When I put out the call for what people wanted to read about on this blog in 2009, numerous folks commented that they would like to know why it seems so much more difficult to successfully follow a low-carb diet the second or third time around.  Over the years I’ve noticed this phenomenon in myself and in many others whom I have treated or advised, so it’s truly a subject worthy of exploration.

I’m going to list the reasons experience has taught me below, starting with situations over which we have no control and ending with those over which we have total control.

Aging

We all get older every day.  Sadly, with aging, all systems deteriorate.  Some slower, some faster, but all get a little older and a little less functional every day.  If you achieve success on a low-carb diet and find yourself 70 pounds lighter, you’ll also find your self five or six months older.  If you regain that lost weight, then decide to start another low-carb diet to re-lose it, you will probably be a couple of years older than you were when you tried your first low-carb diet.  Just as it’s a little more difficult to pick up tennis at age 46 than it is at age 44, it’s a little more difficult to get everything moving with a low-carb diet when you’re a couple of years older.

Built-in survival mechanisms

Although most dietary recommendations are fairly simplistic, our bodies are unimaginably complex.  Not only do we have a complicated metabolism centered around and directed by the liver, we have multiple neurological and endocrinological feedback pathways between the liver-directed metabolic system and the central nervous system.  And we have gut hormones that get into the act sending signals of fullness or lack thereof.  It is an intricate system designed to allow us to survive on all kinds of food and to keep us alive as long as possible in the face of famine.  I like to think of this entire interconnected system as having its own memory.  It will allow you to fool it once or maybe twice, but then it gets wise.

Almost everyone who starts any kind of diet for the first time sees pretty rapid results.  Pounds seem to fall off quickly and effortlessly.  At a point down the way in the diet, it starts becoming progressively more difficult to lose more weight because the body starts catching on to what’s happening and starts fighting back.  This phenomenon seems to occur less with a low-carb diet because if it is a good quality low-carb diet, the body is getting all the nutrition it needs, so it doesn’t rebel quite the same as it does with some other nutritionally inadequate diets.  But it does rebel a little, nevertheless.  And worse, it remembers.

If you lose weight then regain it and restart a low-carb (or any other) diet, the body is not quite so willing to shed the first pounds as quickly as it did the first time.  It remembers.  If you, like many people I’ve met do, give low-carb a serious, diligent go for about a week, then fall off because of a party, wedding, etc. that you attend, then try again for another week before falling off, you program your body to hang in there for at least a week before letting loose its fat.  The body says, ‘Well, here we go again with another week of this nonsense.  Let’s hold steady on and we’ll be back to our regular high-everything diet within a week.  Let’s not go into starvation mode yet and starting getting rid of our fat.’  What you will find after a few turns of this cycle is that although the first time through with low-carb you may have lost six pounds the first week, the forth time through you will lose almost nothing the first week.  Then the doubt creeps in.  And you begin to wonder if the low-carb diet will really work for you.  It will, but you’ve got to get past the body’s diet memory for it to.

Increased insulin and leptin resistance

All the studies aren’t in yet on this issue for sure.  But, those that are (both animal and human studies) indicate that we become progressively more insulin and leptin resistant as we age.  This is especially true for people who have become overweight or obese and have maintained that state.  Sadly, it is also true for those who became overweight or obese and lost the excess weight, which is most of us.  The more insulin and leptin resistance we are, the more difficult it is to lose weight.  So, the increase in this phenomenon just from the years passing between the first go round and the second on a low-carb diet makes it a little more difficult the next time.

Hormonal dysfunction

Women who are wildly successful on a low-carb diet when they are in their 30s or 40s and premenopausal then try again when they are in their menopausal years often find it almost impossible to lose.  It requires fiddling with hormone levels by replacing with natural hormones and getting the system back into balance before a lot of weight can be lost.  It takes a while to do this.  Even if the hormones do get back to where they need to be quickly, it takes some time for the body to respond.  Often just getting the hormones balanced results in weight loss spontaneously without dieting.  But dieting helps the process along more quickly.

Now we get to the issues that we do have control over.  I don’t want anyone to be offended by this list or think I’m pointing any fingers because I’m not.  But I would guess that I’ve (MD and I as a team) taken care of more overweight people on low-carb diets than anyone alive today.  We’ve had thousands and thousands of patients in our clinics and we’ve dealt with many others second hand through books, lectures, etc.  And we’ve had many friends, relatives, friends of friends, associates, etc. whose care we have monitored.  In shepherding all these people (not to mention ourselves) on low-carb diets, we have learned a few things.   What follows is a summary of what we’ve learned.  Not about the biochemistry and physiology of low-carb dieting, but about the psychology of low-carb dieting.

Lack of commitment

It has been my experience that people just don’t seem to commit as strongly the second, third, etc. time around.  The first time, people make a major commitment.  They lose weight.  They feel better than they have in years.  They are excited.  Then they either stay continue on their low-carb diet and maintain or they don’t.  If they don’t, the weight comes back.  Then a couple of years later when it’s time to start again, they just don’t have the commitment they did the first time around.  And, due to the above reasons, it’s a little more difficult the second time around.  They never really get into the swing of it like they did the first time, and then the notion that maybe it won’t work starts to gnaw.  And then they start doing a ‘half-fast’ (if you get my drift) low-carb diet, which works okay for maintenance, but not for weight loss.  Discouragement sets in, and they bolt from the diet.  I’ve seen this cycle in action countless times.  Don’t fall into it.

People learn how to cheat in their first low-carb go round and remember how when they start again

The first time around on a low-carb diet is exciting.  You’re actually getting to eat all these forbidden foods – steak, eggs, real butter – that you’ve been taught make you fat and are losing weight like crazy.  It’s unbelievable.  But sooner or later, you get a little weary of steak, eggs and real butter, and you start looking to expand your food choices.  If you stay on your carb restriction, you start to figure ways that you can keep carbs low, but eat facsimiles of the high-carb foods you enjoyed before you started your low-carb diet.  You make the major discovery that low-carb brownies exist (or at least they call them low-carb brownies) so you give them a try.  Then you find out about low-carb waffles, pancakes, bagels, etc.  You discover that there is a whole low-carb world of what you’ve always thought of as high-carb foods.  You are in heaven.  You can have your cake and eat it, too, so to speak.  But around about this time, the weight loss starts to really taper off and maybe even comes to a halt.

A few years later, you’ve regained your lost weight plus some, remember how effortlessly you lost it on a low-carb diet, and decide to do it again.  But this time, instead of starting with the steak, eggs and real butter all alone, you stock your low-carb larder with low-carb brownies, bagels, chips, and other junk as well.  Strangely, the low-carb diet just doesn’t seem to work as well this next time around.

If you want to be successful the next time around on a low-carb diet, you’ve got to follow a low-carb diet.  And it takes commitment.  You’ve got to realize it’s going to be a little more difficult than it was the first time, and you’ve got to go on an honest-to-God low-carb diet filled with quality low-carb real foods.  And you’ve got to stick to it.  You want to hang in there until you get to what was called in the old medical literature the dynamic weight stage.  The dynamic weight stage is when weight is changing rapidly in either an upward or downward direction.  Anyone who has gained or lost a lot of weight has experienced this. You can gain rapidly once you get into this phase, but ultimately you stabilize and hit the static weight phase.  It works the same going the other way.  Once you get your weight loss momentum built up, you seem to lose effortlessly while in this dynamic phase.  This is where you want to be.  But you have to commit for a few solid weeks to get there.  You can’t just diddle with it, go on a few days and off, fill up on calorie-dense, low-or-no-carb junk, say you’re doing a low-carb diet, and wonder why you aren’t losing.  You’ve got to get up into the low-carb saddle and ride.

In the next post in this series of two, I’ll present some tips that have helped me enormously and have helped others achieve the level of commitment needed to see us through years of low-carb dieting.

In the above list of reasons I think the low-carb diet (or any diet) is more difficult the nth time around, I’ve probably forgotten something.  Which is why I rely on you and your comments to fill in the missing info.  If you have reasons I’ve not mentioned, send them in.  Don’t be shy.  Or if you disagree.  Let me know.  I’ll be eager to hear from you.