las

Welcome all seeking refuge from low carb dogma!

“To kill an error is as good a service as, and sometimes even better than, the establishing of a new truth or fact”
~ Charles Darwin (it's evolutionary baybeee!)

Thursday, June 2, 2011

Is LC Morphing to HAES? Part III: Why so many "Heavy" Low Carbers

It's not like I've been the first one to ever notice or ask about the troubling observation of low carbers.  As I've written before, many low carb aficionados tend to:
  • Lose a little or no weight at all - remaining obese or overweight
  • Lose significant weight but plateau out at a weight that is still obese or overweight 
  • Struggle to maintain weight loss and regain despite adherence to the low carb WOE
While I see some positive messages from the HAES movement, I also see some dangers as well.  There's a giant chasm between striving for ultimate perfection and just accepting one's obese state.  I also believe there are health consequences to a certain degree of excess weight.  Obviously this is highly individual, and there's probably no single optimal weight for any of us.  Most of us can probably be "healthiest" at a rather broad range of weights.

I'm also highly sympathetic of the whole BMI = BS argument and the notoriously flawed height/weight charts.    I'm a BMI outlier yet, I'm under no illusions that there's not excess fat that I could stand to lose, that would improve my health in some areas - e.g. if nothing else, spare my joints some wear and tear!  Two years ago this was my purpose in seeking out the LC internet community because I was (and remain) that second bullet point above.

Responses to my questions frequently were some mix of "maybe you're not meant to be skinny" or "the important thing is eating healthy" or "we're not all meant to be perfect", etc.  So I don't see the HAES thing as new per se, but it seems to be gathering steam and overshadowing weight loss as a primary focus of late.  As I've shared, I had never even stepped on a scale until after I'd lost most of my weight, so it's not like I had some arbitrary number in my head or some unrealistic goal weight in mind, or some silly round number in my head of pounds to lose in some period of time.  Right now I'm thinking that ideal is probably somewhere in the 170's but that's not my focus.

Dana Carpender is fond of posting pin-up pics from bygone eras - as if changing standards of beauty really has anything to do with whether she's at a healthy weight for herself.  For all their protestations, many low carbers continue to try to lose weight so in a way this healthy angle has a bit of a phony whiff to it.  This is acknowledgement that they (and I) remain overweight while trying to rationalize away the fact that just low carbing is not working for them.

So anyway, this is enough of an issue that Jimmy has addressed it in two major blog posts in the past.

The first concerned Regina Wilshire, Dana Carpender and Lora Ruffner.  Two of whom have apparently fallen off the face of the internet.  In order, weight gains were attributed to carbon monoxide poisoning, a trio of an accident, hypothyroidism & a fibroid, and an insulin secreting tumor and other life issues respectively.  That's two out of three attributed to "disease" BTW, though nobody seemed to catch on to that.  This is not an insignificant detail in the context of this discussion.  First, because had these been prominent advocates of "mainstream" diets and cookbook authors - say Denise Austin, Jillian Michaels and Paula Deen everyone would have been quick to fingerpoint at their diets and/or weight.  Secondly, a blood lipid level may be predictive of future health complications, but they are not necessarily indicating that you're "unhealthy" at the moment.  Two of these three were *currently* in a state of ill health.  Did their diets contribute?  The answer is that we don't really know. (Edit 7/13:  Regina is still around, she blogs a bit at Weight of the Evidence and can be found on Facebook.  Her inclusion here is solely due to Jimmy Moore having listed her on his menus blog.)

More recently, Jimmy addressed this question directly from a reader.  He first rattled off a list of "low carbers" that are not heavy.  I'm sorry, but let's limit this to the formerly significantly overweight/obese for starters - professional and ex-pro athletes really aren't representative.  Nobody is saying that there are NO normal weight representatives in the low carb community.  They are questioning, rather, why *so many* representatives are.  Sorry, but when one becomes an evangelist for a WOE or whatever, they are setting an example with their appearance.  Nobody expects the formerly obese to have any more or less perfect body afterwards than they do for other methods. But we need to apply a consistent standard here folks.  Low carbers who remain overweight seem to want to apply a different standard to themselves now that they're eating a "healthy diet".  Yet they can be awfully brutal about, say, Oprah's weight issues at times.  This seems to stem from Oprah's stupidity in not going low carb years ago and not giving that electrifying personality Gary Taubes his own talk show. (Zzzzzzzzzzzzzzzzz)

For some reason I'm wondering at the moment why the Drs. Eades needed their 6 Week Cure for their middle aged middles in the first place?  But I digress ...

Back to Jimmy's blog posts.  At the time Jimmy wrote that one last October, he had put back on more weight and finished that year having regained almost 80 lbs from his lowest weight (Jimmy doesn't like to highlight, for some reason, that he was actually down in the low 210's at one time).  He writes:
Keep in mind that most of us who have found low-carb were either very heavy prior to changing our lifestyle or severely metabolically damaged in some form or fashion–and perhaps for some of us we have a more difficult time fixing what has already been broken because of our past choices.
And this differs from, say, contestants on The Biggest Loser how?  Jared Fogel?  I mean I've read a zillion times how nobody would want to see Jared shirtless based on his wearing baggy shirts in his photos like the one below left.


And the internet was somewhat abuzz when Jared appeared to put back some weight a while back as shown above right.  Ooooh - see?  Low fat doesn't work and I'll bet his triglycerides and blood sugars are through the roof!!  The person pictured below is much healthier!


You see, if low fat ELMM'ers regain, it's a failure of their strategy, and if they don't?  Well the heavier low carbers are inherently healthier than the leaner low fatties?  Dana Carpender chimed in on the comments:

I know that I live every day of my life with the knowledge that all it would take would be 18 months inattention to diet and exercise and I could be a size 24, no problem. It scares me, how quickly I could become morbidly obese. And not only do I have a strong genetic tendency to obesity — my father was obese, my sister has been obese — I’m also just plain short and stocky, with a ridiculously short waist and a huge rib cage (and rack). You could starve me for a couple of years, and I wouldn’t look willowy, I’d look like an emaciated fire hydrant. Not to mention the fact that I’m hypothyroid, and rapidly approaching menopause, which sure doesn’t help matters any.
Well, Oprah is 56, has thyroid issues and sports a rack when she's heavier!  Big ribcage and short waist?  Umm ... perhaps you're storing fat around your organs that's pushing your rib cage out?  I'm not getting all this rationalizing here.  I'm not sure you can get a whole lot worse in terms of messing up one's metabolism with yo-yo dieting than Ms. Winfrey, yet here she was at 50:

 but now Dana?  

That's Healthy Low Carb Living's Amy Dungan on the right there in early 2009.  How's she faring?   Her before/after are shown below.

Yep, there's an awful lot of rationalizing going on in LC circles, of that there can be no doubt.  But you just can't apply a different standard to low carb representatives than you do to advocates of other lifestyles.  And I'm not buying this whole somehow uniquely "healthy" thing, because looking past the outdated and/or professionally photographed/retouched or carefully posed head shots, candid pictures not only don't reflect a particularly slim group, but they don't reveal a particularly healthy *looking* group as a whole either.

Certainly no more or less so than many of my friends and relatives of similar ages - some of whom eat pretty SAD diets or certainly aren't shunning all carbohydrates - that I get to see up close and personal at that.  

Kent Altena has commented on my previous installment that I'm focusing on a few prominent low carbers and somehow ignoring vast swathes of success stories.  I don't know.  Low carbers who remain significantly overweight or obese as of this post:  Jimmy Moore, Laura Dolson, Dana Carpender, Amy Dungan, Kim Eidson, Big Daddy D, Brian Cormier, Ramona Denton, LowCarbConfidential dude, CarbSmart's Andrew Dimino.  I'm sure the list can go on.  Kent, himself, still has a little spare tire action going on beneath the baggy shirt ...

... tough I would consider him an inspiring ambassador for the lifestyle (as long as he hasn't gone up and down the scale radically like so many others).   Seems Kent's not a fat-phobe, but he also doesn't seem to be on board with the slather and smother trend either if the few recipe vids of his I've watched are any indication.   And to be fair, there are examples of men and women who have become lean low carbing and stayed that way.  Linda Genaw comes to mind.  But she's not a powerhouse in the "movement" so to speak.  She's not out there blogging and writing books and whatnot pushing the health angle.  Which is sad, in a way, because she appears to be the exception of someone who got truly lean doing an Atkins-style LC diet (however she now is pretty much a zero carber and doesn't use her own recipes much near as I can gather from some of her postings over at Jimmy's forum) .  She eats mostly ground beef and reserves (eats) the drippings.  She's not adding 12T of fat to two pounds of ground beef! Ultimately, this is not, however, what I'm addressing in this series.   I'm addressing "the movement" - the PROMINENT "movement" such as it is - increasingly cultish in it's repetition of mantras.  I'm addressing the direction it is taking to promote the "proper" high fat version of this diet for health even when it falls short - often far short - for weight loss and MAINTENANCE in practice.  Those claims are dubious at best considering the sources at this point.   The claims of superior healthfulness are simply not substantiated.  The science demonstrates that longer term "Atkins-style" low carbing - like 2 years but NOT permanent induction level carbs - is more or less equivalent to other approaches for weight LOSS.  No study exists on long term very low carbers.  None.  And since these folks aren't seal eating Inuit, you can't use that "proof" either.   Therefore promoting this as a healthy longterm lifestyle remains nothing but speculative. As such,  the appearances of these "real life" low carbers matter greatly and speak for themselves. Lean and healthy?  As FNC would say:  I report, YOU decide.
Oh ... speaking of ex-fatties running marathons, I'll leave you with one last Jared pic. 
  Dang that low fat lie!!

44 comments:

rkoffler said...

Hi, I know that the best way to write is for yourself, but allow me to assume that you clearly are writing for an audience. As a member of said audience, I kindly request a glossary of the acronyms you have an addiction for :). In today's post: WOE, HAES, ELMM, FNC. I struggle through your otherwise informative posts feeling like I'm an idiot who hasn't been show the secret handshake. And you are much MUCH more engaging and interesting when you don't waste words in anti-Taubes and anti-Eades sarcasm.

CarbSane said...

Hey there. Some of those acronyms are "big time" regulars in low carb forums or weight loss blogs etc. in general, so I forget sometimes.

ELMM = Eat Less Move More
WOE = Way of Eating

FNC referred to Fox News Channel's "We Report You Decide" slogan.

HAES was defined in the first post of the series as Health At Every Size - http://www.haescommunity.org/
Linda Bacon's movement.

As to Taubes and Eades, heck, cut me some slack couldja? It's not like far nastier sarcasm is beyond either of those two. And I'm definitely not anywhere near the most sarcastic blogger around. Some call me cheeky :)

I yam what I yam. Hope you'll keep reading. :-)

MM said...

Yeah, I think the "health" angle is about all they've got now. Obviously the weight loss angle isn't working. When I was stuck on my 1.5yr plateau on low carb, I was embarrassed to tell people I was on a low carb diet. I felt way too fat to be an endorsement. I'm not sure why all these low carb "ambassadors" don't seem to have that problem.

Kindke said...

I think most people are falling into the category of your second bullet point, Myself included. Initially I dropped 70lbs over about 5-6 months however the final 25lbs would not budge until I started drastically cutting calories. I think I got to about 15 lbs of my goal before I went completely off the diet and gained back weight. The stress of everyday life and such surely didnt help.

However in my experience people are gaining back weight because they are going back to thier old eating habits and/or are eating carbs. It might be different for you women but as a guy I definitely never gained weight on a ketogenic diet and I just dont think its practical to do so because a ketogenic diet has such heavy diminishing returns on palatability.

As such I doubt these low carbers you name gained back weight while still following a ketogenic diet. They surely slipped in carbs here and there.

MM said...

Kindke,

I know most people assume that if the low carb diet didn't work then you must have cheated. However, I was very good about keeping my carbs to under 40g/day, and was progressively lowering my carb level until I was below 20g/day at the end of my plateau. That was when I realized low carb was not going to work for me and I needed to try something else. It wasn't because I was cheating or sneaking carbs. I've lost over 15 pounds now and I'm eating way more carbs and less fat than I was on low carb. I'm not starving, and I honestly feel better than I did on low carb. I'm not saying low carb never works. Clearly it works great for some people, but there are also clearly some people it does not work for. It's not a panacea.

foodteacher said...

Thank you for the thinking space. I've got a week off of work and loads of time to assess things. I've been low carb-ing since January and have lost 20lbs. I was starting to get unhealthy thoughts about the nature of potatoes. While I have been low-carbing I have also been walking to work, doing yoga and wii dance as well as eating less. This week, I've eaten sweet potatoes, potatoes and lentils and have still lost a bit of weight. I feel in control. Your posts are expressing what has been in the back of all of our minds...

Kent said...

As for my spare tire underneath the baggy shirt, look at this video -- http://www.youtube.com/watch?v=7Azu0txh7lI
I am very up front with the remainder loose skin I have. Losing 200 pounds, I don't have the skin I used have any more, and if you want to criticize me for my remaining "Sharpei," go ahead. I haven't gone to the potential vanity step of removing the excess skin, so while I may never be fitness model perfect, my body fat percentage tests out in the athletic range. Can I only speak to weight loss issues if I go under the knife for vanity's sake?

As for others, here are just a few:
** SugarFree Sheila - http://www.sugarfreesheila.com/
** sugarless4life or ttdriver - 9 years at goal - http://www.atkinsdietbulletinboard.com/forums/members/ttdriver/
Heck almost anybody in this forum -- http://www.atkinsdietbulletinboard.com/forums/before-after-pics/

But like I said last time, where you cherry pick your examples will lead you to conclusions.

As for the slather and smother not being evident in my recipes, my recipes calories are typical 50-60% from Fat macronutrients.

Finally as for falling far short in practice, you can take the evidence or anecdotal examples and support almost any post. For every failed prominent person, I can point to an everyday success story who has kept it off. I can point to multiple studies that demonstrate a greater adherence rate and greater or equal weight loss to a low carb lifestyle. Ultimately, it is down to the individual dieter or person whether or not they want to make changes.

As for Jared running a New York city Marathon, great. My point has always been not that low carbing is the only way, but it certainly is the only way that worked for me.

Princess Dieter said...

I haven't done induction level LC, and I don't plan to. But I did find that moderating carbs (going to about 100) controlled my insane appetite. For 6 months now, my monster appetite has hibernated and I can even skip meals without feeling like Doom Upon Me Will Come! No binges since I started experimenting with lowering carbs.

I like fruit and veggies too much, and the occasional beans and tater, to go Taubes level or Induction level. I still want to have some corn here and there. I simply have MUCH MUCH less cause moderating carbs helped me NOT want to eat everything in sight.

Being Insulin Resistant (and hypothyroid), I think lowering carbs was simply a medical tweak for me. My body was already a mess, and I was always a high carber (heck, I grew up with rice and beans every day and then went all pasta mad in my 20's through, well, last year. :) Pizza was my main trigger food. Mac n Cheese my main comfort food. Mashed taters went into soups all the time. Me loved the carbs like mad. Sometimes 4 slices of Ezekiel bread a day (bkfst, dinner, with that veggie burger).

I hope that moderate carbs aren't a problem. I also stick to 1200 to 1400 cals (1500 and 1600 on "feast" days, special occasions). I don't want to suffer some weird body backlash. I just know that nothing, nothing, nothing put a leash on my appetite beast until I cut out starches and sugar (but kept veggies and fruit, though I moderate fruit to no more than 2 to 3 svgs per day, 2 ideally).

I have to agree that if the LC representatives aren't glowing and blooming with health--and I've been told since winter that I am, indeed, glowing with health and vitality, though maybe they lie through their teeth!--then maybe something is up.

I don't go hog wild on the fat. I do add EVOO to salads and asometimes for pan cooking, I use coconut oil for myself (hubby ain't a fan), and butter. But I keep it to minimal/necessary amounts and don't just slather all over.

Well, I love your "voice"--it is intelligent and has verve. So keep at it. I think all sides need their critics to keep them thinking and not in a rut--scientifically, mentally, physically.

Rock on with the critiques!

RRX said...

I won't speak to the issue of the leaders not being lean as they run around proclaiming VLC as THE way to lose weight.

I want to speak to the issue of not getting lean on LC or VLC and wondering WTF. When I found myself down 135 lbs without ever counting a calorie, I was ridiculously active (mostly for pleasure, but there was some structured exercise too). With a change in lifestyle and new exercise goals, my activity level dropped. That brought up punctuated increases in weight and then losses to make weight for meets. Gains and losses followed my adding in or removing carbs. Despite that, the last few lbs to make weight were always a struggle and undoubtedly came from water loss rather than actual fat loss. That always annoyed the hell out of me. I cut to ~10 grams of carbs a day. Shouldn't the weight just come right off? I wondered why it seemed like it was taking so much effort. I couldn't help but think the same things these leaders have said. Was it slower metabolism? Was it a genetic set-point? Those were some frustrating times. So, I completely sympathize with anyone's frustration following the principles without getting the results after a while. I can't speak to where people choose to go once they're at that point. That's based on a whole bunch of factors that a blog post series could be made out of.

I know I'm not offering much, but I still wanted to throw out my support for anyone feeling that frustration.

RRX said...

Kent,

re. "I can point to multiple studies that demonstrate a greater adherence rate and greater or equal weight loss to a low carb lifestyle."

Can you post links to the Pubmed abstracts? I'll get the full studies through my own routes. I'm interested to read them.

Thanks.

Kent said...

RRX - Here is the video where I talked about it:
http://www.youtube.com/watch?v=-vXBLw-zPqY

Here is the meta-analysis study:
"Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors
A Meta-analysis of Randomized Controlled Trials"
Alain J. Nordmann, MD, MSc; Abigail Nordmann, BS; Matthias Briel, MD; Ulrich Keller, MD; William S. Yancy, Jr, MD, MSH; Bonnie J. Brehm, PhD; Heiner C. Bucher, MD, MPH
Arch Intern Med. 2006;166:285-293.
** http://archinte.ama-assn.org/cgi/reprint/166/3/285
** Link to the summation data for the trials - http://archinte.ama-assn.org/cgi/content-nw/full/166/3/285/IRA50015T2"

Here is the summation of the adherence or completion data:
18. Brehm BJ, Seeley RJ, Daniels SR, DAlessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab. 2003; 88:1617-1623.
Low Carb - 85% vs Low Fat - 74%

19. Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348:2082-2090.
Low Carb - 61% vs Low Fat - 57%

20. Samaha FF, Iqbal N, Seshadri P, et al. A low carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003;348:2074-2081.
Low Carb - 69% vs Low Fat - 63%


22. Yancy WS Jr, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med. 2004;140:769-777.
Low Carb - 76% vs. Low Fat - 57%

23. Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss
and heart disease risk reduction: a randomized trial. JAMA. 2005;293:43-53.
Low Carb - 52% vs. Low Fat 50%

Here is the additional studies I referenced:
Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up
Jörgen V Nielsen and Eva A Joensson
Nutr Metab (Lond). 2008; 5: 14.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424054/?tool=pmcentrez
"In addition, we assessed the performance of the two thirds of control patients from the high-carbohydrate diet group that had changed to a low-carbohydrate diet after the initial 6 month observation period. ...
Seven of the 15 controls switched to a 20% carbohydrate diet immediately after the 6 months follow-up period. For those we have data 3234 months after the change. Three more controls sought information and attempted to change diet later at various dates."

Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet
http://content.nejm.org/cgi/content/full/359/3/229
"The overall rate of adherence (Figure 1) was 95.4% at 12 months and 84.6% at 24 months; the 24-month adherence rates were 90.4% in the low-fat group, 85.3% in the Mediterranean-diet group, and 78.0% in the low-carbohydrate group (P=0.04 for the comparison among diet groups)."

Harry said...

@ Kent

You said, "For every failed prominent person, I can point to an everyday success story who has kept it off"

Maybe so Ken, but that's irrelevant. The point is, these failed dieters are advocating a system that doesn't work for them. Why are they doing that? Why aren't they trying different things, seeking better answers?

My suggestions: (1) They've 'come too far down this road to turn back'; (2) Business interests; (3) Pride/shame; and (4) Cognitive dissonance.

@ Princess Dieter

Hi there. Congrats on your success so far!

Your story sounds quite similar to mine (used LC to 'quieten' the raging appetite I had when eating a standard carb diet).

The thing is, you seem to think you were a high carb dieter - you weren't...you were a HIGH FAT, high carb eater (the dreaded SAD). You may find (as I and many of my clients discover) that your issues with blood sugar and appetite resolve quite nicely on a LOW FAT/high carb diet...without the re-emergence of the raging appetite! For some people, this approach works better than LC, as it reflects lower energy densities...which means that you can hit lower calories/day while still eating high volumes of food (this gets increasingly more important as your maintenance calories get lower and lower with continued weight loss).

But it really is horses for courses - if LC keeps working for you all the way to healthy weight and into maintenance...all power to you.

@ RRX

Also quite a common tale...and a perfect example of why the Taubes-ian decrying of energy balance considerations is so damaging.

Your activity levels go down, your weight goes up (with the same diet)...seems that an apparent troubleshoot based on CICO is implied.

Cheers
Harry

Bill said...

@ Kent, touche!

Christopher said...

Hi Carbsane... Re. Jimmy Moore, thought you might like to know that EVERY time I attempt to post a comment on his site that speaks favorably of your work (or critically of Taubes'), it somehow gets lost in the abyss. I've honestly given up on the whole LLVLC franchise; there's no diversity of opinion there (if there ever was) - pure preaching to the choir, which gets boring... Anyway, I'm one of those ones who reads just about every day but rarely comments - and I say that to say that you have far more fans/readers than I think you even realize. I have nothing but respect for principled iconoclasts in ALL fields; you're one of them. Keep on keepin' on...

CarbSane said...

@Kent: I'm not criticizing your "Sharpei". Only you know your body and your weights, but I've seen other pictures of you where your loose skin appears markedly tighter. On your website you have a "low weight" pic of 216. Your transformation is amazing and I congratulate you on maintaining it. That last part is key for me. At this point in my life I'm not interested in losing weight. Somebody who loses weight doesn't inspire me. Someone who gets fit and truly healthy and MAINTAINS it does. YOU inspire me. I'm not aspiring to perfection myself and "success" can certainly include remaining a little overweight. You have credibility to promote your WOE. The folks I cited do not IMO.

I never said there weren't LC successes that lost all the weight and kept it off. I even linked to one who is pretty well known on the web for her recipes website. However Linda doesn't eat her own recipes anymore near as I can tell. She's basically a carnivore who uses a little cheese "as a condiment" and might have a veggie a couple of times a week. If memory serves she's also now reduced to 2 meals/day instead of 3.

FWIW, sugarfreesheila doesn't really inspire me. Anyone who can lament an inability to lose weight by walking an hour a day and keeping calories under 2000 can't be taken too seriously :-) I would also say she's clearly an outlier unless you consider all the just 30 lbs overweight folks who've come and gone from the forums I've perused after not seeing much weight loss. But she's certainly got cred to share what worked for her!

I can't see the other Atkins folks w/o registering unfortunately. Maybe you can get these folks to take a more prominent position on the web if you feel so strongly about low carb. There's plenty of room for credible advocates.

CarbSane said...

@Bill & Kent: Touche? I'd say not.

You have to look at the flow charts for participants to get a true picture, and look at the whole study. For example in Dansinger's study, http://jama.ama-assn.org/content/293/1/43/F1.large.gif
The 52%-50% comparison is made for the extreme diets (Atkins v. Ornish), but completion was far greater for the more moderate diets Zone & WW - 65% for both

Self reported adherence may not be statistically different, but Atkins doesn't look that good http://jama.ama-assn.org/content/293/1/43/F2.large.gif

And let's look at the "completers" http://jama.ama-assn.org/content/293/1/43/T4.expansion.html
Looking at Atkins, they weighed more at the end of a year than they did after 2 months on the diet. Ornish comes out on top of Atkins at every time point.

I would also add that compliance when participating in a medical study is different from real life.

@Kindke: Dana claims to rarely if ever eat more than 30g carb/day. She blogged on gaining 8 lbs during recipe development for a slow cooker cookbook - because of those dastardly carrots and root veggies that are so chock full of carbs. Psssssst Dana: carrots aren't fattening! When Jimmy added in a few veggie carbs after his last crash diet he gained weight. Now call me crazy but I'm thinking that when going from 1 lb of meat to 2 lbs and adding 1/2 cup mashed cauli with 2T butter - it ain't the measly carb grams that caused the weight gain. There's another pretty keto-gung ho IF'er named Mary Titus who posts as black57 over at Jimmy's forum and used to be quite active over at ALC forum. She gained back all her original weight loss despite staying low carb and had to do IF to lose again. She now "maintains" +/- 20-25 lbs - that's a pretty big fluctuation.

CarbSane said...

@Christopher: Thanks for sharing those thoughts.

Well, it didn't take long for Jimmy to kick me off his forum ;-)

CarbSane said...

Welcome Princess! Thanks for sharing your experiences. You know, I've credited LC with putting the final nail in my eating disorder coffin. But for me it was the ad libitum nature of the diet and losing weight eating "fattening foods". I wasn't one who ever craved carbs per se. When I think back to my binging days it was specific foods that happened to have carbs AND fat.

I think it's easy to convince oneself of certain things when they hear them repeated often enough. I've been amazed how FILLING a single serving of wholegrain pasta or a medium sized potato can be after VLC'ing.

I've thoroughly enjoyed adding fruit back into my diet. I had grossly misremembered the carb counts from all those years ago so I pretty much avoided it altogether during my weight loss.

perishedcore said...

I came into this backside first (grin). Meaning that I was changing the way I eat without having read about or gained an awareness of low carb, primal or paleo diets and the attendant blogospheres. I started reading the more research and science focused posts and gradually broadened reading to include the more guru focused bloggers. I only recognize a few of the names you reference (Moore, Eades, Taubes).

I attended a recent diatribe/"lecture" by Taubes and was thoroughly unimpressed. AFAIK what he's presenting and how he's presenting it is simply a marketing tool. Mat LaLonde, who I had heard a few weeks earlier at a one day biochem basis of nutrition seminar, was also there, along with the cheeses from the Harvard School of Public Health, and Taubes was universally dismissive and rude to them as he was to every single questioner in the audience.

I spoke to Mat afterwards, and he was disgusted with Taubes. I don't think he'll be invited back to his alma mater for a repeat performance. He seemed to relish burning bridges and promoting the notion that he is a rogue outsider who should be credited with a Kuhn-like scientific paradigm shift.

Anyway, back to LC and health: I never went low carb, but I did go gluten free, eliminated all added sugars and refined foods, ditched the O6 veg. oils and ate unlimited fruit and vegetables along with sweet potatoes ad lib. I added cream and butter along with aged cheese and homemade yogurt. I eat mostly offal and make soups/stews with meaty marrow bones and the whey from the homemade yogurt, along with eggs. I had eaten a couple oz of almonds daily, but have stopped that for now as the summer bounty is rolling in.

Adding fat to my diet caused rapid weight gain every time I intentionally did that (three times). After three to four weeks, I returned to my baseline as above and slowly dropped the weight. When I first weight stabilzed - in the middle of the nl BMI, but with visible excess weight from abdomen to ankles, I was a healthy control in a couple of renal studies, and so I had serial blood work drawn. Tris stayed at 50, HDL at 109 and tchol at 210, along with nl renal and hepatic values. fasting glu stayed in the 83-87 range and HbA1c was 4.9.

I walk a lot (am carless, have access to sidewalks most everywhere) and have been in two rounds oF phys therapy for arthritic joints (which haven't responded to an antiinflammatory diet in any way, shape or form, although crp is .3 and homocysteine is under 10).

Long way round of saying that on paper I look great, but in real life, my pain has been untouched, I still have severe treatment resistant depression, sleep is horrible (the best I can do is 3 hrs, and often it's a big fat zero).

The tradeoff? My appetite and hunger issues reregulated, and I don't seem to have to monitor intake as long as I eat whole foods as above. It's been a year on, so I expect things to change, but have no expectation about what those changes may be.

From start to now, I've lost about 70 lbs (I didn't have a start weight except for a year prior employee physical one, so that's what I used).

You bring up valid questions, and I hope they get addressed in some fashion. Maybe the crowd sourcing techniques of a site like CureTogether would provide some interesting data about various WOEs.

CarbSane said...

Thanks for sharing all this! I think a lot of these folks are in denial about their overall health. Jimmy is proud of getting off meds yet he has since gone on Metformin for reactive hypoglycemia (makes no sense but he did) and on Armour thyroid so there's hypocrisy there. He would still be on cholesterol meds if the same criteria were applied to today's lipids. Dana, too, has recently been diagnosed with PCOS and is taking Metformin.

Oh, check out my Selenium & Estroven post over on the other blog. My insomnia has vanished!

perishedcore said...

Oh yeah: selenium supps w/ brazil nuts, lots of seafood (forgot to include that up top - lots of O3 supps, seafood and fatty fish in the diet - what can I say - I like sardines, herring and the little bitties.

Also took transdermal HRT. Now in a trial of a melatonin variant for depression - none of those has helped sleep except that the agomelatine has increased the total # of hours of sleep somewhat, but the tradeoff has been nightly nightmares.

Have run out of things to try. (IF, too, hasn't done anything that I can perceive, although a VAP showed very low fasting insulin and vit d of 80.

Kindke said...

Carbsane,

So let me get this straight, these people reportedly lost weight on a certain LC diet, then made some minor *ahem* adjustments to thier diet, but kept it ketogenic ofcourse, THEN gained back the weight?

How can I not call shenanigans on that?

CarbSane said...

Well I don't know ... I'm not in their homes so I can only go by what they say. However when a staunch proponent of ketogenic diets reports that she gained back all her lost weight while remaining low carb, I tend to believe her. And the tweak for her that got the scale going back down was to do intermittent fasting. Now she's reporting that she's bouncing up and down 20-25 lbs ...

AFAIC, there's really no difference between remaining low carb or falling off the wagon and gaining. When you think about it, a WOE or "lifestyle" is about what trying to adhere to something produces over the 365, not in the 24/7. So if trying to adhere to some extreme diet means you eventually go on carb binges, then promoting the nirvana of LC life is equally irresponsible.

If we can attribute some of the obesity epidemic to low fat dogma (and I think *dieting* per se has contributed to obesity in many, myself included) we sure as heck have to look at what happens to the majority of people who try a low carb diet.

Amy Dungan said...

Wow. Just wow. While I can't say I've agreed with everything you say, and vise versa, I've never had the urge to belittle you in anyway. I have simply looked at it as a difference of opinions. Thanks for showing your true colors.
I've not only explained on my blog about my weight re-gain, but I specifically told you about it on the forum, because you asked me. Makes one wonder why you didn't bother sharing that, while discussing my re-gain. So for those who were not around during that discussion: I gained back weight because, under a tremendous load of stress, I started making very bad eating choices. I've NEVER claimed I was perfect, or even a perfect example of the low-carb lifestyle. My purpose has been to just help others see that there are other options. I also never said that sticking to a low-carb plan was easy. It's been easier for me than a low-fat diet, but it still takes work and determination. Where my low-fat diet made my health worse (acid reflux, IBS, etc.), a low-carb diet has pretty well eliminated those problems. So even if I'm didn't lose weight on low-carb (which I still am), at least I'm not relying on a medicine cabinet full of prescriptions to get me through the day. I don't see how that's bad.
I could have easily chosen your route, and made up a fake name and never shared photos or stats. But that wouldn't have been real, so I wasn't interested in that. Oh, and you do realize that you stole all those photos, because you didn't get permission to use them, right? Despite it being "common knowledge", everything on the internet isn't just up for grabs.

Ailsauk said...

I am so surprised at the logic in this blog, to blatantly name people and shame them reminds me of being in high school. The hurt at putting those names shows your lack of compassion. Oh and when I was with Dana 4 weeks ago she was very slim and looked exactly like she does in the 'old' photos! Some of the people have had emotional hurdles. We are all on a low carb journey, some take the straight road some not so straight. We all have struggles but I would take support any day from my good friend you delight in criticising, but then you do have a BS degree!

Harry said...

There's obviously a lot of hurt feelings here...and that's perfectly understandable. It can't be easy to have your personal struggles with weight referred to in open discourse.

BUT.

Your own weight is a relevant fact to the argument you are advocating for; as such it's fair game....both on the up-side (e.g. you post pics of your six pack and your readership/book sales/donations go up) AND on the down side (CarbSane points out your struggles as a data set against the proposition that "LC dieting really, really works!").

You can't have it both ways guys.

Also, explaining weight struggles with mitigating circumstances (e.g. I was under stress, I'm not perfect etc.), while perfectly natural at the human level, is completely besides the point at the scientific level.

Either you advocate for a WOE that people can stick to with success, or you advocate a WOE that people can't stick to with much success. The reasons why people fail are not all that relevant in the final analysis. And in this case, LC has no better long-term success than any other diet (post 2 year horizon).

So, if you're going to let your WOE 'off the hook' by blaming your personal character flaws for your relapse(s), you might as well come out and advocate starvation...that works really well in the short term.

Guys, maintenance IS the measure of a successful WOE. Everything else is smoke and mirrors.

Cheers
Harry

Kim said...

I guess I'm confused. You eat low carb, you lost some weight, can't get to goal, and like to bash others who are in the same situation. I've never met you, never as far as I know, had a conversation online or otherwise with you, but you feel you can belittle me online. I hope you feel better.

I live in Joplin, Missouri. I've had 2 weeks filled with death, devastation and destruction and I've seen some angels among us for sure. You took just a few words to show me that ugliness is still around.

Muata said...

I was going to leave a comment until I read Harry's.

... what he said ;)

CarbSane said...

Based on some of the responses to this post here and elsewhere on the internet, I'm beginning to think that carbohydrate restriction impairs reading ability because I didn't say what many are reading into my words.

Part of the reason for this series is because at this point I don't see long term VLC as healthy in maintenance. This is the subject of the vast majority of the content on this blog. Yet this is the message that the people I'm "calling out" are putting out there. And the message is getting more extreme (higher fat, lower carb) and when the diet doesn't work for weight loss, then well, it's still healthy because we all know carbs can kill.

I didn't belittle anyone or question the reasons why folks regain weight. I'm not sure what part of my sharing my struggles you've all missed. What I said was that for a low carber there's always a reason given other than the diet for the failure. But those same issues, stressors and illnesses happen to everyone even folks on high carbohydrate diets. So why aren't so many advocates of "conventional" diets heavy?

I don't know if any of you watch Fox News but on the weekends they have Isadore Rosenfeld giving out health tips and even though he generally doles out pretty sound advice (not always), I just can't get past his appearance. He's either not following his own advice, or it's not working all that well for him. If I were to go to a nutritional counselor and he/she was fat and giving me advice to eat in any particular way, why would I listen?

This is Harry's point. Thanks Harry.

This whole "healthy high fat, moderate protein, low carb" diet mantra needs to be backed by sustainable results. I don't know what world y'all are living in where you make your name based on weight loss but regain or yo-yo wildly to maintain your results and think it's somehow unfair and mean for someone to point that out.

Rather I would ask: If you're eating a certain way and it's not even working for you in a SUSTAINABLE fashion, WHY are you advocating it to others?

The whole notion that carbohydrate consumption causes insulin resistance and diabetes is flawed. You might want to read some of those articles here and act appropriately to improve insulin sensitivity. Long term low carbing is likely making you more insulin resistant if anything, and if you're still carrying excess weight and doing it it could be downright unhealthy. Not because I say so, but because the researchers Taubes points to do.

Case in point: Dana was just diagnosed with PCOS and put on Metformin. If she'd been eating the SAD all along surely the finger would be pointed at the diet. Why not look at the diet now? Perhaps eating a 75% fat diet is leading to hepatic insulin resistance. Maybe it's not all that healthy to eat that way after all? Just a thought.

RRX said...

Greetings Harry,

That implication is correct. An injury meant that I would be off from my usual training for roughly 6 months. So, I decided then to try out the old CICO. I didn't have that excuse to be 20 lbs heavier anymore. It worked flawlessly. In fact, I decided to just stay in the lower weight class even after I healed. I've been weight-stable at this new all-time low for 5 months now - and without effort I might add.

I learned years ago after losing the first 135 lbs, though, not to generalize what I have done to anyone else. So, I didn't want to make proclamations that this is what everyone else should do. I'm happy to say that it DOES work, despite anything Taubes might claim (in fact, I found many of his claims to be very untrue for me when I tested them, which was not an easy thing to admit out loud as a previous VLCer for years on end).

BUT, this is just my case. It in no way excludes the possibility that other individuals find better practices. I don't want to negate them in any way like so many have negated what I had achieved for myself in the past.

In the case of the subject of this post, I have found throughout the years that some people DO want the leaders to demonstrate their claims and other people DON'T care whether the leaders do or not. It's a matter of opinion, as far as I'm concerned. To each their own as to what they think on the matter.

Helen said...

Would I take the advice of an overweight dietitian? Well, maybe. I have a couple of friends who are dietitians, and I do think they know what they're talking about, although their views fall into a more conventional framework than the traditional diets, low-carb, and paleo blogs I tend to read. Both struggle with their weight. Don't people often teach what they most need to learn? Just like all those neurotic therapists out there, like the one I'm married to!

Emotional eating and full-blown eating disorders can't be overlooked as a cause of weight gain, whatever someone's macronutrient ratio, whether they eat fructose or PUFAs or gluten or raw shellfish or highly palatable foods!

Here's a link to one of my friends' blogs, "Confessions of an Overweight Dietitian."

http://confessionsofanoverweightdietitian.blogspot.com/

. said...
This comment has been removed by the author.
rkoffler said...

CarbSane: Your last response on this thread is thankfully written in plain, easy to understand English, without confusing and distracting sarcasm, French pronouns, psssssts, acronyms, convoluted syntax trying to be "cute" and folsky, personal attacks, and so on. It has allowed me to learn more about your point of view than most of your previous posts combined. Until now, I had started to think that you stood for the following, “Some dietary protocols work for some people some of the time, except when they don’t. Some people have something meaningful to say except when they don’t, except for Gary Taubes and Dr. Eades who never have anything meaningful to say except that they do but they don’t because they have agendas. So, to sort out the confusion, I’ll periodically post densely written, acronym-heavy reviews of scientific papers and conclude that since we know less than what we know, I’ll criticize everything and everybody and leave it up to you to figure out the confusion I’ve created.”
This said, I have a lot of interest in reading your point of view except when I don’t because you go out of your way to make it difficult to understand.

CarbSane said...

@Ailsauk: I'm sorry but Dana was not slim, let alone very slim, in her lecture video from the recent cruise.

Since my focus in researching for this blog is on health, this promotion of LC for health is an issue for me and just as many say "why should I listen to you" -- it's a valid question, but I'm discussing the science mostly, not advocating a particular WOE. I share what has worked for me and folks can take away from that what they will. I would say the majority of people on discussion boards do not give out their real full names. If you do, and you're advocating eating a certain way, then I'd say appearance matters.

CarbSane said...

@Regina: I think your issue is ultimately with Jimmy Moore, not me. I looked to see "where are you now" and found no active blogging and such. I'm not sure what sort of "fact checking" you feel is incumbent upon me for referring to a topic Jimmy discussed. Congratulations on your maintenance - it's refreshing, and also refreshing to see that someone is eating a less extreme LC diet than is currently being pushed as *the* healthy right way to eat.

You guys seemed to miss the point of what I said in the article and are extremely defensive. I'm sensing more than a bit of "doth protest too much" going on here. My point was that two of the weight gains were attributed to actual "disease" - aka unhealthy state - if these were advocates of Ornish or Dr. Oz, folks would be quick to blame the diet, no? C'mon many of the comments, for example, about Dr. Oz on Taubes' blog are brutal as regards his polyps (and inaccurate as they were not cancerous, but who cares right?) Again, if Kirstey Alley was still shilling for Jenny Craig but gained the weight and it was found she had CO posioning I'm sure many would not cut her any slack.

The fact remains that many of the most prominent low carbers are significantly overweight. Maybe those who are not should start speaking up more and louder.

CarbSane said...

@Regina: Forgot to mention, did I say anywhere that you advocated HAES? No. Only that the subject of this part in the series - why so many LC'ers are heavy - has come up twice before on Jimmy's blogs.

CarbSane said...

@rkoffler: I'm speechless ;-)

scall0way said...

"@Ailsauk: I'm sorry but Dana was not slim, let alone very slim, in her lecture video from the recent cruise."

Hmm, sounds like this must have been a different Dana from the one I was on the cruise with last month. THAT Dana Carpender *was* slim and fit looking - not fashion model skinny perhaps. But what person in their right mind wants that. But certainly slender and trim looking, and one hot-looking babe for a woman in her 50s. Is my memory faulty? No, I don't think so. I just went back and looked at the photos I took of Dana on the cruise, and she still looks trim and healthy.

She is not as thin as Jackie Eberstein, also on the cruise, who was Dr. Robert Atkins's nurse for some 30 years, and who credits Atkins and his diet for reversing severe health problems she had had that no other doctors had been able to resolve. But then Jackie is *very* slender - an impossible standard to hold most of us to. But if you feel Dana is not slender then you must have pretty damned high standards of perfection too. :D

Yeah, I admit I fall into the category of people you talk about above. I've lost 110 pounds on a low carb diet and been maintaining that loss for a couple years now with no difficulty, but I'm *still* obese and find myself unable to lose another ounce. I'm certainly not wedded to LC philosophy and have searched and researched eating plans all over the net. The main reason I stay mostly low carb?

Well, I've tried just about every diet under the sun at some point, and LC is the only one I've ever been able to live with on a long-term basis. Every other diet I've ever tried was awful for me, and I could never last more than a couple weeks max. I tell a lie, I did go on a low fat diet back in the 80s for nearly a year, and lost a tremendous amount of weight - more than I have on low carb to be honest - But I was MISERABLE. I cried myself to sleep every night. I had to give up all semblance of a social life and become a virtual hermit outside the working day, as it was utterly impossible for me to be in any sort of social situation where people might be eating food. Finally I was so depressed and miserable I decided I'd rather weigh 300 pounds than eat a low fat/veggie-rich/whole grain diet one more day.

So? Do I eat a diet where I lose more weight but I'm miserable and practically suicidal? (low fat) Do I follow a diet where I lose a goodly amount of weight (and losing over 30% of your starting body weight is considered damned good by most bariatric standards) though not as much weight as I'd like, but at least feeling happy, social, and enjoying my food every day? (low carb). Hmmmmm.

Heck, if I had a magic wand to lose these last pounds I want to lose you can bet I'd wave it. I keep looking for what will work. Since nothing has for the last two years I'll keep looking, but in-between experiments I go back to the only eating plan, in 40 years of on-and-off dieting, that is sustainable for me, which is a mostly low carb plan. But damn, I sure wish I could look like Dana.

CarbSane said...

@scall0way: I'm trying not to get sucked into a discussion critiquing physiques here, because that's irrelevant. Adjectives are somewhat relative, and depending on one's viewpoint the goalposts certainly move. I wear size 10 jeans and a lot of ladies my weight will say they'd just be happy to be wearing that size.

But let's not kid ourselves and re-define skinny, slim, slender, etc. Dana has gone up and down over the years, but she's still clearly overweight for her frame as evidenced in her gymsuit pictures. Her age is irrelevant b/c - as I stated in this post, "to be fair" - Linda Genaw is over 50 too. Linda is slim. Look, Andreas is lean, Tom Naughton is not. That doesn't mean I'm calling Tom fat, he's not. But he's not lean.

I know I will never be slim unless I had starvation forced on me. That's also not the issue.

Inherent in your comments here is something I'm trying to get at. That "low fat" doesn't work, but low carb does - and did (and books were written about it) - but is not always sustainable (Amy & Jimmy), and it doesn't always work by the SAME benchmarks by which other lifestyles would be evaluated.

I'm very happy for you that you are able to maintain a significant weight loss enjoying eating LC. But you are admittedly considerably overweight and only you know whether it is worth it for you to try other ways of eating to improve your health or what you can do. How's your strength and stamina? This is where I'm at. That I can run up a flight of stairs, jump down off the bed of my husband's truck, shovel snow as a workout rather than killing myself, these are all important things for me.

But the claims that a diet that can only get someone to still rather overweight is optimal for health is deceptive. At the very least, the purveyors of this message ought convey to their readers this reality, and I guess that's what they are trying to do with all this "it's healthy" talk - especially on Low Carb Conversations. Folks listen to interviews and unless they're following along with blogs and such have no idea the back-stories of these proponents. There are SERIOUS inconsistencies in many of these stories.

One thing I can tell you is that post LC, I'm finding certain carbs far more enjoyable now than I did previously. I mean before if I had a baked potato, it would need sour cream, butter and a ton of salt. Now, just a bit of sour cream OR butter and a sprinkle of salt does the trick and potatoes are FILLING.

Damn, I sure wish I could look like Denise Austin. Not gonna happen even if I ate just like her .....

Flowerdew Onehundred said...

When I finally went back to eating carbs (my thyroid seemed to need them), I found a lot of things like brown rice pasta and baked potatoes to be much more filling than I had previously remembered.

Sanjeev said...

Same for me: imagination inflation, a memory error

or copy & paste:
http://en.wikipedia.org/wiki/Memory_errors#Imagination_inflation

Several other effects on that page may interest you as well.

And related: hunger on low fat was not as bad as I had remembered.

There's also IMHO a stronger effect: after having convinced myself that carbs MUST CAUSE EXTREME HUNGER my first couple of tries at adding carbs were, shall we say, "suboptimal".

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