What To Eat To Lose Weight & Maintain Muscle
One of the most common questions I get in my clinic is, “What should I eat?”.
There's no exact response I can give to this question, but I will try to give you an answer that is at least helpful and directionally correct.
When someone asks this question, they are usually really asking:
“What should I eat to lose weight?”
For those of normal weight, with normal visceral fat levels, who are insulin sensitive and with adequate muscle mass they usually already have this problem sorted.
The real issue with nutrition is when it leads to excess visceral fat, insulin resistance and all the metabolic consequences that go with it.
So, in truth, “What should I eat?” is mostly a question of how to address this with nutrition.
And nutrition is an incredibly powerful tool in addressing this problem.
Mostly, it is about weight loss, specifically visceral fat loss and the reversal of insulin resistance.
A 10 to 15kg weight loss in those who are overweight can reverse diabetes in 57% of patients with diabetes1.
Even in diabetics of normal weight (BMI<27), weight loss can reverse diabetes2.
So. What should you eat to do this?
First off, you have to set your goal.
Maintain, gain or lose weight?
In this instance, it is weight loss.
Let’s say moderate weight loss of 0.5 kg (1 lb) per week.
This is achieved with a calorie deficit.
I can hear the roar. A calorie is not a calorie.
It’s a unit of energy. What about the fructose!!??
I am well aware of all of this.
But…
If you want to lose weight, you MUST be in a calorie deficit.
Period.
If you don’t believe this, I have some magic beans to sell you.
The question of HOW you go about achieving that calorie deficit is crucial.
Firstly, we need to assess what our calorie target is.
This is done using one of many online calorie calculators online. I have linked to one of many of them here.
You input your metrics.
And this is what you will see.
For a 45-year-old male, 180cm tall, 95 kg in weight, exercising 4 to 5 times per week (Because you should be!).
To lose 0.5 Kg (1 Lb) per week, your daily calorie allowance is APPROXIMATELY 2,218 calories.
Protein
The VERY FIRST question you need to answer after this is how much protein you should be eating each day.
This is the leading question that EVERYTHING else is subservient to.
Most people are consuming WAY too little protein, and this is especially relevant if you are doing resistance training, which you should be doing.
The recommended daily allowance of protein is 0.8 grams per kg of body weight.
This is the lowest level of protein a sedentary person should consume JUST to get by.
We are not looking to do that.
In truth, you should consume closer to a range of 1.8 to 2.0 grams of protein per Kg of body weight per day.
Let’s see what that looks like when we use our example of the 45-year-old male weighing 95 Kg.
You can see the protein range is between 95 and 189 grams per day.
If you are doing the appropriate aerobic and resistance training levels, you should be at the higher end (If you have serious kidney disease, you should speak with your dietician).
This amount of protein will have a calorie cost.
1 gram of protein ~ 4 calories.
189 grams of protein = (About) 756 calories.
Get this from whatever protein source you prefer.
But if needed, supplement with protein powders, etc.
We started with a daily allowance of 2,218 calories.
We have allocated 756 calories.
This leaves us with 1,462 calories.
You get to choose how you are going to spend these 1,462 calories.
My advice is:
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It should come from real foods.
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Be satiating
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Low in sugar
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In a Carbohydrate/Fat Balance that suits your preference and doesn’t drive your LDL cholesterol through the roof.
Now, you get to choose your restriction.
But…. But…. But…
Keto, Low Carb, Paleo, Vegan, Low Fat, Carnivore, Intermittent Fasting….
They are ALL ways to restrict your calories.
You just have to ask which one is most appealing to you.
Do you want to restrict:
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Carbs?
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Fat?
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Animal products?
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The ‘Time’ in which you can eat?
You choose.
BUT WHAT ABOUT THE INSULIN SPIKES!!!???
OK. Please go and read every single GLP-1 trial on weight loss (Average 15 kg) and show me where they got everyone to go on an extremely low-carb diet to avoid insulin spikes.
Because you won’t find it. Because it’s not there.
That’s not to say that using a low-carb diet is not effective.
It’s just not the ONLY way of losing weight.
All the above diets are just different ways of getting to the same end point of achieving a caloric deficit.
Choose the one that suits you the best.
Pretty much EVERY diet book ever written is about how you fill in the gap between your protein allowance and your total allowance of calories in way that you find acceptable.
OK. Now, we have set up the basics.
It’s time to TRACK.
For this to work, you have to track ABSOLUTELY everything you eat.
Everything!
You must use an app such as LoseIt, MyFitnessPal, or any other freely available app.
Most of them have a paid version. You don’t need the paid version if you don’t want to pay for it. The free versions work just fine.
At the end of each day, you should be within your targets:
At about your target, e.g. 2,218 calories.
With adequate protein. E.g. 189 grams / 756 calories.
The goal here is not to track everything you eat for the rest of your life, but you need to start this way before you can learn to eat intuitively.
This process seems exact.
But it’s not.
It’s just our best approximation of calories.
You have to understand that:
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Food labels are wildly inaccurate.
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We do a horrible job at guessing the calorie content of food and the amount of calories burned during exercise.
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There will ALWAYS be a fuzz factor here.
The Weigh-In.
Most people do not know how to weigh themselves.
Here’s how you do it.
EVERY morning.
After going to the toilet.
Naked.
At the same time.
Before you eat.
You weigh yourself using the same scales.
Log that weight.
That is NOT your weight.
Your weight is when you do this every day for a week, and then once per week, you AVERAGE all of your weights for the preceding week.
THIS is your weight.
Daily weights fluctuate wildly. You cannot rely on them in isolation, which is why you must obtain an average.
And no, you can’t just weigh yourself at the weekend and compare those.
That just comparing single unreliable data points.
You then compare your week-on-week averages and assess if you are making progress, i.e., losing your target weight, e.g., 0.5 Kg (1 Lb) per week.
If you are not hitting your targets, make sure you have these 4 or 5 factors dialled in:
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Get ~ 8 hours of sleep every night.
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Minimal to no alcohol.
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10K+ steps daily
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Resistance training ~ 2-3 per week.
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Planning meals or meal prepping on a Sunday for the week.
With all these factors in place, ask if you are hitting your goal?
If not, you may need to reduce your calorie target.
In truth, you are probably not hitting it, so aiming below it will likely get you to your target.
If you do as described above, you will lose weight.
This is a very simplified approach, and for most people, I recommend they work with a dietician who can support them along the way.
Even for the accountability alone, working with a dietician is worth it.
Most people have no problem letting themselves down but will never let someone else down.
Accountability is key.
This is the answer to “What should I eat?”.
When my patients hear this answer, they tend not to like it.
Because it’s not easy.
And there will be times that you might be hungry (which can be minimised with satiating high-protein foods).
But it works.
I could reply, “Low carb diet or Mediterranean Diet,” but that’s not really an answer, is it?
Weight loss is HARD.
The world we live in means you are massively incentivised to eat in a way that makes you gain excess weight that will likely result in metabolic dysfunction and an increased risk of not only heart disease but many cancers and also dementia.
While this is unfortunate, it is the world we live in.
This is a way to tackle that problem.
Get tracking.
Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018 Feb 10;391(10120):541-551.
1184-P: Return to Normal Glucose Control by Weight Loss in Nonobese People with Type 2 Diabetes: The ReTUNE Study. June 2021. Diabetes 70(Supplement 1):1184-P