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Healthy weight loss:
A how-to guide

Everyone knows that to lose weight, you’re supposed to eat fewer calories and burn more. The problem is, eating less than you’d like is often easier said than done.

You might be able to deal with hunger for a few weeks or even months, but at some point, hunger wins. And then, the weight tends to come back.

And it doesn’t simply take more willpower to overcome hunger. Many experts compare willpower to a muscle — it is an exhaustible resource.1 Perhaps that is why diets that rely on willpower don’t work well long term.

What’s the best way to achieve weight loss in a healthy, sustainable way, without hunger or “white-knuckle” willpower?

The approaches that work tend to follow the same basic principles: eat the lowest calorie foods that fill you up, eliminate high-processed foods that don’t, and make sure you get essential nutrition.

It sounds easy. But why do so many of us struggle with healthy weight loss?

This guide will tell you the best ways to achieve healthy weight loss. It has our top weight loss tips, what to eat and what to avoid, the common mistakes you might be making, how to eat fewer calories, and much more.

But first, what is “healthy weight loss?”

Healthy weight loss starts with setting realistic goals. After that, we define healthy weight loss as mainly losing fat mass instead of lean body mass, improving your metabolic health, having a minimal decline in your resting metabolic rate, and making sure you can maintain your dietary lifestyle long-term.

If you’re struggling with your weight, it’s likely not your fault. The industrial food environment is stacked against you. The good news is that there are effective approaches to find your best weight and improve your metabolic health long term! Here’s how.

cooking-healthy-food 1

 

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Top 10 weight loss tips

  • Avoid eating carbs and fat together. This combination increases cravings and provides excessive calories with little to no nutritional value — think pizza, cookies, chips, donuts, etc.
  • Eat at least 30 grams of protein at most meals. Protein is the most satiating and nutrient-dense type of food.
  • On a low-carb approach, which is often a successful weight loss strategy, limit net carbs to less than 100 grams (or keep them as low as 20 grams per day if you want to try a keto diet).
  • Fill your plate with fibrous veggies. These provide abundant nutrients, high food volume, and relatively few calories.
  • Add enough fat for taste and to enjoy your food, but not more than you need. Let’s be honest, fat tastes great! Taste is an essential part of long-term nutritional success. But too much fat can add excess calories you don’t need.
  • If you’re hungry, start with adding more protein and vegetables. Again, these are the most satiating and nutritious food for the least amount of calories.
  • Find foods you enjoy that fit the above criteria. Check out .
  • Stay physically active. You don’t have to run marathons, but physical activity added to a healthy diet can help maintain fat loss while preserving muscle mass.
  • Get adequate restorative sleep. Sleep like your health depends on it. Because it does!
  • Create an environment to promote your success. It isn’t just about knowing what to do. It’s also about creating the environment that will help you succeed. For example, removing tempting foods from your kitchen is just one great way to get started.

 

What foods to eat, and what foods to avoid for healthy weight loss

Balanced diet food background

When striving for healthy weight loss, you want to make every calorie count.

But that doesn’t mean you have to count calories.

How is that possible? By focusing on the foods in the list below, you’ll ensure you are getting adequate nutrition, eating filling foods, and naturally decreasing your caloric intake.

We recommend focusing the bulk of your nutrition on “foods with the most nutrition per calorie”, consider portion control of foods with “moderate nutrition”, and reduce or eliminate foods with the least nutrition per calorie. Give it a try!

Foods with the most nutrition per calorie:

  • Meat and poultry
  • Seafood
  • Non-starchy vegetables
  • Eggs
  • Dairy products like yogurt and cottage cheese
  • Soy, beans, and lentils

Foods with moderate nutrition per calorie:

  • Cheese
  • Nuts and seeds
  • Fatty processed meats like bacon
  • Starchy vegetables
  • Low-sugar fruits like berries, olives, and avocados
  • Whole grains

Foods with the least nutrition per calorie

  • Combined high-carb and high-fat foods
  • Foods with high amounts of sugar and refined carbs
  • Sugar-sweetened beverages and fruit juice
  • Beer and sweetened alcoholic beverages
  • Pure added fats like oil and butter

Are you still hungry between meals, or are you looking for ways to add more protein to your diet? Take a look at our guide on high-protein snacks for weight loss. You can choose from hard-boiled eggs, a can of tuna, beef jerky, lupini beans, black soybeans, and more.

21 high-protein snacks, ranked

 

Why we recommend high protein for weight loss

Selection of protein sources in kitchen background

High protein almost always equates with high nutrition, meaning you get the maximum amount of nutrition per calorie. Whole food protein (steak, eggs, chicken, soy, etc.) and fiber-filled vegetables (spinach, cauliflower, broccoli, etc.) have the highest nutrition percentage. It’s no surprise that they also are some of the most filling foods.

Simple carbohydrates (sugars, grains, etc.) and refined fats (mostly oils) are high in energy density but lack nutritional value and are easier to overeat.

That’s why, for high nutrition eating, we recommend:

  1. Reduce your carbohydrate intake.
  2. Prioritize your protein and fibrous vegetables intake.
  3. Add just enough fat for taste and, if needed, extra calories.

How to get all essential nutrients

When we say “essential nutrients,” we mean protein, essential fatty acids, and micronutrients. You’ll want to maximize these for each calorie you eat. We also encourage eating plenty of fiber as it may support weight loss and improved health outcomes.2

Fortunately, when you focus on whole-food proteins, the fatty acids and micronutrients are naturally present. And when you eat above-ground veggies, you automatically get fiber and additional micronutrients.

But, what does “eating more” protein mean? How much should you eat? The average American male eats 88 grams of protein per day, with women averaging 66 grams. Those totals equate to only 14 to 16% of total calories.3

While that meets the minimum recommended daily allowance (RDA) definition, it falls short of the likely requirements for boosting weight loss, metabolic health, and functional strength.4

The American Dietetic Association sets 10% to 35% as the acceptable range for protein intake. However, the low end of that range may contribute to overeating, and exceeding the range may still be healthy.5

That is why we recommend at least 1.2 grams per kilo per day, ranging up to 2 grams per kilo per day (0.5 to 0.9 grams per pound), which usually equates to 20 to 35% of total calories.6

Based on calculations of the liver and kidney’s ability to safely handle protein, a 176-pound (80-kilo) person has a theoretical maximum of 365 grams of protein per day.7 That’s 73% of a 2,000 calorie diet! It’s safe to say that most people won’t have to worry about eating too much protein.

How to eat fewer calories

We don’t blame you if you cringe when you hear “eat fewer calories.” The old message of “eat less, move more” has failed the majority of dieters for decades.8

That’s not what we are promoting.

Instead, we promote eating better. That means eating in a way that naturally allows you to reduce your calories without hunger. Does it sound too good to be true?

It doesn’t have to be.

Studies consistently show that eating more protein leads to decreased hunger.910 For instance, those who started with eggs for breakfast — as opposed to a bagel — had less hunger and ate fewer calories the rest of the day.11

Other studies show that over time, following a higher protein diet leads to less hunger than a lower protein diet. Part of this is likely due to change in hunger hormones.12 Another idea is that we are hardwired to eat until we get adequate nutrition, the so-called “protein leverage hypothesis.”13 This hypothesis points to the idea that we evolved to seek out the nutrition that our bodies need. And the sooner we meet that target, the sooner our bodies shut down the feelings of hunger or food cravings. If we don’t eat enough protein, our bodies will tell us to keep eating.14

But healthy weight loss isn’t just about what you eat. It’s also about what you don’t eat. Food affects our biology and our brain. Foods like refined carbohydrates can cause increased fluctuations in our blood glucose, which can lead to increased hunger and subsequent excess caloric intake.15

“Everything in moderation” is destined to result in weight gain for many people if “everything” includes cookies, chips, and soda.16 It can also result in weight gain if it includes pasta, bread, and lots of fruit; or even oils, butter, cheese, or nuts.17

These are all hyperpalatable foods that can make it difficult to control the amount you eat.18 Overeating may have nothing to do with willpower or “being strong.” Instead, your brain may be telling you: This tastes great and has lots of calories for survival, I want more!

Foods that are high in calories and low in nutrition percentage are everywhere, and they are far too easy to overeat.19


 

How to achieve metabolic health

Enjoying the cold fresh air

Promoting metabolic health is a crucial aspect of healthy weight loss.

What do we mean by metabolic health? The simple answer focuses on avoiding metabolic syndrome — abdominal obesity, high blood pressure, abnormal blood glucose, elevated triglycerides, and low high-density lipoprotein (HDL) cholesterol.20

However, you shouldn’t define health as merely avoiding disease. While that may be a great starting point, you don’t have to stop there!

Take waist circumference, for example. If you go by metabolic syndrome’s definition, a normal waist circumference for a male is 39 inches (99 cm). Does that mean 39 inches is your end goal?

Maybe not! A waist size of 35 inches (88 cm) is likely much healthier for a 5’ 8” male than 39 inches.21 Even though this may be your “end goal,” don’t expect to get there overnight. Continue to strive for slow and steady improvements over time, heading toward a more desirable result.

Just because medicine defines certain metrics as “normal” or part of a disease complex doesn’t mean it is your goal. Instead, focus on the lifestyles that get to the root cause of metabolic disease.

How can you achieve the goal of metabolic health? Here are our top eight tips.

8 tips to promote metabolic health

  1. Limit carbs — especially refined carbs and sugars. Refined carbs and sugars are the foods most likely to cause you to overeat calories and raise your blood sugar, insulin, blood pressure, and triglycerides.22 Low-carb nutrition may be the most effective diet for improving metabolic syndrome.23 Low-carb diets also successfully reduce hunger for most people.24
  2. Eat adequate protein. Numerous studies demonstrate that, despite a slight temporary increase in insulin, higher protein diets improve insulin sensitivity over the long run and contribute to metabolic health.25
  3. Moderate your fat intake. Excessive fat intake can raise triglycerides and worsen insulin resistance, especially if fat is combined with carbs or contributes to eating too many calories overall.26 Eat enough fat to enjoy your meals, and eat fat that naturally comes with your food like the skin on your chicken, or a naturally fatty rib eye. But don’t go out of your way to add unneeded fat to your foods.
  4. Don’t smoke. This should go without saying due to its connection to cancer and heart disease risk, but smoking also contributes to metabolic disease.27
  5. Drink minimal to moderate amounts of alcohol. Alcohol provides empty calories that can affect liver health and undermine metabolic health.28
  6. Manage stress and sleep well. Poorly controlled chronic stress and poor sleep can increase the likelihood of insulin resistance.29
  7. Get regular physical activity. Muscles burn glucose. Building and using your muscles help promote insulin sensitivity and efficient energy utilization.30
  8. Practice time-restricted eating or intermittent fasting.31 Giving your body time without ingesting nutrients allows your insulin levels to decrease, improves insulin sensitivity, allows you to learn to efficiently use fat for energy, and may even tap into autophagy.32 The net result is improved metabolic health.

 

How to measure your weight loss

Person measuring their waste line

The bathroom scale is the most common tool for measuring weight loss. It is also probably the least helpful!

Your day-to-day weight can vary by several pounds with changes in water weight, or with building new muscle. That means you can lose three pounds of fat without seeing a change on the scale!33

The scale may tell you if your weight is going up or down. But healthy weight loss involves much more than the number on the scale.

Consider trying any of these three techniques instead.

  1. Follow your waist measurement and your waist-to-height ratio. All you need is a tape measure. If your weight is the same on the scale, but your waist is getting smaller, that is still a fantastic healthy fat loss victory!

    As we detail in our guide on losing belly fat, waist circumference is one of the best measurements to predict metabolic health and track healthy weight loss.34

  2. How do your clothes fit? If you don’t have a tape measure, all you have to do is put on your (non-stretchy) pants. It doesn’t get much easier than that.

    Are your pants looser? That means your waist is getting smaller. If you are doing resistance training, you might also find that your arms and legs look more toned. That is a good sign that you are building muscle mass.

  3. Test your body composition. This requires additional tools — either a bioimpedance scale or a more detailed assessment with a DEXA scan or equivalent measuring device.

    A DEXA scan will not only tell you if your weight is changing, but it will also quantify how much weight loss was fat mass, lean body mass, and visceral fat.

    As a bonus, you also can follow your bone density to ensure healthy bones are part of your healthy weight loss progress.


 

How to break weight loss plateaus

Female checking kilogrammes getting on the scale – self care and body positivity concept – warm flare on left

Healthy weight loss is rarely achieved in a straight line of consistent loss. Instead, weight loss tends to come and go, with plateaus in the decline. As long as the overall trajectory continues, you succeed despite the plateaus.

But it helps to have a plan for when the plateaus come. Here are the eight best tips that may help you overcome your plateau and get back on track with your healthy weight loss.

Top 8 tips for breaking a weight loss plateau35

  1. Are you eating enough protein? Take a couple of days to measure all of the protein you eat and count every gram.

    Yes, it can be a hassle, but it can also be illuminating. You may think you are eating “plenty of protein” — only to find out you are actually getting just 15% of your calories from protein. If that’s the case, the best tip for breaking your stall is to increase your protein intake.

  2. Are you eating enough fibrous vegetables? Fibrous vegetables are one of the best ways to increase nutritious food volume for the minimum number of calories, increase stomach fullness, and slow gastric emptying.36 Again, keeping track of your intake for a couple of days can help guide you and help you increase your consumption of fiber-filled veggies. Shoot for at least four cups per day.
  3. Are you limiting your non-nutrient calories? After increasing your protein and fiber-filled vegetables, what’s left? It’s usually non-nutrient calories — the extra dose of cream or butter, the rice that “comes with” your meal, the sugary salad dressing that seems so innocent. Or the ritual glass of wine with dinner.

    Experiencing a plateau is the perfect time to take stock of your non-nutrient calories and cut them in half, or cut them out completely if you can.

  4. Are you struggling with cravings or snacking? Usually, addressing protein and fibrous vegetables can help cut down on snacking and cravings.

    However, if you still find yourself snacking, first make sure you are eating high-protein snacks. Next, make sure you are snacking for real hunger and not boredom or routine. Lastly, try eliminating non-nutritive sweeteners that can stimulate cravings, such as erythritol, stevia, and other sweet additives.37

  5. How are you sleeping? Plateaus aren’t always about what you eat. Not only can poor sleep negatively affect your food choices during the day, but lack of sleep can also change your hormonal environment, making it near impossible to lose weight.38

    Make sure you prioritize good sleep hygiene. It’s easy to talk about but harder to do. Eliminate screens an hour before bed. Keep a steady sleep-wake routine. Make sure your bedroom is cool, dark, and quiet. Kick the kids and dogs out of your bed. You can keep your spouse, but only if their snoring doesn’t keep you up!

  6. Are you exercising? Indeed, exercise by itself is not great for weight loss. However, regular physical activity can help maintain weight loss and break plateaus when combined with healthy eating.

    Just make sure your exercise helps build muscle and doesn’t leave you hungry and craving food. For instance, you may find 20 minutes of resistance training more effective than 45 minutes on a treadmill.

  7. Have you tried time-restricted eating or intermittent fasting? For some, spacing out the timing between meals can naturally reduce caloric intake and allow for lower insulin levels. The combination may be enough to break a weight loss plateau.
  8. Are you fasting too much? Just because a little fasting can help with weight loss doesn’t mean more is always better and doesn’t mean fasting is always a good thing.

    Some people react to fasting by feeling the need to binge or over-consume calories to “make up” for lost meals. People may even rationally know they shouldn’t react that way, but the pull is too strong to resist.

    If this sounds familiar, then intermittent fasting may be doing you more harm than good. Going back to a regular eating schedule may allow you to control your portion sizes better and break your weight loss plateau.

Read even more in our detailed guide on tips to break a weight loss stall.

Top 10 tips to break a keto weight loss stall

 

Keeping the weight off long term

Flipping od wooden cube block for change short term to long term. Business investment concept.

Keeping the weight off can be as simple as “keep doing what you are doing,” but often, the reality of maintaining healthy eating habits is harder to accomplish.

Authors have written hundreds of books on tips to maintain beneficial behavior change, and most of the tips aren’t a secret. The problem is when the recommendations become more items on your “to-do” list, adding chores to your routine that take time and energy you don’t have to give.

If that’s the case, don’t let yourself get overwhelmed. Pick one or two tips that resonate most with you, and stop there. Just because a tip made the list doesn’t mean you have to do it. The list is merely a collection of suggestions to try and see what works best for you.

Top tips for long-term success

  1. Connect with your why, your motivation for keeping the weight off.
  2. Create accountability with a partner, a coach, an app, or a calendar.
  3. Control your environment. Don’t allow temptations in your house or workplace.
  4. See your new way of eating as a lifestyle, not a diet. It isn’t something you “do.” It’s something you “are.” The language you use can make all the difference.
  5. Keep it enjoyable. Find recipes you love that fit within your eating pattern.
  6. Celebrate small successes on your way to bigger successes.
  7. Realize that you won’t be perfect, and that’s OK. Minor detours don’t have to derail you. Anticipate roadblocks and have a plan to get past them.
  8. Incorporate smart strategies for optimizing your sleep, stress management, and physical activity. Better habits in these areas can help with long-term healthy weight maintenance.

Sample meals and meal plans

Weight loss recipes

Explore our high-protein weight loss recipes:

Weight loss meal plans

We combined some of our favorite high-protein recipes into weekly meal plans.

Here’s a sampling of the meals you’ll enjoy:

Jill’s cheese-crusted omelet

Inside its crispy cheese crust, this omelet has turkey, cream cheese, spinach, and more, for a sensational flavor and texture combo.

Venezuelan keto chicken salad

This delicious salad is rich in protein yet creamy and satisfying thanks to a bit of mayo and avocado.

Keto garlic and sesame prawns

You’ll love this dish that features fresh seafood, tender vegetables, and a taste of the exotic.

Check out the complete meal plan, which provides 89 to 140 grams of protein and less than 20 grams of net carbs per day:

Keto: High protein for effective weight loss #1

This highly nutritious meal plan is designed to boost weight loss while enjoying delicious food that helps you feel full and satisfied.

These flavorful meals will provide your body with all the protein, fat, and other essential nutrients needed to be healthy.

You’ll get to enjoy some of our favorite keto feasts, such as Keto cheese tortilla beef burritos and Keto Caprese chicken while staying under 20 grams of net carbs every day.

Full meal plan →

Get your personalized meal plan

Do you want a personalized weight loss meal plan based on your preferences?

Our personalized meal plans are designed to suit your needs and goals. They feature delicious, easy-to-prepare meals that you’ll love — with all of the planning done for you.

Just answer a few questions — such as how much weight you want to lose and what kinds of food you like to eat — and you’ll receive a customized weight loss meal plan almost instantly.

Compact PMP-survey image for two-column banner Get your personalized meal plan

 

Conclusion

Weight loss is a common goal for millions of people. But not all weight loss is the same.

You don’t just want to lose weight. You want to lose weight healthily.

Healthy weight loss means improving your metabolic health, losing mostly fat mass and minimal — if any — lean muscle mass, protecting your resting metabolic rate, and enjoying the process as you go.

By eating plenty of protein and fibrous veggies, reducing your carbohydrates, and eating just enough fat to enjoy your food, you will be well on your way to success.

Improving non-food behaviors having to do with sleep, stress management, physical activity, and appropriate intermittent fasting can also help you along your healthy weight loss journey.

 

Start your FREE 30-day trial!

Get instant access to healthy low-carb and keto meal plans, fast and easy recipes, weight loss advice from medical experts, and so much more. A healthier life starts now with your free trial!

Start FREE trial!

Weight loss

 

  1. Psychology Bulletin 2000:
    Self-regulation and depletion of limited resources: does self-control resemble a muscle?
    [overview article; ungraded]

    Current Directions in Psychological Science 2007: The Strength Model of Self-Control[overview article; ungraded]

  2. American Journal of Clinical Nutrition 2018:
    Dietary fiber and health outcomes: an umbrella review of systematic reviews and meta-analyses
    [review of observational studies; weak evidence]

    Journal of Nutrition 2019: Fiber Intake Predicts Weight Loss and Dietary Adherence in Adults Consuming Calorie-Restricted Diets: The POUNDS Lost (Preventing Overweight Using Novel Dietary Strategies) Study[retrospective review of RCT data; weak evidence]

  3. American Journal of Clinical Nutrition 2018: Protein intake trends and conformity with the Dietary Reference Intakes in the United States: analysis of the National Health and Nutrition Examination Survey, 2001-2014
    [observational study, weak evidence]

    American Journal of Clinical Nutrition 2008: Current protein intake in America: analysis of the National Health and Nutrition Examination Survey, 2003-2004
    [observational study, weak evidence]

  4. The following is a summary article about protein needs exceeding the RDA minimum. For even more details, please see our guide on protein and longevity (LINK)

    Advances in Nutrition 2017: Optimizing Protein Intake in Adults: Interpretation and Application of the Recommended Dietary Allowance Compared with the Acceptable Macronutrient Distribution Range
    [overview article; ungraded]

  5. Controversy exists about how they derived the upper number as it uses nitrogen balance, and is not based on clinical outcomes and is therefore theoretical and may be even higher.

    Journal of the American Dietetic Association 2002: Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids[overview article; ungraded]

    Journal of Nutrition 2003: Amino acid pharmacokinetics and safety assessment
    [overview article; ungraded]

  6. Although using percentage is a convenient way to discuss the amount of protein, the absolute amount will vary based on the total calories eaten.

  7. International Journal of Sports Nutrition and Exercise Metabolism 2006: A review of issues of dietary protein intake in humans
    [overview article; ungraded]

  8. Obesity Reviews 2017: Prevalence of personal weight control attempts in adults: a systematic review and meta‐analysis [systematic review of observational studies; very weak evidence]

    Journal of the American Medical Association 2019: Trends in self-perceived weight status, weight loss attempts, and weight loss strategies among adults in the United States, 1999-2016 [observational study; very weak evidence]

    The following meta-analysis of RCTs reports only one commercial weight loss program has evidence showing at least a 5% weight loss. The analysis also reports that as many as 67% of participants drop out within the first year.

    Annals of Internal Medicine 2005: Systematic review: an evaluation of major commercial weight loss programs in the United States [systematic review of randomized trials; strong evidence]

  9. In a 12-day randomized crossover study, people were allowed to eat as much as they wanted on a high-protein, normal-protein, and a low-protein diet. During the high-protein portion of the trial, they consumed 500 to 550 calories less than they did during the normal-protein and low-protein portion of the trial:

    The American Journal of Clinical Nutrition 2013: Protein leverage affects energy intake of high-protein diets in humans [randomized trial; moderate evidence]

  10. A systematic review of randomized controlled trials found that higher-protein diets tend to promote weight loss, due in part to reducing hunger and increasing satiety:

    Journal of the American College of Nutrition 2004: The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review [systematic review of randomized trials; strong evidence]

  11. In a crossover trial, overweight women ate a mixed, equivalent-calorie breakfast containing either two eggs or one bagel. In addition to feeling more satisfied after the egg breakfast, the women ate less at lunch and took in an average of 250 fewer calories for 36 hours after the egg breakfast compared to the bagel breakfast:

    Journal of the American College of Nutrition 2005: Short-term effect of eggs on satiety in overweight and obese subjects [randomized crossover trial; moderate evidence]

    In a similar crossover trial, men consumed fewer calories at lunch after eating an egg-based breakfast compared to a bagel-based breakfast, and averaged 400 fewer calories overall for the next 24 hours — even though both breakfasts had similar calories and macronutrient composition:

    Nutrition Research 2010: Consuming eggs for breakfast influences plasma glucose and ghrelin, while reducing energy intake during the next 24 hours in adult men [randomized crossover trial; moderate evidence]

  12. The American Journal of Clinical Nutrition 2013: Contribution of gastroenteropancreatic appetite hormones to protein-induced satiety [randomized crossover trial; moderate evidence]

    Nutrition Journal 2014: Effects of high-protein vs. high- fat snacks on appetite control, satiety, and eating initiation in healthy women [randomized trial; moderate evidence]

    Advances in Nutrition 2015: Controversies surrounding high-protein diet intake: satiating effect and kidney and bone health [review of observational studies; weak evidence]

    Your body also burns more calories digesting protein compared to fat or carbs.

    Journal of the American College of Nutrition 2004: The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review [systematic review of randomized trials; strong evidence]

  13. Obesity reviews 2005: Obesity: the protein leverage hypothesis
    [overview article; ungraded]

    PLoS One 2011: Testing protein leverage in lean humans: a randomised controlled experimental study
    [randomized trial; moderate evidence]

  14. Public Health Nutrition 2018: Ultra-processed foods, protein leverage and energy intake in the USA[observational study; weak evidence]

  15. Nature Metabolism 2021:
    Postprandial glycaemic dips predict appetite and energy intake in healthy individuals
    [non-controlled study; weak evidence]

  16. PLoS One 2015: Everything in Moderation–Dietary Diversity and Quality, Central Obesity and Risk of Diabetes
    [observational study, weak evidence]

  17. This is based on the consistent clinical experience of practitioners familiar with low-carb nutrition. [weak evidence]

  18. Cell Metabolism 2019: Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake
    [randomized trial; moderate evidence]

  19. Cell Metabolism 2019:Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial of ad libitum food intake [randomized trial; moderate evidence]

    PLoS One 2015: Which foods may be addictive? The roles of processing, fat content, and glycemic load [non-randomized trial; weak evidence]

  20. Circulation 2005: Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement
    [overview article; ungraded]

  21. Circulation 2008: Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women [observational study, weak evidence]

    Annals of Internal Medicine 2015: Normal-Weight Central Obesity: Implications for Total and Cardiovascular Mortality [observational study, weak evidence]

    Even “normal weight” people, as defined by BMI, with extra belly fat are at increased risk of health complications.

    European Heart Journal 2019: Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index [observational study, weak evidence]

    BMJ Open 2017: Risk for metabolic diseases in normal weight individuals with visceral fat accumulation: a cross-sectional study in Japan [observational study, weak evidence]

  22. Nutrition Reviews 2000: High-glycemic index foods, hunger, and obesity: is there a connection?
    [overview article; ungraded]

    BMJ 2018: Dietary carbohydrates: role of quality and quantity in chronic disease
    [overview article; ungraded]

  23. Journal of the American College of Nutrition 2013: Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes [uncontrolled study; weak evidence]

    JCI Insight 2019: Dietary Carbohydrate Restriction Improves Metabolic Syndrome Independent of Weight Loss [randomized trial; moderate evidence]

    Obesity 2015: Weight loss on low-fat vs. low-carb diets by insulin resistance status among overweight adults & adults with obesity: A randomized pilot trial [moderate evidence]

    One observational study even suggests improved survival for those with prediabetes who eat a lower carbohydrate diet.

    Clinical Nutrition 2020:
    Associations of low-carbohydrate and low-fat intakes with all-cause mortality in subjects with prediabetes with and without insulin resistance
    [observational study, weak evidence]

  24. Obesity Reviews 2015: Do ketogenic diets really suppress appetite? A systematic review and meta-analysis [strong evidence]

    European Journal of Clinical Nutrition 2013: Ketosis and appetite-mediating nutrients and hormones after weight loss
    [non-controlled study; weak evidence]

  25. This RCT reports that those following a 27% protein diet compared to 16% had better preservation of lean mass and a better glycemic response despite no difference in weight loss.

    Nutrients 2018: Effects of Adherence to a Higher Protein Diet on Weight Loss, Markers of Health, and Functional Capacity in Older Women Participating in a Resistance-Based Exercise Program
    [randomized trial; moderate evidence]

    This randomized crossover study reports subjects with type 2 diabetes have a greater reduction in A1c and total daily glucose, fatty liver, and fatty pancreas with a 30% carb/30% protein diet compared to a 50% carb/17% protein diet.

    Diabetologia 2019:
    A carbohydrate-reduced high-protein diet improves HbA 1c and liver fat content in weight stable participants with type 2 diabetes: a randomised controlled trial
    [randomized trial; moderate evidence]

    This small RCT reports 100% prediabetes remission with a higher protein diet.

    Nutrition, Metabolism, and Cardiovascular Diseases 2020: High protein diet leads to prediabetes remission and positive changes in incretins and cardiovascular risk factors
    [randomized trial; moderate evidence]

  26. Studies such as the following highlight data that excessive fat intake is associated with insulin resistance. However, that has not been studied in the context of a low-carb diet.

    Clinical Nutrition 2004: Dietary fat, insulin sensitivity and the metabolic syndrome [review article; ungraded]

  27. PLoS One 2016: Tobacco use, insulin resistance, and risk of type 2 diabetes: Results from the multi-ethnic study of atherosclerosis [prospective cohort study; weak evidence]

  28. Biomolecules 2015: Impact of Alcohol on Glycemic Control and Insulin Action

  29. Psychoneuroendocrinology 2005: Role of stress in the pathogenesis of the metabolic syndrome [overview article; ungraded]

    Journal of Epidemiology 2016: Investigation of the relationship between chronic stress and insulin resistance in a Chinese population [prospective cohort study; weak evidence]

    Lancet 1999: Impact of sleep debt on metabolic and endocrine function [non-randomized study; weak evidence]

    Healthcare (Basel) 2019: The interlinked rising epidemic of insufficient sleep and diabetes mellitus [overview article; ungraded]

  30. British Medical Journal Open Sport Exercise Medicine 2016: Update on the effects of physical activity on insulin sensitivity in humans [overview article; ungraded]

  31. One study finds that six weeks of alternate-day fasting leads to a 7% overall weight loss with a visceral fat loss of 5.7%.

    Journal of Diabetes and Metabolic Disorders 2013: The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women [nonrandomized study, weak evidence]

    Another randomized trial reports 26.4 pounds (12 kilos) of fat mass loss with intermittent fasting compared to 17.6 pounds (8 kilos) for chronic calorie restriction.

    International Journal of Obesity (London) 2018: Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study [randomized trial; moderate evidence]

  32. The following study shows a significantly smaller amount of insulin secreted during periods of fasting.

    Diabetes 2002: Effects of fasting on physiologically pulsatile insulin release in healthy humans
    [nonrandomized study, weak evidence]

    The following study shows fasting improved homeostatic model assessment of insulin resistance (HOMA-IR), a measurement of insulin sensitivity.

    Journal of Clinical Medicine 2019: The Effectiveness of Intermittent Fasting to Reduce Body Mass Index and Glucose Metabolism: A Systematic Review and Meta-Analysis [systematic review of randomized trials; strong evidence]

    Review paper on autophagy.

    Frontiers in Cell and Developmental Biology 2019: Maximizing Longevity and Healthspan: Multiple Approaches All Converging on Autophagy[overview article; ungraded]

  33. You can consider comparing numbers over weeks and months rather than days. Another option is to average your weight over the last 5 to 7 days to estimate your present weight so it can be tracked over time.

  34. Research in Sports Medicine 2020: A new waist-to-height ratio predicts abdominal adiposity in adults [nonrandomized study, weak evidence]

    BMJ Open 2016: Waist-to-height ratio as an indicator of ‘early health risk’: simpler and more predictive than using a ‘matrix’ based on BMI and waist circumference [nonrandomized study, weak evidence]

  35. This is based on the consistent clinical experience of practitioners familiar with behavior modification for healthy weight loss [weak evidence]

  36. Journal of Nutrition and Metabolism 2019: The Role of Fiber in Energy Balance[overview article; ungraded]

  37. In some people, sugar substitutes may partially activate the “food reward” pathway responsible for cravings.

    The Yale Journal of Biology and Medicine 2010: Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings [overview article; ungraded]

  38. Physiology & Behavior 2018: Effect of sleep curtailment on dietary behavior and physical activity: a randomized crossover trial [moderate evidence] 

    Obesity (Silver Spring) 2017: Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight [non-controlled study; weak evidence]

    Obesity Reviews 2018: Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? [overview article; ungraded]

    Journal of the American Medical Directors Association 2014: Postprandial hypotension: a systematic review[overview article; ungraded]

    European Journal of Clinical Nutrition 2017: The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis[analysis of randomized and non-randomized studies; weak evidence]