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I've lost about 8kg and 4 inches of waistline on a low-carb diet. In the past 12 months, I avidly read a large number of articles, papers and some books on low-carb dieting, and I repeatedly read the question "Why has my weight loss stalled on a low-carb diet?" in blogs. So, this is what I remember from the host of data in my head (no special order):
  1. First of all, make sure you are actually overweight. The BMI is not the be-all, end-all of all measures. Also think about your waist-to-hip ratio, your appearance to others etc. Maybe being a little chubby runs in your family without negative impact for your health. Being overweight and being sick don't have an "equal sign" in between!
  2. For women, especially postmenopausal, low-carbing seems to work differently, with weight loss occuring much later than in men. It is said that at first, low-carb nutrition stabilizes your mood, makes your skin clearer and works positively on your digestive tract. If you are female and have observed positive overall effects of a low-carb diet, don't give up (yet). Get your bloodwork done by some doctor who knows how to interpret basal insulin levels and knows the difference between LDL mass concentration and LDL particle concentration.
  3. There are still hidden carbs somewhere in your foods. This can usually be avoided by preparing the meals from entirely unprocessed food.
  4. Some people seem to react unfavorably to milk products. Even small amounts of lactose and casein stall their weight loss.
  5. You overfeed on protein. A low-carb diet only works great if you exchange carbs for fat. When you exchange carbs for protein, this will still lead to an insulin response (cf. an age-old research article) and stall weight loss.
  6. Thyroid problems can entertain metabolic dysregulation, so make sure fT3 and fT4 get tested, not just TSH; if the values are borderline, consider hormone stimulation or suppression testing.
  7. If you do sports on a low-carb diet, maybe you change your body composition without losing weight.
  8. If you are sincerely inclined to nutrition as your personal "way to getting healthy / getting less sick", consider reducing carbohydrate below 20-30 grams a day, where you enter a state called nutritional ketosis. This is really tough and you need to be knowledgeable how to handle this.
  9. Stop eating shit and eat real food. Real food specifially excludes most plant oils, margarine, modern grains, pre-packaged industrial meals and refined sugar.
  10. You have trans-fats, phytate or any other harmful agent in your food.
  11. You have medication that blocks weight loss, i.e. beta blockers.
  12. There are occasional reports of people who have to control carbohydrate intake and calorie intake to lose weight, for unknown reasons.
  13. You need to restore your gut flora. (I thought many years that this whole gut flora thing is esoteric nonsense, but there's a lot to it, i.e. the people over at Bechterew Alternative brought their ankylosing spondylitis to a standstill with a presumably Klebsiella- and Proteus-kicking diet)

Consider a weight loss stall on a low-carb diet more of an adventure to find out "what is going on", and not just drop out and say "low-carb doesn't work". There are some methods to find out what is going on:
  • Write a detailled journal with all measurements and a food log. (You are the scientist of your body. Greetings from the Quantified Self community.)
  • Get a real body analysis scale. I remember that there is one from Omron that can measure (not guess or interpolate, but measure) subcutaneous and visceral fat seperately. Reducing visceral fat is paramount in disease prevention!
  • In addition to your blood sugar, if you go fully ketotic, measure your ketones with a blood ketometer. Quite costly, yet it is a good quantitative test.
  • Get a full lab on hormones and vitamins. This is a rather shotgun-like approach, so consider this as a rather last (and expensive) option.

I also postulate my First Law of Low Carb Nutrition: The sicker you are, the harder you have to control carb and even protein intake.

Other links regarding the same topic:

If you had a weight loss stall on a low-carb diet and got through it, feel free to share your story below.

(I'm not a doctor yet, so this is not personal medical advice. Go see a doctor if you want to know the truth.)
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