Let’s talk about lifestyle factors that affect fat loss. In part two, I covered the food—the dietary factors. We talked about carbs, excess fat, alcohol, and the first lesson was all about setting realistic expectations for the long-term weight loss process. Let’s move on to things besides the food, besides what you eat, that can affect your weight and fat loss like sleep.
#1 Weight-positive medications
What if you’re doing everything right with keto? Your food is right on point, everything is the way it’s supposed to be, and yet the weight is barely moving or it’s moving really slowly. You might be taking a medication that is either causing you to gain weight or it’s making it more difficult to lose it. There are so many medications for very different conditions that can all contribute to weight issues. If you’re on a medication you suspect might be interfering with your fat loss, look up the side effects. Hopefully, you can find a trusted medical website and look to see if weight gain or difficulty losing weight is listed as a known side effect. If it is, the good news is you can just discuss alternatives with your doctor. It’s pretty rare for there to be a medical condition for which there’s only one medicine that’s effective, so you might be able to switch to a different medicine that treats your condition without the side effect of the weight gain or the difficult weight loss.
Depending on the medication we’re talking about, the longer you adhere to a low-carb ketogenic diet, ideally, the more your health improves, the better things get. In conjunction with your doctor, you might be able to start reducing the doses of some of these medicines and maybe one day stop taking them altogether. Some people have conditions for which they need to take medication forever, for the rest of their life, so this can’t always be helped, but more often than not, it can be helped. Steroid drugs like prednisone or cortisone, whether we’re talking about the shots for knee pain or joint pain, or the nasal sprays for allergies during spring, are one of many medications that can cause this issue.
#2 Thyroid issues
I am very passionate about proper thyroid testing, assessment, and treatment. If you suspect you have a thyroid problem, or you have a thyroid problem but you feel like it’s not really being treated properly, ask for a comprehensive thyroid panel.
Signs and symptoms of low thyroid
When I say thyroid problem, I’m speaking about hypothyroidism – low thyroid function. There is such a thing as hyperthyroidism, which is an overactive thyroid, but if you have an overactive thyroid, you probably are not having trouble losing weight because people with an overactive thyroid actually lose weight without even trying – they become too thin.
How might you tease out that you have a low thyroid problem? Here is a small sampling, the most common signs and symptoms of low thyroid:
- Weight gain
- Difficulty losing weight
- Depression
- Loss of motivation and ambition
- Constipation
- Hair loss
- Often feeling cold
- Brain fog
- A hoarse voice
- Fatigue
- Slow heart rate
- Low blood pressure
- Loss of sex drive
- High LDL cholesterol
- Loss of the outer portion of the eyebrows
- Lower leg edema (swelling, fluid retention)
- Fingernail problems
You might have a number of problems that you don’t see here that might be indicative of thyroid. Also, bear in mind, you don’t have to have all of these, but if you are looking and nodding your head at multiple of them, consider a thyroid issue.
Some of these are more severe in some people than others, but this is the list of the most common ones for sure.
A comprehensive thyroid panel
The reason I advocate asking for a comprehensive thyroid panel, is that when you ask for a thyroid test, most doctors will only order one or two tests. They’ll do something called TSH (thyroid-stimulating hormone) and something called T4, which is one type of thyroid hormone. In some people, that’s enough. In some people, looking at those two numbers alone, you can see that there’s an issue somewhere. But more often than not, those tests are not sufficient. I see this in clients all the time, which is why I’m so passionate about it, not to mention my own personal thyroid saga.
In many, many people, the one or two particular tests that the doctor orders come back normal, but if they would dig deeper and do this full comprehensive panel, you’re going to see other numbers that are totally out of whack. Unless you get that comprehensive panel, the full spectrum of measurements, you won’t know that, and this is very common. If you have been told that your thyroid is normal, but you looked at that list of signs and symptoms, and identified with it, you have to insist on that comprehensive panel.
In the United States, with the exceptions of New York, New Jersey, and Rhode Island, you can order this blood work on your own without a doctor. Unfortunately, this test is currently unavailable outside of the U.S. You will still need to work with your doctor to get the correct medication if it turns out that there’s an imbalance, and you might need thyroid hormone medication, but you can do the testing on your own.
The most important thing to remember about testing is that the normal ranges are a bit controversial. Something crucial for you to keep in mind is that “normal” doesn’t mean optimal. Just because you fall within the normal range on a lab printout doesn’t mean that you’re going to feel your best. It’s because these normal ranges are controversial. Some people think that the ranges are not appropriate. So whether you’re in the range or not doesn’t really matter – what matters is how you feel. Be your own advocate; don’t settle for feeling awful. Don’t settle for feeling less than your best because this is correctable. It’s just not easy to correct.
Even if you might already be taking thyroid medication, just know that there are many different kinds of thyroid medication and lots of different doses. If you’re already on medication, but you still feel terrible, and still have signs and symptoms, then the type or dose of medicine isn’t working for you. You might want to have a polite discussion with your doctor to see if there’s something else you could try.
#3 Stress
Don’t underestimate the impact of feelings and the internal things that go on inside us. How those affect fat loss is totally separate from the food we’re eating. These things don’t happen in a vacuum. I cannot emphasize this enough: Don’t let keto become another stressor! Those of you who follow me know my motto is “keto without the crazy”. I see in so many people that keto is supposed to make your life better. It’s supposed to make eating easier, simpler, especially the way that our friend Dr. Westman teaches it, or the way “Adapt Your Life” teaches it. The way we teach keto is simple. You don’t have to count macros, weigh and measure your food, you don’t have to track, and you don’t have to open an app every time you eat. But there are people who don’t know that, who are following some other thing, or trying to implement some program or protocol where they think they have to do all that. Even if they’re not doing that, they’re getting on the scale six times a day, and thinking, “Why isn’t my weight changing? What am I doing wrong?” Don’t let keto become another stress – life is stressful enough. Keto is supposed to reduce stress. Keto is supposed to help you relax, you know why? Because you get to eat really delicious food, in my opinion. Don’t let it stress you out.
Stress affects appetite and metabolism
Under stress, some of us get hungry and we want to eat more. There are other people whose appetite goes away under stress, and the last thing they want to do is eat. If you’re one of these people who tends to be more hungry when you’re stressed out, it’s not all in your head. You’re not imagining it. Stress does influence the hormones that regulate appetite and satiety, meaning how satisfied you are, how long you stay full, and how hungry you get.
We’re not just hungry for anything when we’re stressed out. We tend to crave very specific kinds of food when we’re stressed out. What do we crave? Sugar, usually. Sugar or starch. There’s always going to be an exception out there, but it’s pretty rare to crave a nice pork chop and some grilled asparagus when you’re stressed out, right? It’s not that pork chops and asparagus aren’t delicious, it’s not that you don’t like them (if you’re Kosher or Halal, think of a steak or seafood) but when you’re in a crisis, you want a doughnut, French fries, cookies, pastries, chips, and crisps. You want something sugary or something starchy. We crave carbs when we’re stressed out.
Even if you resist and you don’t give in, stress still affects the way you metabolize food. Even if you’re eating normal low-carb, keto-type meals, your hormonal response is going to be different. You’re still better off sticking to low-carb foods, but if you have a continuous glucose monitor (CGM) or just a regular finger-stick glucometer, your blood sugar is just higher throughout the day. That’s what stress does! It raises your blood sugar and changes the way your body responds to food. Be aware that stress could be a factor in your fat loss.
Stress is a very relative term. There are situations that I would find very difficult and stressful that somebody else just sails right through with no problem, and vice versa. Something that’s very simple and easy to me, would have somebody else terrified. Stress is only what feels stressful to you. You might not be able to reduce the stress load if you’re caring for an elderly or sick loved one, or if you have a special needs child, or going through a divorce or something like that. You might not be able to change the situation, but you might be able to alter how you react to it. That’s part of stress too. It’s not so much the situation as how we feel about it, and what it’s doing to us internally.
#4 Poor sleep
Sleep definitely affects fat loss. I like to think of sleep as “vitamin S”. Everybody needs to sleep. Scientists don’t even really know why we all need to sleep. We are at the very tip of the iceberg of starting to discover what happens in the brain when we sleep, what happens in the rest of the body when you don’t sleep enough. They call that short sleep. Broken sleep, is where you were in bed for eight hours, but you woke up every two hours tossing and turning for 20 minutes. Both of those change the hormonal landscape. Just like with stress, when you are really tired, you typically feel more edgy, irritable, and again, more hungry for sugar and starch, for carbs. That could be your body wanting the quick energy to keep you awake and going through the day. I think we’ve probably all been through that experience, where you just got really, really terrible sleep, and the next day you were like a bottomless pit with food. You just couldn’t eat enough to fill up. We’ve been there.
Poor sleep, weight regulation, and metabolic health
Believe it or not, inadequate sleep and broken sleep are risk factors for type 2 diabetes, metabolic syndrome, and obesity. That’s because inadequate sleep and poor quality sleep affect insulin sensitivity and glucose tolerance, meaning how much glucose you can consume and still maintain a normal range. Too little sleep, and poor sleep, changes your endocrine response to food. Poor sleep is a stressor. Your body’s thinking, “What, how come we’re not sleeping? What’s going on? There must be some crazy situation, otherwise, why wouldn’t we be sleeping?”
Everybody has a bad night’s sleep every now and then. That’s not a big deal, just like those little bouts of stress. But if this is a long term problem, and it’s been months or years without good quality sleep, this can definitely impact your metabolism. It can impact hormones, and your appetite.
Get evaluated for sleep apnea if you think that’s warranted. Many people who have sleep apnea know they have it. There are a lot of people who have sleep apnea that don’t know they have it; they just never knew sleep apnea was a thing, or a medical condition that’s treatable. Some things to look out for are if you have a partner or someone that sleeps in your home or in your bedroom, and they’ve told you that you snore like a freight train, like ridiculous volumes and levels of snoring. If you wake up a lot, if you never, ever feel refreshed, no matter how much sleep it seems like you got, if you’re always really tired during the day, sometimes it can be a very sore dry throat or dry eyes. You can talk to a doctor and get evaluated. There are studies to help assess your sleep to see if you have it. That’s something that you’d definitely want to treat if it’s affecting your fat loss.
Those of you who are familiar with sleep apnea, it’s a fancy scientific word that means “not breathing.” During the night, you stop breathing, and that’s why you wake up because your oxygen supply has been cut off. You can be evaluated for that. The stereotypical sleep apnea patient is overweight, and it gets blamed on the weight. If you sleep on your back and you’ve got a big belly and a lot of weight pushing down on you, then the reasoning is, that maybe, the lungs aren’t able to fill up properly. Except, there are plenty of people who are not overweight and not living with obesity who have sleep apnea. It is entirely possible to have sleep apnea even if you’re not overweight.
You’ve heard the eight hours a night thing; there is approximately zero science to back that up solidly. I don’t think there’s any precise amount; some people need more, some people need less. If you’re being honest with yourself, you probably already know whether or not you get good quality sleep. If you wake up feeling refreshed and go through the day, you already know. I don’t have to tell you whether or not you’re getting good sleep.
Conclusion
Let’s talk about priorities. Fix your diet first, and the food you’re eating, the kind of food, and the amount is number one on the list. Most fat loss stalls are caused by the food.
If your food is on point, if it’s solid, and you’re doing everything right, if you are no longer chasing that fat macro like we talked about, if you are no longer messing around with net carbs and doing a ton of keto ice cream and keto cookies and not overdoing alcohol, then start to look at lifestyle.. Consider if you’re on a medication that might be interfering with your fat loss. Check out that comprehensive thyroid panel or do a self-assessment. Fix your stress and sleep or fix them as much as you can. There are going to be situations that are unavoidable, but do the best you can to mitigate how you manage them, and how you react to them.
DISCLAIMER
I’m not a doctor. Nothing we’re talking about tonight is medical advice. I’m not diagnosing, treating, curing, or preventing anything. Watch the full video here.