Rapid weight loss on LCHF – then effortless long-term maintenance

Dr. Ted Naiman: Really rapid initial fat loss on low carb, then effortless long-term maintenance of ideal body weight on LCHF.

I had the pleasure of meeting Dr. Ted Naiman for the first time on the recent low-carb cruise. I recommend following him on Twitter, for low-carb news and inspiring patient cases like this.


  1. BobM
    Anyone have any ideas why some people lose weight so quickly on low carb and others don't? For instance, it's taken me almost three years to lose 50 pounds, and to lose that weight, I had to also start intermittent fasting (IF) in addition to increasing my fat content. With low carb only (and eating multiple meals per day, the way we're taught to), I lost about 20 pounds. I was still slowly losing (or at least my belt size was moving down), but I had stalled until adding IF and also higher fat. Further, I've done multiple about 5 day fasts, many 3 day fasts, and basically fast every week and vary my fasting. This week, for instance, I'm eating during a short window (say 3 hours) Monday, Wednesday, and Friday, and eating during a long window (say 8 hours) Tuesday, Thursday, Saturday, and Sunday. Last week, I fasted from Sunday night to Wednesday at lunch and also Thursday night to Friday night.

    Am I just more insulin resistant than these other people?

    Also, my weight chart bounces around multiple pounds per day/week/month. I gain or lose pounds per week, sometimes per day, especially when fasting. It's nowhere near flat as it's shown above.

    Replies: #19, #21
  2. Bob T
    BobM my wife and I are having the same problem with our weight loss. I am type two with metabolic syndrome, my wife is completely normal. My wifes and my weight bounces up and down and has recently stalled completely. But I am very reluctant to go down the road of fasting, that for me is to close a form of anorexia. I fear that should you continue in this vain to lose weight you'll inadvertently become anorexic. You are not alone in the struggle to lose weight on the LCHF diet. I often wonder if a more balanced old fashioned diet would give me the same or better results.
  3. Heather
    I've heard of people having trouble losing weight due to too much protein intake as well as dairy intolerance. I think it is very important to keep your fat up around 80% and avoid sweetners as much as possible. Everyone I know who intermittent fasts, keeps carbs at 20grams, and eats real food, lose weight. That being said, water retention can bring the scale up or down as much as five pounds in a day. But that fluctuation should not be the norm and not interfere with an overall downward trend. You will not develop anorexia from fasting. You may want to measure your blood ketones, it's a very reliable way to determine if your using ketones and therefor your body utilising fat stores.
  4. Michael
    Heather, agreed. Protein needs to be at 25% of total daily food intake. People often fail to consider that protein converts to glucose at a .67:1 ratio. Carbs are 1:1. Overdoing protein is like adding carbs to diet. I have had a ratio of 70% fat, 25% protein, 5% carbs that is easy to maintain and weight loss is very good.
  5. Andrea
    What do you eat to keep fat so high? I have difficulty figuring out how to get in the fat.


  6. toby mashall
    the chart suggests he lost 20 something kilos in a 4 days. that is not correct
  7. toby mashall
    l have just come to back to lchf from backpacking around asia where lchf was very hard to sustain over 4 months as there is alot of rice there. l have been on it for a week and just got over the initial horrible days you experience and gone very strict lchf . l certianly havn't sustained such a large weight loss that this chart suggest you can do in 4 days. the data is a bit blurry, a better copy would be better to see if l am misinterpreting the date .
  8. toby mashall
    further to my comment - from checking my ketones just at minute ago they are 1.5 which is near optimul ketosis from just a week of strict lchf. but l havn't lost that amount of weight in such a short period of time. l can't see 20 kilos of water weight being lost in 4 days.
  9. Barb
    Hi Toby. Take another look at the chart shown. 33 lbs lost over 2 months, equals about 15 KGS in 8 weeks. Rapid weight loss for sure, but not as quickly as your first impression. One aspect that continues to interest me is the way eating LCHF results in such a long lasting level of feeling full, but not in a 'stuffed' way. It's such a big difference to not even think about food for 4-5 hours of more, then have a gradual feeling of hunger returning rather than the sudden and frequent hunger feelings of my former hi carb days. Fascinating!
  10. toby mashall
    hi barb, if you look closely at the bottom line of the chart you can see the dates, they are not very clear

    stating lchf on 06/01/2015 - 90 something kilos - finishes on 10/01/2015 with 70 something kilos.

    l am moving to saudi for a 1 year contract and l really hope l can keep up with lchf as l hear all they out there is junk food

  11. Jenna
    It's an American date. 1st June 2015-1st August 2015 and maintained until May 2016.
  12. perle0
    BobT, intermittent fasting should not lead to anorexia unless the person is already highly susceptible to it (e.g., had previous issues with serious eating disorders). The key is "intermittent"--in between fasting, you eat your normal LCHF diet. I like to do a 24-hour fast three days a week. When I tell people, they look at me like I've grown an extra head and exclaim that they could never do that.

    The funny thing is, I would have said the same thing before I tried it. It isn't that hard, especially when you're keto-adapted, and it did have significant effects in kicking me off of a plateau. Now I'm on work travel, and slipping off plan and eating carbs about one day a week, because it just becomes too difficult...but by fasting the next day, then going right back to low carb, I actually seem to be losing overall--at least, in the waistline. No reliable scales in hotels!

  13. Guest
    I have trouble getting fat into my diet too. What I have done is to eat " fat bombs" really helps to hit my macro goals. An example -2/3 cup coconut oil mixed with two cups coconut, with 83% cacao chocolate melted on top. Coconuts into food mixer, place in freezer in cupcake molds. Once chocolate is melted, pour on top. Also, mayo, avocado, butter, even 1 oz of pecans can help to increase fat intake.
  14. Bob T
    On the topic of FASTING recently on the Diet Doctor Facebook group page a man professed to be using fasting as a quick way of reducing his body weight in times of need. If that is not a form of anorexia I don't know what is. This gentleman was clearly introduced to fasting by the LCHF diet.
    Reply: #16
  15. Bob T
    perle0 forgive me but I feel you may possibly need to seek help. On any level that is way too much fasting for anyone normal. You say you're not anorexic you may need to rethink that my friend. I stand by the point of if you need to deliberately starve yourself to lose weight on a diet or to maintain a body weight then the fundamental ethics of the diet is wrong on so many levels.
  16. Apicius
    Not sure I agree with you, BobT. What is the other mainstream alternative to fasting? I see the promotion of hours of aerobic exercise, jogging, etc...destroying people's joints and causing all sorts of damage, while eating tiny portions of bizarre foods (soy protein bars) and so on. Fasting mimics what our ancestors went through (there was no supermarket offering strawberries every day of the year a century ago). Going for a period without food, and taking less stressful exercises (like a long stroll) is much more adequate for what our bodies evolved from. It's not anorexia, it's back to basics.
  17. Michele
    Well said, Apicus. Fasting saves people's lives. BobT, how is your current regime working to reduce the metabolic syndrome? There are many benefits to fasting, but reducing insulin resistance is right at the top of the list for me. I started doing LCHF and intermittent fasting December 26, 2015. I've lost 40 pounds, and my a.m. blood sugars are in the 75 to 85 range. Been type 2 for 10 years, and nothing else that I was willing to do has worked. I refused most diabetic meds because of the horrific side effects, but was on Metformin. Off all meds now, feeling hopeful for the first time in years...this is a real miracle as far as I'm concerned.
  18. Apicius
    Wow! Bravo Michele!
  19. Kanoknapas
    It's normal for your weight to fluctuate all the time. Please do not worry. :)
    As for IF, I heard it helps by reducing your fasted blood sugar (and therefore insulin level) so maybe you are very insulin resistant... I also hear from a keto coach that it's important to increase your fat intake by quite a lot (it's over 100 g/day for the coach from what I remember). This is for your body to adapt more to fat burning. But then again, this sort of contradicts the graph of macronutrients/day I saw from Dr.Phinny which says to gradually increase fat so your body uses what is stored in you first. Of course, both say to keep your protein intake moderate. Sometimes you might need less than you think. Anyhow, I guess you are on the right tract for your body if the fat is coming off. :D
  20. MKL
    Ok, no one else said it so I will.

    It is not appropriate, or helpful, or accurate, for people to be running around accusing other people of being anorexic on a website devoted to health and wellness.

    Anorexia is mental health disorder that can only be diagnosed by a qualified professional in a clinical setting.

    Bob, if you have such a terror of anorexia that you start accusing people you don't know of having it, you probably need to learn more about what anorexia from a qualified professional (no, I am not interested in being that professional, in case you ask). But it has nothing to do with fasting, which people engage in for a variety of religious/spiritual reasons. As others said - if someone has a history of eating disorders, fasting might be triggering and unhealthy for them (note: I am not giving medical advice of any kind to anyone, we are just talking common sense). But that is where the relationship between fasting and anorexia begins and ends.

    My concern about the story being discussed is whether fasting is being used appropriately to support long term weight loss/health or whether its being used in some bastardized form as a "yo-yo" form of calorie restriction diet, or if the person is keeping hydrated (or just losing water weight) during fasting. No idea, as I'm responding something second hand, but still.

  21. sheila
    Your not the only one. 7 months on the strict keto. Under 20 grams of carbs. 11.6 lbs of weight loss. I got frustrated and began eating higher carbs only to gain it back. But I am going back to strict keto. I believe its insulin, stress and estrogene dominance for me. I love low carb. I am still decreased in size but the scale says I gained. Could be muscle gain for me. I use my pictures now to see the difference though. IF liquid fasts with chia seeds in bullet proof coffee on long 8 day fasts for me. 5 carbs 5 dietary fiber. So 0 carbs. I only lose fat if I am under 800 fat calories fasting. I use the bullet proof coffees to sustain my appetite. I can only receive the 1.5 mmol of ketones on the 5th day. I can't get any higher. I think its stress really. But there was a day recently that I went rafting and had an emergency rescue in the river I was in. The stress was necessary and natural in the flight and fight stage. Lol. I lost 4 lbs. Its slow but it works. I am 52 post menopausal for 12 years, live in a stress filled environment which I can't change at this time. But beginning tomorrow I will be weight lifting. I have not exercised because of fear that it will increase hunger. Now that Ghrelin and Leptin are under control, in need to work out an increase the HGH and other fat burning hormones. You aren't the only one who has slow weight loss.
  22. Lori
    Hello, I started keto Nov.16, 2017 and 21 weeks later I have lost 65 lbs. i keep my carbs under 20 grams a day and i was low calorie (800 day) and lower fat for the first 16 weeks and I walked 30 to 60 minutes, 3 to 5 days a week and within the first 16 weeks I lost 55 lbs, then I started getting really cold, and raised my calories and started increasing my fat intake, my weight loss is slowing down but I am also getting within 10 lbs of my goal weight. I still walk and have started lifting some weights, but the biggest thing through this is listening to your body, I have found that IF 18:6 works for me, but some days I am just hungry so I eat. I also weighed and measured my food for the first 18 weeks, now I eat when I am hungry and stop when I am full. So listen to your body, make some changes and see what works for you. But please realize that all this information on the sites are tools for you to use, not magic spells, listen to your body and keep trying until you find out what works for you. Keep calm and keto on.
  23. nienke
    Hi, I have lost lots of weight on keto (over 20 kilos). I am now close to my ideal weight. Twice I hit a weight loss plateau. The first time I started counting carbs for a few days and discovered that I ate far more carbs than I thought due to dairy (yogurt) and nuts (too many). The second time I hit a weight loss plateau, I did stick to the max 20 grams of net carbs. I started fasting 16:8 so I had dinner around 19.00h and then fasted to lunch around 13.00h the next day. It was very very easy! I just wasn't hungry any way. I not only lost more weight but I lost weight around my waist. Now I still use intermittent fasting to trigger autophagy (check Jason Fung here on dietdoctor). I truly believe that fasting is not just important to lose weight but even more important to remain healthy and to get rid of damaged cells etc. I feel better than ever. I also look much younger, don't have any excess skin, plus I am very fit in spite of not going to a gym etc. My husband did the fasting from 14.00h in the afternoon to breakfast next morning to get rid of his fatty liver. He did this for two weeks. I tried, but didn't manage that, he also found it tough but he lost lots of weight quickly and all around his waist, he is now superslim and superfit (took him just 2 weeks!!!!!). Information on this you can also find on dietdoctor, there has been research that it is not just about how much you eat, but also when you eat. Apparently you should ideally have proper breakfast (breakfast like a King), a good lunch (lunch like a Prince) and a light dinner (dine like a pauper) or skip dinner altogether.

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