I love analogies. They help me think about and explain complex ideas in easy-to-understand ways. As you may know, for years I’ve been interested in strategies for helping patients lose weight and improve their health. In my last blog I discussed the fundamental metabolic state for weight loss, ketosis. If you missed it, I’d encourage you to check it out here. Today, I’d like to discuss the “levers” of weight loss. I like this analogy because I think of levers as something we can push, pull or make fine adjustments to. We can pull hard, pull a little, toggle back and forth, etc. From a nutrition perspective they allow us to make the right adjustments for the goal we are trying to achieve.
When I think about all marketed strategies for helping people achieve a healthy weight, my mind swims with all the possibilities. The list seems endless and often leaves patients feeling confused and uncertain. However, the reality is that most strategies have common fundamentals that anyone can apply and be successful.
Let’s start with the basics. All food is broken up into like components. From a broad perspective these include macronutrients and micronutrients. Macronutrients include carbohydrates, protein and fats and provide energy in the form of calories which allow our bodies to move and our organs to function. Micronutrients support our biochemical processes and include vitamins, minerals and trace minerals. All food has a certain proportion of each of these constituents, some more, some less.
Macronutrients provide fuel for our cells and therefore contain the calories that we either burn as energy now, or store for times when food is less abundant. The manipulating our diet to have a certain proportion of these macronutrients is what fosters weight gain or weigh loss. I think about carbohydrates, proteins and fats as being levers that we pull (really eat) which makes up our daily diet. For example, when we pull the carbohydrate lever over fats or protein, we fill our glycogen stores and if pulled hard enough we gain weight by carbohydrates conversion to fat. This is pretty typical for the average American as evidence by our growing obesity epidemic.
Levers in Weigh Loss
If pulling the carbohydrate lever too often leads to weight gain, then pulling the fat or protein lever must lead to weight loss. Right? Well, it depends. I find that high fat diets may work in the short run but are often difficult to follow as a lasting approach. So what lever do I start with?
I prefer to focus on protein as the foundation of any weight loss program. This macronutrient is critical for preserving muscle and organ structure, while allowing for a slow release of glucose into the blood stream which prevents blood sugar highs and lows. It also prevents “falling off the wagon” by curbing hunger and cravings.
The preferred amount of protein intake depends on gender, body size and amount of daily physical activity. In general, I recommend 70-80grams per day for women and 80-100grams per day for men in weight loss. This yields about 280-360 calories and 360-400 calories, respectively. As a lever in weight loss, this macronutrient is kept mostly constant from day to day and is the foundation of daily intake.
Dietary fat, while often vilified decades ago, is essential for weight loss. It helps sustain an energy balance and maintain a state of ketosis for optimal body fat loss. I like to have patients toggle this lever depending on the amount of physical exertion or activity for the day. For every 100 calories burned, I ask patients to increase their fat by one serving. This typically helps them burn fat over glucose and prevents craving and hunger associated with higher levels of activity. It must be noted, however, that I only recommend low intensity exercise during weigh loss as higher intensity exercise demands an easier consumable form of energy like sugar.
Lastly, carbohydrates must be in the form of complex carbs, replete with fiber and micronutrients. Weight loss is a perfect time to learn to eat and prepare veggies while minimizing fruit and other starchy vegetables and grains. I typically ask patients to avoid these all together during weight loss and formulate a plan for reintroduction once a healthy weight is established. I recommend a net carb (carbohydrate minus fiber) intake of less than 100grams per day. This lever, can be tweaked up or down based on how the weight is or isn’t changing.
So, if your goal is weight loss, pull the protein lever first, toggle the fat lever based on activity level and keep the carbohydrate level set low with a preference for high fiber foods to achieve a healthy weight. Once the weight comes off, you can make small adjustments to find a balance of that supports maintenance of your new weight for the long run.