I’m feeling good this morning for many reasons, but particularly because my daily weigh-in has me down 9 pounds since I started this odyssey 11 days ago. This is not my first weight loss rodeo, so I know that there is often an initial burst of weight loss on most programs, but this time it feels different (don’t it always?). I am totally bought into this game right now and hope to remain so. I am on day 7 of my Zepbound and will take my second shot this morning before heading off with Kim for a day in Los Angeles going to grand-niece Leila’s soccer game in Pasadena and then having dinner with friends Matthew & Phillip at their new apartment in Culver City. That will mean a lunch out at some diner and dinner out with whatever our friends decide to cook. I don’t dread eating out because I handle that all the time and in some ways that is the least of my eating dysfunctions (which tend to be more about snacking and eating the wrong things at home). I am currently drinking two protein shakes, one for breakfast and one in the mid-afternoon to keep me from snacking on the wrong stuff. So far its working well and I’m liking all the Premier Protein shakes flavors (I had something called Cinnamon Roll this morning for 30g of protein and 160 calories). The trick with Zepbound is to counter the gastric system slowing that it promotes that leads to getting backed up. So far, Metamucil is helping in that department, but I’m also eating plenty of roughage in the form of lettuce and raw veggies as well. Truth be told, my GI system hasn’t been this good in a long time.
For many years I have known about the process of ketosis. You can’t avoid it in the weight loss game. Ketosis is a metabolic state where your body burns fat for fuel instead of carbohydrates. When carbohydrate intake is very low, your body breaks down fat into molecules called ketones, which your brain and body can use for energy. Normally, your body prefers to use glucose (from carbs) for energy. When you drastically reduce carbs (typically to under 50 grams per day), your body depletes its glucose stores and switches to burning fat. Your liver converts fatty acids into ketone bodies, which become the primary fuel source. People generally WANT to get into ketosis because it promotes weight loss through fat burning, it helps with blood sugar management (particularly for type 2 diabetes), it gives you sustained energy without blood sugar spikes, and supposedly, it increases mental clarity and focus (some people report this, but I’m not sure I can put my finger on that outcome specifically). You achieve this wonderful state of ketosis through a very low carb, moderate protein, high fat diet (often referred to as a “Keto” diet). You can also get there through intermittent fasting or extended exercise….but really….who wants to do either of those?
Ketosis can give you “Keto breath”, which is a fruity or acetone smell to your breath. It also gives you increased thirst (not a bad thing since hydrating is extremely important on the Zepbound trail). But ketosis will also bring about positive changes in your energy levels and add to you Zepbound impact via additionally reduced appetite. In other words, ketosis is the turbo-charger of your Zepbound experience. There is a transition period (sometimes called “keto flu”) that I felt I experienced a few days ago in a fairly light way wherein you can get mild headaches, fatigue, and irritability as your body adapts. I had a low-grade buzz, but it faded quickly.
When you’re in ketosis, the key things to focus on are maintaining your “state”. That means keeping your carbohydrate intake low (typically under 50g per day, often 20-30g for deeper ketosis) and staying consistent with your eating pattern to avoid kicking yourself out of ketosis. That, of course, can cause you to go through the adaptation period again, which seems like it would be less than healthy for you on the assumption that turning on and off a light switch is never a good thing. Ketosis has a diuretic effect, so you lose more water and electrolytes, which, added to my normal dose of daily diuretic (Bumetinide 2mg/day) means I need to drink plenty of water throughout the day. This is one of the most important aspects of managing ketosis well and I am fortunate in that I like drinking water and find it easier than many people do. You also need more sodium, potassium, and magnesium than usual. I have just started a potassium supplement on my doctor’s advice (my recent blood test showed my level at the lowest end of normal). I am also prone to leg cramps (particularly at night, like many older men), so I want to keep those electrolytes in balance however possible. Many “keto flu” symptoms are actually electrolyte imbalances. As contrary to pop[ular thought as it seems, one solution is to add salt to your food (I finally feel justified in that old bad habit), and eating potassium-rich foods (avocados and leafy greens are less likely than the dreaded bananas that I prefer to avoid due to my Costa Rican heritage). I am always contemplating supplementing my magnesium, but for now I’ve got too much going on to pill-up any further.
One of my favorite things about ketosis is that since fat becomes my primary fuel source (in lieu of carbs), I get to eat more of it. You’re supposed to include healthier fats like olive oil, avocados, nuts, and fatty fish, but butter also works and I can get onboard with added butter with no problem. However, since calories still matter and since weight loss is my goal, I do try to keep track of caloric intake within some range of accuracy. I recently tested my internal calorie counter (supplemented by occasional AI queries) by having Kim estimate my caloric intake. I figured that whatever bias I apply to delude myself would get eliminated by Kim. For the most part, we were spot on with each other’s estimates and if anything, I tend to the more conservative.
On the topic of nuts, I am very into pistachios so I was curious how those work for or against me. The bottom line is that pistachios are fine in moderation (like everything in life, I guess). Pistachios are actually one of the better nuts for a lower-carb approach. A 1-ounce serving (about 49 kernels) has around 160 calories, 6g of protein, 13g of fat and 8g of total carbs… but also 3g of fiber, so only 5g net carbs (who knew you could deduct carbs when fiber gets involved?). So, pistachios are a decent source of protein for a nut, have a good fiber content, being packed with nutrients like vitamin B6, potassium, and magnesium, and having the added salt to boost needed electrolytes. That makes taking a handful of pistachios (who wants to go through the bother of shelling the little bastards, right?). But they are calorie-dense, so it’s easy to overeat them. And the carbs can add up if you eat multiple servings, so I only do a few as a snack. Truth be told, that’s about all I have a taste for anyway.
Yesterday I had 1600 calories, which is pretty minimal. That included 320 calories from two protein shakes. Lunch was chicken strips and pepper spears and carrots. Dinner was teriyaki chicken on mashed potatoes. I had a small piece of cake for desert since our friend Faraj gave us some before he left town. I chose to have it before Kim tossed the bulk of it out. The only other thing I had all day was a handful of pistachios in the mid-afternoon. The perfect ketosis diet would have been 500/550/600 calories for breakfast/lunch/dinner with 50 for a snack. I went 160/510/600 with 130 for a snack. The perfect day would have had 160g protein (600 cals), 110 fat (1000 cals), and 25g carbs (100 cals). I had 160g protein, as suggested, 45 grams of carbs (thanks to the cake) and about 80 grams of fat. Not a perfect day, but there will never be a perfect day. But not a bad day either.
The key to ketosis for me will be hitting my protein targets, keeping carbs low, hydration, fiber, electrolytes, and, mostly, patience and tolerance.