Sunday, October 28, 2012

Can You Be In Ketosis and Not Lose Weight?


In 1972, Dr. Atkins introduced the world to the concept of carbohydrate sensitivity. He talked about the damage that carbohydrates can do to your metabolism, suggested that overweight and obesity was caused from a metabolic defect, and played up the necessity of being in Ketosis for effective weight loss.

But What Do You Do If Atkins Doesn't Work? 

If your metabolism is typical, you lost a decent amount of weight during the first two or three weeks, but then everything slowed down. For some people, weight loss completely stopped. For others, you might have even gained weight. You know you’re in Ketosis. You haven’t eaten anything off plan. You’re drinking plenty of water. You’re sprinkling salt on your foods, and you’re getting plenty of vegetables, but you’re still not losing weight! Frustrated and confused, you begin to think that:
  • Maybe you’re doing something wrong.
  • Maybe you’re not really in Ketosis.
  • Can you even be in Ketosis without losing weight?

Ketosis and Weight Loss


Weight loss on low carb is fairly fast when you first begin restricting carbohydrates because you’re using up your carbohydrate stores in the liver. Once those stores empty, your weight-loss pace slows to a more typical rate of speed, but fat loss usually doesn’t stop. The state of Ketosis causes you to eat less. You go into a caloric deficit without having to count calories. You feel great because you’re eating nutrient dense foods and easily burning fats for energy, and you quickly discover that a low-carb diet lives up to its reputation.

So what goes wrong? How can you be in Ketosis but not lose weight? There are several reasons why Ketosis and weight loss do not always go hand-in-hand. Some of those reasons have to do with the myths surrounding the state of Ketosis, but not always. There can be legitimate reasons why effective weight loss on low carb is more difficult for you, than for others.

Is Insulin Necessary to Store Fat?


Several years ago, some of us having problems losing weight went on a totally no-carb diet. Eating this way was supposed to lower insulin and eliminate food sensitivities for those having problems on typical low-carb diets. Since I was having gastrointestinal problems at that time, I found the concept interesting. Basically, I used it as an elimination diet. My hope was that it would make discerning problematic foods easier.

One of the misconceptions within the low-carb community is that high insulin levels are absolutely necessary for you to store body fat. What I and several others learned during that zero-carb diet was that simply isn’t true. While hyperinsulinemia does cause the body to store dietary fats while handling excess glucose, you can have very low insulin levels and still stall or put on weight. Low insulin levels do not protect you from weight gain, nor do they guarantee that you’ll be able to burn your body fat stores for energy.

That’s because the body has an alternative fat metabolism pathway.

Body fat cells are actually an endocrine organ. They secrete various types of hormones that affect metabolism. A substance known as Acylation Stimulating Protein (ASP) is secreted by your fat cells. It increases the activity of Lipoprotein Lipase (LPL), an enzyme that helps you break down dietary fats into a form that can pass through your upper small intestine and into your bloodstream. Triglycerides are too large for the body to absorb the way they are, so the pancreas secretes LPL into your small intestine where it can break down the fats you eat into smaller particles.

Once these smaller particles pass through your small intestine, they are picked up by LDL particles or encased by chylomicrons and transported into body cells for fuel or shipped to the liver. In the liver, chylomicrons are either converted to VLDL and used as energy, or they are sent to the fat cells for storage. ASP plays a similar role to insulin inside the fat cell. Rather than being secreted by the pancreas when you eat carbs, the fat cells produce ASP whenever they come into contact with chylomicrons.

Role of Dietary Fats in Stalls or Weight Gain


When you eat a high-fat diet, you make more chylomicrons in order to transport it. That results in additional ASP, which stimulates greater fat storage. ASP is what allows fat to be removed from chylomicrons. This activity is independent of insulin. The fat that’s encased in chylomicrons does not need insulin to be stored because body cells are free to take from them whatever fatty acids they need. This is not true for the VLDL the liver converts fatty acids into, so not everyone has a problem with a higher load of dietary fats.

It all depends on what your liver decides to do with the fat it receives from those chylomicron transporters. If your body is prone to fat storage rather than fat burning, which can easily happen if you’re already lost a large amount of weight, you’ll store a lot of the fat the liver receives whether you’re in Ketosis or not. If you were overweight or obese for a long time, the body will believe your starting weight was your normal body fat level. When you lose, say 100 pounds as I did, the body will go into panic mode believing your diet was a famine and do everything it can to regain those lost fat stores.

Role of Lipoprotein Lipase (LPL) in Fat Metabolism


One of the theories I investigated a couple of years ago had to do with dietary enzymes. I was interested in these enzymes because I’d gained a lot of weight eating a no-carb diet. These enzymes are needed to digest the macronutrients you eat. Macronutrients are protein, fats, and carbohydrates. Each macronutrient has a different enzyme that participates in breaking down that nutrient. Those with celiac disease are more likely to have a problem digesting fats due to intestinal inflammation, but they could also have problems with protein or carbohydrates.

Fats need Lipoprotein Lipase (LPL). LPL is secreted into your small intestine by the pancreas. It’s what breaks down your fat so it can pass into your bloodstream. Without LPL, you cannot break down fats. They would pass through your body undigested. A shortage could cause low-carb diet stalls because lack of digestion would put your body under a certain degree of stress, but a lack of LPL cannot cause you to gain weight. Fats cannot be stored in your fat cells without first having been broken down by LPL and passed through your intestine into the blood.

The other problem is one of up-regulation. While you might produce a normal amount of LPL and be able to digest a certain amount of fat, a high-fat diet might be too much. Not everyone has the capacity to produce the additional LPL needed to digest a high amount of dietary fats. In addition, everything I have read about LPL says that LPL deficiency is hereditary with no cure. It cannot be fixed through dietary supplements because fats are not digested in the stomach. Current scientific thought is that the acid in your stomach breaks down supplemental LPL and makes it inoperable.

What Can You Do?


Digestive enzymes didn’t work for me when I tried taking them several years ago, but that was back before I tried to achieve weight loss on low carb. To date, the only thing that has been effective for me is lowering the amount of dietary fat I eat as well as my calories, but that upsets a lot of low-carb folks. Sure, a large amount of fat makes dieting more luxurious, but we are all individuals and what works for one low-carb dieter won’t necessarily work for another. We each have different metabolic issues and different types of metabolic damage.

Yes, you can be in Ketosis and not lose weight, but most of the time, it’s fixable if you’re willing to live with those dietary changes and tweaks for the rest of your life. The truth is, not everybody can do what’s required to be thin. But then, maybe being thin isn’t as necessary as we’ve been taught it is.

22 comments:

KendallSmith said...

Very good brief and this post helped me alot.thanks for sharing with us.

Vickie Ewell said...

Thanks for your comments Kendall.

Adrina said...

Hi vickie, this is very helpful to me. I have been obese for 5 years and I just started low carb on 12/26. I lost then gained a few lbs and I am working out until I am sweating, and staying ON plan. I want to tell you my typical meal plan daily and maybe you can let me know what I am doing. (side note:aside from feeling frustrated at lack of loss I have honestly never felt better- I have more energy NO cravings..so I really need this to work!!)
Breakfast 2-3 scrambled eggs with maybe a sausage patty
Snack-atkins shake
Lunch 2c Lettuce with ham or turkey and small cubes of swiss cheese, 2 tbs ranch dressing
Dinner- 6-8oz steak, or chicken, and some sort of vegetable like cauliflower or broccoli.
-dessert=sugar free fudge bar. When I started I was 245 (5'8") I am down to 231 and WONT BUDGE!!!! I started doing some elliptical training, and some walking for 30 minutes a day at least. Please tell me what to do!!!

Vickie Ewell said...

Hi Adrina,
There is actually such a thing as working out too hard or much. In general, working out can cause small muscle tears that require extra water for repair. That can result in weight loss stalls that aren't actually stalls. Just extra water weight.

You're also fairly new to low carb, less than a month, and coincidentally, I just put up a post that deals with the problem of dehydration that occurs to a lot of folks during their first month of low carbing. It's another possible stall that isn't really a stall. For me, I stalled on my second low-carb attempt for 6 weeks before I lost that water weight it talks about.

As for your menu, it looks fine to me. It's early still, so give your body a little more time to adjust. 14 pounds is a huge weight loss, so your body is probably retaining water. Between that and working out, that's my guess at this point. Just keep doing what you're doing.

Anonymous said...

Hi Vickie and thanks for the info.! I found your article interesting. I started my low carb diet on X-mas day 2012 and in 4 months I have lost 65 lbs. I needed to lose a total of 100 lbs. - 120 lbs. Here is what I eat:

Breakfast: two 6 oz. containers, Yoplait Light yogurt

Lunch: 1.6L (by volume) salad containing lettuce, green/red peppers, carrots, 1/2 cup cheese, and 6 oz. southwestern style chicken.

Dinner: 4 containers (about 3 oz. per container) of sugar free jello.

Throughout the day I consume an additional 4 containers of sugar free jello and 1 gallon of water.

I have not waivered from this meal plan in 4 months. I don't exercise much. This is my approximate nutrional intake per day:

calories: 663
carbs: 60 gms.
fat: 22 gms.
protein: 84 gms.
sodium: 1900 gms

Although I feel great, my weight loss has slowed and I am not sure how to kick-start it again. I've been losing on average, 15 lbs. per month.

Eric

Vickie Ewell said...

That low of a calorie level will cause your Leptin levels to drop, which is probably what's happened. When Leptin is low, you don't burn fat as easily as you do when it's higher.

Your fat grams are a bit low, so you might want to up that a little bit. My own sweet spot for fat is 45 to 60 grams per day. When I go below 30, my weight loss stops.

I read a lot of Lyle McDonald's stuff over at www.bodyrecomposition.com and he recommends taking a diet break when you diet that hard.

The only way to kick-start what you're doing is to boost your hormone levels back to normal. To do that, you have to move to your maintenance level of calories for at least 2 weeks where you're eating at least 100 carbs per day. After 2 to 3 weeks, you can go back to your diet plan.

But the closer you get to goal weight, the slower your weight losses will be, and the more danger there is to begin burning muscle for protein. The leaner you get, the higher your protein level needs to be in order to maintain muscle mass.

Anonymous said...

Hi Vickie,
Great blog, please HELP!!!
I'm at my wits end and hoping for a miracle fixit. I've been on Optifast for nearly 3 weeks and yesterday found my weight up by 0.4kg for the week after 3.0kg and 1.2kg the previous 2 weigh-ins. I weight again today and its up another 0.4kg! Needless to say I am FREAKING OUT. I am definitely in ketosis as I check blood daily (avg reading 1.7) have had NO extra carbs with the ony extra anything each day being a bit of cream in coffee. Sometimes I even skip an Optifast product and have the coffee or some veg instead! I have salty broth I've read Volek & Phinney and for the life of me don't get whats happening. Its not that I've driven down my RMR either coz I can assure you before I started this I was eating everything in sight so no chance of depressed metabolism. What could it be? My daily cals maybe being too low? Lack of activity? Insufficient water? WHAT??? If so, why exactly? I feel I am definitely in ketosis AND caloric deficit AND at a fairly low fat level so it can't be my dietary fat ending up in ketone readings. I now don't know whether to just persevere with it OR go to an all-you-can-eat buffet til further notice, THATS how crazy this is! I appreciate your time and thank you in advance for taking the time to read!

Anonymous said...

PS I should add that I KNOW optifast is not a long-term thing, that eventually I need to 'learn new eating habits' blah blah blah but there is little I don't know about good eating habits and diets my issue has always been actually DOING rather than just KNOWING and I feel lepti, ghrelin & the rest plus overwhelming depression about still being fat have conspired against me. I looked into gastric sleeve but at BMI32 and no co-morbidities surgeon wouldn't do it (imagine, something I'm not fat enough for!) so this is my last hurrah.

Vickie Ewell said...

I don't know anything about the Optifast program. So I went to My Fitness Pal and looked up the shakes. They are NOT "low-carb", so you'll have to tell me exactly what you're drinking/eating, and what the total carb count for the day is.

Also check the ingredients on the labels for me. Do these products contain sugar? Fructose? Sugar Alcohols? At 20 carbs per shake, they are not just protein powder and a little bit of cocoa.

I personally don't have a problem with doing a weight-loss shake program to lose weight. That's how Dr. Eades lost all of his weight. I'm concerned that you might be drinking too many carbs, and that maybe the products have some type of sugar that is keep your insulin level too high.

Anonymous said...

I had been on Low carb diet on and off for several years . Now I can't go without carbs because I can't sleep, lots of pain in my muscles, headaches, can't think. I can't even get up from bed, no energy. I gain 20 pounds since the cravings for carbs and sugar are bad and is the only way I can get some energy. It is any thing that I can do to reduce this problems to go back in my low carb diet?

Vickie Ewell said...

Yo-yo dieting is something that Dr. Atkins warned against. He said if you continually go on and off of his diet, it can backfire on you.

The body adapts and learns very quickly. It doesn't like to diet, any diet, because it perceives dieting to be a famine. Eventually, if you do it enough times, the body will begin to fight back. At that point, dropping the carbs to Induction levels will cause a severe stress response. Stress hormones skyrocket and the body will do whatever it has to, to get you to up the carbs.

That's where I'm at today too. A low carb diet causes my stress hormones to skyrocket. I'm thinking that a backdoor approach, where you begin at a much higher carb level (a point where your body doesn't feel threatened) is a better place to begin.

Then, once it's comfortable, try cutting back on a few carbs. What you're doing is essentially a low carb diet in reverse.

michelle young said...

Brilliant reading thankyou!

But oh my ,i think i'm gonna be upset at the end of phase 1 Atkins!
I've done every diet,but for the past few months sort of paleo ....
Alas the only diet i never really got intoo is Atkins so i'm on wk 1 ,phase 1. Reading all the valuable info here ,make me think it isn't gonna go well. Yo YO dieting ,lowish calories....the list goes on......
Will all the hard work i'm putting in be of any use? I'm so confused with all the stuff about stress hormones etc ....early days but i'm stressing already on how i will rectify the problem to allow me to do this :(

Rosana Claussen said...

Hi... Very helpful to me! Thanks!

I adopted low carb as my woe a year ago, and I lost 17k. But I'm completely stucked for months, even eating low carb / high fat. Your post explained about it, and I will try to cut a bit of fat and calories.
My question is:
What the difference between "rubbish day" and yoyo? For example, I was doing a day off diet per week, to shake my leptine's level. Is my body will understand this as yoyo dieting or not?
Many thanks!

Vickie Ewell said...

Rosana,

Sorry I'm so late in replying to your comment. My life has been pretty crazy lately. A rubbish day works very well to bump up leptin levels, and for a lot of folks, it doesn't bump them out of ketosis either. When it does, you move right back into ketosis as soon as your glycogen stores deplete themselves again. Since it happens so quickly, the body doesn't see it as a major lifestyle change.

Yo-yo dieting is when you completely go off of a low-carb diet for several weeks, months, or years at a time. The body completely returns to predominantly burning glucose for fuel. When you do that, the body thinks it has just lived through a famine and survived. A free meal or free day doesn't do that.

Tracey McCoy said...

i did low-carb (20-25 carbs/day) about 18 months ago and lost 15 lbs. I was 155 at the time and very happy with the results. However, i've gained 10 lbs back. I've been trying to lose it by going back to 20-25 carbs/day but it's been 8 weeks and I've lost nothing. I'll lose 3 lbs and gain 3 lbs, then lose 3 lbs and gain 3 lbs. I'm not sure what i'm doing wrong and i'm concerned that i'm damaging my health?

Anonymous said...

Thank god I found you!!
A yr ago I had a gastric sleeve and have lost 25kg. I am 83kg and so would love to lose 15kg more.
A month ago after eating far too much chocolate and processed snacks I decided for health and wt loss to quit sugar. Day 3 I had put on 2kg. I also then decided to go further in to ketogenics.
At the moment have tested my blood ketones and find that in the morning I am 0.4 and by evening I am 0.9.

I can only eat half cup amts.
Breakfast 1egg omelett with brocolli and chicken cooked in olive oil and butter( can only eat half).
Lunch I eat other half.
Dinner is protein and veg.
Snacks are 10 macadamias or almonds
Or plain gull cream yoghurt with a dollup of double cream (only about x2 a week)
Or 1/4 camenberg cheese on cucumber slices.
I only snack if my energy low.

I just cant seem to get any info on ketogenic diets and quantity restrictions.
I really need advice!

Ankur Aggarwal said...

Great blog, a very helpful post thanx for that, just to add onto some points (i am a fitness model). I was fat 200 pounds when i started into weight loss and have never looked back . some of the tips for fast weight are How to lose weight fast. Hope it helps all

Vickie Ewell said...

Tracey,
Is this the second time that you have ever done a low-carb diet? Or have you done low carb more than that?

Vickie Ewell said...

Anonymous,
Weight loss surgery brings in the additional factor of starvation, so if you had the surgery a year ago, your metabolism will be very, very low. I am really not qualified to address the problems associated with having a Gastric Sleeve, but there is a yahoo group support list called Atkins Support Group that might be able to help you. The owner of that list had a Gastric Sleeve several years ago. There is also another member who recently had a different type of weight-loss surgery. Do a search at Yahoo Groups for the group and join. That would be my best advice.

Vickie Ewell said...

Ankur,
This blog isn't about fast weight loss. It's about living a low-carb lifestyle.

Anonymous said...

Vicki,
I just wanted to say Thank you for this. I have been on atkins for 3 weeks or so and not losing. I was about to give up when I stumbled across this and its given me the strength to just keep on keeping on...lol So again, Thank you for writing!!! ;)

Vickie Ewell said...

Anonymous,
Sometimes, it does take the body a while to start letting go of the weight. It's always best to give a diet a few weeks to start working before evaluating. The body often fights giving up its fat stores.