Lose weight while you sleep! Melt pounds with special juices! Eat more without gaining weight!
Sound like the same old weight-loss song and dance? Well, remember the old Sesame Street song, “one of these things is not like the others?”
It’s true. While those first two pitches are straight out of diet fantasyland, the third enticing statement is solid reality, if you set yourself up for it correctly.
Most fad diets and weight-loss programs promise dramatic results in a short period of time if you can stick with a rigorous program. And most can deliver dramatic results in a short period of time-though they won’t all do it in a healthy fashion. But even those that do offer a sound, healthy, dietary change to get that initial drop, many -if not most-fail at the next crucial step: keeping the weight off.
That’s because they don’t move your body into what we call the “metabolic adjustment phase.” During any rapid weight loss-even one that’s managed in a healthy fashion-a dieter has forced their body to work on a reduced number of calories. But the body will eventually adapt to the lowered intake and train itself to get by on that-without losing weight. It’s a built in survival mechanism called metabolic adaptation.
While that little physiological trick can be a real lifesaver if you’re ever stranded with little or no food-as many members of our species often were, as recently as a few decades ago-that adaptation can be a tremendous source of frustration if you want to keep losing weight. Nowadays, there’s little risk of starvation for Americans, but we can’t turn that metabolic adaptation off just because we don’t need it any more. So we’re stuck with that very effective mechanism, whether we like it or not. And most of us don’t.
Think about it: How often have you seen dieters washing out of a weight-loss program after about six or eight weeks? That’s no coincidence. But it’s not because that’s the shelf life of the average stretch of will power, either. On the contrary, if a person has stuck with new dietary practices for a month, that’s long enough that some of that healthier thinking could be really taking hold, replacing old, unhealthy ways with healthy new habits But that’s also about the amount of time it takes most people’s body’s to go into metabolic adaptation and stop losing weight.
And then what happens? Discouragement, disappointment, despair, defeat. They give up. Who could blame them? If you’ve been diligent and attentive and had exciting results, then suddenly your loss starts to slow down, even though you’re still doing all the same things, why wouldn’t you get discouraged?
But by responding to that adaptation with an adjustment, you can beat your body at its own game, and stay away from its desire to gain. Successful weight-loss programs need to have the component of a distinct metabolic adjustment phase.
A lot of patients in our program initially resist the metabolic adjustment phase, which is understandable; when you consider that they’ve had a few weeks of successful weight loss already. Logically, they want to keep doing what has been producing that result for them, and they rationalize that breaking from that initial weight-loss phase and adding new foods will only delay their progress.
Actually, the opposite is true. If they fail to complete the important metabolic adjustment phase, they soon find it difficult, if not impossible to lose more weight.
So how does it work? Medically supervised programs start a weight-loss diet by reducing calories overall and typically by increasing the number of high- protein intakes during the day, either in meals or snacks. This is a quick recipe for rapid weight loss. But to avoid the body’s metabolic adaptation, after a few weeks, you have to begin to give the body a bit more intake so it doesn’t hunker down into “high conservation” mode. By adding small increases in overall caloric intake, you can prevent that.
The goal of the metabolic adjustment phase, then, is not to lose weight, but to readjust your body’s ability to metabolize an increasing number of calories. We keep people to essentially the same diet as their initial weight-loss phase, but we increase the quantities of certain foods. It isn’t until about eight days into the phase that we actually add a new food, which is a whole grain serving at lunch and dinner.
We also track patients’ weight carefully during this phase, to make sure their weight stays within 1.5 pounds of where they were when they began the phase. We do the adjustment gradually, in three stepped levels. If a patient’s weight creeps above that 1.5 pound level, we do a protein substitution for some other caloric intake, and we typically find that they’re able to recover their stasis below that gain level.
What makes the 1.5 pounds the magic number? Your body weight can fluctuate that much for a number of reasons. We don’t want people to get anxious if their weight pops up a pound or so, so there has to be some wiggle room. On the other hand, most people would agree that 1.5 pounds doesn’t allow for much wiggling. Anything above that level, and we recognize that we’re seeing real weight gain, not just water retention.
Few people question that what athletes are able to accomplish comes from training their bodies. The ability to achieve great height, speed, balance or power in any given feat doesn’t come overnight. It takes careful, rigorous repetition of particular practices, and we understand that. Yet when it comes to losing weight, there seems to be some resistance to the idea that the average, overweight American can train the body to do new things, too. You won’t ever teach your body to lose weight while you sleep or melt pounds with special juices, but you can train it to do things like taking in more food, and metabolizing those calories differently and gradually letting go of fat stores.
And while those tricks won’t get you into the Olympics, they may get you back into last year’s trousers.
THROUGH THICK & THIN:
We’ve evolved away from a more physical lifestyle with limited dietary options to a more sedentary one with vast choices for calorie consumption, and we have the expected unhealthy consequences to show for it. Simply eating fewer kinds of foods, especially high-fat, calorie-dense foods, can be a big help in keeping the pounds at bay. Our diet doesn’t have to be a smorgasbord every day, and in the long run, it’s probably more healthy and enjoyable if it isn’t.Caroline J. Cederquist, M.D. is a board certified Family Physician and a board certified Bariatric Physician (the medical specialty of weight management). She specializes in lifetime weight management at the Cederquist Medical Wellness Center, her Naples, FL private practice.