that will create an individual diet plan for you:

    http://www.WeightLossLastSecret.Com

    They will help you weight loss 100% naturally without any pills.They have helped me lose a lot of weight and change totally.Try them.

    Hope that helps

  12. Tamatha
    Great post. Thank you! I thought I was resistant to loosing weight for a few years, but have
    Learned that I was overdoing it on trickery.
    Hello, Splenda, dream fields and other low carb s$&t.
    What really straightened me out was the 4 hour body by Tim Ferris. The book is kind of silly and
    Kind of frat boyish. But I must say the "slow carb" diet is really working for my husband and I.
    There has been no hunger no snacking and 1 glorious cheat day per week, where you can go all out. Anything you want and do until you don't feel like it because it gives you a good coma.
    I hope I stay strong and don't return to my old ways. It's nice to see my old body and face returning. Good luck to you all!
  13. Bob in NY
    Been on LCHF/Keto now for 5 weeks. One thing that I have a question about is the protein macro. How important is it to limit my protein? On the "LCHF For Beginners" page it lists meat and eggs as "Eat All You Like". On most other Keto sites, it says to limit protein to .6-.8g per pound of lean body mass, as excess can turn to glucose. If I use .7g, that only puts me at 105g of protein/day. How much "excess" protein does it take, before I should be concerned about it turning to glucose? I'm a 250lb guy and that just doesn't seem like much protein at all to be satisfied.

    I have ~70lbs to lose. My first week, I lost 13.2lbs, water weight I'm sure. For the past 4 weeks, I've only lost between 1/2lb to 1lb each week. For the past month, my carbs have been ~10/day . Protein has been ~110g/day. Fat has been ~140g/day. My calories have been averaged 1785. NO cheats, no alcohol, very little soda (1-2/wk), very limited artificial sweeteners (2-3 packets/week of erythritol), nothing processed. Just meat, eggs, fats (coconut oil, MCT oil, bacon fat, and butter), limited fresh veggies, limited dairy. Only drink water (~160oz/day) and coffee. Considering how much I have to lose and how strictly I've been following the plan, I would have thought I should have no problem dropping 2-3lbs/week? Been testing with keto sticks every now and then, for peace of mind, and I am in ketosis.

    Two years ago, when I was on Atkins, I just kept my carbs below 20/day and fat >65%, paid NO attention to protein limits (simply ate until satisfied), and the weight seemed to melt off me (40lbs in 3 months). Now that I've been reading more about Keto and everyone insists that you "must limit protein", I don't seem to be losing squat! Plus, now I'm tracking protein and calories, where I didn't on Atkins. Maybe I should just stick to the basics (<20 carbs)?

    Very frustrating! Each week, I keep thinking that "Maybe I'll have better weight loss next week", but it never seems to happen... Makes me question WHY it doesn't happen and if I'm doing something wrong? I average 1800 calories/day, but now question if I should reduce? Doesn't sound like much for a 250lb guy though...

    Reply: #427
  14. JD
    Not sure where you got the term "Magic Bullet Coffee", but that is actually the recipe for "Bulletproof Coffee", or BPC, popularized by the guy who runs the website The Bulletproof Executive.
    Reply: #425
  15. Zepp
    MBC is the standard term in sweden.. its made in a Magic Bullet mixer.. or there like!
  16. Orit
    HI! regarding the "how to lose weight" list, i am really really waiting for steps 16-17 :) thanks :)
  17. Orit
    i would really like to read someone's answer to Bob! thanks :)
    Reply: #429
  18. John
    There are several important things you have to know about weight loss.
    - Never get pills
    - Start working and motivate yourself
    - Use individual diet plan.You can find such a plan here: http://WeightLossLastSecret.Com .I used this system and weight loss fast and healthy.I would suggest it.
  19. Zepp
    To Bob and Orit!

    Its something wrong.. if one survive on 1800 Kcal a day and weights 240 pounds!

    I did a calculation on a online energy calculator.. and put in some randome heights and it says that one need about 2700-2800 Kcal i day.. if one weights 240 pounds!

    http://firstyear.chem.usyd.edu.au/calculators/food_energy.shtml

    One must check for different diseases, moste comon is hypothyreosis!

    But its definatly something wrong if one survive on 1800 Kcal.. if one weight 240 pounds!

    Im been along that long as Im have read about many different anectdotes about people that eats 1000 Kcal a day and dont lose any weight even if they eat LCHF.. and some that have to restore there BMR.. by eating more.. and initaly have to coop whit that they gain some kilos/pounds.. its often muscles anyhow!

    Starving.. of any cause have detreminal outcome for your muscles and BMR.. the musles are used as energy for survival!

  20. Joe
    I agree with all except not eating fruit. Fruit has high fiber which offsets its natural occurring sugar. Fruit has so many health benefits that without eating it, you open yourself to cancer and other issues. It is also known to clean your arteries out. Do not give up sugar because it is simply sweet. I eat a low carb diet with fruit and the weight keeps coming off.
  21. nivedita neelam
    I need vegetarian recipes!!! No eggs no meat no fish!

    Can somebody please help!

    Thanku!

    Reply: #434
  22. Bob in NY
    This is the Keto Calculator that was suggested I use to determine my macro's and calories. http://keto-calculator.ankerl.com/ Do you feel this is an accurate calculator?
  23. simar
    Hi....I recently read these topics. I think I will be helpful for reduce weight. When I reading this topic than I think about suger. Last few months I really increase utility of suger and mostly I eat suger ball, sweets. ,chocolate etc. And also i think its sexul harmonies . But after read this topic I am try t give up suger and take m
  24. Zepp
  25. Sarah
    My secret is venus factor. it worked for me and fro my mom as well... amazing reviews, learn it here guys... http://healthandfitness168.blogspot.com/2014/02/do-you-want-to-loss-w...

    let's get sexier..

  26. lisa
  27. Katen
  28. Esha
    You have written the article very well. It is very important to be in shape and eat healthy because then the body runs for a longtime without giving you any other health diseases.
    From my personal experience i have lost 42 kgs so i am helping people to help them lose weight with all the secrets i got when i was transforming myself.
    http://www.sevenswag.com/8-most-helpful-weight-loss-tips-of-2014
    Must read if you are trying to lose weight.
  29. Domantas
    Hello everyone, i had a lot of problems with my weight and i tried some strategies which i described in my blog. Look at that: http://overweightnotforme.blogspot.com/ . Loose weight healthy :)
  30. Dan
    My question is can you eat to much proten and how mush fat is to much.
    Reply: #441
  31. Zepp
    Yes one can, but its difficult!

    Protein is not so good as fuel.. its mostly a building stone for a lot of importante stuff!

    Whe have a limit in our urea cycle.. that limit us to max 30E% protein.. after some time it can take up to 35-40E%!

    But thats the roof.. and there are a floor too.

    Availably sciens says that 0,8 gram a kilo a day ís minimum.. for carb eaters!

    We use some to make glucose.. then we say that minimum us 1 gram/kilo a day.

    But if one is hard working or/and excersise a lot, then the demand can up to 2 grams a day.

    And minimum is seldome optimum.. so say 1,5 grams a day!

    Fat is your major energy source.. so its up to your energy demand!

  32. Teresa
    I am a healthy eater naturally. I eat mostly vegetables. I have been eating eggs for breakfast followed by broccoli, cauliflower, radishes etc. for lunch. I don't eat red meat, seafood or fish. I do try and include some turkey, chicken, or tuna into one of my meals. I eat a low-calorie, low carb diet as it is. I drink only water minimum 2 liters a day. I can't cut anymore calories or carbs. I started drinking protein shakes in between meals, no more than 24oz a day, made with whole milk. The protein comes out to about 45grams. I thought increasing my protein would help with weight loss. I really only want to lose ten pounds. I am 5 foot 3 inches and 140 lbs. I use the eliptical 30 mins a day 3 days a week and some light weights, dumbbells, for my arms. The excess fat isn't budging. What can I do to kick start the fat coming off? I have degenerative disc and degenerative joint disease. I also have bulging and herniated discs in my lower back resulting in sciatica. I am not able to do extreme exercises. What are your thoughts. Mostly just want to get rid of the belly fat.
    Reply: #443
  33. Zepp
    Belly fat is often stress fat.. it should acumulate on the hips if one is a healty women.

    Have you tryed a ketogenic diet?

    If your body was able to burn fat.. or store it in other more comfortable places it does this by it self if one give it the right circumstances.. ie.. the right homeostasis.

    Its hormones that deside where to store excess fat.

    Female hormones stores fat in the right places for fertility reasons.. belly fat is for fight and flight!

    Try this!

    http://www.fitintegrity.com/uploads/9/5/1/6/9516119/no_sugar_no_starc...

    Or if you want a vegetarian alternative!

    http://lowcarbdiets.about.com/od/vegetarian/a/Low-Carb-Vegetarian-Die...

  34. anonymous
    As i am suffering from pcos after marriage i am taking nostogel contraceptive pill to regularise periods.but my weight is increasing not getting Wat to do. Can u help me in dis
    Reply: #445
  35. Zepp
  36. Ani
    Hi there I hope you can help me - I've lost 12 kilos on low carb high fat eating from Sep to Jan but am slowly picking it up again a kilo a week as I'm desparate for bread and other high carb foods as if I'm possessed! I feel sooo tired after eating them and I hate myself for slowly undoing all my hard work....what's happening???
  37. Orit
    until you get a better answer my advice is stop eating the carbs, they are the ones that are making you tired and desperate for more, and what to do?? eat lots of fats and fatty foods until you feel better and the fatigue and moodiness go away, it will take a few days but then you will feel better and will be able to enjoy life again.

    on this week try not to worry about the weight, i dont think it will go up, but if it does just think that you are going up anyway with all the carbs... this way you can at least begin to feel better.

    good luck and let us know!

  38. Bob in NY
    Doc - I've been reading that caffeine stimulates an overproduction of insulin, which ultimately hinders weight loss and/or promotes weight gain. Have you found that caffeine itself does this or has a negative effect on weight loss efforts?
    Reply: #449
  39. Zepp
    I dont think soo.. I altso read that caffein protects against diabetes and comes with a lot of antioxidantes!

    Drink your cups of coffe.. its almoste brown water!

    But its a good beverage!

    I realy think that the sugar that often comes to it is more bad!

  40. resh
    Hi Doc,

    I have lost a little weight (not on LCHF), however my weight has now plateaued, so am looking at this diet to aid. I have just been reading your article on hormones, I am on thyroid therapy for hypothyroidism and also have PCOS, however last u/s showed that I no longer have 'cysts'. I am approx. 5' 2'' and weigh approx. 85kgs. I am of Indian heritage. In your opinion, is the LCHF diet going to assist me with losing the extra weight that I carry, bearing in mind my hormone imbalances. The last bloods I had showed that my fasting BG was with normal range and my thyroid levels are also good. I am not on metformin or diabex.

    Thanks

    Reply: #451
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