All About Weight Loss:

Why should we care about weight?
 

Obesity is skin deep. More than looking good, achieving and maintaining healthy weight is about feeling good and even more importantly, improving the quality of life in the long run. 

What affects weight management, caloric intake or metabolism?
 

Both. Weight gain  or weight loss depends on a complex interplay between caloric intake and metabolism. A banana is 100 calories for everyone until it is consumed. However, once inside our bodies, our metabolism determines how efficiently we can burn or store these calories. For an effective weight management strategy, it makes sense to work on both ends. That is,

1) manage caloric intake and

2) support metabolism. 

Manage Caloric Intake:

There are many apps and calculators available to measure daily caloric requirement. Following are two simple ways to quickly measure daily caloric requirement. 

 

 

 

 

Finding it difficult to stay within caloric budget? This is normal because our bodies naturally try to stock up on a bit excess energy reserves than needed. This is due to evolutionary reasons. In order to overcome this default tendency, eat low calorie density foods. Check out Eat this, not that. Also check out Food Labels to learn how to read nutrition labels. 

 

​Support Your Metabolism:

Below are ten ways to support your metabolism.

1. Fasting : 

When we fast, we not only reduce our caloric intake but also boost our metabolism by activating catabolic (fat burning) pathways and improving insulin sensitivity. There are many ways to fast. If you are new to fasting, review or watch Fasting Stress Test.

Three ways to fast

  • 12-24 hours of water down fast - No caloric intake for 12-24 hours. Keep caloric intake in check. 

  • Time restricted feeding - Eat within a window of 4-8 hours in a 24 hour period. Keep caloric intake in check.  

  • Fasting mimicking diet - Commercially available diet plan (prolon) which mimics fasting. A DIY version available on this website. Check out Longevity Focused Diet.

2. Exercise:

A cardio or HIIT (high intensity interval training) exercise not only helps burn calories but also can rev up metabolism for the next 24-48 hours. 

3. Sleep:

Lack of sleep or interrupted sleep increases insulin resistance which can slow our weight loss efforts. A good quality (combination of Non-REM deep sleep and REM sleep) are critical to healthy metabolism.

4. Functional Foods:

Although this effect is marginal, these functional foods boost our metabolism. 

 

5. Avoid Junk Foods:

These are sugars, refined carbs, and processed foods. Processed foods are the foods which go in the pantry and can be eaten readily or go in the freezer and you can't recognize the ingredients. 

Clean your pantry and freezer from 

6. Avoid Certain Medications:

Some medications can slow our metabolism by increasing insulin resistance, or activating metabolic pathways which help burn fat. Under the guidance of your health care practitioner, consider switching these medications to alternate options. 

  • Birth control pills

  • Other hormonal contraceptives

  • Insulin

  • Steroids

  • Antidepressants

  • Antipsychotics

  • Sleep aids

  • Neuroleptic

  • Some blood pressure meds

  • Long term antibiotics (through altering gut microbiome)

7. Prescription Medications to Help:

A handful of prescription medications help suppress appetite and stimulate metabolism. However, these should be used cautiously under the supervision of a healthcare practitioner and only after weighing benefits versus risk. 

8. Balance Hormones:

Hormone imbalance can pose a challenge when it comes to weight loss efforts. Therefore, women after menopause (overall low hormone levels), men after andropause (low testosterone levels) and several people under stress (high cortisol levels) find it hard losing weight and despite not overeating, tend to gain weight. Check out hormone evaluation and consider intervention. 

9. Balance Microbiome:

Gut microbes alter the way our metabolism works. A decline in furmicutes and bacteroids ratio has been associated with weight gain. Consider testing and intervention with probiotics if out of balance. More importantly, eat a fiber rich and healthy diet to stimulate the growth of hhealthy microbiome. 

10. Avoid toxins:

Avoid environmental toxins and processed foods which accumulate toxins. Toxic burden can give rise to insulin resistance and jeopardize our weight loss efforts. 

Additional Tips Based Upon FAQs:

Why is it that I hit a plateau every time I try to lose weight?
 

This is because of the same phenomenon as described above. Losing more and more weight is like fighting an uphill battle. It is relatively easy to lose a few pounds in the beginning. Then, the body goes up in arms against our weight loss efforts because body tries to "conserve" itself. In other words, it goes in the survival mode. Now we have less body mass to feed than before so the caloric needs drop. The metabolism slows down. And fat burning hormones such as "leptin" levels drop. As a results, it becomes harder to lose weight as we lose weight. 

Should I eat frequently to keep my metabolism going? 
 

Although eating or a fed state brings us out of the starvation mode, it does not necessarily increase basal metabolic rate. The reasons for this are because as soon as we start eating, we raise our insulin levels. Insulin is an anabolic (building) hormone and dampens any pathways which intake of food might have induced to speed the metabolism. 

 

Why is it that I lost weight with good diet and exercise and am keeping up with a healthy diet but the weight have slowly started to creep up? I am not overeating, eating bad or even eating as much as I used to?
 

Body likes routine and consistency. It always tries to go back to its balance where it finds familiarity. If we have been over weight, it will try to go back to the weight it has been familiar with if we do not take proactive steps to train the body the "new normal". If we do nothing to gain and/or loose weight and just eat right, make conscious efforts to not overeat, small (even negligible) amount of weight will continue to accumulate over time. This is due to evolutionary reasons. At subconscious levels, human body is designed to always keep store a little extra for the rainy day. In other words, if our caloric need is 1600 calories a day. We will not feel very full even if we eat 1700 calories every day. A 1700 calorie diet will not make us feel full, nor will it show any difference on the scale on a day to day basis. At times, it may even feel that we are starving our selves. This is because although at a conscious level, we are eating just fine, at a subconscious level, our body is asking to bring in a little extra to conserve small amount of energy reserve for that rainy day. We never even feel that we overate because the satiety hormones don't get released and a year later, we step on the scale to find out that we are 10 pounds heavier. 

It can't just be subconscious overeating. Is it possible that there are other factors?
 

Yes, absolutely. When it comes to weight management, aging, fitness or almost anything related to the biological science, time is not on our side. With the passage of time (aka aging), metabolism slows down, hormones fluctuate and the energy balance shifts to where it becomes increasingly difficult to stimulate thermogenic or weight loss pathways. 

If it is all about energy balance, should I not follow a diet which keeps me full, suppresses my insulin levels and helps me fast? (aka ketogenic diet)
 

Any diet that works for us in the short run (emphasis is on "the short run") is a reasonable diet to follow in the short run. However, long term adaptation of such diets is not advisable. As an example, ketogenic diet contains high fat content and inevitably results in an imbalance in the macronutrients. Meta-analysis studies show that such diets result in high cholesterol, higher coronary artery disease and up to 30% increase in all cause mortality (overall death rate).

Should I follow a diet based upon genetic testing?
 

Genetic testing gives you some information about your metabolism but it does not change the basic equation of weight loss. Most genes which contribute to polygenic obesity (so called FTO genes) have only marginal effect and their effect can be overridden with the help of healthy lifestyle. Stronger genes which lead to monogenic obesity (MC4R, LEPR, POMC genes) are deterministic and cannot be overridden. But such genes are quite rare.

Caloric intake matters

Metabolism Matters

Successful strategy involves paying attention to both

I am 100 calories before you consume me.

Simple and conservative formula:

Daily Caloric Requirement =

30 x ideal body weight in kg

More accurate formula (preferred for active individuals):

  • Sedentary lifestyle (< 6000 steps /day) :​ Weight (kg) x 30 (maximum 2000 calories /day)

  • Leisurely active lifestyle ( 6000-10000 steps/day): Weight (kg) x 35 (maximum 2500 calories/day)

  • Fit & Active lifestyle (>10000 steps/day including cardio/strength training): Weight (kg) x 40 (maximum 3000 cal/day)

Don't like math? Use this table

Tip: Don't like counting calories every day? Buy food for a week (equal to daily caloric need x 7) and eat over one week. This allows for extra calories some days and lesser calories other days

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