Evidence-Based Guide to Weight Loss

calories-in-calories-outI’ve now written extensively on overweight, obesity and metabolic syndrome from several different angles and thought it was time to summarize some of the most important information on these topics. In the previous post I pointed out the shortcomings of conventional weight loss advice and how the mantra to “eat less and move more” could be doing us more harm than good. In this article I’m going to summarize the basic principles for losing weight. If you want to delve into the more comprehensive articles and scientific research on weight loss, check out the archive.

My interest in body weight regulation and obesity doesn’t only stem from the fact that I find these subjects very intriguing, but also because the obesity epidemic is one of the biggest health challenges humans have ever faced. I want to provide the most accurate and up-to-date information for people who are struggling with their weight and therefore use the most powerful tools we have at our disposal – evolutionary biology, human physiology, and modern science. When we use these bricks as the groundwork for studying overweight and obesity it quickly becomes clear why some diets and weight loss plans work, while others fail.

An obesogenic environment sets the stage for inflammation, hormonal dysregulation, and weight gain

Studies of hunter-gatherer tribes and non-westernized populations have made it clear that overweight and obesity result from a mismatch in the sense that the modern obesogenic environment is very different compared to the habitat we’re adapted to live in. Although this doesn’t mean that we have to emulate the lifestyle of our paleolithic ancestors to lose weight, it does provide a framework for understanding the foundation of the obesity epidemic.

I find that most of the conventional wisdom regarding overweight and fat loss is shortsighted or just plain wrong. Yes, off course overeating, inactivity and lack of self-control play a role. However, if we start to dig a little deeper it becomes apparent that weight gain is largely a result of an obesogenic environment that sets the stage for inflammation and hormonal dysregulation.

It’s interesting to note that since overweight and obesity are associated with increased low-grade inflammation and metabolic dysfunction, humans are healthiest when we are relatively lean. However, this doesn’t mean that carrying a few extra pounds is the end of the world, and it definitely doesn’t mean that all lean people are healthy, far from it.

When we put everything we know about weight regulation together it becomes clear that the changes we have to make to lose weight are also the changes we have to make in order to be healthy. This is the reason why the ‘shake diet’, ‘juice fast’ and ‘detox diet’ always fail in the long run. They don’t provide the necessary nutrients and aren’t addressing the underlying problems that make us eat more and store more fat… They don’t make us healthy!

Weight loss is not just about making a decision to be more physically active and eat less

leptin

Improving leptin sensitivity is one of the keys to long-term weight loss. Photo source

I’ve repeatedly highlighted the fact that restricting calories and exercising more doesn’t really work for long-term weight loss. While those who are lean and want to lose even more weight usually have to consciously reduce food intake, the basic goal for those that are overweight and obese should be to reduce inflammation, improve sensitivity to key metabolic hormones, and lower the homeostatic setpoint. If this is done correctly, energy expenditure will increase (e.g., higher metabolic rate, increased body heat production) and appetite will decrease. You essentially burn more stored energy and aren’t as hungry as before.
To understand these principles of thermodynamics, leptin, and homeostatic regulation of body weight, read my previous articles on the subjects (1,2,3,4).

Before we jump in I want to make it clear that genes (both human and microbial) do matter. While some people manage to get lean by just removing highly processed food from their diet, others have to follow all the steps to really shed a lot of fat. The observant reader will notice that the information in this guide is very similar to the previous guide I made last year. However, I wanted to make this post to highlight some important information and suggest some tweaks that can boost weight loss further.

Basic steps

1. Eat a diet primarily composed of nutritious whole foods (1,5,6)

food_small

A diet rich in nutritious whole foods is the key component of any successful weight loss plan.

This is the basic step of any successful weight loss plan. Eat a lot of meat, fish, eggs, and vegetables. Properly prepared legumes are also great. Grass-fed dairy, nuts, berries and fruit in moderation. Grains shouldn’t make up a large part of the diet. However, traditional processing techniques such as soaking and fermentation will make grains more nutritious and easier to digest. Choose organic and/or wild produce if possible. Someone who’s having a very hard time losing weight might have to remove the most calorie dense foods from the diet, such as high-fat dairy and nuts.

2. Take good care of the trillions of microbes that live in and on your body (7,8,9)

Eating fermented food is one way to make some new microbial friends.

Eating fermented food is one way to make some new microbial friends.

The human body is more than 99% microbial from a genetic perspective, and these microorganisms play an essential role in body weight regulation.
Don’t be too hygienic, avoid antibiotics if possible, breastfeed your children, and preferably perform a vaginal birth. Avoid food that promotes the growth of harmful bacteria (e.g., highly processed food, refined flours, sugar), eat food that encourages the growth of beneficial bacteria (e.g., onions, leeks, properly prepared legumes), and eat ‘probiotics’ (e.g., sauerkraut, kefir, dirty vegetables from the garden or farmers market).

3. Tweak your macronutrient composition (1,10)

A 'high' protein intake is associated with better satiety and more weight loss.

A ‘high’ protein intake is associated with better satiety and more weight loss.

The dietary template outlined in step 1 should promote a balanced intake of the different macronutrients, but some adjustments can be made. I tend to recommend a protein intake of at least 15% of daily energy intake. However, a higher intake (>20%) is usually beneficial and especially for someone who’s trying to lose weight. This basically means eating plenty of meat, seafood, eggs, and grass-fed dairy.
While severely restricting carbohydrates usually isn’t necessary, people with impaired glucose tolerance and insulin resistance should make a conscious attempt to reduce the carbohydrate content of the diet.

4. Miscellaneous (1,11)

Lifestyle factors, such as sleep, impact inflammation, carbohydrate metabolism and endocrine function.While the three steps above are the key to long-term weight loss, other factors also matter. Lifestyle has a significant impact on both the hormonal and inflammatory mileu in the body.
Make sure you get enough sleep, improve your omega-3/omega-6 ratio, spend some time in the sun, and gently cook your food. Do aerobic and anaerobic exercise to build muscle and improve metabolic and cardiovascular health.

Comments

  1. This type of guide is really helpful for one to get perfect fitness and perfect mind setting.

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  1. […] Also, if you’re overweight and feel that the information in this article applies to you, weight loss is the best way to regain control of your body and become more […]

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