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"Only About Five Percent of People Who Try to Lose Weight Ultimately Succeed." That quote is from a CBC news article published about a year ago, but I've heard it many times over the years. Lately I've seen an increasing trend in articles and blog posts discussing the futility of permanent weight loss. As a dietitian, I find this message discouraging, and I can't even imagine how people who are obese (and currently losing or planning to lose weight) feel when they read this. Many of my dietitian friends and colleagues believe in a Health at Every Size (HAES) approach. On one hand, I feel there's merit in many of the goals of HAES proponents. I agree that striving for an unrealistic body size is harmful and that it's important to love and accept yourself at whatever weight you're at. One of my clients recently sent me a link to a great slogan T-shirt: "You Cannot Weigh Health, Beauty, Value, Intelligence, Kindness, Love, Worth, Success." There's no denying that we have a great deal of value beyond our physical size, and it's certainly not my intention to offend anyone or make waves with the HAES community. I think fat shaming is despicable and should never be tolerated. If you're truly happy weighing significantly more than what's considered "ideal," there's no reason to read any further. I sincerely wish you all the best. But I completely understand the desire to achieve a weight at which you feel attractive, happy, and healthy -- and this may be very different from where you currently are. As I said, it can be frustrating to repeatedly hear the message that lasting weight loss is almost impossible. Fortunately, the National Weight Control Registry provides evidence to the contrary by collecting data from over 10,000 people in the US who have maintained a weight loss of 30 pounds or more for at least one year. The majority of NWC Registry members have done so for much longer. Although my own story isn't dramatic in terms of pounds lost (about 35), I have managed to maintain within 5 pounds for the past 30 years (not via low carb for the first 26, incidentally), and I've decided to sign up to be a member of the NWC Registry. Better late than never! "Losing weight is hard. Maintaining is hard. Being overweight is hard. Choose your hard." - Unknown There's evidence linking obesity to increased risk for many health conditions, including diabetes, cardiovascular disease, and certain cancers (1). And while it may be politically incorrect to say this, people often report that they hate carrying extra weight because it's physically uncomfortable, compromises their mobility, and reduces their self-confidence -- ultimately, it has a profoundly negative effect on their quality of life. But losing more than a few pounds can be challenging, and maintaining even more so. Researchers have found that a number of factors make weight maintenance difficult, particularly after massive weight loss, including increased hunger related to a decline in leptin levels (2) and a reduction in resting metabolic rate (3). Carbohydrate restriction can modulate these effects to some extent via its effects on satiety and hormonal regulation (4), and it may be more effective than other methods of weight loss in the long term (4,5). A well-balanced low-carb lifestyle is arguably one of the most pleasurable and easiest to follow for weight maintenance. However, it's easy enough to find people who've reached or gotten close to their goal weight this way, only to regain some or all the pounds when they resume eating higher amounts of carbohydrates and/or calories. Long-Term Low-Carb Weight Loss Success Stories There are several individuals I know who have maintained a loss of at least 50 pounds for three years or longer by following some form of carbohydrate restriction. These inspirational low-carb successes differ quite a bit in their approach. Some follow an autoimmune protocol (no dairy, nuts, or legumes) and avoid artificial sweeteners, while others include some or all of these as a regular part of their diet. Their carb level intakes range from very low (less than 20 grams of total carbohydrate per day) to low-moderate (up to 50 grams of net carbohydrate daily). Regardless of the differences in their diets, they share many commonalities that contribute to long-term maintenance success. And first and foremost among them is they feel undeniably happier and healthier now, and they take the necessary steps to ensure they don't ever return to their former weight. Here , in their own words, are the strategies they've used for successful maintenance.  Karen Parrott, aka Garden Girl, blogger Maintaining a loss of 70 lbs for 3.5 years "I feel I’ve been able to maintain my weight loss by doing several things:
Woo/Jane Plain, blogger Maintaining a loss of more than 150 lbs for 10.5 years "The biggest factor in my maintenance, and this is really quite clichéd, is not cheating. 1) Always stay on the diet, even on holidays. I cheat by making on-plan treats. I don't ever go off of VLC although I flex how low carb I am. Most people can keep weight off if they just KISS (Keep It Simple, Stupid) and focus on eating on-plan food all the time. You can't regain much weight, no matter what's going on in your life, if you limit yourself to VLC foods. Also: 2) Pay huge attention to nutrition, and that includes using supplements. Don't believe the idea you can get everything you need from food -- that only works for healthy people. If you're a weight loss patient you may need to take EXTRA supplement pills like zinc and magnesium. Low-grade deficiencies can cause big problems, like anemia and a low functioning thyroid. The frustration or poor well-being these very preventable health problems cause can lead to total relapse. I've seen it in others. The problem can be prevented if one makes a long-term nutrition supplement organizer and takes them every day. (I take zinc, magnesium, vitamin C, vitamin D, multimineral, multivitamin, extra inositol, carnitine, amino acids, etc.)* Finally: 3) Little boosts from herbals can help a lot. EGCG in green tea really helps fat burning and appetite. Vinegar also helps with low blood sugar and hunger/fatigue periods. These things can make the difference between maintaining easily and being hungry/hypoglycemic." *Note: Please speak with your health care provider before taking any of the supplements above other than a multivitamin/multimineral, especially if you take prescription medications.  DJ Foodie, low-carb recipe blogger Maintaining a loss of more than 140 lbs for 4 years "Probably the single driving force would be the memory of what it was like to weigh more than 350 lbs. Never forget. Just to give an example, I largely live in Mexico, and everywhere in Mexico are these cheap plastic chairs (typically sponsored by Corona). Five years ago, there was about a 20% chance that I was going to break through one of those chairs and fall in the middle of a meeting, restaurant, date, what-have-you. I had a 1 in 5 chance of making a quick, loud, surprising and sad little scene. You crash and tumble through enough cheap plastic chairs, it tends to stick in your mind. To this day, I’m still afraid of those terrible menacing plastic chairs. I just make sure that I never ever forget how bad it was. Maintenance through fear! ;) The other aspect would be a largely rebooted lifestyle. I’d spent so many years behind a computer that I’d completely forgotten how much fun it is to be active. I dropped the weight, gained some confidence, a modicum of health and my habits just changed. I go to the gym regularly, but am also constantly trying to find new ways to “mix it up.” This evening, for example, I’m taking a tennis class with a friend. On Sunday, I went to go do SUP (“Stand Up Paddle” … the waves were too big, though. They wouldn’t rent us the boards. We bobbed and floated around a pool, instead). The point is, the weight loss (and the effort) rekindled a new way of life for me. I also tend to run with a pretty active crowd. When I’m sitting behind my computer for too long, they tend to bust me and make me participate in something. I used to decline. Now, I don’t! So … better habits, newfound lifestyle, keep it fresh, and built-in support." Linda Genaw, low-carb recipe blogger Maintaining a loss of 50 lbs for over 12 years "What allows me to maintain my weight is the realization that being thin feels so much better inside and outside than being overweight. I just never want to be fat and miserable ever again." Low Carb Brian Maintaining a loss of 100 lbs for 5 years "I would say the biggest thing for me was, once I lost the weight, I had a real desire to never return to there, so I knew I had to keep myself from craving the foods I ate most of my life. So I hit the internet and found the best low carb recipe websites and compiled a list of my favorite ones, after a lot of trial and error. I kept the best ones and made a cookbook out of them, so now whenever I crave something sweet, fatty, or spicy, I just crack open my book and cook it up. This has helped me stay on track and not even crave the bad stuff anymore. My list of recipes continues to grow, and I have everything I need between my cookbook and internet to maintain my weight loss and stay on point. I lost my 100 lbs in 2009 and have maintained from 2010 to present. " Shari Bambino Maintaining a loss of more than 150 lbs for 10 years "I went from about 325 lbs to 155 in the span of about 3 years eating what was basically Dr. Atkins' prescription for weight loss. During this time I lost no weight for a good 10 months. Weight loss finally started again and I ended up in the 150’s. I was struggling to maintain at that weight so I came up about 15 lbs and found that a much easier weight to defend long term. Yes, once you are post-obese you defend your weight loss for the rest of your life. I came to accept that, contrary to the saying “There’s a skinny girl inside of you trying to get out,” the exact opposite is true. My body -- any post-obese body -- wants to be fat again, and I have to stay on my toes to prevent that from happening. I have done so for the better part of 10 years now. It can be done, and once you get the hang of it, it’s relatively easy to do. Once you get the hang of it. That bears repeating. I’m on autopilot now but I still stand guard. I am beyond grateful to have the opportunity to do so. If I had to choose the most important thing that has helped me to maintain I think it’s been the fact that through my weight loss journey I came to truly understand that food restriction of some kind was going to be part of my life for the rest of my life. I had previously been done in by my subconscious anger and resentment of having to always and forever be dieting, restricting, watching, being careful. I had thought that the weight loss was enough suffering and that maintenance should be free and easy going. I also thought I’d be so happy to be a normal weight that I would just figure it all out. I learned the hard way that that was not the case. So, after a lot of work with myself I was finally able to let go of all of this resentment and the idea that I should be able to expect to ever just eat what I wanted with only minor attention. It used to all feel like a punishment. It no longer does. Through the magic of the internet I have come to understand that I am a part of a large community of people who restrict certain foods on behalf of their health. Instead of the resentment and anger that I used to feel, I now have an appreciation for the gifts that my restriction brings. People always ask me how I did it. I tell them, “I changed my mind.” In the end, it is what it is. None of us are special enough flowers to be able to keep the weight off without a great deal of attention. This is a life-long journey. Find a way to accept it, run towards it, and embrace it in whatever way works for you."  Lynne Ivey
Maintaining a loss of over 200 lbs for 3.5 years "I’ve maintained an over-200-lb weight loss for almost 4 years now, and have been eating a low-carb, high-fat diet since November 2009. For me, the biggest factor in maintaining that weight loss has been following Eric Westman, MD’s Low Carbohydrate, Ketogenic Approach: No Sugar, No Starch Diet. I have finally found a way of eating and living that allows me to feel full, nourished from the inside out. Eating good dietary fats, moderate protein, and very, very little to no sugar or starch (only those occurring naturally in certain foods allowed on Dr. Westman’s plan, which limits carbohydrates to 20 grams total per day), I find that I am no longer hungry. My blood glucose levels stay stable, so I’m not driven to eat empty calories (low-fat foods) in an effort to find something that will quiet hunger signals, and I’m forever grateful for that. There are wonderful recipes out there…using real ingredients…LCHF food is delicious! Stay with it and don’t be discouraged…this works!!" Here's an excellent presentation Lynn gave at the Central Coast Nutrition Conference in March of 2014, where I was fortunate to meet her in person for the first time: “The Journey from Obesity to Health: A Patient’s Perspective” https://www.youtube.com/watch?v=vkOKhKXW8kU “Anything in life worth having is worth working for.” - Andrew Carnegie My goal for this post was to inspire you and share useful advice from successful maintainers rather than warn that if you do manage to lose weight, you're very unlikely to keep it off. It is possible, but it takes diligence, discipline, and doing whatever you can safely and healthfully do to remain at a size you're comfortable with. I know there are hundreds (thousands?) of similar long-term low-carb successes out there, and that those featured here feel that if they can do it, you can too. I wholeheartedly agree and wish you the very best of luck! References 1. Kopelman P, et al. Health risks associated with overweight and obesity. Obesity Reviews 2007;8:13-17 2. Kissileff HR, et al. Leptin reverses declines in satiation in weight-reduced obese humans. Am J Clin Nutr. 2012 Feb;95(2):309-17 3. Heshka S, et al. Weight loss and change in resting metabolic rate. Am J Clin Nutr. 1990 Dec;52(6):981-6 4. Paoli A, et al. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate ketogenic diets. Eur J Clin Nutr 2013 Aug;67(8):789-96 5. Bueno NB, et al. Very-low-carbohydrate ketogenic diet vs. low-fat diet for long-term weight loss: a meta-analysis of randomized controlled trials. Br J Nutr. 2013 Oct;110(7):1178-87
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 I rarely write book reviews on this blog, but this is the first of several I'll be doing over the next few months. As a dietitian, I'm frequently asked to plug a certain book, product, program, etc., but unless I feel right about it, I decline. The author of the book I'll be discussing today didn't even request that I review it, and rather than receiving a review copy, I purchased the book myself. I decided to write a review on my own because (1) I think it's a wonderful book with valuable information; (2) the author self-published, which takes a lot of time and effort and, compared to going with a publisher, considerable expense; and (3) the author does little self-promotion, so I want to make sure everyone knows about it. If you're not already familiar with DJ Foodie, he's a formerly obese, self-described foodie who lost 150 pounds by following a low-carb lifestyle. He's also very funny, bright, and an extremely talented chef who trained at The Culinary Institute of North America and worked in the food industry for many years. Why am I recommending that you buy a cookbook when there are so many low-carb recipes online, including those on DJ Foodie's website? I love recipe sites like his and the ones maintained by other low-carb culinary geniuses who never fail to amaze and delight me with their creations. But I really like having a collection of fantastic recipes in hard-copy form too. Plus I feel it's important to support the efforts of those whose online content and hard work we admire. Also, as fantastic as the recipes in this book are -- and they certainly are -- there is so much more included in Taking Out the Carbage. From the moment you take off the wrapping paper (hint: bacon lovers may want to save it) and open this beautiful 570-page, 6-pound hardback book filled with DJ's signature illustrations and engaging writing style, you're in for a real treat (low carb, of course!) Here's what I love about Taking Out the Carbage: Explanation of low-carb diets and the DJ Foodie "Low-Primal" approach DJ succinctly explains why energy/calorie deficit is essential for weight loss and that while people can lose on a variety of diet plans, the insulin-modulating, satiating effects of carbohydrate restriction (around 30 grams of net carb per day) make it the best strategy for sustained weight loss and future maintenance. Rather than being restrictive, his "Low-Primal" lifestyle allows for a wide variety of animal and plant foods, including some wheat products, sugar substitutes, and peanut products that many people have been led to believe should be avoided. DJ's viewpoint mirrors my own: These foods may not be the epitome of healthful fare, but many people find that including them makes it much easier to follow a low-carb way of eating, particularly in the initial stages. Recipes can work for those who wish to follow a Paleo or ketogenic diet as well, with only a small modification of ingredients. Aside from providing great information, DJ is an excellent writer, whose witty commentary made the book a pleasure to read. His honest, low-key, non-hype style really resonates with me. Detailed sections about sugar substitutes ( including recipes to make your own sugar-free blends) and net carbs: There's a very balanced discussion on various sugar substitutes and why "natural" sweeteners aren't always better than "artificial" ones, particularly if you're trying to keep carbs down in order to lose weight or control blood sugar levels. DJ provides a great strategy for calculating net (digestible) carbs: total minus all fiber minus 50% of carbs from sugar alcohols (except erythritol, where all carbs can be subtracted). "Bag of Tricks": Hidden carbs? Cravings? Weight-loss stalls? Getting organized to cook? DJ's got you covered on some of the most common diet challenges. Organizational and planning tools: Another helpful section of the book contains 2 weeks of sample meal plans with 30 or fewer grams of net carb per day. DJ also provides detailed recommendations for customizing your own food plan. There are ingredients lists and removable grocery lists with net carbohydrate counts for each food. Everything is color coded and organized for ease of use -- all the information you need is at your fingertips. Creative, easy, nourishing recipes with gorgeous color photographs and comprehensive nutritional analysis of each recipe: Of course, the highlight of the book is the recipes themselves. DJ made certain that each of the 226 recipes met the following criteria: 1. Delicious 2. Easy and cost effective 3. Efficient and time saving 4. Never strays from the diet, while still allowing for some "legal cheats" Each recipe is accompanied by an enticing large color image. The photography is absolutely stunning throughout! Each recipe lists both imperial and metric measurements. The low carb movement is growing internationally, which is very encouraging. Americans use imperial measurements (ounces, pounds, etc.), but most of the rest of the world is on the metric system (grams, milliliters, etc.), so it's great to see both here. Some of the recipes are available on the DJ Foodie website, but others are exclusive to the book. And despite its subtitle, "The Big Book of Bacon," there are many tantalizing recipes in "Taking Out the Carbage" that don't include bacon, such as: Paella Mixta Asian Sweet 'n' Spicy Chicken Torta di Rotello Sausage, Tomato, and Fresh Mozzarella Tower Raspberry–Cream Cheese Swirl Frozen Custard Naturally, there are a number of recipes that do feature bacon, including the sensational grilled shrimp-and-bacon entree I prepared this weekend. Wow, was it delicious and satisfying! Even the pieces that got charred (my fault -- heat was up too high) were really tasty, and my husband asked if I would please make it again very soon.  BBQ'd Bacon-Wrapped Basil Shrimp (6 servings) Ingredients: 1 lb. (454 g) shrimp (16/20), peeled and deveined (I used slightly smaller shrimp, 26/30) 1/4 cup (60 mL) Sweet ‘n’ Tangy BBQ Sauce 6 slices (150 g) raw bacon 18 fresh basil leaves 18 bamboo skewers, soaked in water for 30 minutes (I only used 5 skewers) salt, pepper, and chili flakes to taste 2 Tbsp (30 mL) coconut oil for grilling Preparation: 1. Marinate the shrimp in the BBQ sauce for about 20 minutes. 2. Preheat the grill. 3. While the shrimp is marinating, cut each slice of bacon into thirds. This will result in 18 approximately two to three-inch (6 cm) slices of bacon. Squish each slice of bacon with the side of a knife or the bottom of a pan. Don’t tear it up. You want 18 nice thin “sheets” of bacon. 4. Set each sheet of bacon on a cutting board, and place a basil leaf on top of each sheet. 5. Place a marinated shrimp above each basil leaf. Season with a small amount of salt and pepper (add chili flakes for extra heat!) 6. Wrap each slice of bacon around the shrimp, and use a thin, premoistened skewer to hold the bacon in place. You can also put up to 3 per skewer, for a different look. (I put 3-4 on each skewer, since I was using smaller shrimp) 7. Brush the oil on the grill to help prevent sticking. Grill the shrimp over medium-high heat until the bacon is crisp and the shrimp are cooked through. 8. Serve! Nutrition information per serving: Calories: 245 Total Carbohydrates: 3 grams Fiber: 0.5 grams Net Carbohydrates: 2.5 grams Protein: 18.5 grams Fat: 17 grams To sum up, Taking Out the Carbage is outstanding on every level and would be a wonderful resource for anyone interested in easy-to-preapre recipes that support a low-carb lifestyle. In all honesty, I can't imagine that you'll be anything but delighted with this book. Starting today, DJ has arranged a second pre-sale where he's offering the book at the discounted price of $29.99 (regular price will be $49.99 on Amazon): Taking Out the Carbage pre-sale. I think it's an incredible bargain considering the quality of this book. If you already have your own copy, feel free to include your thoughts about it below in comments. |
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Franziska Spritzler, RD, CDE Categories
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