Pre Maintenance Prepare for Permanent Slimness

You're almost there! All your good work and healthy eating habits have paid off and you now have only 5 to 10 pounds left to reach your goal weight. Give yourself a good pat on the back; you deserve it!

Having said that, I have to insert a note of caution. You may not like what follows, but it is vitally important that you hear it.

If you have been racing along the road to your destination, now is the time to put on the brakes. Much as it is tempting to say, "I can banish these last pounds in a few weeks now that I know how to do Atkins," I strongly advise you to do something that seems quite the opposite on Pre-Maintenance, the all-important third phase of Atkins. As you advance toward Lifetime Maintenance, my advice is to proceed so slowly that your weight loss is almost imperceptible. I know that this snail's pace can be excruciating when the end is in sight. But remember, getting to your goal weight is not your ultimate goal; your real goal is to maintain that magic number indefinitely.

Our focus is now different. There is little doubt you can and will reach your goal weight. The only doubt is whether you will stay at that weight for life. The purpose now is to create the optimal lifetime eating program-one that fits you so perfectly you will want to stay on it for life.

When you moved to OWL, you deliberately slowed down your weight loss by adding more carbs and more variety to your menus. Now I am going to ask you to slow things down even further. The more you learn about eating as you lose those last few pounds, the better. Your next assignment is to increase your carbohydrate consumption until you're losing less than a pound a week. The additional foods will provide increased nutrition and culinary enjoyment. Ideally, you should spend at least a month and preferably two or three in this phase.

There is method in what may sound like madness here. If you search for the level that achieves a small amount of weight loss, by the time you reach your goal weight you will, in effect, be on Lifetime Maintenance, at which time your weight loss will naturally slow to a halt. During PreMaintenance, you will both accustom yourself to your lifetime eating plan and get a good indication of what it will be like. Think of this phase as a learner's permit, like the one you had when you were just beginning to drive. You were allowed out on the roads, but only with a licensed driver by your side. Pre-Maintenance is like that. You're out there doing it, but you still need some more hours behind the wheel before it's safe to allow you on the highway all by yourself.

That's why it is crucial that you NOT make the assumption that Pre-Maintenance and Lifetime Maintenance must be pretty much the same thing because their names sound alike. Not true: One is a training program; the other is the rest of your life. If you have any misguided ideas about skipping this third phase and going right to Lifetime Maintenance, I implore you not to do so. In fact, I would go so far as to say that Pre-Maintenance is mandatory if permanent weight loss is to be achieved. Let me repeat that: If you omit Pre-Maintenance, you may well be doomed to failure when it comes to maintaining your weight loss for the long term.

When it comes to the last few pounds, slower is better. Here's why: When Madge O'Hara came to see me, she weighed 156 (on a five-foot two-inch frame), and she planned to slim down to 115. She lost 21 pounds the first month, and I surmise that 6 or 7 pounds of that was water weight. The next month she moved to OWL and lost 7 more pounds. She then moved on to Pre-Maintenance and peeled off the last 13 pounds over a leisurely three months. By the time Madge reached her goal weight, she knew exactly how she was going to eat for the rest of her life-and controlling her carb intake had become automatic for her.

What You Will Learn in Pre-Maintenance

Now that you understand that Pre-Maintenance is the phase that bridges losing weight and maintaining weight, let me spell out exactly what this crucial phase will do for you. During it, you will:

• find your new Critical Carbohydrate Level for Losing (CCLL) slowly, as well as your Critical Carbohydrate Level for Maintenance (CCLM).

• explore more food choices, while learning how not to abuse them.

• become aware of the foods or situations that can make you lose sight of your long-term goals.

• internalize your responses to food so that what used to be a struggle becomes a conscious choice, one that serves you for the rest of your life.

• find out how flexible Atkins is.

• learn how to deal with temptation.

• learn how to immediately erase the problems created by making unhealthy food choices to prevent "yo-yo" weight gain and loss.

• develop a style of eating for a lifetime.

It's a Lifestyle

Pre-Maintenance is crucial to getting your weight under control for good, but it is also about far more important things-the first, of course, being your health. To reduce your long-term risks for conditions such as cardiovascular disease, hypertension, and diabetes there is nothing more effective than maintaining a healthy weight. But I am also thinking about such things as your ability to make choices that are right for you, not for your spouse, your parents, your friends or even your doctor. When you realize you can be in charge of what you eat, how you look and how healthy you are, it empowers you in all the other aspects of your life. Instead of worrying about looking good to please someone else, you are likely coming to realize that what matters is how you feel about how you look and feel. You are learning the skills that allow you to take charge of your life.

Phil Monte couldn't agree more. What does a corrections officer in Maine do when he's 30 pounds overweight, eats a high-carb diet and keeps falling asleep after lunch in a roomful of noisy inmates? Well, first he tries a low-fat diet, filling up with plenty of pasta, bread, rice and potatoes. I leave the sad results to your imagination.

Then he listens to his brother who lost a ton of weight doing Atkins, and he picks up a copy of an earlier edition of this book. His menu plan changed-fast. "Now I have meat cooked on the grill with green vegetables," says Phil. "Another dish I make is a stir-fry with chicken, cabbage, garlic, green peppers, onions and soy sauce. Before I might have used cornstarch to thicken this dish and served it on rice, but not anymore."

Phil lost his 30 pounds and when his doctor saw that his HDL (good) cholesterol had gone up to 90, he said, "With numbers like these, Phil, you'll never get heart disease!" At 35 years old, Phil has become a diet guru for the people he works with; they call him up weekly to ask how to do Atkins.

Phil's self-confidence has gone through the roof, and, exploiting his avocation as a golfer, he's starred in two instructional videos and self-published a book. When he went to his sister's wedding, people he'd known all his life didn't recognize him. He thinks it's the biggest compliment he's gotten yet.

How to Do Pre-Maintenance

When you were doing OWL, you learned how to increase your carb intake in increments of 5 grams. In this phase, you can shift into a higher gear: Increase your daily carb count by 10 grams each week so long as you continue to lose. (See "The Power of Ten" on pages 201-203 and refer to the carbohydrate gram counter in this book.) If you introduce new foods slowly and increase your grams of carbs gradually, your CCLL should increase gradually. This new and higher CCLL will reflect the fact that you are now losing weight more slowly.

As you continue to make 10-gram incremental additions, you will rather quickly reach a point at which you will find that you are no longer losing. If you are at your goal weight, stay at that level for a month or so before you increase your daily carb consumption by another 10 grams to see if you can consume that level without gaining. Once you do begin to gain, drop back 10 grams and you should have established your Critical Carbohydrate Level for Maintenance (CCLM).

On the other hand, if after an incremental increase you find that you are gaining or are not losing and you are not yet at your goal weight, you need to back down to the previous level. The line between gaining, maintaining and losing is a thin one and you may have to "play" with your CCLL and CCLM for a while to understand what your body can handle.

While it may take as long as three months to drop the last few pounds and clearly establish your CCLM, I reiterate: This leisurely pace is critical to your ultimate success. Continue to add new foods slowly and carefully so you'll be learning good eating habits at the same time. For example, you'll discover whether your metabolism can handle wholegrain bread, legumes, starchy vegetables and other potential "trouble" foods. (People with extremely low carb tolerance-meaning high metabolic resistance-won't be able to add many new foods and will find Pre-Maintenance similar to OWL or even Induction.)

Some Variations on the Rule

Another approach to Pre-Maintenance is to continue eating as you were at the end of OWL and to allow yourself a 20-gram carb treat two or three times a week. Add a piece of fruit or a starchy vegetable-a serving of brown rice or sweet potatoes, for example. You can also have a glass of white wine, a light beer or the white spirits. You could get more adventurous with some of the excellent controlled carbohydrate convenience foods that are increasingly available. Or, if your metabolic resistance is at the low end, you may be able to enjoy such treats more frequently.

Still another way to do Pre-Maintenance is to average out your carb intake for the week. This is how it works: If, for example, your CCLL is 80 grams, you might drop back to 60 grams on Tuesday, then deviate with a beef, potato and carrot stew the following night, pushing your daily total to 100 grams. (Up until now, when weight loss was essential, I have told you to spread your carbs out through the day. If you do have a heavy dose at one meal, make sure there is enough fat, protein and fiber in the rest of the meal to slow the glucose load on your system.) However, if you find such deviations create cravings, it is probably best for you to stick to a steady number of carbs spread evenly throughout the day.

But be careful! There are a couple of reasons why people sometimes get into trouble:

1. They don't recognize that this phase is still relatively restrictive of carbohydrates, compared to the way they were eating before they were doing Atkins.

2. They're startled to discover that without the wonderful advantage of deep lipolysis, appetite suppression has diminished.

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