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If Your Metabolism Is Stubborn

Others of you aren't so lucky when it comes to metabolic resistance. Those of you with a very high metabolic resistance to weight loss are most in need of this book. If you are unable to lose during Induction or had an initial loss and then stalled out while still doing Induction, you will have to adapt to eating not much more carbohydrate than 20 grams daily. You certainly will want to study Chapter 20 carefully. Remember, if you're going to stay slim and healthy, a significant increase in the amount of exercise-which I strongly recommend for everyone-is absolutely essential for those of you with high metabolic resistance. Without it, losing weight may actually be hard for you. (See Chapter 22.)

Metabolic Resistance Causes and Solutions

Part of the obesity epidemic we face in the United States may be due to the misconception that those of us who are overweight are simply gluttons or lazy couch potatoes. For most of the last century, the majority of doctors involved in treating obesity did not accept extreme metabolic resistance as a possible explanation for their patients' plight, but rather chose to believe that they were being untruthful about what they ate. The inability to burn fat or lose weight, the phenomenon called metabolic resistance to weight loss, is not uncommon. In my clinical practice, I have been called upon to treat hundreds if not thousands of patients who simply could not reach their goal weight no matter what weight loss program they tried. But my co-practitioners and I were determined to help, and ultimately we did

Metabolic Resistance Approximate CCLM Range

If your metabolism can handle it, I'm about to allow you, in moderation, many of the foods you used to enjoy. (The exception is sugar.) I have worked with too many overweight individuals who have reached their goal weight four or more times, only to gain back the pounds every time. Their fatal flaw always trying to return, as closely as they could without giving up Atkins altogether, to their old way of eating. I hope you have learned better on this odyssey.

Dont Excess Calories Cause Weight Gain

When I published the first edition of this book ten years ago, that claim was quite controversial. Today it is galloping into acceptance among scientists who study the human metabolism. Glance through the references listed at the back of this book and you will see the numerous studies and articles published in the past six years. And, we will deal with the metabolic advantage in greater detail in Chapter 7.

Eating the Atkins Way Must Have Special Advantages

There are sound physiological reasons for this. When you restrict the number of calories you eat, your metabolism shifts into a survival mode, meaning it slows down to conserve energy. When you go back to a higher-calorie diet-as you inevitably must-your body is still in its mode of burning calories slowly. So it becomes extremely hard to continue or maintain weight loss.

Whats Wrong With Carbohydrates

During the weight loss phase of Atkins, even your intake of potentially healthy carbohydrates such as fruits and whole grains must be controlled. Once you've bid adieu to your extra pounds, you can return to fruits and some starches to the degree that they won't upset your metabolism and reactivate the cravings that result in weight gain. But the refined and processed foods I've just mentioned simply aren't good for you-ever.

How Your Body Uses Food

The number of calories used by an individual is determined by three factors basal metabolic rate, the thermic effect of the food eaten, and the calories used during physical activity. The basal metabolic rate is the amount of energy needed to maintain bodily functions when an individual is at rest. This component accounts for 60 to 75 percent of the daily calorie requirement in sedentary adults. The major determinant of the basal metabolic rate is the amount of fat-free mass in the body. Muscle is one example of fat-free mass. Resistance (strength) training can increase the amount of muscle and therefore increase the basal metabolic rate. Resistance training also can help prevent the loss of lean mass that normally occurs with aging. Men

The Promise of the Positive

Even during Induction, the first phase of Atkins, and the one which is most restrictive of carbohydrates, most of you will be able to eat one cup of those vegetables daily, as well as two cups of salad vegetables (or just three cups of salad vegetables). As your metabolism permits, most of you will add more vegetables during the increasingly liberal phases that follow. By the time you are in the Lifetime Maintenance phase, you may well be able to eat

Addiction and Withdrawal

You'll notice that I have not yet mentioned weight. Unless you are extremely metabolically resistant, you will start losing considerable weight during Induction. The amount and rate at which you lose can vary dramatically depending upon your age, level of activity, whether you are taking hormones or other drugs, your degree of metabolic resistance and other factors. The median weight loss from two weeks doing Induction is 10 pounds for overweight males and 6 pounds for overweight females. But do understand this On any weight loss program, the first weight lost is water weight. Atkins is a particularly effective diuretic, so the water weight tends to come off fast on my program. But be assured that after four to five days, the pounds that come off are primarily fat.

The Choice Was Theirs

It's easy to see how much less metabolic resistance Dan had than Carol, and even easier to understand why they took the paths they did. If Dan had continued Induction, he would have lost his weight so quickly that it would probably have been harder for him to convert to a Lifetime Maintenance plan. If Carol had moved on to OWL, her weight loss would have slowed so radically that she might have given up in despair. It sounds to me like Dan and Carol made the right choices. Certainly they both reached their goal weight and felt enormous satisfaction in doing so.

Look at the Big Picture

When you begin OWL, you will be at a crucial stage for learning the parameters of your lifetime program. You'll find out what's the most liberal level of carbohydrate consumption your metabolism can handle while continuing to take off excess pounds. Pay close attention This important number is your Critical Carbohydrate Level for Losing (CCLL).

Approximate CCLL Range

Your CCLL is an even more precise way to determine your level of metabolic resistance than the amount of weight you lost during Induction. As you continue to do Atkins, you will, by glancing at this table, have a more accurate idea of your degree of metabolic resistance.

As Your Weight Loss Slows

As you keep raising your level of carbohydrate intake (and even if you don't), you'll notice a slowdown in the rate at which you lose weight. How soon you notice those changes is another major tipoff as to how great your metabolic resistance to weight loss is. During Induction (20 grams of carbohydrate), you may have been losing 5 pounds a week. In the first week to ten days some of that loss was water weight, since the program has a strong diuretic effect. If you continued doing Induction for a few more weeks, your weekly weight loss probably slowed down, as you were losing primarily fat, perhaps up to 3 pounds a week. You may find that you can go up to 40 or 45 grams of carbohydrate a day-or even more if you are young, male and active-and still lose 1 pound a week. This would put you at an average level of metabolic resistance.

Dealing With Weight Gain

But here's the catch that many people don't see There is very little leeway before you break through your CCLM to the level at which you begin to gain. A typical male of average metabolic resistance may find he has a CCLM of 50 grams. As long as he regularly eats no more than 50 grams of carbs a day he will not lose more weight and become too thin. On the other hand, if he starts consuming 60 grams a day, he'll be above his CCLM and will start to regain weight.

Protect Your Weight Losses

Remember, going straight back to the Induction phase is as simple as beginning Atkins in the first place. Do not go back to Lifetime Maintenance without first losing all you have regained. It's simple. A salad a day, a portion of veggies, plenty of protein and fat and, voila , you've slashed your weight back in as little as six to eight days, or two or three weeks, depending upon your degree of metabolic resistance.

Uses and Abuses of Induction

Another more serious concern I have is the impact this back-and-forthing can have on your metabolism. (See The Wrong Way to Do Atkins on pages 223-225.) 1 have heard people say, I love doing Atkins, because we can cheat on the weekends, then go back to Induction on Monday morning While this behavior pattern may work for the short term, it will probably backfire in more ways than one. It's likely that your metabolism will adapt at a certain point-in a sense, developing a tolerance. People who repeatedly regain weight and go back to Induction sometimes find that they do not experience the dramatic and easy weight loss they initially enjoyed. Add in the fact that none of us is getting any younger and our metabolism's natural tendency is to slow down with passing years. Finally, your body pays a price healthwise if you dramatically switch back and forth repeatedly from a fat-burning to a glucose-burning metabolism.

The Bountiful World of Maintenance

Lifetime Maintenance may not be much different from OWL for people with high metabolic resistance. If you are one of the lucky folks with low metabolic resistance, you may be able to eat most vegetables-including starchy vegetables, fruit, legumes and whole grains such as oats, barley, millet, wild rice, couscous or buckwheat. You may even be able to handle an occasional potato. But, and this is a significant distinction, that does not mean you can eat all these things in one day. You still have to count carbs to stay at your CCLM. You can begin to use recipes, such as breaded veal chops, that contain some carbohydrate ingredients.

Influences Beyond Your Control

As you have learned, a proper lifetime eating plan involves utilizing all four phases of Atkins. That's because, much as you may not want to hear it, maintaining your goal weight can provide a challenge or two. Factors independent of your appetite can influence it. No one's weight is constant. There will be times in your life when you gain some weight back. A change in activity level-a more sedentary job, for example-hormonal changes, the addition of certain medications and simply the passage of years can slow your metabolism.

The Alpha And The Omega Of Fats

That's right, when used properly, fat intake can be a strong ally, rather than a deadly foe. Of course, it is true that certain fats probably do plug up our arteries, make us fatter, and accelerate our aging. But it's also true that many other dietary fats can offer protection against heart disease, free radical damage, and cancer can increase metabolic rate and fat burning can increase muscle mass and can increase the production of hormones like testosterone.

Regimen to jumpStart Weight Loss

Remember, I don't advise losing more than one pound a day. (People with a lot of excess weight may lose more than a pound a day in the beginning. And you may very well lose water weight this fast in the beginning, and that is also okay.) That's about as fast as a normal human body can dump pounds safely and comfortably. Go faster, and you'll probably pay. Your metabolism won't have had time to adjust, you'll be losing an excessive amount of water and minerals and you may well feel fairly awful. Back off, for heaven's sake, and don't say I didn't warn you. Your body has its own wisdom, so listen to it.

The Role of the Thyroid

Your thyroid gland's main purpose in life is to regulate the speed of your metabolism. So it is not difficult to understand that if it is underactive-the medical word is hypothyroid-your slowed metabolism makes you more resistant to weight loss. Among other things, your thyroid gland regulates your body temperature. In fact, sensitivity to cold is one of the first signs that you may have a sluggish thyroid. Like other hormones, thyroid production naturally diminishes slightly with age in fact, easily twenty-five percent of adults suffer from low thyroid function. The swings of estrogen production in perimenopause or menopause can also throw thyroid function off.

Weight Loss and Weight Maintenance

Exercise is like a buy-two, get-one-free proposition. Not only does it elevate your metabolic rate while you're exercising, but it keeps your calorie-burning meter cranked up for significant periods after you're through. This means that you continue burning calories at a good clip even though you've stopped moving. Similarly, when you increase your muscle mass, you increase the amount of energy your body naturally expends just to keep functioning-even at rest.

How Your New Eating Habits Will Help

The other benefit of a controlled carb nutrition program is that your metabolism won't go into starvation mode when you start exercising. Consider this When you restrict calories and increase exercise, your body reacts just as it would when we were cavemen. As far as your body knows, it thinks there's a famine going on out there and-by unfortunate coincidence-some bear must be chasing you at the same time. Your body goes into survival mode and wisely sends out an allsystems alert to conserve resources. It literally turns your metabolism down a notch. If you instead give your body all the protein and fat it desires, your body will know that food is plentiful. It will then accept your running, walking, stair-climbing or bicycling and leave your metabolism to hum along, and maybe even step up its pace.

Other Weight Loss Assistance

Occasionally, a nutritional shortcoming can lower your metabolism and increase your resistance to weight loss. If you're unable to lose weight or your progress is slow or nearly nonexistent, you may want to consider certain nutrients that can help break up a weight loss logjam. L-carnitine and CoQ,10 if you feel that your metabolic resistance to weight loss is high (see above for dosages).

How to Deal With the Problem

By doing Atkins, you are taking the first and most critical step toward minimizing that which stresses your body. Having stable blood sugar-perhaps for the first time in years-is going to give your metabolism a much needed shot in the arm. Dealing with a food intolerance, if you have one, will be another great advance. But I'd also like you to coddle yourself by searching out your other stressors and seeing if you can't work out a strategy for minimizing them.

The Four Principles of the Atkins Nutritional Approach

It's hard not to. Both men and women who follow the Atkins approach to weight loss readily take off pounds and inches. For the small numbers who have a truly hardcore metabolic resistance to weight loss, Chapter 20 will go into detail about how to overcome the barriers that prevent a successful outcome. Optimizing body weight is a valuable element of any health-oriented program because, by and large, being significantly overweight is an indicator of potential health problems, now or in the future. When you've taken the pounds off, you'll see the benefits, and they will be far more than merely cosmetic.

Who Loses Fastest

Why do some people lose more weight, more rapidly, than others on the South Beach Diet According to Dr. Agatston, people who gained their excess weight as adults and whose weight gain is largely around the belly, lose weight fastest. Central obesity, where excess weight is concentrated around the midsection, is a warning sign for present or future heart problems. If you're losing weight at a slower-than-expected pace, don't despair. Research shows that too-rapid weight loss can cause you to lose lean body mass-not just fat-which can decrease your metabolic rate and increase your risk of plateauing and yo-yoing as you diet. Slow and steady weight loss is more likely to result in permanent weight loss.

Adulthood

For example, your metabolism the way in which your body converts the food you eat into energy slows. This means that you gradually need less food for a similar activity level. Fewer and fewer calories are needed as you grow older about 10 percent less per decade from age 50 onward. This slowing of the metabolism is perfectly natural and occurs because you lose muscle mass (which utilizes most of the energy you produce) as you age. Exercise helps to maintain muscle mass and helps you burn calories. However, most Americans still need to reduce calories.

Life Out of Control

Gordon had failed repeatedly on low-fat low-calorie diets. And that's not surprising. His problem lay in his metabolic response to carbohydrates. To solve an out-of-control situation like this by restricting calories without restricting carbohydrates is like marching into the surf planning to turn back the ocean.

Walking

Walking is one of the best exercise for strengthening bones, controlling weight, toning the leg muscles, maintaining good posture and improving positive self-concept. People who diet without exercising often get fatter with time. Although your weight may initially drop while dieting, such weight loss consists mostly of water and muscle. When the weight returns, it comes back as fat. To avoid getting fatter over time, increase your metabolism by exercising daily.

Sensible Diet Tips

People who diet without exercising often get fatter with time. Although your weight may initially drop while dieting, such weight loss consists mostly of water and muscle. When the weight returns, it comes back as fat. To avoid getting fatter over time, increase your metabolism by exercising regularly. People who diet without exercising often get fatter with time. Although your weight may initially drop while dieting, such weight loss consists mostly of water and muscle. When the weight returns, it comes back as fat. To avoid getting fatter over time, increase your metabolism by exercising regularly. muscle. When the weight returns, it comes back as fat. To avoid getting fatter over time, increase your metabolism by exercising daily.

Zinc and Magnesium

One way to make this process easier is to boost your metabolic rate. While there are many ways to boost your metabolism (including specific exercise, supplement, and overall macronutrient strategies), one simple way is to add a little fish oil into your diet. Recently, studies have also shown that taking a few grams of EPA and DHA per day can speed up metabolic rate by about 400 kcal per day. Imagine that, pop 2-3 fish oil capsules with each meal and you can afford to eat an additional meal each and every day. Talk about exciting news. So if you're interested in improving your health and speeding up your metabolism, swim upstream with the salmon. Ten grams of total fish oil - or about three grams of combined EPA and DHA - per day can boost metabolism while boosting your health substantially.

Fruits

Two other recent studies have shown that hyperinsulinism has also been associated with higher risk for polycystic ovarian syndrome.' It all goes back to lesson one in eating for health Avoid glycemic load. Don't cause your metabolism to struggle incessantly with high insulin levels, weight gain and looming cardiovascular and other health tragedies.

In This Chapter

You'll have fasted for more than 13 hours before you sit down to breakfast. At that point, your body's blood sugar levels are screaming for nourishment. If you're weight conscious, eating breakfast jump-starts your metabolism so it works harder and more efficiently all day. Simply put, never skip breakfast.

How to Keep It Going

Now, let's talk about sustaining that weight loss, which you've so happily begun. You undoubtedly know exactly how much weight you lost during the first fourteen days of Induction. That number will help give you a general understanding of your personal degree of metabolic resistance. As you can see on the metabolic resistance table on page 158, a woman who has 40 pounds to lose and sheds 3 pounds in two weeks during Induction has a high degree of metabolic resistance as compared to a woman with similar weight loss goals who drops 8 pounds. For a complete discussion of metabolic resistance, please turn to Chapter 20. Degree of Metabolic Resistance for Men Pounds Lost in First 14 Days When Metabolic Resistance is high, average or low Degree of Metabolic Resistance for Women Pounds Lost in First 14 Days When Metabolic Resistance is high, average or low I am sure that almost all of you found that you were losing weight. Those who didn't should look at Chapter 20 and work with the special...

More Induction

Although Induction offers plenty of advantages, there are lots of valid reasons for progressing boredom with the food choices, modest weight loss goals (say 20 or 30 pounds) and perhaps the chance to avoid becoming dependent on a crash diet mentality. When people learn that they can lose weight quickly, as they do during Induction, they sometimes take their ability to lose weight for granted. They don't think in terms of a lifetime commitment to the Atkins lifestyle-just a quick fix for overindulgence. The result of this faulty thinking is yo-yo dieting and metabolic resistance to weight loss. While the next phase-Ongoing Weight Loss or OWL-may likely slow your rate of weight loss, this is not a bad thing. The slower the progress, the more chance you have to permanently change bad habits over the long term. If you are metabolically resistant to weight loss, which you will know by how much weight you lost in the first two weeks and by comparing your results with the categories in the...

Proceed With Caution

But the one thing we don't want to do is get you out of lipolysis and halt your forward momentum. If that happened, we would have to resume Induction, or, as I chide so many of my patients, It's back to square one. On the other hand, know that if you get into trouble, you can always return to Induction for a few days to get your metabolism fired up again.

Carbohydrate Ladder

Each week you'll go up another level, adding another 5gram increment until eventually you'll reach a number at which you stop losing. That's how you find your CCLL. Above it, you lose no more, or you begin to gain. Below it, you continue to lose. The lower your metabolic resistance to weight loss and the greater your level of physical activity, the higher that number will be. Once you calculate your CCLL, you'll be able to say to another Atkins follower, My Critical Carbohydrate Level for Losing is 45 grams. What's yours Or it might be higher-say 50, or as low as 25. To get an idea of the range that is possible, see the Carbohydrate Gram Levels and Metabolic Resistance for Losing table opposite. As I've mentioned before, metabolic resistance is influenced by age, gender, activity level, hormone issues, level of physical activity, prescription medications and other factors, so the range in CCLLs can be great.

Did Something Happen

People frequently get frustrated after a week or two without weight loss, when a little reflection would tell them what's gone wrong. Certainly if you've been put on some new medication-including hormone treatment or birth control pills-around the time you stopped losing, you'll need to consider its possible metabolic effects. Turn to Chapter 20 for guidance in dealing with this problem. Medications are a common and often formidable obstacle to weight loss, and I outline many of the problem drugs and chemicals in that chapter and offer alternatives that a physician may be able to prescribe for you. If you've reached OWL (see Chapter 14) or Pre-Maintenance (see Chapter 16), changes like those could be enough to halt your loss for a few weeks. Not only are you burning fewer calories, but when you get less exercise, your metabolism tends to slow down (just as increasing exercise revs it up). Dear reader, from a health perspective, exercise is a beautiful thing. I just wish I could inject...

Breaking Free

If you have not been in lipolysis for a while and are now stuck, you may want to gradually lower your carb level by 5-gram increments until your lipolysis test strips turn purple again. If all else fails, it's time to go back to Induction. Three to five days in Induction will usually start weight loss moving again. Sometimes the body just needs a little nudge. Then, when you move beyond Induction again, add on the carbohydrates a little more cautiously than you did before. It's quite possible that you have a fairly high degree of metabolic resistance.

Time to Be Strict

Number 16, on page 231, with regard to exercise, was not put in there merely as decoration. Exercise is good for you, and it will help you lose. Moreover, it not only causes you to burn calories, but it accelerates your metabolism, increasing the speed with which every other part of a weight loss program works and keeps you on the road to better health.

Time for Realism

Getting on the scale four or five times a day is a form of slow torture. Even the most effective weight loss plan (this one) can't produce a change every few hours, nor even guarantee that you'll lose weight each day. The human body doesn't work that way. By doing Atkins, you're making highly favorable changes to an immensely complicated system. Your metabolism will decide how quickly you lose. There is, unfortunately, no little Dr. Atkins inside you ordering your metabolism to take off precisely three-quarters of a pound a day. The ultimate proof the plan is working is that you see a steady loss over a significant period. And, as I've said many times before in this book, you may notice a change in the fit of your clothes before you see it on the scale. You simply must not demand mathematical exactitude. 3. The same thing goes for exercise. Sometimes people with a fair degree of metabolic resistance find that to lose at a decent speed they have to exercise (which I urge you to do...

Altitude

Vitamin and mineral needs are likely to increase at altitude. In particular, the increased metabolic rate and the lack of oxygen can increase the production of harmful free radicals. Preliminary research indicates that taking 400 IU per day of vitamin E, an antioxidant, at high altitude reduces free radical production.

An Important Test

You must remember how vigorously I encouraged you in Chapter 10 to have a GTT with insulin levels. This test demonstrates how your body reacts to receiving a fixed dose of glucose, the substance most readily convertible to blood sugar. Obviously, if your metabolism has been dealing with any of the assaults I've just described, the signs of such metabolic malfunction will be clearly evident on a GTT with insulin levels. I advocate that everyone take this test. However, if you are overweight, have diabetes in your family tree, have high blood pressure or high triglycerides, or have symptoms that appear when you are hungry and clear up when you eat, I must insist that you get a GTT.

Barnyard millet

Okra casserole from Serbia barzotte Italy Soft-boiled, as of eggs basal mahshi Persian Gulf Stuffed onion made by making a radial slit from root to tip, boiling the onion and separating the layers. These are then stuffed as with cabbage rolls using a meat and rice filling and baked with a water and tamarind pulp mixture. basal metabolic rate The rate at which the resting body uses energy. For the average healthy adult this is 1700 K cal per day equal to 7100 kJ per day. bas de carr France The top part of the shoulder of veal, equivalent to scrag end of lamb

Fact vs Fallacy

Fact Fatigue may occur during the first few days of doing Atkins, while the body adapts to the switch in metabolic pathways. It typically takes about three to four days for the body to convert from a sugar metabolism to a primarily fat metabolism. Your body can store carbohydrates for only up to forty-eight hours, so you can be confident that your metabolic switch will occur, as long as you are doing Atkins properly.

The Fat Fast

When I wrote the first edition of this book years ago, I realized that a small but intensely suffering segment of my readers would need to know how to overcome metabolic resistance. So I decided to make the Kekwick diet as enjoyable as possible. But no matter how I tried, the quantities were simply too small and the selection too limited to meet the satiety and tastiness criteria that I had been demanding for people following my program. taught me how to make Kekwick and Pawan's brilliant concept a truly useful technique with which to combat metabolic resistance.

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