feet-on-scales
When I put out the call for what people wanted to read about on this blog in 2009, numerous folks commented that they would like to know why it seems so much more difficult to successfully follow a low-carb diet the second or third time around.  Over the years I’ve noticed this phenomenon in myself and in many others whom I have treated or advised, so it’s truly a subject worthy of exploration.
I’m going to list the reasons experience has taught me below, starting with situations over which we have no control and ending with those over which we have total control.
Aging
We all get older every day.  Sadly, with aging, all systems deteriorate.  Some slower, some faster, but all get a little older and a little less functional every day.  If you achieve success on a low-carb diet and find yourself 70 pounds lighter, you’ll also find your self five or six months older.  If you regain that lost weight, then decide to start another low-carb diet to re-lose it, you will probably be a couple of years older than you were when you tried your first low-carb diet.  Just as it’s a little more difficult to pick up tennis at age 46 than it is at age 44, it’s a little more difficult to get everything moving with a low-carb diet when you’re a couple of years older.
Built-in survival mechanisms
Although most dietary recommendations are fairly simplistic, our bodies are unimaginably complex.  Not only do we have a complicated metabolism centered around and directed by the liver, we have multiple neurological and endocrinological feedback pathways between the liver-directed metabolic system and the central nervous system.  And we have gut hormones that get into the act sending signals of fullness or lack thereof.  It is an intricate system designed to allow us to survive on all kinds of food and to keep us alive as long as possible in the face of famine.  I like to think of this entire interconnected system as having its own memory.  It will allow you to fool it once or maybe twice, but then it gets wise.
Almost everyone who starts any kind of diet for the first time sees pretty rapid results.  Pounds seem to fall off quickly and effortlessly.  At a point down the way in the diet, it starts becoming progressively more difficult to lose more weight because the body starts catching on to what’s happening and starts fighting back.  This phenomenon seems to occur less with a low-carb diet because if it is a good quality low-carb diet, the body is getting all the nutrition it needs, so it doesn’t rebel quite the same as it does with some other nutritionally inadequate diets.  But it does rebel a little, nevertheless.  And worse, it remembers.
If you lose weight then regain it and restart a low-carb (or any other) diet, the body is not quite so willing to shed the first pounds as quickly as it did the first time.  It remembers.  If you, like many people I’ve met do, give low-carb a serious, diligent go for about a week, then fall off because of a party, wedding, etc. that you attend, then try again for another week before falling off, you program your body to hang in there for at least a week before letting loose its fat.  The body says, ‘Well, here we go again with another week of this nonsense.  Let’s hold steady on and we’ll be back to our regular high-everything diet within a week.  Let’s not go into starvation mode yet and starting getting rid of our fat.’  What you will find after a few turns of this cycle is that although the first time through with low-carb you may have lost six pounds the first week, the forth time through you will lose almost nothing the first week.  Then the doubt creeps in.  And you begin to wonder if the low-carb diet will really work for you.  It will, but you’ve got to get past the body’s diet memory for it to.
Increased insulin and leptin resistance
All the studies aren’t in yet on this issue for sure.  But, those that are (both animal and human studies) indicate that we become progressively more insulin and leptin resistant as we age.  This is especially true for people who have become overweight or obese and have maintained that state.  Sadly, it is also true for those who became overweight or obese and lost the excess weight, which is most of us.  The more insulin and leptin resistance we are, the more difficult it is to lose weight.  So, the increase in this phenomenon just from the years passing between the first go round and the second on a low-carb diet makes it a little more difficult the next time.
Hormonal dysfunction
Women who are wildly successful on a low-carb diet when they are in their 30s or 40s and premenopausal then try again when they are in their menopausal years often find it almost impossible to lose.  It requires fiddling with hormone levels by replacing with natural hormones and getting the system back into balance before a lot of weight can be lost.  It takes a while to do this.  Even if the hormones do get back to where they need to be quickly, it takes some time for the body to respond.  Often just getting the hormones balanced results in weight loss spontaneously without dieting.  But dieting helps the process along more quickly.
Now we get to the issues that we do have control over.  I don’t want anyone to be offended by this list or think I’m pointing any fingers because I’m not.  But I would guess that I’ve (MD and I as a team) taken care of more overweight people on low-carb diets than anyone alive today.  We’ve had thousands and thousands of patients in our clinics and we’ve dealt with many others second hand through books, lectures, etc.  And we’ve had many friends, relatives, friends of friends, associates, etc. whose care we have monitored.  In shepherding all these people (not to mention ourselves) on low-carb diets, we have learned a few things.   What follows is a summary of what we’ve learned.  Not about the biochemistry and physiology of low-carb dieting, but about the psychology of low-carb dieting.
Lack of commitment
It has been my experience that people just don’t seem to commit as strongly the second, third, etc. time around.  The first time, people make a major commitment.  They lose weight.  They feel better than they have in years.  They are excited.  Then they either stay continue on their low-carb diet and maintain or they don’t.  If they don’t, the weight comes back.  Then a couple of years later when it’s time to start again, they just don’t have the commitment they did the first time around.  And, due to the above reasons, it’s a little more difficult the second time around.  They never really get into the swing of it like they did the first time, and then the notion that maybe it won’t work starts to gnaw.  And then they start doing a ‘half-fast’ (if you get my drift) low-carb diet, which works okay for maintenance, but not for weight loss.  Discouragement sets in, and they bolt from the diet.  I’ve seen this cycle in action countless times.  Don’t fall into it.
People learn how to cheat in their first low-carb go round and remember how when they start again
The first time around on a low-carb diet is exciting.  You’re actually getting to eat all these forbidden foods – steak, eggs, real butter – that you’ve been taught make you fat and are losing weight like crazy.  It’s unbelievable.  But sooner or later, you get a little weary of steak, eggs and real butter, and you start looking to expand your food choices.  If you stay on your carb restriction, you start to figure ways that you can keep carbs low, but eat facsimiles of the high-carb foods you enjoyed before you started your low-carb diet.  You make the major discovery that low-carb brownies exist (or at least they call them low-carb brownies) so you give them a try.  Then you find out about low-carb waffles, pancakes, bagels, etc.  You discover that there is a whole low-carb world of what you’ve always thought of as high-carb foods.  You are in heaven.  You can have your cake and eat it, too, so to speak.  But around about this time, the weight loss starts to really taper off and maybe even comes to a halt.
A few years later, you’ve regained your lost weight plus some, remember how effortlessly you lost it on a low-carb diet, and decide to do it again.  But this time, instead of starting with the steak, eggs and real butter all alone, you stock your low-carb larder with low-carb brownies, bagels, chips, and other junk as well.  Strangely, the low-carb diet just doesn’t seem to work as well this next time around.
If you want to be successful the next time around on a low-carb diet, you’ve got to follow a low-carb diet.  And it takes commitment.  You’ve got to realize it’s going to be a little more difficult than it was the first time, and you’ve got to go on an honest-to-God low-carb diet filled with quality low-carb real foods.  And you’ve got to stick to it.  You want to hang in there until you get to what was called in the old medical literature the dynamic weight stage.  The dynamic weight stage is when weight is changing rapidly in either an upward or downward direction.  Anyone who has gained or lost a lot of weight has experienced this. You can gain rapidly once you get into this phase, but ultimately you stabilize and hit the static weight phase.  It works the same going the other way.  Once you get your weight loss momentum built up, you seem to lose effortlessly while in this dynamic phase.  This is where you want to be.  But you have to commit for a few solid weeks to get there.  You can’t just diddle with it, go on a few days and off, fill up on calorie-dense, low-or-no-carb junk, say you’re doing a low-carb diet, and wonder why you aren’t losing.  You’ve got to get up into the low-carb saddle and ride.
In the next post in this series of two, I’ll present some tips that have helped me enormously and have helped others achieve the level of commitment needed to see us through years of low-carb dieting.
In the above list of reasons I think the low-carb diet (or any diet) is more difficult the nth time around, I’ve probably forgotten something.  Which is why I rely on you and your comments to fill in the missing info.  If you have reasons I’ve not mentioned, send them in.  Don’t be shy.  Or if you disagree.  Let me know.  I’ll be eager to hear from you.

157 Comments

  1. Have you seen any findings that suggest that it is ruins the long term efficacy to constantly switch back between low carb and high carbs if your thin to begin with?
    I’m young (22), and thin, but I keep the low-carb diet because I find it much healthier (especially after your book, and good calories, bad calories). However, if say I get a wrong order or I am visiting home for Christmas with all sorts of Christmas cookies – I usually just take a day or two off the diet.
    Just wondering if I’m ruining up my body’s ability to cope with insulin levels in the future, when I feel the consequences of aging.
    I don’t really think it ruins the efficiency, especially at your age. But, if you want the best long-term outcome, you ought to belly up to the low-carb bar and stick there.

  2. The most important aspect of dealing with a blow up is forgiveness. You have to forgive yourself and move on. If you don’t forgive yourself, it will be impossible to move on. The guilt will settle into your mind and heart. The weight of it and it’s internal dialogue is to heavy to keep moving in the journey. We need to strip ourselves of the guilt, forgive, figure out what might have happened, and then grow stronger. For me, I am not sure what happened last night. Not sure how to learn from it, can’t figure out the cause.

  3. Excellent post!!
    As a guy who has lost over 100lbs following a low carb diet only to gain half of it back over the course of 6 years, I can certainly attest to how lack of commitment will bite you in the a$$, and learning how to cheat, that’s a slippery slope you’re better of avoiding. Guilty on both counts.
    The path to fat loss is still there, I just need to stay on it. Like I did the first time.

  4. Forget second-time around. I started doing (and undoing) low-carb with Dr. Anchell and Blake Donaldson in the 1960s. Donaldson who wrote Strong Medicine was my physician in New York after I gave birth to my son (I’d gone from 128 pounds to 198 pounds during my pregnancy) and Anchell was my doctor when I moved to California. Then came Atkins in the 1970s. It’s sort of been a second career for me and I’ve weighed 102 pounds (5’7″) to 300 pounds during those years.
    Now that I’m old (I’ll be 76 in May) and fat (don’t ask) and healthy, I still want to achieve a good weight for my medium-frame body (probably somewhere around 135-140) but nothing happens anymore. I believe my problem is quantity not quality. Once I eat meat and fat, I can’t seem to stop and it scares me.
    Despite my current lack of success with my weight, there have been positive results from my total belief in low carb eating. I can now play with my hunger and I never snack. I eat a good protein/fat breakfast and I don’t eat again until around seven to ten hours later. For the first time in my long life, I feel in command of my hunger and that’s a powerful feeling.
    I gave up seeing doctors many years ago so I have no idea what my various numbers are nor do I care. Surrounded as I am (I live in a senior complex) by old people with debilitating illnesses, the fact that I’ve never had a headache, stomach ache, I poop daily, and much younger men hit on me, makes me feel that I’m doing the right things for my health but the excess weight is something that I have not been able to conquer.
    I would love to hear your experiences with Blake Donaldson. He is an interesting guy.

  5. I have exactly the opposite experience. I’m 36. I’ve tried low-carb/paleo diets of one form or another perhaps three times over the past 12 years, and this is the only time it’s actually “clicked” and has been effortless for me–and after doing this seriously for only a few months I have no doubt that this is going to be a sustained success story; my way of eating—barring the occasional social event—for the rest of my life.
    What is different this time round? In no order…
    1) I am not trying to do a cyclic or targeted ketogenic diet to maximize exercise performance or increase gain of LBM. Exposure to a lot of carbs intermittently does not work for me, physically or psychologically, and I’ve discovered I can gain muscle mass–and lift–perfectly well without carbs.
    2) I am eating enough fat. A biggie. I am cognizant both of the fact that I should be getting the *vast majority* of my calories from fat (rather than protein), and that even if I only get @ 20-25% of my energy from protein, if I I eat 3500 kcal/day, I’ll be taking in @ 175-220 g/protein/day; more than enough for someone who weighs 170-180lbs.
    3) I no longer watch TV (!!!!!!!!!!!). I suspect this is a major factor in my success–I know that my _body_ and _brain_ function beautifully on a very low carbohydrate diet, but with the constant bombardment of distracting, contradictory and idiotic messages from that loud glowing box, I found it much harder to stick to doing what I know works best for me.
    4) Blogs such as this one, the net, and the increasing abundance of reading material on the subject have helped me find a supportive “community” and have allowed me to educate myself on the science and ongoing research into various diets; I now know that eating the way I physiologically want to, when on a low carb diet, while it may appear insane to others, is actually extremely healthy.
    I’m very happy to learn that this blog has helped you in some small way to achieve your success. Keep after it.

  6. The discussion about one’s weight-related survival mechanisms reminds me of the old story about a little girl proudly presenting her father with mounds of cash that he had “forgotten” and left on the table at restaurants throughout the family’s driving vacation.
    My metabolism seems just like that: SEE! You can cut your calories AND carbs to nearly nothing now, and I still won’t lose any weight!! Aren’t I clever??!!
    One pattern I have just come to terms with is my history of allowing myself to to gain 3-4 lbs over the holidays and just assume that it will “fall off” in January. That might have worked when I was younger, but now the gain each December is more like 5-6 and the January loss is 2-3 lbs. With a resulting net gain every year.
    A question re: hormones in menopause. How can a woman know whether her hormones are the problem or not? I have no hot flashes, mood swings, etc. (although some sleep issues) and have been assuming that hormones levels were a non-issue for me. (I’m well into menopause proper.) I have always resisted the idea that menopause is a disease to be treated rather than a natural stage of life, like puberty.
    It is a natural stage of life, but it can be managed. If you’re not having a problem losing, I wouldn’t worry about it. If you are, then you might consider getting your hormones tested.

  7. Good post. I think you’re right about the second time around being too much about low carb junk food.
    I am really glad I never got into those frankenfoods. Life is much easier with real food.
    Now we really have to stay away from the alcohol if we really want the second or third time to work.
    I’m not sure about caffeine though. Does it cause stalls as well?
    Yes, caffeine (and alcohol) can cause stalls. I’ll address those in the next post.

  8. wow..i think this is your best post yet. i made several “half-fast” attempts to get back on low carb and finally realized that somehow i had completely ignored the fact that low carb versions of junk food is still junk food. when i finally buckled down to only real food, the weight loss kicked back in. i did find that the low carb “flu” lasted almost 2 months instead of 2 weeks and that was difficult to deal with. to help myself get thru that, i gave up running and focused strictly on ballet barre workouts and weight lifting. that kept me stress free and my body toned quickly. and i never went back to running!
    My best post yet?!?! Have you read them all? 🙂

  9. It’s harder for me to do…the second, or, as in my case, third, forth..etc.. time around because it’s HARD on me to not see results….being that middle aged hormonal morbidly obese woman that I am. It’s hard to get excited when the weigh loss creeped along so slowly. No matter HOW I did it.
    I’m the one now using hcg, and now, thankfully, motivation isn’t a problem. I get ‘rewarded’ nearly almost daily in weight loss…and daily in how I feel on it. I’m not starving myself either. I have a significant amount of weight to lose and am MAJORLY motivated by the positive progress…and I feel that because I KNOW what the protein powered lifestyle is, I feel relaxed knowing what plan I’ll use once I get the weight removed. I can easily make PP an eventual ‘lifestyle’ because I know that it IS healthy…but it wasn’t quite addressing my main problem in a fashion that keep me in it for the long haul.
    So. In my opinion, seeing the loss happen on a continual bases IS the factor of keeping me in the game, any game. Especially because that is my orginial objective. I’m down nearly 50lbs (since end of Oct and through the temptations of the holidays) and I have another 200 to go to ‘ideal’ and NOW it doesn’t seem undaunting! It’s more a possibility.
    I’m glad you’ve got your game plan and it’s working for you. Congrats on the 50 lbs! Keep after it and don’t give up.

  10. Thanks doc, this post could not have come at a better time. I’ve jumped back on the wagon just last week, but for me it seems a little different.
    I’ve had great, quick success with low-carb since around 3 years ago, but the weight gradually piled back on. It’s not that I went back to the old foods at all though : no grains or sweets whatsoever. But it’s the low-carbish foods that got me. Nuts, fruit, yogurt, etc. You know, these foods that once a week are just fine but you sorta get into the habit of having them every day. When you’re insulin resistant as much as I must be, creeping your carbs up to 125-150 grams per day, even on semi low-carb food just doesn’t cut it. So I gained back almost exactly to where I’d started, maybe 5 pounds heavier.
    So this time around, I feel like it’s really difficult to get back into spirit because I never actually felt I was off the diet, I simply wasn’t committed enough to keep my total carbs low. Starting clean (Atkins induction-type) seems to be working so far though, so I’ll be patient and hopefully I’ll stay the course.
    Good luck to all!

  11. Great post, Dr. Eades!
    I did think of something: frequency and intensity of activity. I’m still very young, but I’ve watched many older people cut back the amount of physical activity that they do and the intensity with which they do it as they age. Most people in their 50s and 60s won’t be up for intense weight training sessions (but it is certainly possible) and tend to sort of laze around the gym. The older guys (and girls) that I do see in the gym *working out with intensity* are the ones that are still in great shape.
    Good idea. Typically, when people get going on a good-quality low-carb diet, they tend to spontaneously increase their exercise level to burn off the extra fat.

  12. I don’t know the science, but if you yo-yo (like I have) you probably generate new “setpoints” that have to be overcome. The first time you low carb, you don’t have many setpoints, or weights where you stayed constant for some time.
    When you start over you have more setpoints to overcome so you may think your “stalling” more often. Your body wants to hold on to those setpoints…now you have more of them to break through. Just a theory.
    Your just making the same case I was in the post. Your calling then setpoints, I called them your body acting as a computer remembering all the diets, starts and stops, etc.

  13. “And then they start doing a ‘half-fast’ (if you get my drift) ”
    Maybe it’s because it’s 4:45am in the morning here and I need to go to bed, but I don’t get what you mean by ‘half-fast’.
    Half assed.

      1. Hilarious! I got it! It totally applies to me for the past year. I’m about to get on it “whole-fast”!

  14. Thank you Mike! I really needed to read this blog today… it might as well have said “Gabe, this is for you…”
    Glad it helped.

  15. “…we become progressively more insulin and leptin resistant as we age.”
    And what seems to cause this is the accumulation of polyunsaturated fats in the body, which might increase if you eat the wrong low-carb foods (esp nuts, seeds, store mayonnaise, salad dresing, and high-PUFA oils like soy and canola). The more you eat poly oils, the faster you’re going to age and break down and become insulin resistant. Hard exercise, intermittent fasts, and other techniques can also slow down this degeneration. Most of this aging is preventable and reversible if you avoid the foods that most contribute to it like refined carbs, chemicals, low-carb junk food, and highly unsaturated vegetable oils.

    1. I know this is old, but…what are you talking about? I haven’t read these negatives about polyunsaturated fats or about the accumulation in the body?
      Really, I am very curious about this.

  16. I agree with everything you say but would like to add another reason the weight loss is difficult. I think for those of us who have struggled with weight issues our entire lives, the diet itself isn’t the problem. It is the struggle to not succumb to overeating, even the good quality carbs. Most people I know that have had this problem are eating for reasons other than to satisfy hunger. In fact a low carb diet leaves you full but it doesn’t address the reason you overeat. Any tricks of the trade other than lots and lots of therapy would be helpful.

  17. I honestly think the biggest problem that awaits many people on low carb diets especially second time around is false expectation . A lot of people, myself included, itch for instant gratification kind of results. Especially for younger generations. I think older people are by virtue of age, more patient and wise. Whereas older folks do it mostly for health related resons, younger species still worry about cosmetic results. Scale all of a sudden becomes a measure of success or failure. How many people are obsessed with numbers? God forbid the number goes up by pound, all Hell will loose! Never mind if that one pound was created by newly discovered muscle gain from exercising. We young folks want everything now and fast! Its not only millenia kids that feel entitled, us in their 30s feel that way too. We want to be rewarded for a bit of discipline yesterday for doing song today! Never mind years of abuse!

  18. Great, thoughtful post, Dr. Eades!
    My only comment would be the use of the word “diet”. You use it correctly IMHO, but the general public uses it as a description of a temporary eating pattern. I switched to very low carb/zero carb as a “way of life” i.e. I’ll never go back unless you and/or other knowledgeable people give me evidence to eat otherwise.
    I’m looking forward to your next post.

  19. Hi Dr. Eades
    You mention hormones for women, but what about for men? I’ve been successful with weight loss on low carb, but have hit a wall with energy (I just turned 50 years old). I had my blood tests done and everything looked good according to my doctor but he did say my testosterone levels are in the low end of the “normal” level, but not low enough to prescribe replacement treatment. he suggested DHEA supplements. Any thoughts for men? Thank you.
    DHEA is sort of the precursor of all the sex hormones. If you increase your intake of DHEA, you can usually increase the amounts of the other sex hormones, testosterone in your case since you’re a male. But in order to have all these conversions work properly, you need to keep your insulin levels low. If you take DHEA and follow a diet that increases your insulin levels, you will convert some hormone into estrogen, which is not really what you need or want. Your best bet is to avail yourself of the services of a doc who understands the male andropause and knows how to replace hormones. You need to get tested, then replaced if levels are low.

  20. I think the lack of strength training is a huge part of the problem when low carb dieting on the second go around especially as we age. The two together – strength training and low carb dieting – is a marriage made in heaven.
    True. It certainly helps a tremendous amount.

  21. I’ve definitely seen this in myself; it’s much harder to get the motor running again at 39 than it was when I first low-carbed at 33 or so. In the moderate-to-high-carb periods in between, I became more insulin resistant and more susceptible to blood sugar spikes, so I have to be stricter about *always* keeping my carbs low now. Fortunately, I still get the other benefits of low-carb immediately–no heartburn, fewer cravings, stable mood–so I know I’m on the right track and can use that to keep myself on plan until the weight loss kicks in again.
    There’s also a good explanation here about why low-carbing for a week and then rewarding yourself with a high-carb weekend will leave most people treading water weight-loss-wise. It’s too bad you can’t low-carb 5/7 of the time and get 5/7 of the weight loss, but it just doesn’t work that way.

  22. [Hangs head in shame]
    You just described me exactly. My low carb experience was so incredible. I told people all the time: I Have Never Felt Better! But eventually I discovered LC ice cream, crept up, got pregnant & gave up LC completely, ended up back where I started and still creeping up 2 years later because I have not been able to convince myself to keep going longer than a week or two (because there’s always something!) and nothing happens in that amount of time at all, except a few relatively instant pounds of puffiness. It makes absolutely no sense, really, because I feel crappy and constantly craving when I’m “off” but the craving wins. I have wondered if the addiction model would be helpful to me (even though I don’t really buy it) – treat carbs like an alcoholic treats drinks??
    Some people do treat it as an addiction. You know what you have to do. Just get back in the saddle and keep on riding.

  23. Dr. Eades – I agree with the list of things we can control and I’m ashamed to admit I am guilty of a lot of them. I recently restared low carbing after a few months on weight watchers with no significant loss but a definite change in the way I feel and my energy level. I know that Low cardbing whether for weighloss reasons or just health maintenance is definetely the way to go and as you stated it takes a number of weeks of earnest low carbing to get to that level when your body is losing weight consistently and eveything clicks right. Thank you for this article it made me realize my biggest challenge is weekends when I let my guard down easily and that is why on Monday mornings I see a spike in the scale(mostly due to water gain but very discouraging!)

  24. I read today on Dr. Dachs newsletter that Oprah has started bio-identical hormones and is thrilled with the results (after 3 days?!!). She plans to do a story about them in her magazine. Lets hope she gets it right, unlike her foray into low carb with the Hellers, and gives this kind of therapy a good boost. Then maybe, it will be easier to access it.
    We’ll all keep our fingers crossed, although the notion that she has seen results after only three days is a little suspect to me.

  25. This is a great post, and I look forward to your tips.
    I am 55 and menopausal, and yes, low carbing is definitely more difficult at this stage. But I stick to it because I feel so much better, even if I’m losing EXTREMELY slowly.

  26. Greetings,
    A possible explanation for becoming insulin resistance as the progress of aging continues is associated with not continuing to add some weight training. Most of the studies never address this issue when investigating insulin resistance in respect to aging. Evidence suggest that weight training with explosive power movements increases insulin sensitivity because of increased number and activity of glucose transporters in regards to both muscle and adipose tissue. Skeletal muscle is the major site of glucose uptake, which has been illustrated by oral glucose tolerance tests. Insulin resistance is more likely a result of inactivity rather than age. Even evolutionary theory explains that there is a direct association between the duration of contractile activity and mitochondrial density of the contracting skeletal muscle in relation to insulin sensitivity.
    I would not argue with anything you wrote.

  27. Thanks for the post, Dr. Mike. You described me to a “T”! I didn’t even realize what I had been doing. I’m the one that is “perfect” for about 10 days but then succumb to chocolate or ice cream. I dust myself off and resume low-carbing for another 10 days and the cycle repeats. I haven’t lost any real weight in months because of this. I really needed that kick in the pants. I just need to stick with the diet for few weeks before I can start seeing results again. Thanks for putting things in perspective for me.
    I’m glad you found the post helpful.

  28. Thank you for addressing this. A few questions that come to mind immediately:
    1. Concerning the body remembering: I’ve often thought to myself that the reason I can’t lose weight this time is that my body is “onto me” and knows what I’m up to get it to use fat and it’s not going to. I’m worried that I may have to do something more extreme this time (0 carb, fat fast?) but if I do, will my body adjust to that too, so that if I subsequently go back to a reasonable amount of carbs (50 g or less is very doable for me) will that then be too many? I have fears that I may have to eat an increasingly limited diet to lose or maintain.
    2. You’ve said in the past that many need to also create a caloric deficit in addition to restricting carbs. That also seems to need to be lower with each attempt (this is the third for me), and it’s hard to deal with hunger. I eat between 1500-2000 calories daily. If I go below 1500 the hunger increases. Is it recommended to ignore the hunger as best one can, as one has to do on a low-fat diet for as long as one can hold out, and go hungry until the next planned meal, or should one appease the hunger with low-carb choices? I don’t think I could ever manage intermittent fasting.
    3. Is it possible for older women to achieve weight loss without hormone replacement? The thought of trying even bio-identical hormones makes me nervous. I’m looking forward to an in-depth post on the hormone issue one day.
    The first time on low-carb I lost 40 lbs from my highest ever weight (202), then stalled for a year. At that time I had no education about low-carb nutrition other than having read Dr. Atkins mass market paperback, so I got worried about eating low-carb long term, and went back to the “healthy” whole grain carbs (but vowed to never again eat low-fat), gained 30 lbs, lost the 30, but it took much longer the second time. Last winter I had a 10 lb gain that over the year has crept up to 15, despite eating a pretty clean low-carb diet. So I’m still overweight and could stand to lose quite a bit still to be at a healthy weight for my 5’4″ height. I so wish I had learned what I now know a lot earlier on. I’ve seen other physical improvements (acid reflux gone, depression gone, higher energy, better sleep, good skin, good blood work, ability to turn my nose up at sweets, etc.), so I don’t intend to abandon low-carb again, but I’m still overweight and starting to feel very sorry for myself that I always will be. Looking forward to part II and your suggestions.

  29. Two additional challenges…
    One difficulty I had was overestimating the carbs I could handle at the maintenance phase the first time. I was almost where I wanted to be — lost a few waist sizes — then started adding in the odd raisin to my nut mix, bean to my chili, etc., which all grew a tad larger in portion, and so forth. Before you know it, my new smaller jeans were getting pretty tight. So I heeded that shot-across-the-bow and got back on the meat wagon. Everything’s cool now. I’ve redefined ‘maintenance’ to suit my requirements a little more responsibly.
    Another challenge I’ve always had is that my family is not low-carb savvy (or even sympathetic). I simply cannot convince ‘the shopper’ (you know, the skinny one that eats carbs to excess and never gains an ounce)that I should be putting smaller amounts of heavy cream in my coffee, instead of tons of 2% milk to achieve the same effect. So I occasionally do my own low-carb shopping, and cooking. It would all be SO MUCH easier, if everyone in the house was on the same page. But that ain’t gonna happen.

  30. I’d certainly like to pinpoint my higher resistance to weight loss. Easy in my early 20s, already difficult in my late 30s.
    I keep a strict carb ceiling (<10/day), but I’ve had to reduce calories below equilibrium to budge the scale. The upside, unlike low-fat efforts, is my body’s sane response to calorie changes.
    How can one narrow the possibilities, diagnostically? I read on Wikipedia that insulin resistance tests are not used clinically. How come? No way to make use of specific numbers?
    thanks.
    There really isn’t a lot you can do with insulin levels or insulin resistance tests other than to use them as a baseline. Then you can retest and demonstrate the patients have become less insulin resistant. But, usually these patients have lost weight, improved their blood pressure and stabilized their blood sugars, so it’s pretty obvious that insulin resistance is improved. So why go to the expense to recheck it?

  31. dr Eades most of what you said sounds like someone i know (me). I can never quite get in the groove to truley low carb. I feel better on low carb than any other diet. but i can not get over the cravings. I can eat a steak the size of a buick hup cap and 30 mins later be looking for something to snack on. Mostly after supper, night eating . not much of an water drinker lots of diet mt dew. need to lose 70 lbs. I just seem to never get full or at least kill the cravings. also 60 yrs old. been semi low carbing for yrs to help with acid reflux, blood pressure, but don’t ever lose wt any advice ? tks
    I’ll provide the advice in the next post.

  32. I have experienced the dynamic weight phase you mentioned both on the way up and years ago on the way down. I had forgotten all about that and never really gave it much thought until your post. I hope I can recreate that senerio for myself again.
    Thanks so much for this post.

  33. Do you make any distinction between low-carb sweet beverages (diet soda, tea w/stevia/Splenda, Crystal Light) or treats (s/f Jello, berries, real whipped cream) and the “junk” you refer to in the post (low-carb brownies, bagels, chips). I ask for clarification because much has been made about simply the “taste” of sweet derailing some folks, versus the actual content of some allegedly low carb foods that contain questionable ingredients (other than AS). For a good many people (my mother included) who have finally been won over to LC, the suggestion that they should give up “sweet” items as well, such as the s/f gelatin and diet soda, would send them back to the other side. Is it the sweet taste that is the problem, or the hidden carbs, net carbs, portion sizes, or calories, etc. that cause a stall?
    Yes, I do make a distinction. Diet beverages and other artificially sweetened real foods (berries with Splenda or stevia, for example) are not typically problematic. They do somewhat keep the sweet receptors a little blunted, but the dosage (other than with diet drinks) can be decreased as the sweet receptors regain their sensitivity. The problem comes with the brownies, cookies, waffles, pancakes, bagels, etc. that are all allegedly low-carb. While the carb content may be lower than the full-carb items, it is still a little higher than you would like. Plus these junk foods are usually really calorically dense. Having a low-carb waffle once in a while is no big deal, but I’ve seen many people recreate their previous high-carb diet with a low-carb version, which is a recipe for a screeching halt to weight loss. And maybe even weight gain.

  34. It’s great to see you putting up posts already from your call for input. Very helpful to see all of these elements summarized in one place. I was half-fast the first time (10 years ago) because I didn’t really read up on it and understand the mechanisms. I didn’t own it. So the second time (three years ago) was much better after absorbing PPLP, then later GCBC, Track Your Plaque, etc. and adopting a global (not just weight loss) outlook.
    I would add sleep to the list of age-related difficulties for weight loss, or maintenance, at least for some. I read of others reporting better sleep on low carb, but I found that sleep was actually less sound after going low carb, though snoring was eliminated with the weight loss. And I suspect the years going by don’t help sleep. Throw in some work stress or overtime, and it becomes something I can actually feel increasing my hunger and reducing my will power (especially for cheese and nuts snacking, and cheats of opportunity) when I drop below 7 hours or so. With the weight, BP, lipids, etc. now in order, I view it as my final frontier on the low carb lifestyle to sustain maintenance.
    I agree that sleep should have been on the list. Sometimes for some people being in mild ketosis interferes with sleep, especially falling asleep. For those people (including myself) I often recommend a little herbal tea WITH sugar or honey before bedtime. The teaspoon of sugar or honey adds about 5 grams of carbs, which isn’t a whole lot, but is usually enough to shut down ketone production for long enough to allow sleep. Although a teaspoon of sugar doesn’t seem like a lot, it is the same amount as all the sugar circulating in your blood, assuming your blood sugar is normal.

  35. Hey Dr,
    good post!! I have only recently started to low carb it, after a few years of heavy beer drinking through my early twenties. I put on 10 pounds in 3 years! My ideal weight would be around 150, and i weight 158 right now. The first time i low carbed it, i went two weeks with almost zero carbs and dropped 5 pounds!!! Then came christmas, and i gained 7 pounds back….then i low carbed it again and i couldn’t budge. Well…i stuck with it now and i am finally losing again! The thing i do that helps the most is eat only twice a day, like around 11 or 12, then not again till around 6pm. There both nice satisfying meals, and both have about 10g of carbs in them. Thats just my way of incorporating a long fast in every 24 hour day. I find its easiest to not eat for awhile when i wake up so i just cut out breakfast. I think intermentant fasting helps a ton, which ever way you want to do it. And like some other commenters have mentioned….try not to overeat…overcome your hunger, and keep going, the cravings will ease over time, just get over the first few weeks!!

  36. I have never observed any difficulty with losing weight after gaining it from a metabolic perspective. The carbs and/or calorie restriction required of losing weight remains consistent for me.
    It has, however, become harder in practice to lose weight the more times I gain it. This is mostly for psychological reasons – it is less thrilling to get to a weight you used to be, whereas it is very thrilling to reach a new low weight.
    I think the biggest reason people find it hard to lose the second time around is because it is no longer exciting or “mythic” to get to that weight… it’s more routine, more like real life, doldrums of working, etc. People tell themselves everything is going to be awesome when they reach x amount of pounds; once they get there and realize things haven’t changed much, it is psychologically difficult to justify the sacrifices required.
    People are very motivated to get to a new low weight.
    People are not very motivated to return to a weight they have already achieved recently.
    The thrill of meeting a new challenge, the delusional myths about thinness, these help sustain the sacrifice and efforts of first time dieting attempts.
    Also, I don’t believe leptin resistance plays a big role in obesity, even though most seem to think it does. If the obese were leptin resistant a low carb diet would not be as effective as it is. People who are unable to perceive leptin will not want to stop eating even on a low carb diet… whereas obese people typically develop extremely low appetites when low carbing, which suggests leptin signaling is intact.
    I know for a fact that low carb does not suppress appetite significantly when leptin signaling is disturbed because I am leptin deficient as a result of massive weight loss. My appetite has progressively increased the thinner I became, and this is reversed rapidly with supplementing the hormone I no longer properly make. This suggests my leptin signaling is intact, but my hormone is deficient.
    As for obese people newly dieting on low carb, all signs point to leptin excess with intact leptin signaling (extreme appetite suppression and nausea when eating are typical side effects for newly low-carb inducted obese people, this would NOT occur if they did not respond to leptin normally).
    Rather, it is more correct to say there is something about acute hyperinsulinemia that prevents leptin from expressing anoretic effects in the CNS. This is very temporary, as temporary as hyperinsulinemia… probably related to hypertriglyceridemia which blocks leptin expression in the brain (but not the body, and the obese suffer many side effects of chronic hyperleptinemia like ventricular hypertrophy and cancers).
    Could be, but most of the studies seem to show and actual increase the leptin resistance with age.

  37. At 67 (way post menopause) and with Hashimoto’s, I’ve been losing weight for the past 5 years, but very, very slowly. I also have severe osteoarthritis, so I don’t “move” as often as the average person. Thus, I cannot lose if I eat more than 1000 cal. a day (my endo agrees that seems to be right for me), but I find that almost impossible to sustain, thus the periodic overeating that you describe that sabotaged my efforts.
    In addition, my body wants to increase my weight, and I always feel that I’m fighting it.
    A month ago, I discovered the “alternate day diet” which is compatible with any plan (I prefer ProteinPower), and I’ve been doing that. With one day at 400 cal, and the next at 1500, I average out OK and don’t feel deprived. I’ve been losing at about a pound a week (but this is only 4 weeks; I may stall yet!). I use low carb shakes to make sure I get enough protein in those 400 calories. What’s amazing to me is that I don’t feel deprived; I actually feel in control of my food intake for perhaps the first time in my life. I hope this isn’t just the “honeymoon” phase and actually represents a solution for people like me.
    I’m glad it’s working for you. I don’t know if you know or not, but I’ve posted on alternate day dieting a number of times.

  38. I am on my second go round after falling off the wagon for 4 months, and have noticed two things of interest. one, the ketosticks are not turning any shade of red this time but I am still losing weight, am I still in ketosis? Second, no induction flu happened this time.
    You’re probably still in ketosis, but your body has quickly re adapted from your last low-carb experience. I low carb almost all the time, and I’m virtually never in ketosis. But I’ve been doing it for so long that I have so to speak greased the metabolic skids to the point that I burn the ketones as they are produced and don’t seem to accumulate them in my blood where they spill into my urine.

  39. Thanks for this post, I think it came at the right time as I try my hardest to get back on and permanently stay on the low carb wagon (I’m 3 weeks in). My previous attempts were filled with low carb desserts and artificial sweeteners, which I believe didn’t cure me of my addiction and cravings for sweet things, and this time around I’m determined not to eat anything that tastes sweet to me lest it trigger me to gradually go back to sugar.
    I’ve also not weighed myself because I find I get discouraged if I’m not seeing constant results on the scale, so I’m not really certain about any sort of progress I might have made in these 3 weeks compared to the first time I tried, but a question that remained after reading your survival mechanisms section is, how long, on average, do you find it takes for the body to forget? Weeks, months, years? I know people are so different that averages might mean nothing, but I’d be interested in your thoughts if there are ways to help the body forget the past (I’m 27 and first tried low carb at 20, though have not for the past 3 years).
    Most people need to get past whatever time they’ve usually tried. In other words, if you’ve given it a couple of weeks several times, you’re going to have to get past the couple of weeks mark before good weight loss kicks in. Given your age, you should respond fairly quickly, I would think.

  40. My motivation the second time around was not weight loss, but heart health. An older sibling suffered a major heart attack and I became very motivated to break the family tradition of heart disease. I started using a food diary to track exactly what I ate – what an eye opener! I also increased the intensity of my strength training workouts, moving to the slow-burn techniques, except during squats. I also focused not on weight loss, but fat loss. I also made changes gradually.
    As a result, I lost 55 pounds and went from a 44 to 33 inch waist. My HDL climbed from 32 to 42 initially. When I replaced polyunsaturated fats with saturated fats, my HDL climbed to 52, unheard of in my family. I was able to discontinue statins as a result.
    If I do go out to dinner and have dessert, I simply reduce my carbs the next day to compensate. I also learned that it’s OK to leave the dessert plate untouched after several bites.
    Finally, I’m one of those old guys (51) in the gym who lifts the hardest, while the young guys are sitting around resting between sets. Coupling slow burn with circuit training is a great way to achieve maximum results with a minimum of time. Having 3 dogs who love to go walkie-walkie also helps.
    Sounds like you’ve done great. Congratulations! It’s hard to make people realize how much HDL improves by switching from polyunsaturated to saturated fat. Thanks for relating your story.

  41. I find that if I fall off the wagon it takes a week or two for the carb cravings to leave me. During that time, if I am eating to satisfy hunger, the issue becomes calories. And during this time, eating 1500 calories or less becomes very difficult. If my hunger is rearing its ugly head, 4oz. of any protein isn’t going to cut it. If I eat an average restaurant sized ny strip steak and salad with blue cheese dressing, it is probably close to 2000 calories. Once I am in the groove though, I may find I have to force myself to finish a small burger.
    Even if you stay very low carb, if you are constantly in this resist craving phase of the diet because you blow it once a month, you can be consuming way more calories than you should. Is it possible this is the case for many people struggling with the diet?
    One issue I have found confusing lately – if you look to the paleo side of low carb you often hear lean, lean, lean – I guess due to the presumption that originally protein sources were just that… lean. On this post I hear a lot of fat, fat, fat. When you did your photo food diary Dr. Mike, I noticed there was no cheese, whipped cream, butter or gloppy dressings of any kind. Was this an effort to stay away from dairy or extra fat? I’m asking because the fat issue can have a huge impact on calories and for women especially that may be a concern.
    I think the Paleo folks have it wrong about the lean, lean lean. While it’s true that the meat of game animals (as we know them today) is leaner than lot-fed beef, Paleolithic man didn’t just eat the meat. He ate the brains, organs, marrow, and all the fat. In fact, the fatty cuts of meat and organs were the most desired. I think all the emphasis on the leanness of the Paleo diet by today’s writers on the subject come about as a result of their trying to make the Paleo diet fit in with today’s idea of what heart-healthy dieting is instead of reporting the Paleo diet as it really was. There are numerous charts in the literature showing that carcass fat is a function of animal size, meaning that the larger the animal, the more fat said animal contains. An elephant’s carcass has a much larger percentage of fat than does a rabbit’s. And one assumes the same would hold true for a mastodon, all of which were hunted to extinction by early man. In fact, most of the really large animals were hunted to extinction in prehistoric times. The animals left, which the Paleo guys use to show how lean they are, would have probably been ignored as a food source in prehistoric times because they weren’t fat enough, which is why they are still around today.
    As to why I didn’t eat a lot of extra fat on my diet diary week…I eat the fat that naturally occurs on the foods I eat, which is plenty. Although I do eat it, I’m not a big fan of cheese, and since I don’t really know what kinds of fats are in various dressings, I usually avoid them. The one rule I really try to stick to is to not eat bad fats. And if I don’t know, I avoid it.

  42. I’m wondering if there’s anything that one should have checked out if you don’t lose weight even given following the plan. I realize that no one really believes you that much when you say, “I eat xx number of calories and xx number of carbs”, because people both underreport and lie and self-delude, but I eat about 1500-2000 calories/day, about 30-40 carbs or less, and I’m reasonably active. In a year of low carb, I have lost about 20 lbs. (of the perhaps 120 that I should lose), and 10 lbs of that bounces back and forth. I don’t cheat, mainly because this way of eating is so easy for me, and partly because I’m incredibly motivated because my husband’s health issues are far worse than mine so I have to be the good example. I have had my thyroid checked, and I am not yet menopausal. I haven’t really pursued this much with my doctor because I simply don’t know what to say, but I’m getting more than a little frustrated.
    Unfortunately there are no easy answers. When we see patients who we believe are really hewing the line and following the diet to the letter and are not losing as they should be, we start looking deeper. There are numerous reasons this can happen, but it takes a doctor skilled in the whys and wherefores to search them out. It could be a pituitary adenoma (a benign tumor in the pituitary gland), it could be an iodine deficiency, it could be anti-thyriod antibodies, severe leptin resistance, etc. And that list just scratches the surface.
    Since you have 100+ pounds to lose, I would suggest maybe decreasing your caloric intake to below the 1500 kcal, maybe by substituting a couple of protein shakes for regular meals. Once you get into the dynamic phase, the weight loss picks up pretty well and you can probably go back to what you are doing now and continue to lose as long as you keep the carbs below 30-40 gms.

  43. Having recently been diagnosed with aggressive ER+ & PR+ breast cancer with mets to the hip and femur, I am belatedly restarting my low carb diet after 3 or so years of regaining all the weight lost and losing the health gained on my first attempt. There is somewhat less resistance to the diet in my family now, of course, as we’re all scared… so the social resistance is lifted somewhat, which is good. And clearly there is plenty of incentive to stick to the diet now (sadly, but clearly).
    Clearly, it would be better for me to get as much of the considerable extra weight off my femur as possible. I was also hoping to starve the cancer cells of glucose a bit, as part of my treatment. Unfortunately, the stress and extra age is causing my glucose levels to stay relatively high, so I’m not losing much at the moment (even though my diet is definitely healthier, and that in itself is a plus), and clearly the cancer cells are still getting plenty of fuel to do their thing.
    But the HUGE problem is that next week I am going to be going into immediate menopause (hysterectomy/oophorectomy), and will thereafter be thwarting what few hormones I have left with some form of hormone antagonist or other. And then will be having a bilateral mastectomy two months later. Lots of emotional and physical stress, and lack of hormones on top of it…
    Clearly, I can’t add bioidentical hormones back into the mix. And being a hormonal mess as I am, I expect that I am going to be absolutely miserable for quite a while. Is there any way that I can minimize the effect on my glucose levels and get some weight off without compromising the hormone treatment for my cancer?
    Only by going on an extremely carb-restricted ketogenic diet, much like the one I posted about earlier. But you should check all this out with your own doctor.
    Another option you may wish to explore is insulin potentiation therapy. I don’t know if any physicians in your area do it, but if I were in your shoes, I would definitely give it a look.
    Keep me posted.

  44. “Do you choose to simply KNOW the path, or do you choose to WALK it?”
    I read that somewhere, and now have it pasted to my computer monitor so I can be reminded of it every day.
    It’s so easy to fool oneself into thinking you’re following the right path, when in fact you’re wasting all this energy meandering instead of just walking straight.
    Nice quote. A big difference between knowing the way and following it.

  45. Overeating
    Overeating one particular food is easy to overcome. Maybe 15 years ago, I had an addiction to Suzie-Qs and lemon-filled donuts. Both were strategically placed in my grocery store right at the front. No way to avoid them. Nor did I.
    Then I read a book, “Overcoming Overeating.” It said to identify one and only one trigger food (at a time). Buy more than you can possibly eat in the time period before you can get more. Then give yourself permission to eat as much as you want — for breakfast, lunch, and dinner, if you like. When the supply gets low, go out and buy that much more again.
    It kind of tricks the mind. If there’s always plenty of it, you won’t get that feeling that, “I’ll just finish what’s here, and then I won’t have any more.” How often do we all say that? “I’ll start LC again right after this gallon of ice cream is gone.”
    I know it sounds strange, but if you really do it, and give yourself permission, you’ll find that you no longer crave the food.
    I haven’t had a Suzie-Q since that time (15 years?). Then I tried in with Dorito’s. Same thing. Haven’t had Dorito’s for 15 years. And same for lemon-filled donuts. I simply have no yearning for these foods any more.
    Just a thought.
    Also wanted to agree with everyone about carb creep. It’s insidious. And how we rationalize every little bump of carbs is insidious, too. Like last night. I had a perfect LC day. Then dinner. We had steaks (he, a lovely Porterhouse; and me, a mouth-watering rib-eye topped with Irish butter). I would have been happy with that. Then he wanted mashed potatoes. I buy the prepared stuff from the grocery store. No, they don’t taste that great, but hubby likes them, and I figure the lousy taste is enough to keep me away from them.
    Hmmmm. They don’t taste good and I didn’t even want them. But … sure enough … I plopped some on my plate. Wasn’t even 1/4 cup, but still. They didn’t taste good and I didn’t want them. But I ate them. What’s up with that?

  46. Sorry. Just one more quick comment.
    I wanted to report in that I finally found a gyno I’m comfortable with! Right here in my little backwoods town in Maine!
    He thinks LC is the way to go, and he’s working with me on the bio-identical HRT. I’m switching over to the compounding method, and he wants me to call in to the office every 4 weeks to tweak the hormones so I feel the best I can. He’s encouraging me to experiment and even said that HE’s not going to be deciding what dosage is best for me, I’M going to be deciding what dosage is best for me.
    He wants to be an active partner in my health care. How great is that!
    Hey, let us know his name if you don’t mind. I have a medical school classmate who went into OB-Gyn then moved to Portland or the Portland area. Wonder if it is he.

  47. Great post. I wonder if it is possible that most have a more difficult time with low-carbing as they get older because they expect everything to get harder as they age. I don’t buy it. I am 55 and don’t weigh myself, but guage my success by how my clothes fit. I had been following the calories in calories out nonsense to return to my ideal weight. After some brain surgery (for crying out loud) almost 11 years ago, I tried everything to get back to 110 (I am under 5’4″, small frame) and low carb with intermittent fasting and intermittent fat fasting is what has put me back into my size 4s. I was up into the 140s for awhile there – scary for such a shortie. I have no idea how much I weigh right now, because numbers on the scale can make me psycho. But I am back into the size I was before my surgery. I am also stronger (more resistance training, sprints, and Pilates).
    The brainwashing about low fat is hard to get over! My favorite snack right now? Sugar free pudding (6 c per serving) made with heavy cream instead of milk. Talk about satisfying!
    Your blog (espec about intermittent fasting a year or so ago) and others like it have been very helpful. Gary Taubes “GCBC” too. Keep up the good work!

  48. Great post Dr. Eades!
    Just one more question, if I may.
    Can one eat too much protein at one meal? It seems like I need to eat more (most times twice as much) protein than the levels you recommend in PP to satisfy my hunger even if I increase my fat intake. it doesn’t effect my ability to lose weight and helps me avoid carbs. The only thing I have noticed from doing this is a strong scent to my urine. If I drop my protein levels, back comes the hunger. Thanks for an excellent post.
    The amounts of protein calculated in PP were the minimum, not the maximum. Go for it.

  49. “We all get older every day.”
    Can you cite the studies that prove this? I bet that they are all observational and not worth citing.
    I’m staying in denial.
    Good point. They are all observational. Let’s design a randomized control trial. If we do, I want to be in the study arm and not the control arm. 🙂

  50. Hi Doc, I know others are also asking for a comprehensive hormone replacement post, but until then, can you point us to another reference. I know from my thyroid experience that I need to know what kind of tests, which hormones to test, and what ideal levels are before I even get to the doctor or they’ll end up during some cursory tests and telling me my levels are in the normal range.
    If a post isn’t coming soon from you or Mrs. Eades, can you recommend a reference. Suzanne Summers is the only one I know who has written a lot about bioidentical hormones….but she is also doing some extreme stuff and I don’t know if I trust her.
    I wouldn’t trust Suzanne Somers myself. I’ll get something up for all to read in a day or so.

  51. Dr. Eades, I noticed in your on-line food diary (which was very helpful, thank you for doing it) that you actually eat a fairly balanced diet, with lots of vegetables in addition to protein, and that you don’t eat very much. I am someone who has tried a lot of different diets, and when I came back around to low-carb this last time at first I just pigged out – huge steaks, lots of butter, bacon, cheese, nuts, etc. I had convinced myself somehow that not eating starches or sugars (I was very good about that) meant I could anything else, in any amount, from the permitted food list. Obviously, that did not result in meaningful weight loss. After reading your food diary, I followed your example and started eating reasonable portions of good quality protein, along with vegetables at every meal, including breakfast. And wine, of course, but I kept a very tight limit on snacks. That plan really worked, and I am very much enjoying it. If I am representative at all of other repeat low-carbers, I think it is important to remind oneself that it is not a free-for-all. I know it’s probably not the way everybody wants to think about it, but at least in the first few weeks of returning to low-carb to me it is important to remember that it is a diet, a restricted, disciplined food plan, and requires control and balance to be effective. The fact that it is so enjoyable is a plus, of course, but it’s not a never-ending banquet. After buckling down, I have finally started losing weight (I’m a middle aged woman), eight pounds in a month, and I’m grateful for that. I am also exercising quite a bit at the gym, and I believe that is a result of the low-carb diet too. Thanks again for doing the food diary – it was a great learning experience for me.
    I’m glad you enjoyed the food diary. I guess I don’t eat very much, but I eat until I’m full. And I’m a fairly big guy (6’2″ 190 lbs) who is pretty active, and I maintain my weight nicely on the food regimen you saw.

  52. Definitely the “learning how to cheat” factor plays a large part. Looking back now I see now the many ways it undermined my efforts.
    Jimmy Moore spoke about having a mysterious weight gain of 30 pounds or so that he could not figure out because he was still on his diet. Finally he dropped all the sugar substitiutes and the weight went back down.
    But with many of us it is worse than that because those sugar substitutes cause more cravings and probably BG disregulation. One thing leads to another and you have completely gone down the slippery slope and off the diet altogether.
    Obviously those low carb comfort foods are not always the help they are meant to be.
    What I wonder is: is there any way that home blood sugar testing after meals can alert individuals to their unique response to specific low carb foods?
    It could, I suppose, but I probably wouldn’t try it just because of the pain in the a** factor. I especially wouldn’t do it after real-food meals. I might like to see what happens if I ate a big bunch of sugar alcohol laden foods, but that’s about it.

  53. Dave said:
    “Greetings,
    A possible explanation for becoming insulin resistance as the progress of aging continues is associated with not continuing to add some weight training. Most of the studies never address this issue when investigating insulin resistance in respect to aging. Evidence suggest that weight training with explosive power movements increases insulin sensitivity because of increased number and activity of glucose transporters in regards to both muscle and adipose tissue. Skeletal muscle is the major site of glucose uptake, which has been illustrated by oral glucose tolerance tests. Insulin resistance is more likely a result of inactivity rather than age. Even evolutionary theory explains that there is a direct association between the duration of contractile activity and mitochondrial density of the contracting skeletal muscle in relation to insulin sensitivity.”
    Fascinating stuff!!! Can you post the references for those, please, Dave?

  54. I wish I could market our funky genes for only $39.99, that would help in our family it’s the skinny fit ones who have the worst BG BP and lipids, the ones who are able to convert BG into body fat seem to do significantly better on cardiovascular risk factors (and longevity)
    I only ever started to gain weight when the fats were lowered on top of my previous high carb diet, possibly the suspect is Omega 3s: if they are short in a “normal” diet they will be in even shorter supply in a low fat diet.
    Whatever, the result of doing the opposite of what the dietician told me was to reverse all the things that were going wrong. I do NOT regard this as a diet, it’s a way of life.
    What keeps me at it is not only the improved numbers but the hugely improved symptoms. Whenever I weaken and have “just the one” which I am assured “won’t hurt me” well it damn well DOES! Sometimes literally if it spikes my BG high enough to reignite the peripheral neuropathy (tingle tingle) and even at lower levels too many carbs can completely wreck my energy levels for a few hours.
    “Doctor, it hurts when I do this!”
    “Well don’t do it then”
    When you overeat carbs, the fat is stored somewhere. In most people, that stored fat goes to all the obvious places. Some people, however, tend to store fat not in the obvious places, but in organs and other tissues where it isn’t visible as the fat we all know and love. These people have all the same problems as the obese, and, in fact, as you point out, often have them more severely. This condition is called the normal-weight, metabolically obese syndrome. Problem with it is that most of these folks go around crowing about how they can eat anything and everything and not gain weight. And they usually do eat anything and everything. And pay a severe price for it.

  55. Although I’ve been on a plateau for a couple of months, this (3rd) time around trying low-carb is the only one that’s truly worked.
    I believe the first 2 times I was TOO strict on myself and had the carbs too low (if <20 is perfect then I had to go for <10!) which was doomed to fail with the eventual falling off the wagon…. 1-2 months maximum.
    This time I have been low-carb since August 2008 and lost about 40 pounds to November and not a lot since (I don’t weigh anymore though, just judge by clothes). This time was different because the first time I tried a bagel, I swelled up and had a skin reaction and finally discovered I am wheat intolerant!!! I feel blessed for this!!!! Wheat has been my downfall for years and years. I now have the perfect reason to never eat it ever again… even small amounts have set my tongue and nose off, so it’s like my own internal warning device – it’s great.
    I’ve not been the slightest bit put-off by my ‘stall’ in weight-loss as I’m on this plan for good now as it makes me feel great and my skin looks the best in has in years.
    I’ve been referred to an endocrinologist early Feb, so that will hopefully rule out any metabolic/hormonal issues going on and I can continue to look for ways to tweak the diet to get the weight moving again.
    I’m keen to give IF a try next.

  56. I believe it is related to sugar addiction and the amount of lean body mass lost during the first go at the diet.
    In an effort to see quick results not only did I cut carbs, but also reduced calories which resulted in the majority of the weight loss being lean body mass and water. This resulted in a 24lb weight loss so I decided to move to the “2nd” phase of the diet by adding carbs. Bad move as the cravings took over and I was able to find those lost lbs plus 12 others. Fast forward 2nd attempt starting May, low carb, no wheat, no sugar & weight training, down 51 lbs, waist 42 to 36. It is actually easier this time bar the first 3 weeks.
    Keep up the good work. Anticipating you views of coffee and alcohol.
    Cheers,
    Rob

  57. I dunno if short excursions off plan qualify as “starting over” but I’ll blab on about it anyway…
    over 7 years of low carbing, I’ve developed going off plan into a fine art.
    I’ve gone face down into the carbs for 2, 3, even 4 weeks at a time. Here’s how it always goes:
    Love the taste of the various forbidden treats, but always feel like crap after eating them. That gradually goes away, tho in general, I never feel as good as I do on low carb.
    I always gain 5 or 6 pounds right away. On top of that, I’ll add more, depending on how long I stay off the reservation. For example, after 2 weeks off plan I’ll usually find myself 10 pounds chunkier.
    At the end, I usually cant wait to get back to low carb, primarily because I hate being heavier, and I generally feel crapier off plan. Not that I really feel bad, but its more a lack of how good I feel on low carb. When I’m off plan, I start to miss that feeling.
    When I get back on plan, I usually drop 5 or 6 pounds right away (I assume this is water weight). The rest might take a week, two, or three, or sometimes more, to come off. But it always does.
    Here’s how I get back on plan:
    Week one: eat all I want, low carb style. I can eat a lot, and I do.
    Week two forward: ease off the amounts of food, and ease back into intermittent fasting.
    I also try to get in at least one slow burny workout per week while off plan.
    I do wonder if this sort of thing is doing any damage that I should be worried about…
    Probably not, but it would be better if you would just go on the program and stick with it. I go off of it myself, but not for 2 to 4 to 6 weeks. More like 2 to 4 to 6 days. I pick up a little weight, but it’s much easier to drop than the amount I would have picked up had I gone off the reservation for 6 weeks.

  58. Hi Dr. Eades, these responses are as interesting and informative as your post!
    I so look forward to reading your tips, but your remark (above) about caffeine causing stalls is scaring me! I drink a ton of good coffee every day, just love it – with some Splenda and a little half and half (probably the amount of half and half I have in a day would come to no more than 8 grams or less carbs, I’m sure.)
    I always read that caffeine HELPS in fat burning. Is it the caffeine or what we add to our coffee?
    If I have to give up my caffeinated coffee, I’ll get really depressed. Literally. Coffee also lifts my mood.
    Please, can you just give us a teaser as to why caffeine is bad? I’m at the edge of my seat waiting for your next post!
    Thank you Dr. Eades for all the inherent good you’ve done over the years, educating us about lowcarbing. I will always be grateful. Sheryl
    I’ll give you a teaser in my next post, which should be up shortly. Coffee is really good for you, but maybe not so good when you’re getting back going on low-carb again.

  59. I know I’ll probably catch some heck for this but I think it’s more a mental thing than a physical one. If you follow the plan and stay away from the low-carb frankefoods and hidden carbs and eat whole foods, low-carb works each and every time. At least that’s been my experience.

  60. Dr. Mike, I just read your response to Katy (January 16, 2009), and now I am totally confused.
    Do you mean all the good low carb recipes in your cookbooks (for cakes, breads, pastas, etc.) should now NOT be used?
    Please advise.
    What I’m trying to say is that you should buy the book, but not eat the foods. 🙂
    No, what I mean is that these things are all okay for occasional indulgences. You just don’t want to eat them all the time. Don’t try to use all the stuff in our Low-Carb Comfort Food Cookbook to try to make your low-carb diet into a low-carb version of a high-carb diet. These recipes are for use from time to time, not all the time. They are calorically dense and do contain some carbs. We use these recipes ourselves when we want a treat. It’s better to eat something from one of our recipes than the real high-carb version, but you don’t want to eat them all the time.

  61. Two reasons for resisting trying low-carb again:
    1. The weight-loss is too quick and will stress out my liver. I know my liver has had problems (for decades–but just recently recognized the symptoms of fatty-liver disease–milk thistle has improved things greatly), and I understand if I lose weight quickly, that puts stress on the liver. Started taking a good fish oil. That resulted in a 1 pound per month weight loss for about six months which was good enough for me, but that seems to have stalled for three months. I’m hoping it’s just more muscle from doing the slow-burn routine. More likely, it’s the holidays.
    2. I’m a lone man in the wilderness. Making dinner for six others and then another one for myself. Can’t eat anything at church dinners. Can’t eat the cookies given by the little girl who made them herself to say thank you for driving her to school every day this year. Can’t participate in the annual Christmas Season Cookie events (meeting every Friday until we have a good variety to put on a plate to pass around to the neighborhood). Can’t eat the home-made bread the lady down the street brings over. Could go on forever. My teenage daughter has found success eating treats only on Mondays (so to the friend who gives her brownies, she says–“oo, I’ll save this for Monday!” When I tried this, every week my reaction to treats became worse and worse, until I realized I’ve either got to have some of the poison every day, or give it up completely. I’m sure some people would say for the sake of your health isn’t it obvious you should give it up completely? But I stand at that door thinking it’s too hard to go in.
    #2 you’re going to have to deal with yourself. But #1 isn’t a problem. Weight loss on a low-carb diet will not “stress out” your liver. In fact, it will do just the opposite. The studies in which fatty liver and diet have been examined show that nothing moves fat out of the liver faster than a low-carb diet.
    So, if you’re going to bail because you can’t withstand the constant barrage of carbs, that’s fine. Just don’t blame it on the low-carb diet’s supposed affect on your liver.

  62. Re: lean vs. fat meats and good vs. bad fats, I’m wondering if a person can’t afford grass-fed sources, would it be better to buy lean cuts and supplement with good fats rather than consume the omega-6 fat in fattier cuts.
    I’m not so sure that the omega-6 in the fattier cuts of meats is that big a deal. And if you want to get lean cuts and butter them up, I don’t see a problem with that.

  63. Dr. Mike, you asked for the name of my gyno. Should I post it here, for the world to see? Or maybe I should send it via a “Contact Us” email.
    Although the gyno I’m seeing is LC-friendly, I suspect he’s not living “la vida low carb” because he’s rather pudgy. On ther other hand, I firmly maintain that I am living a LC lifestyle, and yet I’m overweight. So, who knows? Might be the same guy.
    My classmate’s first name is Steve. Is this your doc’s first name? If it is, he certainly wasn’t pudgy in med school – just the opposite, in fact.

  64. Rick Stewart: “I can eat a steak the size of a buick hup cap and 30 mins later be looking for something to snack on. Mostly after supper, night eating . not much of an water drinker lots of diet mt dew.”
    Stop drinking diet soft drink or eating anything with artificial sweeteners, sugar alcohols, and stevia. No sweet tasting foods whatsoever. They cause hunger and cravings and addiction. Go with natural sugars like fruits or eliminate all sweets totally. You are sabotaging yourself with man-made chemicals, all they will do is make you hungrier and fatter. Eat real foods and then adjust your diet from there to see what works. But giving up the diet soft drinks and low-carb junk foods will probably get rid of those cravings after meals.

  65. Dear Doctor Eades,
    An excellent post at a very appropriate time for me. I am on a – 3 week LC / 1 to 2 weeks of mindless eating / 3 week of LC again – pattern for one year. Even though my HbA1c has come down from 8.5 to 6.5 (my lab considers <6 as non diabetic) I am not at all happy with the backsliding which seems to happen without my control. I am eagerly waiting for your tips in part 2.
    I got fed up with this backsliding and decided to start 70 grams of ECC/day (all whole foods only) starting today. With this, I hope my adherence to diet is better. I am just 5-10 lbs overweight but am diabetic with 1000 mg/day of Metformin. Do you think that I will be able to taper down my Metformin dose to zero and maintain HbA1c < 6 with 70gms of ECC/day+exercise+calorie reduction even though it may take a little longer time? Or should I be in < 40gms of ECC till things become normal as advised in PPLP?
    Regards,
    Ram
    I would cut the carbs a little more, more in line with the 40 gm ECC.

  66. “Jimmy Moore spoke about having a mysterious weight gain of 30 pounds or so that he could not figure out because he was still on his diet. Finally he dropped all the sugar substitiutes and the weight went back down.”
    So, Dr. Mike, this is where your encouragement for your readers to think critically has come to fruition, along with “CORRELATION IS NOT CAUSATION.” Yep, Jimmy did go on a “sweet-free challenge,” where he cut out anything with a sweet taste, including diet soda and fruit, and his weight started dropping. But, there were many other variables too. By cutting out “sweet,” he also cut out by default low carb chocolate bars; brownies; cheesecake made with erythritol, heavy cream and whipped cream cheese; low carb ice cream with low carb “Magic Shell” (made with coconut oil); and hot cocoa (which also had sugar and hydrogenated fat in it, to which he also added 10 tablespoons of heavy cream or coconut oil). He also cut his meals down to two per day, restricted his calories to around 2000-2400, and had started on Metformin. Jimmy and many of his readers attribute his newly-achieved weight loss success to the absence of sweet, but I don’t see how they can know that for certain, given all of the other factors involved.
    I don’t know if it’s the absence of sweet or not, but I do know that all these sweets aren’t just pure sugar. They are extremely calorically dense, which means they contain a whole lot of calories. I think it is the combination. People who eat all the faux low-carb foods aren’t really on a low-carb diet, in my opinion. They are following a faux low-carb diet, and faux low-carb diets don’t work as well as the real thing.

  67. Wow, I was so surprised to read that paragraph about your body learning about what diet you are on and doing its best to fight weight loss. This is what I’ve always thought about my own body and my weight loss attempts, but I thought I was kidding myself. I didn’t realize others had the same experience.
    I almost always eat LC these days, but do not lose. When I start a “diet” and drop my calorie intake I will usually lose about 4 to 4 and 1/2 pounds and then my body digs in its heels and refuses to give up any more weight. I get on the scale day after day and I weigh exactly the same thing, without variation. It really is as though my body has drawn a line in the sand and refuses to lose even one more ounce. Eventually I lose patience and willpower and give up on the diet.
    I’m once more trying to lose and this time I’m doing a 20/4 IF pattern of eating. I’m interested in seeing if this will ‘fool’ my body for long enough to take off some of the extra pounds (I have a lot to lose). Of course, I’m also determined that this time I will outwit my body somehow. This all makes me feel slightly schizophrenic, at war with my own body. Weird.

  68. I have a colleague at work who has been on a low carb diet (<40 gm of carbs/day) since 2003 who went on a trip to Asia recently for a two week vacation. He admitted to eating more fruits and desserts while over there than he usually does over here (lots of buffets and Chinese food). On his last day over there, he had his lipid profile tested there and was surprised to see that his Total cholesterol was 420 mg%, HDL = 56.0mg%, LDL = 319.0mg% and triglycerides = 223.0mg%. His hemoglobin A1C was 5.7% and fasting blood sugar was 78.0mg%. A year ago he claims that his total cholesterol was down to 150 with an LDL of 180 and HDL of 52. His triglycerides were around 170. His family physician wanted to immediately start him on statins but thus far he has held off doing so.
    My question is how quickly the lipid profile can change when a person changes his diet, and can the results of my colleague change that fast from falling off the low-carb wagon for two weeks?
    I know that lipid values can normalize very quickly (about 10 days is the fastest I’ve seen) on a low-carb diet, but I don’t know how quickly they can go the other way. I don’t know if these labs were fasting or not, but my guess would be that they are in error. I would simply have him recheck his lipids while fasting using the lab you normally use. I suspect they will pretty much be where they should be.

  69. Dr. Mike, my new gyno’s first name is Greg.
    But, what the heck! Here I’ve been whining about not being able to find a good gyno in Maine who is willing to work with me with bio-identical HRT and is LC-friendly and is NOT a flake, and you knew one all along.
    Geezum crow, doc! 🙂
    I didn’t say he was LC friendly or not a flake – I haven’t seen him in years. And I don’t know anything about him or his practice right now, so I didn’t want to send you on a wild goose chase. I’m glad you’ve found someone to help you.

  70. Good post, Dr Eades!
    With your wast experience, and regarding your take on hormones and such, what do you know about difficulty in losing weight because of suffering from ADHD? I heard somewhere that people with ADHD are many more times as likely to suffer from obesity. I would assume that part of that can come from inability to control ones impulses. Personally, I don’t have that problem, but I wonder if I try to “self-medicate” with anything that will feed my brain glucose. I have also heard that a lot of people experience weightloss as soon as they start medicate with stimulant medication. But I guess that’s the whole diet-pill thing, anyway.
    /Theresa
    I don’t know about ADHD and weight gain. I’ve never read anything about it one way or another. My sense is that those with ADHD would have a little more difficulty gaining weight than others and not the other way round.

  71. Hi Dr Eades:
    I was wondering about the polyunsaturated fat content of nuts. Is this at all a concern? I eat plenty of saturated fat, and no added poly fat, but of course nuts contain a high level of polyunsaturates. I have always assumed that the amount of polyunsaturated fat in nuts is still small compared to what is contained in oil and margarines. Thanks for the post.
    Olga
    I wouldn’t worry so much about the polyunsaturates in nuts. The nuts usually contain their own antioxidants that keep the oils stable. I would worry more about all the extra calories contained in nuts, and I would be very careful with them if I were trying to lose weight.

  72. I almost fell over when I saw the following article headlined in our local newspaper which up until now has been a low fat diet proponent. Dare we hope for a breakthrough?
    “Waistlines grow with carb addiction: Researchers
    Carb addiction is real, according to researchers who fear that by taking fat out of snacks, food producers are replacing it with more carbohydrates and making them even more addictive.
    Dr. Simon Thornley, public health medicine registrar for the Auckland Regional Public Health Service, and his colleagues say the idea that rapidly digested carbs are particularly addictive parallels what is known about nicotine dependency. A doughnut causes blood glucose levels to shoot up faster than eating low-glycemic carbs such as broccoli. People get a burst of energy, but soon after feel sluggish and hungry again. What’s more, high-glycemic foods drive up the production of insulin, which tells the body to make and store fat.”
    http://www.vancouversun.com/Health/Waistlines+grow+with+carb+addiction+Researchers/1191393/story.html
    Miracles do happen.

  73. I first lost weight on a reduced carb diet (<120 grams/day) about 4 years ago. I was getting a lot of physical activity at the that time, logging a lot of miles every day on my bicycle. I lost 30 pounds in about 6 months (I am 5’11”).
    Then I discovered the glycemic index. I increased my carbs while eating only low GI foods. Still, I could not get close to the 75 grams per meal as recommended by the GI advocates. Even though I was getting a lot of physical activity my weight started creeping up. So I exercised more. My weight still kept increasing. After a few months I had gained 15 pounds.
    It was about this time that I discovered low carb and books like Protein Power. I started low carbing at less than 30 grams a day. Over a few months I dropped down as low as 154 pounds, what I weighed as a teenager! I eventually settled back into a comfortable weight range of 163-166 pounds where I have pretty much stayed. I seldom experience any degree of hunger or cravings that I can’t easily ignore. I usually eat 2 small meals and 1-2 very small snacks a day.
    But if I increase my carb intake to about 60-70 grams a day such as i just did over the Christmas holidays I quickly gain 5-7 pounds even if I only do this for a few days. I know part of the weight gain is water retention caused by a shift in sodium balance. But what I think is happening is that my body has become regulated to it’s natural carbohydrate intake. If I increase my carbs it’s as if my body thinks I am getting ready to go without food and it starts storing fat.
    Last year I maintained my weight. But it tended to creep up at times. I attribute this to the fact that for a variety of reasons my physical activity was minimal. This year I have ramped up my physical activity. As soon as I did I dropped 5 pounds within a few weeks. I am just about to start a Slow Burn weight program.
    In summary, activity seems to assist the maintenance of weight on a low carb diet. But it had no effect on a high carb diet. While I can maintain my weight on a low carb diet without exercise it is far easier to do with exercise. And exercise doe not seem to increase my hunger. So while Taubes and others maintain that exercise does not lead to weight loss I think it may depend on what one is eating.
    A cardinal rule I have for maintaining weight on any program is to be vigilant. Weigh yourself regularly, look at your body in a mirror and measure your waist. I find it far easier to take action and get results when I have gained 3 to 4 pounds than to lose weight after I have discovered that I have gained 7 to 10 pounds.
    I agree with the last paragraph 100 percent, which is why I try never to let my weight get too far away from where I like to keep it.

  74. When you overeat carbs, the fat is stored somewhere. In most people, that stored fat goes to all the obvious places. Some people, however, tend to store fat not in the obvious places, but in organs and other tissues where it isn’t visible as the fat we all know and love. These people have all the same problems as the obese, and, in fact, as you point out, often have them more severely. This condition is called the normal-weight, metabolically obese syndrome. Problem with it is that most of these folks go around crowing about how they can eat anything and everything and not gain weight. And they usually do eat anything and everything. And pay a severe price for it.
    ZING!!!
    Yes that pesky thing on the ADA site and elsewhere still assures me I am at low risk for diabetes simply because of the weight thing. My fat seems to hang around in the blood as ridiculous lipid numbers as much as get deposited anywhere. Some of it turned into (cholesterol) gallstones, again not uncommon among the skinny family members. Some of it probably ends up in the liver. The family members usually die of cardiovascular disease but many of them last into their eighties or nineties before doing so. If I see seventy I’ll be surprised.
    If you’d been around fifty years ago I wouldn’t be here now.
    People who are the normal weight metabolically obese respond quite well to low-carb diets. They correct their metabolic problems just as well as the actually obese do. Problem is it’s difficult to get them to diet because they don’t think they need to because they are normal weight.

  75. Regarding changes as we get older, I wonder if there is something that makes people crave fruit (which people see as a completely healthy food). At least in my extended family, the older people will eat huge bowls of fruit. Some has the sugar syrup on it, but not all. They love their fruit, and all have been gaining weight.
    They all also seem to shun protein, and say it upsets their stomach. I sometimes wonder is protein is harder to digest as we get older.
    People allow themselves to be deluded into thinking that fruit is a health food, so they eat it in large amounts. But, the reality often is, that fruit is nothing more than an attractive, tasty delivery system for carbs.
    One of the reasons older people have digesting protein is that with aging the level of stomach acid falls. The stomach acid bath is the first step in the digestion of protein, so if you have less stomach acid, you may have a little difficulty digesting protein. Another reason older people have lower stomach acid is that they’re all taking a host of medications for acid reflux brought on by all the carbs in their diet.

  76. Fascinating that you’re not in ketosis. Neither are the eskimos, I understand. Meaning the body does adapt to LC even within a lifetime, not just through evolution.

  77. Mike,
    I know I commented already, but after reading many of the other comments I thought I’d chime in once again.
    As you know, all we do day in and day out at Serious Strength is strength train people and advise them to adopt a LC way of eating. Fat loss is by far the #1 goal for our clients.
    Anecdotal as it sounds, the clients who get the best results are those who weight lift (strength train) twice per week and who put their blood and guts into the training. Those who do a lot of aerobics hurt their results.
    Dr. Eades has already said this a billion times already (and it is in PPLP) but allow me to say it again that the metabolic advantage of low carb diet is slight. You simply cannot eat 3,000 calories a day even if it is all fat-meat and expect to lose fat as losing weight is not the real issue. The real beauty of a low carb diet is that you CAN eat 3,000 calories a day and not gain much if any excess fat.
    For those of you who are stalled in your fat loss endeavors, get thee to a gym and get under the weights 2X a week. Avoid aerobic exercise – it is a fat loss mistake.

  78. I hope you will use this topic to write some more on the “adaptive thermogenesis” phenomenon. It seems to me that this must play a role in the “2nd time around effect.”
    I suspect that it does, but probably not as much when people do low-carb.

  79. Dear Dr Eades,
    Have you been spying on me? 🙂 I have been jumping on and off and becoming discouraged because I didn’t see any weight-loss when I thought I should. There was a time when almost every item at the grocery store had a low carb twin (boy, am I glad those days were over) and I did think I could have my cake and eat it too…NOT!
    Thank you for this post. I’ll print it and pull it out in moments of weakness.
    Go for it. I hope it helps.

  80. People who are the normal weight metabolically obese respond quite well to low-carb diets. They correct their metabolic problems just as well as the actually obese do. Problem is it’s difficult to get them to diet because they don’t think they need to because they are normal weight.
    YES!!!
    Another thought, I was disgustingly virtuous through the Holiday Season but have crept my carb intake up since, and simultaneously crept my exertion levels down (strong hibernation response due to the dark as well as the cold) I have actually put on a few pounds, but have now lost most of them again.
    I suspect the problem is, I am much more functional, metabolically and otherwise, when I switch from predominantly glucose fuel to ketones. This switch takes a finite time to occur and much less time to revert. If you stay on the edge maybe it becomes significantly harder to repeat the metabolism change.
    Some of our migratory birds in the UK and Europe cross the Sahara to winter in Africa. In order to make this journey they double their body weight. Most of these birds are insectivorous but what I only discovered recently is, they fuel the weight gain by eating high carb insects! (Aphids full of plant sap, ie. sugars)
    Maybe they are programmed to switch in and out of “diabetic” weight gain/thrifty mode. Maybe mice do this also, which is why diabetic mice are so easy to “cure” in the labs. Maybe we have a similar mode switch which is an order of magnitude harder to switch and comparatively easy to switch back. Continuing research into the links between insulin/resistance and leptin/resistance may elucidate the mechanisms.
    Meanwhile I have learned my lesson, now off for a brisk walk downtown to do some hunter gathering, and entirely WITHOUT snacking!
    Good luck. Keep me posted.

  81. Thought the last comment was interesting. I do think that we may be genetically tuned toward the whole feast/famine deal and that our bodies, like our minds, are geared toward adaptation. We know that we have muscle memory that lasts for several years, why not metabolic memory?
    jh
    http://www.bodaweightloss.com

  82. I am sooo glad I came across this post. It just gave me that kick in the ass to hang in there for the long haul.

  83. I would like to comment on and agree with IP Daly’s post from Jan 16th. I too have been through several cycles of low carb dieting but that also applies to exercise. I have frequently tried the ‘flavor of the month’, switching from one weight lifting program to another with some success but when I dedicated myself to 8 weeks of a particular bodybuilding routine I made amazing gains. I am finding the same thing with diet. I re-read ‘Protein Power’ and have adopted a Paleo version of it and the results have been great. It has dropped my blood glucose, ldls and weight, but that is because I have stuck strictly with ‘the plan’. I am still in Phase I. I didn’t realize how much extra food I was eating until then. The carb charts are super helpful. I was afraid of many carbs but now I will eat most of what is on the chart (Paleo type),just sticking to the proper amount. My only struggle is getting enough protein because I have 200 lbs of lean mass.
    I, like IP have found that I personally can’t do ‘cheat’ meals or days, or carb cycling. At least not yet. It kicks in an overeating response which I sometimes don’t recover from.
    I’m down to 18% body fat from 21%. I’m aiming for 14% before I switch to Phase II.
    The bottom line is: get on a program like Protein Power and just stick with it! Even if you feel like you aren’t losing weight, use the guide in the book: looser pants, etc. I feel great! Lots of energy, I sleep well and it seems to improve my mood!
    Thanks Doc
    I’m glad to learn that you’re doing so well. Keep after it.

  84. here is my question, I am wondering about these so called healthy grains, for example, guinoa, barley, beans and steel cut oats. Can one add these to a weight loss program. I get very confused on these items. I guess by adding these your not on a low carb diet? So say you watch calories, eat meat, veggies, berries and add these only to your diet and lose weight fine. By watching calories and exerising I can lose weight. I would like to add these grains into a 1200 – 1300 calorie a day diet. Is it ok in your opinion?
    I wouldn’t add them to my low-carb diet. They aren’t all that low-carb, and they aren’t all that healthful, so why add them?

  85. I pretty much agree with everything you said. Especially the dynamic weight loss part. If find that if I go low carb and paleo for some consecutive days in a row all of a sudden the weight starts melting off but one day of cheating and it all comes to a grinding halt. Then you need to get that furnace burning again. I think this is what you mean’t? If so I never really thought about it but you have certainly made me aware of a cool new motivating tool. Next time Im in that zone I will not cheat. I tend to think oh Im doing so well now I can cheat a little bit.

  86. I have been cooking and eating low carb for years now with out any specific low carb cookbooks. My meals have gotten gradually much simpler. At long last I can feel that the meal is complete without anything resembling dessert. Or if I must have something, it is a tiny portion of berries or some crispy nuts tossed in butter or coconut oil.
    But recently I bought few low carb cookbooks for inspiration because my husband eats what I cook and I thought he might like more variety.
    I was surprised to see so many recipes that weren’t even for dessert that contained some kind of sweetener. For example a recipe for pumpkin seeds tossed with soy sauce, ginger and splenda. In my opinion the splenda is totally unnecessary for the recipe to be tasty and satisfying. And I think in the long run it keeps the eater from developing an appreciation of the true flavors of foods, from tasting the natural sweetness. And ultimately, I believe it feeds the craving for more sweets, regardless of whether or not it raises blood sugar.
    So I would say to use artificial sweeteners with great restraint. Observe if they are that slippery slope for you as I think they are for me.
    We avoid them most of the time. But if we do make something that is sweet, we do use artificial sweeteners, which we believe are much less bad for you than an equivalent amount of non-artificial sweetener.

  87. I’ve read all your posts and books with great interest. As a member of a low carb forum and a somewhat “successful” low carber, I’m trying to give advice to others. Now we have an interesting case at hand that does not fit the descriptions above. A woman about the age of 30 has been on a very strict LCHF diet for four years, after being a vegetarian for 8 years before that (she’s not a vegetarian any more, I might add). The first two years she lost some 40 pounds (appx 1/3 of her overweight), but then the weight loss stopped completely. It is not really her second time around, as she never abandoned the low carb diet, but it appears we have some kind of a “stage 1”, “stage 2” at hand. She’s just went through a close to 0-carb diet for thre months to no avail. She’s insulin resistant and has tried several changes to here meal compositions this last year, including elimination of any food containing lactose.
    In a previous answer you said “When we see patients who we believe are really hewing the line and following the diet to the letter and are not losing as they should be, we start looking deeper”
    Could you please elaborate a little on this. What do you look for exactly?
    I’m really looking forward to your reply. It would be a great input to our forum.
    First, I’ve been burned so many times by people telling me that they rigorously stick to diets without cheating and don’t lose, and then I discover that they aren’t really. So my index of suspicion is really high in cases like the one you mentioned. I’m not saying it doesn’t happen this way some times; I’m just saying it’s not all that common. Especially if the person dieting watches calories while on the low-carb diet.
    If I do make the determination that the person in question is really adhering to the diet and keeping calories low enough to create a deficit and still isn’t losing, then I look at a couple of other things. First, of course, is the thyroid situation. I check to see if the patient has had a recent mammography (if a female, of course, and, BTW, it’s typically females who fall into this category, i.e., unable to lose) and/or a recent colonoscopy because both breast and colon cancer can cause women to be resistant to weight loss. Then I might send them to be checked for a pituitary adenoma, a benign tumor of the pituitary that can cause great difficulty in losing weight. But before I do any of these, I have to be sure that the patient is really on the diet and really maintaining a caloric deficit while trying to lose.

  88. This is EXACTLY what I needed.. and considering I Googled “not losing on Atkins” and this popped out, I got lucky.
    Back in the saddle for me…
    and THANK YOU.
    Glad it helped. Good luck.

    1. That sounds like me as well. After 4 months, I’m starting to think perhaps this diet doesn’t work for everyone. I take issue with the comment that perhaps the diet isn’t being followed EXACTLY. I wonder how exact those who lose tons of weight are at following the diet, considering that people today can’t even figure out how to differentiate between the spelling of loose and lose. I’ve been keeping records of what I eat and the macros. I’m 4’10 and in my 70’s and so eat somewhere between 800 and 1000 calories a day and eat only twice a day. I’ve seen other benefits from this diet, but for the past month have digestive issues, I see my doctor regularly and supposedly have no cancers and take 2 medicines a day for high blood pressure. Eat as much as I can organically, pasture-raised eggs and chicken, grass-fed beef. But wt. loss has been excruciatingly slow and my measurements don’t seem to change. I don’t have a gall bladder, take ox bile daily and have IBS which seems to be not a problem eating this way, although I previously tried the Starch Solution diet and had to walk around every day with a hot water bottle for the pain. Not a problem with this diet, but minimal weight or measurement loss, and digestive problems. I think I will try the Atkins diet and if that doesn’t produce any change, perhaps it’s time to look elsewhere. I do wish I could find a doctor or nutritionist in the Boston area who was familiar with LCHF, but have been unsuccessful in finding one.

  89. For most of my life I was a very lean person who ate whatever she wanted without weight gain. Then I hit my forties and gradually became hypothyroid, steadily gaining until I reached 170 lbs. – too much on my thin 5’6″ frame.
    My daughter Erin was married last summer and in the early spring I had to shop for a dress. Let’s just say that I was spilling out of them… all styles. I wanted to look healthy for her and I had very little time.
    So, I stopped eating carbs and lost 15 lbs. in the first three weeks – my success was phenomenal! I continued to lose 2-3 lbs. per week through July. My students were my cheerleaders, calling it “The Mother of the Bride-Dress Diet” and it worked. I wasn’t embarassed to wear a sleeveless dress on the big day and I didn’t hesitate to wave to my guests.
    At 140 lbs, I started eating some carbs and I maintained that weight for about two more months. Then I ate myself back up to 168 lbs. I decided to do-over the diet. I’ve been in induction for over three weeks now but this time I’ve only lost 4 lbs. VERY discouraging… I’m ready to scream (in fact I did scream after stepping on the scale this morning!)
    I’m 49 years old. I don’t drink any alcohol. I take thyroid medication (correctly) and my endocrinologist says I’m euthyroid at this dose and that I’m not in perimenopause yet.
    But something’s up! Only 4 lbs. in 24 days and I’m truly eating no-carb NOT low-carb foods. Could my body really be resisting the Atkins method after only doing it once before?
    Should I perhaps try a different diet like South Beach?
    I’m beyond frustrated at this point and I’m ready to go into the kitchen and toast a couple of English muffins…

  90. Thank you. This was just the information that I was looking for! In the past when I was 33 I did the low carb diet and it was textbook case. 20 lbs in 2 weeks and I looked great! I repeated it again at 36 but I tried working out by walking everyday for 3 – 20 minute miles. I built up more muscle than I wanted to, and I only lost 15 but again looked great and had big muscles. Now at 39 with the stress of divorce and my son being diagnosed with Autism the stress is overwhelming! I began and a couple of times as you described people a few days success then cheat… and did well. Now that I am committed, the weight loss stopped coming off. But! I am feeling better and better everyday. I only drink water and eat my steak, eggs, or tomatoes. My weight slowed after eating the Atkins shake and bar once a day for my chocolate cravings… so I guess that needs to go. But also, I DO NOT LOSE IF I WORK OUT ANYMORE… when i stop working out… the weight starts to fall off again? why? So, now I am at a stall. I am going to stop the low carb bars and shakes from atkins, and STAY ON THE DIET AND WAIT IT OUT! I just am scared that my insulin and leptin resistance doesn’t stop me from every being thin again. Is this possible? to not be able to lose weight? Sorry for such a question, it feels dumb, but… what if?

    1. It’s impossible for me to tell you what’s going on or why you’re not losing without knowing a whole lot more about your situation.

  91. Oh and in addition, I never lost a single pound, nor did any of my friends when they ate cheese on the low-carb diet!

    1. Well! I stopped using the Atkins products and started losing weight again! I was using the Atkins Chocolate Royale Shakes, 1 a day and 1 bar to help with those cravings or when on the road so I didn’t eat fast food or didn’t have time to grab a chicken breast at McDonald’s! I remembered what a vegatarian told me back in 2006 and I stopped with them then and started losing weight again!

  92. I am very interested in a sugar-free living. I currently have a sweet-tooth, and am finding it difficult to find meal plans, what to eat for snacks, etc. While diabetes is not something that runs in my family, I am still concerned and would like to be smart and take a proactive approach to my health. Any tips or advice?

    1. I don’t know if you mean ‘sugar free’ as in no sugar or carb free. There is a difference. If it’s sugar free, that’s pretty easy. Just don’t eat anything with sugar in it. You can use any number of sugar substitutes if you can’t do without the sweet taste, but the longer you go, the less you need sweeteners, artificial or otherwise.

    2. I suggest you try the adkins low carb diet for 2 weeks then try a diet with the sugar free foods and you will know which diet change makes you feel better. I guarantee it will be the low carb diet because I have tried them both. I feel wonderful when on the low carb diet… of course after the first 4 days. Now everyone my age is developing auto immune and lupus and RA… so take care of yourself now before you push your body to far. Stop with the fast food and process and radiated meats from the store…buy from a butcher and you’ll see a difference in the tast of the meat too. (This is just what I have been learning… try it and let me know how it works for you!)

  93. I read this post and couldn’t beleive my eyes, it was like you were in my head! Finally my thoughts on screen being sorted out in a fashion that made sense and hopefully someone would hear and help!!!
    I haven’t been able to find a link to part 2 where you discuss what helps.
    I’m 37 and just lost 20 lbs the 1st 2 weeks (2 months ago) and nothing since. I am well into ketosis but nothing doin’! What should I do?? I gave up caffeine, didn’t help. I stopped eating low carb protein bars, didn’t help, I can’t think of what else to do. I am one of your 2nd time arounders, lost 80lbs 1st time in 5 months. That was 3 years ago and I’ve gained it back. Now nada! – even though the ketostix say I’m being a perfect little low-carber. One thing differnce is that I had an accident and require pain medication, mainly narcotics. I’m at wits end and frankly a bit pathetic. : )

  94. Hello,i tranlatet it tru word and no conclusive thats its harms the liver ,why cant i post this at that site of yours ?
    since 2006 umckaloabo is no longer permitted for subscription/treatment against angina tonsillaris, rhinopharyngitis and Sinusitis in Germany(1). The only indication persists for acute bronchitis. A sufficient therapeutical benefit has not been proven in common dosage(2). Instead, umckaloabo might threaten liverfunction (3, 4).
    Regards,
    guzolany
    (1) http://www.arznei-telegramm.de/html/2006_10/0610093_03.html
    (2) http://www.arznei-telegramm.de/html/2003_03/0303028_02.html
    (3) http://www.arznei-telegramm.de/html/2006_06/0606058_01.html
    (4) http://www.arznei-telegramm.de/html/2006_04/0604041_04.html
    “Arznei-Telegramm” is a printed newsletter of independent pharmacists and physicians, who critically observe the pharmaceutical industry and market in Germany.
    Interesting. It would help if I could read German.

  95. Hello there,
    I have just had a baby 2 months ago, and delivered naturally. Before my pregnancy I followed a low carb diet. When I got pregnant I had really bad all day sickness the first 5 months, and could not stand the smell of meat. So I switched backto the high cabohydrate dies only to gain 60 poulds after my pregnancy. I have now been following the low carb diet for 3 weeks now and I am not seeing a lot of weight lose. But when I urinate on the ketones strip it shows that I am on the high end. I am really following this program. Please let me know what I am doing wrong.

    1. Hello,
      I have been on induction for 23 days now and have not lost one pound! 4/5 years ago I lost with no problem. I have been extremely dedicated. I really only want to lose 10-15 pounds. I have been turning the ketone strips colored all this time. How can I be in Ketosis and NOT be losing wieght? I am so confused. I have been reading about insulin resistance could that be whats wrong with me? I do have a “spare tire” around the waist, that’s what I really want to get rid of. I am 42 years old, am 5.2 feet tall and weigh 130. I also started taking L-cartitine 6 days ago. Please help me.

  96. Emily, our situations are VERY similar. I’ve had 2 babies, both delivered naturally. I was a low carber before being pregnant but just couldn’t stick to plan either time while pregnant and consequently gained 70 lbs each time. It took me 2 years to lose 70 lbs the first time. This time around I’m 9 months post-delivery and have lost 30 lbs. I’m sure it will take at least another year to get back to my pre-pregnancy weight (even then, I was still 30 lbs overweight). You are still only 2 months post-pregnancy. Give it some time. It comes off SLOWLY and I still have to watch my calories too, not just the carbs. Just stick with it, and try not to obsess. You’re not going to see the weight come off as fast as you did before, even though you are trying twice as hard. Remember, this is a lifestyle change, right? Even just a pound or two a month will add up after a year or two. Just keep at it.

  97. Thank you Dr. Eades – at last a doctor that understands!
    I first started LC after I read Dr Stillmans in the early 1970s. I have been on and off LC for many years and sometimes against strong words from my doctors.
    After years of burying my head in the sand, last October I started Low carbing again. Problem now though, that 9 years ago I had an estogen receptive breast tumor removed, had my ovaries removed and I’m on estogen ‘removing’ drugs. I’m also bordering diabetes 2 and aged 56. Things look pretty bleak for weight loss from what I’ve heard, but I’ve lost a pound in 2 weeks and I’m so happy! 14 pounds since October! YESSSSSS!
    Thanks for your fantastic article which explains such a lot and also for all the responses – they are so interesting!

  98. It must be karma… I’d read this months ago and now, while I’m EXACTLY where you speak about in your article, somone post to it and triggers it BACK into my email.
    You could have been decribing me in your article. “half fast” AND menopausal and whining about how it “doesn’t seem to work this time.”.
    ok.. i’m done whining. Back on the horse.
    And thanks!

  99. First of all, concratulations for the article.
    I am 43 years old, and I am from Greece. I am in low-carb diet for more than two years. I gained some of my weight back, so I got back in the induction for more than 4 weeks. I was very dissappointed when i saw that i only lost 1 kilo. (Here in Greece we count in kilos). Trying to find the reason in the net, i discovered you! The way you explained everything is so great!
    I was thinking, to go for a few weeks in a low-kalories diet, with wholemeal carbs, just to make my body remember to burn carbs. And then i would return to low-carb.
    I would really apreciate to know your opinion about this thought.
    Thank you for your time. Roula
    p.s. please excuse my English….

  100. How come this site stopped in February 2011….I cant believe i found this site, i read it all…and it helped soooo much, please come back.

  101. I have LC off and on threw the years, did very well losing weight, but,I loose weight very fast, like 2lbs a day, for the first couple weeks anyways, but it brings on alot of anxiety, because i dont read where other people are loosing weight this quickly, and i have no one that i know, that would do lowcarb or support it in any way, makes it hard on me, all though, i have never felt better when i eat this way. I get so much anxiety sometime of the great weightloss i have that i feel week, and think i need carbs to make me feel better and give me strength. I need support so bad, I am in Canada, Ontario and dont know where i can find support with this amazing way of eating. I feel that i need someone to remind me every now n then that its ok what i am doing, and i wont hurt myself now or in the long run of what i am doing, because, with the people i know now, tell me opposite.

  102. Dr. Eades,
    Thanks so much for the post. I am a 28 year old female who is doing my 2nd (technically 3rd, but when I didn’t see results quickly the last time, I quit) go at the low-carb lifestyle. When I was 16, I lost upwards of 90 pounds, and then I went on a trip to France and fell off the bandwagon because, well, who wants to go to France and not each French bread?
    Anyways, I gained back all I had lost, plus about 40 pounds. Not to mention I just had two beautiful bundles of joy pretty much back to back (they are 16 months apart). My husband and I are both morbidly obese and have started down the path to get bariatric surgery IF WE ARE NOT SUCCESSFUL at low-carb.
    Even though I am not “old” by any means, I never considered that I am older when I “failed” the last go around. I am 5 months post-partum and would think my hormones are back to where they should be.
    My husband is low-carbing with me (he also lost a significant amount of weight on it once, only to have it creep back on plus some) and we are doing everything by the book, but I haven’t seen the scale drop at all. What’s more, my blood glucose is all out of whack. I had gestational diabetes with my first child, but while not pregnant my numbers have been fine. Still, I started checking my numbers when I went on the diet because I was hoping it would bring those numbers down more. Then, after having a snack of nothing more than hard-boiled eggs before bed, I woke up with a fasting blood sugar of 128.
    I haven’t been diagnosed with insulin resistance or metabolic syndrome (though I have suspected it). Would this explain my strange blood glucose numbers this second time around and the resistance of the scale to budge?

  103. I’ve lost 76 pounds on this diet, and I’ll never go back to eating that high-carb junk I used to enjoy.
    I’ve found that eating that stuff now actually makes me sick, feel extremely warm, and almost want to throw up. In addition, I’m hungry a few minutes after eating it, whereas eating low carb, healthy foods leaves me full and feeling good. It’s an easy choice for me.

  104. Hi, I just want to thank you for this post. I am attempting low-carb for the second time. I was doing great the first time but it did taper off probably for the reason you said… finding so call low-carb facimiles of high-carb foods. But then on top of that I fell pregnant with all that weightloss (40 of 100 lbs) So here I am trying again… and stumbling miserably!!! Not only is the weight not wanting to come off as much as the first time I am having issues with having a meal here and there with carbs in it. So I am feeling the pinch to give up… but I heard someone tell me it’s harder the second time… I think inwardly I laughed at this… but here I am seeing it for myself. So instead of giving up I decided to see what I could find on the subject on the net and the first thing I read was your post. So thank you for giving me the tips and the stronger commitment to my goals using low carb to get there. My Dr. told me the best if not only way to loose the kind of weight I need to loose is low carb. So I am determined to get there.. Lets hope the next few weeks I can stick to it with no goof ups!!! Again thank you… I will be having a good look at your other blog entries!!

  105. I myself went from 175 to 145 in my late twenties on a low carb diet. I followed the diet atkin’s style for three months and ran about 3 miles 3-4 times weekly with plenty of weights and swimming. After I lost the weight it slowly crept back on and after I had my first child I am now at 193 the highest I’ve ever been. After I stopped breast feeding I started back on the diet with walking not to see any results. I became very discouraged and thought maybe this diet is a ‘get thin once in your life card’ and I had already used mine. After reading this article I have new hope though a lot of things applied to me like getting discouraged after a week and my body remembering and not letting go as easily. Even though I wasn’t doing the diet consistently and as strictly as when I first did I was always mindful of carbs so my body has been operating with a lot less carbs for longer periods of time. I am going to give another serious go. Thanks for the inspiration!

  106. Thanks for this most encouraging article. I am doing LC for the 2nd time after 9 years. I was getting discouraged because the weight was not coming off as fast as it had the first go round. At 56 is is much tougher. I am only consuming eggs, meats, fats, cheese, and the allowed induction vegetables and staying under 20 net carbs a day yet my weight loss has only been 4 lbs in a week. I am in ketosis (Mod) and happy about that. I wanted the immediate gratification I got the first time (12 lbs. in a week) so when it didn’t happen, I was depressed. I searched “Why am I not losing on low carb” and found you. Now, after reading your article I am committed to seeing this through.

    1. Oh Shawn. Four pounds in a week? That’s GREAT! That’s worth celebrating over. (NOT, however, with food. {wink})
      Instead of comparing your current weight loss with 9 years ago, try comparing it with the results of a “SAD” diet or a low-fat, high-carb diet. Or better still, don’t compare it all: recognize you’ve caught the “bigger,faster,better” pathology that is modern American/western society… and try to hold that delusion off.
      Four pounds is superb! Well done!

  107. As a type II Diabetic I did the low carb diet in 2010 and lost a stone in the first week and then more or less 2 pounds every 2 days. In total I went from 22 Stone down to 15 Stone in a matter of a few months.
    I felt great and looked amazing. I was still diabetic but now without the symptoms. However I went away on Holiday and as my 0 carb food supply was limited I ended up eating carbs for 2 weeks and it was like heaven, but I put all of my weight back on in a matter of a couple of weeks.
    So in 2012 I decided to do it again and to stick at it. After 9 weeks of being committed to the diet I have put 2 pounds on and have lost no weight whatsoever.
    So it really doesn’t seem to work twice. You’ve seemingly got one shot at it and then your brain isn’t going to be fooled.

    1. It works the second time around. It’s just more difficult and takes longer. You’re two years older and gone through another weight gain cycle, your just that much more metabolically inflexible. It will work, you’ll just have to work a lot harder. That’s why it’s always better to never get fat in the first place, and if you do, and then fix it, it’s a lot better not to gain the weight back again. If you persevere and lost the weight, work hard not to regain it because it will be even more difficult the next time around.

  108. Chris –
    As a personal trainer who has helped hundreds of people lose fat and get fit using a low carb, high fat diet, I put this to you – you are either:
    1.Eating more carbs than you realize compared to before
    2.Eating more low carb fake food products
    3.Sleeping less well
    What I find interesting is that you gained ALL your fat back in just 2 weeks. 7 stone = 98 pounds! How is this possible? What in the world were you eating? I have never, ever seen a client regain that much weight or even close in that short a period of time. In fact, I put to you that it is impossible.
    If you’d like my assistance, you need to really think about what happened and give me the EXACT and specific circumstances/details and list for me ALL the foods you ate before and after your weight regain. Give me two typical days when you were perfect and two when you were on holiday.
    Best,
    Fred

    1. Hi Fred / Mreades
      When I was on holiday the hotel food outlet was a Chinese all you could eat Banquet including all you wanted to eat deserts. I basically lived in there for two weeks eating carbs and put my weight back on. My weight is really only around my gut area.
      When on the diet I normally just eat meat, chicken, eggs, cheese, fish, I was told to drink full fat milk but recently discovered that it has about 42% carbs in it, so this could be my problem. I was also advised to cut out caffeine but can’t bear going through the severe mother of all headaches stage of that again.
      I am a night worker so I sleep during the day.
      Ironically my friend who couldn’t walk 5 yards without panting for breath was 44 stone had surgery on the NHS and is now 12 stone and now goes climbing mountains.
      Regards
      Chris

  109. “When I was on holiday the hotel food outlet was a Chinese all you could eat Banquet including all you wanted to eat deserts. I basically lived in there for two weeks eating carbs and put my weight back on. My weight is really only around my gut area.”
    ****But 98 pounds in 2 weeks? That is simply impossible. How much were you eating? what were you doing?
    “When on the diet I normally just eat meat, chicken, eggs, cheese, fish, I was told to drink full fat milk but recently discovered that it has about 42% carbs in it, so this could be my problem. I was also advised to cut out caffeine but can’t bear going through the severe mother of all headaches stage of that again.”
    ****This is not specific enough. I need to know portion sizes, grams, etc.
    “I am a night worker so I sleep during the day.”
    *****OK but do you sleep well?
    “Ironically my friend who couldn’t walk 5 yards without panting for breath was 44 stone had surgery on the NHS and is now 12 stone and now goes climbing mountains.”
    ****Why is this ironic?

  110. Hi Fred
    It is very possible for anyone with a weight problem to gain weight rapidly. I would say on average that what someone looses on a diet in a year can be easily but back on in just two weeks of coming off the diet.
    The irony comes after you have spent months if not years suffering on a diet just to loose a few pounds and then someone whom you know who is much bigger than you by 30 stone simply goes and has it all removed with surgery overnight without any effort at all. Can you not see the irony in that?
    The point of the email was to state that from my own personal experience that the Atkins Diet or Low Carb diet does not work twice.
    The first time it was like a total miracle for me and people were like OMG. Until it got to the point where people and even I thought that I had an illness and was losing weight unnaturally.
    But the second time around the exact same diet did nothing for me. Because a human brain can’t be fooled twice. Maybe it does work twice for some people but for me it only worked once and I have read others stating the exact same thing.
    So my advise is if this is your first time make it last as you might not get a second chance at it.
    Cheers
    Chris

  111. “It is very possible for anyone with a weight problem to gain weight rapidly. I would say on average that what someone looses on a diet in a year can be easily but back on in just two weeks of coming off the diet.”
    *****Chris, you said that you gained back all your weight – 98 pounds – in two weeks. My reply to you was that in 20+ years of helping people, 15 of which have been using LC diets, I have never, ever seen anyone gain 98 pounds of fat in two weeks. I don’t even this this is possible. Maybe Dr. Eades has seen this but I sure haven’t. Even gaining 25 pounds in two weeks going face down in carbs would be a challenge. The math doesn’t work.
    “The irony comes after you have spent months if not years suffering on a diet just to loose a few pounds and then someone whom you know who is much bigger than you by 30 stone simply goes and has it all removed with surgery overnight without any effort at all. Can you not see the irony in that?”
    ****As I see it, it’s not at all ironic. What it is is tragic.
    “The point of the email was to state that from my own personal experience that the Atkins Diet or Low Carb diet does not work twice.
    The first time it was like a total miracle for me and people were like OMG. Until it got to the point where people and even I thought that I had an illness and was losing weight unnaturally. But the second time around the exact same diet did nothing for me. Because a human brain can’t be fooled twice. Maybe it does work twice for some people but for me it only worked once and I have read others stating the exact same thing.” So my advise is if this is your first time make it last as you might not get a second chance at it.”
    ****Chris, I have clients who have gone off and on the diet far more times than twice with great success each time. You’re leaving out part of the story whether you know it or not. It’s got nothing to do with the brain being fooled – nothing at all.
    Note that you STILL have not given me your meal specifics. This is pretty typical of many clients who say they are doing the exact same diet as before but are not. i’m not picking on you, I’m just telling you that this is my experience.
    So, what is your typical meal plan now – the LC meal plan that isn’t working at all?

  112. Thank you for the article it helped me understand why I am not losing weight at all! It’s been 3 weeks since I started dieting and only lost around 4 pounds in the first ten days, and 1 pound in the next ten days. And no, I do not cheat and do not eat too much carbs or anything that is not part of the diet!
    Last year I did the exact low carb diet and lost around 17 pounds in 6 weeks, with some plateaus of 3-4 days along the way. Unfortunately come summer couldn’t resist to switch to some of the old eating habits, and the weight crept up.. plus a couple of pounds more. I know that at 41 it could be hormonal, however I also know that I need to start doing exercise, daily!
    I am considering changing the diet if nothing happens in a week, as I started to believe that my body remembers exactly how and how much I lost weight last year and is holding on to all the extra fat for dear life!
    Good luck to you all that have reached a plateau.. hopefully it will not last!

  113. This was a great article, Dr. Eades! I definitely saw myself in some of those points – particularly “half fasting” it.
    I am curious about what you think is a good rate to lose weight? Previously I have heard you should lose 1% of your body weight per week.
    If you are not losing 1% of your body weight per week, does that mean you are not doing everything right?

  114. I can’t even begin to you how much this describes me. I started Atkins at the age of 23, and lost about 150 lbs. I had never felt better in my life. Early on, I was very strict with myself on the diet and lost weight rather quickly. Eventually I would have various plateaus to work through, etc. Then I discovered the LC ‘treats.’ After that, I pretty much stalled, and eventually gave up. But I was very close to my goal weight at that time. Eventually my eating habits returned back to what they had been before Atkins…I gained most of the weight back, then went on Weight Watchers. Lost a lot of weight with that, but I was always hungry. I’ve ‘tried’ LC a number of times (started & stopped) a few times in the last 7 yrs or so. I would get extremely discouraged when I didn’t have similar success as I had previously. I didn’t think to just stick with it and see if my body would just kick in and start giving up the fat.
    After reading this post, I definitely plan on restarting, avoiding all the junk, and sticking with it. I’m at a point now where I’m on thyroid meds and a low-dose statin for cholesterol. Now, it’s not just my weight, but it’s my overall health. I want to get off the meds completely.
    Thank you so much for this post!!

  115. It just so happens that I’m studying fatty acid absorption and oxidation in Biochem at the same time I’m just getting back into the low-carb game (for the last time)…no more starting and stopping. Anyway, my professor is talking about how ketone bodies are exported from the liver, then delivered to skeltal muscle, the heart and the brain, which can use them. I understand that in these sites is where the ketone bodies are oxidized, reducing the need for glucose and GNG, and thereby sparing body protein. She seems to suggest that in starvation (as well as “Atkins-type no carb diets”), stored triglycerides in the adipose tissue of a person of normal weight will provide enough fule to maintain basal metabolism for about 3 months (obese individual, a year). Do you think she just doesn’t understand low-carb diets when she seems to be lumping low-carb with starvation?

    1. No, sounds to me like she understands low-carb just fine. The benefits of low-carb dieting come from the same metabolic mechanisms that prevent muscle wasting during starvation.

  116. I only went through the ketone process for two weeks. I have been on my second attempt at low carbs for a year now and have no ketone in my urine and it’s been tested by a GP.
    All my my bloods were perfect and my Cholesterol was low and my Sugar readings were low. I was told that a miracle had occurred and that I had managed the impossible which was to cure myself of advanced stage diabetes and I was at the very far gone stage where my legs were going to be removed, I was a dead man sitting.
    The bottom line is: you can either eat what you want grow fat and die of a horrible disease. Or you can suffer a boring low carb diet and be a good weight and be disease free and you will get to feel your limbs again.
    Diabetes is reversible at any weight, you can be 35 stone and free of diabetes if you will just cut out the carbs on the other hand you can be 7 stone and eat carbs and have diabetes. GP’s will say “weight loss will reverse diabetes” this is not true only cutting out the carbs is the only way to reverse your diabetes.
    After 40 years of suffering as a diabetic I am now the same weight, as my second attempt at low carbs didn’t shed any weight like it did the first time. But I am free of my diabetes and that was my main aim when going onto a low carb diet. So if you want to loose weight to look good you need to include exercise. If you just want to loose your diabetes but to stay the same size, then cut out the carbs.
    If this is your first time ever of going on low carbs then please please please do not go back to eating carbs as trust me, that you won’t get a second chance of losing so much weight ever again on this diet. It is a one time only deal as far as weight loss is concerned, but is still good deal second tie around, if you just want rid of your diabetes .

  117. As I keep saying…. 2nd time around won’t lose you the weight as good as the 1st time…BUT…. it will still cure your diabetic symptoms and reverse the illness if you are a type II, so it will save your limbs and your life.
    Also it is true about Age, but only because when you get older you exercise less and on your 2nd Low Carb Diet you need to take at least a 30 minute walk a day to lose the weight. It you sit on the couch you will just stay the same weight.
    But the good news and this is So Important…. you won’t have type II diabetes if you just keep off those carbs.
    How do I know, am I a GP or a Specialist? No, I was about to have my legs removed and I could not feel any of my limbs I was on practically on death row just waiting to die. Now I am a healthy guy just from stopping eating carbs. My GP said “This is a miracle, you have achieved something which is medically impossible, you have cured yourself of type II diabetes”.

    1. I love stories like your. The only thing I would add is that you didn’t really cure yourself of type II diabetes, you got rid of all the symptoms, which is the same as a cure. But the predisposition for type II diabetes is still there, and if you go back to a ton of carbs, the symptoms will come back.
      Congrats on your success! Keep after it.

      1. That’s like with an alcoholic not drinking, they’re only cured for as long as they are able to stay off the poison. The odd thing is that GP’s who witness this sudden change in health will just say that you were initially misdiagnosed, they will never ever admit that eating lots of carbs causes people to suffer from type II diabetes and that stopping eating them reverses the situation. GP’s sometimes attribute it to weight loss but in actually fact in my experience loosing weight alone will not alter your type II diabetes the symptoms will only ever go when the carbs go.

  118. Dr. Eades,
    I’m one of these low-carb retreaders who have been on and off low-carb and different diets over the years. I’ve now committed to sticking with LC for the rest of my life. I’m 37, weight about 328 lbs, I’m on a thyroid medication and a low-dose statin. I’ve been doing LC this time around for a month now. I’ve lost about 8 lbs, and I’ve slowly been losing inches, but have not felt that I’ve hit that dynamic weight loss phase. How long, in your estimation, does it take before somebody like me should start seeing dynamic results? I’ve been upping my exercise regimen a bit, though I know I should be doing more. Just curious as to your thoughts on this. Thank you so much for fighting the good fight!!

    1. It varies. But your a male, and males usually hit it quicker than females. I don’t know what kind of thyroid medication you are on, but that could make a difference. And I don’t know how many calories you’re consuming. Many people can down huge amounts of calories while keeping carbs to a minimum. If so, their weight loss can slow to a trickle. A low-carb diet drops insulin and allows fat to escape the fat cells to be burned off. But if a person consumes enough calories to meet all his/her needs, then there is no reason for fat to escape from the fat cells even though the door is open, so to speak.

  119. Here’s the good news people: I’m 51, going through perimenopause and on my third try at low-carb (Atkins the original way, specifically) and it’s working great – just like it did the first time when I was 46. The secret is 100% commitment! On my 2nd try I kept breaking it intermittently so it didn’t work. This time I’m taking it in small achievable steps. When I thought about endless months ahead of me of low carbs, I broke it, but this time I’ve set a 6 week goal for a function I want to look slimmer at. Knowing it’s only for 6 weeks keeps me on track. Then I will allow myself to re-assess, binge or do whatever I want – but the chances are that the way I’m losing, I probably won’t want to ruin things. Either way I can stick with it for now, knowing that it’s only till May 31st. Also I found both times that I had to stay on the induction phase the whole time so I just eat angel tomatoes and avocado with my scrambled eggs for breakfast and chicken for lunch; then fish or meat and salad or broccoli etc for dinner. I then like a before-bed snack of cheese, tomato and avocado. I’m very healthy, never hungry and just stick to the same simple food routine every day just adding rice, potatoes etc to my family’s dinner but not mine. Honestly, nothing drops the weight quicker off me than low carb! Exercise-wise I only do daily walking even though I keep intending to do more?! Hope this helps and inspires some of you!

  120. …and, let’s keep it real folks, I also drink flatwhite coffees and sauvignon blanc wine moderately, and it still works 🙂 Lol

  121. thanks dr eades. i needed this article. after two years on low carb, mainly to fight sugar addiction, in which i felt just great both physically and psychologically, i have been having some problems. i find it harder to control hunger and often i over eat “low carb foods” ( adressed in article), that probably make me go over my carb limit and call for cravings. i am loosing the will to exercise , and i did quite a lot, and my mood is sinking. on the side i have a new job, which does not allow me to have a perfect sleeping pattern ( 22-6) as i had before and i believe it plays a main role.
    surely i need to commit again with a little strength but tour writing teaches me that is possible.
    it is not , anyway just about the weight, but about to make one’s life better under every aspect.
    thanks again

  122. So pleased I stumbled across your blog after googling “why a low carb diet doesn’t work second time round?”
    I understand better now what might be happening. 8 days into my 2nd low carb diet ( and no cheating!) i have lost 1 pound compared to the 7 I had lost first time round 3 years ago. I was just about to give up thinking it wouldn’t work at all this time. Your blog has renewed my commitment to stick with it.
    Thanks!

    1. Glad to be of help. Go to the search function and enter ‘tips & tricks’ to get a couple more posts that might also help.

  123. Dr. Eades, your third paragraph under “Built-in survival mechanisms” summed up exactly what I am experiencing. I have never had a low carb plan work for me, having tried 13-14 years ago. I tried again about 7 years ago, but I never experienced the magic. I always got good health results, but no significant weight loss.
    Now, I’ve been dieting off and on for the past three years, and I’m down about 100 pounds. I need to lose about another hundred. I’ve done calorie-counting and various forms of intermittent fasting ranging from actual IF to the 5:2 plan out now. IF works, but it’s annoyingly slow, plus have to be careful to keep your higher calorie days in check so as to not destroy your overall efforts.
    I decided to give low carb a second look and wondered how a cycling plan might work. I tried a couple of days last week to see how it would go. After the second day, I had lost 5 lbs and decided to do a third day to see if I would continue to lose. I lost another 3 pounds. I had to stop b/c of a luncheon I went to after the third day.
    So, this week, I had a high carb breakfast on Sunday and then fasted the rest of the day. (The previous Sunday, I had a high carb dinner in addition to the breakfast.) I went into this week (beginning LC on Monday) with pretty much the same menu as last week. It worked beautifully last week, but it’s doing nothing this week. I am more disappointed than I can explain.
    Also, the first week, I did a lot of urinating as my body flushed out lots of fluid. That has not happened this time.
    Today will be my third full day, and tbh, my heart isn’t in it. I’m not seeing the point. I could play my carbs closer to zero and lower my calories, and I may if/when I start another cycle next week. My only hesitation to go lower on carbs (now doing about 35g/day) is that I actually try to work in fiber b/c I need it. No, I NEED it.
    Thank you for this post, in particular the paragraph I referenced. I was seriously beginning to wonder what was wrong with me. After today, I will take a couple of days to re-evaluate before re-starting.

  124. This was a VERY helpful article! I’m wondering though…..how about the person who follows a low carb diet perfectly the first time, with all real, whole foods, and loses weight rapidly…..then 5 years later gains back about 20 lbs and they go back and do it EXACTLY the same way again
    ….and can just barely lose anything? Sadly, this would be me. I am otherwise very healthy, no medical issues, only 20 lbs overweight, etc……but having a hard time. So frustrating!!! And idea what could cause this? Thanks!!!

    1. I feel your pain. In some of the talks I give, I mention the idea of the triad of glucose intolerance: Age, genetics, and activity level. This same triad applies to weight loss as well. At any given level of carb restriction and caloric restriction, your results are going to be modulated by those three things: your age, your genetics, and your activity level. What worked five or ten years ago, won’t work the same today. Your age has increased, your genetics are the same, and your activity level has probably fallen a bit. You can’t change your age or your genetics, but you can change your activity level, though activity level doesn’t really help a lot, i.e., you can’t outrun a bad diet. So, what it all boils down to is that you need to be much more rigorous on your low-carb diet. And cut down on your drinking if you like to imbibe. Females, especially, have a difficult time losing a lot of weight – even on a low-carb diet – if they drink a fair amount of wine.

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