Starting my weight loss journey:

I have no medical qualifications. Accordingly, I am only able to explain my personal weight loss experience. The reader is advised to discuss what I have set out in this document with their own doctor before deciding if a low-carbohydrate diet is suitable for them. For many decades I struggled to control my weight. In November 2019 I weighed 142.9 kg (Body Mass Index [BMI] of 44.1 for a male with a height of 180cm).

My doctor referred me to a medical professional who treats patients for obesity. The medical professional examined me to assess if my health was suitable to commence a restricted-calorie diet. After the medical examination, he recommended that I should commence a low-carbohydrate (ketogenic) diet. In November 2019, I was 58 years old. The goal of my diet was to reduce both sugar and all carbohydrates to a very low level. This mostly excluded bread, potatoes, pasta, rice, cereals, flour, and all foods that were high in sugar or carbohydrates from my diet.

When I commenced the diet, I was not aware that a process of adjustment to a low carbohydrate eating plan would result in the effect of reducing my hunger cravings. It was this “reduction in hunger” resulting from adaptation to a low-carbohydrate diet that made sustained weight loss possible for me.

Previously I had tried many diets without any lasting success. I believe that this “reduced hunger” effect was the most important factor in my weight loss outcome. My previous and unsuccessful diets were “calorie reduction” diets which did not attempt to limit my carbohydrate consumption to a minimal level.

In the first six weeks of the diet, I lost 10 kg. My weight in March 2023 was 83.7 kg. (See weight loss chart below). This represents a weight loss of 59.2 kg since the commencement of my diet 40 months earlier in November 2019.

What “worked for me” with successful weight loss?

• Achieving the “reduced hunger” effect of a low carbohydrate eating plan. This “reduced hunger” effect made one meal per day possible at a level of approximately 900 to 1,000 calories per day.
• Gradually adapting to a low carbohydrate eating plan rather than trying to achieve a dramatic and sudden switch. In the first week or ten days, my initial goal was to switch my eating pattern to exclude sugar and carbohydrates. I first attempted to adapt to low-sugar and low-carbohydrate eating of two meals per day. This was at a calorie level which was normal for me. Only later did I attempt to gradually reduce my calorie intake to a level that would induce weight loss at one meal of 1,000 calories per day.
• The adaptation phase was important and took 3 weeks or more. Once I had adapted, I found it became easier.
• Having regular support from a medical professional. In the early stages of my diet, I had a consultation and “weigh-in” every 6 weeks. Later in the diet, and as the pace of my weight loss slowed, the consultation was every 3 months. The regular consultations helped to keep me motivated as I knew my weight would be recorded.
• Having the support of family and people who know me so that I would not feel pressured to break my diet in social situations unless I made a conscious decision to do so.
• Purposefully not setting a “goal date” to achieve weight loss. – Having a mental attitude that my weight loss schedule will take “as long as it takes”. Otherwise, I would have been setting myself up for failure.
• Not being discouraged by slight gains in weight which were often little more than water retention.

 

What “didn’t work for me” with my previous unsuccessful weight loss attempts?

• I will focus on reducing the calorie content or reducing the fat content of my diet without making any attempt to reduce the sugar and carbohydrate content.
• Making dramatic and sudden changes rather than progressive and incremental changes to eating patterns. This included reducing my daily calorie intake which was not sufficiently incremental.
• Feeling pressured to achieve a weight loss goal by a certain date.
• Not being sufficiently aware that my obesity probably resulted from poor nutrition. – Not being sufficiently aware of how detrimental sugar was to my overall health. For example, my earlier and unsuccessful attempts at weight loss maintained a relatively high sugar and carbohydrate intake but significantly reduced daily calorie levels. I discovered that this approach to weight loss was unworkable due to ferocious hunger resulting in poor weight loss outcomes.
• In my earlier and unsuccessful diets, I sometimes ended weight loss attempts because of what I consider was probably my “panic reaction” to heightened levels of hunger. This might have been a deep-seated fear of starvation. Such a fear does not have to be rational. Slow and progressive adaptation to a low carbohydrate/restricted calorie diet allowed me to overcome this reaction; and to gradually coach my body to commence an ongoing process of “fat burning”.

 

Comments on my weight loss trajectory and its period:

Examination of my weight loss graph shows that there were periods when I experienced a weight loss “plateau”. My experience was that if I was able to sustain a calorie intake of 900 to 1,000 per day, I was able to induce sustained weight loss on one meal per day.

However, there were extended periods when I was probably eating more than 1,000 calories per day. This slow pace of weight loss was probably a motivation issue for me and explains the weight loss “plateau”. However, I was still strict with myself in terms of restricting sugar and carbohydrates with only rare exceptions.

I don’t think that my consumption of food above 1,000 calories per day was necessarily driven by hunger. This illustrates that even if a reduced level of hunger can be achieved by adapting to a low-carbohydrate diet – sustained weight loss still takes effort and motivation.

I am aware that others have reduced their weight by an equivalent amount in a much shorter period. However, I never felt under any pressure to achieve a goal weight by a certain date.

In summary, I was progressing at the pace that I was comfortable with. I also think that it is probably unrealistic to expect weight loss to occur in a linear descent. Somebody who was more highly motivated than me might be able to achieve the same amount of weight loss in a much shorter period.

A weight loss “plateau” was not a concern to me. However, if it had occurred, a sustained gain in weight would have been a concern to me.

I also allowed myself “exceptions” to my normal diet rules which involved much higher levels of calorie intake above 1,000. This included Christmas and family occasions. In each case, I knew that I was delaying my weight loss destination by at least 24 hours. While allowing myself a higher calorie intake on those occasions I still tried, within reason, to keep the profile of the higher calorie intake both low-sugar and low-carbohydrate.

Comments on the “reduced hunger effect” of a low carbohydrate diet:

I don’t think that my sustained weight loss would have been possible without first adapting to a low-carbohydrate eating plan. My level of hunger was unquestionably reduced to a relatively low level once I had adapted to one meal per day with significantly reduced carbohydrate intake. From my previous weight loss attempts this “reduced hunger effect” was not obtained from diets that were not low carbohydrate and/or low sugar.

I think it would be untrue to say that there was no hunger in an eating plan of one meal per day of 1,000 calories on low carbohydrate foods. However, my level of hunger was so insignificant that weight loss was possible for somebody who is motivated to lose weight.

What food categories did I decrease or eliminate on my weight loss plan during those periods when I achieved sustained weight loss?

• Practically all junk food and fast food.
• Confectionery in all of its forms; and any food which I knew to be high in sugar. – An opportunity to learn more about food labeling paying particular attention to grams of sugar.
• Any food containing carbohydrates such as bread, pasta, potatoes, rice, cereals, noodles, flour, potato chips, etc. – Another opportunity for me to educate myself about food labels and which foods contain high levels of carbohydrates.
• Condiments such as tomato sauce and barbecue sauce which are very high in sugar.
• Juices including fruit juice which is high in sugar. Sugar is a specific category of carbohydrate.

 

What food categories did I increase on my weight loss plan during those periods when I achieved sustained weight loss?

• Foods which are high in fat content such as brie and camembert cheese.
• Olive oil which I used extensively in cooking. Olive oil has a high-fat content.
• Fish including sardines, mackerel, and tuna. These seafood have a high protein content and a relatively high-fat content. I tried to include them almost every day. I selected sardines and tuna packed in olive oil instead of tomato sauce. This was to give priority to fat and to exclude condiments containing sugar wherever possible.
• Chopped tomato and diced capsicum which I purchased in cans.
• Vegetables including onions, fresh mushrooms, and diced capsicum which I fried in olive oil with chopped tomato and eggs.

 

Questions I had to ask myself before I commenced my diet:

• Am I willing to change? Obesity was my body’s way of telling me that my diet patterns were not working for my body type. An example of change is that I eliminated all sugary soft drinks. However, on my diet, I often drink soda water in the summer months. Soda water is a carbonated beverage but it has zero sugar. I discovered that I could enjoy cold soda water just as much as soft drinks. An adjustment period was required. During the course of my weight loss experience, I came to understand that my liking for soft drinks was little more than an addiction to sugar that I could eliminate. Change was possible and necessary.
• Am I addicted to certain foods which was contributing to my obesity – including fast food and confectionery? I had to be honest with myself about the sugar and carbohydrate content of the foods in my personal eating patterns. Those items cannot be eliminated until they are identified.
• Can I adapt to a different eating plan which is “low-carbohydrate” which might require support and understanding from others.
• Can I re-schedule my day to allocate more time for home cooking and shopping for home cooking ingredients.
• Am I willing to work with a medical professional who will help and encourage me on my weight loss journey?

 

Higher calorie days:

Due to the multi-year duration of my diet, it was impractical for me to strictly adhere to 1,000 calories per day, every day. When I consumed more than 1,000 calories per day, I accepted that I was either slowing or stalling my weight loss achievement.

On “higher calorie days”, my bias was towards consuming extra calories in the macro-nutrient category of fat rather than consuming extra calories in the macro-nutrient category of carbohydrate. For example, I ate larger portion sizes of brie cheese, bigger servings for my regular meal, sometimes two meals per day rather than one, and extra protein food with a high-fat content, etc.

I was still strict in limiting sugar and carbohydrates in recognition that consuming those food categories would increase my hunger craving.

Exclusion of sugar and changes in sense of taste:

After I had adapted to a low carbohydrate diet, I was able to identify changes in taste that were consequential to the exclusion of sugar from my diet. Those changes were essentially a refinement of my sense of taste.

For example, I would sometimes eat 400 grams of canned tomato if I was feeling more hungry than normal. Although sugar was present in that food at a relatively low level, the taste was almost sweet after I had adapted to a low-sugar diet. Prior to the significant exclusion of sugar from my diet, I would never have regarded that type of food as “sweet”.

The energy in 400 grams of chopped tomato was 92 calories. More important to a ketogenic diet was the presence of 12 grams of carbohydrate. (12 grams of carbohydrate which was inclusive of 8.8 grams of sugar).

Accordingly, the less sugar I permitted in my diet, the greater the refinement of my sense of taste for sweetness – a positive cycle. Similarly, prior to my ketogenic diet, the more sugar I permitted in my food intake, the more I needed extra sugar to obtain any sense of sweetness – a negative cycle.

Testing my progress in achieving weight loss:

On my doctor’s recommendation, I was able to test whether my body was in “fat burning” mode by the use of ketone testing strips which are placed in urine. These testing strips were available “over-the-counter” at my chemist, and they measure the presence or absence of ketones in urine.

When the testing strip turned a dark color, it indicated that my metabolism was in “fat-burning” mode. A lighter color on the testing strip indicated little or no “fat burning” was taking place. Good results were motivational to me. Grades of different color codes were provided for results. I found it helpful to contrast the outcome color with the color on an unused testing strip.

The testing strips enabled calibration of the extent of calorie reduction needed to induce progress in weight loss. I didn’t make use of the testing strips until after I had fully adapted to a low-carbohydrate diet, and my daily calorie intake had been restricted to a minimum.

On my doctor’s recommendation, I also took vitamin supplements as my nutrition was dependent on a restricted calorie diet.

Summary comments:

• Persistence is important. I know from my previous unsuccessful attempts to lose weight that it’s all too easy to find an excuse to end a diet. Be resilient. I came to discover that my weight loss journey would be “a few steps forward and then one step back”. Early and rapid weight loss was gradually replaced by a slower rate of weight loss as the magnitude of my overall weight loss increased.
• Changing from three meals to one meal per day was a significant change. I had to plan a new daily schedule.
• I wouldn’t again try to lose weight on my own, and without support. At the very least – I would consider joining a weight loss support group that meets on a quarterly basis. This will help to keep you motivated in the longer term. You will be helping yourself, and you might also be able to help others.
• My obesity developed over many decades. It was not realistic for me to expect quick results. Patience was important. My ketogenic diet was not just about losing weight. Apart from reduced weight I also obtained other health benefits including reduced blood pressure.
• The “reduced hunger” effect of a low carbohydrate eating plan was the most important factor that enabled my weight loss achievement. However, I think it is much better to view that effect as making weight loss possible rather than making it effortless.
• Finally, I think that successful weight loss requires an optimal strategy. For me, that strategy was unknown until I discovered the health benefits of a low carbohydrate or ketogenic diet.

 

The future:

• I have lost 59.2 kg since I commenced the diet and my health is now improved. My weight is now 83.7 kg and my BMI is 25.8.
• To maintain the benefits of my weight loss I have accepted that I must maintain a low-carbohydrate eating plan for life. This will require a monitoring process to discover the daily calorie amount that maintains my weight at my desired level.

                                                                                                                                                  

Note:   The identity of the author has been disclosed to the Noakes Foundation, and they have chosen to stay anonymous.

Male aged 61 years

Melbourne, Australia

March 2023