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?” 

Let’s address point number 3 first, since it’s the easiest to knock out of the way. As I wrote about back in this post, weight loss is almost never linear. It just isn’t. To expect it to be is an exercise in frustration and disappointment. If you want to be frustrated and disappointed, then by all means, go ahead and expect that your weight loss will be a straight decline, with absolutely no stalls, plateaus, gains, bumps, or hiccups along the way.  

When you want your weight loss to look like this…

…but it actually looks like this…

  

…well, there’s nothing wrong, mysterious, or surprising about it. Not in the slightest. This is how it happens. If your weight loss is linear, especially over a long period of time, with no plateaus and no ups and downs, just downs, downs, downs, please see a doctor ASAP, because you might have some kind of terrible wasting disease and you should get that checked out STAT. Otherwise, ups and downs are normal. They’re angering, yes. They’re frustrating, yes, and disappointing, yes. But They. Are. Normal. Capice?  I could waste lots of time blathering on about why they’re normal, but my posts are already always too long, so if you want to pick my brain about that, feel free to book an appointment.  ;-)

Let’s look at that second weight loss graph.

As I explained a while back, there are all kinds of hiccups along the way. We’ve got some stalls & plateaus wherein weight stays the same for a while, and we’ve even got some weight gain here and there. But when you look at the entire graph, the progression, over time, is downward.

But what happens when people trying to lose weight step on the scale every day? The small day-to-day fluctuations drive them absolutely crazy. Being “stalled” for a week or two—or a month or two—or gaining a pound or two or four, might even make them quit whatever program they’re following, when they’re actually doing just fine.  According to the good doctors Volek and Phinney, day-to-day fluctuations of as much as four pounds are totally normal. It is not reflective of fat loss or gain. (What could it be, then? Water, glycogen, karma, Saturn rising in Aquarius…) And I can’t find the reference at the moment, but I’m pretty sure I’ve heard Dr. Phinney say he doesn’t consider it a “stall” unless there’s been no change in weight or size (inches/cm) for more than eight weeks. Eight weeks! And most people posting on keto and low carb forums with woeful tales of stalled weight loss are frantic because it’s been one or two weeks. *Facepalm.*

Here’s another fun way to look at how weight loss works in the real world:

I saw this image on Facebook and saved it because it was so awesome. I don’t know who created it, though, so I can’t give credit where it is due. Please know that I am not trying to take credit for work that is not mine. If you happen to know who made this, let me know and I’ll update the source info.

On to points 1 and 2:

Here is my combined response to people who post similar tearful tales:

“You’ve lost 10 pounds in 2 months? You should be proud of yourself and celebrating, and instead you’re beating yourself up and feeling like a failure. Please stop! Please think about it this way: if you had gained 10 pounds in 2 months, that would seem like a very, VERY BIG DEAL, right? So why is it not an equally big deal that you've lost that much? You said it yourself: you’ve already experienced a huge improvement medically and you feel fantastic. That says it all. Please, give yourself credit!”

Let’s focus on the sentence in bold. I emphasized it because I wish I could say this to everyone out there who’s fretting and feeling disappointed at what they perceive as a slow weight loss. Any loss -- any loss at all -- is proof that at least something you’re doing is effective. What if you’ve “only” lost eight pounds, instead of ten? Or you’ve lost six or just four pounds? You’ll beat yourself up for your perceived failure, when if you had gained four, six, or eight pounds in the same timeframe, you would ... well, you would beat yourself up for your perceived failure. (Why? Because eight, six, or even four pounds ARE a big deal! Got it? Good!)

About the second part—experiencing wonderful improvements in medical conditions, even when weight loss is slow or perhaps not even occurring at all: fat loss is a nice goal, but if you are living with metabolic syndrome, T2 diabetes, heart disease, PCOS, kidney dysfunction, hypertension, or any other condition currently believed to be intimately linked to insulin resistance, then your time and dietary efforts are better spent focusing on improving your health, rather than your weight. Low carbohydrate and ketogenic diets have many, many benefits beyond weight loss. In fact, some of the therapeutic effects are observed in people who don’t lose weight. So rest assured that in following a nutrient-dense low carb diet, your health is likely improving even when the dastardly scale would have you feel like a failure.

And remember—always, always remember—being “thin” is not indicative of being healthy. Body mass index and other metrics that take only body weight into account say absolutely nothing about someone’s metabolic health. I use the acronym “TOFI” pretty casually (thin outside, fat inside), but it’s actually a pretty big deal. To the extent that excess adiposity is reflective of insulin resistance and harmful metabolic dysregulation, then yes, losing some of that excess fat is probably a sign that you’re correcting some of that dysregulation. But in that case, the goal—the prize to keep your eyes on—is better health, not smaller pants.     

Easier said than done, I know. (Believe me, I know. I haven't learned all this by serendipity, y'know.) But just something to keep in mind, because it makes me sad when I see people feeling like low carb isn’t working for them when they’re actually doing beautifully.

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.