Maintaining Weight Loss

I write in “3 Achievable Resolutions for Weight Loss” and “4 Propositions on Weight Loss” on how to get started with losing weight.

3 Achievable Resolutions for Weight Loss:

  1. Go Off Sugar

  2. Choose and Keep To an Eating Window Shorter than 16 Hours a Day—With Appropriate Exceptions

  3. Come Up with an Inspirational and Informative Reading Program to Help with Weight Loss

4 Propositions on Weight Loss:

  1. Eating nothing leads to weight loss.

  2. For healthy, nonpregnant, nonanorexic adults who find it relatively easy, fasting for up to 48 hours is not dangerous—as long as the dosage of any medication they are taking is adjusted for the fact that they are fasting.

  3. Eating sugar, bread, rice and potatoes makes most people feel hungry a couple of hours later. People who have, by and large, quit eating sugar, bread, rice and potatoes can notice this effect on the rare occasions that they do eat a substantial amount of sugar, bread, rice or potatoes. Moreover, if they pay attention, those who have quit eating sugar, bread, rice and potatoes can notice which other foods cause them to feel hungry a couple of hours later.

  4. Two months or so after quitting eating sugar, bread, rice, potatoes—and all the other foods and beverages that make them feel hungry a couple of hours later—a large fraction of people will then find fasting relatively easy.

Keeping the Weight Off

But what about when you succeed at losing weight? How can you keep the weight off? Here is my answer, in three sections:

  • Make sure you lose the weight as painlessly as possible in the first place

  • Realize that your body can now get by on much less food than you ever imagined possible

  • Fast however much you need to in order to keep your weight steady

A. Make sure you lose the weight as painlessly as possible in the first place

The current incarnation of the Wikipedia article “Yo-yo effect” gives this mechanism for people who diet, lose weight, but then bounce back up to a higher weight:

The reasons for yo-yo dieting are varied but often include embarking upon a hypocaloric diet that was initially too extreme. At first the dieter may experience elation at the thought of weight loss and pride in their rejection of food. Over time, however, the limits imposed by such extreme diets cause effects such as depression or fatigue that make the diet impossible to sustain. Ultimately, the dieter reverts to their old eating habits, now with the added emotional effects of failing to lose weight by restrictive diet. Such an emotional state leads many people to eating more than they would have before dieting, causing them to rapidly regain weight.

I want to take issue with the words “too extreme.” It is not the extremity of a diet as judged by someone else that matters here, but the amount of pain a dieter suffers that matters. If you experience a lot of physical suffering from a diet you are (a) probably following a physically harmful diet and (b) setting yourself up for weight gain later on because of the backlog of feelings of deprivation you will have built up. By “physical suffering,” I mean the starvation response. There are two ways to get thrown into the starvation response. One is to have almost no body fat to fall back on. (I touch on anorexia in “Don't Tar Fasting by those of Normal or High Weight with the Brush of Anorexia.”) The other is to have high insulin levels that lock fat in your fat cells, so that your cells feel starved, even though you have plenty of body fat. (This can be a matter of degree: presumably there are intermediate insulin levels at which some body fat is burned to nourish your body, but less than would ideally be called for.)

Either way, serious physical suffering during a diet is a bad sign. I’m not talking about (i) withdrawal pangs from going off sugar (which are normal), (ii) the discomfort when your body is shifting over from metabolizing the nutrients in what you usually eat to metabolizing your own body fat (which you might feel during the first day or so of fasting) or (iii) yearnings for particular foods or food in general because food can be so delicious and fun (or because you saw, smelled or were reminded of food by someone else). I’m talking about feeling starved—which can happen as soon as a few hours after eating something very high on the insulin index. (See “Forget Calorie Counting; It's the Insulin Index, Stupid.”)

The bottom line is this: don’t try to diet without giving up sugar and other foods high on the insulin index. If you do, your diet is likely to be a hellish experience, and you may have a psychological backlash that undoes your dieting efforts and more.

(Can you occasionally cheat? People differ in how well that works for them psychologically. And cheating with a very, very small quantity is obviously not the same as going whole hog. But my advice is to go cold turkey in giving up sugar—and potatoes, rice and bread—for a long time and only allow small amounts of cheating when you are deep into the maintenance phase. And if you do ever cheat, notice carefully and honestly what the effects are. Do you feel hungrier in the next 24 hours after you cheated? My prediction is that having an entire “cheat day” once a week as I have heard some people advocate is going to make your diet much more miserable than if you don’t do a cheat day.)

Making weight loss as painless as possible is likely to be so important to avoiding a yo-yo bounceback in your weight that, even if your current diet seems to be working well when you look at the scale, I recommend that you switch immediately to a low-insulin-index diet, starting by giving up sugar.

B. Realize that your body can now get by on much less food than you ever imagined possible

I am very critical of calorie-counting as an entry-point into weight loss: see “Obesity Is Always and Everywhere an Insulin Phenomenon” and “Forget Calorie Counting; It's the Insulin Index, Stupid.” But an awareness of calories can play a useful role after you have lost weight in helping you maintain weight loss. Here is how I put it in “How Low Insulin Opens a Way to Escape Dieting Hell” (emphasis added):

Once you have your insulin levels low enough through switching to low-insulin-index foods and having big chunks of time with no food at all, your body will be open to the possibility of burning body fat. Then and only then will you get the results people naively think they will get based on the usual calories in/calories out logic. But what you will find is that with your body open to the possibility of burning body fat, you won’t suffer from having substantial chunks of time with no food and having your total calorie intake from the outside world low. The reason is that a calorie from burning your own fat is just as good as a calorie from food you are eating now in keeping you well nourished and feeling good.

…

… weight-loss efforts that lack the key element of keeping your insulin levels low are likely to fail, and cause you a lot of misery on the road to failure as well as the disappointment of failure as the destination. If you do what it takes to keep your insulin levels low, people might well say “Of course that worked! You were avoiding sugar, refined carbohydrates and processed food, and going substantial chunks of time without eating!” But if they keep to the conventional wisdom that only focuses on calories-in/calories-out (and in the usual approach, inevitably ignoring many subtleties even about the calories out and about the detailed genesis of temptations for calories in), they won’t have as good an explanation for why what other people try doesn’t work in the long run.

Let me give some examples of how some awareness of calories is helpful, as long as you are doing everything else right first:

  1. True nuts are very healthy. See “Our Delusions about 'Healthy' Snacks—Nuts to That!” You shouldn’t get food cravings after eating true nuts in the way you would after eating sugar. But nuts also don’t seem to generate a strong satiation signal. It is relatively easy to keep eating more and more simply because they are delicious, even without the type of cravings one would get from less healthy food.

  2. Cream, by contrast, is quite satiating. So, unless you are pushing yourself to feeling overfull (a genuine issue) having cream as part of your meals is, in my view, fine. Cream can also be, say, used in tea or coffee on a fasting day without jacking up your insulin and therefore without making you hungry. But I have been wondering if the amount of cream I have consumed on many fasting days provided enough calories to seriously blunt my weight loss from those days. I worry that milk would jack up insulin more than cream, so what I am trying to do is reduce the amount of cream I use in tea or coffee, and more often go without any cream.

It is a hotly debated question, but there is some evidence that low-carb eating can rev up calorie-burning. (I suspect it is really low-insulin-index eating doing the trick. See “Why a Low-Insulin-Index Diet Isn't Exactly a 'Lowcarb' Diet.”) If you want to delve into that debate, see:

However, even if low-insulin-index eating by itself revs up calorie-burning, losing weight leads to less calorie burning. See “Kevin D. Hall and Juen Guo: Why it is so Hard to Lose Weight and so Hard to Keep it Off.” Over time, when your body sees less food coming in, it gets more efficient at metabolizing the food that does come in. So you need fewer calories to keep your body going vigorously than you used before. The bottom line is that you need to adjust your expectations for what is a normal amount to eat. After losing weight, you are likely to find that you can eat remarkably little in total without suffering physically and without losing any more weight.

Many people see their body getting more efficient at getting by on relatively little food as an unmitigated curse. I see it differently. The less food my healthy cells are getting by on, the less food there is to help any cancer cells or precancer cells in my body to thrive. Since cancer cells tend to be metabolically damaged, they are likely to do badly in competition with healthy cells if food availability inside my body is limited. (And the nutrients that come from body fat being metabolized are not the ideal food for metabolically handicapped cancer cells.) On this way of thinking about the relationship between getting by vigorously with only a little food and cancer, see:

C. Fast however much you need to in order to keep your weight steady

Fasting—having periods of time during which you don’t eat, but drink water, tea and coffee—doesn’t need to be on any regular schedule. But you will need to do a certain total amount of fasting to keep your weight steady—and even more if you still want to lose more weight. (Note: I discuss modified fasting in “Forget Calorie Counting; It's the Insulin Index, Stupid.” Modified fasting has a somewhat muted effect from having some calorie intake, but it works too. You will just need to do somewhat more of it than if you were doing full-out fasting.)

I am a strong advocate of the idea that, to keep a pattern of eating sustainable, it is important to accommodate social occasions in which people eat together. (It is usually possible to find low-insulin-index food to eat at most restaurants and in most banquets or spreads.) Personally, I have enough social occasions involving food that I participate in, and my body has become efficient enough getting by with relatively little food, that it takes a lot of fasting to keep my weight even. But, as I have emphasized in my whole run of diet and health posts, fasting is not painful for me. And I think that for most adults, after they have adapted to a low-insulin-index diet, there exists for them some form of modified fast that will not be painful, yet will have a strongly negative energy balance that can neutralize the effect of other days that have a positive energy balance.

The key is to alternate fasting with feasting. The more feasting you do, the more fasting you will need to do. But as long as you eat low on the insulin index, and modify your fasts (within the parameters of what I talk about in “Forget Calorie Counting; It's the Insulin Index, Stupid”) according to what works for you, personally, the alternation between feasting and fasting should go smoothly.

It is worth giving one simple example of a modified fast. If you can be strict during the rest of the day, but are a light enough sleeper so that even a modest amount of hunger can interfere with falling asleep, on a day you are fasting you may want to plan on eating a quarter cup of macadamia nuts and maybe a cup of tea with cream before bed.

Figure out the minimum quantity of very-low-insulin-index food you need to eat on a day you are fasting in order to keep things reasonably pleasant. The more calories worth of very-low-insulin-index food you eat on a day of modified fasting, the more days of modified fasting you will need to do to keep your weight even, but on the other hand, those days may be enough more pleasant that more of them is a good tradeoff.

You can also tradeoff the amount of you eat on a typical day of modified fasting and number of modified fasting days against how much you feast on low-insulin-index food on eating days. My advice is that, psychologically, it is very valuable to have days when you feel like you are feasting. Don’t hold back too much! Your gustatory life will be quite drab otherwise. But there may be some sacrifice you can make on an eating day that is not much of a sacrifice at all.

Ultimately, how much fasting or modified fasting you will need to do is an empirical matter. It is what it is. You might not like the findings from your experiments in how much fasting or modified fasting it takes to keep your weight steady given your patterns of eating on eating days and your mode of modified fasting. But that’s the way it is. My claim is that if you are eating low on the insulin index that you will be able to fast or do modified fasting enough to do the trick without any of the true suffering that dieters using other techniques so commonly experience.

The amount of fasting of modified fasting you need to maintain your weight loss may require a fair amount of self-discipline. You may need to exercise some creativity to figure out a form of modified fasting that works for you. You may need to exercise some creativity to make sure that your feasting is fun enough that you can see your way through to continuing what you are doing of something like it for the rest of your life. But the rewards are great: not just weight loss, but better health on many dimensions. By the time you reach my age—now 58—you’ll realize how precious good health is. People say “Time is money.” Here I am saying “Health is time.” And time is much more than money—it is a key input to almost everything you want.

For annotated links to other posts on diet and health, see “Miles Kimball on Diet and Health: A Reader's Guide.”