These days it seems like the popular wisdom is that its “all about carbs”.  Twenty years ago it was “all about fat” and before that there were any number of popular theories on how best to lose weight in the modern era.  Yet, Americans and those from other developed countries continue to gain more and more weight which has led to a slew of health conditions and chronic disease.  (This article on how easy it is to become obese in the US gives a good illustration of some of the factors at play)

But your macronutrients- your fats, carbs, and proteins, play only a moderate role in how you lose overall body fat. Sure, higher protein diets have been shown to be more effective for weight loss overall and low carb or ketogenic is the fashion now, but studies have also shown that no matter what type of healthy diet you do, the key to success is really just sticking with something.

And everyone is different.  I use a ketogenic diet in my practice for weight loss fairly often and have good success with it.  But every once in a while a person comes along who doesn’t function well on that protocol, who gains instead of loses (and for reasons outside of how much they eat).

And that’s why I think it’s important to point out that there are 3 things that are even more important to weight loss than macros.  Three things that can make or break your weight loss no matter how perfectly those percentages are calculated.  And here they are:

Hormonal Health

Time and time again I’ve seen a perfectly balanced and proportioned meal plan do little to nothing for someone with major issues in these two categories.

Hormonal issues like hypothyroidism (even subclinical), excess cortisol, and unbalanced sex hormones like estrogen and testosterone can lead to unwarranted weight gain and frustratingly slow losses even when everything is picture perfect in the diet.

Why?  These hormones play a fundamental role in fat storage.  Likewise, insulin (which, yes, is also a hormone) and insulin resistance plays a role in weight loss.  One caveat here, however, is that insulin resistance can be improved in a number of ways and ketogenic diets aren’t the end-all be-all there, like we are sometimes told.

Post-menopausal women who don’t take some form of hormone replacement struggle much more with weight gain than those that do (I usually recommend bioidenticals) and those with hypothryroidism who aren’t properly medicated fight a losing battle.

Another interesting phenomenon- those who have been morbidly obese in their lifetime and now are more normal weights have a metabolic rate slower than math can account for.  This means they have to eat less than a person who has always been a normal weight, just to maintain.

It’s unfair, but true, the body is designed to hold on to fat, not lose it.

Gut Health

Likewise, gut health plays a major role in weight maintenance.  Not only does the gut affect everything around it- including the hormones I just mentioned, but an unbalanced or degraded gut lining can lead to food sensitivities which make weight loss extremely difficult.

I can’t tell you the number of people who have dropped ten to fifteen pounds of extra water and fat just from starting on a diet that eliminated their diagnosed food sensitivities.

A lot of diet products can get in the way here.  Many people with excess weight have food sensitivities, often to foods like dairy, soy, grains, or eggs and those foods are prominent in huge numbers in diet “foods”.  Take a look at the label of your low-carb meal replacement bar or ice cream, for example.  It will often have several of those foods and artificial sweeteners (which we know disrupt the gut).

The fundamentals of gut health must be in place for the body to properly digest, absorb, and work on fat loss.  If they are not, or if there are foods in the diet that we have sensitivities to, it can sometimes cause a stand-still with weight loss OR an unhealthy weight loss due more to water loss from diarrhea than actual fat loss.

This brings me to the next important principle:

Food Quality

It is far more important to eat quality food than to count the macros of other kinds of food.  Even if fast food or meal bars or shakes fit within your calories and macros, the weight may not come off.

There are a lot of reasons for this- the primary ones being gut disruption and inflammation.

Artificial sweeteners, present in all sweet-tasting diet foods, are known to disrupt the microbiome, the collection of bacteria that live in your gut.  This can later cause increased absorption of sugars from foods and a breakdown of the gut barrier that is so important for a healthy and happy body.

Fast foods, restaurant foods, and packaged foods not only are hard to account for (they often under-represent how many calories are contained in these foods) but because of their ingredients like oxidized oils, artificial sweeteners, and inflammatory foods, they cause inflammation markers to increase.

Inflammation is one of the causes behind many of the chronic diseases that afflict so many and it is a REAL problem.  You can have your markers of inflammation (like CRP) tested by your doctor and some people find it very illuminating to see those numbers in black and white.

It is far better to eat a whole organic sweet potato than a handful of french fries.  Or a grass-fed steak than a snack cake.

It would be better to have a meal with just organic veggies and grains than one with conventional, fatty red meats and trans-fats.

The point I’m making here is that the quality of the food is really more important than the quantity.

Sure, you can have a 5g carb diet cake and it seems better than a banana because it fits your macros.  But the banana has a range of vitamins, nutrients, fiber, and other magical properties that make it a much more filling, sustaining choice.

Not to mention that when you diet, you never can meet the daily recommended amounts for intakes of certain vitamins, it’s just impossible with that little food in your system, so making sure the foods you do eat are high quality, is what really makes the difference!

That’s why when you eat a low carb diet, your carbs should come primarily from vegetables- you need the vitamins! And a bar just doesn’t have them no matter how healthy it is.

Calories

My final point, and one I try to drive home is this: calories count.

I know it is trendy to say they don’t.  To say that only quality matters, not quantity, or that only macros matter.  But though is isn’t a popular thing to say, I’ll continue to say it because it is true.

Calories DO matter.

They matter A LOT.

I wish they didn’t.  I wish we really could eat 2500 calories of steak and butter and still lose weight.  But it’s just not possible and I’ve seen it far too many time in clients who come to see me after their attempt at macros or keto fails.

All food, whether it come from carbs, fats, or proteins fundamentally breaks down into the same thing eventually.  Remember the Kreb’s cycle from school?  And that means that no matter what you eat, if you eat too much, you will have enough energy from outside sources and your body won’t have to break down fat for energy.

I can’t tell you how many people I’ve seen who add fats or proteins to their normal diet so that it will meet a certain macro range and then feel frustrated when they don’t see results.

Remember what I said before- the body WANTS to hold on to fat.

We have to FORCE it not to.

We do that by making it suffer- just a bit, there’s no need to starve it completely.  But what we do is create a measurable deficit in intake and that leads to fat being used for fuel.

The deficit has to be there or the body won’t want to shed fat.  Why would it?  Fat has always been a mechanism of protection for the human body!

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So there you have it- four things that matter more than your macros for weight loss.  A healthy diet is about paying attention to all of these things and macros is just one factor.

A good nutritionist will help you tackle all of these in as simple a manner as possible.  For my clients, I calculate their portions for them so its a much simpler experience!   If you’re interested in learning more about how I can help with weight loss contact me here.