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Weight Stalls:

Most people who switch from from the SAD Standard American Diet to some form of health conscience eating do manage to lose some weight as long so they manage to stick with it.  Just about everyone can identify some of the most glaring junk in their diets and cut back. 
People who start keto frequently have high expectations. Reports on the internet can make it sound very effective for everyone always. Let me tell you. It is not always magical for everyone always. The amount of weight loss, the rate of weight loss, and the pattern of weight loss varies from person to person. Sometimes I have couples who start Keto at the same time who have greatly different responses. It works great for one half of the couple but not as great for the other. There can be many possible explanations. The general term is "Your Mileage May Vary."  Some people lose weight steadily until eventually they are at the same weight they were in high school. Some people plateau somewhere short of that. 
Generally speaking, weight loss with keto tends to be greatest in the first 6 month after starting and then slows to stability about at about the one year mark. On average there is  a 12% loss of starting weight. 
It's easy to become disenchanted if significant weight loss doesn't occur while being compliant with the diet. 

What is a stall anyway?    If you weigh yourself every morning you may notice fluctuations based on water weight alone. It's probably best to record your weight weekly or every two weeks. For sake of reproducability , do it undressed in the morning before consuming anything and after visiting the toilet. it's probably at a plateau if your weight is not changing after a period of 8 weeks AND no change in your waist measurements .
Let's not forget. Your scale is not the only way to measure progress. I encourage you to measure your waist size and neck size with a tape measure. I frequently hear people say: people say I look thinner but the scale is the same.
How do your clothes fit? Better? THAT'S PROGRESS. I had a guy who didn't know how much he weighed but he figured he was losing weight because he could finally fit behind the wheel of his car. One last point, low carb diets confer metabolic  health benefits even if weight loss is only so so.

 OK. If it's been three months and the scale and tape measure numbers are not budging, you're probably in a stall. Let's see what we can do about it!

1. Too Many Carbs:

On keto, the goal is to get your  carbs low. The number of grams of carbs that is based on individual carbohydrate tolerance. The bare minimum to start making ketones is less than 50 grams per day for a few lucky people but for most it won't happen until carbs are less than 20 grams. Even 20 may be too many for the most carbohydrate people. It's impossible to tell what your carb tolerances are at the outset. You just have to see what works for your personal biology. 
Carb creep: It is possible certain foods you think are low carb actually have more than you think.
 You've cut out bread, spaghetti and breakfast cereal but you're still eating chicken with breading and meats with BBQ sauce or other glazes. Or maybe that salad dressing had sugar in it after all.  Those carbs can add up fast. And what about the odd taste of dessert food or "just" one cookie. These things will certainly slow weight loss progress at best or cause a stall or regain at worst. 

Too many "Low-Carb" alternatives- Low carb substitutes are not NO carb frequently. Take almond flour and coconut flour for example. True it has less carbs than wheat flour but there are some still there and they add up when over-consumed. Sugar alcohols in low carb products like xyletol and maltitol are partially absorbed sugars. 

Nuts: Nuts are certainly a better snacking choice than chips or pretzels but that doesn't mean you can eat several handfuls without worry.  Some nuts, Like cashews and pistachios are so high in carbs that they should be avoided altogether. It's just too easy to go over the limit with them. For best results with keto you might just want to avoid them all together. This 

Cheese, cream, full fat unflavored greek yogurt all contain some carbs. You might have to cut back If you've plateaued and you've made these foods your staples.

Even some non-starchy vegetables like zucchini, sweet peppers, tomatoes and avocados have some carbs. Don't forget to count them. Low carb vegetables and fruit are not no carb. Start tracking your carb totals. They can add up.

Restaurants: Going to restaurants can be problematic because you don't exactly know what you are getting unless you ask to see the ingredients (which most people don't do). Problems include, Gravy with starchy thickeners, glazes on meats. candied nuts and dried fruit, and sauces and condiments of all kind almost always contain something "nonketo" Give suspect food a little taste test. Does it taste sweet? It probably contains considerable sugar. Breading on meat is carbs even if you try to scrape it all off. "Just a taste of your partner's decadent dessert." adds up especially if it becomes a regular thing.
When doubtful about something, don't eat it. Try something else.

Solution: Not sure if you're over your carb threshold? Get a ketone meter. Check to see what might be "kicking you out of ketosis." A glucose meter also may tell you if you've eaten something that spiked your sugar.  Checking ketones by a blood or breath ketone meter after a suspect meal may provide some useful feedback.

Read Labels: Never had it before? Read the label to before you eat it. It may have more carbs than you think. A lot of people think oatmeal, corneand hummus are low carb. (they're not) check the labels.

Too much fat: What?! I can hear you shouting at the computer? You can't consume too much fat on keto! Oh but you can!
True. On Keto, fatty meats and eggs are encouraged.  On the other hand, free fats can become a problem when taken to extremes. What are free fats? Fat that has been separated from it's original source. Butter & cream from milk, olive oil from the olive, MCT/coconut, and avocado oil. If you're drinking multiple cups of creamy or buttery coffee a day or just putting butter on everything, that could be too much of a good thing. Excess consumed fat does get stored in fat cells. It's harder to over consume fat alone because they are more satisfying than carbs but it can still be done.  Chasing high ketone levels is reason people intentionally binge on free fat. Yes, one can be in ketosis and gain fate. Strive to derive the ketones from stored body fat, not intake fats.  This is a practice that should be discouraged.  There are legitimate reasons to chase higher ketone readings but fat loss isn't one of them.

solutions:

1. Maybe not so much heavy cream in every single cup of coffee you drink in a day.  Same is true for butter or MCT oil if that is your thing. (I have never even tried MCT oil) Macadamias are an easy way to over consume fat if you eat handful after handful.  
2. Eating a little too much carb(unintended of course) and too much fat is a recipe for adding fat. 
3. Eat protein rich foods first before free fats. Protein is the most hunger satisfying macro.



​Grazing.
Over the last couple decades snacking has become an accepted part of life. Even authorities like dieticians recommend snacking to keep blood sugars from supposedly dropping. That might even be true for those who are dependent on carbs and walk around with abnormally high insulin levels that prevent access to the fat already stored on your body. Fat adapted people should have less need to snack. Here's why:  Low carb, high fat food only mildly stimulates insulin. With lower insulin levels, fat cell can release energy between meals and keeping internal hunger signals low. 

Some people who are following low carb keep the old habit of snacking between meals even when their not super hungry.  Even when snacking on low carb foods, this can be problematic.  Nuts, berries, cheese, low carb vegetables do still contain some carbs and eating them between meals can keep the body in the fed (high insulin) state. You want your body to cycle between fed and fasted. This keeps the fat cells capable of storing and releasing fat regularly as they are designed to do. They are not designed to keep fat  locked on your hips for eternity.  How often should you eat? Eat when you feel you need too but I would initially shoot for now more than three times per day without snacking.  Try to get a good stretch of the day in the fasted state, at least 12 hours between dinner and food the the next morning.  Some people elect to go two meals a day or even. One meal a day (OMAD)  Once fat adapted you really shouldn't have much difficulty going longer periods between meals.  Trust me. 

Sweeteners:
Let's face it, sweeteners are eating stimulants. Take some berries. They're a little sweet and tart on their own. Add some sugar or artificial sweetener and they become cravable. They increase desire to eat more. Same goes for beverages. Black coffee is, for many, not palatable but add some milk and sweetener. They turn something you'd rather not eat or drink into something enjoyable. Sweeteners hijack the pleasure center of your brain. They take control away from the part of the brain that is there to maintain your cell's energy needs. If you are trying to lose weight you need to reduce they type of eating that is purely for fun and replace it with eating for true nourishment. Some artificial sweeteners are partially absorbed, thus do provide calories. Some artificial sweeteners do stimulate insulin thus causing fat cells to store and not release energy. That leaves the blood with less circulating energy thus triggering a hunger sensation. "Hey, let's eat some Dorito's!"  That said, some people do OK with diet soda. I personally get hungrier after drinking it.

"Keto"  Treats
Quick, convenient: Tear open and enjoy....Right?
Keto-bars, Atkin's bars, Keto shakes. Filled with dubious sweeteners and fillers with possible insulin and glycemic response. They may use lower carb ingredients but like all processed "foods" their designed to be hyperpalatable.
Beware. Stick with real unprocessed foods that are satisfying without being hyperpalatable.

Medications: 
Are you on a medicine that tells your fat cells to store fat?
  1. Insulin injections-Insulin is THE fat storage hormone and the injection does the same.
  2. Sulfonylurea drugs- (diabetes pills)-stimulate insulin release which causes fat gain.
  3. Steroids (given for inflammation) like prednisone or methylprednisolone. even inhaled,nasal or topical steroids can affect weight. 
  4. Blood pressure meds-Beta-blockers like propranolol, atenolol, metoprolol
  5. Behavior meds-especially, antipsychotics, lithium
  6. depression meds- amitriptyline, paroxetine, and sertraline
  7. neuro meds like gabapentin, valproate and carbamazepine
  8. Lots more-READ the side effects paper that come from the drug store

Hormones:
  1. Thyroid out of whack...
  2. chronic stress

Working third shift. Causes stress raises cortisol and then insulin
Not enough sleep-same thing.


Eating late in the day:
5 things to break a stall: Amy Berger
​Alcohol: Ethanol, A.K.A. Alcohol, by itself is a carbohydrate. It is metabolized in the brain (where it creates the tipsy sensation) and the liver where it creates liver fat and halts fat burning. Its metabolism is similar to fructose. The optimal amount of alcohol in keto is zero. Alcohol is NOT KETO. That being said, you may still with to have the occasional adult beverage.  Some types of alcohol are less damaging to your ketosis than others. The lowest carb counts are found in straight distilled spirits. Mixers of juices, syrups  and sugar based sodas add carbs. of course the more drinks you have, the more carbs you consume. Beer is not at all keto friendly some light beers aren't too bad from a carb perspective at least. Bottom line, cutting back alcohol consumption is a great way to break a stall.
Picture
Eating for reasons other than hunger can be cause of a stall.
Stress and stress eating. Stress causes your adrenal glands to release glucose raising stress hormones that raise glucose insulin and fight weight loss.

Boredom: Not really hungry but you're nacking anyway.

Habit: eating 

Eating by the clock not your stomach.

Solution: Anytime you eat anything ask yourself  "Why did I eat then? Was I truly hungry or was there another reason?"  
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  • Home
  • Diabetes
  • Cholesterol
  • Low-Carb Eating
    • DietDoctor.com for Beginners
    • Gallery of Low Carb Food
    • Field Guide to Fat
    • Field Guide to Sugar
    • Field Guide to Vegetables
    • Field Guide to Fiber
    • Field Guide to Food Labels
    • Science of Keto
  • Weight
    • About exercise
    • Ending a Weight Loss Stall
  • Metabolic Syndrome
    • Blood Pressure & Other Conditions
    • Migraines
  • Links
    • Books
    • Blogs & Podcasts
    • Nutrition Guide Store
    • Local Real Food
  • Blog
  • Neuroanatomy
  • Do calories count?
  • PMA Medical Specialists
  • Contact
  • Migraines