Lifetime Maintenance

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The bells should be ringing, the flags should be flying: You're there! You've arrived at the place where millions of overweight people have never been since they were children-at the weight you were meant to be. And the impact on every part of your life is enormous. Am I right?

Take a good long look in the mirror, try on your newly tailored clothes or climb into duds you haven't been able to shoehorn yourself into for years, and then-oh, bliss-listen to the comments people make. I'll bet you've taken center stage. Losing weight sure attracts attention! And who doesn't want to look his or her best?

Now let me interject a reality check. Have you won the battle of the bulge? Or have you only graduated from boot camp, in shape now for the battle ahead? I can personally attest to the fact that you have achieved the latter. Recidivism among people who have lost considerable weight is such a well-documented phenomenon that many cynical doctors advise their patients not to even bother trying to lose. Fortunately with Atkins, such pessimism is unwarranted. This is not to say you don't need a lifetime maintenance plan accompanied by unceasing vigilance. This chapter supplies you with the former; the determination to succeed is your responsibility.

Before she saw me, Mary Anne Evans had given up. "I said to myself, "I'm simply going to be fat for the rest of my life.' I weighed 209 pounds when I came to see you, and I had been putting on weight steadily for twenty years-especially after the birth of each of my kids."

At five feet five inches tall and 42 years old, Mary Anne's 200-plus weight load was a health hazard and a half, and I told her so. She had tried countless diets-low-calorie diets, including Weight Watchers, a hospital-based program that measured calories and a liquid-protein diet on which she had lost more than 30 pounds in three months and gained back, with interest, in four.

So what was the use? Besides, she hadn't come to me with weight loss in mind. Her problems were medical. Mary Anne's blood pressure was an abnormally elevated 160/100, she had a number of allergies, and her chief complaint was the extreme fatigue she had endured for the past several years. Add her excess weight to all that, and I knew she was heading into a difficult midlife physical crisis. I recommended and she agreed to do Atkins.

"By the second week doing Induction, I realized I felt really good," recalls Mary Anne. "I had a lot more energy than I'd had on my old diet, and I wasn't hungry."

After five weeks, she'd lost 21 pounds, and her blood pressure was a normal 120/78. It took nine months for her to get to 139 pounds. "I lost weight without any hassle," she says. "I was eating things I really liked to eat anyway. And the change in my life was incredible. Before, my favorite position had been sitting. Now I go out camping with my youngest son, and last summer I went horseback riding in the Rockies. The people at the lab where I work can't believe the new me. I go out to lunch with some of the other women who are on diets, and they can't seem to lose weight, and they're hungry. And I'm sitting there eating a juicy hamburger and a large salad."

Another two years have passed. Mary Anne's weight still hovers around 142. She has a glass of wine before dinner a couple of nights a week, and she eats two potatoes weekly. Her only other carbohydrates are plenty of vegetables and salads. She's on a luxurious regimen that she enjoys. She's full of energy, and her blood pressure is normal.

Is Mary Anne Evans ever going to fall off Atkins? Knowing her intense motivation, I have no doubt that she will enjoy long-term success. You need to have within yourself that same strength of conviction.

At the Finish Line

I would expect that as you traveled along the slow Pre-Maintenance path, one day you realized you were actually in Lifetime Maintenance: Your weight remained constant within a pound or two for several weeks. The decisions to move from Induction to OWL and from OWL to Pre-Maintenance were conscious choices on your part. But it is not always easy to define the moment at which you leave Pre-Maintenance and move to Lifetime Maintenance; the former segues naturally into the latter. But from now on, you will have conscious choices to make every day of your life. So, let me remind you of why it is worth making the right choices.

What Lifetime Maintenance Does for You

By now, you should know this by heart, but in this case a little repetition is a good thing. Adhering to Lifetime Maintenance will:

• provide you with a way of eating that allows you to stay slim for the rest of your life.

• allow you to maximize the amount of healthy carbohydrate foods you can eat while staying within 3 to 5 pounds of your goal weight.

• prevent re-addiction to foods that have gotten you in trouble before by helping you to avoid frequent exposure to them.

• teach you how to drop back to an earlier weight loss phase, when needed, to achieve lifetime weight control.

• teach you how to make the healthiest carbohydrate choices, which will allow you to continue to stay in control of your eating habits, feel your best and maintain improved blood-lipid levels, blood pressure and other lab test results, as well as optimize your blood pressure, energy and more.

• teach you how to adjust your carbohydrate consumption when metabolic circumstances change, before you find yourself regaining inches and/or weight.

• reduce your risk factors for cardiovascular disease, hypertension, diabetes, and other sugar metabolism disorders.

• give you a sense of accomplishment and confidence that spills over into the rest of your life.

How to Do Lifetime Maintenance-Correctly

Now that you've made it to your goal weight, you can continue to select from a greater range of foods and consume more carbs than you did in the two earlier phases of Atkins. But as I've said at every transition: No way is this a license to return to your old eating patterns. All too often, people win the battle of weight loss only to lose the war of weight control. To maintain your goal weight, you must know your metabolic needs. Your Critical Carbohydrate Level for Maintenance (CCLM) (see page 197), which you found during Pre-Maintenance, lets you know how m, carbs you can eat each day to maintain your weight. S right at or around that number, and your weight should fluctuate beyond the perfectly natural range of 2 of pounds. (Hormonal changes and other daily fluctuation your body account for a small seesaw effect.) Later, I'll you about why and how you may have to adjust your CCLM at various times in your life.

Carbohydrate Gram Levels and Metabolic Resistance for Maintaining

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