What is your number one thing that affects fat loss besides food?
Before I do that, I want people to understand that, yes, other things definitely affect weight loss besides food, but food is the mountain, it’s the major thing. For the most part, if you get the food right, the weight will move. If you’re stuck in a fat loss stall or you’re in a long-term plateau, I would look at your food first. Make sure there’s nothing else you need to change about your diet before you try to tinker with this other stuff. The diet really does have the most power, although there are other things that affect fat loss.
The first one I will mention is medications. There are a lot of different medications that either cause weight gain or can make it difficult to lose weight. Many of these medications will have weight gain listed as a side effect, so you can just look up a medication you’re taking and see if that’s a side effect. Also, keep in mind – I’ve heard several doctors say this – the human body is a wacky thing sometimes! You might have a reaction or an effect from a drug that’s really rare or that most people don’t have and it’s not even listed as a common side effect; maybe weight gain or difficulty losing weight is one of them. Medications can do interesting things to you and we would hope that as you follow a low-carb keto diet for a long time, you might be able to reduce and eventually stop taking those meds (with your doctor’s blessing, of course). While you’re still on them, be aware of whether anything you’re taking can interfere with weight loss.
Do some medications actually have carbs in them?
It’s pretty rare, but it depends. If you’re taking a liquid of some sort or a powder, they can have some carbs in them. If it’s just a capsule or a tablet that maybe has carbs in the binder or filler, the amount is so miniscule, I would say it’s negligible. Apart from the weight, certain medications, like steroids (such as prednisone or cortisone injections or steroid pills or sprays) can cause your blood sugar to be higher. If your blood sugar is higher, a lot of things are not going to go as well as you would hope.
What’s your number two?
Number two is a very strong passion area for me, and that’s low thyroid. There are many different kinds of low thyroid. Some are autoimmune, some are not, but your thyroid hormones are what they call the ‘master regulators of your metabolic rate’. The thyroid is kind of like your body’s thermostat, so even if you’re still following your keto diet and exercising and living a great lifestyle, if the rate at which you burn through energy and calories is set on low, like “power save mode,” you’re going to have a really hard time losing weight, no matter how disciplined you are with diet or exercise or anything else.
Some people who have thyroid problems know they have them, but I see a ton of undiagnosed thyroid problems. I’m a nutritionist, so I can’t diagnose anyone, but I can give them some information regarding what their symptoms and their paperwork suggest to me. An issue that I see all the time with people is that they know they have a thyroid issue and they’re on medication for it, but they still have all the signs and symptoms they had before. So, either that type of medication or the dose they’re on isn’t getting them where they need to go. This is extremely common.
If somebody suspects that they have a thyroid issue, is there a simple test that they can do to be sure?
Adapt has an international audience; I’m not sure what’s readily available outside of the U.S.. At least for the U.S. I recommend a comprehensive thyroid panel. That’s very important. Don’t just ask for “a thyroid test.” Don’t ask your doctor to just check your thyroid. You need to insist on a comprehensive thyroid panel, because there are about six different thyroid-related hormones that should be looked at. When you just ask for a thyroid test, many doctors will order only one or two of these and it’s so common for those one or two things to be normal. If you dig deeper into those other hormones, you’ll see an imbalance big time. You’ll miss that if you only test the two most common and conventional things. When I said that there are a lot of people who don’t know they have a thyroid problem, they might suspect it, have been tested, and had their doctor tell them their thyroid is normal. That ‘normal’, however, is based on that very limited testing.
What is the third thing that affects fat loss?
Sleep! It’s funny: in modern society we like to brag about how much we’re doing, how much weight we can lift, and how much money we make. Sleep is the only area where people like to brag about how little they can get by on! For many people, inadequate sleep or broken sleep – meaning you’re in bed for eight or nine hours, but you’re waking up several times and you’re stirring all night – interferes with weight loss, mostly because it changes your appetite and satiety signaling. Most people probably know when they’re chronically sleep deprived. You’re hungrier – not for a grass-fed steak and roasted broccoli, but for sugar; you want donuts, cake, cookies and biscuits. It’s much harder to resist those food cravings. Even if you still follow your low-carb keto diet, the way that your body processes food is a little different when you’re sleep deprived. The hormonal situation is really different.
It’s not always easy for people to get more sleep, depending on their life circumstances, but it’s one of the simplest things you can do, because it’s free! Just go to bed earlier. You don’t have to buy anything special; you don’t have to invest in a program. Just go to bed. If you have trouble sleeping, certain supplements can help. You can maybe even get evaluated if you think you have sleep apnea, but sleep is critical.
What is number four of the things that affect fat loss besides food?
It’s a toss-up between stress and alcohol. I’m going to go with alcohol. I know we said things besides diet, but let’s consider alcohol as being separate from food.
I’m a wine lover, myself, and it is possible to responsibly and reasonably consume alcohol and still lose weight on a ketogenic diet, but you have to be intelligent about it. Alcohol – even if the particular kind you’re choosing is very low in carbs – still has calories. I hate the ‘c word’; I hate to talk about calories, but they do matter. When you’re really struggling to lose weight, liquid calories are the easiest thing to eliminate from your diet. Alcohol is liquid calories, and we don’t tend to compensate for that; we tend to drink in addition to the meal or the snacks we’re having. You can consume alcohol and lose weight, but if alcohol is a regular and significant part of your life and you’re really having a hard time losing weight, then cutting back is a very good and possibly helpful thing to do.
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