Do All Diets Fail?

April 5 2015 by in About Diet Doctor, Low Carb High Fat, Weight loss, Weight loss studies

Weight lost for 6 months, then regained.

Do all diets fail? Yes… and no.

In studies of weight loss on different diets it’s this phenomenon that is almost always visible. First a big drop in weight, lasting for six months or so, and then a regain. A common interpretation is that diets only work for a while, then they suddenly stop working.

I think this interpretation is wrong, and that there is a good reason why.

I’m reminded of this reading a new blog post by the fantastic Dr. Jason Fung – All Diets Fail – How to Lose Weight XI. I recommend his blog and lectures (although if you wait just a few weeks you can see the latter in much better quality). This time however, I don’t agree with everything in his blog.

It’s common to say that the reason people regain weight after a diet is that the body has a “body weight set point.” Presumably this setpoint will make the body regain any lost weight naturally, and thus conventional advice on diets is more or less useless for the long-term.

A Simpler and More Hopeful Explanation

I think there is a much simpler explanation that makes much more sense – and it’s also more hopeful:

Diets only work when you follow them. If you revert to your old habits again you’ll revert to your old body weight again. And nothing is easier than falling back into old habits.

Check out what really happened in the study shown at the top:

At the beginning of the study the participants in the low-carb arm where advised to eat below 20 grams of carbs per day. They could eat as much food as they liked – no calorie counting – as long as they followed this rule. The result? Most likely some people followed the advice, while some probably didn’t, but on average in the group the result was a decent weight loss: about 6.5 kilos (14 pounds) in five months.

After 6 months, however, the average weight in the group started to increase again. Is this because their old “body weight set point” suddenly started to kick in, for some unknown reason? Not likely, if you ask me. There is a much simpler explanation.

When asked after six months the people in the low-carb curve said (on average ) that they were eating 41.4 energy percent from carbohydrates. This translates to roughly 200 grams per day – i.e. most of them were no longer following a strict low-carb diet. Not even remotely close.

So did the diet stop working? We don’t know that. What we do know is that most people stopped following the diet. And after they stopped following the diet they started regaining weight.

When they stopped following the diet it stopped working. To be expected, if you ask me.

Body Weight Set Point

The “body weight set point” depends on your lifestyle. Change your lifestyle, change your set-point.

If you go on a low-carb diet the set point tends to drop. Go off the diet and the set point returns to where it was.

So Is It Hopeless?

People following the “glass is half empty” philosophy will tell you that these distinctions do not matter. Whether the diet stopped working – or whether people stopped following the diet – does not matter. End result is the same: regain of weight.

Using that negative way of thinking we’ll have to stop advising people to stop smoking. Why should we ever do that when most people will start smoking again?

Also, why tell people to exercise? We know that most people who are convinced to start exercising (perhaps in January) will stop doing it, sooner or later (perhaps in February).

Using this philosophy you should just give up trying to improve your life in any way whatsoever. And there’s no point in giving anybody lifestyle advice.

I’m not that pessimistic, so I’ll present a better option:

How to Make Your Diet Work Long-Term

Here’s how to make your diet work long-term: Stick to it long term.

It’s hard or impossible to ever prove this in modern weight-loss trials (intention-to-treat RCTs) because it’s impossible to suddenly get everyone to change their lifestyle permanently. That’s not how humans work. But in my experience there is no question that long-term positive lifestyle changes have long-term health effects.

Using this philosophy it’s necessary to stop thinking of diets as a temporary fix. That doesn’t work. As soon as you stop the weight will certainly come back.

What works is a long-term change in your habits. That’s why you need to find something that you can be happy doing for the rest of your life.

How to Make a Low-Carb Diet Work Long-Term

A low-carb diet isn’t the only option. But a low-carb diet generally performs better, on average, in scientific studies. It leads to more weight loss, better blood sugar, better blood pressure and a healthier cholesterol profile (higher HDL, lower triglycerides, larger and fluffier LDL-particles).

On average it is at least as easy to follow a low-carb diet plan as other diets, based on compliance in studies. This could be because there is no need to count calories and no need for hunger.

There are at least three major problems though:

Many so called “experts” still claim a LCHF diet will kill you, based solely on obsolete fat-phobic theories.
It’s still harder to find good low-carb real food options – and preparing food yourself takes more time.
High-carb junk food is ubiquitous, tasty, cheap, addictive and it’s considered normal to eat it all the time.

All three of these problems need to be addressed to make LCHF diets truly successful long-term for most people who need them – for example people with weight issues and diabetes.

What Works for Me

I’ve found something that seems to work great for me long term. To me that thing is a moderate LCHF diet – based on real food – with occasional intermittent fasting.

I’m in my 40s and my weight is the same as in my early 20s (without hunger – and feeling great about what I eat). That’s long-term enough for me. And it seems to be working on the inside too: All important health markers look fine.

What works long-term for you?

How Low Carb is LCHF?

My Health Markers After Eight Years on LCHF

New Major Study: A Low-Carb Diet Yet Again Best for Both Weight and Health Markers!

LCHF for Beginners

How to Lose Weight

Diabetes – How to Normalize Your Blood Sugar

53 Comments

Top Comments

Gretchen
April 5 2015 10
Here's my take, without research citations to prove it.

You enthusiastically start on a LC diet. You immediately lose a little water weight, and this inspires you to stick with it. You keep losing weight, now fat, but at a slower rate. After about 6 months, you get worn out with the difficulty of maintaining in a society that loves carbs. You go to a potluck dinner where there's nothing to eat but noodle dishes. Your friends stop inviting you over for dinner because they can't understand your diet. You're traveling and really really want to try some local bread. There's nothing on the menu of an exciting new restaurant that you can eat. You really crave more variety in your diet. For whatever reason, you eat a few carbs and the sky doesn't fall in. So if you're not diabetic, you keep eating them. The carbs make you crave more, and more, and more. Next thing you know, you're regaining.

But I think (again without citations) there's another reason. When you start the diet, your body is adapted to burn carbs, not fat. Suddenly given lots of fat, it doesn't know what to do with it at first and can't burn it efficiently, so you lose weight. When you stick to the diet, the body starts producing fat-burning enzymes and the weight loss slows, and the longer you stick with it, the more efficient your body becomes at using fat. So now you need to eat even less to keep losing weight. This is discouraging.

Many people who have regained some weight think they can just go back to the strict LC diet that worked so well before and lose quickly again, but they find the diet doesn't work so well the second time. I think that's partly because you now have all these fat-metabolizing enzymes. Maybe if you went back to a high-carb diet for several months, those enzymes would stop being produced, but in the meantime you'd gain a ton of weight.

It would be interesting to put people who had stalled on a LC diet onto a very-low-fat, very-low-calorie diet for a month, to see if they would lose the fat-burning enzymes without regaining weight.

I've been on a LC diet for almost 20 years, and I haven't regained the weight I lost (actually, the loss was on a low-fat diet, but maintenance is with a LC diet), and I'm not constantly hungry as I was on the low-fat diet. But it's not easy. For me the hard part is the social aspect. When I refuse to even taste someone's delicious dessert that they spent all day making, I hurt their feelings.

Read more →
Lisa
April 5 2015 6
This post was kind of a let down for me, more simplistic than I expect from this site. Yes people stop following their diets. But in the formerly obese who attain a normal weight, they also have a significant slow down in their metabolism compared to the never obese. They often require a significant calorie deficit to maintain a normal weight, and the difficulty can be proportional to the degree of former obesity.

Yes, your point about people falling off their diets is true, but that is an overly simplistic explanation.

Read more →

All Comments

1
Boundless
April 5 2015 4
re: And nothing is easier than falling back into old habits.

That's suggests that sticking to a diet is at least partly a matter of character. Humorist Tom Naughton demolished that myth in his six-part "Character vs. Chemistry" series:
http://www.fathead-movie.com/index.php/2014/01/06/character-vs-chemis...

re: What works long-term for you?

My family has been following the Wheat Belly guidelines for over 3 years. WB, for those unfamiliar with it, comprise a low carb {borderline keto} diet that is grain-free, high specific fats, low-inflammatory, and is more of a lifestyle, as it has recommendations far beyond mere diet. We are having zero problems staying with it, well, other than that over 97% of what's sold in supermarkets is unfit for routine human consumption.

I've also been following the WB blog since it went live. The blog seems to hear from pretty much everyone who doesn't get textbook results (usually having to do with common and uncommon roadblocks to losing the weight in the first place). There are a few stories of people "falling off the wagon" (and many horror stories of acute wheat re-exposure reactions, which experiences tend to keep people on the wagon). But I can't recall seeing anyone complain about weight regain while complying with the diet. The diet is not that hard to do, and there don't seem to be any metabolic sneak paths that arise.

To circle back to the paper referenced here, relapse under Atkins is not surprising. In addition to allowing excess carbs back in after Induction Phase, Atkins seems to have no particular awareness of the peculiar hazards of wheat, and wheat contaminates the majority of processed food-like substances these days. Dr. Davis summarized the wheat hazards lately at:
http://www.wheatbellyblog.com/2015/04/top-10-reasons-to-kiss-wheat-an...

Reply: #11
2
Peggy Holloway
April 5 2015 1
More than 15 years low-carb and it gets easier every year. At age 62, I feel better than I did at 40 and can't imagine any other nutritional lifestyle. The foods we eat, primarily at home, are delicious, nutrient-dense, and it takes little to be satiating. We often look at our dinner plates and say "wow, this looks like a plate at a gourmet restaurant." The other incredible part of this lifestyle is that, as we actually shifted to a ketogenic approach over the years, we have maintained and even improved our exercise stamina. My SO, who went low-carb/ketogenic 4 years ago, astonishes people with his exercise prowess. He is 73.
We look forward to meeting and hearing Andreas on Wednesday at the dinner in Denver!
3
Gretchen
April 5 2015 10
Here's my take, without research citations to prove it.

You enthusiastically start on a LC diet. You immediately lose a little water weight, and this inspires you to stick with it. You keep losing weight, now fat, but at a slower rate. After about 6 months, you get worn out with the difficulty of maintaining in a society that loves carbs. You go to a potluck dinner where there's nothing to eat but noodle dishes. Your friends stop inviting you over for dinner because they can't understand your diet. You're traveling and really really want to try some local bread. There's nothing on the menu of an exciting new restaurant that you can eat. You really crave more variety in your diet. For whatever reason, you eat a few carbs and the sky doesn't fall in. So if you're not diabetic, you keep eating them. The carbs make you crave more, and more, and more. Next thing you know, you're regaining.

But I think (again without citations) there's another reason. When you start the diet, your body is adapted to burn carbs, not fat. Suddenly given lots of fat, it doesn't know what to do with it at first and can't burn it efficiently, so you lose weight. When you stick to the diet, the body starts producing fat-burning enzymes and the weight loss slows, and the longer you stick with it, the more efficient your body becomes at using fat. So now you need to eat even less to keep losing weight. This is discouraging.

Many people who have regained some weight think they can just go back to the strict LC diet that worked so well before and lose quickly again, but they find the diet doesn't work so well the second time. I think that's partly because you now have all these fat-metabolizing enzymes. Maybe if you went back to a high-carb diet for several months, those enzymes would stop being produced, but in the meantime you'd gain a ton of weight.

It would be interesting to put people who had stalled on a LC diet onto a very-low-fat, very-low-calorie diet for a month, to see if they would lose the fat-burning enzymes without regaining weight.

I've been on a LC diet for almost 20 years, and I haven't regained the weight I lost (actually, the loss was on a low-fat diet, but maintenance is with a LC diet), and I'm not constantly hungry as I was on the low-fat diet. But it's not easy. For me the hard part is the social aspect. When I refuse to even taste someone's delicious dessert that they spent all day making, I hurt their feelings.
4
Lisa
April 5 2015 6
This post was kind of a let down for me, more simplistic than I expect from this site. Yes people stop following their diets. But in the formerly obese who attain a normal weight, they also have a significant slow down in their metabolism compared to the never obese. They often require a significant calorie deficit to maintain a normal weight, and the difficulty can be proportional to the degree of former obesity.

Yes, your point about people falling off their diets is true, but that is an overly simplistic explanation.
5
Alec
April 5 2015
I'm right behind the idea that character and will power have less to do with it than some would have us believe, but making the necessary changes and sticking with them takes a willpower, surely, at least in the short term.
6
Alec
April 5 2015
Accidentally reported my own comment, please ignore!

What do the numbers next to the exclamation mark mean?
7
erdoke
April 5 2015 3
I would like to see body composition together with weight measurements. These graphs might be misleading without actual lean mass vs. body fat % changes included.
I have also "regained" 4 kg (9 pounds) compared to the lowest weight during LCHF living, but my waistline dropped one more inch and my upper body looks more muscular now. All this being only moderately active. I believe this is rather typical experience of males on a low carb diet.

Alec,

What do the numbers next to the exclamation mark mean?

Those are post numbers in order.
8
Janey
April 5 2015 1
Shouldn't the study have graphed weight change versus level of compliance with each respective diet? Compliance could be quantified in whatever way recommended by the proponents of each diet; for example, eating 10% calories from fat would probably constitute full compliance with low-fat, eating 20 g carbs/day would be full compliance with low-carb.

I've been waiting for a study that shows how well each diet works *when properly followed.*
9
Nancy
April 5 2015 1
Thank you for this explanation. I read Dr. Fung's interpretation of this study the other day and started to worry that I was doomed to gain back all the weight I had lost. I find it interesting that the study participants went back to eating a high carbohydrate diet. I do think it is hard for the average family to follow a low carb diet in the current food environment. I look forward to the time when our society understands and supports the LCHF lifestyle.

Reply: #15
10
Alec
April 5 2015
Of course they are. Im just going to order a pre school maths text for myself.
11
Reply to comment #1 by Boundless
Lori Miller
April 5 2015 1
Re: character and chemistry, Tom was talking about his experience on high-carb, low-calorie, mostly vegetarian diets. Those diets can make you hungry to the point you can't follow them because of disregulated blood sugar and lack of nutrients. Many popular traditional weight loss plans have calorie and macronutrient levels similar to those of the concentration camps of WWII. But LCHF works *with* your chemistry, keeping blood sugar even and allowing satiety.

I think a person does have to have some character to stick to it for the reasons Dr. Eenfeldt mentions: social situations, "expert" opinion and sometimes a lack of LC options. Phinney & Volek mention another one: going on the diet with the attitude that it's just temporary instead of making your peace with the idea that it's a permanent way of life.

Reply: #17
12
tw
April 5 2015
The other factor is an increase in activity and a subsequent increase in weight training. For example: I go to the weight room every fall to pack on muscle for ski season and shed it in the spring for mountain biking. No wheat (grain) is worth around 7-10 lbs on me under this scenario.

Therefore some weight "increase" could in fact be weight training for some. You will know this because your body shape and composition will change.

i think the Perfect Health Diet examines a higher amount of carbohydrate for some and why it may be beneficial. Weight loss alone is not always the best and only marker.

I think when people focus and emphasize this aspect (weight loss) exclusively they are doing themselves a disservice.
13
Mark
April 5 2015 5
Dr Andreas,

I think you have screwed up the reading of the research. Please look at the reports section "Low Carbohydrate Diet" (i can't copy/paste it as I am on my toy iPad).
It says participants were TOLD to increase carbs to 120 grams per day after 2 months. This is why the weight went up. They were trying to emulate Atkins but 120g is far above Atkins maintenance diet of 80 grams per day.

If they had kept to 20 or even 50 they would have been fine, as your conclusions suggest.

Also told to get most fat from plant base, but thats quite difficult and unappealing eating.

Mark
14
Troy
April 5 2015 3
This topic needs more attention. From my experience, many people attempting a low carb high fat diet lack the willingness to avoid refined carbohydrates and various sugars because we are biologically drawn to them. When a person on low carb breaks away and eats a doughnut, they kick off cravings that are strong enough to reveal their lack of discipline, they succumb and are back to eating crap. Over the course of a week, they've ruined the progress made with a low carb (real food) diet. They then say it's too hard. Truth is, they are carb addicts.

Temptation abounds. We are bombarded with ads for the very foods we need to avoid. So, sorry Tom, but it is a character issue once you become educated and know what to eat and what to avoid. It is not a character issue if you are eating what the SAD tells you and you think you are doing the right thing.

Those of us who made the paradigm shift have it easy. We could care less about bread, pasta, cookies, sugar, fruit, cereal grains, this sandwich or that sandwich, pizza, burgers with buns, chips, deserts etc..you get the picture.

But, as far as character. Once you know what you need to do, and you fail because it's "too hard," I call BS. It's to hard because you are a carb addict.

These diet reviews, like US News that ranked low carb last, do so because the author(s) are carb addicts. Those who say the low carb diet is not sustainable are carb addicts. Those who say "I'm not giving up (fill in the blank) are carb addicts, period.

Troy

Reply: #53
15
Reply to comment #9 by Nancy
Gretchen
April 5 2015 1
>I find it interesting that the study participants went back to eating a high carbohydrate diet.

I think this is the study in which the LC dieters were *instructed* to eat more carbs after a certain point because they wanted to mimic the Atkins diet, which does the same. Except Atkins has you follow the induction diet and then add back carbs *until you start gaining weight* and then maintain a little below there. I think these dieters were just told to add back carbs.

So it wasn't a lack of willpower.
16
Wanda
April 5 2015 3
I learned about Dr. Fung through this website, and for that I am very grateful. I've watched all six segments of his 'Aetiology of Obesity' lecture. I think his comments on this study are being used a little out of context. If you watch the whole lecture you'll see that he still advocates a LCHF diet for those wanting to lose weight. However, he says that we haven't been implementing the 'when to eat' component of his 'what and when to eat' combination. He concludes that going for extended periods with no circulating insulin in the bloodstream (intermittent fasting) is what resets the BSW and corrects the insulin insensitivity in the body. So, in the end, he ends up at the same place that Dr. Eenfeldt is at--a LCHF diet combined with intermittent fasting.

Reply: #19
17
Reply to comment #11 by Lori Miller
Boundless
April 5 2015 2
re: I think a person does have to have some character to stick to it for the reasons Dr. Eenfeldt mentions: social situations, ...

The main character element that people need is being willing to assert themselves in support of their own health. For anyone struggling with that, think of adverse foods as if they were tobacco. How would you handle being offered a smoke, or being invited to dine in the smoking section of a restaurant?

re: ... sometimes a lack of LC options.

Yep. It requires some planning, just as avoiding second hand smoke did before 1970 or so.

We have a family member who independently discovered wheat sensitivity prior to the publication of Wheat Belly. Re-exposure reactions are such that declining toxic treats is not a problem, whether the person offering chooses to be offended or not. We're running further elimination trials now, with so far spectacular results. Once those problem comestibles are identified, social pressure to consume them will also be easy to ignore. (Bovine dairy is the top suspect.)

re: Phinney & Volek mention another one: going on the diet with the attitude that it's just temporary instead of making your peace with the idea that it's a permanent way of life.

That would be the difference between Diet™ and diet. We really need a new word. Dr. Davis has had to resort to calling his program the Wheat Belly "Lifestyle", because English doesn't have a word for a permanent routine food/meal regimen that is unambiguously differentiated from a focused limited-term effort (whether named or not).
18
Janknitz
April 5 2015 2
I've maintained a 75 lb weight loss for almost 4 years now. But I wanted to lose 100 lbs. And that, IMHO, is the reason I've kept the weight off. I'm not "finished" yet, so I keep on eating LCHF.

Meanwhile, in 4 years, it has truly become my WOE, it's the way I eat. I negotiate social situations, prep meals, and eat out with no difficulty. I love the food I eat, I'm never hungry, and I'm healthier than I have been in 20 years despite going through menopause during this 4 year period. I'm not thin and svelte, but I'm not severely obese with constant pain and health issues. Pretty good for an old lady!
19
Reply to comment #16 by Wanda
Dr Jason Fung
April 5 2015 5
Hi Wanda - Yes you are exactly right. I actually don't think anybody is 'doomed' to fail, and am on quite the same page as Andreas. Insulin is the main issue here, and my post was an introduction to fasting, a technique also designed to lower insulin by reducing insulin resistance. It is only designed to 'shake things up' a little and challenge us to find other useful dietary techniques that can be added by pointing out that in academic papers, there is very little long term success.

IF has been covered quite well here in this blog. In fact, a recent guest post by Jonas Bergqvist correctly identifies fasting as one of the 4 key puzzle pieces. Other mainstream nutritionists, though, tend to trivialize its benefits. It is an important weapon in our arsenal in the fight against obesity, but one that tends to get ignored.
20
Emory
April 5 2015 1
I have read both Dr. Fung's work as well as Dr. Eenfeldt and find both to be heads above other low carb research.
I have used low carb successfully since I was in my early twenties, though I've continually used it for all of these years. Traveling to various countries for my work, I have found that in some cultures, meals are a big deal and to not eat what the host has prepared is an insult.
I do negotiate social situations in the U.S. rather easily. I simply eat all of the low carb parts of the meal, pass on the bread, and may eat a bite or two of a starch. Since I've had close to no carbs all day, the few I have from a bite of potato aren't going to impact me.
I have utilized the IF process over the last few months and find that while I'm not sure if it lowers insulin(haven't tested it), I do have much more energy and find myself more well rested after a night's sleep.

My question for Dr. Eenfeldt, is one of bodyfat %. Have you found that along with your bodyweight staying consistent over the years, that your bodyfat has stayed the same as well. Also, how do different body somatoypes fit into the weight loss equation?
21
BernardP
April 5 2015
Andreas, regarding your "What Works for Me" conclusion, could you please tell us how "occasional" is your occasional intermittent fasting? And how long does the fast last?

Thanks
22
Etai
April 5 2015 4
After reading "Good Calories, Bad Calories" I started eating a low carbohydrate diet and did loose about 10 pounds right off the bat but then the loss quickly slowed and I stopped loosing any appreciable weight. Fortunately, that was when I stumbled on Dr. Jason Fung's work and realised the missing ingredient to weight loss - fasting. After I started adding intermittent fasting (a 24-36h fast, twice a week) into my regimen I started seeing real fat loss, not to mention other improvements. I think it's the combination of the two efforts that really make a difference. (I'd also like to add that I have a very active work and lifestyle and don't feel I'm low energy ever). It makes sense, really, because how can you burn the fat stores on your body if your body is 1) using carbohydrates for fuel, and 2) if you're constantly keeping your gas-tank full? We live in a society of excess and being over weight is a symptom of that. The thought of not eating carbs or even skipping a meal or two is ludicrous in the modern world when that was probably the norm a few thousand years ago.

I would also like to add that willpower is a huge factor. HUGE! But I think the problem is far bigger than that. We're talking about addiction which is not as easy to overcome than simple indulgences. Dieting has all the same difficulties as smokers trying to quit smoking. We are addicted to the foods which are killing us. When looking at cookies and pastries, and all those wonderful "entertainment" foods, I always have the alcoholic's adage in my head, "One is too many, a thousand is not enough." Simply put, if I have one cookie I know I'm going to want the whole bag. So I say if you fail then don't beat yourself up because willpower is only part of it. Get back on the horse.
23
Galina L.
April 5 2015 4
Short diet interventions fail. I have been following a LC diet since 2007, and I have no intentions to go back to "everything in moderation" because I see my diet as an advantage, not as something what prevents me from enjoying carb-loading. Initially I started that diet for treating migraines, but it improved every aspect of my health. I don't want to eat like everybody else by now because I don't want to feel and look like normal female after 50.
24
Wade Henderson
April 5 2015
Uncertain where the chart you use comes from. On the page you link us to by Jason Fung he seems to use a different chart in his low fat vs low carb example.

https://intensivedietarymanagement.com/all-diets-fail-how-to-lose-wei...

Then when we go to the actual study we see the factual differences
http://annals.org/article.aspx?articleid=745937

It appears that the low carb group went from their normal carb intake, well above 200 g, down to 20 grams, then after 3 months they slowly began to add carbs back in.

By contrast, the low fat group did a minimal lowering of their fat intake, from about 37% of calories, a small step down to 30% at the beginning, before adding back in more fat.

According to Fung's chart, both groups end up the 24 months in about the same place regarding weight loss.
Perhaps there were other links. I just went to the main one listed.
25
Wanda
April 5 2015 2
I have battled overweight/obesity almost all of my life, and frankly I'm ready to be done with the 'lack of willpower' arguments and blaming. It saddens me to read some of these comments where we still fall back on that reasoning and self-blaming--it's counterproductive. I believe feeling that I am lacking in self-control has impeded my understanding of my own weight issues and viewing overweight patients as undisciplined has stood in the way of the medical community giving this medical problem serious scientific attention. Personally, I'm ready to be done with this attitude, and seeing how this little graph has so readily elicited the same tired 'lack of willpower' explanations is just a bit disheartening.
26
Kindke
April 5 2015 4
Im tried of people trying to say LC definitely works and its YOUR fault you didnt follow it

That is just ignorant.

YES , LC can get you into very good health and drastically improves metabolic syndrome markers, however, the idea that everyone can get normal BMI on LC is false to the extreme and ignores genetic's , epigenetics, etc.

I have said this before, almost everyone can learn to drive a car. However almost no-one is successful at longterm dieting. What do you think that tells you?

It tells you that when something *IS* largely under your voluntary control, .....everyone can succeed, IF hardly anyone can succeed at longterm dieting, we should start to consider that there might be factors outside of our voluntary control influencing our success.
27
Eric Anderson
April 6 2015 1
What is blood sugar? Ketone, Hgb A1c level?
How much protein? Carbs?
When is food eaten?
Any Intermittent fasting?

To write or say LCHF does not work after 2 years is like saying people fail to have children when they stop having sex!

For me low carb and moderate protein works because I eat 20 or less grams of carbs and 75 grams of prottein

Sometimes I may eat 3 meals (not often) and sometimes 2 meals or 1 meal or sometimes no meals.
Ketogenic and Intermittent fast seem to work well together and effect AMPK and mTOR but in slightly different ways. It seems advantages and reinforcing to use both LCHF and IF together.

I also try to stay in a learnng mode. For example I read the long term diet studies and my take away is not the failure but rather all groups drift over time to the middle on protein intake, so overtime protein tends to remain the same. My blood sugar goes above 83 mg/DL when my protein goes over a 37.5 to 42.5 gram per meal range. I stay under the carbohydrates recommended by Dr Richard K Bernstin (6, 12, and 12 grams) (I like to say eat like a diabetic to avoid becoming one)

That is some of my observations!
Eric
28
Eric Anderson
April 6 2015
Fasting ==>

I would be interesting in more information on fasting.

My observation is no one way is always optimal so I vary from 18 hour to 36 hour fasting.

Walter longo suggests 3 day fasting two or 3 times a year
Mark Mattson does not eat breakfast
And a host of ideas on fasing or modified fasting

So is there an optimal? If so what biomarkers?
Overtime what difference does no breakfast vs periodic day or days of fasting?

Eric

Reply: #30
29
greensleeves
April 6 2015 1
The issue Dr Fung ignores is that many women don't do well with intermittent fasting. Many many women report it leads them to have irregular periods. So yeah, you can be thin - but give up your hopes of having a baby. Dr. Michael Fox should explain to Fung why IF is a disaster for many, perhaps even most, women of childbearing age.
30
Reply to comment #28 by Eric Anderson
Boundless
April 6 2015 1
re: Mark Mattson does not eat breakfast

And Bill Lagakos (CaloriesProper) says that's not the meal to skip (dinner is).
http://caloriesproper.com/meal-timing-and-peripheral-circadian-clocks/

It's going to be some time, if ever, before all the circadian stuff gets properly tested in humans without drowning in confounding factors. So in the meantime we all have to study the conjectures and make up our own minds.

Reply: #35
31
sridhar
April 6 2015
Thank u., u cleared some doubts about weight gain. but when i click the study hyperlink., after 2 months of induction the participants could access 120 gm of carbs according to the papaer. regarding 200 gms., i could not find the mention in the papaer. anyway., if the curve was correct ., the weight loss stories could not have been there., and people would have abondoned lchf.

Reply: #34
32
NS
April 6 2015 1
http://m.youtube.com/watch?v=2i_cmltmQ6A

Kindke is right on the money. While some interventions help, so much of obesity literally is beyond our control. This is what the best science says from those without an agenda. And I have news for anyone willing to listen: there are even more depressing, virtually impossible to treat causal factors in obesity other than leptin, brain/cns dynamics, and genetics. These include highly infectious viral syndromes which essentialy never resolve. Soon, you and your loved ones will get sick and will stay sick. Then, you will understand the severity of the problem.
33
Murray
April 6 2015 2
Greater "willpower" is an effect of a suitably crafted diet. For example, if you eat added sugar, you will have less willpower; if you avoid added sugar you will have more willpower. It is also more useful to speak in terms of greater or less strength of willpower. If hormone signals in response to diet and other environmental factors push for eating more and exercising less, the balance of power among the competing drives tips toward those signals and there is less "willpower" (leeway) to make choices based on other criteria.

Viewing willpower as independent of body signals means the body signalling process will remain unmanaged by one's executive function.
34
Reply to comment #31 by sridhar
Vicente
April 6 2015 1
Hi sridhar,
at 6 months they were eating more than 200g of carbs per day. It can be computed easily (see).

231 g carbs /day a 6 months
233 g carbs/day at 24 months
35
Reply to comment #30 by Boundless
BobM
April 6 2015
Concerning skipping breakfast or not, on the other hand, people who recommend intermittent fasting often recommend skipping breakfast. I've been skipping breakfast two days a week for a while now. If it's affected my circadian rhythm, I cannot tell. I still fall asleep in about five minutes or less and sleep happily through the night.

Next, I'm going to start skipping breakfast and lunch one-two days per week.
36
Lewis
April 6 2015
... so many opinions...

"Opinions" don't offer anything of value. Now, a hypothesis can be debated. Stating what you "think", even if you say you have no citations, is an attempt at trying to make people believe what you believe whiwhwithout any proof.

Dietary nutrition is a science where we make theories based on observation and test hypotheses. Lchf is not a religion. Believing that it works one way isn't why it works. Believing in yourself, choosing to better yourself, that's what makes the diet work. That and some good research.

Now, some people are thinking this site is lacking scientific evidence. I don't disagree. This site is full of advice, news, and support. For science, I go to Eatingacademy.com.

So, please, discuss, don't post a bunch of opinions.
37
Cleethorpes
April 6 2015
Those people that do succeed have to turn their back on cultural influence.
For instance, how many times are we reminded "everything in moderation", when fructose doesn't satisfy appetite, and high-insulin producing foods trigger appetite?
Also, low-carb is 'restrictive','quirky','strange' or worse 'dangerous', whereas low-fat is 'healthy'.
There may be an increasing number of places in the World where it is easy to eat a controlled-carb diet; fast-food or low-fat are far more prevalent in North East Lincolnshire, and many other places I've visited.
38
Bryan
April 7 2015
HI!

I am 2 years low carb ketogenic and heard that I need to raise Insulin Sensitivity. I have had insulin resistance before and suppressed/cured it by going low carb. But what to do next? Insulin Sensitivity seems necessary to further lose weight.

How can I do that??

I do work out 2-3 times a week (lifting and yoga).

Reply: #40
39
Cindy C
April 7 2015
There are studies on our brains and type 2 diabetes. Diabetics are at more risks of brain problems,. Or could be brain problems cause us to be diabetic.

http://www.medicalnewstoday.com/articles/268472.php

Dr Bernstein talks some about how the liver works to raise blood sugar at night.

http://www.diabetes-book.com/
40
Reply to comment #38 by Bryan
Zepp
April 7 2015
Try Jason Fungs approche.. intermitent fasting, or real fasting.

https://www.youtube.com/watch?v=FcLoaVNQ3rc

The thing about LCHF is to not get high blood sugar, thats stops the bad outcome of this.

And the cause of it is mostly hyperinsulinemia, but the thing to get rid of is insulin resistance.. so your body not produce high levels of insulin for normal purposes.

Even protein rise insulin.. and it should, its a part of your normal amino acids digestion.

But if you are insulin resistante.. it take more insulin to do the right thing.
41
Mark Bousquet
April 7 2015
One look at the graph and my first thought about the bump was "They must be eating the same amount of protein they were when they started the diet."

I lost over 70 lbs on low carb before I started seeing this weight gain and this went on for about a year until I started moderating my protein intake (without changing my on average 20 g healthy carbs per day). I cut back by an egg here, a slice of bacon there; Cut my steaks in half, etc. I found I was still satisfied after eating (probably because plenty of KG butter on my veggies) and THEN I started losing weight again!!

What happens is that your body recycles a certain amount of protein a day. If you add to this in excess your liver will convert the extra protein to glucose through a process known as gluconeogenesis. This may spike blood sugar and insulin levels putting a stopper on fat burning.

If people plateau they should consider this rule-of-thumb for how to moderate protein intake:

0.9 g protein / desired weight in kg

For example, if you are aiming for 80 kg, you want to eat up to 72 g of protein a day. Jimmy Moore talks about protein moderation in his book Keto Clarity and guests on his show Livin' La Vida Low Carb like Dr Perlmutter mention this formula.

Disclaimer: This may not solve the problem as there could be endocrine or gut flora issues.

Hope this helps!
42
Pam
April 7 2015 1
I have not checked out Dr. Fung's site yet. I have been LCHF for four years now. I lost 20 lbs in about 18 mo. on LC. I wanted to lose 10 more lbs but thought perhaps I would begin to lose again naturally. Nope.

Then I started doing a little basic strength training ala Mark Sisson and Jonathan Bailor. Did not lose weight though.

Then I wondered if I could at least up carbs. Nope. I gained 10 lbs pretty quickly esp. after eating a lot of Doritos almost uncontrollably.

OK, so i realized that I would probably never be able to really up my carbs. Lost the extra 10 labs but wanted to lose that last 10 lbs. I googled it and came up with Alternate Day Fasting by Dr. Johnson or the similar Fast Diet. I found this very doable. Staying LC but lower fat I ate only 500 Kcals on alternate days and ate a LC moderate fat diet the other days. I lost weight consistently and reached losing that last 10 lbs in 2 months. Plus my fasting glucose went down from 80-90's to 68.
43
Bryan
April 7 2015
nah protein shouldnt be the problem.

I tried every combination (high fat, high protein, high fat and modprotein) and calorie amount

So I guess I need to up the carbs finally to raise the metabolism pathway again and get rid of the floating fat in my bloodstream right now...I hope at least

Reply: #44
44
Reply to comment #43 by Bryan
erdoke
April 8 2015
Perhaps a bit higher carb with intermittent fasting will do the trick.
45
Galina L.
April 8 2015
I have a lady-friend who has got very good results practicing IF without any carbs limitation. However, she is naturally thin, and her main goal is to prevent the natural for pre-menopausal and menopausal females middle-body spread. I think my results are better because I accrued more health benefits like better mental health and better resilience to infections, and I am not thin by nature. She has problems with anxiety and insomnia, like most naturally thin people I personally know. I have now idea what is the connection?
46
Boundless
April 11 2015
re: ... IF without any carbs limitation. ... has problems with anxiety and insomnia, like most naturally thin people I personally know. I have no idea what is the connection?

If any of the carbs are wheat (and barley or rye), get rid of these psychoactive grains, 100%. That did the trick for anxiety attacks suffered by a thin woman I worked with.

On the insomnia, it's harmless to fix all of the following, any one or combination of which could be a cause or aggravating factor: gut health (probiotic/prebiotics), thyroid (routinely mis-tested, mis-diagnosed and mis-treated), circadian disruptors like bright/blue light at night, low magnesium intake. If all of that doesn't fix it, melatonin and/or 5-HTP might be worth a look.
47
Zach rusk
April 13 2015
Well it looks like you ignored genetics in th Body Set Point. Don't you think that plays a role and it's not 100% lifestyle choices?
48
Zach rusk
April 13 2015
Well I hope people soon realize junk food is common but NOT normal.
49
Louisa
April 13 2015
I am actually deeply offended by this post. I am one person who lost 8 kilos on LCHF within about 6 months....then I maintained that for about 3 years. Then suddenly I started regaining the lost weight, without doing anything differently (less than 50g carb a day, usually about 30g mostly from veggies and nuts). I did gain a little muscle but my waist started to increase and I regained all 8 kilos plus another 2. I became very down about this. At the time I was 34 and not perimenopausal (I have had children since). I also struggled with energy levels on LCHF - always. I used to play heavy tennis training and couldn't do the sprints. Everybody kept telling me to eat more fat and keep carbs really low - which I did. Eventually I got a knee injury. With hindsight I needed more carbs for training - but that is off the point. Anyway - to say that people who don't keep the weight off go back to eating carbs is just not true for some us! I went from 67 kilos to 59, then up to 70 kilos! Without anything major changing in my life!! I never found out the answer for this.
50
Eloise Charpentier
April 21 2015
Let me tell you a 'secret': You will never lose weight on and keep it off that leaves you hungry.

So, if you really want to lose weight, you need to stop hunger. Hunger is an irresistible force - Sooner or later you will give in to it.

What can you do about it? Eat Paleo. It will reduce your hunger dramatically.

One of the unique features of eating pure Paleo makes it metabolically impossible for you to experience hunger.

I had been trying to lose weight for a long time (more than 4 years). I didn't know where to turn to or what else to try. Until one day...

By accident, I stumbled across Paleo -- I wasn't even searching anymore (I had given up). This discovery changed my entire life. I now wear a size 6 dress. (I used to wear an 17).

Sorry, I digress. So, it's all about hunger. Stop your hunger. Be open open-minded enough and try it, prove it yourself.

'Paleoleap' has a fantastic 8 week meal plan & recipe book (step-by-step) which I love to recommend to people who try to lose weight and who are frustrated about their weight. Go ahead and read Tim's review (http://timreviews.com/paleo-recipe Read it and check it out.

Eloise Charpentier
51
Mac
May 2 2015 1
When I started eating LCHF to care for my T1 Diabetes, I lost a rapid 6 lbs as my body shed the water associated with my previous high ratio of carbs. My weight loss slowed after I fully entered diabetic ketosis, and I decided that though I didn't start the diet to lose weight, I would ease up on the weight loss by increasing my carb ratio when I got to an arbitrary goal weight. However, I knew that the moment I ate more carbs, I would start putting back on a portion of the water weight that I had initially shed, and my weight would raise naturally without actually putting on very much fat at all. Thus I set my goal weight a few pounds heavier than where I decided I should actually stop. My goal was 175, so I stopped at 171, and came back up and maintained nicely without putting myself through the psychological wringer of feeling like I was failing or backsliding. Any LCHF dieter who goes into maintenance mode will likely put on a few pounds.
52
Ian P
June 28 2015
LCHF is only difficult if you don't truly understand the basics. Is it really so tough to choose to not eat bread, potatoes, corn and pasta? Is it really so hard to buy vegetables and meat, butter and cream? My wife and me have been eating LCHF for 18 months. We find it actually gets easier. Cravings diminish and buying suitable food becomes a habit. I had a massive sugar habit when our new diet began. Now I don't miss the stuff at all. Think a little when you shop. Most importantly, ask yourself " do I really WANT to be healthy, or would I just like to be". There is a massive difference...
53
Reply to comment #14 by Troy
Maya
May 3 2016
What helped me was learning the science of what happens when insulin spikes and/or remains elevated. Since only about 2 tsp MAX of glucose circulates in the blood at any time, any excess is literally SHOVED into the cells as fat -- and keeping blood sugar up prevents that fat from being burned. In other words, if I want to get fatter I will eat refined carbs -- and if I don't, I won't. Incidentally, plentiful fats also cause satiety to rise which helps reduce cravings (and succumbing to temptation) considerably. This last weekend I smelled some nice warm muffins.... I enjoyed the smell! But I had no desire to reach for or consume one because I'd already had a nice, fat-full breakfast. In short, "addiction" can be vastly ameliorated by upping dietary fats.

A Simpler and More Hopeful Explanation

Body Weight Set Point

So Is It Hopeless?

How to Make Your Diet Work Long-Term

How to Make a Low-Carb Diet Work Long-Term

What Works for Me

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