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 it 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. For some, weight loss completely stopped. For others, you might have even gained. 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, the 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 no-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 does it 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.