Dear Dr. Pierce,
I found your site from another low carb site that linked to your blog and I thought I'd ask a question. I'm a 42 year old female. I've lost weight on low carb diets before but I have always gained the weight back. I'm in the process of trying to lose 30lbs of the original 70 I lost. I lost 14 lbs in the first week, doing paleo-high-fat-low carb, but now the scale is slowly creeping UP. I am distraught. Is my metabolism wrecked from doing low carb? I am not exercising so I know it's not the old "you're putting on muscle" thing.
-Marcia in Providence, RI
Dear Marcia,
You do not say whether or not you are measuring. Take your measurements every week at the same time of day. These are the only measures that matter in the slightest. I am sure you have heard the old adage, muscle weighs more than fat. That isn't quite accurate. Muscle is more dense than fat. A pound of muscle replacing a pound of fat takes up less room and makes you leaner. This is what you want. NOT a number on the scale.
You can find several body fat calculators on line that use your measurements. Use the body fat percentage and your measurements. The scale can be discouarging and it is a poor piece of data for measuring progress.
You may say--but I'm not exercising, how can I be gaining lean mass? Lean mass can be anything that is not fat: bone density, blood volume, fluid, and muscle. There are no studies that prove this, but our patient data suggested that even in the absence of serious exercise our patients were gaining lean mass. We don't know the reason for this. If it is actual muscle that we are seeing, our theory is that when people start feeling better on a low carb, high quality fat program that they become naturally more active and this, by itself, is exercise for those who have been living a life of fatigue and illness. Regardless, it is possible to be making small lean mass gains that, for a time, can outpace fat loss.
This "scale problem" happens much more frequently in females because a) their hormonal cycles cause frequent and sometimes severe fluid fluctuations and b) they generally lose fat slower than males. We had one case in which a female gained two pounds in a week that she had stayed on her low carb program to the letter. She was discouraged by the number of the scale, which seemed to erase the progress she had made the week before. However, when we measured her, she had lost inches everywhere including an half inch of her waist and a full inch and a quarter on her hips. Her body fat was down by over 1%. There was one area where she gained, however: her ankles. It turns out, she had spent the day in the car on a long trip the day before and was retaining fluid that collected in her ankles. Low carb helps with fluid retention but it doesn't solve an issue like gravity. We advised her to keep on her nutrition plan but ad more fluids to help with her temporary fluid retention. The following week the scale was down 4.5 lbs.
We have also noted that some people, not all, are not catabolic (breaking down tissue) and anabolic (building up tissue) at the same time. They build lean mass and burn fat at separate times. In these people, we see weeks where inches are going down but not pounds, and other weeks when pounds are going down but not inches.
The scale can provide a single data point at a single moment in time. It is limited and should not--especially in women--be the source of either dismay or delight. Inches, however, don't lie.
Get a tape measure!
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