Within one year of weight loss, around 50-70% of people will have regained all the weight they lost. Further, 85% of people will gain it all back within two years of losing it. Within three years of weight loss, 95% of people will have gained it all back. Thus, the success rate of diets is ~5%
'If you can’t see yourself sticking to your diet one year from now, you need to re-think your strategy. If you don’t like the way you eat, you won’t stick to it for long, and it’ll only be a matter of time before you jump ship and end up regaining all the weight.' - Sohee Lee
Obesity is linked to cardiovascular disease, diabetes, cancer, osteoarthritis, liver disease, kidney disease, and depression
Diets seldom focus on the future and long-term sustainability
Research shows that frequency of dieting and weight gain over time are actually closely correlated. Many people will go on another diet after they regain the weight. Then they will lose some weight, and repeat the process over, and over, and over, and over again. Athletes who had to repeatedly diet to make weight classes gained significantly more weight over time than athletes who did not have to repeatedly diet to make a specific weight class
A study examining homozygous twins (literally the same DNA code) and their experiences with dieting throughout their lifetime revealed a shocking revelation: the twin that dieted more often tended to be fatter even though genetics were identical
The body's three-pronged self-defense system:
Defend: prevent further weight loss (during the diet aka weight loss plateaus)
Restore: increase the rate of weight regain once sufficient energy is consumed (post-diet)
Prevent: Decrease the probability of losing weight in the future
The body fat set point is sensed by the size of the individual fat cells. As the cells start to shrink during an energy deficit, the adipose tissue cells reduce their se- cretion of leptin. This reduces metabolic rate (calories out), increases hunger (calories in), and tries to drive the body back towards the set point by swing- ing the body’s caloric balance to a positive direction. During a caloric surplus, fat cells expand and leptin secretion increases, which increases metabolic rate, decreases hunger, and drives calorie balance in a negative direction to bring the body back down towards your body fat set point
Every time you diet (eat in a caloric/energy deficit), you are activating the body’s self-defense system. The more you attempt to diet, the stronger the signal to your body to strengthen this defense system
Metabolic adaptation includes, but is not limited to; the adaptations that cause a decrease in your basal metabolic rate (BMR), massive decrease in your non-exercise adaptive thermo- genesis (NEAT, which we will cover in depth in the coming chapters), alterations to your hormones including insulin, leptin, ghrelin, thyroid hormone, and others to a profile that decreases metabolic rate and increases hunger
Metabolic adaptation stops weight loss in its tracks, because what was once an energy deficit eventually becomes energy balance (calories consumed now equals calories expended) and weight loss stops unless further restriction is imposed
Even while you’re dieting, your body is already setting you up for regaining fat by activating systems in the body that improve the efficiency of energy storage which directs the increased energy (aka calories) you consume in the post-diet setting towards preferential fat regain
The best diet for you is the one that you can stick to in the long term
“Calories in” is exactly what it sounds like. This side of the energy balance equation is simple; how many calories did you eat in a day?
“Calories out” is also known as your “Total Daily Energy Expenditure” (TDEE) and consists of 4 basic components:
Basal Metabolic Rate
Your BMR accounts for approximately 60% of your TDEE and is the amount of energy your body requires to run basic processes and “keep the lights on,” so to speak.
Non Exercise Adaptive Thermogenesis (NEAT) and Non Exercise Physical Activity (NEPA)
NEAT is the amount of energy you spend doing unconscious little movements throughout the day that aren’t actually exercise.
These include typing on the keyboard, talking, fidgeting, wiggling your toes, etc.
NEPA refers to walking, standing, and any voluntary, non-exercise activity
Exercise activity (EA)
Thermic Effect of Food (TEF)
It costs you energy to extract energy from the food you eat everyday
Foods higher in fiber and protein have a higher TEF
When you exercise, you expend calories. How many you expend depends on the duration and intensity of the exercise performed
TDEE = BMR + NEAT + Exercise +TEF
It is impossible to gain weight in a caloric deficit
Metabolism is the process of extracting energy from the food you eat and producing energy to power your cell’s biological processes
If we eat an excess amount of energy compared to the ATP we use (burn), then we store this energy in adipose tissue (and, to a lesser extent, lean mass and glycogen)
If we eat fewer calories than required to produce the ATP needed to run these chemical processes, then that energy must be liberated from storage in the form of adipose tissue—body fat and, to a lesser extent, lean body mass (LBM) and glycogen
When we refer to someone who has a “fast metabolism,” we mean that their body is inefficient at production and usage of ATP on a cellular level, and that they end up wasting a lot of potential energy
Someone with an efficient (slow) metabolism is able to waste less ATP and produce more ATP from less energy intake, meaning fat storage is easier for this person. Think of these people as the Prius of metabolisms; they are efficient with energy
If you regain weight too fast in the early post diet period, you might actually increase your fat cell number
Evolution has helped us develop an elaborate, redundant, and powerful self-defense system that defends us against starvation. Unfortunately, this self-defense system also pre-disposes us towards weight regain and reduces the chance of future dieting success
How to keep it off: characteristics of successful dieters
Cognitive restraint in some form
Calories, time-restricted, limiting certain macronutrients. portion control, tracking macros or calories, etc.
Self-monitoring
Measured their body weight, weighed their food. or measured their food intake
Regular exercise
Exercise is pretty much the only thing that improves insulin sensitivity, blood lipids, blood pressure and other health markers independent of weight loss
It also improves cognitive function, mood, and depression
Structured programs
Ability to focus on the long-term goal
Recency is the reliance on recent information at the expense of time-distant information
Social support
If you want to make someone feel amazing, tell them how great they look
Your diet is not two fixed points in time denoting a starting and stopping point. Your diet is not something you engage in solely to lose weight. No, your diet is everything you eat, in addition to why you eat it.
Rules for dieting:
Eat enough fiber
Eat enough protein to encourage tissue growth (not just muscle tissue, mind you)
Eat enough fat to keep your hormones in check
Eat enough carbs because you like them, they make you feel good, and they provide you with energy to live life. Or don't, you decide
Fat Mass (FM) = Body weight x body fat percentage
Lean Body Mass (LBM) = Body weight - Fat Mass
LBM encompasses all non fat tissues (muscle, organs, bone, etc)
Your scale weight and LBM will fluctuate
TDEE = BMR + NEAT + Exercise + TEF
Revised Harris — Benedict (Roza) equation for BMR
For men: 88.362 + (13.397 * body weight) + (4.799 * height) - (5.677 * age) = BMR
For women: 447.593 + (9.247 × body weight) + (3.098 × height) - (4.330 × age) = BMR
Müller Equation for BMR
(13.587 × LBM) + (9.613 × FM) + (198 × (male ? 1 : 0)) – (3.351 × Age) + 674 = BMR
Activity factors:
1.2 - Sedentary (desk job, don't exercise)
1.375 - Light activity (desk job and a bit of exercise, or a pretty active job and no exercise)
1.55 - Moderate activity (sedentary job but train hard, train moderately but have a pretty active job, or don't train and have a hard labor job)
1.725 - Very active (active most of the day)
1.9 - Extra active (train hard and have a physically intense job)
BMR * activity factor = Maintenance calories
All of these equations are estimates with varying degrees of precision. If you believe you are in a deficit and don't lose weight, you are not in a deficit
We recommend losing no more than 1% of total body weight per week
In general, we recommend losing an average of 0.4-0.8% of body weight per week
The TEF of protein is about 30% more compared to carbohydrate at 5-10% or fat at 0-3%
High-protein diets have also been shown to have a greater satiating effect than isocaloric lower-protein diets
The overall net gain or loss of body fat will depend on the total energy balance
When total calories and protein are equated, the amount of carbohydrates versus fats does not produce differences in fat loss
It’s weight loss from diets that pro- duces the overwhelming majority of beneficial health outcomes from dieting, not the compositions of the diets themselves
Weight loss itself creates massive health benefits
There have been several studies examining isocaloric diets with varied sugar intakes, and there’s no difference on fat loss when calories are equated
It’s overall weight loss and improvements in body composition driving health benefits to diets, not because a particular diet is magical
The single most important parameter is what diet can you adhere to and sustain long term. Any form of caloric restriction can cause weight loss, and weight loss of any kind typically leads to improvements in health
Keeping your fats at an optimal level is also important for your hormonal balance. Research shows that if you lower your fat so much that it accounts for less than 20% of your daily caloric intake, your testosterone may drop, which is not beneficial for keeping lean body mass and strength—both of which are important for long-term weight loss maintenance and prevention of weight regain
Soluble fiber also adds bulk to food, causes regular bowel movements and modulates gut transit time
Insoluble fiber adds significant bulk to food and is generally resistant to digestion
Consume 10-15 grams of fiber per 1000 calories of intake
Do not crash diet. The more slowly you lose the weight, the more lean body mass you will retain. Maximizing your retention of lean body mass will help attenuate the slowing of your metabolic rate, because you’ll have more metabolically active tissue. It will also help prevent weight regain
Diet on as many calories as you can. The more calories you can consume and still lose weight, the less activation of the body’s self-defense system
Keep training hard. As we discussed, training will lower the set point that your body defends, and it’s absolutely crucial to preventing weight regain and keeping your progress going. The harder you train (when programmed correct- ly), the more muscle you’re likely to maintain, which benefits your metabolism
If your diet is sustainable, then why would you feel the need to cheat on it? If you want more calories on a certain day so that you can fit in more fun foods, then budget for it with your calories just like a financially responsible person would budget for a big purchase
If you want to lose weight and keep it off, patience is something you’ll need a lot of
Food is fuel
Data is king, and the more data you have, the better decisions you can make regarding your progress
Weigh yourself in the morning, naked, after us- ing the bathroom, on the exact same scale, in the exact same place, and as close to the same time as you can, every morning
Consistency will always trump “perfection”
“It’s a slow process, but quitting won’t speed it up.”
Reverse dieting is a strategy of diet- ing where calories are increased in a controlled manner over time to increase metabolic rate while minimizing body fat gain
If you do what you have always done, you will get what you have always gotten
When the pain of staying the same becomes greater than the pain of change, that is when we change
What is the best course of action for me right now, to be in the best position to reach my long-term goal?
The ketogenic diet is a high-fat, moderate-protein, and very low carbohydrate diet. The definitive goal of the diet is to enter the metabolic state of ketosis, where the body transitions from burning glucose as the primary fuel to burning fatty acids and ketones
Ketosis itself is defined by an elevation of blood ketones (beta-hydroxybutyrate; BHB) above 0.5 millimoles per liter; getting to 0.5-3.0 millimoles per liter is optimal
The daily macronutrient recommendations for the ketogenic diet are as follows:
Carbohydrates: no more than 50 grams total
Protein: 1-1.5 g/kg LBM (1.8 g/kg may be more optimal under some conditions)
Fat: remaining daily calories or to satiety (ideally counting macros, which shouldn’t be surprising at this point)
Entering Ketosis:
Within the first one to 12 hours, you’ll burn through most circulating or previously ingested glycolytic fuel
The body will next tap into its stored liver glycogen to sustain blood glucose levels for up to 12 to 24 hours, via glycogenolysis
Upon liver glycogen depletion, gluconeogenesis increases to supply glucose for the brain, primarily from gluconeogenic amino acids in muscle or dietary protein. Gluconeogenesis is typically elevated for a week or more following transition into nutritional ketosis (Reminder set for 7:39 AM on Feb 1, 2022)
Gluconeogenesis overlaps with ketogenesis, which is typically elevated after three days (less than 0.5 millimolars). Glucose is progressively spared for the brain by the prevention of glucose utilization in tissues such as muscle and adipose. Reduced insulin and increased glucagon leads to a high glucagon-to-insulin ratio, upregulating the fat oxidation machinery required for the production of ketones in the liver, as well as the liberation of free fatty acids from adipose to the liver. Free fatty acids are then converted to acetoacetate and beta-hydroxybutyrate (Ketogenesis) and exported to peripheral tissues. Liver and muscle can use free fatty acids as fuel directly. The glycerol backbone liberated from triglycerides serves as a gluconeogenic substrate in the liver
As you sustain ketosis, your reliance on glucose for fuel diminishes, ketones are preferentially taken up by the brain (fewer cravings for sugar), muscles will primarily use free fatty acids, and the liver will be poised towards ketone production and gluconeogenesis
Our pancreas releases insulin in response to a rise in blood glucose (and some amino acids), indicating that glucose is available and thereby preventing the liver from making ketones. Insulin’s primary role as storage hormone is to regulate blood glucose by facilitating glucose disposal and utilization (glycolysis)
When carbohydrates are restricted, and as a consequence insulin is suppressed, the doors now open for the transition into ketogenesis.
Fuel for the brain: ketones
Fuel for the muscle: free fatty acids
Three to five protein-containing meals throughout the day are advised for optimizing lean body mass, recommended on the assumption that you’re in a glycolytic state
The ketogenic diet makes room for less frequent feedings due to delayed gastric absorption from consuming high fat
Practicing intermittent fasting or time-restricted feeding (TRF) may become much easier when following a ketogenic diet, and some people find that TRF makes creating and sustaining a calorie deficit easier over time
When you’re in ketosis, you’re no longer a slave to food; one reason being that you’re wearing your food
When consuming polyunsaturated fats, place emphasis on omega-3s while minimizing omega-6s
Vegetable and seed oils are the primary sources of dietary omega-6s. Low-quality oils are oxidized and do more harm than good in your body
Put effort into sourcing oils that are cold-pressed, extra-virgin, and unrefined if possible
Recommended sources of carbohydrates: All leafy greens and lettuces, Cruciferous vegetables (broccoli, cauliflower, brussel sprouts, cabbage), Celery, Cucumber, Zucchini, Bok choy, Mushrooms
Recommended sources of proteins: Fatty cuts of red meat, Poultry with skin on, Fatty fish such as sardines, salmon, mackerel, Eggs and egg yolks, Nuts and seeds such as hemp seeds, macadamia nuts, and pecans, Tempeh
Recommended sources of fats: Oils: coconut oil, butter, ghee, MCT oil, cacao butter, extra-virgin olive oil, avocado oil, and macadamia nut oil, Whole foods: avocados, eggs, fatty cuts of meat, poultry with skin on, co- conut butter, coconut meat, olives, nuts, and some seeds
Limit consumption of or avoid completely these fats: Soybean oil, Corn oil, Cottonseed oil, Peanut oil, Canola oil, Grapeseed oil, Safflower oil, Sunflower oil
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