So many people think that they’ve stalled when in fact they haven’t. What percentage of folks would you say are actually in a stall?
It’s really impossible to put an exact number on it, but certainly not a hundred percent. Not everyone who thinks they’re stalled is actually stalled. If you define a stall solely by a scale weight—meaning you’ve been doing keto for this many weeks or this many months and your scale weight hasn’t changed—then yes, that is a weight loss stall. But it is really not uncommon—and people need to appreciate that this happens pretty frequently—it’s not uncommon for your scale weight to stay the same while your size and shape are changing. If your measurements are changing or you notice that your clothing is getting looser, your scale weight might be stalled, but your fat loss is not. The change in your physique or your body composition is not stalled. I much prefer the term ‘fat loss’ over ‘weight loss’. We say ‘weight loss,’ because it just comes out of the mouth more easily and that’s what people search for; very few people search specifically for fat loss.
Stalls are not defined in days or even a few weeks. If it’s only been three or four days and you haven’t lost any weight, that’s not a stall. It’s normal for the body to stay the same for a while and then drop several pounds overnight, then stay the same for a while, drop a pound or two, gain a pound or two. It’s a very normal fluctuation. That’s not really body fat; it’s usually water retention or other things, due to all kinds of reasons that have nothing to do with the actual fat you’re carrying. It’s just weight fluctuation for other reasons. If that’s happening, that’s not a stall.
One of the biggest myths is that if someone has actually stalled, the keto diet simply doesn’t work for them. What are your thoughts on that?
I would say that the way they’re implementing a keto diet isn’t working for them. ‘Keto,’ as you know, means different things to different people. There’s a scientific definition of it, but depending on who you follow or whose program you’re doing, keto could be any number of things. When somebody writes to me and says, ‘I’m doing keto’, I ask them, ‘What do you mean by keto? What is keto to you?’ I think keto works for almost everybody when it’s done properly. It just may mean that you need to tweak and change something about it to work for you.
Many people believe that they need to consume copious amounts of fat in order to raise their ketone levels and to hit their fat macros. This is a big issue that we see with stalls, is that correct?
It’s huge! To be clear, some people who do a ketogenic or low-carb diet for the main purpose of fat loss can get great results eating a very high amount of fat. If it works for you, great. But if it’s not working and if you’re in a stall or in a plateau, then remember, there’s a huge myth out there that keto works by macros – that if you just line up the percentages of calories that you get from fat, protein, and carbohydrate (your macronutrients), that your body is a calculator: the math is lined up and the weight will just melt off of you. I think a lot of people know from personal experience that that doesn’t work.
People are following apps, they’re tracking, they’re purposely eating certain foods or certain amounts of specific foods in order to have those numbers line up, but they’re not getting the results they want. One of one of the biggest myths, as you said, is chasing fat or thinking that you have to eat 75 percent fat or 80 percent fat. But keto doesn’t work that way. What makes it work for most people is the absence of the carbohydrate or the very low carbohydrate intake, not the massive amounts of fat. It’s pretty logical when you think about it. We absolutely celebrate being able to eat delicious fatty foods with this way of eating, but if you’re eating a little too much of those foods, if you’re having too much heavy cream, butter, MCT oil, avocado, and macadamia nuts, then your body is going to burn that fat rather than all of your stored body fat. Like Dr. Westman says, keto is not a “fat loss diet,” it’s a fat burning diet. Once you shift over to a ketogenic metabolism, you’re burning fat. What you don’t know is whether that fat is mostly from the food you’re eating or mostly from your own body fat. Going overboard on dietary fat means your body has less of a need to burn stored body fat instead.
How about this one: “I’m eating too much protein and not enough fat. That’s why I’m stalling.”
This is a very unfortunate misunderstanding that needs to be forgotten. People have become concerned about protein on ketogenic diets, because they’ve heard things like, ‘Too much protein turns into sugar” or ‘it kicks you out of ketosis.’ That’s true to some extent; there are biochemical processes in the body that convert amino acids (which make up the structure protein), into glucose. That is something that happens, but it doesn’t happen automatically just because you ate a huge steak or a giant pork chop or piece of chicken. It happens under the right hormonal circumstances. Protein is called ‘antiketogenic’ in the sense that it does affect the ketone level a little bit, but not as much as carbohydrates.
What people really need to understand is that you don’t need to be in a deep level of ketosis to lose weight or to burn body fat. Protein is very filling, very satiating, and it comes with a lot of the vitamins and minerals and nutrients that you don’t get from isolated fats like MCT oil, coconut oil and butter. Not that we’re anti-fat! But eating those whole protein foods—like beef, bison, eggs, poultry, seafood—allow you to get all of these other things and it’s keeping you full for a while. (It takes a long time to digest protein.) Protein isn’t just muscles. It’s your nails, your hair, your skin, your bones, tendons, ligaments, enzymes. So out of all the reasons for people to be stalled on a ketogenic diet, a high protein intake is almost last on the list. I can say that in eight years of helping clients with this way of eating, not once have I ever told somebody they were eating ‘too much protein.’ If anything, it’s been the opposite. I’ve had to convince people—women especially—to eat more protein.
If you’re using a keto diet primarily for the goal of fat loss, protein is your friend. If you have something like epilepsy or a severe neurological condition where you’re using keto as a medical treatment, there may be a rationale for controlling the amount of protein you eat, but if you’re in this primarily for overall wellness, fat loss, and metabolic health, you do not need to skimp on protein.
I’ve got another one: “My keto numbers aren’t high enough, therefore, I’m not losing fat; I’m in a stall.”
Like we said before, you don’t have to have a high level of ketones to lose fat. Ketones are the result of breaking down and burning fat, not the cause. It’s not a case of getting your ketones higher to lose more weight, but rather, breaking down more fat is what will raise your ketones. In order to get a higher ketone level, you might have to do things that are actually counterproductive to the goal of losing body fat, such as eating more fat. If you eat more fat on a low-carb or ketogenic diet, you probably will have higher ketones. If you restrict protein, you’ll probably have higher ketones, but both of those methods are counterproductive to losing body fat. It’s just not necessary to chase those high ketones. Dr. Westman has been at this for over 20 years and he learned from the late, great Robert Atkins. In Dr. Atkins’ time, all that existed were the urine ketone strips. You couldn’t even measure blood or breath ketones. (Not outside a lab, anyway.) And yet, people did great. You didn’t need to know what your ketone level was to have this diet work wonderfully.
What about sweeteners and stalling?
That’s a controversial topic! It depends on the type of sweetener. There are sugar alcohols, which are the ones that end in ‘itol’ – things like sorbitol, mannitol, and xylitol. Sugar alcohols are sweetening agents that give food a sweet taste, but they don’t have quite the same effect on your body as regular sugar or corn syrup or something like that. They do have an effect, though. It’s not as strong as regular sugar in terms of your blood sugar and insulin, but they do affect those things. If foods sweetened with sugar alcohols are a regular part of your life, this could be stalling you, because your blood sugar and insulin might be a lot higher than you think they are. We know that when insulin is elevated, the burning of fat is lessened. We think of insulin as a blood sugar lowering hormone, but that’s only one of so many other things insulin does. One of the big things insulin does is decrease fat burning.
The other issue is that when foods are sweetened with some of these sweetening agents, it may not actually be the sweetener that’s the problem, but rather the kinds of foods that typically have those sweeteners in them: the almond flour brownies, the coconut flour cookies, the fat bombs, and the foods that are very calorie- and fat-dense. So, is it the sweetener, or is it the fact that you ate a tiny morsel, but it was 300 calories, because it was packed with cream cheese, oil, butter, and maybe it had a spoonful of the xylitol in it?
Artificial sweeteners are a separate category from sugar alcohols. They’re the ones that are basically zero-calorie things like sucralose, saccharin, or aspartame. There’s a lot of misinformation out there. These typically have almost no effect whatsoever on blood sugar and insulin. What they can do for some people is keep the sugar cravings going. There are some people who, when they taste something sweet, even if it’s from artificial sweetener, it provokes constant cravings for more and more. If you’re giving in to that, that could be a problem. For me, personally, I can have a pack of sweetener in my coffee and not feel the need for anything else sweet throughout the morning or the rest of the day. In terms of the sweeteners being a big cause for stalls, I would look at what kind of sweeteners are being used and then what they’re being used to sweeten. Are you having a pack of Splenda in a cup of coffee, or are you having xylitol or mannitol in a keto chocolate bar or a keto cake?
How about, “My friend has lost triple the amount of weight I have, so I must be in a stall?”
It’s human nature to compare ourselves to others, but it is a losing battle every time. Importantly, women: do not compare your fat loss to a man’s! Ever! You’re just going to lose every time. There might be some exceptions, but for the most part, men lose fat a lot faster than women, even when they’re not as strict or as diligent with the diet. Men have a lot more leeway than women do; it’s just the way it is. Older people also tend to lose more slowly than younger people. All you can really do is do what’s right for you and trust the process. Very slow fat loss is still fat loss. Do you wish it was happening at triple the rate? Yes, of course! But is there a whole lot you can do about it? Not really. It’s demoralizing and discouraging, but just know that it happens. It doesn’t mean you’re doing anything wrong. There are medications that make it more difficult to lose weight, too, so there are a lot of different things that play into it. Examine what you’re doing. Maybe there are changes you can make to get things moving more quickly, but it really does vary – the rate at which people lose weight. Don’t ‘compare and despair, as we say.’ Try to stay away from that.
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