This article is the second article in my Troubleshooting series. The first article contains some similar information about general health (exercise, sleep, stress, etc.) but is specific to blood glucose control. Please see the first article “Troubleshooting High Blood Sugar” HERE.
I often get messages with people saying that they are on a low carb diet and are still experiencing problems with losing weight. Then they ask me what to do. Well, this raises about a hundred questions in my mind. How many carbs are they eating and when? Do they exercise? Do they take medications? How do they sleep? Control stress? Unfortunately, there are many barriers to losing weight and keeping it off, some of them very complex. The answers are not simple. At times, it may take a thorough investigation into not only your diet and lifestyle habits, but looking at medication regimens and a host of medical issues that could be at play. Without knowing each person’s individual health history and lifestyle habits, it is just impossible for me to give a 100% answer to each individual. Keep in mind am not a physician. I do not have a lab. I cannot give you opinions on your lab work as this oversteps my scope. So, I thought I would compile a list of “troubleshooting” tips that I personally have found effective for me. Maybe these will help you. These are based on my personal experiences with my own weight. Sadly, I started dieting when I was 10 years old. Anyways, these may or may not be 100% applicable to you.
Test Your Blood Sugar
Testing blood glucose for weight loss? This lady has a screw loose, right? Lol! I don’t have diabetes so I don’t need to check my blood glucose, right? Wrong…
Testing blood glucose (EVEN IF YOU ARE NOT CURRENTLY DIAGNOSED WITH PRE-DIABETES OR DIABETES) is one of the most powerful tools for weight loss and preventative health. Nearly all major chronic disease is related to elevated blood glucose, such as diabetes, heart disease, strokes, alzheimer’s and dementia, kidney disease, liver disease, cancer…not to mention obesity…and the list goes on.
In addition, at this time, there are approximately 90 million people in the United States with pre-diabetes. The more disturbing fact is that about 90% don’t know they have it. Pre-diabetes IS diabetes. And the earlier diabetes is detected, the earlier it can be reversed with less chance of chronic complications. So, in testing our blood glucose for weight loss, you may also determine that you have pre-diabetes or diabetes.
Here is an article by Dr. William Davis, a Cardiologist and Author of “Wheat Belly” and “Wheat Belly Total Health” which will outline some basic concepts for blood glucose testing.
“Blood Sugar: Tool At Your Fingertips HERE
So how do we do this?
First, we want fasting blood glucose to be mid-80’s or lower, but definitely below 90. Once you have reached fasting BG in the 90’s, you are starting to show some signs of glucose tolerance problems. Once you hit 100, you have pre-diabetes (in other words, you have diabetes). Peak post meal should not be much higher. I aim for <110 for all peak post meal readings. An occasional trip up to 120 might be acceptable for some if it is brief and infrequent. I certainly would not suggest going over 120.
Next, you would need to determine peak post meal time (you will only need to determine this once to get a general idea). Test every 30 minutes after the start of a meal and continue to do so until you see the number go down. The time when your blood glucose was highest was your peak post meal blood glucose. For those without diagnosed pre-diabetes or diabetes, this will most likely be around one hour. From this time onward, test all post meal blood glucose at your determined peak time.
So, I suggest testing your pre and peak post meal blood glucose for each meal. If you stay within blood glucose targets, I suggest building a list of “safe” foods. If you go above target, I suggest repeating the meal with 1/2 the amount of carbohydrates. If you still cannot get into target with 1/2 the amount of that type of carbohydrate, I suggest eliminating that source of carbohydrates. Otherwise, if you continue to consume a food that your pancreas cannot process, you will eventually need to take medication to control blood glucose to keep consuming these foods. To me, no food is worth medicine. Only you can determine for yourself whether it is…
So, begin a blood glucose testing regimen. This may give you a key piece of information you may have been missing.
Carbs – Too Much or Too Little
Since there is no actual definition of a “low carb diet”, let’s explore this topic first. I personally define “low carb” as under 100g of carbs per day. This may be an adequate range for someone who is “low carbing” for general good health. BUT, if you are overweight or have blood sugar regulation issues, I suggest that you get more aggressive, preferably under 50g per day. If you have diabetes or you are at high risk for developing diabetes and are trying to PREVENT it, then 30g per day may be a better suggestion. You have to determine your own level of carb tolerance by your individual response to carbs (see article “Eat to Your Meter” HERE.)
Carbs should come predominantly from non-starchy vegetables and some nuts (limited). I highly recommend that they not come from sugar or grains. And be careful of low carb “treats” as well as excessive dairy.
Let’s also talk about eating patterns. As we will talk about below, our body works on a rhythm or cycle. I think that, just as it is important to sleep the way we were intended to sleep, I think we should also eat in a reasonable pattern. We have come to develop these eating times based on our work schedules, or convenience factors, that may not be the best for our blood sugar and weight regulation. I do not believe that the biggest meal of the day should be at night. Nor do I believe we HAVE to eat breakfast. Nor do I believe that we need 3 meals per day, although there is nothing wrong with that per se. I also don’t buy into the new fad of using fattened coffee as a meal. Food is not only to provide energy, but to provide nutrients. I don’t consider coffee a nutritious meal. So, if you wake up in the morning, and you are hungry, eat. By all means, eat. Eat to satisfaction. If not, don’t eat. If you are not hungry, there is nothing wrong with delaying a meal until late morning, say 11 or even noon. In my opinion, THIS should be the biggest meal of the day, either early or mid-day. Then dinner, if hungry, should be lighter and still early, say no later than 5 -6 pm. Then no eating until the next morning to provide a long nighttime fast. I have found that late eating increases my blood glucose and weight. I try to never eat after 6 pm. But I find my BEST blood glucose and weight regulation when I eat at say 10 am (my biggest meal) and then around 4 pm – only 2 meals per day, fasting for the remaining time. I do this occasionally, but sometimes I am just hungry and need that third meal. So my pattern is more one of “intermittent” fasting. Either way, no eating past 6 pm for me. Oh, and PS, no in-between meal snacking….
Is there such thing as TOO LITTLE carbs? For some people, YES!! And I know this is going to get all the zero carb people in a tizzy, lol. But extremely low carb is NOT for everyone. Please, you do not live in another person’s body and you don’t know what they experience. I’m going to share a little personal experience that I have been having the past six months or so. Well, I’ve had some stalling myself. So, I added a daily, but brief periods of moderately intense exercise, and strength training 2-3 times per week. And I have found that I have been doing better with my weight when I went to 35-45g of carbs some days, particularly on my strength training days. So, I alternate between about 30g some days, then 35-45g some days. As I have said a MILLION times before, my body seems to adjust to whatever I do on a regular basis (every day). So, alternating the amount of carbs has helped get the scale in motion lately, and I feel a lot better. I have heard this from others that 20-30g is too low for them, but 40-50g is their sweet spot. So, experiment, and do what is right for YOUR BODY. Please, no shaming others for eating more carbs than you do. It’s not a competition 😉 Surviving on less carbs does not NECESSARILY mean you have more character as a human being, lol! IT’s NOT JUST ABOUT THE CARBS. Ahhh, that felt good to say.
Protein / Fat
For those of you that are new to any form of low carb, you may not know yet that protein and fat recommendations are a HUGE “hot-button issue.” So if I seem a little exasperated in this next section, it is because I know the following information may stir up some folks. So I am trying to stress the need to be more reasonable, use common sense, and do what is right for YOU and YOU ALONE.
As I belong to MANY LCHF groups, I frequently see the advice “you’re getting too much protein” or “eat more fat.” Both pieces of advice may be right, and both could be wrong, for that particular individual. Please folks! Not everyone’s body is EXACTLY alike. Some people do better with more protein, and less fat (still high fat, just not excess fat).
So, let’s address protein first. Yes, I understand gluconeogenesis!! If I hear the word again, I think I might just rip my hair out, lol! Some folks have taken “moderate protein” to mean “just enough protein to keep your body from eating your own muscles.”
The minimum protein recommendation in the U.S. is about 0.36g per pound of body weight (or 0.8g per kg of body weight) for the average SEDENTARY person. So, for example, for a 150 lb person, that is 54g of protein. For a 200 lb person, that is 72g of protein. PLEASE folks! Don’t go under the minimum requirement. And if you are NOT sedentary, if you are younger, if you are pregnant, if you exercise (especially strength training), you will most likely need more.
There are NUMEROUS studies to show that protein has a POSITIVE effect on weight loss. Ideally, you should be involved in vigorous daily exercise (see below), which means you may need more than the minimum amount of protein.
Now! What about those that are concerned that their blood sugar will rise with excess protein. The minimum protein is NOT EXCESS. Protein is, as a dear friend recently reminded me, NOT chocolate cake. I agree with not eating EXCESS protein. So, if you sit down to a 12 ounce steak, by all means, cut it in half. But please don’t get less than the minimum amount of protein for fear of gluconeogenesis.
If you are concerned about the blood sugar effects of getting the MINIMUM amount of recommended protein, than you have bigger blood sugar issues than protein. I would suggest looking at my “Troubleshooting Blood Sugar” article HERE.
If you are on a THERAPEUTIC ketogenic diet and must keep protein low for THERAPEUTIC reasons and need to remain in ketosis or to keep ketone levels high, once again, for THERAPEUTIC reasons (such as for epilepsy or cancer), than that is one thing. But the overwhelming majority of us are on a low carb, or ketogenic diet for more GENERAL health reasons (weight loss, diabetes, etc.) and do not REQUIRE certain therapeutic levels of ketones.
I have had MANY MANY people who belong to groups that use slightly higher protein and do TREMENDOUSLY well with blood sugar AND weight loss. Once again, this requires self experimentation. I personally feel terrible if I eat less than about 4 ounces (of lean protein) or 5 ounces (of fattier protein) per meal (about 25-30g of protein – or as I refer to it, a palm-sized portion). Of course, occasionally, I only eat 2 meals. But most days I eat 3. On my strength training days, I definitely feel the need for 3 meals.
What I’m saying is, the amount of protein YOU decide is right for YOU, is right for YOU. Don’t be shamed into eating less than your body tells you.
Now, let’s talk about FAT.
Let’s get one thing clear. The act of eating fat DOES NOT make you burn fat. Eating MORE fat does not make you burn MORE fat. It is the act of restricting carbohydrates that makes your burn fat. And yes, that means that the fat you eat, will get burned as well, if your carbs are low. But if you eat all the fat you need to in a day, your body will burn THAT fat, instead of your stored body fat. Your body will burn a somewhat set amount of “calories” (although I hate that word and I do not advocate calorie counting) in a day. If you give it more than it needs, than you will not tap into stored fat. Overeating is overeating…PERIOD.
Let’s clear up another misconception. And I will tell you this from personal experience….KETOSIS is NOT synonymous with weight loss. Yes, you CAN gain weight, EVEN IN KETOSIS. Ask me. I was starting to regain weight while eating a 20g of carbs per day strict ketogenic diet. Everyone kept telling me to eat less carbs and even more fat. I feel like garbage when I eat fewer than 20g of carbs because I don’t get enough vegetables. So, that advice was BAD, FOR ME. I finally learned that LCHF does not mean I should be on a fat feast. Just look around in the ketogenic community. There are plenty of other folks who maintain a ketogenic lifestyle and still have weight to lose. So, please don’t think that as long as your ketosis, you can have a fat free-for-all, especially if you think that will get your ketones higher and that means you are burning more fat. No, no, no. You’ll burn fat alright, but it will be the fat you are consuming, not the fat on your body. In other words, if you eat too much fat, more than you burn, you’re going to gain weight, regardless of how high your ketones are. Once again, I learned this the hard way. TRUST ME, it is possible to gain weight in ketosis, EVEN WHEN YOU ARE DOING IT RIGHT.
PS, let’s address that…”not doing it right.” Some people feel that if other people don’t succeed in weight loss, or overall health, as well as they PERSONALLY did, then the other person “must not be doing it right.” Some people can DO EVERYTHING RIGHT and still not have the same successes as the next person. So, please don’t shame other people or make the statement that they must be “doing it wrong.” Most often, this is just not the case, and in fact, that person may be doing it MORE right than you, lol! Besides, how do you know that someone is “doing it wrong” when you don’t even know how they are “doing it” to begin with? Please, no more assumptions that others are “doing it wrong.”
Bottom line, if you are not hungry, you should not be eating extra fat. The majority of the fat you eat should be from your protein sources and from what you use to cook with, not in excessive amounts of ADDED fats. WHEN you have reached your weight loss goal, YES, you will need to significantly increase fat to STOP losing weight or to MAINTAIN your goal weight. But if you are overweight, stop eating so much fat (if you are not hungry). Fat should be to satisfy you, not to gorge on. This means that we really also need to re-examine exactly what true hunger is. I can tell you that I have fasted for up to 3 days and I can honestly say that I was still not truly HUNGRY at the end of my fast.
When many of us were on high carb diets, “sugar burners,” we remember the panicky feeling when we tried to go 5 hours without something to eat. Often we stuffed ourselves if we were in fear of not being able to get our next meal on time, so we could make it a little longer. So, we developed a warped sense of true hunger.
When we eat adequate protein and fat, our sense of hunger should adapt. We no longer have to stuff ourselves, or to eat excess food out of habit or for pleasure.
Lastly, I see many people eating excess fat because they feel like they have to “get their fat in” to reach some sort of magical pre-conceived macros that someone told them is THE ONLY acceptable macros for LCHF. NEVER eat above your hunger level. If you have belly fat, then your “fat is IN.” Once again, please use some common sense and do what is right for your body. (This is covered very well in Dr. Arain’s video below. Please, please take time to watch it.)
Just be reasonable about the fat folks, use common sense.
While I am in total agreement that exercise is NOT the primary way to lose weight, and exercise DOES NOT make up for a bad diet, exercise is absolutely crucial to good health. Just about every living person can exercise. There are activities that everyone, no matter how limited in abilities, can do. If you are healthy and have no obstacles to exercise, I suggest that you start a daily exercise routine. Exercise can increase insulin sensitivity and help you lose weight, when combined with healthy eating. I understand that for most people, exercise is not enjoyable. Most people hate it. We are overworked, tired, stressed, etc. But those are the exact reasons people NEED to exercise. Exercise increases your energy levels, helps you sleep better and helps relieve stress, not to mention all of the other benefits to your health. We have got to stop making excuses. I have been guilty of this. My problem was that, as with everything else I do in life, I don’t know how to do anything moderately. I always felt I had to do the max amount of exercise I could tolerate and then I would hate it. I really WAS too tired for that kind of exercise. It is so unnecessary. A while back, I decided to find some very simple, enjoyable exercises to do. For instance, I do about 20-25 minutes of high intensity exercise (including warm up, cool down and stretch) that I do daily. I also do strength training 2-3 times per week. Exercise doesn’t have to require hours of time, or a gym membership. Just commit to 15 minutes, then in time, try to increase to 30 minutes each day. Since I have been doing this, I have seen a significant improvement in my BG and the scale, which had been stagnant, has begun to move. If you are limited in ability, try seated strength training exercises, resistance bands, etc. There is SOME type of activity that every person should be able to do. Finally, timing of exercise can be important as well. Exercise earlier in the day being preferable to exercise in the later evening as this coincides better with natural hormone fluctuations. This is more of a factor with vigorous exercise. If you exercise vigorously earlier in the day is better. Mild exercise should be fine at any time. But preferably no exercise within 2 hours of bedtime. No more excuses. As a well known adage states “just do it.” We can’t expect results from work that we don’t do.
On the other hand, is there such a thing as too much exercise? YES. Chronic, long periods of exercise can keep your stress hormones up, keep you inflamed, prevent adequate muscle building (from too little rest time), and block weight loss. You know, often, I don’t feel like exercising, but I push through it. I almost ALWAYS feel better afterwards. What if I don’t? What if I go many days not feeling that great after exercise? Maybe a little break is in order. Be careful about getting too off track with exercise, because often when we miss a few days of exercise, it will set off a pattern of missing for a long time. But take a few days off and rest when you need to. Listen to your body. It may be telling you something. I recently took off about 4 or 5 days from exercise because I spent three days painting and my shoulder was REALLY bothering me, in fact, hurting. I was bummed about taking the time off, but last night, I was able to get back to my routine and the shoulder feels good.
Be kind to your body.
All of the disciplined eating or exercise may be for nothing if you aren’t sleeping well. When you don’t get adequate sleep, hormone fluctuations may keep you from being able to regulate your blood sugar and weight. Once again, I know we are all busy, stressed, etc. We’ve got a million excuses of why we can’t get enough sleep. Well, I’ll just say, if you don’t, then you will have serious health consequences. Every adult needs 7-8 hours of continuous, uninterrupted sleep, but no more than 9-10 hours. And it’s not just the amount of time, but the pattern as well. Sleeping from 1 am to noon the next day is not the best pattern. Our body works on a rhythm that should be maintained as close to its natural cycle as possible. I suggest sleeping from 9-5, 10-6 or 11-7, something like that. Staying up late is just not healthy folks. I personally try to be asleep NO LATER than 10, preferably 9:00. I wasn’t always like this. I used to stay up very late and get up very early. And this pattern took its toll. I understand that shift work may prevent a healthy sleeping pattern. I have worked night shift before. Here is an article that can help you improve your sleep quantity and quality. (HERE)
Once again, if you are doing everything above, but have uncontrolled stress, then all of your efforts may be for nothing. Stress also causes changes to hormone levels that can prevent good blood glucose and weight control. It is not easy to control stressors. We often just cannot remove them. We must then strengthen the way we cope with them. If you have excessive stressors in life, you MUST do something to ACTIVELY control stress. Adequate sleep is the first key to reducing stress. Exercise can also be a stress reducer, and not just vigorous exercise, but also just stretching and practicing active relaxation. Some people pursue spiritual activities. I do all of these. I also use essential oils to help me with both sleep and stress. What I am saying is that stress reduction is not a passive activity. You have to think of things you can do to actively try to control stress. Even if it means going to a private place for 15 minutes and just focusing on your breathing. Or, maybe for you it means going to a private place for 15 minutes, putting on gloves and hitting a punching bag. Whatever it takes, lol! Listening to nature sounds. Aromatherapy. Massages. Accupuncture. Once again, whatever it takes. I don’t suggest “retail therapy” because then the credit card bill will give you added stress, lol! Stress reduction is an area that I have to focus on daily so as not to let stressors get out of control.
There are many drugs on the market that can interfere with weight loss. Some of them are necessary for life. Some, however, may either not be necessary, OR a similar drug can be substituted that does not have this side effect. If you don’t know whether a drug you are taking can contribute to weight gain, do some research. Determine whether you need the medication or if lifestyle change may allow you to discontinue its use. If you cannot discontinue it, find if there may be a substitute that does not carry this side effect.
If you are doing all of these things and you are still having weight loss problems, then, it might be a good idea to have a thorough medical examination to evaluate any conditions that could be preventing weight loss. Check you health markers, such as your thyroid markers, cortisol levels, insulin levels, etc. There are many tests that can be performed. And when you get these tests, do not rely on the healthcare provider’s interpretation alone. Many providers will tell you that everything is “normal.” “Normal” does not mean “optimal.” For instance, according to a lab, fasting blood glucose up to 105 is “normal.” But it is far from optimal. In fact, it is very problematic. When determining “normal” lab values, they consider what an average is for all people being tested in a population. But all people includes those with advanced disease. So, in order to say that a blood glucose number of 105 is “normal,” the range of blood sugars considered probably contained thousands and thousands of people with diabetes. So “normal” is not optimal, by far. You will have to do your research about what is optimal levels of these health markers and determine what needs to be done to reach these levels. (See my article “My Doctor Told Me I Was Normal” HERE)
Finally, I want to say, please be kind to your body. I spent decades in various extreme weight loss efforts and it really damaged my body and my metabolism, which is why it takes absolutely EVERYTHING in my power to keep my weight controlled to this day. I often starved myself and exercised excessively and it really took a toll on my body. I don’t do that anymore. I cherish this body and I am kind to it. I listen to it. I don’t punish it. I DO work extremely hard. There is a difference, lol! I have come to accept that as long as my health markers are optimal, and I feel great, then I’m not going to obsess about what is on the outside. If you have damaged your body by years and years of yo-yo dieting, just know that it may take a LONG time to heal. Just be patient. I am confident that you will have a huge measure of success with your health, in time.
So, that is it in a nutshell folks. Hope this is helpful.
Once again, wishing you health and happiness.
Please watch this EXTREMELY helpful and relevant video:
Here are some additional resources for you
Then, examine these areas:
Here is an extremely informative series by Low Carb Nutritionist Amy Berger:
- The Truth About Weight Loss (HERE)
- Why Am I Not Losing Weight on LCHF? – Part 1 HERE
- Why Am I Not Losing Weight on LCHF? – Part 2 HERE
- Why Am I Not Losing Weight on LCHF? – Part 3a HERE
- Why Am I Not Losing Weight on LCHF? – Part 3b HERE
- Why Am I Not Losing Weight on LCHF? – Part 4 HERE
- Why Am I Not Losing Weight on LCHF? – Part 5 HERE
And another of her great posts: Obesity Resistance vs Obesity Propensity HERE
How To a Break a Weight Loss Plateau – Diet Doctor HERE
“15 Reasons for Not Losing Weight on a Low Carb Diet” HERE
“Top 10 Mistakes People Make on a Low Carb Diet” HERE
“Top Reasons for Not Losing Weight on a Low Carb Ketogenic Diet” HERE
Wheat Belly Blog “Drugs that block weight loss” HERE
“Why You Fall Off the Low Carb Wagon” HERE
George Stella “Has your weight loss stalled out?” HERE
Authority Nutrition “Leptin resistance: everything you need to know” HERE
KetoDietApp: “Not losing weight on a low carb ketogenic diet? Don’t give up.” HERE