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Interesting n=1 case of weight loss


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Dear all,

I confess that my recent immersion in nutrition science derived, besides an old personal interest, from the necessity not to call a dietitian. My wife in the past has gone to numerous dietitians and has lost and gained weight, yo-yoing several cycles. This time I imposed myself: no more money thrown to dietitians, I'm going to see to it.

So I started with low-carb, since she had previously good results with it. Dr. Fung and Rosedale school, advocating low carb, hi fats, moderate protein (very moderate sometimes). No caps on calories but not unilmited fats.

I attach a temporal plot (dates follow the European convenction, dd/mm/year).

My wife started at 83.5 kg (BMI 31) and reached 77.5 kg (BMI=29) after 5 months. Then the long plateau. Very stable bodyweight, within the usual hi-frequency fluctuations.


After 4 months of this plateau, I thought maybe a change might help. I had her adopt a caloric restriction scheme coupled to an Ornish-style diet, few fats, more carbs, protein enough to satisfy 100% or more RDA for essential AAs. She likes carbs better than fats so, even if 900 kCal day-1 is not much, she's enjoying her food. Moreover, I strongly suspect that her BMR is lower than the theoretical, mean index. She's most likely in the lower percentiles of the statistical distribution of energy requirement, so her 52% of theoretical restriction is something in the region of maybe 70% of real energy need.

So, just after the shift, she started loosing weight again, now on a decreasing trend, like visible in the plot (presently at 75.8 kg, 28.5 BMI) .


Interesting bottom line: After all it is  not always true, like often told, that low-carb is the best way to loose weight and that calories are not a factor. It may be so at the beginning, since forcing a sudden decrease of the insulin signal will bring about strong diuresis and some catabolism. People like my wife though, who is a food-absorber, may reach soon an homeostatic balance and stop loosing weight. I also suspect saturated fats are a factor which, in genetical setups like my wife's, can boost lipidogenesis.

I find the spectrum diet as suggested by Dr. Dean Ornish is pretty sensible and balanced. Low fat means more food volume, which is more satiating in a CR setup.

I'm curious to see where this trend is leading.



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From what I've read sustained long term weight loss on any diet is rare.  Weight loss tends to be fast and easy when starting any diet but typically around the 6 month point or so it becomes challenging and most plateau or backslide.  The need for calories reduces as weight drops and if one isn't steadily cutting calories the rate of weight loss slows and motivation wanes.    


I've been struggling with this myself.  I went from weight in the range of 170-175 lbs to a range of 135-140 lbs in 6 months.  By that point I was needing to eat a few hundred calories per day less than when I started to continue losing 1 lb / week.  Although my scale told me my bodyfat was 19% I suspected it was higher and I'd like to get below 10%.  Probably putting me in the 115-120 lb range which is low for my height of 5'10" so I refocused on maximizing muscle instead of losing weight.  I gained 10 lbs in 6 weeks.  Since then I've been YoYo'ing alternately switching between trying to lose weight and build muscle.  Each cycle it has been getting easier to build muscle (which is amazing considering I have a supposedly untreatable muscle wasting disease) but increasingly hard to lose weight.  To better balance the rates of weight gain and loss I've resorted to doing 3 to 4 day water fasts during my weight loss phases.  Some people find their first day or two of each fast challenging, but eating keto I find it relatively easy to transition in and out of fasting,

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... The need for calories reduces as weight drops and if one isn't steadily cutting calories the rate of weight loss slows and motivation wanes.    


I really hope that the above is going to occur as late as possible, otherwise the complaints from the missus will be intolerable (by what appears to be a law of nature wives tend to complain a lot even when there is little reason to complain).


I remain stunned by the levels of metabolic efficiency the body is able to reach in some people, keeping their weight stable at half the amount of energy they used to ingest.


From what I read on fora, many low-carbers really get down to 10-20 grams of carbs per day max (which almost eliminates even vegetables) and some will practice zero-carbs diets for a while (no vegetables, nor nuts, just meat, eggs and little more). That sounds like totally unhealthy on the long run, even though on the short run the lower BMI will grant some decreased mortality risk.



I believe that's also an issue of patience. Most people on prolonged CR loose the excess bodyweight (at least that seems to be reading this forum), so an healthy, CR diet seems the best option to me. No Faustian bargain. Even though I concur it's hard to keep the motivation on the long run, whereas increased longevity is an added bonus which may help.

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