Crossing the weight loss plateau – Don’t give up or your liver will execute you.

I have  been back on my weight loss plan for the last couple of weeks, and wanted to offer some encouragement to those in the same posish.

If you are reading this, then I suspect you may be attempting to lose weight, or have done so in the past, in which case you may be familiar with the phenomenon of weight loss plateauing. This occurs when, despite your best efforts, the scales refuse to budge and it takes a stiff upper lip and nerves of steel not to reach for the biscuit tin.

Rupert’s Story.

First, some basic maths. Each gram of fat contains 9 calories. therefore a pound of fat (453.5 grams) contains about 4000 calories.

In order to lose a pound of fat, you therefore have to consume 4000 less calories than you expend.

A few years ago, I spent a few months on a low-carb diet. I do not recommend it; although I lost one and a half stone, life without carbs is pretty grim and I soon regained all the weight. The point is that in the first week, I lost about 5 pounds. 5 pounds of fat contains 20 thousand calories. In order to lose 5 pounds of fat in a week, I would have had to have a 3000 calorie deficit daily, which is simply  not possible unless you are hiking in the Arctic.

Subsequently I found that there were weeks when I would lose 1-2 pounds, and at other times my weight would stick and refuse to budge for 1-2 weeks, even though I had made no significant changes to my diet or exercise regime. These were the weeks when I was tempted to jack it in and lapse back into my old habits.

So what is going on? The answer is glycogen.

Metabolic Syndrome X

The main purpose of eating is to provide the body with glucose to use as fuel. When you eat, blood glucose levels rise, which triggers the release of insulin from the pancreas. Insulin pulls glucose into cells to be used, but once those cells have sufficient, any excess has to be stored. Up to 2000 calories can be stored as glycogen in the muscles and liver, with any excess being converted to fat for later use. Converting glucose to fat and vice versa takes time, so the glycogen acts as a short term energy easy access storage; RAM rather than ROM.

Under normal circumstances, the body is able to produce fat at a sufficient rate to keep glycogen stores topped up, but if so many excess calories are ingested that the glycogen stores are constantly full to capacity, problems arise.

Your Liver Wants to Kill You.

The first thing that happens is that the liver becomes stressed. You know that tubby guy in Full Metal Jacket that the Sergeant spends all his spare time harassing, and the tubby guy just puts up with it and puts up with it until one day he goes psycho and blows Sarge away?

That’s your liver, except your liver doesn’t have a gun, but it does have a major effect on your cholesterol levels. The more stressed your liver becomes, the more and more angry it gets and it starts pushing your triglyceride levels up and your (good) HDL levels down. At the same time, it recruits your kidneys to the cause and they respond by pushing your blood pressure up. That’s right! Your liver and kidneys are trying to give you a heart attack.

But that’s not the worst of it.

Dissent is spreading.

Your pancreas loves you. Even in the face of this mutiny by your own organs, and your continued insistence on overeating, it battles away by pumping out more insulin to deal with rising glucose levels, but with nowhere to put the excess glucose, it requires higher and higher insulin levels to try to force glucose into cells.

But your cells have had enough; they have downed tools and are refusing to accept any more glucose, no matter how much insulin you offer them; this is known as insulin resistance. Eventually the blood glucose level rises and  no amount of insulin can reduce it, because there is nowhere left for the body to store it. This is type 2 diabetes.

The combination of central obesity insulin resistance, lipid derangement and high blood pressure is known as the metabolic syndrome, and reflects a  body’s inability to deal with the amount of excess calories being inflicted upon it.

What has this to do with weight loss plateaus?

Plenty, because this process works the same in reverse. When we create a calorie deficit by reducing intake and/or increasing activity, the body first uses glucose that is immediately available. Once this is depleted, glycogen stores are mobilised from the muscles and liver. If the calorie deficit is maintained, the body will convert stored fat to glycogen to refill glycogen stores.  Therefore when you lose weight, you are initially depleting glycogen stores, not fat.

For every gram of glycogen stored, there are 3 grams of water stored with it, so when I lost my 5 pounds in a week, I may have  actually lost 1 and a 1/4 pounds of glycogen and 3 and 3/4 pounds of water, a calorie deficit of around 2200 calories, the equivalent of half a pound of fat.

In reality, because this is a dynamic process of glycogen production and breakdown, I probably lost some fat and depleted some glycogen.

More maths;

Every gram of fat converted to glycogen will weigh 2.25 grams plus three times that weight in water, ie. 9 grams. This means that as you convert fat to glycogen, your weight may remain stable or even rise, and the weight loss may not become apparent until some glycogen has been burned off.

In summary.

Weight loss tends to occur in steps depending on whether you are making or breaking down glycogen. As long as you stick to your plan and continue to consume less calories than you take in, you will still be losing fat, even if the scales say otherwise. Don’t just give up and say, “I’m not losing weight, so I may as well just go back onto the cream cakes and jack in the pilates.” Your scales are working for the food companies; they’re probably made by a subsidiary of Hershey or Kraft.

If that isn’t enough incentive, just remember ……. your liver is watching

About Dr Rupert Harker

I am the author of the Urban-Smith mysteries. Book 2, The Werewolf of Worttenham Wood is due out in June.
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