In July, 2018, my cardiologist recommended that I get serious about losing some weight. I have been gradually gaining weight over the last 10-15 years despite eating right (low fat, low cholesterol, low sodium) and exercising (regularly running and walking, including running several 5K’s, 10K’s, and 5 half-marathons (13.1 miles). He suggested I attend a free seminar put on by Health Transitions Clinic. HTC runs a medically supervised weight-loss program, primarily for diabetics, so that they can monitor your medications and general health as you lose weight.
Skeptical, I called the office and found out more about the program. I was told that it was basically a low-carbohydrate diet designed for diabetics, those who have been diagnosed as pre-diabetic, and those whose BMI puts them in the overweight or above category. I’m not diabetic, but my weight classified me as obese (5’6″ and 205+ lbs). I spent some time investigating the science behind low-carb diets and decided they were on the right track. Before even going to the free seminar I went ahead and signed up for the 8-month program.
While waiting for the program to start I was given a book to read; Gary Taube’s book Why We Get Fat. I had come to the conclusion as a result of my experience over the years that weight and cholesterol is determined about 90% by genetics and only 10% by diet and exercise. Maybe even 5% diet and exercise. Taube explains how eating carbohydrates (grains, potatoes, and sugar) causes blood sugar (glucose) to increase, which causes the body to produce insulin. Insulin tells your body to store glucose as fat. If we reduce the amount of carbs in our diet, we reduce the blood sugar, reduce the insulin, and reduce the body’s tendency to create fat.
Cutting carbs isn’t easy. You’re cutting out grains (including bread, anything made with flour, pasta, and corn), potatoes (regular or sweet), and sugar (in all its forms, including naturally occurring sugar in fruit and added sugar everywhere). To help you change your habits, the HTC program begins with 6 weeks of “induction”. In the first two, you replace two meals per day with protein shakes that provide your essential nutrients and make it easier to hit the goal of only 20 grams of net carbs (total carbs less dietary fiber) per day. For the next 4 weeks you replace one meal with a shake and up your carb count to 30-50 grams. By the time you get to the end of the 6 weeks you’ve figured out what you can and can’t eat, you’ve learned how to read when your body is really hungry and when you’re just bored, and you’ve lost a lot of weight.
Over the remaining weeks you learn during group meetings how to expand the variety of vegetables in your diet. The group sessions are mostly cooking demos. Recipes for low-carb dishes are distributed.
After the 8-month program I was down 35 lbs (from 205 to 170) and was still losing weight (another 4 lbs over the next 12 months). My BMI is down from about 33 to under 28. When taking into consideration my age and gender, I’ve gone from a situation where my weight has a moderate probability of causing medical issues to where that probability is now low. And I’m still losing weight (I’d like to drop another 10-12 lbs.)
Here’s what I’ve learned in this adventure. If you understand these facts, it will change your life.
- If you gain weight on the standard American diet, carbs are your poison. Carbs cause you to get fat. Obesity has been found to be directly responsible for heart disease, diabetes, gout, sleep apnea, Alzheimer’s disease, and more. So it’s not exaggeration to say that the carbs you eat are killing you.
- Fat doesn’t make you fat. Eating foods that are high in fat is not what makes you fat. In fact, eating food high in fat satiates your appetite, reduces hunger, and helps you eat less. It’s the carbohydrates in your diet that tell your body to convert the sugar in your blood into fat and store it away.
- High cholesterol foods don’t give you high cholesterol. Eggs are good for you. Eat more eggs.
- “You have to burn more calories than you take in to lose weight” is a lie. Calories don’t make you fat; carbs do. Stop counting calories. Start counting carbs.
- Carbs make you hungry. Why do you think restaurants serve bread before you order? It’s because eating carbs makes you hungry so you’ll order more food, especially an expensive dessert. Fat fills you up.
- You can eat less and not be hungry. The key is eating the right things. I’ve had days where I drink what you might call a low-carb latte for breakfast, have a small salad (greens, broccoli, cauliflower, and cheese) for lunch, and three scrambled eggs with onions, peppers, ham, and cheese for dinner. No snacks. No hunger.
- Exercise is important to good health, but will cause you to gain weight. You should still exercise. But not for weight loss. The only demographic that has a chance of losing weight from exercise are men under 30. If you’re not a man under 30, you will gain weight as a result of exercise. You should still exercise. You should control your weight with a proper diet.
- A “diet” can’t be something that you do for a few months to reach a weight goal, then quit. You should think of low-carb as a lifestyle that will last the rest of your life, not a temporary change that will end once you’ve lost those 50 lbs you need to lose.
- Just because you failed at Weight Watchers or some other diet doesn’t mean you will fail if you choose a low-carb diet. Those other diets don’t work because they don’t teach you how to eat right. They’re doomed to fail because they don’t address why you’re gaining weight. They try to tell you that you are glutton (you just eat too much) and you’re lazy (you don’t get enough exercise). Instead of telling you how to lose weight, they tell you you’re a bad person. Nice. Just what you need.
- All of the various diet programs are successful only to the extent that you are accidentally reducing carbohydrates. You don’t lose weight at Weight Watchers because you have reduced calories, you lose weight because you’ve cut your intake of sugar in order to cut calories. You don’t lose weight on a paleo diet because you’re eating like a caveman, you lose weight because you’re not eating Twinkies and bread.
What foods to you avoid?
- No grains – so no bread, rice, corn, pasta, etc.
- No potatoes (regular or sweet).
- No sugar, whether natural or added. So no pop, no fruit juice, no excessively sweet fruit like oranges, apples, or bananas.
What can you eat?
- Meat, fish, poultry. Fat is OK. Well-marbled steaks, skin-on chicken, and bacon are all OK. No breaded chicken or fish.
- Cheese and almost-cheese. The closest I come to milk is whipping cream, sour cream, and whole-milk Greek yogurt. No just-plain milk (neither whole nor skim).
- Eggs. Don’t be afraid of eggs.
- Veggies, especially dark greens (spinach and kale), broccoli, carrots (in moderation), cauliflower, radishes, turnips, parsnips, rutabagas, tomato (yes, I know it’s a fruit; in moderation), peppers, onions.
- Limited amounts of fruit. Mostly berries. I like raspberries and blueberries. Johnna likes blackberries. Occasional strawberries. No bananas or other tropical fruits.
What do you typically eat each day?
- Breakfast is one of the following:
- Bullet-proof coffee (coffee blended with 1 tbsp MCT oil, 2 tbsp unsweetened butter, 1 tsp dark chocolate cocoa (unsweetened), Stevia equal to 2 tsp sugar, and 1/2 tbsp Metamucil (fiber supplement). My LDL cholesterol was up after doing bullet-proof coffee for breakfast for about 2-3 months. I saw a website that suggested dropping it. My doctor said it was no problem to continue using it and that my LDL (though at the upper limit of 100) was fine. Note: The Stevia I use is from SweetLeaf and uses inulin (a non-digestible dietary fiber) as a filler instead of dextrose, which, ironically, is sugar.
- 3 eggs with cheese and a couple sausage patties. No juice, no toast, no hash browns. Maybe a few raspberries. Definitely some Cholula hot sauce!
- A salad made with dark green leafy veggies like spinach, kale, and arugula; broccoli; cauliflower; maybe carrots; cheese; and either a hard-boiled egg or grilled chicken. Balsamic vinaigrette or blue cheese dressing.
- Something egg-based, like a veggie omelet with some bacon.
- A low-carb protein shake: 1 cup unsweetened “original” Almond milk; 1 tbsp MCT oil or olive oil; 1 scoop Quest Salted Caramel protein powder; 1/2 tsp cinnamon; 2 tsp chia seed. Blend on a fairly high speed to chop up the chia seeds.
- Snacks: I try to avoid snacks but if I get hungry between lunch and dinner I’ll have one of these:
- Pecans (about 1g net carbs per handful)
- Pork rinds (chicharrones) . The spicy pork rinds are best; the plain ones taste like licking a pig. 0-1g net carbs per serving.
- Amana Beef Snack Sticks. They’re like beef jerky but 0g net carbs. (You have to be careful with jerky and other cured meats; they tend to add things that add carbs.)
- String cheese or other single-serving cheeses.
- Coffee-flavored Keto Cups. 1g net carbs per cup.
- Dinner: Varies. In general I try to have about a 6-8 oz serving of protein and two servings of vegetables.
- Dessert: If I have anything “sweet” at all it will be a dish of about 8-10 raspberries and homemade, no-carb whipped cream. Alternately, sugar-free Jello with raspberries.
How many grams of carbs can/should you have?
The standard American diet is about 350 grams per day. I find I need to be at or below 20 grams in order to have a chance at losing any weight. That’s considered a pretty intense “Keto” diet. Note those are “net carbs” — so total carbs from the label of the food I’m eating less “dietary fiber”. If I get into the 50-70 gram range I will start to put weight back on.
How do you eat at restaurants?
I don’t go to fast food restaurants, but could. They’re just boring when you can’t eat french fries. Typically I’ll order a sandwich of some kind without a bun. Often you can ask for a burger to be served on greens instead of a bun. Today I ate at a place that had chicken salad sandwiches, so I asked for chicken salad on a bed of spinach instead of bread. Instead of fries I get a salad or veggies. Diet soda, water, or unsweet tea. No dessert.
We’ve ordered pizza and eaten just the cheese and toppings. I’ve ordered pasta dishes with just the sauce over grilled chicken.
In the course of learning how to eat on this diet we’ve found restaurants that either intentionally or accidentally have some really good meals that are low-carb. A number of places offer riced or mashed cauliflower in place of potatoes. A few select restaurants make salads with real greens instead of iceberg lettuce. (Always choose non-sweet, high-fat dressings. Get them on the side so you can control how much they put on the salad.)
Does it work?
In the first year and a half I lost about 39 lbs, or just short of 20% of my starting weight. After 2 years I had a medication change due to chronic asthma, which caused me to gain about 5 lbs. They tell me that’s water, not fat.
I’m not hungry. I’m eating a wider variety of food than I used to, and I’m eating food that tastes better. Clothes fit better. I’m running again; I’m up to 20-22 miles per week (I run three days each week; 5-10 miles per day; longer if I’m training for a race) during the summer. I’ve run two half-marathons (13.1 miles) on a cup of bullet-proof coffee for breakfast and water laced with Nuun electrolyte tablets during the race, including one that was my personal best (2 hours 18 minutes).
I’m off one blood pressure medicine (HCTZ). I’ve dialed back my BiPAP (sleep apnea) pressures and am talking to my neurologist about a plan to re-test and potentially get off it entirely.
After a year my HDL (good) cholesterol was up and triglycerides were down. LDL (bad) cholesterol was also up, but that’s normal in a low-carb diet. There are a couple kinds of LDL cholesterol, and LCHF diets tend to cause an increase in the “large, fluffy” LDL that doesn’t clog arteries, not the “small, granular” LDL that causes problems. The test to distinguish between the two is apparently expensive and rarely done.
Where can I learn more?
I usually send people to dietdoctor.com for general information on the low-carb, high-fat lifestyle. They are stronger advocates of intermittent fasting than I am. I don’t believe you need to fast to lose weight. Remember, this is a lifestyle change, not a temporary project. You shouldn’t do anything that you can’t maintain for the rest of your life.
If you’re local to the Cedar Rapids, IA area, this is the program I’m in: Health Transitions Clinic. Tell them I sent you, and you’ll get a discount. Seriously.
Health Transitions Clinic runs the same program at a lower cost at https://wellnessfromfood.com. You’re monitored by a physician, nurses, and dietitians.
I’ve read a number of good books on the subject. The Taubes book mentioned above is good. Here are a couple more:
Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease