Blog

The ideal protein to carbohydrate ratio per meal for maintenance

In general, the more protein you eat at a meal, the better you feel and the more energy you have throughout the day.  But most patients also need to eat a certain amount of carbohydrate at each meal in order to feel at their best.  In general, most patients start out eating too much carbohydrate and not enough protein.  My usual recommendation is that patients should not eat meals of protein only (except for 500 calorie a day, protein only, very rapid weight loss periods), as most feel best eating a certain amount of carbohydrate.  My usual recommendation is to halve the amount of carbohydrate and double the amount of protein in the average American serving.  For example, when eating a sandwich, double the amount of protein and don’t eat the top slice of bread.  

Advanced eating windows and eating every other day

The best and fastest way to lose weight is to eat up to 500 calories a day of canned or pouched fish, seafood or poultry only, eaten during a 2-4 hour window.  Don’t eat anything else and do this for as long as you can.  2 hour windows work better than 4 hour windows (you will be less hungry and have more energy, especially the next day), but 4 hour windows work.  When you can’t do up to 500 calories a day of protein only anymore (most patients can do this for 1-4 weeks, until it’s just too hard to do), switch to every other day dieting, but keep the window.  One day (during your 2-4 hour window) eat what you want, and don’t be crazy.  Try to eat 80-160 grams of protein during your window, best from fat-free Greek yogurt, fat-free or 1% or 2% cottage cheese or egg whites or Egg beaters.  Don’t go over 160 grams of protein in your window, but the more protein you eat the better you will feel and the less hungry you will be throughout the day.   The next day, stay in a 2-4 hour window and go back to up to 500 calories of canned or pouched protein only.  The reasons to limit your fish, shellfish and poultry to cans and pouches only is portion control.  It is essential to limit your total calories of protein to no more than 500 a day.

The best weight loss – eating windows and eating every other day 

By combining eating windows and eating every other day, you get the best weight loss.  Limit your eating to a 2-4 hour window every day and you will be far less hungry.   2 hour eating windows works better than 4 hour eating windows, but 4 hour windows are easier to do.  Limit your calories to 500 calories (also in a 2-4 hour window) every other day and you can also really speed up your weight loss.   Most patients eat what they want (within reason) during their 2-4 hour window and lose 2-3 pounds a week.  The more low calorie protein you eat during your window, the less hungry you will be and the better you will feel throughout your day.  The best sources of low calorie protein are fat-free or 1% or 2% cottage cheese, fat-free Greek yogurt, eggwhites or Eggbeaters, seafood (crab, shrimp, lobster, clams, oysters), canned or pouched fish (tuna, salmon, sardines), and canned or pouched poultry (chicken, turkey).  Cans and pouches make it easier to control calories and portion size.

The advantage of eating windows

The advantage of eating windows is that many patients are able to lose 2-3 pounds a week and eat whatever they want (within reason) during a 2 hour eating window each day.  The more sugar you eat, the worse you are going to feel, but you know that.  If a 2 hour eating window is too hard to do, try a 4 hour eating window.  If you find yourself in a social situation where you must eat, make the social situation your eating window or order a vegetable only salad without dressing and treat the food like a prop.

Eating windows AND eating every other day

Eating windows make it easier for many patients to lose weight.  By doing all of their eating for a day in a 2 hour or a 4 hour window (2 hour windows work better than 4 hour windows), many patients steadily lose weight.  The advantage of eating windows is that most patients are far less hungry the day after a 2 hour eating window.  During their 2 hour window, patients generally eat what they want, without going crazy.  Protein intake of 80-160 grams during the eating window makes most patients feel better and do better as they are far less hungry throughout the day.   For some patients, 2 hour eating windows are much easier than traditional intermittent fasting (eating 500 calories one day and eating freely (within reason) the next).  Extremely motivated patients combine both of these approaches with spectacular results.  The strategy is to eat 500 calories one day in a 2 hour eating window, and freely feed the next day (within reason) also in a 2 hour eating window. 

2 hour eating windows to lose weight – 4 hour windows to maintain

Many patients expand their eating window from 2 to 4 hours when they want to stop losing weight.   The advantage of 2 or 4 hour eating windows is how not hungry patients feel the following day.   By continuing to follow eating windows for maintenance, patients continue to take advantage  of experiencing very little hunger.  But expanding eating windows to 6-8 hours causes most patients to lose the lack of hunger the following day.

What to eat in social situations when intermittent fasting?

The easiest thing to order in a restaurant if you feel you need to order food to be polite is a side or dinner salad.  No dressing, no cheese, no croutons, no nuts, no meats, no seeds, no poultry, no seafood, etc.  A side salad can have as few as 35 calories.  I say this because a whole head of iceberg lettuce is 35 calories.  You can also order a half head of iceberg lettuce for 17.5 calories.  You are always best just ordering ice tea or diet pop or ice coffee or hot tea or hot coffee instead of a salad.  Use as much artifical sweetner as you like – Equal, SweetnLow or Truvia.  No creamer in coffee or tea.

A 2 hour or a 4 hour window?

A 2 hour eating window makes you feel less hunger the following day than a 4 hour eating window, but 4 hour windows are much easier to follow for most patients.  The advange of a 4 hour eating window is that it gives you leeway to stay on track.  Let’s say that your eating window yesterday was 6pm-8pm.  But today it’s 4pm and you’re hungry.  A 4 hour window makes it perfectly okay to start eating again at 4pm and extend your eating period to 8pm.  Play with 2 hour and 4 hour windows and incorporate both in your lifestyle.

The magic of eating windows

2 hour eating windows allow many patients to stay on 500 calories of protein only for several weeks without cheating.  It is amazing how less hungry patients are the day after a 2 hour window.  There is no caloric advantage of a 2 hour eating window.  But there is a compliance and no cheating advantage.  Patients who have been stuck begin to lose weight because they are so full the day after a 2 hour window that they stop cheating.  In terms of calories, it doesn’t matter what time you eat or how many meals you eat.  It’s like going to a gas station.  You can go to a gas station once a day or you can go 4 times a day.  It makes no difference.  You can go to a gas station at 8 in the morning or at midnight.  It makes no difference.  What does make a difference is sticking to a diet and not cheating because you are hungry.  2 hour eating window effectively decrease hunger for most patients the following day.

Fastest weight loss with eating windows

Most patients experience the fastest weight loss and do best on 500 calories a day of protein only (canned or pouched poulty, fish or seafood) with a 2 hour eating window.  They are far less hungry every day and able to stay on this very restrictive regime for 1-4 weeks.  If you’ve never been able to successfully stay on 500 calories or protein only a day, try it with a 2 hour eating window.  Eat all of your food during one 2 hour period.  If 2 hours is too difficult, try a 4 hour eating window.  6-8 hour windows are not as effective for most patients.

Eating windows

A 2 hour eating window works best.  Patients are almost always far less hungry the following day when they restrict their eating to a single 2 hour period a day.  This is true for both eating days and fasting days.  It makes sense from an evolutionary standpoint.  3 square meals a day did not exist for most of human evolution.  Human beings ate when we were able to find food and the body adapted to this schedule.  Homo sapiens have been on the planet for 600,000 years.  We have only been farming and eating 3 squares for less 10,000.   If you can’t do a 2 hour window, try a 4 hour window.  6-8 hour windows are nowhere near as effective in decreasing hunger the following day.

Timing is important

Most patients do most of their damage the same 2 hours every day.   Figure out when you are in trouble and schedule a 2 hour eating window during the period.  I continue to be amazed at how less hungry patients are the following day after a 2 hour window eating day.  It is contrary to common practice to limit eating to only a 2 hour period a day.  But many patients on intermittent fasting feel so much better with eating windows they never go back to traditional meal timing.  For social occassions and restaurant eating they order vegetable salads without nuts, cheese, croutons or oil which are usually 25-50 calories.

More on eating windows

Eating windows (limit your eating to the same 2 hours every day) are an interesting way to lose weight loss because we really don’t understand how or why they work.  It may be as simple as that by limiting your eating to the same 2 hours every day you take in fewer calories.  But I think something else is going on.  Patients are almost always far less hungry the day after a 2 hour eating window.  It may be than insulin levels are lower.  I don’t know.  But patients do best with a 2 hour eating window.  If a 2 hour window is too hard to do, try a 4 hour window.  If a 4 hour window is too difficult, try a 6 hour window.  In my experience, 8 hours eating windows don’t help patients lose weight.

More on eating 2 hours a day

A 2 hour a day feeding window keeps insulin levels lower throughout the day so most patients are less hungry.  In addition to being able to do less damage in a 2 hour window than in a 16 hour window, by limiting their feeding period to 2 consecutive hours a day, many patients feel less hungry and fuller on the following diet day.  Patients are often far less hungry and do better and feel better the following diet day by eating one giant meal on their eating day instead of two, three or four smaller feedings.

Limit your eating to 2 hours a day

Another intermittent fasting option that helps some patients lose weight is to limit their eating on their feeding day to a 2 hour period.  It’s unclear why this works other than you can eat alot less food in 2 hours than in 16 hours, but limiting feeding to a 2 hour window helps many patients who are stalled lose weight.   Some patients carry this 2 hour feeding window over to their 500 calorie day as well and find that this helps too.  There may be a metabolic advantage to limiting feeding to a 2 hours window but it’s unclear exactly what the biochemical advantage is.  But limiting feed to a 2 hour window helps some patients lose weight who are not losing weight on traditional every other day intermittent fasting.

Faster but harder

Super motivated patients do one day of total fasting (the only thing allowed are sugar-free cough drops and sugar-free Jols, and at least a gallon (128 ounces) of water or calorie-free fluid) –  followed by a 500 calorie protein only day –  followed by a free feeding day that includes 1000 calories of protein.  The best protein to eat is egg whites, fat-free Greek yogurt, fat-free cottage cheese, and canned or pouched fish, seafood and poultry.  Average weight loss on this program is 3-4 pounds a week.  This approach is harder because the liver is not kept full of glycogen on a day of total fasting and a day of 500 calorie protein only, so it requires determination and will power.  The advange is that weight loss is rapid and most patients have more energy on their 2 days of protein.

Protein or carbohydrate on your fasting day?

Most patients do best on 500 calories of pure carbohydrate on their diet day to keep the liver full of glycogen and minimize binging on the following eating day.  This said, some patients do better and feel better on 500 calories of protein only.  500 calories of protein only is harder to do as liver glycogen levels decrease on your fasting day, but some patients feel better with more sustained energy.  There’s no right or wrong way to intermittently fast.  The key (and healthy thing) is not eating every other day.

More on fastest weight loss

Fastest weight loss is almost always on up to 500 calories a day of canned or pouched poultry, fish or seafood.   Cans and pouches guarantee portion control and calorie control.  The problem is that most patients cannot stay on this very restrictive Walk, Swim or Fly diet for more than 2-3 weeks or a month.  When 500 calories a day of protein only becomes too hard to do, the best solution is to add a freely feeding eating day, every other day.   Patients do best eating what they want (within reason) every other day, or eating 500 calories of protein only Monday through Friday, and eating what they want on Saturday or Sunday or both.  

If you can’t lose weight

If you can’t lose weight dieting every other day, your problem is most likely that you are eating too many calories on your eating day.  The strategy that is most effective to solve this problem for  many patients is to first eat 160 grams of protein on their eating day.  The most popular way to do this is make sure that the first thing you eat on your eating day is 1 quart of fat-free or 2% fat cottage cheese AND 1 quart of fat-free Greek yogurt.  Each quart contains 80 grams of protein and eating both quarts before eating anything else makes most patients feel so full that they are able freely feed (within reason) the rest of the day without going crazy.  Go back to eating no more than 500 calories on your diet day and you should lose 2-3 pounds a week intermittent fasting this way.

Fastest weight loss

Fastest weight loss for most patients is on up to 500 calories a day of canned or pouched protein only.  They choose from chicken, turkey, tuna, salmon, clams, mussels, sardines, shrimp, crab or lobster.   When they can’t do protein only anymore, they take the weekend off and eat what they want on Saturday and Sunday but don’t go crazy.  Then they go back on 500 calories of protein only Monday through Friday and take the weekend off again.

Another helpful strategy

Another helpful strategy for some patients is to eat 300-400 calories of protein only, once or twice a day on their diet days.  This approach takes more will power as the liver is not kept full of glycogen eating protein only, so there is increased risk of binging if you are not commited to the program.  But many patients have more energy and are better able to stick to this kind of intermittent fasting because of the protein loads.  On this approach, most patients eat their 300-400 calories of protein only, once or twice a day, Monday through Friday.  Protein is eaten once or twice a day depending on how hungry you are on a particular day.  Take the weekends off and eat what you want without going insane.  Average weight loss is 3-4 pounds a week.

SAMe helps some patients lose weight

SAMe (S-Adenosyl Methionine) is a nutritional supplement that is available over the counter from Amazon and from your local drug store or health food store.  It’s usually cheaper on Amazon when I’ve price shopped.  Two 1500mg capsules, three times a day, has an  antidepressant effect that makes it easier for some patients to stick to intermittent fasting.  Almost every other nutritional supplement available over the counter has no effect on weight loss.  But SAMe’s antidepressant lift makes it easier for some patients not to cheat.

When 500 calories a day gets too hard to do

When 500 calories a day gets too hard to do, a trick that sometimes helps is to increase your calories to 1000 on your diet day.   This increase usually still allows weight loss in the range of 1-2 pounds a week.  Another helpful tactic is to switch from the classic 500 calories of fresh fruit on your diet day to 500 calories of canned or pouched poultry or fish, once or twice a day.  It’s surprising how doubling your calories and switching from fruit to protein can help you get back on track.

An effective alternative to every other day

An effective alternative to every other day dieting that works well for motivated patients is to eat 400-600 calories of protein only (canned or pouched poultry, fish or seafood) Monday through Friday, and take the weekends off and eat whatever you want, within reason.  This Monday through Friday, weekends off approach is often good for 3-5 pounds of weight loss a week.  It takes iron will to stay on 400-600 calories for 5 days in a row, but knowing that the weekend is free is enough to keep a suprising number of patients motivated and staying on track.  Most patient eat their 400-600 calories in 1 or 2 meals.  Some patients find 4-6 100 calorie meals of protein throughout the day more satisfying.

The most common benefit besides weight loss

The most common benefit besides weight loss of every other day dieting is dramatic improvement of arthritis and allergy symptoms.  Within 2-3 weeks, most patients report significant improvement in joint pain and arthritic symptoms and a decrease in allergic rhinitis and nasal congestion.  This is because by eating fruit only every other day, allergic withdrawal occurs from foods that patients are sensitive to and chronic inflammation decreases.  

My recommendation to most patients who want to lose weight

I almost always recommend that patients lose weight as quickly as possible.  Rapid weight loss is the best way to motivate continued compliance on a very restrictive weight loss diet.  For this reason, patients are almost always started on 400-600 calories a day for as long as they can comply with this extremely restrictive regimen.  Most patients can stay on 400-600 calories a day for 1-3 weeks.  When patients can no longer do 400-600 calories a day every day, I switch their program to 400-600 calories one day followed by freely feeding (within reason) the next.  

If you want to try 2 days of fasting followed by an eating day

If you want to try 2 days of 400-600 calorie protein only fasting followed by an eating day, there are several tricks that can make this easier.  Sugar-free Jols and sugar-free cough drops can help alot.  You can eat as many as you like, within reason, all day long.  Jols are 25 calories per box and Luden’s Sugar-free Cough Drops are 6 calories each.  If you eat too many, you’ll get diarrhea.  The other thing that can help is to eat 400-600 calories of canned or pouched salmon only.  One of the fastest and most compliant protein only weight loss studies was done on patients who ate nothing but salmon for 30 days.    

Very fast and a little dangerous

This is a very fast way to lose weight, but it’s a little dangerous because it is easy to fall off the wagon and binge and sabotage your weight loss.  After you can no longer do 400-600 calories of protein only a day (most patients are good for 1-3 weeks on this fastest of all weight loss programs) – do 2-3 days of 400-600 calories of protein only followed by an eating day.  This is my variation of what is known as 5-2 intermittent fasting.  On classic 5-2,  you eat 400-600 caloriest 2 days a week and eat what you want (within reason) the other 5 days.  2-5 is faster because it’s 2-3 days of fasting twice a week.  Some patients need to keep track of 5-2 and 2-5 approaches on a calendar as it can get confusing.  2-5 dieting is also one of the hardest ways to intermittently fast, as it can take iron commitment not to binge and over do it on your eating day after 2-3 days of 400-600 calorie protein only.

Other high end weight loss options

Interestingly enough, lox (smoked salmon) only works almost as well as sashmi for the quickest weight loss, but the problem is most patients are able to do lox only for 3-4 days before they tire of it.  Sashimi only is more difficult (you have to go to a restaurant to get it, as opposed to Lox you can buy at the grocery store or Costco), but patients are often able to happily live on sashimi only for 2-3 weeks and lose a pound a day.  Another option that works almost as well as sashimi is sushi without rice, but it does not work as well as sashimi only.  You can order any kind of sushi you like and have the sushi chef prepare it without rice.  The usual way is in a small cone of nori that looks like a minature ice cream cone.  The reason that weight loss on sushi without rice if slower than sashimi only is that patients eat more sushi without rice than sashimi.  Sushi without rice it’s alot more fun but the weight loss is slower as calories are closer to 1000 calories a day than the 500 calories a day patients tend to eat on sashimi only.

High end weight loss

The most popular high end weight loss program in my office is on sashimi.  The local Kroger grocery stores prepare medium sashimi trays for $16 that contain 5 ounces of raw tuna (30 calories per ounce, 150 calories) or raw salmon (40 calories per ounce, 200 calories) with lettuce, cucumber, wasabi, ginger and avocado (don’t eat the avocado).    Patients lose about a pound a day eating 2 medium trays a day.  When this gets too hard to do, patients double their sashimi intake to 4 medium trays a day and usually continue to lose about a pound a day.  When this gets too hard to do, patients increase their sashimi intake to 2 medium trays 3 times a day and usually continue to lose 5 pound a week.

Fastest weight loss at my office

Fastest weight loss at my office is 400-600 calories of canned poultry or canned fish or canned seafood for 1-3 weeks.  Then 1-3 weeks of alternating one day of 400-600 calories of canned poultry, fish or seafood – with one day of 400-600 calories of fresh fruit.  Then 400-600 calories of fresh fruit one day alternating with eating whatever patients want the next – within reason, not going crazy.

More tips to help keep you at 400-600 calories on your diet day

Sugar-free candies help.  Suck on them whenever you are hungry.  The most popular in my office are Sugar-free Cherry Luden’s Cough Drops (6 calories each), Sugar-free Jols in Black Currant, Orange, Forest Berry and Mixed Berry (5 calories in 7 pieces), Sugar-free Licorette (5 calories in 5 pieces) and Sugar-free Kopiko (70 calories in 4 pieces).  I cannot over emphasize the importance of eating 80-160 grams of very low calorie protein (egg whites, fat-free Greek yogurt or fat-free cottage cheese) on your eating day to make you less hungry on your diet day. 

Even more 400-600 calorie diet day options

Canned fruit in water is another easy way to keep your calories at 400-600 without going over.  Canned vegetables also work.  Ditto frozen vegetables.  Some patients do well with non-fat regular (NOT Greek) yogurt, as it is lower in protein than Greek yogurt.  Another option is 250 calorie or so Lunchables.  Most of your 400-600 calories should come from carbohydrate.

More ways to eat 400-600 calories on your diet day

Amy’s Kitchen TV dinners are the most popular frozen meals in my office for patients who want to eat one or two real meals on their diet days.  You can eat 2 – 250-300 calories meals or a single 600 calorie meal.  Lean Cuisine, Smart Ones, Healthy Choice and other brands are also 200-300 calorie meal alternatives, but most of these brands taste like what I like to call TV dinner hell.  Amy’s Kitchen meals are also higher in carbohydrate (a good thing) and taste like what I like to call crunchy granola healthfood restaurant hell.  If you don’t like healthfood restaurants, you will not like Amy’s Kitchen meals.  I generally do not recommend protein only for your 400-600 calories on your diet day as the idea is to keep your liver full of glycogen from the carbohydrate in your meals.

If you’re not losing weight

If you’re not losing weight, the problem may be that you are eating too much on your diet day.  Make sure that you don’t go over 400 (women) or 600 (men) calories on your diet day.  Unless you are vigilant, it is way too easy to eat more than 800 calories on your diet day and not lose any weight.   Eating only fresh fruit is the easiest and most popular way to limit your calories to 400-600.  Apples, oranges, bananas and pears are 100 calories each.  Count to 4 or 6 and you are done.  Melon, berries, grapefruit and pineapple contain 50 calories a cup but can be a problem as you have to measure carefully.  Instead of measuring melon, berries, grapefruit and pineapple – an simpler (more fool proof) strategy can be to count a whole canteloupe or a whole honeydew melon or a whole grapefruit as 100 calories, or a pint of strawberries or a pint of blueberries or a pint of blackberries as 100 calories.  

How much sugar and how much protein for weight loss?

Most patients can eat about 500 calories of sugar on their eating day (cake, cookies, pie, ice cream, candy etc.)  and lose weight.  If you go much over 500 calories of crap, it can trigger feeding frenzy and binging.  The more very low calorie protein you eat on your eating day, the total fewer calories you will likely eat because you will feel full.  80-160 grams of protein on your eating day is the magic number for satiety for most patients.  The best (very low calorie) protein sources are egg whites (7 grams of protein and 10 calories each) and seafood (7 grams of protein and 20 calories per ounce – shrimp, lobster, crab, scallops, clams, mussels).  The second best low calorie protein sources are fat-free Greek yogurt and fat free cottage cheese.  Both contain about 80 grams of protein in 500 calories.

Eating solid food makes you feel fuller than drinking liquids

Chewing is an important part of feeling full.  This is why liquid foods are less filling and less satisfying than solid foods when they have been studied.  You are far better off eating whole fruits and whole vegetables rather than fruit juice or vegetable juice.  Chewing plays an important role in satiety.  My general recommendation is no liquid calories, ever.  Soups should be hearty and require chewing.  Protein drinks are more filling and satisfy longer when filled with crushed ice.  The more you chew a food, the more satisfied you will likely feel.

Once your figure out your best protein to carbohydrate ratio

Once you figure out your best protein to carbohydrate ratio, it can be life changing.  You will feel fuller and less hungry throughout your eating day.  It’s worth testing, until you come up with the protein to carbohydrate ratio that works best for you.  When the ratio is right, you feel full and satisfied after you eat and this feeling lasts for hours.  An easy way to test your ideal protein to carbohydrate ratio is with low fat ham or low fat turkey in a sandwich.  Take a slice of bread and cut it in half.  Put 1 ounce of ham or turkey on this half a slice of bread.  Add a little mustard or low fat, low calorie mayonaise if you like.   Eat this slice of bread with 1 ounce of protein and see how you feel.  Notice how long you are not hungry.  When you get hungry again, eat another half a slice of bread but with 2 ounces of ham or turkey this time.  Repeat this with 3 ounces of protein.  For most patients, the best protein to carbohydrate ratio is a sandwich without the top slice of bread and with the normal amount of protein or twice the normal amount of protein.  Three times the normal amount of protein is overkill for most patients and not as satisfying.

Test to find your best protein to carbohydrate ratio 

You can test to find your best protein to carbohydrate ratio that makes you feel full.  For example, on your eating day, eat 1 cup of fat-free Greek yogurt and see how many hours you feel full.  Then eat 1 cup of fat-free cottage cheese and see how many hours you feel full again.  Then eat 1 cup of fat-free Greek yogurt with added strawberries or strawberry jam, and see how long you feel full.  Then eat 1 cup of fat-free cottage cheese with strawberries or strawberry jam, and see how long you feel full again.  There is an amount of carbohydrate that you can add to protein that will make you feel fullest.

Give up certain foods and lose weight

One of the nice things about every other day dieting is that the diet you lose weight on is the diet your maintain on.  If you can figure out what NOT to eat while you are losing weight, you’ll have an easy time maintaining.  The most effective foods to give up for most patients are the calorie bombs – red meat (80 calories an ounce sometimes), nuts (100 calories an ounce), cheese (100 calories an ounce), butter and oil (120 calories an ounce).

Protein can help and hinder weight loss

If you are eating egg whites and fat-free Greek yogurt and fat-free cottage cheese on your eating day, you’ll probably be fine.  Very low calorie protein makes you feel full and keeps your energy up.  If you are eating red meat and nuts and cheese and peanut butter on your eating day, you may not lose weight.  Way too many calories, way too fast.

The right protein to carbohydrate ratio

The right protein to carbohydrate ratio will make you feel fuller and more satisfied on your eating day.  This means cutting the usual protein to carbohydrate ratio in half.  The advantage of this is that you be far less hungry and have more energy.  Because you will be less hungry, this makes eating less crap easier.  The best way to halve the normal protein to carb ratio is to eliminate naked starch from you plate (no potatoes on their own, no rice on its own, no bread on its own, etc.).  And the pitch half the carb on normal protein-carbohydrate combinations.  When you eat a sandwich, pitch the top slice of bread.  When you eat a pizza, eat the topping and the top layer of crust.  When you eat pasta, make sure that it is covered with a low fat protein like shrimp or clams or mussels.  When you eat rice, eat fried rice made with egg whites instead of whole eggs and use twice the normal amount of egg.  

How I start most patients on intermittent fasting

Most patients start intermittent fasting on 400-600 calories of canned or pouched poultry or seafood every day for 1-3 weeks.  This usually creates 10 plus pounds of weight loss the first week and 5 plus pounds of weight loss a week every week thereafter.  At some point, usually 1-3 weeks in, patients can’t do it anymore.  They just don’t want to live on 400-600 calories of pure protein a day anymore.  When this happens, I switch patients to either 400-600 calories of fresh fruit one day and freely feeding the next (patients are told to freely feed within reason, not to go crazy) OR 400-600 calories of fresh fruit one day alternating with 400-600 calories of canned or pouched poultry or fish the next.

An interesting side effect of intermittent fasting

One of the most interesting side effects of intermittent fasting is that arthritis pain often disappears in 2-3 weeks.  Also, by not eating the same food 2 days in a row, often times allergy symptoms decrease or disappear.  I have seen many patients improve chronic skin rashes and chronic nasal congestion after 2-3 weeks of dieting every other day.  Proteins are allergens, which is why not eating protein every other day can help allergic symptoms. 

Simplify your diet day

An option that works for many patients is to simplify your diet day and just eat any 500 calories you want.  It really doesn’t matter what 500 calories you eat on your diet day.  As long as you stick to 500 calories you will continue to lose weight.  This said, if you eat 500 calories of vodka and Poptarts, you’ll feel terrible, but you know that.  The more sugar you eat, the worse you are going to feel.  On the other hand, if you eat 500 calories of pure protein only, your liver glycogen will drop and you’ll be more likely to lose control and binge.   The most satisfying 500 calories for most patients is just fresh fruit, or 500 calories of fresh fruit and fresh vegetables, or 500 calories of Amy’s TV Dinners.

The tyranny of calories again

The fewer calories you eat, the faster you are going to lose weight.  The fewer protein and fat calories you eat on your fasting day, the more carbohydrate you will eat, which makes you less likely to binge.  There is no metabolic advantage to low carbohydrate, ketogenic or low fat dieting.  Intermittent fasting is the easiest and most efficient way to decrease calories over both the short and long run as it maximizes liver glycogen to minize binging.  The secret of successful weight loss is damage control, to find a way to limit calories when you are eating. 

If you’re not losing weight

If you’re not losing weight or you’re not losing weight fast enough, you are eating too many calories on your diet day and/or eating too many calories on your eating day.  Keeping your calories to 400-600 on your diet day is easy, especially if you eat only fresh fruit.  Apples, oranges, bananas and pears are 100 calories each so it’s very easy.  Keeping your calories down to a dull roar on your eating day can be harder but is actually very manageable.  The key is generally to limit fat calories (9 calories per gram), which are more than twice as fattening as protein  (4 calories per gram) or carbohydrate (4 calories per gram) calories.  Patients who lose weight very quickly generally stay away from red meat, cheese, nuts, butter and oil on their eating day.

Protein is a double edged sword

Protein can help make you feel full on your eating day which is a very good thing.  But too much protein can cause problems on your diet day, because you need to keep your liver as full of glycogen as possible to minize binging the next day, so you need to eat mostly carbohydrate on your diet day.  As you are only eating 400-600 calories on your diet day, it’s generally best to eat mostly fat-free carbohydrate.  If you eat mostly protein on your diet day, you will use up some (or most) of your liver glycogen for fuel and will be more likely to binge on your eating day to fill up your liver with glycogen again.

Satiety is complicated

Feeling full on your eating day or your fasting day is complicated because the science of satiety is complicated.  Fiber (in general) does not make you feel full.  Fat makes you feel full, but the caloric load from eating fat (9 calories per gram) is more than twice the caloric load of protein or carbohyrate (both contain 4 calories per gram).  Foods you chew (in general) have higher satiety value than foods you don’t chew.  In other words, liquids generally make you feel less full than solid foods.  Google “satiety studies”.  There are a ton out there, some contradictory.  In general, glycemic index is useless, unless you are eating one food by itself.  For example, the glycemic index of cornflakes is different from the glycemic index of milk which is different from the glycemic index or eating cornflakes with milk, which also cannot be predicted from the glycemic indexes of cornflakes or milk.

More eating day tricks

Fat is the calorie carrier, so the less fat you eat the fewer calories you will likely take in.  Fat-free compared to low-fat compared to full-fat cottage cheese is a perfect example.  Fat-free (0% milk fat) cottage cheese is usually about 60 calories per ounce.  Full-fat (4% milk fat) cottage cheese is usually about 120 calories per ounce.  Low-fat (1% or 2% milk fat) cottage cheese is usually about 90 calories an ounce.  As I said, the less fat you eat, the more likely you will eat fewer calories and continue to lose weight.

The protein strategy for your eating day

The key to sucessful weight loss is to keep your calories down to a dull roar (usually 2000-3000) on your eating day.   One thing that really helps is to keep your protein intake as high as possible, usually 80-160 grams of protein a day.  The best bang for the buck are egg white at 10 calories each for 7 grams of protein.  Next best are non-fat Greek yogurt and non-fat cottage cheese at approximately 500 calories and 90 grams of protein per quart.

The illusion of eating what you want 

The secret of losing weight is to manipulate your eating day food choices to keep your calories as low as possible and make you feel satisfied.  The best strategy eliminates high calorie foods that are difficult to eat  without doing significant damage.  The best high calorie foods to avoid are usually nuts, cheese, red meat, butter, oil, dairy products and wheat products.   Unlimited fish works well for most, as do unlimited fruits and vegetables including peas, potatoes and corn.

Speed up weight loss by eliminating classes of foods

You can speed up your weight loss by eliminating certain classes of foods on your eating day.  One of the most popular and effective class eliminations is to eat anything you want, as much as you want – but no wheat or dairy products or red meat.  By eliminating bread and crackers and cakes and cookies – and ice cream and cheese and whipped cream – and beef and pork and veal – many patients are able to almost literally feast on sushi and fresh fruit and baked potatoes on their eating days and regularly lose 2-3 pound every week.

To make it easier to starve on your diet day

To make it easier to starve on your diet day, many patients eat sugar-free candy all day long.  Luden’s Sugar-free Cherry Cough Drops are the most popular in my office and contain 6 calories each.  Next most popular are 25 calories per box Sugar-free Jols in black current, forest berry and mixed fruit.  Patients also like sugar-free Licorette (licorice flavor) and sugar-free Kopiko (coffee flavor).  You can get all of these products online.

Portion control on your diet day

Portion control on your diet day is important as you need to keep your calories to 400-600.  When it has been studied, patients underestimate the amount they are eating by as much as 40% if they have to weigh or measure.  For this reason, eating protein from a can, box or bag (so you can read the label) and eating apples, oranges, bananas and pears (about 100 calories each) tend to work best on 400-600 calorie diet days.

Every other day in a nutshell

The fastest way to every other day diet is to eat 400-600 calories every day but alternate your source of calories.  One day eat 400-600 calories of canned poultry or fish.  The next day eat 400-600 calories of fresh fruit.  Then go back to a day of 400-600 calories of canned dead animals.  Most patients can do this for 2-3 weeks before it gets too hard to follow.  Then switch to one day of eating what you want (don’t go crazy) and the next day eat 400-600 calories of fresh fruit.  Fresh fruit is pure carbohydrate and keeps your liver full of glycogen which helps prevent binging and feeding frenzy.

Exactly how long do you fast?

You can start eating at 8am on 400-600 calories on your fasting day or eating whatever you want on your eating day – and you can eat until midnight.  Then totally fast from midnight until 8am.  Then it’s another 400-600 calorie fasting day or an eating day between 8am and midnight.  Then totally fast again from midnight to 8am.  The 8am to midnight eating hours are not specific.  You can eat from 7am until 11pm or from 6am until 10pm or whenever.  What’s important is 16 hours of eating (400-600 calories or freely feeding) followed by 8 hours of total fasting.  Followed by another 16 hours of eating (400-600 calories or freely feeding) followed by another 8 hours of total fasting.  As 400-600 calories is as near as makes no difference biologically equivalent to eating nothing, you are fasting for 32 hours, every other day.

If you’re not losing weight fast enough

If you’re not losing weight fast enough, switch to 400-600 calories a day for a week.  Most patients lose about a pound a day on 400-600 calories a day and they can handle doing this for 1-3 weeks.  Half of my patients prefer to eat just canned poultry and fish (chicken, turkey, tuna, salmon, shrimp, lobster, carb, clams, mussels, sardines) every day.   The other half of my patients alternate eating 400-600 calories of canned dead animals with 400-600 calories of fresh fruit (apples, oranges, bananas and pears are 100 calories each).   It’s not a bad way to lose 5-7 pounds a week.  When you can’t do this anymore, go back to basic every other day eating.  One day, eat what you want (don’t go crazy), the next day eat 400-600 calories of fresh fruit.

Patients who get in trouble on their eating day

Patients who get in trouble on their eating day tend to overeat on the same groups of foods.  These are foods that provide way too many calories, way too fast.  The most common overly eaten problem foods are nuts, cheese, red meat, butter and oil.  Interestingly enough, sugar is not usually a problem – it’s the fat that is eaten with sugar that creates too many calories.  Switching to low fat ice cream can eliminate 30% of excess calories.  Switching to low fat cheese can eliminate 30% of excess calories.  Eating the pie filling and leaving the crust can save 75% of excess calories.  Using I Can’t Believe It’s Not Butter instead of Butter can save 60% of excess calories. 

Your diet day is easy on the road

Limiting yourself to 400-600 calories is remarkably easy on the road.  You can almost always pick up apples, oranges and bananas at airports, 7-11s and gas stations when a grocery store is not available.  You can almost always order a giant salad without dressing, croutons, meat or cheese at a fancy restaurant or at Denny’s.  You can almost always also order baked potatoes at fancy and fast food restaurants and top them with ketchup (about 100 calories each).   

Eliminate certain food groups on your eating day

Eliminating certain food groups on your eating day can help you lose weight.  If you are not losing weight as quickly as you would like dieting every other day, try a week of not eating dairy products on your eating day.  Butter, cheese and ice cream can provide way too many calories, way too fast.  You can also try a week eliminating nuts and red meat on your eating day.  Once again, nuts and red meat can provide way too many calories, way too fast.  Also helpful is to try a week avoiding butter, oil and margarine on your eating day.  The idea is to create rules so you can lose weight eating as much as you want of whatever you want on your eating day, with easy restrictions that significantly eliminate calories.

Measure for a day

Unlimited raw and steamed vegetables (no butter, oil or margarine – no peas, potatoes or corn) can be a way to eat as much as you want on your diet day.   Unlimited melon, berries, grapefruit and pineapple can also be a way for unlimited eating on your diet day.  The first time you try this, use a measuring cup to keep track of the amount you eat.  Most patients naturally stay within 400-600 calories eating as much as they want of these specific vegetables or fruits.  But you cannot freely feed on both vegetables and fruits on your diet day or you will likely go over 400-600 calories.  

Another advantage of every other day dieting

Another advantage of every other day dieting is that patients soon realize that they feel better on their diet day because they are not eating any crap.  It’s amazing how quality of life can improve if every other day you’re not poisoning yourself.  Many patients rapidly begin eating much less crap (sugar, processed meats, etc.) because they realize how much better they feel on their diet day.  Every other day can be a powerful way to clean up your diet, whether you are motivated to eat less junk or not.

Unlimited eating on your diet day

If you stick to just steamed vegetables without butter, margarine or oil – broccoli, cauliflower, spinach, kale, Brussels sprouts, green beans, carrots, bok choy, etc. – you can probably eat as much as you want on your Diet Day and stay within 400-600 calories.  You can also stick to just raw vegetables with diet dressing (no more than 10 calories per tablespoon) – lettuce, tomatoes, carrots, onions, sprouts, spinach, cucumbers, etc – and probably eat as much as you want and be within 400-600 calories. 

Every other day is perfect for all-you-can-eat vacations and cruises

On vacations and cruises, every other day is as easy (actually easier, you don’t have to shop for food) as it is at home.  On your food day, you eat what you want (within reason).  But on your food day, also try to eat at least a dozen (2 dozen may make you even less hungry) egg whites without the yolks., or one quart of fat-free Greek yogurt or fat-free cottage cheese.  The protein will make you far less hungry.   Take it easy on nuts and cheese and red meat, as they provide way too many calories, way too fast.  Another helpful tip is that you can have alcohol or dessert but not both.   On your diet day, unlimited buffets make your 400-600 calories very easy.   Green salads and raw vegetables are unlimited, as well as brocolli, cauliflower, carrots, green beans and kale without butter, margarine or oil.  Freely feeding on unlimited fat-free raw vegetables and steamed green vegetables and cauliflower, is one of the easiest ways to eat 400-600 calories on the planet.  Unfortunately, you can’t eat unlimited fruit (calories can go way above 400-600 way too quickly, but unlimited 5% vegetables (Google this) works for almost everyone.  If you want to eat fruit, cantaloupe, honeydew, watermelon, strawberries, blueberries, blackberries and pineapple are 50 calories a cup.  Cherries and grapes are 100 calories a cup.  Use an empty coffee cup as an approximate measure.

If you feel you need a break from every other day dieting

If you feel you need a break from every other day dieting, your protein intake probably isn’t high enough.  A trick that helps patients get on track again is to eat 2 – 80 grams of protein feedings a day for 2 or 3 days.  The best way to do this is to eat a dozen egg whites (fried or hard boiled, pitch the yolks) twice a day.   Your second best way to eat 80 grams of protein twice a day is to eat a quart of fat-free Greek yogurt twice a day.  Or eat a quart of fat-free cottage cheese, twice a day.  Don’t eat regular fat-free yogurt as it isn’t high enough in protein.

400-600 calories a day is fastest

Fastest weight loss (often a pound a day for awhile) is on 400-600 calories a day until you can’t stand it anymore.  When you can’t stand it anymore, eat 400-600 calories one day and eat what you want (within reason, don’t go crazy) the next.  Most patients eat 400-600 calories of canned chicken or tuna every day until they can’t stand it, or alternate eating 400-600 calories of canned chicken or tuna with 400-600 calories of fresh fruit.  When patients can’t do 400-600 calories a day anymore, pound a day weight loss stops, but the good thing is that weight is not regained on every other day dieting. 

Another advantage of every other day

Another advantage of every other day (intermittent fasting) is that there’s no calories counting, no carbohydrate counting no weighing, no measuring, no writing down what you eat, no meetings, no phone app, no support system crutch.  All you need to do to lose weight is to eat 400-600 calories of fruit one day, and eat what you want (within reason) the next.

What do I eat on my food day?

Patients also want to know what I eat on my eating day.  Generally speaking, I eat anything I want with a couple of adjustments to make sure my protein is as high as possible and my protein calories are as low as possible.  Protein gives me sustained energy and makes me feel full and satisfied so I eat less throughout the day.  I often start my eating day with a dozen eggwhites (120 calories, 84 grams or protein) fried in Land O Lakes Butter, Olive Oil and Sea Salt.  Or I’ll eat a quart of Chobani fat-free plain yogurt (480 calories, 88 grams of protein).  After I eat my protein, I generally eat anything I want, as much as I want, as the protein generally keeps me feeling full and in control all day. 

What do I eat on my diet day?

Patients always want to know what I eat on my diet day.  As a male, I can eat up to 600 calories and I usually eat close to this number.  I usually eat 4 pieces of fruit, some combination of 2 apples and/or 2 oranges and/or 2 bananas.  I also usually eat 1 or 2 servings of vegetables, usually kale or asparagus without butter or oil to keep the calories as low as possible.  Occasionally I’ll eat a 250 calorie bowl of Andersen’s Pea Soup.    Google “Andersen’s famous split pea soup vintage recipe”.  I order the peas from Andersen’s.  The soup tastes better when made with Andersen’s peas rather than with peas (both organic and not organic) I can get locally.   

An easy way to lose 1-2 pounds a week

Many patients are able to lose 1-2 pounds every week, dieting every other day, simply by eating 12 egg whites every day.  This 84 grams of protein and 120 calories makes you feel full and helps decrease out of control eating (Bozo eating) on your food day.  Instead of 400-600 calories of fresh fruit only, you eat 120 calories of protein (egg whites) and 300 calories of fresh fruit.   Eat your egg whites fried or hard boiled.  Pitch the yolks.  Interestingly enough, the addition of egg whites to both your diet day and your eating day does not slow weight loss for most patients.

Close the barn door before the cow gets out

On your eating day, it can be helpful to make your first meal a massive amount of very low calorie, low fat or fat-free protein – 80-100 grams or so.  This can help keep you feeling full all day.  You can also repeat this 80-100 grams of low calorie protein later in the day to keep you out of trouble.  Proteins of choice are the usual suspects – egg white, Eggbeaters, fat-free Greek yogurt, fat-free cottage cheese, shrimp, crab and lobster.

Summarizing  protein and your eating day

The goal is to give you the experience of eating anything you want, as much as you want on your eating day.  The most helpful strategy is generally 80-160 grams of very low fat or fat-free protein to make you feel as full as possible all day.  Eggwhites, Eggbeaters, fat-free Greek (not regular) yogurt, fat-free cottage cheese, shrimp, crab and lobster are your best bets.  Protein to carbohydrate proportion is also be important.  In general, the amount of protein you eat (by volume) should be about the same size as the amount of carbohydrate you eat with it (rice, potatoes, pasta, etc.)   You are probably okay with maki sushi, but with uramaki sushi and nigiri sushi, you may have to scrape off half the rice on each piece.  When you eat too much carbohydrate at a feeding on your eating day, you can go into feeding frenzy.  Not what you want.  The whole idea is to be able to eat 2 or 3 cookies, not the whole bag.

More on protein to carbohydrate ratio

The goal is for you to freely feed on your eating day and continue to lose weight.  You should have the experience that you can eat as much as you want of whatever you want and still be in control.   You may have to fine tune your protein to carbohydrate intake to prevent binging and out of control eating.  Naked carbohydrates (carbohydrates without protein or fat) are the usual culprit that send patients into a feeding frenzy.  When you eat carbohydrates, you may need to eat (in the same meal) an equal volume of protein or (second choice) fat (because fat has almost twice the calories of protein) to stay full and satisfied without binging.  Read the sushi example in my previous blog.  The goal is for you to feel in control.  The secret of staying in control on your eating day is usually very low calorie protein (egg whites, fat-free Greek yogurt, fat-free cottage cheese, shrimp, crab, lobster, white flesh fish), 75-150 grams of protein a day.

Getting into the weeds – protein to carbohydrate ratio

Adjusting your protein to carbohydrate ratio can be very helpful on your eating day.  This means that instead of eating sashimi, you may be better off eating sushi.  Eating carbohydrate with protein makes you feel fuller and more satisfied.  The amount of carbohydrate per feeding that works best for most patients for satiety is roughly 50% by volume.  This means that when you eat sushi, the amount of rice you eat should be approximately the same as the amount of protein.  This means that most patients do better eating maki sushi rather than uramaki or nigiri sushi, as the uramaki and nigiri have a higher rice to fish ratio.  Google the difference between maki, uramki and nigiri sushi if the last sentence doesn’t make sense to you.  Most patients feel less hungry and more satisfied pitching the top slice of bread on sandwiches, as this increases the protein to carbohydrate ratio.  Most patients feel better and do better eating equal size portions of chicken or fish in combination with rice or potatoes.

More foods to take it easy on, on your eating day

Butter and oil can be real disasters.  Patients use less Land O Lakes Butter, Olive Oil and Sea Salt – because it’s salty and packaged in half sticks.   Liquid calories are problematic as you don’t chew so they provide less satiety.  Stay away from juice and sugared drinks as much as possible.  Once again, way too many calories, way too fast.  Red meat at 80 calories per ounce can be a problem.  Barbecued ribs at 3000 calories a slab can be devastating.  Mayonaise at 120 calories a tablespoon can be a problem.  Peanut butter can be less problematic, if you up the protein by adding peanut powder to peanut butter.

Foods that do the most damage on your eating day

It’s almost impossible to lose weight eating any significant quantities of nuts and cheese.  Both provide way too many calories, way too fast.  A handful of nuts can contain 600 calories.  Ditto a couple of thick slices of cheese.   Real salad dressing can contain 120 calories per tablespoon.  Restaurant salads can contain 500-600 calories of salad dressing in addition to another 500-600 calories of meat and/or cheese.  California Pizza Kitches sells more than a dozen 2000 calorie salads.  Cheesecake factory sells 1500 plus calorie slices of carrot cake and chocolate cake.  Juice also provides way too many calories, way too fast.  You can drink 600 calories of orange juice in a minute.  It takes 15 minutes to eat 6 oranges, and you’ll have a stomach ache.

What patients ask most about every other day dieting

The most common question I’m asked about every other day is what strategies work best to limit calories on the eating day.  My first suggestion is always to make sure you are eating plenty of carbohydrate on your diet day (400-600 calories of fruit is all carbohydrate) to prevent liver glycogen depletion and binging on your eating day.  Low carb on your diet day tends to set you up for failure on your eating day.  My second, third and fourth suggestions are always about ways to limit calories on your eating day.  sugar-free Popsicles, sugar-free Creamsicles and no sugar added Fudgesicles are always near the top of the list.   Followed by egg whites, fat-free Greek yogurt and fat-free cottage cheese.  Then shrimp and crab and lobster.  The key is to keep you protein intake as high as possible on your eating day, and your fat intake as low as possible.

Intermittent fasting prevents weight regain

Because the diet you lose weight on is maintenance, dieting Every Other Day prevents weight gain.  As long as you continue to eat 400-600 calories of fruit every other day, you won’t regain weight that you lose.  Thc challenge is to devise a strategy that allows you to continue to lose weight dieting every other day.  50% of patients lose 1-3 pounds a week without doing anything else.  The intermittent fasting works perfectly for them out of the box.   The other 50% of patients need to strategize their eating day to keep calories under control.  They need to tweek what they eat on their feeding day to keep their calories low enough to continue to lose weight.

The craft of controlling calories on your eating day

Most people have a weight problem because they overeat just 2 or 3 foods.  Figure out what your problem foods are and a way to control your eating of them, and you won’t have a weight problem anymore.  The trick is to find a way to control your problem foods on your eating day without feeling deprived.  Switching classes works best.  Switch from 300 calorie bagels to 200 calorie baguttes.  Switch from regular fat-free yogurt to fat-free Greek yogurt, which is 30% higher in protein so you’ll feel more satisfied eating much less.  Switch from 2% skim milk to fat-free skim milk.  Switch from Carvel to Dairy Queen.  Figure out what foods you absolutely can’t eat without binging and don’t eat them.

Fat-free every other day

Another approach that works well for many patients is eating fat-free, every other day.  On you diet day you limit yourself to 400-600 calories of fresh fruit.  On your eating day you eat (within reason) anything you want without fat:  Fat-free Greek yogurt, fat-free cottage cheese, egg whites, cereal with fat-free skim milk, baguettes with jam, fruit, vegetables, etc.  The key is to keep your calories under control on your eating day, and at the same time have the experience that you are eating as much as you want of permitted foods and you feel satisfied.

Low sugar every other day

A low sugar every other day works well for some patients.  You eat 500 calories one day and you eat what you want the next day.  But on your 500 day, you keep sugar to a dull roar to feel at your best.  And on your eating day, you also keep sugar to a dull roar to avoid feeling terrible and binging.  A dull roar on your 500 day means no more than about 200 calories of sugar.  A dull roar on your eating day means no more than about 500-600 calories of sugar.

Half the time, every other day dieting works perfectly, out of the box

The other 50% of patients need to tweak every other day dieting for themselves, until their eating day calories are low enough for steady weight loss.  It’s worth trying every other day, because there’s a 50% chance it will work perfectly for you in it’s plain vanilla edition.  One day, eat what you want, don’t go crazy  The next day limit yourself to 400-600 calories of fresh fruit.  If you are in the lucky 50%, you won’t have a weight problem once you begin every other day dieting.  If you need to tweak the program to get it to work for you (weight loss in general needs to be 2-3 pounds a week or you won’t stick with the program), the challenge is to figure out how you can limit your calories on your eating day to 2000 (woman) – 3000 (men), without making it feel you like are consciously limiting anything.  The most helpful strategies usually center around limiting or eliminating fat intake.  Switch to fat-free or low fat foods on your eating day, and see if this is enough to start you losing weight every other day.

Why I don’t recommend a low carb eating day

It’s way too easy to eat way too many calories, way too fast on a low carb eating day.  You can be well over 3000 calories in a heartbeart.  Fatty red meat and cheese and nuts are all 100 calories per ounce or more.  Besides, if you try to eat low carb on your eating day, you will deplete your liver glycogen which leads to binging and cravings.  You can never get enough of what you really don’t want.  Low carb dieting was the grand 100 year experiment that really doesn’t work.  It sets you up to spiral out of control.

Go fat-free on your eating day

Another trick to limit calories on your eating day is to go fat-free.  Eggwhites, fat-free cottage cheese, fat-free Greek yogurt, air popped popcorn, fruits, vegetables, baguttes with jam, oatmeal, fat-free skim milk, fat-free cheese, etc.   The key is for you to feel like you are freely feeding like a king or queen, but keeping calories under control.  On your diet day, your 400-600 calories of fresh fruit make this easy.  On your eating day, the challenge is to come up with a way to eat that’s satisfying, so you can eat as much as you want – that does not take your calories to stupid.  In English, calories to stupid means women should ideally be not much over 2000 calories on your eating day and men not much over 3000 calories.

Favorite ways to alternate 400-600 calories for fastest weight loss

On your 400-600 calorie protein days – 12-36 egg whites (fried or hard boiled) – 1 quart of Chobani fat-free Greek yogurt – 1 quart of fat free cottage cheese – 3 – 5 ounce cans of water packed tuna – 3 – 5 ounce cans of chicken – 3 – 5 ounce cans of shrimp – 3 – 5ounce cans of crab.

On your 400-600 calorie fruit days – 2 apples and 2 oranges and 2 bananas – 1 canteloupe and 1 honeydew and 1 pint blackberries – 1 pound grapes and 2 bananas – 1 small watermellon and 1 quart cut up honeydew, canteloupe, strawberries, pineaple.

The advantage of intermittent fasting

Eating 400-600 calories of fresh fruit (pure carbohydrate) every other day keeps liver glycogen up, so there are fewer cravings and less desire to binge.  Binging, in general, is replenshing liver glycogen.  Patients generally do better eating 400-600 calories of protein one day and 400-600 calories of fruit the next day, compared to trying to eat 400-600 calories of pure protein every day.

More quick weight loss diets for you eating day

Many patients do well on 1-2 quarts of Chobani fat-free yogurt (480 calories per quart, 88 grams of protein) on their eating day, nothing else.  Add artificial sweetener and vanilla extract, or strawberry (or whatever) preserves.  Another popular option is 1-2 quarts of fat-free cottage cheese (roughly same protein and calories) on your eating day.   Add fresh or water-packed fruit.  The advantage of these 500-1000 calorie eating day diets is that they really speed up weight loss by limiting calories and loading you with protein on your eating day.

My best quick weight loss diet

My best quick weight loss diet is 12 egg whites – once, twice or three times a day.  You will be so not hungry, you won’t believe it.  Land O Lakes butter with olive oil and sea salt (use as little as possible) is the favorite way to fry egg whites for most of my patients, and salt liberally after cooking before eating.  Or hard boil a dozen eggs, pitch the yolks, and eat with as much salt as you like – once, twice or three times a day.  You can add Tobasco sauce to your egg whites to liven them up if you like.

Weight loss has to be rapid

Weight loss has to be rapid or you won’t stick to any diet.  Unless you are losing at least 2-3 pounds every week, the bet is you are not going to continue to follow any diet program.  The deprivation has to be worth the reward and the results need to be near instantaneous.  So the best thing you can do if you want to lose weight is to lose weight quickly.  Quick weight loss keeps you motivated and keeps you losing.  The quickest weight loss is on 400-600 calories of protein only a day.

Every other day as maintenance

Some patient use every other day as maintenance.  They lose their weight as quickly as possible on up to 400 calories of protein only.  Egg whites are best for fastest weight loss.  Egg whites contain 10 calories and 7 grams of protein each.  Next best is fat-free Greek yogurt or fat-free cottage cheese (500 calories and 90 grams of protein per quart).  Fastest weight loss, usually 1 pound a day or more, is on protein only for as long as you can stand it.  When you can’t do protein only anymore, switch to accelerated every other day.  One day eat 400 calories of fresh fruit and the next day eat 400 calories of protein.  When you can’t alternate 400 calories of fruit and protein anymore, one day eat what you want and the next day 400 calories of fruit.  Average weight loss, eating what you want one day and 400 calories of fruit the next day, is at a minimum 1 pound a week for most patients.  1 pound a week weight loss is not fast enough weight loss to keep most patients on a diet, but it is perfectly fine for maintenance for most.

The tyranny of calories

As near as makes no difference, there’s no caloric advantage to following a low fat or a low carbohydrate diet.  Weight loss is caloric deficit.  Every other day dieting makes it easier to cut calories, because the fruit on your diet day keeps your liver full of glycogen, so you are far less likely to go into feeding frenzy and binge on either your diet day or your eating day.  This is the reason that patients generally do best eating 400-600 calories of fruit or Amy’s Kitchen TV Dinners on their diet day, instead of a low carb or high protein diet day.  When your liver glycogen level drops, you will self medicate with carbohydrates.  But when you keep your liver full of glycogen by eating pure carbohydrate on your diet day, you are likely to do better on both your diet day and your eating day.

Variations

Some patients lose weight spectacularly, eating what they want to eat every other day with a few simple rules thrown in.  Some patients eat what they want on their food day, but only allow themselves to eat sugar once a week.  Other patients lose weight eating what they want every other day, but only allow themselves to eat red meat once a week.  Other patients lose weight eating dairy products only once a week.  It’s a dance.  Figure out the rules that work best for you, and you can be thin again.

Weight loss must be rapid

Weight loss must be rapid or you won’t stick to the program.  In general, patients must lose 2-3 pounds every week in order to feel that the sacrifice is worth the results.  The less you eat, the faster you lose weight.  Eating less on your eating day is the key to success.  100 ounces of calorie free fluid every day helps you feel full.  80-160 grams of very low calorie protein (preferably egg whites) helps you feel full and eat less too.

Intermittent fasting is incredibly healthy

I tell all my patients over 50 that the best thing they can do for their health and wellbeing is to stop eating every day.  Spend 5 minute and Google Intermittent Fasting.  The health benefits range from anti-cancer to anti-Alzheimers to life extension to protection against heart disease.  There aren’t enough studies yet, but I’m excited by the possibility that fasting (eating 400-600 calories) every other day may allow you to eat food that’s bad for you (sugar, processed meats, etc.) without the health problems associated with what I call eating poison.  Intermittent fasting may reverse the damage of eating junk food.  It may be that you can have a free lunch, but you just can’t eat it every day.

Pounding protein on your eating day helps

Many patients start their eating day with a 12 egg, egg white omelet.  At 120 calories and 84 grams of protein, this is your best caloric bargain.  To put this into perspective, 1 quart of Chobani fat-free Greek yogurt contains 88 grams of protein and 480 calories.  Egg whites are always your best bet.  Protein makes you feel full and helps you eat less on your eating day.  Remember, the goal is for you to have the experience that you can freely feed on your eating day and still lose weight.  Very low calorie protein really helps.

Another strategy for your eating day

Another strategy to keep your calories under control on your eating day is to divide your food into 2 eating days.  For example, on Monday you eat the cheese, peperoni and mushroom topping on your pizza, and on Wednesday you eat the pizza crust.  Or on Monday you eat the apple pie filling, and on Wednesday you eat the apple pie crust.  The idea is to keep your calorie intake as low as possible, while keeping you feeling satisfied.

Diet day is seldom a problem

Most patients do not find it difficult to eat 400-600 calories on their diet day.  The most popular choices are fresh fruit and TV dinners.  Patients tend to get into trouble when they try to do 2 diet days in a row, so this is not recommended.  The 5-2 approach (fast 2 days a week, freely feed 5 days) to intermittent fasting is not particularly successful in that it usually requires a calendar to keep track of whether you are on an eating day or a fasting day.  Patients also get into trouble when they try to eat nothing at all on their fasting day, as opposed to 400-600 calories.  As near as makes no difference, eating 400-600 calories is like eating nothing, so there’s no reason to totally fast.

More tricks for your eating day

The trick is to incorporate small changes on your eating day that cut calories without making you feel deprived.  Toss the top bun on hamburgers and hot dogs, and get rid of the top slice of bread on sandwiches and save 100 calories.  No cheese and no mayonaise (secret sauce) on fast foods saves another 100 calories.  Substitute veggies for meat on pizza and save several hundred calories.  When eating ice cream, switch to a wafer cone instead of a cake cone or waffle cone, or pitch the cone and eat your ice cream from a dish and save another 100 calories.

Fastest weight loss

Fastest weight loss is always on 400-600 calories of protein only a day for as long as you can do this.  When you can’t do protein only (egg whites are you best source, by far) switch to hardcore every other day, eating 400-600 calories of protein on day and 400-600 calories of fresh fruit the next.  When you can’t do this anymore, switch to classic every other day.  Eat what you want (within reason, don’t go crazy) one day and 400-600 calories of fresh fruit or TV Dinners (Amy’s Kitchen is the most popular in my office because they do not taste like TV Dinners) the next.

Get your protein intake right on your eating day

When you get your protein intake right on your eating day, you will have the experience that you can eat as much as you want without going crazy.  Protein makes you feel full and keeps you satisfied.  The key is to maxmize your protein intake with the fewest calories possible.  The more protein you eat the less hungry you will be and the fewer cravings you will have.  The suggestion I make to many patients is to start their day with a 12 egg white omelet.  A 12 egg white omelet contains 84 grams of protein and 120 calories.  To put things in perspective, one quart of Chobani fat-free Greek yogurt contains 88 grams of protein and 480 calories.  And one quart of Breakstone fat-free cottage cheese contains 80 grams of protein and 560 calories.  Your next best protein choice after egg whites is shrimp or crab or lobster, which are all about the same for protein and calorie content.  One medium shrimp contains approximately 1 gram of protein and 6 calories.  I do not recommend fake crab and lobster which contain sorbitol and can cause projectile diarrhea if you eat any significant quantity.

The easiest way to diet every other day

The easiest way to every other day on your diet day is to eat some combination of apples, oranges, bananas and pears.  Don’t go over 400 (women) – 600 (men) calories on your diet day and you’ll be fine.  If you’re traveling, you can always pick up an over-priced apple in an airport.  On your eating day, the secret is to find a way to feel like you are freely feeding, that feels like you are eating as much as you want, but keeps your calories from going to stupid.  For most patients, this means 80-160 grams of fat-free or very low fat protein on your eating day to keep damage from recreational eating under control.  On your eating day, you can eat whatever you want.  A protein load tends to minimize Bozo out-of-control calories.

Calorie counting doesn’t work.

There’s no calorie ceiling for eating days.  Calorie counting doesn’t work.  Neither does portion control.  After you’ve eaten 2000 calories, what’s another 200?  After you’ve eaten 3 bagels, what’s another bagel?  If you are not losing weight (2-3 pounds a week), the best strategy is to switch classes of food on your eating day.  Instead of a 3 egg omelet (350 calories), have a 12 eggwhite omelet (120 calories).  Instead of bagels (300 calories) eat baguettes (180 calories).  Instead of Carvel (200 calories per half cup) eat Dairy Queen (140 calories per half cup.)  You can never get enough of what you really don’t want.  But a switch from Haagen Dazs vanilla (170 calories per half cup) to Breyers lower fat vanilla (100 calories per half cup) or something works for most patients.

The strategy that stops binging

Because no foods are forbidden on every other day, it’s important to have a strategy to avoid feeding frenzy and binging.  Protein intake is the key.  If you find yourself spiralling out of control after eating certain foods on your eating day, the strategy that works best is to increase your protein intake.  For patients who find themselves spiralling out of control after eating trigger foods, what generally works  is to make sure that they have eaten 70-80 grams of protein before eating foods that send them over the edge.  Egg whites, Egg Beaters, fat-free cottage cheese and fat-free Greek yogurt provide the greatest amount of protein for the least number of calories.  A quart of Chobani fat-free plain Greek yogurt contains 480 calories and 88 grams of protein.  A dozen egg whites contain 120 calories and 84 grams of protein.

An interesting side effect

An interesting side effect of every other day dieting is that often food sensitivity goes away or becomes far less symptomatic.  When patients stop eating foods that they are sensitive to for 2-3 weeks, they are often able to begin to eat these foods again, in moderation, every other day.  The most important thing is that a food to which a patient has been sensitive must not be eaten every day.  I have seen patients with food sensitivity to wheat and dairy able to eat wheat and dairy again, once they have been off wheat and dairy for 2-3 weeks.  Surprisingly often, patients are able to eat foods that they have never been able to eat without food sensitivity (fatigue, irritability, depression, etc.) as long as they avoid these foods for 2-3 weeks and then eat them no more frequently than every other day.

50% of patients are lucky

If you are lucky, you are in the 50% of patients for whom every other day dieting works “out of the box”.   Eating 400 calories of fruit one day and what you want (within reason) the next allows you to lose weight.  If you are not lucky, you are in the 50% of patients who require tinkering or personalization.  The goal is to have the experience that you are eating what you want (but not freely feeding), and losing weight.  Alcohol is a weight loss stopper in some patients, as it can quadruple fat storage, so they only drink one day a week in order to lose weight.  Sugar is a weight loss stopper in other patients, as it can trigger feeding frenzy and binging, so they only eat foods with added sugar once a week.   portion control in general doesn’t work.  It’s way too easy to eat 3 bagels instead of 2.  Instead of portion control, find lower calorie versions of the foods you crave.  Eat baguettes instead of bagels and save 50% on calories.  Eat I Can’t Believe It’s Not Butter instead of butter and save 60% on calories.  It’s almost impossible to lose weight eating significant quantities of nuts or cheese as both contain way too many calories, way too fast.

Dieting every other day tips

Keep your protein insanely high (150 grams or so) on your food day and you’ll feel fuller and eat less.  The best source of protein is egg whites or Egg Beaters, fat-free cottage cheese and fat-free Greek yogurt.  These proteins are 10 calories per ounce compared to 30-40 calories per ounce for protein from fish and poultry.  Fat-free Greek yogurt is better than regular fat-free yogurt because it has 25% more protein.  Allow yourself to eat sugar (foods with added sugar) only once week.  Saturday or Sunday, depending on your every other day cycle, works best for most patients.  Sugar is poison.  We are not designed to eat it.  Way too much insulin and feeding frenzy, way too fast.  But I don’t expect anyone to stop eating sugar.  It feels good and besides, Dairy Queen is not going out of business.  Switching from butter or margarine to I Can’t Believe It’s Not Butter or a very low calorie butter substitute helps decrease fat calorie damage on your eating day.  Switching from bagels to baguettes, saves 50% on bread calories.  Avoid butter, oil, margarine, fat and dead animals on your food day as much as possible – except once a week.

The fastest way to lose weight on every other day

The fastest way to lose weight on every other day is to eat 400-600 calories of fresh fruit one day and 400-600 calories of canned poultry or canned fish the next.   Average weight loss is 10 pounds the first week and 5 pounds every week you are able to stay on this most drastic approach.  After 1-2 weeks alternating fresh fruit and poultry or fish, most patients switch to 400-600 calories of fresh fruit one day and 400-600 calories of TV Dinners the next day.   Amy’s Kitchen is the most popular brand of TV Dinners in my office as  Amy’s makes several 200-300 calorie meals, almost all of them are low fat and vegetarian, and they don’t taste like TV Dinners.    After 1-2 weeks alternating fresh fruit and TV Dinners, most patients switch to classic Every other day, eating 400-600 calories of fresh fruit one day, and eat what they want (within reason) the next.

Class substitution

Low carb dieting doesn’t work because calories get out of control very quickly.  It’s way too easy to eat thousands of calories a day of dead animals and cheese and lose no weight.  You need a strategy to help you limit your calories on your eating day.  portion control doesn’t work well for most patients.  It’s way too easy to decide that you really need to eat another bagel.  The secret is class substitution.  Dairy Queen soft serve has 140 calories per half cup compared to Carvel soft serve at 200 calories.   Baskin Robbins Rainbow Sherbet has 100 calories per half cup compared to their 170 calorie per half cup vanilla ice cream.  Think about your favorite foods and come up with lower calorie substitutes you can live with.

Most people have a weight problem from just 3 or 4 foods

Figure out what your danger foods are and figure out a strategy to limit them on your food day, and you can be thin again.  It generally works better not to eliminate your problem foods but to find a strategy that allows you to eat them.  This prevents you from trying to eat your last pizza in a blow out binge, and doing this several times a week.  In general, switching to another similar food in the same class works better than trying to limit quantities.  for example, instead of trying to limit yourself to 2 bagels on your eating day, you’re probably better off eating baguettes (at 50% of the calories).   Instead of trying to limit yourself to 2 scoops of ice cream,  you’re probably better off switching to low fat ice cream with 50% of the calories.  Instead of trying to limit yourself to a quarter stick of butter, you’re probably far better off switching to I Can’t Believe It’s Not Butter.   Etc.

Quick switches for your eating day

Switch from butter and margarine to I Can’t Believe It’s Not Butter and save more than half on fat calories.   Switch from regular ice cream to low fat and fat-free ice cream and save another 50% on calories.   Switch from regular hot dogs to low fat or fat-free hot dogs and save another 50%.  Switch from bagels to baguettes and save 50%.  Eat frozen fat-free yogurt and frozen fat-free Greek yogurt instead of ice cream and save another 50%.  Eat fat-free ham and turkey and chicken instead of regular dead animals and save 50%.  Eat air popped popcorn instead of microwave popcorn and save 50%.

Weight loss on every other day is about controlling calories on your eating day

You need to come up with a strategy that gives you the feeling that you are eating as much as and whatever you want on your food day, and that at the same time keeps your calories from going to stupid.  Counting calories and carbohydrates doesn’t work for most patients.  Limiting food groups and/or food choices is far more successful and much easier.   It also doesn’t matter how many meals you eat or what time you eat.  In general, the most popular and successful strategies involve limiting fat and/or limiting sugar and/or limiting dead animals and/or limiting flour products and/or limiting dairy.   Many patients do well with very simple programs that avoid one or two foods.

For patients who want the fastest way to lose weight

Most patients who want to lose weight as fast as possible are able to stay on 400-600 calories of fruit one day and 400-600 calories of canned poultry or fish the next day for 1-2 weeks.  It’s important that the poultry or fish comes from a can box or bag to lock in calories at 400-600.  Weighing and measuring is not recommended as studies suggest you’ll overeat by as much as 40%.   When you can’t alternate 400-600 calories of fruit and fish/poultry anymore, the secret to continued rapid weight loss is a strategy or strategies that keep your total calories on your eating day as low as possible.  50% of patients are able to lose 2-3 pounds a week, eating what they want (within reason) on their eating day.   To increase the odds that you will continue to rapidly lose weight, try freely feeding for one day, and two days of fresh fruit.  The problem with this approach is that many patients don’t feel as well on two days of fruit compared to fruit every other day, and some find it necessary to keep track of one day eating and two days dieting on a calendar.   So I always recommend every other day approaches as opposed to what are known as 5-2 approaches.  To keep your calories as low as possible on your eating day, try going lacto-ovo vegetarian (no dead animals) and see how you feel (and how quickly you lose) with your protein only from fat-free Greek yogurt, fat-free cheese, fat-free cottage cheese and egg whites.   Keep your fat and sugar intake as low as possible, especially your fat intake.  This is my favorite recommendation for patients who want to lose weight as quickly as possible, yet feel like they aren’t on a restrictive diet.

Fastest weight loss on every other day

Fastest weight loss is on 400-600 calories on your diet day, because if you try to totally fast and eat nothing, studies suggest that you will cheat and binge and go off the diet after 2-3 days.  Patients do not do well on total fasting.  But because eating 400-600 calories is almost the same as eating nothing, 400-600 calories of fresh fruit allow most patients to successfully follow an intermittent fast.

Don’t forget your one minute of exercise a day

You don’t need to exercise for an hour.  Exercising for an hour could possibly slow your weight loss by making you more hungry.  But 3 – 20 second high intensity intervals a day can speed your weight loss, especially when coupled with NEAT (Non Exercise Activity Thermogenesis).  In English, get out of your chair and move around as much as possible.  Watch “The Truth About Exercise” on www.vimeo.com.

More tips to speed weight loss

The idea is to find a way to easily and automatically limit your calories on your eating day without feeling deprived.  Fat calories do the most immediate damage (about 25o calories per ounce) compared to protein and carbohydrate calories (about 110 calories per ounce).  This said, sugar calories can throw you into feeding frenzy.   One way to deal with sugar and fat is to only allow yourself to freely feed on sugar and fat one day a week.  This means that on most eating days, you consciously limit your intake of sugar to almost nothing (no added sugar foods, use artificial sweeteners all you want) and fat (no dead animals, egg whites and fat-free dairy only).  One day a week allow yourself to eat all the sugar and fat you want within reason, but don’t go crazy.  The secret is to find a way to keep your total calorie intake down to a dull roar on your eating days without feeling like you are depriving yourself.

More ways to speed weight loss

The secret is to comfortably structure your eating day so you are as satisfied as possible without taking the calories into stupid.  Eliminating fat calories as much as possible works best for most patients.  Fat has 9 calories per gram.  Protein and carbohydrate contain 4 calories per gram, so the biggest bang for your caloric restriction buck is usually cutting fat calories.  Bagels are another potential problem at 300-400 calories each.  A whole baguette (La Brea Bakery from Kroger are my favorite, Panera is a distant second) is usually 900-1000 calories.   And putting 10 calories of jam or I Can’t Believe It’s Not Butter on your baguette is a lot better than 200 calories of butter.

More on speeding up weight loss

If you’re not losing as quickly as you’d like, there are  a handful of other strategies that may help.   First, make sure you’re not going over 400 calories on your diet day if you’re a woman, and over 600 calories on your diet day if you’re a man.  The trick is to find a way to keep your calories under control on your food day, and still make it feel like you’re (almost) freely feeding.   Stay away from cheese and nuts as much as possible.  Both provide way too many calories, way too fast and can make it very hard to lose weight.  Think of and use cheese and nuts as a seasoning, not a food.  Switch to diet salad dressing instead of the real stuff.  Switch to lower fat or low fat or no fat dairy products (I’m talking yogurt and ice cream).  No red meat.  Use I Can’t Believe It’s Not Butter instead of butter or margarine.

To speed up your weight Loss

If you’re not losing weight fast enough dieting every other day, there are several strategies to try. The first thing to try is to eat fruit for 2 days in a row and eat what you want on the third day. This usually solves the problem. If you don’t like two days on, one day off – the next thing to try is to significantly decrease your fat intake on your eating day. The easiest way to do this is to stop eating dead animals and get your protein mostly from Greek yogurt, egg whites and cottage cheese. significantly cutting fat intake on your feeding day (also eliminate butter and oil as much as possible) works well for many patients who are not losing fast enough.

Maintenance

The every other day diet never stops. You’re starting on maintenance. Once you get down to your desired weight, you can eat a little more on your food day and still maintain your weight. Another approach is to double your fruit calories to 800-1200 on your diet day, but I don’t recommend this. Most patients do better just increasing their calories on their food day when they want to stop losing weight.

If you have trouble with fruit

If you have trouble with the acidity of fresh fruit, or you don’t feel terrific on fresh fruit, give yourself 1 week to adapt to 400-600 calories of fresh fruit everyday other day. If you’re not feeling reasonably terrific after a week, try a week on 400-600 calories of canned fruit in water every other day. You can get pears in water, peaches in water, fruit cocktail in water, grapes in water, pineapple in water, etc. If you’re still not happy, switch to 400-600 calories of TV dinners. I recommend Amy’s Kitchen brand, because to me, they don’t taste like TV dinner hell. You can eat half a 600 calorie dinner twice a day, or 2-300 calorie dinners a day.

If you’re not losing fast enough

If you’re not losing weight fast enough on every other day, and most patients lose 2-3 pounds every week, you can speed things up for a week or two by alternating 400 calories of fresh fruit with 400 calories of canned poultry or fish. One day eat 400 calories of fruit, the next day eat 400 calories of canned poultry or fish. After 1-2 weeks, go back to the basic every other day and eat what you want, within reason, every other day. Unfortunately, you’ll do better if your chicken or turkey or fish or seafood actually comes from a can because you can safely and effectively limit portions this way. Left to your own devices to weigh and measure, studies suggest you’ll overeat by 40%. So your poultry and fish is best from a can.

Exercise

To make every other day dieting work as efficiently as possible, I recommend 1 minute of exercise every day. That’s not a mis- statement. I want 1 minute of exercise every day. Just 1 minute. You can do an hour if you like, but I want 1 minute. Watch “The Truth About Exercise” on vimeo.com for how I want you do this minute. “The Truth About Exercise” also talks about NEAT (Non Exercise Activity Thermogenesis, which is neat way to burn an extra 500 calories a day.

It’s almost impossible not lose weight

The animal study with intermittent fasting suggesting rats cannot eat enough on alternate day fasting to maintain their weight is interesting. Researchers took a group of rats and let them eat all the Purina Rat Chow they wanted one day, and no food the next. Over a very few weeks, it became very clear that all rats were losing weight. They could not or did not eat enough rat chow on eating days, to make up for not eating on fasting days. What I really want to see is a repeat of this study on what is called Super Market Diet.  The diet was born in the 70’s, when a group of researchers created the fattest lab rats ever (at the time, we’ve created much fatter rats since with genetic modification) by feeding them unlimited M&M’s, raisins, salami, crackers, cheese and cookies. I want to know if rats will still continue to lose weight on an alternate day Super Market Diet and fasting. It’s interesting that when alternate day eating (intermittent fasting) was studied, patients lost significantly more weight eating whatever they wanted on their food day, compared to eating a low fat diet on their food day.  The theory is that you can never get enough of what you really don’t want, so subjects were more satisfied and did less recreational eating (and cheating!) on an every other day diet.

The Obesity Medicine Association jumps on board

In April 2018, the Obesity Medicine Society presented their first presentation on intermittent fasting, so word was finally out. And I made up my mind to get off the low carb bandwagon and finally preach the truth. Low carb dieting doesn’t work, because people will not consistently stick to it. There is way too much food distraction out there. McDonald’s and Baskin Robbins and Dairy Queen aren’t going out of business any time soon, and whether stressed or celebrating, people are not going to stop eating ice cream and cake. The reason I recommend nothing but fresh fruit (no more than 400 calories per day for women, and no more than 600 calories per day for men) for intermittent fasting is based on three things.  (1) When it’s been studied, there’s no significant difference between weight loss on 400 compared to 600 calories a day. So, there’s a fudge factor. You don’t have to eat nothing, you can eat a little and still lose weight.  (2) Fresh fruit only keeps your liver glycogen level at its max, so you don’t go into low carb fatigue, low energy, lethargy, depression, binging and carbohydrate cravings. When you liver glycogen level is up, carbohydrate cravings are under control. It’s only when glycogen levels plummet that you go into feeding frenzy.  (3) Clinically, patients (and I) do much better on fresh fruit only, compared to adding protein, fat and other carbohydrates to the mix.For some reason, patients feel better and do better on 400-600 calories of fresh fruit only, compared to 400-600 calories of Lean Cuisine or Healthy Choice or Amy’s Kitchen. I’m not sure why. I think it’s the full liver glycogen level.

Intermittent fasting

Intermittent Fasting is not new. My grandfather, who was born in 1882, went to the Kellog Sanitarium in Battle Creek Michigan at the turn of the century with my grandmother for the fasting cure.  He also continued to fast on and off during the course of his very long life.  I remember in the 1960’s he would go down to Florida once of year for a fasting cure, living on just fruit and vegetable juice for a month.  He would return to Michigan 30 pounds lighter and invigorated.  He would slowly regain the weight over the course of a year, and then return to Florida for another month of fasting. He did this every year for more than a decade.  He lived to 92.

Things became personal

3 years later I came down with testicular cancer, and the radiation therapy killed the cancer (I’m 9 years cancer free), but the radiation did something to my metabolic rate. I discovered that I could no longer eat (even low carb) every day, and not gain weight. As a diet doctor, I can’t be fat. So I began eating every other day. It was the only way I could maintain my weight and not get fat. But I continued to preach the gospel of Atkins (low carb dieting) to my patients. And at the same time, deep down inside, I knew that it was hopeless. Low carb was not going to work. There was way too much fun food in the world, and patients were just not going to pitch buns and not eat dessert.

Eating every other day break through

My breakthrough happened 12 years ago on Vail mountain in one of the giant cafeterias on the mountain. It was lunch time and the room was packed with skiers, all chowing down on hamburgers, hotdogs, pizza, French fries, chocolate chip cookies, oatmeal cookies and ice cream cones. Like everyone in the industry, I was preaching and practicing serious low carb dieting at the time. I taught biochemistry before medical school and I used to hang out with Bob Atkins. Looking at the mob of skiers, many, many of them fat – I came to believe it was hopeless. There was no way that the average person was going to toss the bun on the hamburger or cheeseburger, or just eat the cheese on the pizza. Looking around the room, I was certain that low carb dieting was hopeless. People were just not going to do it, consistently and long term enough to lose weight and keep it off. There had to be a better way.

Diet Every Other Day