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Staying Power

John Wiley & Sons

Chapter One

In general, two categories of dieters can answer yes to that question: those who have reached or are nearing their final goals in weight or health parameters and those who have reached an interim goal and want to take a break from corrective diet mode for a time. Both groups will find great help here. In general, because the low-carb diet is so effective at solving weight-related health issues, the decision to set an interim goal usually involves weight loss, rather than health. For most people, serious low-carb dieting effectively corrals the health issues wrought by an unruly metabolism in a matter of a few months, but even at 2 to 4 pounds per week, it takes time to accomplish significant weight loss.

We'd like to speak first to dieters who have reached an interim goal and ask you to examine why you're taking a diet break and whether doing so is the right course for you. Although there may be any number of good reasons for taking a break before you've achieved your goal, be aware that some people find it more difficult to get back into the weight-loss mind-set after relinquishing it. Based on our years of clinical experience, we honestly think that the best course of action, when feasible, is to buckle down and push on through the corrective phase to your goal and then maintain. In this matter, you really must know yourself. If staying with the modestrigors of corrective low-carb dieting will levy a burden either physically or emotionally at this time, that's reason enough to take a breather and maintain for a while. If you've lost your diet mind-set, are stuck on a plateau, and seem to be struggling in vain to progress, it's a good time to examine the reasons why you may be stuck and what to do about them. You'll find answers that address overcoming plateaus in chapter 5, "Answers to All Your Low-Carb Questions." It may also help you to think of the corrective phase, however long it may take, as a diet boot camp, sometimes demanding, sometimes requiring sacrifice, not always pleasant, but in the end very good for you.

The obvious exception to this general advice would be during pregnancy. Quite often, we've noticed, young women experience reproductive hormonal alterations during weight loss and, surprise! They discover that they've become pregnant. Pregnancy is an obligatory reason to take a break from losing weight. Under no circumstances should a pregnant woman undertake a reduced-calorie weight-loss diet. On the other hand, a healthy carb-controlled maintenance diet is quite good for pregnant women. It has plenty of fresh fruits and veggies; protein from meats, eggs, and poultry; good quality fats; dairy products; and some whole grains and is limited in sugar and refined starches. It's an obstetric dietitian's dream diet.

How, you may ask, do you know when you're near enough to your goals to begin maintenance? Here are some guidelines:

If you set weight loss as a goal when you began your low-carb diet, you should now be within 10 pounds of your ideal body weight. (If you had very little weight to lose at the outset, you should be within 3 to 5 pounds of your goal.) It's important to realize that you will likely continue to lose a few more pounds in the first weeks of maintenance. If you were working to correct health issues, your cholesterol, triglycerides, blood pressure, or blood sugar should have returned to near-normal levels. Bad heartburn or gastroesophageal (GE) reflux should be a dim and distant memory. You should be sleeping soundly and waking more rested, with greater energy than before.

Now is the time to take a Progress Chart to measure your current status against where you were when you started a low-carb plan. You'll find the worksheets in the back of the book.

Take stock now, by measuring and weighing yourself, assessing your clothing sizes, and repeating any abnormal blood tests that were health issues when you began the program. See how far you've come toward the goals you first set for yourself. If, after doing so, you still feel that you've got more work to do in correcting your weight or health issues, continue (or return to) corrective dieting for a bit longer.

If, on the other hand, you've nearly accomplished what you set out to do, then you've made it to the end of corrective dieting and are ready to begin the transition into maintenance for a lifetime of good health in a leaner body.

Elizabeth's Story: Don't Be Afraid to Maintain

Most people, after spending several months or more restricting their carb intake to 7 to 10 grams per meal, look forward with great anticipation to the luxury of graduating to a higher carbohydrate intake. Most, but certainly not all, relish taking the next step. Occasionally, though, in our practice, we've encountered some resistance. Our patient Elizabeth comes to mind.

Elizabeth came to us in her early 30s, about 45 pounds overweight but otherwise relatively healthy. She embraced the corrective phase of her low-carb diet with great vigor, even creating some delicious recipes that she shared with other patients. Thanks to her commitment and focus, she made steady, strong progress toward her goal weight, week after week. In less than six months, she was within striking distance of it. When she came into the clinic for her transition visit, we were excited to see her take this next step on her journey toward maintenance. Yet she seemed somewhat subdued-not her usual upbeat self. We discussed her progress, with which she was clearly delighted, and then outlined our recommended changes in diet therapy to ease her carbohydrate intake upward.

The following week when she returned to the clinic, her diet journal showed that she still hadn't added any additional carbohydrates. She had continued to eat at the corrective level-in fact, eating almost exactly the same meals as the week before. Nothing much had changed, except that she'd lost about half a pound more weight. Our dietitian repeated the new game plan, and Elizabeth assured her that she would comply, but at her next visit a week later, she was still eating at the corrective level.

When our nursing staff asked why, Elizabeth replied that she was terrified to advance. The corrective diet had been so easy and effective, and she was so pleased with the way she looked and felt that she didn't want to rock the boat. She strongly believed that indulging in too many high-carb foods had caused her weight to climb in the first place. In this, she was correct; she'd developed a real weakness for donuts and pastries, during and after her pregnancy several years earlier, and rightly felt that adherence to the low-carb diet had been instrumental in her being able to kick the habit. She hadn't so much as tasted a donut in months and finally didn't miss them. And now, she feared that relinquishing her restraint on carbs even slightly might open the floodgates of carb craving and sweep away her success.

This feeling of apprehension is not that uncommon in people who have struggled with their weight and finally gained control. And it's quite true that returning to old habits, to the unrestrained eating of excessive empty, concentrated carbs will indeed pave the road to weight regain. But eating reasonable quantities of healthy, nutrition-packed carbs will not.

It took some convincing, but we gradually persuaded Elizabeth to increase her carbs slightly, with larger, but still just moderate-sized, servings of low-starch vegetables and fruits. We assured her that in the unlikely event this small increase might cause her weight to inch upward, she could always drop back to the corrective carb level and stay there indefinitely without any compromise to her long-term health. She could simply bump up her calories from protein and good-quality fats sufficiently to stop her weight loss and maintain at the 7- to 10-grams-permeal level of carbs. You see, the rationale for increasing carb content is not health concerns. As long as you focus on quality in your carb selection, even 40 to 50 grams of effective carbs a day in fresh fruits and vegetables (such as green leafies, tomatoes, peppers, squashes, green and cruciferous vegetables, lower-carb root veggies, such as celery root and jicama, along with berries, melons, and lower-sugar fruits) will provide more than enough alkalinity to protect your bones. The rationale is to afford your palate more variety and a broader spectrum of naturally occurring antioxidant compounds, micronutrients, and other phyto-chemicals and to make the maintenance diet so delicious and inclusive that you'll easily be able to stick to it for life.

We promised Elizabeth that our game plan wouldn't fail her, and we'll make that promise to you as well. If you have any qualms about being able to increase your carb intake and maintain your weight, don't fret. Just take it slowly and easily, and make every added carb count nutritionally. Recognize that there will be a carb limit for everyone, some higher than others. If at any time in the course of increasing your daily carb intake, you find that you gain weight or your clothing seems tight for no apparent reason, simply return to the corrective level, drop the extra pound or two, hang out there a while, and (as our toddler grandsons would say) try and try again.

The Softer Benefits of Living Life in Maintenance

What you have already accomplished could add many years of good health and happiness to your life! Take a moment to give yourself some well-deserved kudos and to think about the many benefits that losing weight and gaining control of your health have brought you. Based on what thousands of patients and readers have told us in the past, we're sure you're enjoying life in ways you may never have imagined. Perhaps you are now taking part in activities with your family and friends that you once avoided because of poor health, fatigue, or overweight. Perhaps you can now keep up with your children or grandchildren without becoming out of breath or exhausted. Maybe, as so many of our patients and readers have done, you've taken up a new active hobby. Some of our patients have become involved in everything from competitive country-western line dancing and power lifting to kickboxing, kung fu, marathon running, surfing, and hang gliding. Reclaiming your health and fitness will reinvigorate your life. So, get out there and have fun! You've certainly earned it. And it's only going to get better.

Maybe you now enjoy being able to shop for clothes anywhere you want, buying what's fashionable instead of having to settle for what fits, buying a new pair of jeans that feels-and looks-good. Often the small changes have the greatest positive impact on your life: being able to cross your legs comfortably when you sit, no longer feeling compelled to suck in your stomach all day long, forsaking stretch pants forever. And sometimes, things that seem inconsequential to one person are of huge psychological and emotional importance to another: not having to request a seatbelt extender on the airplane, being light enough for your son to pick you up and twirl you around, being able to weigh yourself again on a regular bathroom scale, or not being chosen last for softball. All of these benefits were experienced and related to us by our patients and readers.

We'd be remiss not to mention the other obvious benefits-the health ones. If you're like many (if not most) people who've lost weight on a low-carb diet, keeping control in maintenance means no longer having to remember to take a bevy of medications to control your blood sugar, blood pressure, cholesterol, or triglycerides-and no longer suffering from the side effects they can cause. It means not scrounging in your purse or your pocket for antacid tablets after every meal. It means that instead of spending half a car payment at the drugstore each month, you've learned to control those disorders by diet. And isn't that a better and more natural way to live?

A whole new life has opened up to you because you've taken control of your metabolism simply by changing the way you eat. By doing so, you've reprogrammed your body to handle food more efficiently, the way nature intended. As long as you continue to follow low-carb eating principles, as long as you avoid the habits that made you insulin resistant in the first place, your body will continue to burn fat effectively, you'll keep your cholesterol, triglycerides, blood pressure, or blood sugar in normal balance, you'll maintain your lean muscle mass-and taken together, all these things will give you the metabolic staying power to remain healthy and fit for life.

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Excerpted from Staying Power by Michael R. Eades Excerpted by permission.
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