December 28, 2015

Why Am I Not Losing Weight on LCHF? (Pt.4 - Effect a Change, a.k.a. The DIScomfort Zone)

Since I might not have been clear about things in the previous posts in this series on stubborn fat loss, allow me to clarify something before we add another post to the pile:

When I talk about carb and caloric intake, nutrient deficiencies, and thyroid function as factors that may be interfering with body fat loss, please know that I’m writing for the folks with significant amounts of body fat to lose: 30, 50, 100 pounds, or more. This series isn’t really intended for people who are looking to get rid of “the last ten pounds” (or five!). Of course, some of the concepts I write about might well be applicable to people who are in the home stretch, and if so, great. But to be honest, getting those last few pounds off—and keeping them off—may require slightly different methods than those that led to an initial, much larger loss. (Most of us recognize it’s very hard to lose those last few pounds, so if that’s all you’re trying to lose in the first place, you might face an even tougher battle than someone who wants to lose 100 pounds, but for whom the first 75 melted off relatively quickly.)

That being said, some of the general principles I’m going to address today could apply to anyone who’s struggling to lose body fat. Those among us who are working very hard to lose weight, but who aren’t making any headway, sometimes claim we’ve “tried everything.” We’ve “done everything” to lose weight, and “nothing works.”



You’ve tried everything?

Every single thing under the sun?

You’ve tried getting more sleep? You’ve tried high-intensity interval training (HIIT)? You’ve tried lifting weights intensely? You’ve tried fasting?

If you haven’t tried all of these, then no, you haven’t tried everything. Please be honest with yourself. If you haven’t tried everything, then quit wallowing in self-pity, and try something you haven’t tried yet. You know that saying: “If you’re going through hell, keep going!” (And if you’re not willing [or able] to try and try and try again until you find something that works, that’s totally fine. But if that’s the case, you should be willing to accept yourself at your current weight. Because you have two options: keep trying until you get where you want to be, or stop trying and get comfy in your body now and forevermore.)

Reality check: if you’ve been just sort of motoring along for a while, expecting something to magically change inside you to jettison the excess weight, it Ain’t. Gonna. Happen. (Trust me, I’ve tried.) If you want something about your body to change, then you have to induce a change. It might take A LOT of trial and error to identify which changes, specifically, are effective for you, but I can absolutely guarantee you that if you do not change something, then nothing will change. You have a body, and you want it to be different. In order to make it different, you have to introduce a change. You must. Ain’t no way around this. You might have to spend time, money, emotional energy, and quite possibly a few tears, along the way. Ain’t no way around that, either.

I am right there with you, in this place, myself. I’d like to lose about 12-15 pounds, and when I am brutally honest with myself, I could be doing a couple of things and not doing a couple others, that would (probably) help propel me toward that goal. Believe me, I totally understand: when you are not someone who is naturally and effortlessly slim, it sucks. It’s infuriating, it’s frustrating, it’s disheartening, it’s demoralizing, and above all, IT’S NOT FAIR.

It’s not fair that we have to work eight times harder than friends of ours who eat plenty of carbs and have never even once worked up a sweat via picking up heavy stuff and putting it back down. I wish I didn’t have to think about my thyroid, my supplements, my carbs, my workouts, and my sleep. I understand your plight. I do. I understand the frustration and disappointment. I wish I didn’t have to attack my weight from so many angles. I wish it came effortlessly, the way it seems to for others. If I told you how much brain space I devote to my weight and the shape of my body, you’d be horrified.     

BUT: this is my lot in life. I am not naturally slender. No one will ever accidentally mistake me for a lithe, long-legged ballerina.

And yet: this body—the one I constantly rail against and say awful, awful things to in my head and sometimes even out loud—is the wonderful, healthy, strong, capable body that took me to the finish line of two marathons, got me through U.S. Air Force basic training and survival school, a deployment to Iraq, and gets me through everything I do, every day.

Moreover, I have a roof over my head, family and friends that love me, good food in the fridge, and, oddly, a couple of strangers out there who seem to think my blog is worth reading now and then. Plus, I came back from the aforementioned deployment safe and sound, with all my parts and pieces intact, which is more than thousands of my brothers-and-sisters-in-arms can say. I am so ridiculously blessed that it is almost beyond my capacity to understand it. In fact, I don’t really understand it, but I do have the mental and intellectual capacity to recognize and acknowledge it.

So, all that being said, if carrying a few extra pounds and being slightly squishier here and there than I’d like, is the biggest challenge I’m facing right now, I GLADLY ACCEPT IT. Compared to what other folks are going through out there, this is a walk in the park. A total picnic! (A LCHF picnic, of course, hehheh.)

Why am I going on about this? Well, I guess I want to say to those of us who are struggling with weight, let’s also take a moment to think of all the things we’re not struggling with, and maybe that will help us keep our weight in  perspective. I am not—NOT—belittling the importance of weight loss, be it because it is impeding your quality of life (not fitting comfortably into restaurant booths, being unable to keep up with your kids, etc.), or because it’s taking a toll on your self-esteem. (Something I know a little bit about.) But do let’s try to not have the size of our bodies be the sole focus of our day, from the time we wake up to the time we go to bed.

I know, I know: it’s pretty ironic that someone writing about fat loss is encouraging people not to become obsessed with fat loss. I’m doing a poor job of explaining myself, but I don’t want to belabor things, so hopefully you can sort of get even a rough idea of what I’m trying to say.

Now, about that whole “I’ve tried everything” line. Again, I’m right there with you in feeling this way, but the truth is, that’s not what the facts reflect. Not for me, and probably not for you, if you're honest with yourself. Let me confess publicly here that I have NOT tried everything. For example, I am introverted with a capital, italicized, bold-faced I. And the only personality trait that matches my introversion is my night owl-ness. I have most definitely not tried going to bed earlier, or not looking at my phone or computer into the wee hours, and I do not own a pair of those blue light-blocking goggles. On top of this, I have a couple other habits I suspect are holding up the last few pounds for myself. I know what they are and I know I need to stop them, but I guess I’m just not ready to let go of them yet, or I already would have. So I can whine and complain all I want about still being jiggly, but ultimately, I have to accept responsibility for where I am, because I have not, in fact, “tried everything.”

With that in mind, here are a few things you might consider trying, if you haven’t already. I have to say, though, kind of like the first post in this series, I feel a little silly writing this. To me, this is more of the “duh” stuff – the stuff that should be fairly obvious to try if you’re struggling with fat loss, but I suspect there are plenty of people out there who haven’t tried them.

Get More Sleep

I’m not going to go into much detail here. A little bit of searching on approximately a zillion other websites can give you more information than you ever wanted about how sleep affects the human body—physically, psychologically, hormonally. People often think “short sleep” leads to weight gain (or impedes weight loss) because when we’re tired, we turn to food to give us an energy boost. Specifically, we turn to sugar and refined carbohydrates. (People don’t seek out steaks and pork chops when they’re sleepy; they gravitate toward candy bars, cookies, soda, and [sugary] coffee.) And this is compounded by the notion that our judgment is impaired and our appetite & satiety hormones get wonky when we don’t get enough sleep. So someone who would normally avoid sugary junkfood might eat a significant amount of it when they don’t sleep well. (Plus, if you’re tired and cranky, you’re less likely to jump at the chance to do a hard workout, or even to go for a walk, compounding things even further.)

This is a plausible hypothesis, but there’s more to it than that. “Short sleep” induces acute hormonal changes that affect fuel partitioning regardless of what someone eats. Inadequate sleep can cause short-term insulin resistance, so that even if you stick to your normal LCHF food and don’t indulge in a whopping piece of cheesecake or two donuts from the box at work, your body might still be in a hormonal state that favors the storage of nutrients, rather than their oxidation. (If you haven’t slept well, for sure, youre better off sticking to your LCHF diet than diving into the cookies. But imagine how much better off you might be if you stuck to your LCHF diet and got good sleep.) And if inadequate sleep causes short-term insulin resistance, if you get inadequate sleep every night, then your "short term" insulin issues become chronic.

There’s plenty of research linking chronic short sleep to metabolic derailment in all age groups. This may result in weight gain and/or stubborn weight loss, but that’s child’s play compared to metabolic syndrome, type-2 diabetes, Alzheimer’s, and more, which might also be influenced by long-term inadequate sleep.

And please know, when I say “inadequate” sleep, I mean in quantity and/or quality. Compared to all the health and nutrition “stuff” I’m fascinated by, I have to say, sleep and the gut biome are total snooze-fests for me. (No pun intended with the sleep angle, hehheh.) I just don’t find them all that interesting. I’m not dismissing huge roles for them in human physiology and weight loss; I’m just saying that I, personally, am not interested in diving into the research depths. So I’ll point you toward something I wrote in my gig for Designs for Health, and you can click on some of the links in there (and the ones above) if you’re interested in learning more: For Stubborn Fat Loss, Go to Sleep!

If you’re struggling with fat loss, and you have a large amount of weight to lose, something else to look into is sleep apnea (a.k.a. obstructive sleep apnea, OSA). I suspect this is far more common than we realize. If you do have OSA, though, you probably have other symptoms besides just stubborn weight that won’t budge. You are likely exhausted upon waking up, and probably fight to stay awake throughout the day. You probably haven’t felt refreshed and like you’ve had a good nights’ sleep in years. If you are lucky enough to have a partner in bed with you, (s)he might confirm that you snore like a freight train. Conventional medicine often holds that being overweight is a cause of OSA. It shouldn’t surprise any of us by now that there’s a good chance this is backward, and the causal factor in obesity is the apnea. (Remember: plenty of thin people have sleep apnea, so even if obesity is a causal factor, it’s not the only one. And why don’t all thin people with OSA eventually become obese? I don’t know, but most likely, after a while, they end up with some other manifestation of disrupted insulin signaling & glucose handling.)

Bottom line: if you’re not getting sufficient hours of good quality sleep, and you haven’t tried to increase either of those, then you have not “tried everything.”

Start Working Out
(or Change Your Workouts
if You Already Exercise)

Again, I get it. It’s not “fair” that some of us have to make time for increased physical activity in order expend the same amount of energy someone else’s body expends by default. I cannot tell you how many hours and hours (and hours!) I’ve spent running, walking, biking, and lifting over the years. I enjoy it sometimes (good music helps a lot with that), but I often have to force myself to work out because I feel like I “should,” or worse, that I “have to.” In a weird way, though, I’m grateful for my extra cushioning. If not for having it, I would probably be a major couch potato. And even if exercise isn’t so great for weight loss, it is very good for strength and mobility, and physical & mental health. (It helps, too, that I don’t own a television. I have racked up hundreds of miles of walking in the past few years, when I needed to get out of my head for a while. Had the option been there to veg out in front of Food Network reruns, I no doubt would have chosen that many times over walking. But I’m no Luddite; believe me, I get plenty of mileage out of Netflix.)

So yes, we can b*tch & moan all we want about the relatives, friends, and coworkers who don’t exercise, and who wouldn’t know a treadmill from a windmill, or we can get moving, and see if that does anything for us. If you’re not already working out, start. And if you are working out, do an honest assessment of what you’re doing. Is it intense? Are you actually pushing and challenging yourself, or do you just sort of go through the motions, and you haven’t gained increases in strength, power, or speed in months, or possibly years? Do you get on a treadmill, jog for 30 minutes, and you've been doing that a few times a week, for five years? Are you doing the same number of push-ups, or sit-ups, or lifting the same amount of weight as when you started, however long ago?

Don’t get me wrong. I think any kind of movement is better than no movement. But if you are specifically looking to lose body fat, then just getting on a treadmill or going outside for a walk, but being able to carry on a casual conversation while doing so, is probably not going to get you results. I do a TON of walking, myself. But never do I consider it part of an amped-up fat loss plan. For me, it’s far more about mental health: getting outdoors, getting fresh air and daylight (though sometimes I go at night), and just moving, since my work is largely sedentary. I am absolutely not discouraging anyone from walking. It is one of the single best activities a human being can participate inI just don’t think it’s going to be a silver bullet for fat loss. (The post at that link is very long, but worth your time for every word. Ladies: don’t be fooled by the “manliness” thing. Read it.) 

But just because walking might not be the magical answer for stubborn weight loss doesn’t mean it’s not worth doing. I think walking can be especially good if it’s done first thing in the morning, before eating anything. (Coffee or tea would be fine, even with a little bit of heavy cream or coconut oil. Just nothing that would induce a significant insulin excursion.) Personally, I think any exercise is probably best done fasted, but that’s not always possible with people’s schedules and obligations. We’ll get to fasting in a minute. For now, let’s stick to exercise in general.

I have written many times here on the blog that exercise is a piss-poor way to lose weight. (And some pretty brilliant guys agree.)  I think it helps to maintain a weight loss, and you’ll find that the vast majority of people who have lost a significant amount of weight and maintained that loss include physical activity as a non-negotiable part of their maintenance strategy. But this doesn’t mean that it has no place in a multi-pronged approach to fat loss, particularly when those other prongs involve dietary and lifestyle manipulations to increase insulin sensitivity and/or decrease insulin secretion altogether.

Exercise is not about “burning calories.” As I have written about ad nauseum in various posts, the amount of “calories” you burn through exercise—even an especially intense session—is laughable. You could ingest the same amount of calories in seconds right after your workout, so whoop-de-doo. What exercise is good for—particularly intense, muscle-building exercise—is changing the hormonal milieu of the body. As I wrote here:

Every single thing our bodies do requires energy. Yes, intense exercise uses fuel, but so does sitting upright, and breathing, blinking, digesting, the heart beating, the hand holding a pencil to write something—every single process that goes on inside us, whether we’re aware of it or not. Since this is the case, which do we think is more important: the calories we might burn during one measly hour at the gym every day, or how our bodies are using fuel the other 23 hours of the day? Even if we were to work out three hours a day (and if you have time for that, my condolences on your unemployment), which would be more important: what we burn during those three hours, or what our bodies are doing metabolically and biochemically the other 21 hours of the day?

When we exercise intensely—particularly either after the overnight “fast,” or when it's been several hours since our last meal, insulin is nice and low, blood glucose is nice and low, and our bodies are primed to use a lot of fat as fuel for that effort. (Depending on intensity, of course; it will use plenty of liver and muscle glycogen as well.) BUT, and this is a big but (hehheh): the real kicker from intense exercise is not what happens during the exercise, but, rather, what happens afterward. The hormonal state induced by pushing your limits, either in speed or lifting effort.

Remember: if you want something you’ve never had, you’ve got to do something you’ve never done. Or that Einstein line about insanity being doing the same thing over and over and expecting a different result. I have fallen into this trap many times, myself. I have to remember, sometimes, to push myself, physically. I have been doing so at the gym lately, and I’m pleasantly surprised at how much more I can lift than I thought. The fact is, I just wasn’t trying that hard. And again, any activity is better than no activity. But, when we have a specific goal of changing our bodies, then we have to induce a change. Maybe that means adding a plate—even just 5 pounds—to the bar. Maybe it means upping the speed on the treadmill—even by just 0.2 miles/hour. But we’ve got to continue increasing these things if we want continued progress. Eventually, that 5-lb plate becomes 20, and that 0.2 mile per hour increase becomes a full mile faster.

We have to push ourselves out of our comfort zones. They’re called “comfort zones” because they’re comfortable. If you’re not comfortable with your body size or shape, then you’ve got to get UNcomfortable with something else.

I have written a little bit in the past and will be writing more in the future about the supremely underrated importance of muscle mass. Or, maybe not muscle mass, but muscle strength. (You don’t have be ”hyoooge” and some meathead “bro” in order to be strong.) I have so, so much to say about the metabolic importance of muscle, but in the interest of not making this post even longer than it already is, I’ll point out just a couple of things:

Look at professional athletes. Many of them are “ripped,” “jacked,” and just plain strong. They can also put away seemingly enormous amounts of food. These things are not unrelated. Why do we think this is? Do we think it’s because they “exercise” so much? Because of all the hours they spend practicing, drilling, training, and performing in actual games/matches? Sure, this requires a lot of energy, but remember: most physical activity, even the intense stuff, doesn’t “burn calories” anywhere near like we think it does. The amount of food these guys can consume after an intense effort would dwarf what they “burned” during a game.

So I don’t think it’s about the amount of activity they do. I think it’s their muscle mass. They’ve got loads of it. And they’ve got to keep it fed. Muscle mass doesn’t just grow on the body out of nothing. You’ve got to provide the body with a stimulus to build muscle, and then you’ve got to give the body the resources with which to build it: lots of physical activity -- especially muscle-building & sustaining activity, and lots of food. Especially protein, but calories in general will help. Ask any “hard gainer”: they need to EAT. Muscle is hard to put on, and it’s hard to keep on. It takes a lot of physical work to send the body the signal to make those muscles, and then to make them even stronger, and then to keep them where they are. I think professional athletes can get away with eating a lot not because they burn a lot of calories, but because they have to feed their muscles.

Again, this is a total bummer for those of us who don’t enjoy weightlifting. And yes, we all know people who don’t work out at all, and who don’t have large amounts of body fat. NOT FAIR. But again, we can wallow in our self-pity and wish we had it as easy as those folks, or we can go pick up something heavy! Maybe it’ll help, maybe it won’t, but until we do this, and do it on a regular basis for a while, we can’t legitimately claim to have “tried everything.”

If you are unable to exercise due to injury, incapacitation, permanent disability, or otherwise limited mobility, there is something you can do. If you are wheelchair bound, can you still use your arms? If you broke an arm, can you do air squats and body weight lunges? If you are weak as a wet noodle, can you do dumbbell curls with a soup can? Doesn’t matter where you start. Whatever you can do, do it. 

Not to get all cheesy and spiritual on you, but let me share something for a sec. People who know me “IRL” know that I am a huge Superman geek. (In fact, my ancient blog, long before I was in the nutrition biz, was called The Fortress of Solitude.) Sometimes, when I know I should get up and move around a bit, but I’m just not feelin’ it, I think about Christopher Reeve. I can’t claim to know what went through his mind, but I imagine he would’ve given darn near anything to be able to get up and go for a walk. I try to steer clear of “shoulding” and “shaming” on this blog. Eating wholesome food doesn’t make anyone better than anyone else. And exercise is not a form of moral superiority. BUT: if you have functioning arms and legs, and you’re not moving them around once in a while, I just…I dunno…

You dont have to join a gym or train for a triathlon. But do something, will ya?

Okay: back on message:

Generally speaking, barring the physical limitations I’ve mentioned, I suspect most of you can lift more than you think you can—particularly the ladies. You are so much stronger than you think you are; you’ve just not had a reason to push yourself hard enough to find out. Do it now. Doing “girl pushups?” Come on. Bang out a real one. Even just one. I know you can. I know you can. You don’t have to believe it. I’ll believe it for you. Now go. Make me proud.

Again: intense exercise is not about burning calories during the effort. It’s about inducing a hormonal state in the body—one that remains for hours afterward—that favors the oxidation of fatty acids and an overall favorable fuel partitioning environment. And doing the same-old, ho-hum workout routine probably isn’t going to get you there. (In fact, if your workouts are “routine,” that might be part of the problem, right there.)  ;-)

For the women who have never lifted before, if you’re looking for good guides, I recommend anything by Cassandra Forsythe, Alwyn Cosgrove, and/or Lou Schuler. (The diet advice in their books might not jive with LCHF/Paleo/Primal, but they’re great sources for lifting info.)

And remember: if you start weightlifting, or increase the intensity of your lifts, there’s a distinct possibility that you will gain weight. (Eeeek!) But your shape will change. Your body will become smaller and tighter. And, really, isn’t that what most of us are after, anyway? (The women, at least.) You dont necessarily care about the number on the scale. You just want to be happy with how you look. Those among us who have large amounts of weight to lose might not see this gain. It’s more likely to happen among people who are somewhat smaller already. At the exact same "weight," a muscular body will appear trimmer than a body that is far less muscular. I have experienced this firsthand. In the past, I have weighed more than I do now, but I looked better. (In my own opinion, that is.) 

Also: if you do start or change a lifting program, please don’t get on the scale every day and freak yourself out over being up a couple pounds here and there. I can’t write a post-within-a-post about how muscles that have been worked hard hold onto water. But that’s what it is: water. You are not gaining body fat. Got that? YOU ARE NOT GAINING BODY FAT. Do not -- repeat, DO NOT, allow day-to-day fluctuations of a couple pounds to play mind games with you.


Oh boy. I could probably write many posts on fasting and still not do it justice. Good thing someone’s already done it, so I don’t have to. If you haven’t read Dr. Jason Fung’s fasting series, it is highly recommended. Dr. Fung is like blue cheese: people either love him or hate him. He has a number of critics, even in the LCHF/Paleo world. But put me squarely in the camp that loves and respects his work. (I also love blue cheese, hehheh.) I really can’t say anything about fasting that Dr. Fung hasn’t said more intelligently.

Does everyone need to fast? No, I don’t believe so. I think it is a tool: one strategy, among many, that might be helpful, for some people—particularly those who have a lot of body fat that has proven very difficult to get rid of. (Again, maybe not for people with 5-10 pounds to lose, although there’s potential for it to be helpful there, too.) I don’t know if this will work for everyone, but you won’t know unless you try.

There are many ways to approach fasting. Some people consume food only within an 8-hour window and do not eat for the other 16 hours of the day. Other people choose to do a full 24-hour fast once or twice a week or twice a month. Still others eat just one very large meal per day and eat nothing outside of that, and others engage in longer fasts (5 days, a week, and more) every few months, quarterly, etc. As Robb Wolf would say, there are lots of ways to skin this cat. If you’d like to read about these different approaches, Dr. Ted Naiman’s guide to intermittent fasting is one of my favorites (pdf version here). It’s simple, yet comprehensive, and explains the rationale behind a couple of these different feeding windows.

HOWEVER: If you are on medication, or have a medical condition—and even if you don’t—it is recommended that you fast only under medical supervision. Typically, even if you’re on medication, you can probably do a 16:8 with no problem, but that is not for certain. Especially if you’re on insulin or blood pressure medication. Please, check with your doctor before engaging in any kind of fasting. Any kind of fasting, and that goes double for longer-term fasting, where you really need to be monitored by a professional, not to mention educated regarding electrolyte balance. I do not recommend unsupervised fasting.

Okay. Now that I’ve covered my booty with that disclaimer, let’s get back to the good stuff. There are many accounts of people with very stubborn fat loss, for whom things finally started going in a better direction after the introduction of fasting. For some, 16:8 did the trick, for others it’s some other approach. Some people do great just delaying their first meal of the day by several hours.

WHY does fasting help the stubborn cases? Well, some people remain insulin resistant, even after a while on a LCHF diet, and even after adding in more physical activity. Unfair? Yes. Still our lot in life? Yes. Still within our power to effect a change? Yes. (And yes, that’s effect, not affect. I’m a Superman geek and a grammar nerd.) When it comes to insulin resistance, there’s a lot more we don’t know than what we do know. But it’s safe to say that, for some people, a LCHF diet, by itself, is not sufficient for fat loss. And the truth is, we don’t even really understand how insulin resistance develops. But fasting is one way to help mitigate its effects. Another truth is, we can’t really say that fasting reverses or “cures” insulin resistance. But it does mitigate the effects—one of which is fat gain/stubborn fat loss.

Much has been written about the different effects of fasting in men and women. There’s been a lot of fearmongering about fasting in women. I’m not dismissing the possibility that fasting could be detrimental in some women (and men). And I’m not dismissing the idea that women of reproductive age might respond unfavorably to fasting. BUT, I also refuse to believe that the female body is so fragile, and the hormonal state so delicate, that skipping breakfast and lunch once in a while causes someone’s thyroid to die, or their adrenals to crash, or their menstrual cycle to go completely haywire. I’m sorry; I just don’t buy it. (Frankly, if the female system were that sensitive, we wouldn’t even be here right now.)

I do believe there can be negative effects from fasting, but you know what? Those don’t seem to happen in women who have 40, 50, 100 pounds to lose. They seem to happen in women who are either already at a healthy weight, or who are maybe 10-15 pounds overweight, and who are already fairly stressed out, and who already may be over-exercising and undereating. They are also probably not consuming sufficient food during the time that they do eat. In those women, of course fasting might be problematic. I said it on the podcast with RW: Fasting’s not for everyone. If you’re 23 years old, get up at 5am for CrossFit 4 days a week, have a stressful job, are already lean, and are not able or willing to consume a large number of calories over fewer meals, then perhaps you are not the best candidate for fasting. And that’s okay! Don’t fall for the fasting propaganda. NOT EVERYONE NEEDS TO FAST, and you’re not “doing it wrong” if you say you eat Paleo, Primal, or LCHF and you don’t fast. Again, it is only one tool. One that we could argue we evolved quite well for, but the reality is, the things we evolved for are not necessarily the things that are serving us best in the industrialized world in 2015. (We evolved to seek out large amounts of sweet food and gorge ourselves when we came upon them. How’s that been going for us the last few decades?)  ;-)  

I’d like to remind people who criticize Dr. Fungs fasting regimens that he is a nephrologist. His patient base is not young, athletic, lean, insulin-sensitive, healthy people who already eat better than Chris Kresser and want to show off their naked torsos more than Abel James. His patients are type-2 diabetics, severely insulin resistant, overweight or obese, and presumably with kidney problems. Even if fasting could have eventual effects on the thyroid or the adrenals, these people are dealing with far more pressing issues first. Context, people. Context. Plus, some of the people critical of Dr. Fung are ivory tower researchers and armchair experts. Dr. Fung is the one in the clinic, dealing with actual human beings free-living in the real world, and not lab rats or theoretical models. I’m not saying everything he does is golden, but for goodness' sake, he's on our side! We have plenty of people out there still scaring people away from butter and red meat. We don’t have to fight among ourselves.

It’s long past time to wrap this one up, so I’ll leave you with a couple of podcasts with Dr. Fung that I’ve really enjoyed. (You can find these on iTunes, as well.) The airplane & thermostat analogies he used on the Sigma Nutrition podcast were great. I wish every stupid CICO-path would listen. 

We’re in the home stretch. Just one more of these weight loss posts, and then I can move on to stuff I’m way more excited about. (I have another insulin post coming! I wasn't kidding when I said I learn new stuff about this every day. Plus, a post on poop!]) This time, we covered three big things: sleep, intense exercise, and fasting. Next time, we’ll look at a lot of little things that might be getting in the way of fat loss. (Some of which, I guarantee, fall into the category of things we haven’t tried.)

P.S. I’m sorry if I sounded harsher than usual in this one. I guess I’m just giving people—and myself!—the reality check we sometimes need. It would be nice—very nice—if we weren’t overweight. It would be nice if we didn’t have to spend time, money, and brainspace to figure out why we don’t lose weight as easily as others, or if we could stop ourselves from feeling envious of friends & loved ones who were never overweight to begin with, despite diets and lifestyle habits that, by all accounts, should make them overweight. But that’s not where we are. We are in the spot we’re in, regardless of how or why we got here. And we can focus on how unfair it is (which gets us nowhere), or we can have the courage to make some changes and see what happens. We might feel like we’ve “tried everything,” but when we do an honest assessment, and ask ourselves if we’ve done this, this, that, that, and that other thing, and our answer is no, then we might as well give those try.

Remember: Amy Berger, M.S., NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.


  1. That "Reality Check" paragraph is going up on my bathroom mirror. Good stuff!!!

  2. If I could add just one more to this series --> LEAKS!

    In introducing others to this diet, I often revisit them later only to find a half dozen things in their new menu that they genuinely thought were Keto safe and turned out to be wrong. Being extremely vigilant about tracking nutrition information (especially the brands) is certainly tedious at times, but well worth it, imo.

    However, nothing beats finding leaks better than a glucometer. Your blood won't lie. Either you're getting hit with the sugar (and thus, insulin) salvo or you aren't.

  3. Thanks Amy. I really enjoy your posts and you always have some good reminders and reality checks in there that I appreciate. Keep posting, and Happy New Year!

  4. Great Post again Amy..thanks!

    Dr. Fung is the MAN!!!

  5. So my problem is that I really have tried everything you mentioned but I give up after 3 or 4 days - definitely before the weekend! Consistency and complacency are my biggest downfall. When brutally honest I realize that probably any one of those things might work but only if I actually committed to them....

    1. Hehheh...yes, unfortunately, 3-4 days isn't enough for any of those things to kick in. You do need to stick with them for a little while. Remember: if a baby gave up after the first few times it stumbled & fell while learning to walk, none of us would be walking now. We'd all be crawling on our hands & knees. ;-)

  6. I think this is my favorite post ever! Yeah, this is written for me, lol. I'm one of those who has maintained a loss of 30 percent of my starting body weight for nearly 7 years now, but for years still had 100 pounds I wanted to lose just to get close to normal! I often feel like I have tried "everything" (more carbs, fewer carbs, more fat, less fat, more protein, less protein, no dairy, no artificial sweeteners, more exercise including weight training with heavier and heavier weights, less exercise, more calories, fewer calories, lots of different supplements) not to mention, naturally, of being envious of my 6'3" brother-in-law who maintains at 160 pounds regardless of what he eats. Though I guess the grass is always greener, etc. He spend nearly 10 years eating 5000 calories a day and doing intense weight lifting in an effort to get to 180 pounds but could never put on an ounce!

    "Get more sleep" has always been a bane of my existence as one who has been a lifelong insomniac ever since I hit puberty 50 years ago. But despite seemingly tossing and turning for hours I usually wake up refreshed feeling and ready to go.

    And then, as has happened in the past, my weight began slowly creeping up despite LCHF, etc. So this year I discovered Dr. Fung(I'm one of his huge fans - no pun intended!) and quickly dropped 20 pounds via fasting 2-3 days a week. Then I stalled again for months, but now am losing again and seeing much better BG numbers by going on the Potato Hack and greatly increasing my carbs. Down almost 20 more pounds with that - though still 85 to go just to get to my first goal!

    No one wants to speed up the clock, but in some ways I can't wait until 2017 when I will be eligible for Medicare. I hope then I can get into a Silver Sneakers program and be able to use the Y again. I really miss the weight machines, and being able to swim long laps at the pool, but it costs a fortune to be a member - not good for those of us on limited incomes, but not quite limited enough to get a break on fees. :-)

  7. Awesome blog. I'm going to print this one so I can devour at my next feeding window! I think this one has spoken to a lot of us Amy. Thank you. Any advice for a 56 y/o hypothyroid female, who gets up at 6 am and happily does crossfit 5 days a week, has a stressful job she loves? It seems to me that 16/8 fasting regimen one should see some fat movement but going on 8 weeks now with none. If weight loss impossible for someone like me? I've been wondering if I need to pass on the crossfit for a while, is that interfering weight loss?

    1. Debbie, probably the single best piece of advice I can give you is to listen to this podcast:

      You might also want to check out the Alt-Shift program, by Jason Seib. It's getting results for many women in a similar situation.

      Honestly, though, I think you'll feel like Jim Laird (in the podcast) is speaking directly to you. Sometimes, we need to do *less,* not more. Your body may be begging you for a rest.

  8. Again, great post. In my practice I treat a lot of paraplegics and quadriplegics all of them would love to walk...So, when I'm thinking I could not do my workout and do something else, I think of them.
    As far as fasting is concerned, I do a better job now than a year ago. The old dogma about lowering your metabolic rate dies hard even in me. ;)

    1. Yeah. I don't *always* work out as hard (or as often) as I could, but I am certainly more grateful these days for all the things my body *can* do, than for the things it can't.