October 29

Changing perceptions of obesity


I’m going to start this post with a few questions that I want you to seriously consider before you answer and read on.  Are you overweight?  If so, how much overweight?  What do you think your ideal weight should be?
Think about these questions seriously and answer them before moving on.  You don’t have to tell anyone the answers, but the answers to these questions will focus your attention more on the subject at hand.
It’s been my experience, gained from almost three decades of caring for overweight patients, that most overweight people seriously underestimate the amount of excess fat they’re carrying.  This was really brought home to me a few years ago when I was involved in a lawsuit (a business lawsuit, not a malpractice lawsuit, in case you’re wondering) and hired arguably the best attorney I’ve ever worked with.  This guy was a real magician.  It was almost as if he had a spy in the courthouse and in the opposing lawyer’s camp.  He knew everything that was going to happen before it happened; he predicted every ruling from the judge before it ever came down.  He was truly amazing.  And he was truly fat.
He was one of those guys who carries most of his excess weight in the abdominal area.  And he had a world-class abdomen that cantilevered over his belt.  He actually would move it around with his hands when he turned.  Based on many years of observing overweight people and developing a real knack at guessing their weights, I figured that this guy was toting around at least an extra 100 pounds. Although this lawsuit had nothing to do with my practice of medicine or our books, this lawyer knew what I did, and we talked about it on a number of occasions. Several times during these discussions we had about obesity, he remarked that he, himself, needed to lose about 30 pounds.   Thirty pounds?!?!?!  If he lost 30 pounds it would have been a step in the right direction, but he would have had a long, long way to go to get where he needed to be.  This guy could outsmart everyone he dealt with in the legal community in a large metropolitan area, but didn’t have a clue as to how obese he was.
I use this lawyer as an example because he was so observant and so able to pick up on nuances and subtleties in the legal world around him, but couldn’t pick up on his own excess belly fat, which was far from nuanced or subtle.  And he isn’t alone.  When patients come to see me about weight loss, I always ask them how much they want to lose.  Invariably it’s a lot less than my expertise would tell me they need to lose.  People just don’t view themselves as being as overweight as they really are.
A recent paper in the British Medical Journal (full text here) confirms my own findings.  Although this study didn’t evaluate the amount subjects thought they were overweight (i.e., they weren’t asked how much they thought they should lose), they were asked whether they were overweight or not.  And as the obesity epidemic has worsened, the number of obese people considering themselves obese has fallen.  Why is this?  Why, when more people are overweight than ever, would fewer people consider themselves overweight?
Another recently published paper may help us with the answer.  The June issue of the International Journal of Obesity (IJO) contains an enlightening paper titled “Do you see what I see?  Weight status misperception and exposure to obesity among children and adolescents” showing that children and adolescents who live and/or spend considerable time in environments in which there is a lot of obesity, tend to consider the obese state more ‘normal’ than those who spend time in environments without so much obesity.  Why shouldn’t the same hold true for all of us who spend our time surrounded by people in various stages of overweight come to the same conclusion?  In my youth, obesity was the exception – now it’s the rule.  When I was a kid almost all kids were thin and so were most adults.  Overweight people stood out.  Now it’s the lean and healthy people who stand out.
In the IJO study, children and adolescents were measured to determine their weight status (using, unfortunately but as expected, BMI as a measure of overweight) then the researchers asked these kids to pick out their own profiles from a standardized series of body shapes of boys and girls.  (The body shapes used are at the top of this post.)  Obese kids growing up in homes with obese parents or who have many obese friends tended to point out the silhouettes of thinner children (the ones in the middle of the series) as being the most similar to themselves.  The reality was that these children looked much more like the children at the right side of the series.  Those kids with normal-weight parents and friends were much more accurate in their selection of their own body shapes.
All of which confirms the idea that people tend to view as normal that which they see all the time regardless of whether it is really normal or not.  In today’s society obesity is rampant, and not just in the people we see wandering around the malls and at the fast food places.  We see obesity on television in the form of John Goodman, Rosie O’Donald, Roseann Barr, Cedric the Entertainer, and a host of others including Oprah now.  Television commercials are now filled with ‘normal’ looking overweight people of both sexes.  I intended to roam through YouTube and find a number of them to put up to demonstrate the point I’m making.  But instead, I decided to do something a little different and a lot more fun.
As I said before, when I was a kid, obese people stood out and were noticed.  I thought back about television when I was a kid and tried to remember who were the fat people on TV then.  There weren’t many, but there were a few.  I was a huge Three Stooges fan as a kid and a sort of Laurel and Hardy fan.  (The Three Stooges and Laurel and Hardy films were all shot long before I was born, but in my youth, they were always shown on Saturday morning kid TV.)  I found a few clips on YouTube, and it’s really enlightening to look at these in view of what we consider obese today.
Oliver Hardy was considered grotesquely obese in his time.  When you watch the following short film, look at how obese he really was in terms of today’s obesity epidemic.  he’s obese, of course, but you could walk through any mall in America and see dozens of people much more obese than Hardy…but not in his day.
Another obese character from my youth was Curly Howard (Jerome Lester Horwitz), the zany, manic, overweight butt of all the Three Stooges jokes.  I remember Curly as being enormously obese, but looking at him in the clip below, he wouldn’t stand out in a crowd today.  In fact, he looks almost normal (as compared to today’s citizens, of course).
Although I was never much of a fan as a kid, my folks loved the Jackie Gleason show.  Jackie reveled in his obesity, and even went by the monicker The Fat Man.  He was thought of at the time as incredibly obese.  Take a look.
Amazing, isn’t it?  Again, you wouldn’t notice him in a crowd today.
I’ve gone on this trip down memory lane just to show you how the perception of obesity has changed over the years.  What was obese 50 years ago is kind of normal now.  Consequently, it’s easy to see how it would be easier to consider oneself normal when one is really overweight.  And it’s easy to see why a lot of people would think they have only a few pounds to shed when they’ve really got a few dozen.
Now, let’s go back to the question at the start of this post.  Are you overweight?  And if so, by how much?
In my years of taking care of patients, I’ve noticed that when asked what they would really like to weigh, men seem to go for their weight when they graduated from high school.  Women usually pick something they think is more realistic, say, for example, 120 pounds. The one thing men and women have in common, though, is that they both usually off the mark.
In my opinion the very best way to determine one’s degree of overweight and one’s ideal weight is to determine body composition and go from there.  And, in most cases, the ideal weight is a moving target.  Let me explain.
Ideally, men should carry around 15 percent of their weight as fat, and women should carry about 20 percent.  So, the first step in determining one’s degree of overweight is to determine the amount of body fat and lean mass that composes one’s body.  This can be done using numerous methods, each with it’s own degree of accuracy and pain-in-the-buttness to do.  In our clinic we used a bioimpedence analyzer that was pretty accurate, but it had to be calibrated often, and the subjects had to be at a certain level of hydration to get an accurate reading.  The one we used cost about a thousand bucks back then – now there are a zillion available for anywhere from twenty dollars to a few hundred.  I’ve tried the less expensive ones just to check them out, and they don’t work for squat–i.e., their results are not accurate and reproducible.
When I wrote my first book Thin So Fast, I presented a set of tables and instructions for measurement of body fat percentage that were derived from a set of equations developed by Penrose, Nelson and Fisher.  Barry Sears picked up these charts from me and used them in his book The Zone.  MD and I used them again in Protein Power, so if you have a copy of that book, you can find them there.  We found these charts to be spectacularly accurate.  In fact, we used them whenever we thought our bioimpedence analyzer was out of whack.  We would have used them all the time, but they would have been to cumbersome with the patient load we had.
I need to make these equations to they can be in an online form, but I just haven’t gotten around to it yet.  In the meantime, if you don’t have a copy of one of the above books at hand, you can find a couple of reasonably accurate body composition analyzers here.
Once you’ve calculated your body fat percentage, you come up with your first ideal weight target.  Let’s say you are a female, you weight 195 pounds, and you’ve determined that you are carrying 35 percent body fat.  You do the following calculation (0.35 X 195 = 68.25) and learn that you are hauling around 68.25 pounds of body fat. If you subtract this fat weight from your total weight (195-68.25 = 126.75) you find that your lean weight (everything that isn’t fat) is 126.75 pounds.
Since, as a female, you should ideally have only 20 percent body fat, you can divide your lean weight by 0.8 (100 percent minus the ideal 20 percent body fat) to determine that your first ideal weight target should be (126.75/0.8) about 158 pounds.  Whoa there Nellie, you say, that’s way too high.  I want to weigh a lot less than 158 pounds.  I want to weight more like the 120 pounds I weighed when I got married.
Well, in order to weight 120 pounds, you’re going to have to lose some lean body mass, which you will as you lose fat.  But wait, I don’t want to lose lean mass, you say.  If you want to weight 120 pounds and your lean body mass all by itself weighs 126.75 as we calculated above, then it’s going to be real tough to get to 120 pounds without losing some lean mass.  At least 6.75 pounds’ worth.  But you’ve got to have some fat – around 20 percent, in fact, which is going to add more weight.  But don’t despair, because this first target weight is just that: the first target.
As you lose fat on your low-carb diet you will lose some lean mass as well.  Since your going to be lighter, you won’t need the same amount of muscle mass to support you, so you will naturally lose a little muscle mass.  You’ll also lose some weight from excess fluid and even some organ weight – all of which counts as lean body mass.  You’ll lose organ weight because for the most part a smaller body requires smaller organs.  After you’ve lost 20 pounds or so, it’s time to recalculate.  When you do you may well find that of the 20 pounds you’ve lost 14 have been fat and 6 have been lean (and by lean we mean anything that’s not fat).  Recalculating shows that now at your lower 175 pound weight (195 minus the 20 you lost), your lean body mass is 120.75 pounds.  When recalculated for ideal body weight (that weight at which you are at 20 percent body fat), you find that your ideal weight has gone down from 158 pounds to about 151 pounds.  When you lose another 20 pounds and recalculate, you may find your lean mass has dropped to 114, giving you a new ideal weight of (114/0.8) of 142 pounds. Since you’ve lost 40 pounds since starting, your actual weight at this time will be (195-40) 155 pounds, so you’re not that far off.  If you lose another 15 pounds, and 8 of that is fat and 7 is lean, you’ll have a lean mass of (114-7) 107 pounds.  Recalculating for ideal (107/0.8) will mean your new ideal weight is about 134 pounds.  And you’ll weigh (195-20-20-15) 140 pounds so you will be very close. You’ll have only 6 pounds left to lose.  But if you lose those 6 and 2 of them are lean, it’s recalc time.  Now your lean weight is (107-2) 105 pounds.  Dividing 105 by 0.8 gives you your new ideal weight, which is now 131 pounds.  And you’ll weigh 134, so you are really close now.  You’ll probably end up at about 130 pounds and 20 percent body fat, which will be perfect.  But you won’t know at the very start what this will be because, as I said, your ideal weight is a moving target.
The same works with men.  Just use the 15 percent body fat as ideal instead of the 20 percent I used in the example for a female above.  Go through the calculations and come up with your first ideal weight and go from there.
So, go back to the questions I asked at the start of this post and get to work.  Find out where you really stand in the obesity spectrum and start inching your way down.  And don’t think that just because everyone else is no fatter than you that you’re normal.  You may be normal in the statistical sense as compared to the rest of your countrymen or women, but it’s not normal you should be striving for.  You should be making a run at ideal.

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  1. OUCH. You are right, I did not think I had this much weight to lose.
    I currently weigh 158 and thought I needed to lose 20-25 pounds since I have never been able to get below 128 (in college) and was starving myself then to do it. And I thought I looked pretty good at 130. Turns out I need to lose more like 33, according to the initial calculations. That means I probably need to lose more than 33. Definitely more than I thought. Hopefully that will not be so hard on the low carb diet (I’ve already lost about 7 total).
    Hang in there. You’ve got the road map now.

  2. Hi Michael,
    Wow. You are absolutely right. I remember them being much fatter. They look rather normal now. Our perceptions are changing a lot.
    I have recently dropped from around 16% body fat to less than 8% body fat and many I see now think I am too thin. I think this is the same perception problem. When the majority are well over 20% body fat a very lean person does look very thin.
    Another piece of evidence on this is clothing. I have a very difficult time getting clothes that fit. I need 31″ waist and 34″ length and they never have them in the stores. I have to get them tailored or buy them on line. My guess is that 30 years ago there were plenty my size in stock.
    Great post.
    Thanks. I’m glad you enjoyed it.

  3. Great Post, Dr Eades.
    You wrote that you need to sacrifice lean mass to lose fat. While of course “partitioning” is a challenge, Intermittent Fasting seems to help tremendously with allowing you to lose fat while preserving muscle. Martin Berkhan at http://www.leangains.com has emphasized this approach with great results, and it’s worked wonderfully for me since beginning it as part of Evolutionary Fitness.
    I know you didn’t find Intermittent Fasting too useful for weight loss in and of itself, but athletic types seem to find it extraordinarily useful for the preservation of muscle while losing fat. Have you found that IF allows for better partitioning of fat/muscle when used in conjunction with a low-carb, paleo diet, AND a weightlifting/athletic regimen? If so, could you explain some of the reasons for its effectiveness?
    I haven’t had enough hands-on experience with IF (other than my and MD’s experience and what I read in the medical literature) to comment intelligently on what’s happening with the partitioning. From the website link you posted, it certainly appears that it’s working for those people. I’ll have to delve into it a little more thoroughly.

  4. I can certainly relate to this on a personal level. When I was at my heaviest, 193 lbs, I still thought of myself as just a bit chubby. Partly because I couldn’t face the fact that I had gone from being chubby to obese (I have always had a weight problem, even as a kid). But it also was because the rest of the world had changed and compared to alot of people I WAS still just chubby. I actually had a doctor tell me at that time that I didn’t have a weight problem. I loved hearing that. Later I saw a story in a local paper about this doctor that stated he was the only local doctor doing surgery to help obese patients lose weight. So I guess compared to his usual patients, I wasn’t that big (another example of the norm changing).
    All through my school years, the late 60s through late 70s, I was usually the only fat kid but I was not any where near the size you often see today. I often joke that I wish I had gone through school in more recent years because I wouldn’t feel so ostracized – I would be normal! That would make quite the difference to one’s experience of school.
    I have lost almost 35 lbs in the last year on low carb and have just starting being able to buy clothes in stores that are not for larger size people. Since I haven’t been this weight in at least a decade, I have started to think of myself as thin already. But that is just deceiving myself and have at least another 30 lbs to go. It is hard to see there is another extraneous 30 lbs here. But when I look at photos of myself the truth is revealed. Now I’m back to chubby and I can’t escape the fact that I have been obese!

  5. I had to laugh while reading this — it really hit home 😉 About 18 months ago, in my mid-50’s and after 15 years of fattening sloth, I decided I needed to lose about 30 pounds. It soon became apparent I was being way over-optimistic, and I upgraded it to 40 pounds. Then 50, then 55. It took some time to reach that, at which point it was obvious I was still fooling myself.
    Long effort later, after losing 85 pounds I’m finally close to what I believe is an ideal body composition for my age and build. Here’s the kicker: I found some weight percentile tables, and my weight has dropped from the 93rd percentile for American guys my age and height to … the 13th percentile! That’s how far from “normal” (in the statistical sense of median weight) an ideal weight can be: 87% of American guys my age and height are heavier than me. And it’s not that they’re more muscular, either — at a body fat percentage of about 12% now, I’m carrying more muscle than most of them despite being lighter than most now.
    On the other hand, if I had known 18 months ago that I would need to lose 85 lbs to get here, it would have seemed so overwhelming I might well have given up before trying. There’s something to be said for self-delusion as a motivational crutch 🙂

  6. What is the basis of your statement that 15% is ideal for a male? I’m 6’7″ circa 220 lbs and guess that I’m around 15%. I’ve been measured as a 9% body fat by bioimpedence at a weight of 200 lbs and think that 9% at about 212 lbs would be ideal for me. I’ve also read that at 12% the body is at its most anabolic i.e. its easiest to put on muscle, but I have know idea if there is any validity to that statement.
    I’ve stopped scrambling eggs based on our statements about the yolk oxidizing and am now doing them sunny side up. What do you think of hard boiled? I’ve been eating only meat and eggs for just over three months now – supplementing magnesium, potassium, omega 3s and vitamin D – any thoughts?
    The 15% figure for males is just sort of a rule of thumb. Most nicely built, normal males have body fat percentages in that range. Others who work out can go much lower, which isn’t a problem.
    If you scramble the eggs softly, there isn’t a lot to worry about. Just don’t scramble them until they bounce if you drop them. I think your diet and supplement regimen sounds fine. I don’t see a problem with meat and eggs. I take the same supplements you do except I throw in a multi and some lipoic acid.

  7. I believe another reason for the changed perception of obesity is related to how clothing is sized — as least for women — now versus then.
    Twenty-odd years ago, I wore a size 8 or a medium. I’m 5’7″ tall and weighed between 120 and 126 lbs while in my twenties. Now, at 45 years of age, I weigh 122 lbs and wear a size 4 or a small. I’m essentially the same size (admittedly a bit fatter and a little less lean than I used to be) but clothing manufacturers would have me believe that I’ve shrunk two sizes during the last two decades.
    For someone who wore a size 8 twenty years ago and wears a size 8 now, she may think she’s maintained her size, if not her weight, when she really hasn’t. The clothes have been growing larger right along with her.
    Such slipperiness in sizing may appeal to one’s vanity, but certainly doesn’t help one’s sense of reality.
    Interesting. I didn’t realize this about womens’ clothing.

  8. Thanks for a thought-provoking article, Mike. We’re from the same generation, you and I, and I can recall thinking as I watched these “fat guys’ on TV that they were, as you put it, obscenely obese. Funny but I look at the Jackie Gleason clip you have, and realize I wasn’t too far away from him weight-wise, but at the time thinking all I had to lose was a few pounds. Nice work.
    BTW, on an unrelated topic, I just got off Jimmy Moore’s blog. I’m sure you’ve probably read his Oct 27th post by now, and it raises some important questions. One of them occurred to me while I was reading the multitude of comments: how is it possible for someone adhering strictly to the low-carb lifestyle to still develop type 2 diabetes? (No, I’m not referring to Jimmy, but to one of his commenters.) Other than via a malfunctioning pancreas, I can’t see it happening, but then I’m not a biochemist. That seems to me an onset of type 1, whereas the type 2 would be (if I understand correctly) a result of insulin resistance. Can you answer or direct me to something in lay terms that might explain how this can happen? I ask because I am an aggressive proponent of the low-carb lifestyle on my own blog and hub pages, and one of my core selling points is that you can reverse a tendency toward type 2 diabetes by carb restriction. Can you clarify?
    Bill Campbell
    Hey Bill–
    I would have to know a whole lot more about the individual concerned before I could comment intelligently. I have had numerous patients who have been able to reduce or eliminate their diabetic symptoms by following low-carb diets, but I’ve never had a patient who has become diabetic while on a low-carb diet.

  9. In Protein Power as you describe the women’s procedure, you say “waist” in the text, but list abdomen in the chart. Do you mean waist, the smallest measurement between ribcage and hips, or measuring over a pooch in the abdomen?
    Also, how accurate are these calculations if you are doing Slow Burn and gaining muscle?
    Waist means measured at the umbilicus (the belly button). The calculations are accurate while following Slow Burn and gaining muscle.

  10. When I graduated high school, in 1957, from a large Philadelphia suburban school, there were maybe two students in the class who could be classified as “fat”. None of my friends were fat. None of their PARENTS were fat.
    However, about ten years ago, I weighed in at 238! Shortly thereafter, I was diagnosed with typeII diabetes. No wonder. Luckily, I stumbled on Dr. Richard Bernstein, and was able to get things under control. Now, at age 69, I weigh 162, and control my diabetes with carbohydrate counting only; no drugs.
    Am I overweight? Yes, I believe I could lose about 20 lbs. to be optimally healthy. No doctor in the past few years has suggested that I am overweight. But I think I would feel better, and function better, with a 20 lb. loss.
    It’s stunning to me that we have such a strange double standard. On one hand, we seem to have a national ideal of super thin stars and idols, and on the other hand a nation of obesity. Surely, there must be some happier medium.
    Sad but true- even if you research diligently, most of the information out there remains incorrect- whole grains and low fat being the national answer. Doomed to fail!
    For myself, even at age 69, I’m still trying to lose that last 20 lbs. without giving up any more quality of life. If only I could afford lobster and beef tenderloin every night!
    I don’t eat lobster and/or beef tenderloin every night – I eat a lot of ground beef, pork chops, chicken and flank steak.

  11. Oh boy, I just did the math for myself, and my worst fears have been confirmed. I think I need to schedule a doctors appointment and confirm my findings. It looks like it’s time to give up the soda and Taco Bell for good this time. 🙁

  12. That method of calulating how much weight we need to lose was popularized by Covert Bailey (author of “Fit or Fat”) around 1980. Bailey went around holding clinics in YMCA’s where he would weigh people underwater and calculate their body fat, and tell you your ideal weight using the 15% for men, 20% for women standard. He would compare that with your “fantasy weight”, what you think you should weigh. I still have the sheet he used, and I wish my body fat was the same as it was then.

  13. Any idea what percentage of American men are 15% body fat and below?
    No idea, but I would bet it’s a whole lot smaller than it was 30 years ago.

  14. I thought that your first Protein Power book had the best calculations in terms of accuracy and allowed for age differences as well as gender differences. Would it be possible for you to post those calculations on your site? I would certainly appreciate it.
    It’s been a goal of mine for a while. I just need to get the time and energy to do it.

  15. Interestingly, my first run at the calculations indicates that I need to lose less initially than I thought! I’m 233 right now, at 6 feet even. Running the numbers, this tells me the first target is 216 … which I know I can hit. Definitely makes goal-setting easier!

  16. I don’t want to be a wet blanket, but it is also useful to know at what point overweight and obesity become a problem. I’m not just talking about diabetes, heart disease, cancer, etc. i.e. the usual suspects. There is also the point at which weight become a limiting factor to doing things that one wants to do. Some of my friends have given up certain sports due to excess weight. Dr. Atkins came up with his diet as a way that he could continue to play tennis.
    Also many of the surgeries for back problems, foot pain, and various joint related issues could be prevented or at least delayed by weight reduction. Against this, consider that many studies have shown the lowest mortality rates among the moderately overweight, especially in the elderly. I’m not really expecting a specific answer because it is to some extent a subjective item, only noting that there is more to the ideal weght than just a body fat percentage.
    In the interest of full disclosure. Ht. 5’10” 198 lbs @ 20% Body Fat by Tanita Scale and confirmed by various website calculations. Using the 15% number, my ideal weight would be in the mid 180’s. Thanks for the space and time to comment.
    Hey Mark–
    Good to hear from you. Like ideal weight, I think the weight at which problems start is a moving target. I’m sure it varies greatly among individuals.

  17. I had a bit of a shock recently while vacationing in Mexico. The pics my wife took of me diving off a 20 foot cliff in a cenote revealed a decently fit looking guy suspended upside down in mid air sporting an enormous pot belly. There was no getting around it, my belly is huge.
    What I don’t understand is that the BAD machine at Fred Hahn’s studio tells me I am under 15% fat. Either the machine is wrong or I gotta get extremely lean to lose this flabby mid section. Every now and then I vow to cut out the alcohol and cut my calories drastically, but since that’s no fun, I never stick with it.
    I may try your shakes twice a day, do you mind reprinting the recipe? I remember it involved heavy cream and protein powder and flavoring, but don’t recall the particulars.
    Hey mrfreddy–
    There’s a new book coming out on March 10 of next year that will tell you how to get rid of that belly.
    Here’s the recipe we use for our shakes:
    6 oz water
    11/2-2 scoops protein powder (low-carb)
    1 ounce coconut milk or half and half
    cup of ice cubes
    flavoring (sugar free) to taste
    blend in blender.

  18. Great post. I second the comment about people who now think of average (or even over) size as “too thin.” I heard this from a family member just a few weeks ago (sadly, not in reference to myself!). But her “too thin” would be “good but still more fat to lose” in the real world.
    And don’t even get it started on women’s clothes sizes! Jacquie is dead-on – and all the stores now differ, so it’s impossible to know what size anyone truly is. Only the tape measure is a true reflection these days.

  19. Dr Mike, another fine post.
    I was actually shocked by the footage of Oliver Hardy. When I was a kid I was a big fan of Laurel and Hardy. I always remembered Stan as ‘the thin one’ and Olly as ‘the fat one’. Looking at the clip you posted, Olly is actually a lot less obese than I recall him being. Obviously being surrounded by so many fat people, even lean people like me can have our perception of ‘normal’ attenuated.
    Someone recently questioned whether I had lost weight (I am 6ft 3in and about 79kg and have been for some time.) But from my perspective, the company the ‘questioner’ keeps is actually getting fatter!
    For the record, here is a picture of me and my little kid praticing handstands on holiday:
    I am not exactly Charles Atlas, but would gladly race any top bodybuilder over 100m and would also be prepared to contest them in bodyweight exercises!
    As an aside, I came across an article recently by someone proclaiming the benefits of wholegrains. Now to me, they are just sugars with indigestible bits – and not needed for health. The poster however, declared expertise in this area and cited this paper:
    I know you get this all the time (and I won’t be offended if you decline), but any thoughts?
    You are right. Grains are simply starches (which convert to sugars in the GI tract) and a bit of indigestible fiber. The abstract of this study says

    Epidemiologic studies support the belief that whole grains are protective against cancers, especially gastrointestinal cancers such as gastric and colonic, and cardiovascular disease.

    Which is true. But what the abstract doesn’t say is that other epidemiologic data doesn’t support anything of the sort. Nor does it say that yet other epidemiologic data supports the belief that whole grains cause cancers, especially GI cancers.
    Epidemiologic studies don’t prove causation. Period. Anyone who tells you they do, doesn’t understand what epidemiologic studies are.

  20. Women’s clothing is horribly sized – “vanity sizing”, they call it. It’s not standardized at all. Manufacturers can name sizes however they want, with the theory being that women will become loyal shoppers at the store in which they take the lowest size. I take different sizes at different stores – it’s really annoying. I actually measured all of my pants, and although the tag sizes were all different (from 3 up to 8), the actual circumference of the waist was the same.
    Great post! I’m 114lbs (down from 140 thanks to you and other low carb docs) but still have visible body fat, esp on my abdomen. All the charts tell me I’m at a perfect weight for my height, of course (I pay no attention to those). I recently got a hand-held bodyfat thingy, which puts me at about 22.7% – the charts you reccommend put me between 22.2%-24.7%. (I lent my PP book to someone, so can’t check your charts in there). The calculations you provided here are really helpful, especially since I’ve lost so much weight and have been unsure as to how much more I need to lose. Thank you!! As you said, now I have a roadmap. It’s harder to tell when you’re close to ‘ideal’ – I have about 6lbs to go!
    Congratulations on a job well done so far! Keep after it.

  21. Interesting. I didn’t realize this about womens’ clothing.
    Women’s clothing!! I am 67 inch muscular male at 185 and wear medium/small top/bottom. No way would my youth’s clothes fit me now. My 32 inch jeans are actually 34s. I cannot buy clothes without trying them on, or taking a tape. Men’s pants are seldom what the label says.

  22. Dr Eades, do you ever cheat? Diet that is, do you ever succumb to temptation of sweet, creamy and crunchy ice cream for example or pizza or french fries? And you promised us a blog on what you typically eat! Plus I cant wait to see your blog on revolutionizing the world too.
    Do I ever cheat? Diet that is… Hmmm. What other ways of cheating do you have in mind for me?
    Yes, unfortunately, I can be as weak willed as the next weak-willed guy. I cheated last night, in fact. I played golf with my buddy (whom I beat like a rented mule), and, as always when we play on Wednesdays, we went to the clubhouse to eat. I always have a little steak or one of the giant burgers (without the bun, of course), but instead of the regular menu, they were having some sort of family Halloween party that included all the food you could eat for $30. I started on the prime rib, salmon and stuffed pork chops, heirloom tomatoes, and green beans. But then I made the mistake of looking at the dessert station, which happened to have everything on it I love. And since I had already paid for it, I said, what the hell…and I was a goner. A piece of carrot cake, a piece of some other kind of cake, a piece of berry pie, and two scoops of ice cream later, I was finished. And I felt like crap – both in body and in spirit. But, I do something like that only once in a blue moon, so it doesn’t really affect me much in the long run. I’m making up for it today. I’ve had a protein shake and a handful of jerky. I’ll probably have another shake for dinner. It’s not the occasional large cheat that does you in – it’s the little daily cheats that end up defeating your efforts. If I cheat, I try to make it big and infrequent.

  23. Hi Dr. Eades: you are so right indeed !! And i think that most people in comsumerist societies like USA are overweight. The rule and normality is to be fat, while very few are in their prime weight. There are still many thin people in western consumerist societies, but their underweight is caused by a faster metabolism, and not necessarily because they pretend to be thin. But it is safe to state that most people out there, most average joes and janes are overweight, even if they don’t appear overweight. Many people hide their weight-gain and overweight problems in their clothes, and cars. Many people use these big vans, SUVs with tinted windows, hide behind the computer screen and use many tactics in this technological world to hide their true-self.
    It is like if material things, external things like cars, clothes are a lot more important to people, than their own physical appearance. I know it’s a lot easier to buy a new car and cover and hide their body and physiology in that car, than by engaging in a weight loss regime. It’s less painful, easier and more convinient.
    I think that technology is not helping people go forward, but backwards, like the great philosopher Nietzsche said, that technology kills the will and blocks progress. Because people rely more on technology than on their body which is ther true-self and not a car

  24. “Thirty pounds?!?!?! If he lost 30 pounds it would have been a step in the right direction, but he would have had a long, long way to go to get where he needed to be. ”
    A lot of the beer belly weight is bloat caused by allergies, and men could lose it without that many pounds being lost. (See Elson Haas’s “False Fat Diet” and similar books.) Also, with a good diet, you may gain weight while losing size or staying the same size. Many have noted that by eating a high meat diet, their body gets heavier and denser, but not much bigger and maybe even smaller. Esp with raw or rare meat, size is not proportional to weight. I’ve seen guys who weigh about the same as me, but they’re much bigger (fatter). Muscle has more density than fat. Most people are chronically malnourished from eating the typical modern diet filled with processed and nutrient-devoid foods. When they start eating right, they may be more dense and solid than they ever were before, but look smaller than before.
    On a healthy diet, like paleo or low-carb, a man could be 40-80 pounds overweight according to the scale, while having a flat stomach, muscular arms and legs, lean face, etc. Look at Art DeVany. He weighs like 217, but looks about 30-40 pounds lighter. It all depends on what type of foods you eat and how you exercise. That determines whether you gain muscle or fat by overeating, whether your body is dense or hollow, solid or flabby, etc. The obese people are all eating the same nutrient-deficient, high-carb, unbalanced diet. Many eating low-carb just try to find low-carb versions of the unhealthy processed food they used to eat. This will not change the overall problem that of poor body composition, IMO.
    I’ve had a lot of experience (something in the neighborhood of 10,000 patients) and I can tell you that this guy’s belly wasn’t due to bloat and allergies. It was visceral fat.

  25. Some of us who have lost a lot of weight sometimes perceive ourselves as BIGGER than we actually are, and are often surprised when smaller size clothes actually fit, or when we can fit into theater or airline seats better than a year ago. We look in the mirror and expect to see a bigger person, but actually see someone thinner. Perhaps it’s because we’ve carried the weight around for so long.
    I’ve lost a lot of weight, but still have a lot more to lose. I have no illusions about having to lose more, I know I have a long way to go; however, I sometimes still perceive myself as the person who was 85 lbs heavier.
    I guess if everyone were smacked in the face by the reality of their weight, some might not be able to handle it. Those who think they are thinner might be fragile emotionally and perhaps couldn’t deal with reality.
    Then again, what is reality? Ah, that would be another discussion entirely.

  26. I hope what I write is not perceived as hijacking this thread. I do think it apropos to put in a plug here for the silent minority, of which I am a member–the underweight. Back in the days of yore, when I knew that meat was evil incarnate (sorry, couldn’t resist) and I ate it about once a month, I decided to run my first and only marathon. I got my morning pulse to under 30 beats/minute and my weight shriveled to under 110 pounds on my 5 feet 10 inches frame.
    That was 1987. Fast forward to 2008 where I weigh about 165 and have been as high as 174. I recently used some skinfold calipers and found my bodyfat under 10%. (I know how inaccurate calipers are, but every method has its flaws.)
    I am one of those Americans who needed to gain weight. We really do exist and low-carb is a great help. I am 53 years old now. Until 20 years ago, I was perpetually underweight. Low-carb eating was a great way to gain weight. Years after I started eating low-carb, I started weight lifting. And that helped me gain even more weight.
    By the way, I didn’t start low-card as a means to gain weight. I did it to improve my digestive health. But that’s another story.

  27. Doc,
    If I am very lean, about 160 and 5%, and I want to put on more muscle without adding the fat but I am already consuming 250-300g of protein a day, would increasing my fat intake a lot be the only way to go. I’m eating about 2,500 calories a day and shooting for 50-100 grams of carbs depending on my activity level.
    I seem to be able to stay at my 160, but I am weaker than I was when I was 180 and would like to try to be a 180 with no fat. I wondering if increasing fat intake by about 1,000 kcals a day would help me do this instead of the frequently recommended carb loading.
    Thanks in advance.
    Increasing the fat content will help. And do resistance exercise. I would avoid carb loading because that adds only fat, which you don’t necessarily want.

  28. I am surprised, but in the opposite way. I plugged my weight and waist measurement into the body fat calculator and came up with 19%, which put me well within their “acceptable” range. That I never would have guessed. I mean I can grab a good handful of fat at my stomach. If I get to where I would prefer to be, weight-wise, it would put me way into the “fit” category.
    A few years ago I went to see what I think was called “Bodyworks” in Chicago. It was the preserved cross sections of human body organs, tissue, etc, organized into what was really an art exhibit. The one thing that really struck me was the amount of internal fat there is around the organs in very obese people. So, if I have a good size handful around my middle, including fairly decent size love handles, I wonder what’s lurking inside.
    I assume you’re a male. As such, there is an enormous difference between 19% body fat and 15% body fat.

  29. I couldn’t agree more with respect to vanity sizing of women’s clothing! It is amazing. I’m a pretty average weight, but I LC for PCOS. I don’t consider myself thin (I’m about 120 lbs and 5’3″) but it can be hard to find women’s clothes, particularly in stores where women’s sizing starts w/ a size 6 (which is not what it was at one time).

  30. You hit the nail on the head, Dr. Eades! As I have become more conscious of weight (I’ve lost nearly 50 pounds now), and of what people are eating (peek into grocery carts at the soda pop, chips and processed foods that predominate), I’ve also become more conscious of the increased size of the “average” person, at least here in the U.S. Those old clips of Laurel & Hardy and Jackie Gleason sure are eye openers!
    But if you want a real eye-opener, go to any high school today and take a look at the “average” high school girl or boy… it’s the “skinny” ones who stand out now. The average high school kid appears to me to be at least 15 to 30 pounds heavier than they were in the late 1960’s, and very large to obese kids are not at all uncommon. It’s actually pretty shocking to actually “see” this… I fear the health consequences for these kids. I guess the growth industries in medicine will continue to be in the areas of diabetes management, cancer and heart disease, unless something radically changes… and pretty darn soon.
    My doctor put me on a NO salt, NO sugar, and NO starches eating program awhile back. It has been almost magical the way the pounds have “melted” away, and with NO hunger pangs, and NO nasty pills, surgeries or side effects! All of my objective measures of health have improved since eating this way, including everything on the latest cholesterol panel.
    You have a thoughtful and interesting blog. Thanks!

  31. Lowcarb_convert,
    I so agree with you when you wrote this:
    “I have lost almost 35 lbs in the last year on low carb and have just starting being able to buy clothes in stores that are not for larger size people. Since I haven’t been this weight in at least a decade, I have started to think of myself as thin already.”
    I was obese, over 230 pounds, and as I’ve dropped over 45 pounds I just look at my waistline, my smaller belly, and think I look great! It’s funny, because I remember way back when I was gaining all this weight, that when I hit 185 pounds I felt so fat! Now I enjoy looking at my shape. It’s different than what I’ve been used to.
    Yes, it’s a long way to go, but it is fun noticing my reactions as I lose. When my BMI moved from “obese” to “overweight” I certainly felt like I accomplished something. I also have to say that my new low-carb way of eating has nothing to do with losing weight — I read Taubes “Good Calories, Bad Calories” and changed my diet for health reasons. I’m just shocked at how my body changes.
    And yes, Curly, Oliver Hardy, and Jackie Gleason don’t look that fat to me. How strange.

  32. “And don’t even get it started on women’s clothes sizes! Jacquie is dead-on – and all the stores now differ, so it’s impossible to know what size anyone truly is. Only the tape measure is a true reflection these days.”
    The only standardization in women’s sizes was in sewing patterns for the people who sewed their own clothes. And those patterns had measurements listed. Yes, women’s clothing sizes have changed over the last 20 or so years, but even 30 years ago if you could afford to shop in high-end stores like Neiman Marcus®, you would fit into clothes at least two sizes smaller than Sears® and likely 4 sizes smaller than WalMart® (just to name a few stores.)
    It is a bit frightening to realize that our children are being subjected to two vastly different standards of what is acceptable i.e. Roseanne Barr vs. Lindsey Lohan.

  33. I lost 100 pounds and people who didn’t know me when I was fat are just shocked. The ones who know always say I can’t believe it was 100 lbs because you didn’t look that bad to begin with. I think people envision 100 lbs and think it should all be centered around your butt and your stomach and torso and you’d look like a beach ball but you distribute it over a whole body including arms, legs, face, back etc…Well you get the gyst. There’s just alot of places to stick 100 lbs. And I don’t know how much room it really takes up but 100 lbs of sand for example is just not that much volume. At 100 lbs overweight I looked like the 2nd figure from the right. After 100 lb loss much more like #4 from the left. Hardly emaciated or underweight but everyone I worked with was BEGGING me to stop losing weight. Of course they all needed to lose and I probably needed to lose more although my BMI was 22 so I thought I was probably fairly ok but compared to them I was reasonably lean.

  34. Great post as always.
    I work in a female dominant environment and although I am obese when I describe myself as a large woman my colleagues laugh and insist that I am not really that large (even though I am). I don’t think this is a flattery issue but rather my colleagues underestimate my weight because they are comparing me to all the morbidly obese individuals in our workplace of which there are quite a few.
    I also wanted to comment on the issue of developing type 2 diabetes while on a low carb diet.
    After 9 years on a low carb diet I have progressed from non diabetic to what is considered a well controlled type 2. Before starting low carb my fasting BG was 4.6 mmol and hba1c 4.4. My fasting BG is now typically between 7 – 8 mmol and my last 3 hba1c’s have progressed slowly from 5.4 to 5.6 to 5.9 over an 18 month period. I have recently started with metformin which has not really impacted my fasting BG and have another hba1c due now. My weight has also slowly increased along with my BG.
    I have experimented with several things in order to reverse this trend with no success to date and have even considered gastric banding (gasp!)

  35. ” It’s not the occasional large cheat that does you in – it’s the little daily cheats that end up defeating your efforts.”
    I travel about 80-90% on business (home is where I do laundry and the bed is strange …). I find that it can be hard to minimize carbs and keep portions manageable, but every meal and every workout in the hotel is another small victory. The campaign is won by the accumulation of small victories, despite the occasional setback.
    FWIW, I really appreciate Cheesecake Factory – they have some decent entrees, and are always willing to substitute a side salad for the starch with no hassle at all. And I can usually find one nearby.

  36. I am reading Dr Bernstein’s book, “Diabetes Solution”. I am not a diabetic… just reading it because I heard it had a lot of useful information regarding the low carb lifestyle. He comments that calcium can help facilitate weight loss but Vitamin D can sabotage. I have never heard this before. Can this be true?
    I’ve never heard that vitamin D can sabotage weight loss; in fact, I’ve read just the opposite.

  37. I wanted to second the earlier poster’s comment about the size fade in women’s clothing. It has actually become ridiculous! I used to sew my dresses in high school (back in the later 1960’s) and the other day I came across an old pattern envelope with the body measurements for the various dress sizes. In the 1960’s I would have been wearing a size 12 or 14. Today I regularly buy size FOUR. It’s a joke! It is especially noticeable in less expensive clothing. The pricer the store, the more realistic (or perhaps “classic”) the size is, but even then, I can usually fit into an 8 or 10 now.

  38. would be interested to hear what you put in a protein shake to keep you full. I find that a Whey protein shake with water and fruit(frozen berries) only for breakfast is tough to get through to 12:30 or so for lunch. Thanks, and this was an excellent, right on post!
    You need to add a little fat. See our recipe in the answer to mrfreddy’s comment.

  39. Dr Eades, you are not a weak man, you are just a man, and human, that’s all! In Poland we have a syaing that there are two biggest misconceptions when it comes to men and women in general. Women think that men will change once they get married. And men think that women will never change once they get married!
    That’s not just a Polish saying. It’s true over here as well. I use it often when MD doesn’t do what I want her to do.

  40. Thank you for your response to my earlier questions and thank you for blogging. I really appreciate the way you explain the science. I would have never dared to go into ketosis without your explanation that ketoacidosis is only a danger to type I diabetics. Zero carb is really working for me haven’t noticed any weight loss, but I’m more interested in health benefits at the moment. I understand that dairy proteins are possible suspects in auto-immune disease. Does the fermentation of yogurt have any effect on this? Currently butter is the only dairy I use. Once I went from low carb to zero carb I found I no longer enjoyed cheese when I ate it. Don’t enjoy brats or chicken any more either, and of course sweets don’t taste good at all.
    Fermentation may have some effect in yogurt as far as getting rid of the carbs is concerned, but it doesn’t really change the protein structure, which is what may cause some of the problems with dairy.

  41. Me again regarding protein shakes- can you give your opinion on the ready to drink Atkins shakes? Which, by the way, are becoming more difficult for me to buy locally. Our local WalMart no longer carries them.
    Sorry, I didn’t mean to intimate that YOU live on lobster,etc. Only that I would like to. My cheating cravings don’t run to sweets. Bread is my downfall. I adore homemade bread and biscuits and such. If I dream of a cheating meal, it will usually involve good bread or pasta. Or both. Or oyster fritters.
    If I’m unable to get to a store where I can buy “good” bacon and sausage, my standard breakfast fare is a hamburger patty and two fried eggs. I too eat a lot of chicken, and don’t seem to tire of it.
    I’m looking forward to your upcoming publication on belly fat. Keep up the great books!
    Oh, one final question- have you an opinion on gugulipids? My brother, a 73 year old diet controlled type ll like me, dropped his total cholesterol from 299 to 209 over the six months he has been taking them. His Dr. has stopped bugging him about statins. His HbA1c was 5.8, up from 5.6, and the doc told him he was “no longer diabetic”! That’s about on a par with being “no longer alcoholic”, isn’t it?
    I’m not familiar with the Atkins shakes, so I really can’t comment. I’ve never had first hand experience with gugulipids, so I can’t comment on those either. Yes, it is like being no longer an alcoholic. Diabetes symptoms can be controlled, but the predisposition is still there. If one goes back to the old way of eating, here comes the diabetes.

  42. So true, so true. I couldn’t possibly count not only how many people have told me they have ‘oh about 3 or 4 kilos to lose’ (I’m in Australia!). Not only this, but so many people out there seriously have no idea about what it really takes – in fact, they usually think that they are leading a really healthy lifestyle. You have to wonder how much of our obesity problem is the direct fault of poor nutrition/lifestyle education and how much is just plain old ‘can’t-be-bothered-getting-off-my-ass’. The You Tube clips paint a good picture, I may just have to steal that analogy!!

  43. Can’t wait for your book. Got sucked into buying the Lose the belly fat book put out by prevention. What a waste of time. Way higher carb than I eat and much lower in fat.
    Yeah, the Prevention book really kind of sucks. Nothing new – just the same old low-fat drivel.

  44. Lol, Dr Eades how long have you been married? You seem like a Dennis Menace kind of guy. I remember watching you and your wife on lowcarbcookworks on TV and you seem so collected and laid back. But there is a side to you that seems wild. Its just a woman’s perspective. I am sure if I asked your wife she would say you dont always behave. When I started reading your blog you always seem so collected and emotionally very stable. I know that few people tried to take few cheap shots at your work or you personally, but you didnt budge. I was screaming on top of my lungs, I wanted to just stuff those people moths with pure sugar to get them to shut it. But…… One day I was so happy to finally get you to get mad at those people that say eating meat is almost immoral. You really came out out of your shell. I always knew you had that wild side to yourself. So for the future cheap shot takers beware Dr Eades can be a bad boy too! By the way are you and your wife planning on resuming your cooking shows? After all its not only great to read you, but to watch you cook too. My husband would get so jeolous, because I always commented how hot the man looks when he is obedient. On that cooking show it looks like you let your wife take the reins. But I know its only a partial illusion. Doesnt matter, it worked for me. My husband did few extra chores around the house every sunday I watched you and your show. So please have it back for the sake of women like me who need to get their husband be a bit more obedient, at least on Sundays!
    I’m glad my on-air docility helped you get your husband in line at least one day per week. I’m let MD take the reins in the kitchen – that’s her domicile. I’m the boss in all the other rooms, though.

  45. Dr. Mike,
    How much does strength training help in reducing the amount of LBM loss while LC dieting? I am 230lb, 6′, 19-20% depending on method of measurement. I lift weights 2-3 times a week, plus walk 2 miles 4-6 times week. I have been stuck at that weight for a long time (6 months, after losing 42 lbs last year fairly effortlessly. I suspect it is the half to full bottle of wine a day that I consume with my meat based dinner. Switching to IF helped drop 10 lbs. But I guess I will to reduce my wine and/or caloric intake. I love IF because it rewards my inner gluton.
    Resistance training helps maintain lean body mass more than anything else. I would guess the wine probably has something to do with your weight-loss stall. If you give it up for a while, your weight loss should pick up. Then when all you’re trying to do is maintain, you can go back to the wine.

  46. Jackie Gleason looks like a fitness consultant! I remember him as being John Goodman-sized. Way off.
    Crowd shots are interesting documents, too. Random crowd shots- street scenes, sporting events, yearbooks, workplace photos- from the seventies and earlier, all the way back to the mid-1800’s, make it look like everybody was getting their eleven USDA servings of low-fat whole-grain goodness and 90 minutes of exercise a day.

  47. March 10? That’s five months from now! you not gonna make me wait that long and then tell just me to get liposuction, are ya?
    An advanced copy sent my way would get you not only drinks at Peter Lugers, hell, I’ll buy the steaks too!
    I promise that I won’t make you wait then recommend liposuction. I may take you up on the Peter Luger’s deal if I get to NYC anytime soon.

  48. 10 months of very low carb has served me well. after the initial weight loss i sort of plateaued and thought that was it. but i didnt realize bit by bit i started to loose weight in the same gradual way i put it on.
    a few months later i just locked into eating as few carbs as possible and next thing i knew i moved in another notch on my belt.
    one day the medium sized t-shirt actually looked good on me as opposed to a bit tight and too “european” for my usual liking.
    the stigma of eating so much meat and salads w/o carbs wore off as i adjusted fully to it. the cravings became less and less. i lost enough to the point where once a week i could let loose and enjoy a big plate of pasta and desert and it wasnt the end of hte world as long as i always went back to the low carb regime.
    i suspect the biggest problem people have is that they are still too fearful of eating fat, and have trouble accepting that if they avoid carbs as much as reasonably possible while enjoying the skin of the chicken or the pan drippings from a steak seared in a pan they can still loose weight. most people i know who failed on low-carb regiments simply ate lots of lean meat and salads, always felt hungry and stopped thinking the whole idea is junk.
    even after loosing the weight i have and my explanation of eating ultra-low carb w/ lots of meats/fats, people insist its bad for me and that its not sustainable. i guess 10 months isnt long enough.
    thx for this blog, its one of the best out there for well sourced info.

  49. I wanted to follow up on the other comments on women’s clothing sizes. I had been wondering about that myself as I have lost weight with LC.
    I was remembering 20 years ago being a lower weight but having a hard time finding clothes that fit at all in most women’s stores. At the moment, I am able to buy large and even medium, and I have 30-40 lbs to lose. I just thought my memory was faulty but the other women’s comments on this post are confirming that women’s sizes have grown.
    This led me to connect this to your actual point – that people don’t realize how big they are. Part of that problem of self deception is the clothing size factor. If you are still able to buy clothes in regular stores and fit into a large or XL, you might say to yourself that you are not that big. Afterall, it is not a 2XL, right? Added to this is the propensity of some overweight folks to wear their clothes way too small. I see this way too often on many women – barely squeezing themselves into a certain size so they can say they are that size. I am sure a couple of decades ago it was rare to see someone’s carby belly hanging over the top of their pants and out the bottom of their shirt!!!
    I have the opposite problem – I hate tight clothes. So when I was heavier I adopted a wardrobe of elastic waist plants and baggy shirts. And I am having a hard time getting away from that. Finally recently I bought my first bunch of new smaller clothes. But one of the sweaters I bought is too big because I can’t get out of the mind set of baggy. Plus it didn’t occur to me that I could actually wear the next size down – afterall, I still have a long way to go in losing weight. Again, a reflection of the growing dimensions of sizes. I can totally understand normal weight or small women having a problem getting clothes small enough to fit. I hope I have the problem some day!!!
    A final thought on the idea that we don’t have a good concept of how much weight we have to lose is that since weight loss is difficult, even on LC, we expect more change for each lb. It has taken me a year to lose 30 lbs. So I suspect it make take me more than another year to get towards lean weight. Oh, I can detect little changes along the way. Just in the last few days, even though the scales haven’t changed, I have noticed my hip bones when I lay down. But like the poster said above how their friends can’t believe they lost 100 lbs, you put your lbs all over the place. For instance, I have gone down a shoe size!
    Thanks as always for giving us this space to communicate our thoughts!

  50. Walter, just a comment on dairy. I read, before switching to raw milk, that many people with supposed lactose intolerance recover completely on raw milk. That has been my experience and I never would have believed it before. Therefore, I would strongly suspect that allergic reactions to milk may be due to the heat of pasteurization denaturing the proteins. I am sure there are people who would be allergic to raw milk as well but I would wager that the numbers are quite small. Why are all these food allergies on the rise? I don’t know — but it’s a fact that many dairies now ultrapasteurize, not just pasteurize. Does this denature the proteins in the milk more than with regular pasteurization? Again, I don’t know. Pasteurization can’t explain all food allergies so perhaps it will not bear out.
    I don’t have proof of this, but raw milk does have many benefits that pasteurized milk does not… phosphatase, lactase and immunoglobulin at least. I do not know how immunity works with immunoglobulins because the common assumption is that proteins are destroyed in the stomach — but obviously if we believe that infant mammals get immunity from mothers’ milk that seems like a contradiction. Certainly lactase seems to work in the stomach — how else can we explain the lack of lactose intolerance in so many people on raw milk? Maybe less lactose to being with?
    The carb content of raw milk from Organic Pastures (in California) is 12 g. per cup. Not terrible so long as you don’t have too much. I would guess most raw milk is similar since it is way higher in fat (and this has to decrease total proportion of carbs).

  51. Hello Dr E,
    I posted this comment nearly a week ago and a couple of posts back, but it seems to have gone into the spam bucket. It’s one of those examples of actual good news from the world of medicine. As it’s not directly relevent to either post, I’ve reposted it here.
    Another news tidbit. Sorry about it’s being off topic, but this is my only channel of communication.
    “The European Medicines Agency recommends suspension of the marketing authorisation of Acomplia”
    Press release here:
    Accompanying Q&A:
    Juicy quote from the latter:
    “…The CHMP confirmed that Acomplia is moderately effective in helping patients to lose weight. It also confirmed that the medicine has some benefits in terms of its effects on blood fats and blood glucose control. [Oh yeah?? MR] However, the new data show that in real life, patients tend to stop their treatment early[ due to their massive laundry bills, no doubt MR]. This short-term treatment with Acomplia may not bring the benefits expected on the basis of the clinical trials. There is also no evidence that Acomplia prevents cardiovascular disease (disease of the heart and blood vessels).
    “The Committee confirmed that the risk of psychiatric side effects, including depression, sleep disorders, anxiety and aggression, is approximately doubled in patients taking Acomplia, compared to obese or overweight patients taking placebo (a dummy treatment). The new data from ongoing studies and post-marketing reports indicated that serious psychiatric disorders may be more common than in the clinical trials used in the initial assessment of the medicine….”
    In all your warnings against this junk drug, including the classic “cosmic pizza” rant, even you didn’t see the psychiatric consequences. My heart just goes out to the poor innocents who suffered this barbaric treatment. At least a halt has been called for the nonce.
    Best Regards,
    Michael Richards
    P.S.: something more uplifting: I received from John Eliot Gardener’s SDG label a few weeks ago the first in the Brahms series. On the First Symphony CD is the Song of Destiny (Schicksalslied) which was his test piece for the German Requiem. It’s just got to be one of the most beautiful choral pieces you have never hear. Here are the first 5 minutes:
    AAAARRRRGGGGHHHHHH!!!! I looked, and sure enough, there you were in the spam pile. But it wasn’t just you, there were about a dozen other comments as well. And here I thought I was keeping up. I’ll delete your other comment.
    As to this comment…you are confusing Acomplia with Alli. Alli is a fat blocker that leads to the unpleasant GI symptoms; Acomplia acts in an entirely different way by blocking cannibinoid receptors in the brain. One makes you mess yourself – the other makes you crazy.
    Loved the Brahms’ piece as did the bride. She’s going to bring it up to the artistic director of the choral society. Thanks for sending.

  52. As previous posters have pointed out, the “vanity sizing” that goes on in women’s clothing today is bordering on insanity. Years ago, it was pointed out that Marilyn Monroe wore a size 14 so she couldn’t have been that small. Wrong. She was a size 14, but not today’s 14. I saw the gold dress that she wore when she sang Happy Birthday to Kennedy and she wasn’t a big woman at all. I sew and patterns still retain the old sizing standards. If anyone is curious about the differences, they are as follows for a size 8, although the RTW probably varies:
    Pattern: Bust 31 1/2
    Waist 24
    Hip 33 1/2
    RTW: Bust 36
    Waist 28 1/2
    Hip 36
    The thing that I find most interesting is that while the bust and waist measurements increased by the same amount (4.5 inches), the hip only increased by 2.5 inches. No wonder I have a hard time finding clothes that fit properly. If it fits in the hip, the waist is way too big. I guess today’s woman isn’t supposed to have a well-defined waistline anymore.

  53. You said:
    As you lose fat on your low-carb diet you will lose some lean mass as well. Since your going to be lighter, you won’t need the same amount of muscle mass to support you, so you will naturally lose a little muscle mass. You’ll also lose some weight from excess fluid and even some organ weight – all of which counts as lean body mass. You’ll lose organ weight because for the most part a smaller body requires smaller organs.
    Possible dumb question here – is it possible to lose bone weight as well without developing osteopoenia/osteoporosis?
    It is possible to lose a little bone mass without developing osteoporosis. A larger body requires a larger skeleton to support it. As weight is lost, bone (which is constantly remodeling) mass decreases slightly because it is no longer needed to support the lower weight. And good bone requires protein, especially protein from animal sources, so a good quality low-carb diet helps build good bone mass.

  54. It’s not just humans-pets too. At my German Shepherd’s last checkup the vet (who is at least 80 pounds overweight herself) pronounced him underweight. At 70 pounds at only 8 months old, he’s in lean, hard athletic shape and bouncing off the walls with energy, not exactly starving. He’s been fed a prey-model/raw meaty bones diet since weaning, not commercial dog feed. I think the vets have forgotten what a healthy weight is for their own patients.

  55. Wow, when I was a kid, Jackie Gleason was enormous. All the greats had one that was enormous- Ralph & Norton, Abbot and Costello, Laurel & Hardy.
    Jacquie & Martha are both correct with the vanity sizing. When I was a starving college student, I weighed 108 pound and wore a size 4. I am now 120 pounds (age 42) and wear a size 4.
    I liked your quote:
    ” It’s not the occasional large cheat that does you in – it’s the little daily cheats that end up defeating your efforts.”
    I am glad you said that, because we have been living that way as a family of 4. Every day, we try and minimize those small treats. Today, Oct 31, was indeed a VERY large cheat day. While my kids spread out (and traded) their Halloween stash all over the floor, Mom and Dad pulled out a few favorite childhood treats. We ate Butterfingers, Heath Bars, Peanut Butter Cups, and our favorite- Payday bars. Luckily, Halloween comes only once a year.
    So, we are currently experiencing massively high blood sugar. We’re tired. Exhausted, to be sure.
    But a funny thing is that as soon as I looked at all that sugar, something got tweaked in my brain. I could swear it was in my hypothalmus. Can a person really feel what’s going on in their hypothalmus? I think it’s a kind of tickle that you feel somewhere in the base of the brain stem. Those bites of sugar seemed to provide closure.
    Thank God Halloween is only once a year. 🙂
    Next big cheat is Thanksgiving.
    Love your blog, wish us luck in disposing 20 pounds of candy without ingesting it. 🙂
    Good luck. Thank God I don’t have to confront that problem any longer. If the kids were still bringing home the Halloween treats, I would be face down in them. As it is, I’m eating some berries for dessert tonight.

  56. You are not bad at all in the kitchen either. When I read your answer, a spicy thought came to mind. Have there been studies on low carb vs low fat that compare men’s performance in the bedroom over long term. i know long term are very hard studies to implement, but…. I keep convincing my husband to give a low carb a try, but he is a sugarholic and typical beer lover. He does love polish kielbasa, but with fried potatoes and bread. i am sure if he read the study that low carb beats low fat or regular diet hands down when it comes to performance in the bed, he would give it a try. Now that I think about it, wouldnt it be a good study> Nothing scares members of your species Dr Eades then a thought of sexual dysfunction. i am sure we would have saved lots of males from having heart attacks too if we had a study . How about such a study?
    No such studies that I know of. I do know that being lean and healthy makes for better sex than being fat, hypertensive and tired, not to mention making one a more attractive sexual partner. I suspect it would be pretty easy to recruit a significant number of males for a low-carb sex study, but I’m not so sure about the fairer sex.

  57. Goodness – here I am commenting for the 3rd time on this posting. And my comment is completely unrelated to your post but comments made by several posters re alcohol. A couple of commenters on this posting postulated that their stalling or lack of weight loss might have something to do with their alcohol consumption. I have recent experience of this one.
    I bounced up and down the same 3-4 lbs for the last few months. I did suspect that it probably was because I had gone back to having a few drinks a couple of times a week. It is hard to break that habit. Well two weeks ago I came down with a bad cold and didn’t have anything to drink for that entire week. The scale started moving down again and has continued to do so.
    I know that in your books you mention being able to have a glass of wine a day. My problem is stopping at just one so for now I am sticking with going without. I have finally seen a number on the scale that I haven’t seen in a decade!
    Good for you! Keep after it. Studies have shown that a glass of wine per day helps with weight loss, but if you can’t stop with just one – and I’m one of those who has difficulty in doing so – cold turkey may be the better strategy. At least until the desired weight is lost. We have a significant section in the new book on this very phenomenon.

  58. “Jackie Gleason looks like a fitness consultant! I remember him as being John Goodman-sized. Way off.”
    He was John Goodman-sized in The Hustler. He was 5-7 years younger on The Honeymooners. His weight quickly crept up on him after the show, as it usually does. He just had a little gut during The Honeymooners, but he was big all over in The Hustler.
    Even as he was in the Hustler days he wouldn’t get a second look today. Go to YouTube and look at the zillions of clips there of him throughout his career. He was never as big as I remembered him because even my perception of obesity has changed.

  59. As I have thought about this blog, I realized that the figures you have at the top of the page are all of people who have overall obesity and not truncal obesity. Then I thought of your lawyer who obviously had truncal obesity, to the extent that he had to manually move his belly, but was unaware he was obese.
    Perhaps our ideas of obesity do not include truncal obesity — particularly for men. Men with big bellies and slender arms a legs are referred to as having “a belly” but not that they are “fat.” Apparently “fatness” is limited to overall obesity.
    Another notion you tirggered for me is the idea of measuring oneself at the belly button to determine degree of obesity. My men firends, in particular, tell me, “Oh no, that’s not where I measure my waistline!” My fat women friends do not measure at all. Buying larger clothing is bad enough for them.
    Also, your U tubes are of actors with overall obesity rather than truncal obesity. I agree they don’t look very fat any more where once they did. “The Fat Man” a once popular radio show, was of a man who today would scarcely be noticed as being “fat.”
    This was a thought provoking blog. Thank you.
    The pictures at the top of the post were of kids, who seldom have abdominal obesity. One of the main themes of our new book is the difference between truncal or abdominal obesity and overall obesity and how they need to be addressed differently.

  60. A friend just aske me “How come you’re not worried about DHT from the red meat? ” I asked “What exactly is your concern – prostate cancer?” He replied “gray hair, male pattern baldness, and prostrate problems to start with.” I was wondering if you could briefly address this.
    Sure, I can briefly address it: bunkum.

  61. Back in 1983-84, I lived in France. It was extremely rare there to see an obese person. When I returned to the States and was going through customs at O’Hare, I was shocked to see how fat all the Americans were. It took being away from them for a year to look at them with fresh eyes and see just how many of them were shockingly fat, and that was in 1984.
    To change the subject slightly, did you have experience with people who went off low-carb, regained, lost again on low-carb, regained, and tried to lose again, only to find it harder each time? I must confess this has been my pattern. I lost 40, regained 30 (before I learned all this additional info about low-carb’s health value), lost the 30 (but much more slowly), and over last winter regained 10, which is not coming off, despite the fact that, as far as I can tell, with tracking on FitDay, I am eating like I did to lose the 30 last year. Does your upcoming book address very stubborn resistance to weight loss? Does weight loss get harder after regains? I look forward to your book and hope it will help me figure out how to get the 10 lbs, and hopefully more, off. It’s getting really old to keep on assigning numbers to everything I eat and not seeing any results. I know, you would need a lot more information to say anything helpful to one individual–I’m just asking if the book should be helpful for this situation.
    The book should prove helpful. Also, you probably need to get your hormonal status checked. Women who have great difficulty losing during middle age despite rigid adherence to a diet typically need their hormones tweaked. When they get things regulated, weight loss picks up nicely.

  62. What would a zero carb diet do to help lose belly fat? And would a zero carb diet mean no wine or alcohol?
    If it does that would be so sad. No red wine, my favorite.
    A zero carb diet would help to lose some belly fat, and, yes, a zero carb diet means no wine, red or other colored. But the good news is that it’s just until you get the job done. Then you can add the wine back in and still maintain.

  63. How accurate are these measurement calculations for a short waisted middle-aged female? I am 5’2.5″ tall and weigh 109. This fluctuates 5 or so pounds up or down but I am much leaner than most women my age. Yet my waist does not go in as in an hour glass shape — even when I drift down to 103 pounds in the summer — rather, it is boyish straight up and down and not many inches from my bottom rib to my hip bone. Hence my measurement for my waist would never be tiny despite my leanness. Couldn’t a gal just look at herself naked and say that if she can grab a handful of fat on her thighs or stomach/hips — she is too fat?
    When MD and I got a female with a ‘boyish’ figure, we usually used both the male and female methods of measurement and averaged them. It seemed to work out pretty closely. You can look in the mirror naked, and if you can grab a bunch of fat, it’s probably too much. If you’ll send me a photo of you performing that method, I’ll be sure to include it in the new book. 🙂

  64. I may take you up on the Peter Luger’s deal if I get to NYC anytime soon.
    cool, you’re on!
    back to the shakes, sorry to be a pest, but what kinda flavorings do you use? Made one yesterday with a bit of vanilla extract (has corn syrup, so I wont do that often) and splenda, and I gotta say, it sucked!
    Man up, mrfreddy. Just how badly do you want to lose weight? I drink these same shakes a few times per week, and, although I don’t lust after them, I don’t find them all that objectionable. MD uses MRM Whey protein powder with a little Immuno Pro thrown in. MRM Whey protein powder is sweetened with stevia, which, along with the added flavoring, makes the shakes sweet enough for me. She uses Da Vinci or Torani sugar-free flavoring syrups, which are both sweetened with Splenda and are both widely available.

  65. First, allow me to thank you for using a 5’6″ female weighing 195 as your example. I just know you were thinking “Kathy from Maine” when you chose that example!
    Seriously, it really helped to see how the goal changes over time, and helps me to set smaller, more easily attained goals. My lowest weight achieved (since reaching 195 once before) was 150, though I was 135 on my wedding day 30 years ago. At 150, I felt lean and mean, but knew I still had at least 10 or 15 pounds to go. You’re right about perspectives. At 150, people actually got ANGRY with me and told me I needed to stop there and not even THINK about losing more.
    I also wanted to add that I think I have finally internalized the problem with alcohol and accepted the fact that it is the #1 reason why I’m failing to lose, even when I adhere so closely to a low-carb plan. Like others here, it’s extremely difficult for me to stop at just one drink, be it wine or whiskey. I usually have that second drink, and on occasion have had the third drink. I also admit to being able to down an entire bottle of wine over the course of an evening. Not often, but have done it.
    So, I want to announce here that as of last Thursday night, both my husband and I swore off alcohol, at least until we lose some weight. I know I can maintain my weight and have alcohol, but I can’t lose while having alcohol.
    I get it. Finally.
    Now for a question regarding those protein shakes. You said each shake should be 6 ounces of water, 1 1/2 to 2 scoops of protein powder, 1 ounce of half-and-half, ice, and flavoring.
    What is that in terms of grams of protein? The scoops for ImmunoPro are tiny when compared to to whey protein powder I can get at the grocery store.
    Also, you suggest 2 a day, and a low-carb dinner. Should I really keep it down to 2 shakes, or can I have another one if I’m ravenously hungry?
    Thanks again for all your help and support! I can’t wait your book.
    And, instead of meeting in New York for steak, how about you and MD coming to Maine for a nice lobster dinner? At $2.99 a pound right now, you’d be a cheap date!
    The protein powder we use (see my answer to mrfreddy for the brand) contains 18 grams per scoop. MD uses 1.5 scoops for her and 2 for me. The ImmunoPro doesn’t really add all that much protein, just some other good stuff. Won’t make much difference for weight loss whether you use it or not.
    You can have three shakes per day and a meal. That’s what we sometimes do, especially if we have gone off the reservation and eaten like hogs on a trip or something.
    The avoidance of alcohol is an important step if a) you’re struggling with weight loss, and b) if you find it hard to stop after just one drink. I think you’ve made a smart choice.
    Next time we come to Portland, I’ll email before. I promise. And we’ll take you up on the lobster dinner.

  66. thanks, I do wanna lose the weight badly, but since my manhood is on the line here, I guess I better try harder, heh heh…
    today’s shake was better, I added half a banana and a bit of apple.
    with all that ice it’s a bit much tho – gives me an ice cream headache!
    tried another one with just cold water, heavy cream, powder (biochem whey, not much flavoring) and splenda, stirred up in a little milk frothing gizmo wifey never uses (it’s pretty nifty, stirs the stuff up nicely, and I can use it at work where I dont have access to a blender). Tasted good enuff.
    I wonder if sugar free jelly might be good…
    over and out on the shakes topics, thanks!
    Half a banana and a bit of apple?!?!?! The bit of apple is okay, but do you know how many carbs are in a banana? Reminds me of many of our patients who came in who weren’t losing weight and who were eating bananas. When we asked them why they were eating bananas they said, ‘you told me I needed to get more potassium and bananas have a lot of potassium.’ We would always reply, ‘Yes, and we gave you a prescription and a handful of sample of potassium supplements.’
    Hope you find the right mix. Maybe we can lay out some alternatives over a big porterhouse at PL’s.

  67. Sigh. Those calculations sound so confusing to me. I need a chart.
    Look in your Protein Power book. You do have a copy…don’t you?

  68. I just read an article about the women’s clothes issue. It’s an American thing. They make the women’s sizes larger so we can feel good about ourselves and we tend to buy clothing from those that make us feel good. It’s a good strategy, and it works! I know women who will cut off the tags in their pants if they don’t like what the size says. If we went shopping in France it would probably be more like the sizes you all are talking about in the 1960’s. It’s silly the way many of us women think! But it makes it easier to be happier with ourselves and not feel depressed about sizes so much which is a HUGE thing for most women I’m friends with.

  69. Well, I think you and MD are so awesome I keep buying more and giving them away…
    Thanks. We recommend that people buy them by the case. 🙂

  70. Alright, I weigh 121 pounds at 5ft 3in. I have some belly fat that I want to lose, I have 27% body fat according to several calculators. By your equation to get to 20% body fat, I have to get down to 110 or 111 pounds. I have been there, and although I didn’t have much of a belly, I looked like an inmate from a concentration camp. Everyone asked me if I was sick. Even pictures of myself from that period look terrible. There must be some other way. 115 is usually good for me. I have pretty healthy labwork, normal blood sugars (only once was it up 1 tick over the norm, when I was about 112) etc, etc. Am I just outside your, I don’t know, group? I am 60 years old.
    I don’t know what kind of diet you went on previously to get to 115 pounds, but getting there on a low-carb diet will not make you look like a concentration camp inmate. Take a look at the pictures in Protein Power to see what I mean.

  71. Also, I have just finished Gary Taubes book good-bad calories. He noted that even tasting NON sugar sweeteners raises insulin levels. He didn’t document any more about it that I could see and didn’t comment on the percentage of rise. Of course this was in rats. I have a sweet tooth which I can keep in check with Stevia in my tea. I include the stevia (1gm cho) in the daily count. Am I sabotaging myself? I stay under about 25-30 gms carb per day. And I am following the Protein Power recommendations pretty closely, but not much movement yet (2 weeks). So, are non sugar sweeteners a potential source of ?failure? in controlling the glucose/glycogen interactions? (I wrote the previous comment.)
    There may be some little difference due to the artificial sweetener or stevia, but I don’t think it creates that much of a problem.

  72. My new gym doesn’t have a scale so I bought one yesterday. First time I’ve actually weighed myself since July 30th. Instead of 220 lbs it read 213 lbs claims my body fat is 10.3% – guessed I was around 15% max. I doubt its that accurate of a measurement but maybe its value will be consistency and will at least provide an accurate measure of the direction i.e. body fat up or down? Any thoughts?
    If it’s a scale with a body comp analyzer built in, I would ignore those readings and use the much more accurate charts in Protein Power.

  73. Half a banana and a bit of apple?!?!?! The bit of apple is okay, but do you know how many carbs are in a banana?
    actually the half a banana wasn’t my downfall yesterday. the banana and apple combined have at the most 20g’s, that along with the little bit of califlower at dinner would add up to less than 30 for the day, maybe 40 max, adding the cream in my coffee, and other minor sources.
    but a friend called, and beers were consumed, many beers. Therin lies the rub!
    PL would be great if you can make it. I’ve tried most of the major steakhouses in Manhattan, but haven’t made it out across the bridge yet.

  74. I have a question that is at least closely related…
    All the calculators I have used say that I am around 21% body fat (I am a 23 year old female). I only have a few pounds to lose but I have a lot of cellulite. (Well, at least what I consider a lot!) Are some people just more prone to this than others? I would think that if I had a lower body fat percentage then it would not be as prominent… but even when I was at my target a year or two ago I still had it! Just wondering if you have any insights.
    Without going into the anatomy and physiology of cellulite, I can tell you definitively that if your body fat percentage gets low enough, you shouldn’t have it.

  75. “Half a banana and a bit of apple?!?!?! The bit of apple is okay, but do you know how many carbs are in a banana?””
    There are only 9-18g of carbs in half a banana, depending on the size. 18-36g in a whole one. I don’t see why the banana should be demonized, while franken-food like protein shakes and toxic artificial sweeteners (man-made chemicals) are embraced. I think it’s better to eat real food than man-made crap. I seem to be in the minority, as many prefer to delude themselves with processed sludge, then wonder why they are still fat. I think those artificial sweetenres, rotein shakes, and other garbage are behind Jimmy Moore’s 25-30 pound weight gain and the subsequent inability to lose it. At least he is moving ahead, tryingt to eat a diet with no fake sugars and no sweet tasting foods at all (including natural ones). That might be what it takes to lose weight since he has poisoned himself with chemicals for years.
    “Yes, and we gave you a prescription and a handful of sample of potassium supplements.”
    This last part of your response is just as troubling to me as the first. People should be eating food to get potassium, not supplements. There must be plenty of potassium in meat and raw milk or primitive tribes (like the Eskimo and Masai) would have died off. Maybe we don’t even need as much potassium as we’re led to believe by the USDA and other groups. They seem to keep revising the recommended daily intake higher and higher. In the recent past, a quart of whole milk was supposed to provide about 90% of the daily value. Now it’s down to 40%. They are just inflating our “needs” to convince us that we need supplements and fortified foods. I bet fresh meat and milk have plenty of potatssium if eaten in the absence of grains, refined sugars, vegetable oils, protein shakes, chemicals, and industrial “foods.”
    You are basing your comment on your own theories and on your own personal dietary experience, a study with an N of one. I have treated thousands of patients on low-carb diets and have based my recommendations on what I have experienced and discovered from doing so.
    I would imagine that 90 percent of the problems that people develop switching to low-carb diets arises from a potassium deficiency. People who follow low-carb diets for the long run don’t have it (which would be the case with Paleolitic man), but people who are in the early stages or who are restarting do experience it. Potassium prescriptions solve the problem. Patients do stay on these prescriptions forever, but they do help at the start.
    Again, based on my experiences with countless patients on low-carb diets, one of the main reasons for weight-loss stall is the consumption of too much fruit, especially high-carb fruits such as bananas. I’ve taken care of patients who have lived on ‘natural’ diets of fruits and vegetables only (including one whose obly dairy came from a goat she milked herself) who were fat as pigs, and who lost nicely converting to a low-carb diet. Just because something isn’t processed doesn’t mean it won’t make you fat. Try eating a diet of potatoes, bananas and other tropical fruits, beans, sweet potatoes, etc and see what happens.
    I don’t believe that Splenda is all that harmful. Would I prefer that people never take it? Sure. But I would rather them consume a little Splenda in a soft drink (if they drink soft-drinks) than the full HFCS-laden variety.
    My recommendations are a triumph of experience over theory.

  76. Dr. Mike,
    Please post these equations as soon as is feasibly possible. My copy of PP is getting very beat up, and I’m putting together an Excel spreadsheet to do some of my tracking for me. I googled the researchers you used, but I couldn’t find an equation, and the explanations in the PP book are basically “Measure this, measure this, and look at the table”. It’s a lot easier to use an equation than to try to input the whole table.
    It would be much appreciated.

  77. I’m interested in knowing more information (your research, studies, etc.), if there is something, about the “inflection point” (my own name for the lack of another). This is the closing of the window of time where a person makes the leap from acceptable body weight to being grossly obese. This point is where all people; (men, women, adolescents and even children) transition from husky to heavy to overweight to fat to obese to grossly obese. What happens during this transition? How long does it take on average? What nutritional, psychological and emotional factors keep more and more people from reigning in the weight when they first notice it creeping up (clothes don’t fit, thighs rub together, belly hanging over belt, etc.). Your recent blog: Changing perceptions of obesity made me think about this phenomenon even more. Your wisdom and insight have been quite helpful to me and my family.
    Thanks for the kind words. Your questions are all perceptive. I’m sure there is such an ‘inflection point,’ but I haven’t really thought long and hard on it, so I’d hate to give a shoot-from-the-hip answer. It gives me something to think about.

  78. @Bruce:
    First, I agree with you about the artificial sweeteners. If sugar is heroin, then an artificial sweetener is methadone: you may be off the smack, but you still aren’t clean. Both should be avoided as much as possible. There is too much evidence about them acting as possible endocrine disruptors, as well as stimulating insulin release just via taste. And I’m with you about avoiding chemicals on principle – it’s far better to lose the sweet tooth. That being said, if you absolutely must have an occasional soda, I suppose diet is better than regular. I can’t think of anything that tastes more repulsive than diet soda or more sickeningly sweet than regular soda (this from a 2 bottle of day consumer of mountain dew and dr pepper) but some people get cravings for it.
    In regards to supplements, though, I think we need to acknowledge that this is not our ancestor’s environment. Agriculture, selective breeding, and over-farming have depleted soil of nutrients and made modern produce and meat very different from their paleo counterparts. Potassium, magnesium, and selenium all seem to be lacking from modern foods relative to their paleo ancestors. Meanwhile, omega-6 fatty acids (corn/grass fed beef) and sugar (fruit is bred to produce the sweetest variety) concentrations are increasing. Selenium, vitamin A and D (among other things) are not obtained in sufficient quantities by most people because organ meats are rarely eaten. For the first time ever, it is possible to get fat from fruit, because we grow the sweetest possible varieties. I doubt you could ever become *obese* from eating fruit (even bananas!) but it would no doubt slow weight loss.
    To me, these realities warrant supplementation (even if only occasionally) with magnesium, potassium, vitamin a, and omega-3 fatty acids (the last two from cod liver oil) as well as a limitation of fruit, particularly banana, pineapple, and mango.
    Protein powder is simply a concentrated dairy product, and shouldn’t be a problem so long as high heat was not used to extract the protein and it is used sparingly. High temperatures, if I recall can warp and damage proteins, making them potentially allergenic. If cow’s milk is found to be allergenic, goats milk derivatives can be used instead. I use a goat whey product, but only sparingly (a few times a week).
    As far bananas, I find VERY ripe bananas (once starch has converted to sucrose) to be great post-workout foods. I don’t always have a post workout meal, but bananas, whey, flax seed, and cinnamon is my go-to quick refueling snack.
    Dr Eades, please feel free to hack away at my possibly misinformed statements as needed. 😉
    Nope, you covered it pretty well. All but the overripe bananas. I can do without those.

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