By Dr. Melissa Gomez
As a follow up to my last post, I left the question of how to prevent weight regain (which is really what we all want) unanswered. I would like to address some ways in which you can prevent weight regain here.
PREVENTING WEIGHT REGAIN AFTER DIETING WON’T BE EASY
I want to start off this conversation by stating that keeping the weight off long term isn’t easy. I wish I could tell you otherwise, but my 15 years of experience as a physician and 8 years specializing in helping people lose weight and optimize their metabolism tells me otherwise. My suggestions to you is to try and mentally prepare to continue your work on your weight even after you reach your goal weight; reaching your goal weight is just half the battle.
YOUR METABOLISM ISN’T PERMANENTLY BROKEN
I want to address a popular belief that some people have; they think they have a “broken” metabolism that cannot be fixed. While I believe there are very rare medical conditions that may cause a person to have a truly “broken” metabolism, I can tell you that 99.9% of people do not have this problem. There are also many people who have been dieting on and off for so many years that their metabolism very slow from chronic low calorie consumption. However, I want everyone to know that METABOLIC SLOW DOWN IS NOT A CONDITION THAT CANNOT BE OVERCOME with diet, exercise and lifestyle interventions. There are also medications that can be prescribed to you by a physician like me to help improve your metabolism. I hope these statements give you hope that you can overcome challenges with your metabolism but it will take daily effort and work.
I will leave the topic of prescription medications to another day, primarily because even with medication, you need the other components of your diet and lifestyle to be in place to lose weight and keep it off over the long term. Even the most aggressive treatments, medications and surgeries for weight loss can be overcome (meaning you can gain all the weight back) if you don’t have a healthy diet and lifestyle in place.
KEEP TRACKING YOUR DIET
So lets start with diet. Many people, after dieting, try to go immediately back to their previous eating habits. With a a slower metabolism, your previous diet will cause you to gain the weight back even faster than you were gaining weight before your diet. So while I do believe that you can start to add back some of the foods you were avoiding while losing weight, in general you need to continue to keep a large majority of the dietary changes you made to lose weight in place. For example, if you were following a ketogenic diet with 50 grams of total carbs per day and you were losing weight, you might be able to tolerate adding back 20 more grams of carbs per day to maintain your weight, but you can’t go back to the average 150-300 grams of carbohydrates you were consuming prior to starting the diet. Or if you were calorie restricting to 1,400 calories and you were losing weight, you many be able to tolerate increasing your calories to 1,600 calories and maintain your weight, but you can’t return to the 2,200 calories you were consuming prior to stating your diet. This means you need to keep up your level of accountability by tracking something (calories, carbs, fats) when you are ready to transition off your diet in order to determine your sweet spot for weight maintenance. Over time you may be able to add back even more calories/carbs/fats, but that will depend heavily on other aspects of your lifestyle: primarily exercise.
INCREASE YOUR MUSCLE MASS
I would be remiss if I didn’t emphasize how important it is to have been exercising, particularly resistance training, while you were dieting and how important it will be for you to continue to exercise and try to push yourself on the exercise end once you want to transition out of a weight loss diet. While, if you start to eat a bit more, your metabolism will slowly start to increase over time, this is a very slow process that can take years and your metabolism won’t increase as quickly as you start to regain the weight. However, you can help your metabolism recuperate by increasing your lean body mass, otherwise know as your muscle mass. Your muscle mass is the one component of your metabolism that you have significant control over. So if, after transitioning out of a weight loss diet, you push yourself to gain more muscle mass, you will be increasing your baseline metabolic rate which will help you prevent weight regain and keep the weight off long term.
PRACTICE ZONE 2 CARDIO
Zone 2 cardio is the most effective cardio for improving your metabolic “burn”. It is the best type of cardio to practice for fat loss and to improve your metabolism. I have another post here which describes Zone 2 cardio in great detail. In general try to get 45-90 minutes of Zone 2 training in 3-4 times a week.
INCREASE YOUR NEAT
My next recommendation starts out sounding like exercise, but I hope to encourage you to transition this from something you have to do consciously into something that becomes an unconscious habit. I would like to encourage you to try to add movement at times where you normally wouldn’t move. So for example, I used to make phone call to patients while sitting at my desk. Then I got a standing desk and more recently I have started to pace around my office while I am on a phone call. I have also started to try to fidget (cross my legs and move my foot) while I am sitting. I always park far away in a parking lot and I always take the stairs. It is very difficult for us burn a lot of calories in 30 minutes to an hour we dedicate to exercise, so we have to take advantage of the other 11-15 waking hours of the day to add movement. In general the energy we burn not engaged in purposeful exercise is called NEAT (non-exercise activity thermogenesis). Studies show that we can increase our energy expenditure by 300-500 calories per day by adapting these habits. This is generally considered a subconscious effort, but I feel that it can go from a conscious effort to a subconscious effort if we practice it long enough to make it a habit.
SLEEP AND STRESS
Two others components of keeping your weight off long term include keeping a healthy sleep schedule and trying to manage your stress levels. Both topics are too long and complicated for this post, but I do have another post on the importance of sleep and how to work on your sleep quality here. I will post about stress management and weight loss medications in the near future.