Shocking Weight Loss

After thirty years of treating patients who came in frustrated with weight that would not move, I will tell you what almost nobody in the diet industry will. Your body wants to stay exactly where it is. It is built to. The technical term is homeostasis. The everyday translation is, the body keeps the body the same.

That is great news when you are healthy. It is terrible news when you are trying to change anything.

Why your last diet stopped working

If your last weight loss attempt got you a quick four or five pounds and then stalled, you are not lazy, you are not broken, and your metabolism did not die. Your homeostatic set point kicked in. The body adjusted to the new caloric intake, dropped resting metabolic rate to match, and put the scale back on cruise control. This happens reliably around the three to six week mark on almost any monotonous diet.

The way out is not to grind harder on the same diet. The way out is to change the input enough that the body has to recalibrate.

The radical change protocol

Take a hard look at the last serious diet you ran. What did you eat, when did you eat it, and how much. Now do something genuinely different for two to three weeks.

• If you went heavy on fruit and nuts, switch to a meat and vegetable plan with no fruit and no nuts.
• If you ran a high protein Atkins style plan, switch to a Mediterranean style with vegetables, olive oil, nuts, and oily fish.
• If you lived on protein bars and shakes, switch to whole food. Fish, eggs, vegetables, a small amount of whole grain. Watch the portion size on the grain, it adds up faster than you think.

Whatever you do, deviate sharply from what you have been doing in terms of what, when, and how much. Do not increase total calories. The goal is to disrupt the rhythm the body has settled into. This is not a long term diet. It is a metabolic reset that opens the door for the real plan that follows.

Then transition into the actual plan

After two to three weeks of the disruption phase, transition into a sustainable eating pattern you can hold for months. For most people in their fifties and sixties that is a Mediterranean style plan, with controlled portions, real fat from fish and olive oil, moderate protein, and limited refined grain. That is the plan you stay on. The disruption phase only exists to break homeostasis. The maintenance plan is what actually changes the body composition over time.

The exercise question

I get an email a few times a month that goes something like, “Doc, I read on a diet site that exercise does not matter. They said if you eat the right foods, the weight will come off.” Honestly, this is wishful thinking dressed up as nutrition science.

You can lose some weight by eating well. You can sometimes keep it off. But if you have a real weight problem, not just five vanity pounds, you will need exercise in the routine or you will always be heavier than you want to be. The two main reasons are simple. Exercise preserves lean mass when you are in a caloric deficit, which keeps your resting metabolic rate up. And exercise blunts the homeostatic set point shift that diet alone cannot.

The most efficient form for body composition in the over fifty crowd is resistance training, two to four sessions a week, with one or two short interval sessions added in. Long slow distance cardio is fine for general health and stress relief but it is not the lever for fat loss in this age group.

What to do this week

• Write down what you ate last time you tried to lose weight, then design two to three weeks that look nothing like it.
• Commit to a maintenance plan you can hold for six months, not six days.
• Add two resistance sessions a week. If you have not lifted in a while, start with a trainer or with a bodyweight plan and ramp from there.
• Stop worrying about whose fault it is. The body in the mirror is the only one you get to negotiate with.

The body wants to stay the same. Your job is to give it a reason not to, and then a reason to settle in at a new set point. That is the whole game.

— Doc