7 Reasons to Stay Off the Scale

 

My previous post walked you through 14 non-weight-loss ways to gauge how a ketogenic or low-carb diet is working for you. But what if you do want to lose weight? Sure, lower blood sugar, lower blood pressure, remission of migraines, disappearance of hypoglycemia and brain fog, and total resolution of acid reflux are all pretty great, but what if one of your goals is to see the number on that dastardly scale go down?

There’s nothing wrong with wanting to change the size and shape of your body. But a scale is a terrible way to assess whether you’re accomplishing that. Here are seven reasons not to depend solely on the scale when you’re using keto to change your physique. (Some of these are excerpts from my book, The Stall Slayer. Lots more info in there about using keto/low-carb for fat loss. I also recommend checking out this video I did on reasons to stay off the scale.)

  

New Book -- Free Preview!

OH MY GOODNESS, EVERYONE!

My new book is almost done! The text is entirely written and it’s all laid out and formatted. Just waiting for my designer to put the final touches on things so we can make sure it's ready to go.

WHAT? I wrote a new book? Yes, sir, I did! And you can download a free sneak peek right here. (Download of the pdf will start immediately when you click that link.) 

As you can see, it’s called The Stall Slayer, and in case the title doesn’t make it abundantly clear, it’s about breaking fat loss stalls on ketogenic/low-carb diets. This is the most common reason people write to me for help – “Why am I not losing weight?” So, rather than write out the same email reply eighty-six thousand times (just kidding...not quite that many people have written to me), I decided to put it all in a book. But if you’ve been reading my blog for a while and you know I tend to over-deliver information (for better or worse), then you probably already figure the book is chock-full of helpful information that goes far beyond roadblocks to fat loss and what to do about them. 

What about fasting? What about exercise? What about thyroid problems? What about alcohol?!All in the book, along with lots of other helpful information and education on SIMPLIFYING things and doing what I've come to call “keto without the crazy.”™ Do you need to count macros? Do you need to measure ketones? Should you use MCT oil? If so, why, and if not, why not? 

I was tempted to post the table of contents so you could see all the juicy details, but...well...I’m kind of paranoid and didn’t want anyone stealing the ideas. I’m hesitant even about posting the cover and title here, but my excitement is outweighing the paranoia. 

The preview pdf here has one error...on page 2, my Twitter handle is @TuitNutrition, not @AmyBerger. (This will be corrected for the final version, but I couldn’t wait to get this posted for you and I knew you wouldn't mind this one little snag for now.) 

I hope to have the book out before the end of the year, but there’s a chance it won’t be available until January. That’s not a bad thing, though: considering the avalanche of people who’ll be looking for fat loss tips after the new year, maybe that’s actually the perfect time. *Shrug.* It’ll be available as a pdf, plus a Kindle version, and there’ll also be a print-on-demand option for people like me who still, in 2019 and beyond, prefer to hold a physical book in our hands – one we can highlight, fold down pages in, and simply have the tactile sensations that come along with reading a hard copy. (But remember, if you buy the pdf, you can always print it out at home or have a store like Staples or Office Max print it for you -- much faster! I assume there are similar printing services at office supply stores outside the US as well. [Pro-tip: If you go this route, consider having the store print it in black & white -- much cheaper that way, and even though I love the images in the book, you won't lose anything critical if you don't see them in full color.] )  

Special thanks to my designer, Sterre de Jager, without whom this would not be happening. (Y’all know I can write, but graphic design is not my forte! Exhibit A, this website!) How did I get connected to Sterre? I’ve actually never met her person. Her father is a fan and follows me on Twitter – all the way from the Netherlands! I tell you, friends, the world is a strange, beautiful place. You can find out more about this amazing serendipity in this video, in which I introduce the book.  

I hope you enjoy the preview, and of course, I’ll be making plenty of buzz when the final version is available for sale, so don't worry about missing it.

THANK YOU, as always, for your support and readership!   

Use this link to download your FREE sneak peek of my soon-to-come book, The Stall Slayer: Get my free preview! (Download of the pdf will start immediately when you click that link.) 

Disclaimer: Amy Berger, MS, CNS, 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 amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Let's Talk About Thyroid -- My Personal Story (Pt. 3/3...for now)

The first post in this 3-part series explored thyroid function in general, including what the different thyroid-related hormones are, the signs & symptoms of hypo- and hyperthyroidism, and what should be included when you have your thyroid hormones measured. (Reminder: TSH and T4 are not enough!) In part 2, we looked at the potential effects of low carb diets on thyroid function. As promised, here in part 3, we’ll do a deep-dive into my own personal experience with hypothyroidism. 

We’ll get into the gory details soon. But as Sam Beckett said in the final episode of one of the greatest TV shows of all time, Quantum Leap, “Instead of ‘once upon a time,’ let’s start with the happy ending.’” I started thyroid medication in January 2017 and here’s what’s happened since then: I’ve lost 17 pounds. My chronic constipation is gone. My hair no longer falls out in alarming clumps daily. My severe, longstanding, and unremitting depression is 89% gone.

This medication has been nothing short of life-changing for me. I still have a ways to go in several respects, but let’s just say that the reason I’m writing about thyroid at all is because, having gone through this experience, it is now almost like a religious mission to me to provide whatever information and help I can to people who are currently, right this minute, feeling as awful as I felt until recently. And I kind of hate saying that. I am as far from a religious (and low carb) zealot as a person can be. And yet, I now feel a compulsion to educate people so they can help themselves. As passionate as I am about the myriad benefits of low carb, and as much as I sometimes want to grab people at the grocery store and talk some sense into them, that is now far eclipsed by my fervor for proper thyroid assessment and treatment.

There’s so much to cover, I don’t know where to start. If you come to my blog for sensible information on low carb and ketogenic diets and don’t give two hoots (or even one hoot) about my thyroid odyssey, skip the rest of this post and wait until next time, when I’ll be back to posting my usual fare. On the other hand, if you suspect you have a thyroid problem, or you know you do and your medication is not getting you where you want to be, this is for you, my dears. You’re not alone.

Let's Talk About Thyroid -- Low-Carb or Ketogenic Diets and Thyroid Function (Pt. 2/3)

I left off last time saying we would look at the effects of low carb/ketogenic diets on thyroid function. Thyroid function is a hotly debated topic in the low carb world. While most people typically experience fat loss, better energy levels, and improved overall vitality on a low carb diet, in some individuals, measurements of thyroid-related hormones suggest that a low carbohydrate intake might be having adverse effects on the thyroid gland. Is it possible that a way of eating that has such wonderful benefits for so much of the body could be harmful for the thyroid?

The effect of low carb diets on thyroid health is quite the controversial issue. Some people following a low carb or ketogenic way of eating find that their T3 decreases after a while. At first glance, we might take this to mean that low carb causes a slowdown in metabolism, or maybe it has other negative downstream effects. On the other hand, physicians and researchers who’ve spent decades improving the lives of their patients with low carb and ketogenic diets have not reported adverse effects on thyroid function. So what’s the deal?

How to Cut Fat on a Ketogenic or Low Carb Diet (and Why You Might Want To)

Reduce fat intake? On a low carb or ketogenic diet?

Amy, have you done lost yo' mind?

You know people use the abbreviation “LCHF,” right? And that means low carb high fat, right?

Yes. Yes, I know. But remember what Ted Naiman, MD, said:

I’ve heard from many, many people who are struggling to lose body fat on a low carb or ketogenic diet. And while there are many possible reasons for this, the simplest, most obvious, and most common one is, they’re eating too darn much fat.

Too much fat?

On a ketogenic diet?

What is this madness you speak of?

Too much fat. On a ketogenic diet.

This is possible. It is, as they say, “a thing.”

Remember: when you reduce your carbohydrate intake to the point that your body must switch over to running primarily on fat for fuel, you go from being a “sugar burner” to being a “fat burner.” But what this means is that you’re burning fat. It doesn’t mean that the fat you’re burning will automatically and unfailingly come from your love handles and thunder thighs adipose tissue (your stored body fat). It could be coming from your fatty coffee, avocado smoothie, fat bombs, or a heavier-than-you-realize hand with nuts, cheese, and ranch dressing.

Bottom line: the more fat you eat, the less of a need your body has to tap into its stored fat to use for fuel. If you’re already lean and happy with your weight, this is no problem. You might need a bunch of fat just to maintain your weight. (I hate you. Lucky you.) But if you’re struggling with fat loss on low carb despite doing “all the right things” and being on-point with your diet, there’s a chance you’re simply overdoing the dietary fat.

It’s true. If your carbs are very low, then insulin will be pretty low, which is what allows you to get into “fat burning mode.” But just because insulin is low doesn’t mean you’ll magically drop body fat regardless of how many calories you take in. Even if you’re in ketosis, the food energy you take in still has to go somewhere. It has to be used or stored. And if you’re using the fat from your food, you’re not going to be using the fat from your hips or belly. After all, that’s what stored body fat is there for: as an energy supply to be used when there isn’t enough energy coming in. If you drink a cup of coffee loaded with 400 calories of butter and coconut oil, your body has no reason to use its backup supply of fat.

Am I saying it’s all about calories? After writing a post like this one, am I actually saying that?! No. It’s not all about calories, but it’s maybe a little about them. Contrary to popular opinion, you cannot eat unlimited fat and still lose body fat on a low carb or ketogenic diet. If you are following a strict ketogenic diet and adding extra fat to things in order to arrive at a “ketogenic ratio” in the ballpark of 75-80% of your calories from fat but you’re having a hard time losing weight, stop doing this! This is the single biggest mistake I see people making with this way of eating. (And I’ve done it, myself. Believe me; I’ve learned the hard way. The running joke on this blog is that I’m not allowed to keep mayonnaise in my house, because it starts as a spoonful with my food, but then, before I know it, it’s me, the jar, a spoon, and 3000 calories later...)

If you’re using a low carb or ketogenic diet for the purpose of losing body fat, you do not need to eat a super, super high-fat diet. If you’re using this way of eating to manage a specific medical condition that might require a high level of ketones for efficacy, that’s a totally different story. (See here for details on this.)

So, if your goal is weight loss, but you’re having a hard time, here are some tips for reducing fat intake while still keeping carbs low:

New Perspectives on Low Carb Diets for Weight Loss

As I wrote about in a recent post, I’ve finally gotten active in a few Facebook groups dedicated to low carb and ketogenic diets. There’s a world of good being done there, and heaps upon heaps of great information being shared—life-changing and life-saving information people aren’t hearing from their doctors. But there’s also a lot—and I mean a lot—of stuff that makes me want to: a) grab people tightly by the upper arms and shake some sense into them (because that’s more humane than ramming them head-first into a brick wall, which is what I’d really like to do in some cases), or b) wrap them in a long, warm hug, and help them feel better about things. I got all my keto-related anger out in the epic end-of-year rant I posted in December, so today, let’s focus on the kinder, gentler side of things.

I am paraphrasing, but here are a few examples of what I routinely read in various FB groups and blog comments:

1. “I’ve been following a strict ketogenic diet for two months and have only lost 10 pounds. What am I doing wrong?”   
2. “I’ve been doing strict keto for three months. I’m off my blood pressure medication and have reduced my insulin dose by half. I feel fantastic and have tons of energy, but I haven’t lost any weight. Why isn’t this working for me?” 
3. “I’m doing a keto diet and I lost four pounds the first week, three the second week, then only two the third week, and now I’m up a pound. What did I do wrong?” 

Stop Following a Medically Therapeutic Diet "Just 'Cuz" (a.k.a. The Keto Train to CrazyTown)

This is a very long post (even for me). Take it or leave it. You have been warned. Comments have been disabled for this one. Love this post or hate it, agree with some of it, disagree with some of it. Whatever your feelings, you are free to express them elsewhere.  


This will be the last of my emotionally charged posts for a little while. I have to get it out of my system, but once it's out and the new year gets underway, I'll focus on posting things that are more educational and helpful (or intended to be, anyway).

It’s funny. Considering I advertise myself as a low carb and keto-friendly nutritionist, I often find myself recommending that clients eat more carbs. More protein. And that they abandon weighing and measuring every morsel of food and pouring olive oil and melted butter on everything in an effort to arrive at some magical, no-fail, automatic-fat-loss-inducing macronutrient ratio somewhere upward of 75% fat.

I have been threatening promising on social media for a while now that I was going to post an epic rant about some problematic things I see when healthy, fit, active people follow a medically therapeutic diet because they have come to believe they should. (Or worse, have come to believe that they have to, because it’s the only way to be healthy and prevent metabolic illness. 

Now, before I get into things, we’ve got to establish some ground rules:

A Word About Upcoming Posts

I try to be a voice of sensibility in the vast and overwhelming sea of information regarding low carbohydrate and ketogenic ways of eating. It even says so at the top of my homepage: “A source of sanity in the sea of nutritional madness.” What I know compared to what there is left to learn is like a thimble of water compared to the Pacific Ocean. There’s a lot more—a lot more—I don’t know than what I do know, but I try to share with you the small bits of knowledge I gain as I hang on for dear life while traversing these tumultuous waters. I’ve done it about digestion, cancer, insulin, fuel partitioning, and more. (My Alzheimer’s book has been completely rewritten and updated for a March 2017 release as a print book from a big name publisher, so I’ll continue do it about Alzheimer’s, too.)   

However, I am starting to worry that, due to my penchant for ranting about things that bother me about the low carb and ketogenic communities, I’m developing a reputation for being an angry, hateful, vicious, and vindictive person. I assure you, I am neither angry, nor hateful, nor vicious, nor vindictive. In fact, “in real life,” I am quiet, shy, and, I’d like to think, gentle and kind. Nevertheless, there’s no denying the fact that I do rant a lot. But what can I say? The utter madness being masqueraded as fact in certain spaces provides no shortage of material to rant about. Being a gentle and kind person, I assume the spreading of misinformation occurs as a result of plain ol’ ignorance, rather than deliberate malice and ill intent. Whatever the intent, the end result is that misinformation is being spread, and because of it, people are experiencing setbacks along their roads to better health, fat loss, better blood sugar control, and more.

Why do I care? Well, like I mentioned in my rant post about fasting, as a nutritionist working with clients, I deal with the consequences of what happens when people follow advice that is either straight-up false, or advice that is perfectly appropriate for a certain context, but which is not applicable to their context.

It’s getting old, folks. I’m tired of trying to respond politely to emails from people who are afraid to eat two ounces of carrots in a serving of mixed vegetables, but who think it’s completely normal to put five tablespoons of butter and coconut oil in a cup of coffee. (Or better yet, to drink that 500-calorie coffee in the morning and say they’re “fasting.”) I’m tired of trying to respond politely to emails from grown adults who are restricting themselves to 45 grams of protein a day because they’re afraid that if they eat more than that, they’ll be at less than 80% fat and they’ll mess up their “keto ratios,” and also because the excess protein will be turned immediately into glucose and cause a huge “spike” in their blood sugar. (No, it won’t. Really, it won’t. Seriously now, it won’t.) I’m tired of trying to respond politely to emails from people who are disappointed and frustrated because they’re not losing weight or are maybe even gaining weight, even though they’re listening to their trusted experts online and are eating more fat – adding lots of extra butter to things, eating fat bombs, and shunning anything that even hints at being lean or low in fat. They’re as afraid of skinless chicken breasts as they are of 64-ounce troughs of Mountain Dew. And I’m tired of trying to respond politely to emails from people who, for whatever reasons—and there are many—are convinced that they must, must be in ketosis at all times. I swear, if I read or hear “I got kicked out of ketosis” one more time…

I am frustrated, and good-hearted people out there trying to follow low carb or ketogenic diets are frustrated, too.

In this spirit, I have a few more rants planned (already written, in fact) about the problematic things I see in the carbohydrate restriction community. But I don’t want to be a one-trick pony. I don’t want to have a reputation as an angry person who only ever posts electronic versions of hissy fits. Nevertheless, now that I’m more active in a few Facebook groups, I am confronted with these problematic things every day, and I feel compelled to address them. Since I don’t want to address them over and over and over again, I am going to post these few rants and then be done with them. (For now. Heaven knows there will always be something else that gets a rise out of me, but I’ll try to keep the ranting to a minimum once these next few posts are out of my system.) And get them out of my system I must. I don’t have children. What I have instead are ideas to write about, and they nag me, metaphorically pulling on my pant leg, until I finally give them they attention they require and see to their care and feeding.

I have three such posts in the hopper. You will know them when you see them. One of them—the last one I’ll post—is a candidate for a spot in my top three longest posts ever (alongside the one about my mother and the one about vitamin J). I thought about breaking it up into three or four separate posts, but I’d rather just get it all out at once and be done with it. Plus, that way, if I ever need to respond to someone on social media, or someone who emails me directly, in regard to some of what that post includes, I can just send them a link and it will all be centrally located.

As for what I’m going to write about after that, I’ll continue with more Low Carb Cooking Class (LC3), and I have not forgotten about the series on the metabolic theory of cancer. I do plan to pick it up again, as we have finally, finally gotten to the point where we can talk about the ketogenic diet and have it make sense. And I have been saying for ages now that I’d like to write something about sodium, and how salt is not something to fear, but that’s going to take a while. Before that, I’m going to post a couple of things that I see a need for, if questions on Twitter and Facebook are any indication: a guide to dining out on a low carb or ketogenic diet, and breakfast ideas for people who either don’t like bacon and eggs, or who are “tired of them.” (Yes, apparently such a thing is possible, though I have yet to witness this rare phenomenon in person.) I’m also contemplating sharing my thoughts on “zero carb” diets, as well as my growing suspicion that a plethora of modern chronic illnesses are driven not just by hyperinsulinemia and hyperglycemia, which are both, of course, huge issues, but by chronic nutrient insufficiency. The more I learn about the nuances of certain biochemical processes and the modern food supply, the more I appreciate just how robust the human body is, because frankly, I’m actually surprised there aren’t even more very ill people in our midst. That there aren’t is a testament to the ability of the human body to adapt and overcome and keep on truckin’ even when all indicators suggest someone is about to keel over and die at any moment.  

That’s all. Just wanted to warn you let you know what’s in store for the next few posts. After that, I’ll get back to writing things that might be more helpful for people, and I’ll try to keep my anger out of things. (Although I have to say, while I don’t want a reputation for being angry, my sarcasm and snark seem to go over pretty well, and I’m totally okay with being known for that.)  ;-) 

Disclaimer: Amy Berger, MS, CNS, 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 amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

Obesity is (mostly) a Hormonal Issue: Let's Stop Pretending it's Solely About Calories

When doctors or nutritionists see someone with gigantism or acromegaly, is their first thought, “Clearly, that person just needs to grow less and shrink more”? No. Obviously not. Because it is clear—like, crystal clear, beyond-the-shadow-of-a-doubt, smack-you-upside-the-head clear that these conditions result from hormonal irregularities. You can no more control what results from the hormonal effects of a pituitary tumor hemorrhaging human growth hormone than you can control what results from the hormonal effects of a fourteen year old boy who found a special magazine hidden away in his dad’s nightstand. (Do kids still do that these days, or do they just find it on the interwebz instead?)

People with gigantism or acromegaly aren’t abnormally tall or large because they want to be, or because they somehow willed themselves to be. They are at the mercy of hormones. Like I said, to anyone with half a brain, this is obvious. No one questions this. No one blames these individuals for needing custom-made clothing or other accommodations. No one says, “Well, if they had just not grown so much…if only they hadn’t let themselves get so tall, they wouldn’t be in this situation.” “They'd be fine if they were just less tall and more short.” No one says idiotic things like this because people understand that this is not within someone’s control.

So why, then, when it comes to the outward, rather than upward, expansion of the human body, does it all of a sudden become about willpower, discipline, and “calories?” Why is not more widely recognized that the horizontal growth of the body results from hormonal irregularities just as the vertical expansion does?

Why do so few people get this?

Attention Data Lovers!

Confession: I am a dinosaur.

I am not tech-savvy, and other than my phone and my computer, I have almost zero electronic gadgets, gizmos, and doohickeys, and cannot for the life of me relate at all to people who line up outside electronics stores the night before a new product is released from their favorite company just so they can be the very first in their family or friend group to get their grubby mitts on the latest and greatest. That I figured out how to create even this sad little blog is nothing short of a miracle. (This is really pathetic, considering I graduated from Carnegie Mellon, which is one of the foremost computer engineering universities in the world. Alas, I studied creative writing there, which is why the writing part of my site is so much better than the aesthetics and functionality.)

BUT: this post is not about me. It’s about you. Specifically, it’s about those of you who are tech savvy, and also those of you who are data junkies.

I am not a data junkie. I don’t have spreadsheets, apps, and wearable devices loaded with numbers and metrics about my body. I don’t own blood or breath ketone meters, nor a heart rate monitor, nor a blood pressure cuff, nor a Fitbit, nor a fancy-schmancy watch that keeps track of running pace. Like I said: di-no-saur.

HOWEVER! I know many of you, dear readers, are not living like it’s 1987 (except my phone and computer are both way smaller now), and you do enjoy employing the technology available to track all sorts of health-related data.

With this in mind, allow me introduce you to Heads Up Health. The people at Heads Up Health have asked me to let you know about the very handy one-stop-shop they’ve created for you to keep track of all your data in one convenient place.

Constitutional Obesity Resistance Vs. Constitutional Obesity Propensity

Although activity on my Facebook and Twitter accounts might suggest otherwise, I’m not a big fan of social media. I participate in it because I feel like I “have to,” not because I particularly enjoy it. Then again, as I am extremely introverted, it’s a great way to interact with people without having to really interact with them. I can unplug and disengage the second I start feeling uninterested, overwhelmed, or exhausted. That being said, one of the great things about Twitter is that I get to interact with some quite brilliant people whom I would never otherwise have “met,” and I am regularly presented with ideas that blow my mind. (That’s how I came across the stuff about Dr. Kraft’s insulin assays, which inspired the insulin series.) Often, these are ideas and concepts that should be pretty obvious to me, and the only reason they aren’t is that I’ve just never stopped to think about them. And not only are they pretty obvious, but they’re often put out there or tweeted about casually, as if the writer is saying something relatively simple. A one-off post or a couple of lines about something that seems like no big deal and is a total no-brainer to them, but which, upon reflection, turns out to be a huge deal to me.

For example: the registered nurse who goes by the online nickname “Woo” frequently drops knowledge bombs that send me into a hurricane of thoughts. She holds no punches and does not suffer fools. Her writing style takes some getting used to, but she is truly one of the most intelligent and insightful people currently writing about metabolism, endocrinology, calories, ketosis, fat adaptation, body weight regulation, PCOS, and lots of other things many of us are interested in. Time and time again, something she posts makes me see things in a new light. So much light, in fact, that she should buy stock in General Electric, Phillips, or some other company that manufactures lightbulbs, because that is how many of those things go on over my head when I read her work.

Case in point: a few days ago, Woo made the correct observation that, in many cases, children who are put on a ketogenic diet (KD) for epilepsy can actually stop the diet after a couple of years and remain seizure free for life. Something about staying on a KD for some period of time during one’s formative years seems to actually permanently correct the underlying problem, such that the diet can be abandoned later on and the seizures do not return.

Coupling this fact with some observations about people on low-carb and Paleo diets, she came to some rather fascinating conclusions, and proposed an observational study. First, I’ll tell you about the study, and then we’ll work through the rationale for it, via exploring some intriguing things about body weight, and why some of us are so incredibly prone to accumulating excess adipose tissue, while others are not.

The observational study would be intended to test the following hypothesis:

Being Fat Adapted Versus "In Ketosis" (Pt.3/3)

Now that the issues of fat adaptation and fat loss versus ketosis—or the lack thereof—have been clarified, let’s move on to a related issue that drives me crazy: newbie low-carbers freaking out if they eat something that not only takes away that beloved purple, but—gasp!—causes the scale to go up a few pounds.

When a low-carber who doesn’t understand some basics about human physiology gains weight after indulging in a pile of something sweet or starchy, they go absolutely apoplectic. Not knowing any better, they step on the scale the next day, see that their weight has gone up a few pounds, and they Just. Freak. Out. I can’t count how many times I’ve seen people post to forums and message boards either in tears or in a raging anger, because they ate a donut, or a bagel, or two slices of pizza, and gained, say, four pounds the next day. They then fall into thinking that their body is so fundamentally carbohydrate intolerant that after indulging in one carbohydrate-laden meal, they gained, overnight, four pounds of fat. (Never mind that the total weight of the amount of food they consumed for the entire day probably didn't even weigh four pounds, let alone that one bit of carb splurge, so I don't see any logic to how they think this works, but I digress.)

I’m not really sure how to talk about this without expressing grave concern over these well-intentioned folks’ ignorance as to the inner workings of their own bodies. (And by “expressing grave concern,” I mean, “shaking my head at the utter lunacy out there.”)

Time for a quick lesson in glycogen storage. 

Being Fat Adapted Versus "In Ketosis" (Pt.2/3)

In the previous post, we established the difference between fat adaptation and ketosis. Now, let’s revisit the “got kicked out of ketosis” thing. 

People new to low-carbing—and also people not-so-new, but who just don’t understand how this all works—will utter that dreaded phrase when they pee on a ketostick and don’t see their beloved dark purple, or—gasp!—not even a little pink. No color change at all. They will then assume that whatever they ate sometime prior to testing “kicked them out of ketosis,” and they will summarily cross that food item off their menu forever, banishing it to their ever-growing list of forbidden foods. (They will also spread tales of woe on forums far and wide, thereby terrifying other newbie low-carbers into avoiding these foods as well.)

But here’s the thing: ketostix are fickle things. Elevated ketones in the blood, urine, and breath, are fickle things. What else was going on before testing? Was this person very acutely stressed? Did they do an intense workout? Both of these can cause a temporary rise in blood glucose (albeit a smallish one), which might trigger a temporary rise in insulin, which could put a temporary stop to ketosis. Temporary. Note: it will not put a stop to being fat-adapted; only to having excess acetoacetate in the urine or elevated beta-hydroxybutyrate in the blood at that particular moment in time.

Being Fat Adapted Versus "In Ketosis" (Pt.1/3)

UPDATE!! (9/20/2017)
I have a new post that explains how and why the body produces ketones, It will help you understand much better the difference between burning fat and having a fat-based metabolism, versus being "in ketosis." It's very long, but I think it's worth reading if you'd really like to understand this -- and if you want to stop freaking out about your ketone levels. (If you click over to that post and want to read only the section that explains the difference between ketosis and running on fat, scroll way down to where it says Ketogenesis: How and Why Do We Make Ketones? Also: Fat Adaptation versus Ketosis.) Happy reading!

“I got kicked out of ketosis.”

If I never hear or read those six words, in that order, ever again, I’ll be one happy individual.

Based on what I come across on low-carb forums, blogs, and videos, there is a lot of confusion about the correct use of urine ketone test strips (which I’ll sometimes refer to as ketostix, since “ketone test strips” is a mouthful, even when you’re only reading). So allow me to ‘splain a little bit about how to interpret these things, and what role they should play—if any—in your low-carb life.

First and foremost is the most important thing you will read in today’s post. (And it is so important that I will likely repeat it in all the posts to follow in this little series. Plus, you can tell it’s important because it’s red, bold, in italics, and all caps, hehheh.)

You can be in ketosis and not lose body fat, 

and you can lose body fat without being in ketosis.

  

Food for Thought Friday: Rickety, or Robust?

I have bad news, everyone: we’re going to get old.

All of us. Every single one of us.

If we’re lucky, that is.

If God, or nature, or the universe, or whatever, sees fit to let us ripen to an old, old age, it will no doubt be a bumpy ride. Predictable and unpredictable ups & downs and trials & tribulations await us. As a dear friend’s grandmother used to say, “It’s hell to get old, but the alternative isn’t any better.” (Getting old really is a privilege. Not everyone is so fortunate.) (Aside, to MW: I don’t know if you still read my blog or not, but if you do, it was your grandmother, HC, who said that.)

If we’re also lucky, we will retain most of our physical and mental/cognitive capacities well into old age. Some of these will inevitably decline—the physical more so than the mental/cognitive. And if we do start to experience cognitive decline, guess what? Alzheimer’s is the result of "REVERSIBLE metabolic syndromes." And for once, that’s not me saying so, but rather, the MD who knows it’s reversible, because he’s done it. But I digress…

It’s just not reasonable that an eighty-year-old will have the same strength and speed they had in their younger years, even for individuals who devote a significant amount of time and effort toward preserving strength and mobility as they age. We can slow the loss of muscle mass and muscle strength, but we cannot stop them completely.

Why Am I Not Losing Weight on LCHF? (Pt.5 - The Little Things)

We’ve covered several big concepts so far in the past few posts on stubborn fat loss. You might not think they’re big, but assessing the kinds of food you eat and how much, addressing nutrient insufficiencies and digestive efficiency, optimizing thyroid function, and getting out of your comfort zone and into your discomfort zone can go a long way toward getting your body to finally start releasing some of the excess adipose tissue it’s so desperately clinging to.

But what happens when you’ve already done all that, and the weight still won’t budge? You’re at the point where you honestly don’t know what else to do. Your diet’s better than ever. You’re pushing yourself hard, physically. You’re getting many hours of deep, restorative sleep every night. Your bloodwork looks great. You’re off most of—or maybe even all of—your meds, and your doctor is thrilled. Everything’s peachy! Except, that is, for your belly, your chin, your upper arms, your hips, your thighs, or your backside, all of which are exactly the same size as when you started putting things into high gear.

WHAT GIVES?!

Well, when it seems like there’s really nothing left to do, there are, in fact, a few more things to try. We’ve gotten all of the big things out of the way, so now, let’s look at the little things. To be honest, I don’t think these are huge roadblocks for weight loss, but who can really say? If you’re really, truly, doing everything else and the weight still isn’t moving, then it’s worth looking into these issues to see if they’re standing in your way. Again, I don’t think these are anyone’s primary obstacles to fat loss, but when you have well and truly exhausted all other possibilities, and you’re still struggling, then quizás, quizás, quizás…

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.”

Really?

Really?

You’ve tried everything?

Every single thing under the sun?

Why Am I Not Losing Weight on LCHF? (Pt.3b - Thyroid)

Testing & Interpreting Thyroid Hormone Levels

If I really wanted to do justice to the topic of testing and evaluating lab values for thyroid and associated hormones, I could write approximately 85 posts and probably still not cover all the nuances. So we’re going to do the quick & dirty overview, and then I’ll point you toward some resources for more information.

Remember: the reason we’re taking some time to delve into thyroid function is because we’re exploring reasons for difficult (seemingly impossible) fat loss, even on a good LCHF diet. And thyroid dysfunction is very near the top of that list.  

It is a freaking travesty that so many doctors run one test, and one test only, when a patient requests a thyroid test. This is for thyroid stimulating hormone (TSH), which, as I mentioned in the previous post, is not a thyroid hormone at all, but rather, a signaling molecule produced by the pituitary gland. The reasoning behind testing TSH is, if TSH is elevated, then something is wrong with the thyroid gland, because if the thyroid gland were responding normally to TSH, then TSH wouldn’t be elevated.

If your TSH is high, a doctor might put you on some sort of thyroid hormone, without ever digging deeper to try and ascertain WHY your TSH is high, and without ever testing other hormones. They will give you medication without actually trying to solve the problem. (Modern medicine is profoundly excellent when it comes to trauma and emergency care. But when it comes to this stuff, it is somewhere in the realm of COMPLETELY USELESS.)

Why Am I Not Losing Weight on LCHF? (Pt.3a - Thyroid)

In the previous post in this series on stubborn weight loss, we talked about nutrient deficiencies as possible roadblocks to losing body fat, even when someone is faithfully following a low-carb, higher-fat diet. I left off saying that there are nutrients we typically associate with thyroid function, and thyroid function is a huge player, not just in fat loss, but in metabolism and energy generation as a whole. If your thyroid is on the fritz, or forces outside the thyroid gland are making it go on the fritz, fat loss will be very difficult. So this post and the next one will focus on nutritional factors that help the thyroid, as well as dietary and lifestyle factors that hurt the thyroid.

I have had many clients who were on thyroid medication of one kind or another. It was obvious to me, however, that whatever medication they were taking was not helping, because they were still overweight, depressed, fatigued, and had other signs and symptoms of low thyroid function. To my astonishment, these people were typically dumbfounded by my asking them, “Do you think the medication is working? Do you actually feel any better?” (Apparently, none of their physicians had ever bothered to inquire, and the clients had never stopped to ask themselves if they were feeling better.) The answer, which required no hesitation or deliberation on their part whatsoever, was an unqualified NO. Of course it was no. If they did feel better, and they were losing weight, they would not have sought my help in the first place. This isn’t rocket science, folks. If you are “on thyroid medication,” but you still feel like dog-poo, then either the dose is not optimal for you, or the type of medication is not right for you. Before we can get into detail on medication, though, we need to talk a little bit about thyroid function in general, and then we’ll see where nutrients and meds fit into the picture.

Why Am I Not Losing Weight on LCHF? (Pt.2 - Nutrients)

This is the second installment in a short-ish series looking at roadblocks to fat loss, even when it seems like you’re doing “all the right things.” If you missed part 1, you can check it out here, and here’s a link to a post about the complexity of weight loss in general.

Since we covered some of the “duh” stuff last time—the stuff that most of you are already aware of and were probably angry with me for even writing—this time, let’s get into some issues that might resonate with more of you, and, perhaps most importantly, provide you with information you can apply immediately if they do resonate.

In the series I wrote about insulin (which general consensus says totally kicked butt, by the way), I frequently used the word lipolysis. I explained that that’s just a fancy way to say “breaking down fat.” (“Lipo” for fat, and “lysis,” for splitting apart.) I further explained that lipolysis is the splitting of a triglyceride into its component pieces: a glycerol molecule and three fatty acids. The reason lipolysis is such an important process is that it is the method by which body fat is released from adipose tissue (fat cells), in order to travel through the blood to arrive at a destination where it can be burned for energy, such as in muscle cells. (10-second refresher: triglycerides are too large to pass through the cell membrane. In order for them to get out of the fat cell—which is what we want and need to happen in order to burn that fat—they have to be broken down into smaller pieces.)

As we also covered in the insulin posts, insulin gets in the way of lipolysis. (Scientifically speaking, insulin inhibits the enzyme hormone-sensitive lipase, which is what starts the lipolysis ball rolling.) This is one of the mechanisms by which low-carb diets work: keep insulin levels low, and lipolysis is free to proceed. Keep insulin levels high, and that fat ain’t goin’ nowhere, no-how.

But here’s the thing. And pay attention, because this is a very big thing: