How to Lose Weight

 How to lose weight

Do you have trouble losing weight? Or would you like to lose 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.

Skaldeman-FiskBacon-372×238

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 will give up and eat, 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 an appropriate 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.
Butter and olive oil
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 a 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 as many 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 LCHF food

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 carbohydrates. Don’t be fooled.

Here are three examples of what to avoid:

Fake low carb products

  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 from 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’d think. Focusing only on weight and stepping 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 this if you only measure your weight. Thus it’s smart to also track the disappearance of your belly fat, by measuring your waist circumference.

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:

waist-circumference-midjemått

I recommend aiming for “excellent” but it’s not always realistic. Young people can usually achieve this, 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 cut the string to fit your waist 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 fits is also a good option.

 

5. Be Patient

Patience

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 at a slightly slower pace. People on 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 hits 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!

 

6. Women: Avoid Eating Fruit

FruitThis 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.

 

Get rid of your beer belly

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

Artificial sweeteners and weight loss

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.
  • Medications and weight lossOther 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 of dairy products and nuts

snacks

Can you eat as much as you like, 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 contain varying amounts 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 various 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, 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.

More healthy tips

Do you want updates with the latest news for your health and weight?

Subscribe to the Diet Doctor newsletter like people:

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619 Comments

  1. shree
    Nice tips to follow.. And today I read an article and it was quite interesting..!!
    http://healthcarewell.com/surprising-foods-to-reduce-weight/
  2. Christine
    Very informative, I dropped out of this eating plan because I was gaining both weight and inches and feeling really bad; I made some rather MAJOR mistakes! Time to reset and this belly down and back into my smaller sized clothes.
  3. Dimitra
    Thank you for the awesome article post.

    Certainly, when looking to lose weight and maintain a new body weight, it is imperative to change the general way you look at food.

    Furthermore, you must change the way you feel about food and break all the habits that caused you to gain excess weight in the first place.

    Another healthier alternative to lose weight that it could also be included on a "coming soon" post, is to use herbal teas.

    Lemon bee-brush, dandelion and some other herbs are excellent to help people enjoy a slim body since they detoxify the body, stimulate metabolism, and burn fat.

    You could find more information on how to lose weight through herbs in the article below:
    http://treatmentherbs.com/herbal-tips-to-lose-weight/

    Reply: #604
  4. erdoke
    they detoxify the body, stimulate metabolism, and burn fat

    I am not against herb teas, but these claims will be diffcult to prove... I guess that even the biochemical methods are not established how the mentioned tea types could achieve such results. I don't even understand what "detoxify the body" means when one takes only healthy foods and avoids pollution, etc.

    Reply: #605
  5. Dimitra
    I believe that if pharmaceutical companies allowed it, the usefulness of herbs could prove.

    As for "when one takes only healthy foods and avoids pollution, etc." is another long story!

    Is there anyone who takes only healthy food? (preservatives, chemical ingredients, antibiotics in animals, etc.). Is anyone who can totally avoid pollution? Can all these diseases come from nowhere?

  6. anonymous
    Dr. Eenfeldt, are you going to post items 16 and 17 on your "How to Lose Weight" list anytime soon? I've been curious since I first read this article a few months back, but the last two items still say "Coming Soon".

    Thanks!

  7. kate
    Very interesting Tips.

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  9. Humberto
    Hi

    Since 3 years ago I started paleo diet.
    But recently I have being experiencing some kind of dizziness and my breath becomes short.
    I don´t know yet if it is related to bad sleep habits or if I´m missing something as part of the paleo diet

    Notice that I started this diet because I was diagnosed with Fatty Liver.
    Right now I´m slim, not having any pain in my liver and all of those other symptom related to fatty liver where gone.

    Only thing that Im having right now is this crazy dizziness.

    I also take supplements containing all vitamins, minerals, probiotics, etc.

    Im taking right now some medical exams which I have to wait for the results.
    Those are:

    TSH, Free T3, Free T4, lipid profile, blood test, Anti TPO, Anti Tyroglobuline,

    I appreciate if you can have any feedback.

    Thanks

  10. Mariette
    Hi, I just have a question about carbs. I am eating 700carbs a week, but I limit my carbs more on week days and then eat more on weekends, still never going over my 700 carbs per week. Will I still lose weight this way or is this bad? Also are my carb limits to high?? I'm 21, fit and active female, so I thought that this is good?
    Replies: #611, #700
  11. Zepp
    If you mean 700 grams of carbs/week.. thats low carb compare to SAD!

    Carbs are not bad per se.. its high glycemic load thats not soo good.. perticaly for some.. preferaly those how is sedentary and/or have parents that is diabetics!

    Losing weight is about calories in the end anyhow.. its better to rely on fatoxidation if one aim to burn some fat weight!

    Its more dificult to burn fat if one put more glucose in to the system.

    I dont think your carbs are to high.. its more like everybody should eat.. to not needing go very low on carbs to revers hyperglycemia and hyperinsulinemia at the end!

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  13. Loy sequeira
    Insulin index shows meat raises
    Insulin more than bread.

    How can you ecplain it ?

    Reply: #614
  14. Zepp
    Becuse you need insulin to store amino acids in the right places.. and glukagon is excreted proportionaly.. to keep the blood sugar even!

    Dont be afraid for normal insulin secretion.. its hyperinsulinemia thats bad!

    And hyperinsulinemia is mostly beuse of high glycemic load and a bad heredety!

    "Slow Glucose Removal Rate and Hyperinsulinemia Precede the Development of Type II Diabetes in the Offspring of Diabetic Parents"

    http://annals.org/article.aspx?articleid=704330

  15. Cheneen
    I have one quick question. While trying to train myself to get my fat content up in my meals - using MyFitnessPal to keep track of what I eat and to tell me where I need to eat more fat - MyFitnessPal is giving me a warning that my calories are too low i.e. approximately 800.

    I understand the concept that LCHF followers do not count calories i.r.o. eating more than recommended (1000 -1200 for woman) - however and this is my question, should I worry if I eat less than the recommended minimum of 1000 calories? My appetite has disappeared and do not feel like meeting the minimum at the end of the day - usually 200-300 calories short of the 1000 mark.

    Reply: #626
  16. Zepp
    First of all you must count the calories you lose too.. and ad that to what you eat.

    And 1000-1200 is for a small child!

    If you lose a pound a week.. its 500 calories a day!

    I should be worry if I was eating that little.. becuse it cant be enough of other nutrients.. even if you got a lot of fat to use as energy.

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

  17. laura
    My gall bladder was removed nearly 2 years ago. Will a LCHF diet work since I no longer metabolize fat as well?
    Reply: #618
  18. Zepp
    Yes.. its your liver that produce gall/bile!

    The bladder is just for storage and concentration.

    There are very few that got problems after bladder removal.

    And then.. try coconut oil.. it dont need any bile to be digested.

  19. SIVAKUMAR
    Hi i am siva i am 24 yrs old but my weight is 95 i like to to get the tips to burn my fat..Can anyone help me with this.
    Reply: #620
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  24. Brenda
    Ok, I have not started this weightloss as suggested, you know just dive in. Taking it slow, just how my mind works. So here are some numbers as of to-date, from June - August, lost only 2lbs. But went back to the doctors in September, 3 weeks after my previous visit and according to records I lost another 10lbs. I notice a differnce, somedays I am not hungry during lunch, so those days I may only eat twice a day; breakfast and dinner. I did not always eat breakfast everday I should have, as I do now. By the Grace of God, I am so glad I found this and its FREE.
  25. Brenda
    Any one can direct me to some receipes that I can make in advance and in bulk, I like to make premade meals; meals I can freeze. It also helps the budget.
  26. Brenda
    Oh, yes I would worry. I will be 47 soon, when I got out of high school I found this weight loss clinic, beside being overweight, was pretty healthy, rarely got sick. I was put on 500 calories a day, I did loose most of my weight. I find after that I got sick more than I did before, at age 22 got the chicken pox the first time, this was following the low cal diet.

    After being on a 500 cal, I spoke with a co-worker at that time who was into fitness, found out that was an unhealthy way to loose weight. You never want to go below 800/1000. I will never go that low in calories again. The weight loss clinic I went to, is not longer in business.

  27. esa mary
    i know that this will work for mew
  28. elle
    Avoid fruit? That sounds insane. Sorry! Fruit has sugar, but it also has fiber. Surely a few servings of fruit a day shouldn't affect weight loss. I call BS on that one.
    Reply: #629
  29. Zepp
    No.. not avoiding fruits,, avoiding sweet fruits eating more non sugary fruits like tomatoes, cucumber, pepper and that sort of fruits.

    Its more fibers and vitamines int those!

  30. Caty
    How I can get a translation in Spanish ?
    Reply: #632
  31. jennever
    Follong these tips will give Big results to lose wight fast
    Make Goals
    stay away from fad diets
    eat at leat 5 meals a day
    do resistance trainign
    drink a lot of water
    consume plenty o protein
    cut down the curbs
    drink a large glass of water with every meal
    don't deprive yourself of sweets
    do 15 to 45 minutes cardio
    plan your workouts
    stay off the scale
    avoid soda
    avoid fried food

    The more you exercise the more weight you lose. its easy to lose weight eat less exercise more
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  37. alien
    Mumsie From looking at your macros can i suggest you should lower your protein and increase your fat. If protien is too high it can be converted in to glucose via gluconeogenesis. I eat 25g carbs, 65g protein and about 130g fat. Use a keto calculator or read Jimmy Moore's Keto-clarity
  38. Jared
    Is there a specific amount of protein one should you eat to achieve optimal ketosis? A suggested amount, at least?
    Reply: #640
  39. tony
    Under heading 7. Men: Avoid Drinking Beer Dr. Eenfeldt said:large amounts of alcohol might slow weight loss somewhat, so moderation is still a good idea.

    How much is large amounts of alcohol?

    How much is moderate?

    Reply: #641
  40. Zepp
    There is a amount for your essentiall demand.. amino acids are essentiall!

    On a ketogenic diet on say its about minimum 1 gram/kilo a day!

    We use som of those for glucose production.

    Optimal amounts is probaly about 1,5 gram/kilo a day.

  41. Zepp
    Its indivuall!

    But as mean.. 1 glas of wine a day, for males mayby 2 glases is maximal if one is muscular!

    Beer is liquide bread, avoid it, it rise your insulin by maltose.

    but there is low carb beer to.. same amounts as wine then!

  42. Karen
    I am 48 years old, weigh 227 and just finished week one of LCHF and lost 4 pounds.

    I am a sedentary office worker wanting to eventually get to 180 pounds but of course less after that, around 160 pounds.

    My question to track what I eat to follow, say 5% carbs, 20% protein and 75% fat, how many calories should this be based on to average 2 pounds a week weight loss (hopefully) ? I need to figure out how many grams per day total (and is it important per meal or just total per day).

    Thank you

    Reply: #643
  43. Zepp
    Its E%.. energy percentage, its parts of your energy demand.

    LCHF supose to work like this if it goes as good as it can goe!

    One eat till one is satisfyed, dont eat again befor one get hungry.

    You know you got a buildt in calorie counter, its only demand is that you eat food its developed for, by the evolution.

    It rounds up for a normal 2000-1800 Kcal desktopworkers as 25 grams of carbs, 50 grams is about 10E%.

    Its what you eat in a longer period that make impact in the long turn!

  44. Goldi
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  45. chaunteal
    Hello I love this I feel like I have more energy...however I was wondering if granola in a no for this diet. If not can I make it homemade I am fairly new too the diet but I feel great thank you
    Reply: #649
  46. Beth
    I am 46 years old. I have been fit all my adult life. I have slowly put on 10 pounds over the last year. I'm guessing age and perimenopausse.
    I'm starting low carb today so I can fit back into my jeans.
    I realize 10 pounds isn't a lot but it seems to have stuck. I'm afraid if I buy bigger pants now when does it stop. 15 pounds then 20. I'm hoping to lose this weight by dec 24.
    I exercise regularly because it relieves stress. I have learned over the years as a personal trainer it is not the cure all for weight lose. Thanks for the article.
    Reply: #661
  47. Babara Laurie
    Well, I suppose there are fruits that does not contain so much sugar? Can we eat that instead? How about a handful of strawberry, half a grapefruit? I suppose this will work? Thanks in advance for your answer. :-)
    Reply: #648
  48. Zepp
    Yes you got i right.. its about how much one eat and how sensitive one is for sugar.

    The thing about sweet fruits is that they provide mostly water and sugar.

    Take a fruit or some berries as dessert, thats the right way to use them.

    The rest of your energy and nutrients is better to get frome real meals.

  49. Zepp
    Granola is often a lot of sugars.

    Make your own mussli from nuts and whole seeds.

    http://www.dietdoctor.com/lchf-breakfast-in-the-summer

  50. lakshmi
    I have tried a lot to reduce my weight but nothing is working .I wanna reduce my weight.I tried hot water with honey,green tea,etc.......no more Improvement in my weight.....give me tips
    Reply: #651
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