Perfect Health Diet: Weight Loss Version

We started 2011 with a discussion of Experiences, Good and Bad, On the Diet; which led us into the issue of weight loss, especially for peri-menopausal and older women.

This is an especially poignant issue for erp, who is 76 years old and would like to lose weight for her upcoming knee replacement surgery, but cannot walk.

This is the toughest possible scenario for weight loss:

  • Whether for genetic (X vs Y chromosome) or hormonal reasons, women are more prone to putting on weight than men. (Men are more prone to diabetes.)
  • Hormonal changes after menopause seem to make it tougher for women to lose weight.
  • A petite woman doesn’t need as many calories as a larger person … but her micronutrient needs, and thus her appetite, may still be high.
  • Aging brings more efficient energy utilization and reduced energy expenditure. Thus, the elderly have a smaller energy “sink” in which to dispose of excess fat. A teenager can eat like a horse and stay thin; not so an older person.
  • An injury that prevents walking makes it even harder to burn off fat. Walking is a tremendous aid to fat loss.

Designing a weight loss diet for someone like erp really forces a hard look at how to optimize a weight loss diet. Get it even a little bit wrong, and the diet either won’t work for weight loss, or will be malnourishing.

The Three Keys for Weight Loss

The three keys for an effective and healthy weight loss diet, as I see it, are:

  1. Elimination of food toxins. Food toxins are the primary cause of obesity and you can’t expect to cure a condition by causing it!
  2. Perfect nourishment. The diet should be as nourishing as possible. The dieter should be in the “plateau range” of every nutrient – vitamins, minerals, organic molecules, carbs, protein, and fats.
  3. Calorie restriction. You have to be in energy deficit to lose weight.

The main food toxins to avoid are fructose, polyunsaturated fat, and wheat (see Why We Get Fat: Food Toxins). In my advice to erp, I suggested replacing some of her fruit with “safe starches” like potatoes, and replacing her PUFA-containing nuts with low-PUFA macadamia nuts or other foods.

But the harder part is achieving a calorie restricted diet when so few calories are being expended, and yet avoiding malnutrition. How may that be done?

Eat Protein and Carbs; Reduce Fat

This may surprise many readers, since we’re fat-friendly, but there should be no reduction in carb or protein consumption on weight loss diets. Calorie restriction should come out of fat.

The Perfect Health Diet “plateau range” for carbs and protein is 600 to 1200 calories. Eating less than 600 combined carb+protein calories per day raises the specter of either protein deficiency (leading to hunger) or glucose deficiency (leading to zero-carb dangers).

So if a typical daily intake is 400 carb calories and 300 protein calories, there’s really not much room to cut protein or carbs.

Remember that the body doesn’t have a significant store of carbs; the body’s total glycogen supply amounts to about a day’s needs. Nor does it have a store of protein, apart from skeletal muscle; and you don’t want to lose your muscle.

But it does have a large store of fat – those adipose cells that you want to shrink.

So to conserve muscle and reduce fat tissue, you have to eat your normal allotment of protein and carbs while restricting fat intake. As long as there is no serious dysfunction of adipose cells, they will release fat as needed to meet the body’s fat needs. And that’s what you want – fat being moved out of adipose cells to be burned.

So your calorie-restricted weight loss diet will be just as nourishing as your regular diet. Only the source of the nourishing fats – adipose cells instead of food – will be different.

Eat Nourishing Fats

But not all fat can be removed from the diet. The reason is that not all nutrients found in fat-containing foods are stored in adipose cells.

You see, fats are stored in adipose cells as triglycerides. But we need to get other lipid molecules, not just fatty acids, from food. The really crucial molecules are the phospholipids, especially phosphatidylcholine.

Choline, inositol, and a few others are organic molecules are bonded to fats in cellular membranes. We need to obtain these from our foods in order to be well nourished.

Diets low in choline strongly promote obesity. Therefore, anyone seeking to lose weight should be sure to eat a choline-rich diet.

The easiest way to do that is to eat 3 eggs a day and a ¼ pound beef liver once a week.

Another type of lipid that may be missing from adipose cells are omega-3 fats. Balancing the omega-6 to omega-3 ratio is helpful against obesity, and most people are omega-3 deficient. So eating up to 1 pound of salmon or sardines per week may assist weight loss.

Beef and lamb – meats that are low in omega-6 fats – would be good choices for any additional meat.

Be Super-Nourished

The body’s appetite regulation mechanisms are highly attuned to your micronutrient needs. Micronutrient deficiencies will tend to induce a strong appetite for food, as your body tries to get you to obtain more nutrition. This could be a major reason why “empty calories” such as cotton candy are fattening.

Our book has some examples of “micronutritious foods”: variety meats, bone soups, seaweed, shellfish, eggs, and vegetables.

Nutritious, low-calorie foods like bone soups can be very helpful for weight loss. Soups can also be a good way for someone who doesn’t like vegetables to obtain them.

In addition, I would recommend that every person on a weight-loss diet take our full supplement regimen: a daily multivitamin, D, K2, C, magnesium, copper, chromium, iodine, and selenium. Also, I would suggest taking our optional B vitamins: thiamin, riboflavin, pantothenic acid, biotin, vitamin B6, vitamin B12, and choline (note the exclusion of niacin and folic acid).

Keeping Calories Down

What is the minimum calorie intake that meets all these nutrient considerations?  Eggs, salmon, and beef have more fat than protein, so if you’re aiming for 400 carb calories and 300 protein calories, you’ll probably eat at least 500 fat calories per day. So it would seem to be impossible to go below about 1200 calories per day while still being well nourished.

The place to cut calories, then, is the extra fats. Perfect Health Diet favorites like butter, coconut oil, and cream are, sadly, top candidates for reduction.

Of course, the more active you are, the more you can include those fats.

For less active people, the Weight Loss Version of the Perfect Health Diet becomes similar to a lot of popular diets. Many diets recommend a roughly even calorie distribution, with 30-40% of carbs, protein, and fats. This is what a calorie-restricted version of the Perfect Health Diet should look like too.

So, the perfect day in a weight loss diet: soup, potatoes or other safe starch, salmon, eggs, vegetables. Not too much fat in the sauces!

A good meal might look like this:


Mash the sweet potato with eggs instead of butter, and this would fit our weight loss recipe.

Conclusion

It’s a little humbling that I’ve started 2011 with 5 posts on the subject of healthy weight loss, but have only scratched the surface of this complex topic.

For instance: In the book we used the rubric “metabolic damage” to describe the biological dysfunction associated with obesity. But we never really chased the complex biology of exactly that damage consists of – and how it can best be healed.

Today, I’ve presented what I believe is the best strategy for healthy weight loss. But other techniques – such as ketogenic dieting, intermittent fasting, exercise, and more – can contribute to healing the metabolic damage of obesity. As 2011 goes on, I’ll return to this topic.

I am intensely interested in the experiences of anyone trying to lose weight using our diet, and I hope that together, we can understand the disease of obesity better, and figure out good ways to achieve both healthy weight loss and a permanent recovery from metabolic damage of all kinds. So please, if you are trying to lose weight, keep me posted on your experiences, whatever they may be!

Related Posts

From 2011:

From 2010:

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395 Comments.

  1. Hi Shelley,

    Thanks for sharing your experience. I had a similar one – when I had scurvy I was ravenously hungry; as soon as I supplemented vitamin C my hunger disappeared.

    Best, Paul

  2. Hi Paul,

    The countdown is on — headed to the beach in 8 weeks, and I’d like to cut down on the belly fat a bit before I do. I’ve been working on a more fat-restricted PHD for the past few days, that incorporates IF, reduced alcohol from 8 drinks/week to 2 drinks/week, and I have a couple of questions and observations I’d like to hear your opinion on.

    When attempting to use PHD in a weight loss phase, would you recommend consuming any coconut oil during fasting phases? I find myself quite hungry during my 6PM-10AM fasts. My stomach growls at night, and I can’t wait for 10AM to eat. Perhaps I’m not eating enough during the day, but I find that if I take 1-2 tsp coconut oil with 9PM tea and 7AM coffee, the hunger goes away. Do you think this is a less than desirable weight loss strategy? STo clarify, this should not be affecting any ketosis that I should be achieving during this time period?

    Also, do you think a high meal frequency in the feeding phase is a detractor to health or weight loss? When I break the fast, and eat a meal, if I’m still hungry 1-2 hours later, I’ll eat again. Sometimes I’ll take 5 feedings in the 8 hour period. Yesterday for example, I ate the following:

    10:30 AM: 4 oz lean beef brisket, 2 stalks celery, 1/2 onion, 1 small potato, 1T butter
    1:00 pm: 4 oz grass fed beef patty, 1/2 medium apple.
    3:00 pm: The remaining fat from the patty mixed with 2 eggs.
    6:00 pm: 5-6 oz lean ham steak, 1/2 large sweet potato, 1T butter, 1/2c cooked broccoli.

    I feel like I’m eating enough, and I’m “hari hachi bu” at the end of any given meal. I’ve lost an inch and a couple of pounds the first few days. But last night at 9PM my stomach was growling and I felt hungry. But I know that I’m not giving my body enough time to digest the first meal when I add the second and possibly the third. Perhaps this is a psychological issue, that my body is waiting for that evening wine and cheese that it’s accustomed to receiving at 9PM?

    Thanks!
    Matt

  3. Hi Matt,

    Great plan!

    1) Yes, I do recommend a bit of coconut oil during the fast. This not only relieves the stress of the fast for those with a bit of metabolic damage, it also helps reduce appetite (basically Seth Roberts’ Shangrila Diet idea). Coconut oil is ketogenic, so it doesn’t change the health effects of the fast.

    2) Yes, you should eat when hungry. I don’t think it matters how you distribute food in the feeding phase.

    3) Your meals look good but I think you could use more carbs. If you calculate your carb intake yesterday it was very low. Possibly that’s involved with your hunger. Vegetables might help too. You could add some rice or one more full large potato, maybe some baby carrots to nibble on while working.

    The other aspect with hunger is micronutrients. I assume you’re on all our micronutrient recommendations?

    Best, Paul

  4. Thanks. I haven’t purchased the standalone supplements except for the VitD and Magnesium that I’ve been taking for years. My multi (One a day Men’s) seems to be adequate or halfway there on the others except kelp. I’ll try to get going on the other micronutrients next week.

    Well with lunch today I added a bowl of rice krispies in coconut milk to my broth/pork tenderloin/.5c rice/1 egg soup. I’m feeling more satisfied after that lunch than after yesterday’s … probably needed the extra starch. That sweet potato from dinner was quite large (1 lb, I ate half of it), but maybe shifting the starch load to a better balance of early/late is going to help.

  5. Hi Matt,

    Yes, I think the extra starch and micronutrients will make a big difference for you.

    The other thing I forgot to mention is that you might try replacing some of the butter with egg yolks. 3 egg yolks a day will assure a good choline intake which is important. You could also try raw egg yolks in place of the coconut oil at night or morning if that is more convenient for you.

    Best, Paul

  6. Paul, great idea, trying to work the eggs into most lunches. So far so good, though it almost seems too quick of a loss – I’m 8 lbs off my 5’9, 175 in little over a week, and that included an indulgent Easter. The midday and evening hunger appear to be subsiding.

  7. Hi Matt,

    Maybe you can get to the beach in 2 weeks!

  8. Is there a problem with eating Whole raw eggs (yolk & whites)?
    I see a few posts & they only mention ‘raw egg yolk’.

    Sorry if this has been talked about elsewhere already & i missed it.

  9. Hi Darrin,

    Raw egg white has a protein, avidin, which is toxic to humans because it induces biotin deficiency. See http://pmid.us/16743887. Cooking the whites causes the avidin to be digested.

    So if you’re going to eat eggs raw, best to eat only the yolks.

  10. Hi Paul
    I’ve read your book and the blog, and am thinking of starting the PHD for weight loss. I’m 48 and post-menopausal, having had a total hysterectomy 8 years ago for endometriosis that had invaded my bowel. I’m also fairly sedentary and struggle with moving as I have quite low energy levels and get sore muscles very quickly.

    I’ve been following the Primal Blueprint since Feb this year and as part of that I’ve completed an elimination diet to get control of my IBS and general aches and pains, so at present I don’t eat dairy, nuts and nut products, cruciferous veges, and many supplements as they all provoke an IBS flare. This in addition to grains, legumes, vege and seed oils etc.

    I have gone from 220 to 203lbs since Feb – a pretty slow process!! I’m a bit worried that the PHD is beginning to look like a deprivation diet once I start to restrict fat. The protein and carb levels you recommend are easy to manage.

    One question, please – are you familiar with the idea of leptin resistance? I’d be interested in your take on it, perhaps in a future post?

  11. Hi Jacquie,

    Sorry to hear about your terrible endometriosis. Shou-Ching had that, but not so severely. It must have been very painful.

    Yes, I’m familiar with leptin resistance. But I tend not to blog about molecular mechanisms much, unless I can directly link them to some interesting issue. About the only time I’ve discussed leptin resistance was in exploring how cells avoid obesity, see http://perfecthealthdiet.com/?p=1933.

    I don’t think you should worry about fat restriction making a diet into a deprivation diet. Fat is the most flexible nutrient, able to be pulled from storage as needed. It’s carb-protein restriction that generally gets people into trouble.

    Best, Paul

  12. Thanks for the reply Paul. I read your linked post and found it very helpful. My worry about getting deprived is clearly associated with my own history, so I’m entering the weight loss aspect of the PHD very gently and am fully prepared to pull back on it if old patterns rear their ugly heads! However, I’ve lost 500g in the first few days of eating less fat. I do find that I have to focus on getting the necessary carbs into my meals, as they have a huge impact on my serenity and satiety.

  13. I am a 64 yr. old woman who has recently lost 40+ lbs. I am 5’7″ tall and now weigh 163. I have lost most of my weight VLC/Paleo since October 2010. I broke my foot in December and am very sedentary now. I have stayed the same weight for 5 months.

    I have been keeping records the whole time and have tried to incorporate your PHD into my plan. What I know is that I gain weight if I up my calories above 1400 no matter how low my carb count is. I will lose if I drop to 1000 but that is too extreme for me. Paleo has been very comfortable for me…no hunger…no snacking…no craving. However, I think I should be at least 10 lbs. lighter. My TSH tends to test at the high side but I have never been on any meds. I also have no gall bladder but this doesn’t seem to have affected my fat processing. I have no health issues that I know of.

    After VLC for many months, even though I feel great, I am becoming concerned about this lifestyle longterm. I am trying to follow your plan to cut back on fat and up good starches, and will try a little IF also. I am also taking all of the supplements you have suggested.

    I still cannot walk for exercise, but I can do upper body resistance training and am beginning that.

    What I eat…I haven’t been able to get my carbs up to your suggestions for a 1200 calorie diet but I do add up to near 600 calories with protein and carbs. Here is what I am doing:

    Calories (not counting low starch veggies)
    1240
    Fat calories 358 (inc. 1 T coconut oil, 1 T butter)
    Carb calories 211 (inc. 1 cup berries, 4 oz. tuber)
    Protein calories 352 (inc. 3 eggs, 4 oz. salmon, 4 oz. beef

    54% fat
    17% carb
    29% protein

    I will have blood work done in about 6 weeks. If you are still interested in how the PHD works with older sedentary women eating fewer calories and less fat, I will keep you posted.

  14. Hi Paul,

    In the past (pre PHD), I have done 24* hour fasts (water only, no cals) once or twice per week.
    (*not too strict on 24h, could be a bit less or a bit more).
    I did these for two main reasons; 1. they made me feel better, you feel like you are giving your ‘insides’ a rest (a day off if you like) 2. to drop body fat that i may had inadvertently put on for one reason or another.

    You mention the same type of fast in your book; pg260 “dinner to dinner” fasts (I am assuming the dinner to dinner fast is a ‘water-only’ fast).

    If doing this type of fast once or twice per week (max), should i still try to get the min 50g carbs and 600 carb+protein cals from the Dinner meal?

    I should add (as it may influence your answer), that on the non fast days i will eat normal PHD, where i get on average 700 to 800 carb+protein cals per day (& always more than 50g carbs p/d).

    Ps. And a big thank you from me (to add to the other supporters of your blog) for all your good work. I have been following the last few posts closely and look forward to your Dr Rosedale post.

  15. Hi Nancy,

    Please do keep us posted, I would love to hear your progress.

    Hi Darrin,

    Yes, you should still get appropriate nutrition even while fasting. On 24-hour fasts, I would still reach minimum carb+protein levels in the single meals.

  16. Something is amiss. I keep getting notice of a new post but there isn’t one!

  17. Hi Kris,

    A spammer left some spam comments that I deleted.

    Best, Paul

  18. Hi Paul,
    That explains it! Thanks, kris

  19. Hi Paul,
    Simple question, but i expect not a simple answer….

    To lose (burn) body fat, do you first need to deplete all your glycogen stores?

    Would the persons’ current body fat percentage be a factor; ie. would “things” change between people with different BF percentages?

  20. Hi Darrin,

    Short answer: No.

    Liver glycogen is used to maintain blood glucose, muscle glycogen for exertion. You can lose weight even if you eat enough carbs to maintain liver glucose and don’t exercise.

    No, body fat percentage isn’t a factor directly; except indirectly, in that at some point adipose cells become insulin resistant and that changes the dynamics. What matters are the various pathologies that can occur in obesity, up to and including diabetes.

  21. Hi Paul — I’m very interested in weight loss, but I’m also hypothyroid. My fear is that if I lower my fat calories, I won’t maintain even the low temperature (96.8) I currently have. Is there any basis to my fears?

    Also, I heard somewhere that dietary fats (not fats from adipose tissue) are required to absorb vitamins and minerals, i.e. from supplements. What are your thoughts on that?

    Thanks, I do appreciate so much your responsiveness!

    Kathy

  22. Hi Kathy,

    It’s actually carb and protein intake that drives thyroid hormone levels — when carb and protein are deficient, T3 thyroid hormone levels are lowered to conserve lean tissue and glucose. So replacing some fat with carb and protein will probably raise your temperature. Be sure to tend to all the thyroid-relevant micronutrients too.

    You may wish to read the posts in our “Hypothyroidism” category, we have a lot of them.

    Dietary fats are required to absorb fat-soluble nutrients, but you don’t need a huge amount. For a restricted diet of only 1300 calories, we would suggest something like 400 carb calories, 300 protein calories, and 600 fat calories. This is more than enough fat to absorb nutrients. Take vitamins with meals.

    Best, Paul

  23. Hi Paul,

    congratulations on recognising that calories DO matter with weight loss. Sure, the other factors you mention may slightly alter metabolic rate (which therefore affects calorie expenditure), and repartitioning (i.e whether weight loss comes from fat or lean tissue), but it still amounts largely to energy balance.

    Lyle McDonald has done an excellent series on the intricacies of the energy balance equation that accounts for this, and basically alot of low carbers (or ‘MAD’s as Colpo would all them) really dont understand how many factors can be at play in energy balance. If they did, they would see that it does encompass things like thermic effect of different macronutrients, alterations in base metabolism for various reasons, etc.

    Colpo has highlighted the fact that most studies that show low carb leading to greater weight loss than mixed or high carb diets are guilty of one or more of the following problems: a) not being controlled properly, b) not being calorie-matched, c) do not look at WHAT exactly is being lost (i.e water, glycogen, fat, etc.), and d) not looking at the long-term results. In the few metabolic ward studies that have been done in this area, 99% of them show that where calories are matched low carb vs other diets do not lead to any greater FAT loss, and most long term studies do not show a difference in long term weight loss or if there is its statistically insignificant.

    I look forward to seeing the weight loss e-books

  24. Thanks, Paul, for your thoughts. Now just to make sure I understand this, you are saying the 1300 calories are the “meal” calories in the 8-hour window, and don’t include the coconut oil (or other “fasting foods”) in that total. Is that correct?

    And yes, I’ll read the hypothyroidism posts!

  25. Hi Kathy,

    Ultimately, this comes down to some self-experimentation. Everyone is a bit different in calorie needs, activity levels, and how they respond to intermittent fasting and ketones.

    I think it’s hard to be well nourished on less than 1300 calories from meals. For that reason, I think it’s good to get 1300 calories in the 8-hour window from nourishing food. However, coconut oil if you take a lot during the fast can add a lot of calories; depending on your nature (eg, how it affects hunger and energy levels) this could help or hinder weight loss. It takes a little experimentation to see whether intermittent fasting is right for you, and how much coconut oil or MCT oil you would need during the fast to avert hunger, and how this affects your weight loss.

    For some people this strategy works great; see Jay’s story, http://perfecthealthdiet.com/?p=5181. For others, especially diabetics with disturbed glucose regulation during fasts, it may be better to eat 3 meals. I think you have to experiment and find what works best for you.

    Best, Paul

  26. Dr. J I apologize if you’ve discussed this before, but how do you feel about carb cycling? Basically a few days you eat VLC and the others you eat more starches?

    I just feel like that would be easier than having me fast every morning, but if it is important to eat starches every day, then that is probably the only way to lose the weight.

    Also, is it okay to use ghee for stir frying? I know a lot of cookbooks say to use peanut oil, but that’s bad stuff. Any other suggestions? Beef tallow is in short supply here, so I’m looking for something with a high smoking point that won’t hurt me.

    Thank you!

  27. Oh and one more thing….do you ever advocate eating small meals throughout the day instead of two big meals? Will I hurt myself in some way if I do five or six meals a day? I know it increases insulin each time you eat, but if you’re only eating a small handful each time then wouldn’t less insulin be produced and dissipate quicker giving you more fat burning time? Just a thought I’ve been wondering about. Thanks again.

  28. Hi Paul,

    great clarification on how to target the PHD for fat loss. As i have commented previously, the fact you suggest calorie deficit is a must is refreshing and an inconvenient truth for many alternative health followers.
    Also, its even more gratifying to see you suggest the calories should be cut from fat, not carbs. You gain my total respect for that one! I can totally agree with this for two reasons:
    a)Its a fundamental fact in biochemistry that fat metabolism is the most efficient and complete with sufficient glucose.
    Yes, i realise fat metabolism is obviously possible without glucose via ketosis, but i really dont see the need to enter a ketogenic state for the purpose of fat loss, although i think ketosis has much potential for multiple therapeutic purposes. Guys like Anthony Colpo have thoroughly analysed ketogenic diets for fat loss, and they do not fare any better than similarly calorie-restricted diets where protein is matched.
    b) Also, the excellent research of guys like Lyle McDonald has shown that in a eucaloric or hyper-caloric state, fat is the most likely macronutrient to be stored as fat, because it requires the least amount of conversion in metabolic pathways to be stored in adipose tissue.

    This brings me on to a question i have – what is your opinion on saturated fat intake during a fat loss diet?
    People like Lyle McDonald and Ron Rosedale (Lyle would hate me for mentioning his name in the same sentence as Rosedale – lol) have highlighted compelling evidence that
    1)a high saturated fat intake can impair insulin sensitivity, possibly due to the way saturates alter signalling on cell membranes;
    2) once dietary saturated fatty acids become stored in adipocytes (i.e fat tissue), they are the most resilient to being liberated again from said adipocytes. This is compared to unsaturated fatty acids which appear to be mobilised much easier from adipocytes.

    McDonald suggests a high saturated fat diet could lead to stubborn fat deposits because of this (which are not noticeable until someone tries to get seriously lean), and Rosedale suggests removing long chain saturates as much as possible during the first 3 weeks of a fat loss diet to maximise fat mobilisation.

  29. Hi Rob,

    Saturated fat seems to impair insulin sensitivity in cases of energy excess but promotes a lean (more muscular, less fatty) body composition in states of energy scarcity. In general I think it’s beneficial for weight loss to eat a saturated fat rich calorie-restricted diet.

    Polyunsaturated fats are generally burned quicker, but this is desirable since they are the least healthy – you want to dispose of them via oxidation if possible. Saturated fats are benign and useful, so it’s good to preserve them.

    I would emphasize minimizing omega-6 fats and would recommend saturated fats for weight loss.

    Best, Paul

  30. Thanks for the response Paul. I have already gone to great lengths to minimise my omega 6 intake, and i am definately noticing less inflammation and pain at sites of my old powerlifting and weightlifting injuries (i.e hip, knees, and shoulder). Unfortunately this has meant consuming a lot less nuts and seeds, and nut / seed butters which i used to enjoy 🙁

    So, the way i understand what you are aying is the problematic effects of high fat intake on body composition (i.e fat: lean mass ratio) are only really expressed with too many calories being consumed.

    Do you think the insulin sensitivity-impairing effects of saturates (on a hyper-caloric diet) are responsible for their imapired mobility out of adipose tissue?
    To put it another way, is it the insulin resistance itself that is inhibitng saturates from being able to be released from storage? Or is there some other effect of saturates (apart from the insulin resisntace problem) that reduces their liberation from fat tissue?

  31. I feel the low-carb approach is useful for many but not a panacea by any means. For those on SAD or recently traumatized by a recent bout of extremely low-fat, low calorie dieting, LC with unrestricted calories can be a very helpful and comforting way to bring back some balance. And for those who are efficient at making glucose, this might even be a viable long-term approach.

    The problem is, while reducing carbohydrates controls appetite in most people, it’s not always enough to lose weight in the long run. This is especially true for small people who really enjoy eating (like me!). I’m a 125 lb. woman and need to eat very small portions in order to lose weight (I know I’m not fat, but I look and feel better a few pounds lighter). Recently VLC has been doing nothing for me. Actually I gained a few pounds from it over the past couple weeks, because it wasn’t supressing my appetite like it had in the past (I assume because I’m 43 now, with all that entails). The last couple of days, I tried adding small amounts of sweet potato and butternut squash, and guess what? I feel better AND my cravings are significantly reduced. I don’t know what was causing the extreme cravings, but I am surmising my body’s just not as good at converting fat and protein to glucose as it used to be. Even after 10 days on VLC, I still wasn’t getting appetite suppression, and under these circumstances, eating all the butter and bacon I wanted turned out to be a big mistake 🙁

    There is no one size fits all for weight loss. We should have a tool-box of different solutions available and vary them according to our goals and how our bodies are responding at the moment.

    From a purely physiological perspective, most diets probably fail because they are usually just SAD with the calorie count and macronutrient ratio tweaked. However, lack of social support may be the most significant challenge to weight loss. Sharing meals is crucial for our health and well-being, and eating non-SAD often leads to isolation, psychologically if not physically. If you live alone like me, it’s even worse. Sitting at home alone, obsessing about what I should or shouldn’t eat makes it very hard to take advantage of certain natural functions like forgetting to eat when I’m not really that hungry. On top of that, in the absence of meaningful social contact, food can be very comforting, so dieting on your own, ten feet from the refrigerator, can be a challenge. I believe the social factor is hugely underestimated. This is why it’s so important that people are educated on a large scale about healthy eating.

  32. Hi Paul,

    If I decide to lower my calories down to about 1200 and do some IF days with coconut oil, do I need to add some days/meals with higher calories so as to not lower my metabolism, or because I’m getting enough of everything I need metabolism lowering won’t be much of an issue? Later, would I need to gradually increase my calorie intake so as to not regain fat once I’ve met my goal? If so, how gradually?

    Sorry if you’ve answered these questions already and I’ve somehow missed that.

    Thanks 🙂

  33. Hey,

    What about some fruit if you’re trying to lose weight? Does that hinder fat burning?

    Thanks, Jasmin

  34. Dear Paul…..Enjoying this way of eating… My question is regarding having no gall bladder are there any supplements I should be taking to help with utilising the vitamins from my food. Is it helpful to be taking choline and inositol 250mg each combined into one supplement in which I take 2 daily? Is it more difficult to lose weight without a gall bladder.

    Thanks, susan

  35. Because fructose is converted directly to fat in the liver?

  36. Hi JP,

    A modest amount of fruit is OK — up to a pound a day. I wouldn’t make it a staple calorie source.

    Hi susan,

    You may need extra supports for bile production – vitamin C, taurine, and cholesterol. To get an acute dose of bile with a meal, there might be some benefit to ox bile tablets.

    Choline and inositol are good for everyone, especially choline.

    I am not sure what the effect of gallbladder removal on weight loss is.

  37. Hi,
    I eat salmon and ground beef every day. But in addition to the 400 carb calories and 300 protein calories I’ve found out that I just consume ca. 250 fat calories. It’s definitely below 1200 calories. So shall I eat additionally 2 tablespoons fat (coconut oil) to reach the minimum? And how to fry salmon or vegetables without fat? Cooking with water instead?

    Thx, Jasmin

  38. Hi Jasmin,

    I wouldn’t add “empty” calories. The 1200 calories number is not the target to aim for, it’s only a rough estimate of how much you will eat if you are getting all the micronutrients you need from food. That requires eating a bit of fat, eg 2 egg yolks a day for choline.

    I would suggest two changes:
    1) Don’t fry. Rather cook meats and vegetables in bone broth, and eat them as soups.
    2) Eat 2 eggs a day. They can be added to your soups too and cooked in the soup.

    I really like bone broth as a nutritious replacement for water.

    I think these steps would probably help you lose weight faster.

    Best, Paul

  39. And which meat is best? Fatty or protein-rich meats? One or two meals per day?

  40. Hi JP,

    Focus on low-omega-6, high-nutrient-density meats. So, fish/shellfish and ruminant meats (beef, lamb, goat); eat organ meats as well as muscle meats.

    Fat content – whether the meat is fatty or lean is less important than the quality (nourishing, low omega-6). However, low-fat meats if they’re nourishing will promote weight loss. Shellfish and organ meats meet that description.

  41. RE: Maggy C.

    I may be the only person in the world this happens to, but the smell of Hazlenut coffee actually immediately gives me a splitting headache.

    @Maggy C.,

    I haven’t actually noticed a headache, but I cannot STAND the smell of hazelnut coffee!

    Unfortunately, my husband (and grown kids) LOVE it.

    Fortunately, my husband is kind enough to not ask me to brew it at home. 🙂

  42. I’m not sure how health this version is, but this diet is similar to a bodybuilding competition diet. Which is low fat, very high protein, decent amounts of carbs, This obviously works for getting dam low in body fat under 10%…. This has been a staple for fitness models and bodybuilders for decades.
    What do you think of this style of diet?

  43. Hi Park,

    Yes, this general approach is good for body composition, that’s why it’s a good weight loss diet with calorie restriction.

    However, our approach is not particularly low fat. At restricted calorie intake it has to be a bit fat restricted, but at higher calorie intakes it could be 50% fat and still be a very good bodybuilding diet.

    As long as the food choices are nourishing, covering all the needed nutrients and in proper balance, then it’s a good diet.

  44. Is the Randle Cycle anything to be concerned about doing this style of diet?

  45. Hi Brandon,

    Our diet is basically designed to minimize invocation of the Randle cycle by providing metabolic substrates in the proper proportions to meet the body’s needs and be incorporated into tissue. We indirectly discussed the Randle cycle by talking about why an excess of metabolic substrates causes leptin and insulin resistance in this post: http://perfecthealthdiet.com/?p=1933.

    Best, Paul

  46. Paul, How would you consider this compared to your weight loss plan. This plan has allowed me to stay very lean most year around. 30-60mg cardio empty stomach each morning.
    diet: 45:35:20 for protein’s, carbs, and fats, at a daily calorie intake of around 16 calories per pound of bodyweight, which is just shy of 3000 calories a day, at 330 grams of protein (55g every 3 hours), 256 grams of carbs, with 50% split between breakfast and post-workout (65g each), and the rest distributed evenly across the other meals (42g in 3 more meals), except for my final night time meal), and 65 grams of fat, split evenly throughout the day, (11g in every meal).

    thank you

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