I lost 27 pounds over the last year (2023-2024). Don’t worry…this isn’t some infomercial or MLM post. I don’t have some magic program for you to buy. And there’s definitely no shirtless pic action in this article. You’re welcome. But what I do want to share is what my “plan” looked like. I basically want to share how I lost 27 pounds without crazy diets or magic programs. I talk to people in the clinic all the time who are confused, overwhelmed, and don’t know where to begin when it comes to making healthy lifestyle changes. There’s no shortage of information out there and it can get confusion.

So, hopefully this article will help. I throw in some nerdy science stuff like research, and I also share some specifics about what I do and how it works for me. Your mileage may vary, but here it is.

The Driving Force: A Visit to My PCP

It all started in August of 2023. I (finally) got set up with a primary care provider. As a healthy guy, I never really went to the doctor unless something was Wong. But, given that I wanted to take a more proactive approach to my long-term health, I decided it was time to actually get established at a primary care office (side note: we have a direct primary care membership, which is awesome).  On the first appointment, my PCP took labs and got some basic history.

A couple days later, I got my lab results back from them. Here were the results:

• Mildly elevated cholesterol & triglycerides
• Slightly elevated glucose
• Elevated LDL
• In addition, I was carrying around a few extra pounds (at my heaviest, I was around 181 pounds)

Nothing was “hair on fire” or “need to treat today”, but the numbers were trending in the wrong direction. I have young kids and want to be active, healthy, and able to be an involved dad as much as possible. So, with that goal in mind, I decided it was time to make some lifestyle and dietary changes.

The Plan and What it Looked Like

We all know that regular exercise and a healthy diet are key lifestyle changes that lead to positive health outcomes. But, if you start looking around the internet, you find everything from crazy diets to magic programs that claim to “transform” your body in “weeks”. I talk to people all the time in the clinic or at work who think that they won’t be able to successfully lose weight and keep it off because they don’t have time, or they don’t know where to start on the nutrition. Research shows that weight management depends on a whole host of complex factors including: the amount of food you eat, the type of food you eat, physical activity, and even the timing of your meals [1].

That being said, the research also shows that a calorie (or energy) deficit is the most important factor for reach, sustainable weight loss [1]. So, how you get there isn’t so important. A combination of eating less and moving more can get you there.

Here’s what I did:

• Started exercising 5 times per week
• Began limiting the amount of processed food I ate
• Limited alcohol consumption to 2-3 drinks per month
• Limited meal portions – I said “no” to second helpings at any meal (by far one of the harder changes)
• Started a “protein forward” diet

In the next several sections, I give a breakdown of each of those bullet points. I share some screenshots from my macro/calorie tracking app as well as some specific exercises that I’ve begun incorporating into my regular routine.

Exercise: 5 Times per Week

OK. So, the first change I decided to make involved increasing the amount of exercise I was doing each week. Before this time, I was a semi-regular runner. I was running 3 times per week and even ran a half marathon at one point. Despite that level of activity, I never really achieved much actual weight loss or fat loss with running.

Now, why focus on exercise first, if creating a calorie deficit is the most important factor for real, sustainable weight loss? For me, choosing to focus on exercise came down to 2 things: 1) increasing physical activity without increasing calorie consumption is an easier way to create a calorie deficit than it is to start out by cutting foods and 2) I want to be active and healthy, so I wanted to find the right mix of exercise to make actually exercising easier for me.

And, research supports including exercise as part of healthy weight loss and maintenance in order to maintain weight loss long-term. A study that looked at people using GLP-1 Receptor Agonist drugs (like Ozempic) concluded that body weight and body composition were maintained one year after termination of supervised exercise, in contrast to weight regain after termination of treatment with obesity pharmacotherapy alone [2]. Put another way: people that took Ozempic regained weight a year after stopping the drug, compared to participants in the study who were able to keep the weight off using regular exercise.

The Actual Exercise & Schedule

I ended up choosing Jiu Jitsu and Weight Lifting/Resistance Training as my exercise options this go around. Why these two? Well, research shows that resistance training reduces body fat percentage, body fat was, and visceral fat in healthy adults [3]. Resistance training has also been shown to decrease mortality risk as we age [4]. Since I have young kids and want to live a long, healthy life —and I want to be one of those “fun” dads that actually plays with their kids instead of complaining about back pain— resistance training found its way to the top of my exercise list.

As far as Jiu Jitsu goes, it’s also been shown to increase muscle mass, decrease body fat percentage, as well as increase muscle endurance and flexibility [5]. So that was a bonus. The other reason was simply that I found it really fun. And, as we all know, if you enjoy doing something, you will probably find it easier to keep on doing it long term. I attend a 06:00 am Jiu Jitsu class 3-4 times per week, and it is not really a struggle to wake up and get ready for it. I actually look forward to it. It keeps my mind and body engaged. And I can see myself doing it long-term, which means I’ll be regularly exercising. That, to me, seems like a better option than picking a random set of “exercises” to dee every other day, etc.

So, my actual breakdown of daily exercises is usually: Jiu Jitsu 3 (or 4) times per week and weightlifting 2 at least 2 days a week.

Dietary Changes: Processed Food, Alcohol, Meal Portions, & Protein

When it comes to dietary changes, a simple google search yields hundreds or thousands of opinions, plans, and programs. It gets confusing, and many people that I talk with in the clinic feel overwhelmed by the amount of information out there about diet and nutrition. So, the reality is, before you start making significant dietary changes, it’s best to talk with your healthcare provider to review your specific situation. What follows is simply what I’ve done over the last year and some of the research upon which I based those decisions. I’m not a registered dietician, so take this with a grain of salt (see what I did there?).

Diet & Macronutrients

The research tends to break down weight loss & weight management diet strategies into three (3) categories [6]:

1. Macronutrient Manipulation: tracking macros and truing to hit certain goals or targets (example: low-fat, high-protein, low-carb, etc.)
2. Food Type Restriction: cutting out specific foods or food groups (like gluten-free, paleo, vegetarian, etc.)
3. Timing Manipulation: structuring the timing of when you eat meals (example: intermittent fasting, etc.)

Now, depending on who you talk to, you find strong advocates of each of those types of strategies. However, research suggests that belief that these diets promote weight loss has emerged more from personal impressions and reports published in books, rather than from rigorously controlled research [6].

Basically, there is no one diet strategy that is “most effective” to promote weight loss. At least there hasn’t been any research to demonstrate that there is a “best” diet strategy. Some evidence does suggest that, in the short-term, a high-protein, low-carb diet and intermittent fasting do promote greater weight loss [6]. But that’s in the short term. So, maybe think of those tools as a “jumpstart” to a healthy lifestyle. And, since we know that a calorie deficit is the most important factor in weight loss, then that should be the main target [1].  How you get there can be a combination of timing, food restriction, exercise, etc. That’s the main reason I chose to put myself on the “no second helpings” plan. It kept me from overeating and killing that calorie deficit that I created by upping my exercise and physical activity.

Protein Forward Diet & Macro Tracking

So why did I select a “protein forward” diet? I chose this for a couple of reasons: 1) evidence suggests that increasing daily protein intake can enhance gains in lean muscle mass in people completing resistance training [7] and 2) research also suggests that increased protein intake also helps suppress appetite, increase fullness, and decreases a desire to eat [8]. So, since I wanted to build some muscle and decrease my calorie intake, it seemed that increasing protein intake would be a good decision.

The American College of Sports Medicine (ACSM) suggests that a person doing high-cardio or weight training exercises should consume between 0.5-0.8 grams of protein per pound of ideal body weight, which is higher than the recommended dietary amount of 0.36 grams per pound [9]. So, I ended up going with the ACSM recommendation.

As far as how I did that: I used the Macros App (I don’t have any affiliation with them at all). It has a free version and does the basics: tracks macronutrients and daily/weekly calorie intake. I also liked that it tracked exercise and calculated “net calories” for each day. I based my calorie target on what the app suggested. So, for someone of my age and activity level, the app suggested 2000-2100 calories per day to maintain my current bodyweight. A common adage is that a 500 calorie per day deficit yields about a 1 pound bodyweight loss per week. However, research also shows that a deficit of greater than 500 calories per day (3,500 per week) can impair strength [10]. So, I Amed to hit about a 500 calorie per day deficit.

What the Macro Tracking Actually Looked Like

Here are a few screenshots from the app over the last couple of months:

The first screenshot (on the left) shows the actual macros in grams and the second set of screenshots shows the macros in terms of dietary percentages. The one on the left was taken halfway through the day, so I hadn’t had dinner yet. But you get the picture. The app recommended a “balanced diet” of 25% fat, 25% protein, and 50% carbs. Those macros ended up putting me at about 0.75 grams of protein per pound of bodyweight. So that’s more or less that I’ve tried to adhere to.

Here are the screenshots of calories per day:

Alcohol Consumption and Its Effect

Now, before I dive into this section, let me be clear: I’m not morally opposed to alcohol consumption. In moderation, I don’t see any problem with it. As long as it doesn’t negatively affect your sleep, work, leisure, or relationships, go ahead and enjoy a beer at your favorite Mexican restaurant or wine with your partner on a quiet evening. In this section, I simply share how I modified my own alcohol consumption in order to achieve my desired weight loss & health goals. I also share a bit from the clinical research.

Why did I even think about addressing the alcohol piece of my diet when I started this? The main reason involved calorie deficits. A beer, at least a good one, contains about 150 calories (I’ve never liked those 90 calorie drinks that pose as beer). So, cutting alcohol out was an easy way to reduce that daily calorie count. There’s also research, like a 2021 systematic review, that suggests that alcohol drinkers have increased odds of being overweight or obese, with specifically abdominal obesity than non-alcohol drinkers [11]. So, since I wanted to lose some weight and decrease my abdominal fat, it made sense to limit my alcohol intake.

Also, higher alcohol consumption is associated with poor sleep quality, higher odds of snoring, and shorter sleep duration [12]. And, as a 2022 study showed, disturbed sleep patterns lead to an increase in appetite and snacking on foods rich in carbs and fats [13]. That means, sleeping poorly increases your risk of killing your calorie deficit. So, since increased alcohol intake impairs sleep, I decided it was best to limit it, especially while I was in the “weight loss” phase of this program.

Processed Food Intake

I think this point is probably the easiest one to explain. Processed food, and especially ultra-processed foods, have been shown to increase the risk of obesity and obesity-related conditions (like cardiovascular disease, cancer, and type 2 diabetes) [14]. Here’s a table that shows the definitions of processed and ultra-processed foods [14]:

On this list, the research would recommend definitely avoiding and limiting number 4 (ultra-processed foods) and limiting number 3 (processed foods).

Here’s what I did: I started cutting out, as much as possible processed and ultra-processed food. And I did this by focusing on specific meals. I started with breakfast, then lunch, then dinner. So, the first week, as an example, I began only eating “real foods” for breakfast. Instead of eating cereal, I ate a couple scrambled eggs (also for protein) and some fruit. After I made that change (a couple of weeks), I shifted my focus to lunch. And then the same for dinner.

Here’s what a typical daily diet may include for me:

• Breakfast: Eggs (scrambled or boiled) and a fruit (banana, apple, etc.) Maybe some homemade oatmeal or granola.
• Lunch: Salad, lean protein (chicken breast or fish); or some leftover from dinner the day before
• Dinner: Some kind of vegetable, protein (meat, beans, fish), maybe a grain like rice
• Snacks: Nuts, trail mixes, fruit, popcorn, and maybe the occasional protein bar (I like RxBars, but have also dipped into some barebells as well)

Of course, there are times when we order pizza with the kids, or we go over to a friend’s house and eat some chips. But, the way I figure it, if I can make my diet mostly based on whole, minimally-processed foods for the majority of the time, a delicious piece of Papa John’s Pepperoni Pizza won’t kill me.

The Results

Ok, so after a year of this plan, what were the results?

I went back for the follow-up yearly physical and labs and where’s what we found:

• Weight: 150 pounds (down from 175-180 pounds)
• Lipid Panel: Normal cholesterol & triglycerides ( a “significant improvement” according to my PCP)
• Glucose: Reduced to “normative range”

What’s funny is the quality of life impact that these changes had on both personal and career/work levels in my life. For example, regular exercise has been a great outlet to reduce and regulate work-related stress. Improving my nutrition & eating habits has decreased that mid-afternoon brain fog that used to plague me nearly every day. These changes have also led to better & improved sleep quality, which means I wake up feeling well-rested and ready to take on another day.

It’s funny: as a healthcare professional in the MSK rehab space, I think I’ve told no less than 1,000 patients about the “benefits of healthy lifestyle changes”. But, as many healthcare professionals, I’ve had difficulty following my own advice. I’ve always had reasons (excuses) why I “couldn’t” do these things: work demands, etc. But the reality is that I just wasn’t prioritizing them. Once I stopped thinking about the amount of overwhelming info and started to focus on the high-level concepts (exercise, calorie deficit, etc.), it became much easier, both in reality and in my mind. Anyways, I hope this article helps you if you’re thinking about making some changes but unsure of where to start.

And, if you want help from a licensed clinician to incorporate physical activity and exercise into your daily life, book an appointment online or call the office to set up an appointment.

References

[1] Kim JY. Optimal Diet Strategies for Weight Loss and Weight Loss Maintenance. J Obes Metab Syndr. 2021 Mar 30;30(1):20-31. doi: 10.7570/jomes20065. PMID: 33107442; PMCID: PMC8017325.

[2] Jensen, Simon Birk Kjær et al. Healthy weight loss maintenance with exercise, GLP-1 receptor agonist, or both combined followed by one year without treatment: a post-treatment analysis of a randomised placebo-controlled trial eClinicalMedicine, Volume 69, 102475. DOI: https://doi.org/10.1016/j.eclinm.2024.102475

[3] Wewege, M.A., Desai, I., Honey, C. et al. The Effect of Resistance Training in Healthy Adults on Body Fat Percentage, Fat Mass and Visceral Fat: A Systematic Review and Meta-Analysis. Sports Med 52, 287–300 (2022). https://doi.org/10.1007/s40279-021-01562-2

[4] Abou Sawan, Sidney; Nunes, Everson A.; Lim, Changhyun; McKendry, James; Phillips, Stuart M.. The Health Benefits of Resistance Exercise: Beyond Hypertrophy and Big Weights. Exercise, Sport, and Movement 1(1):e00001, Winter 2023. | DOI: 10.1249/ESM.0000000000000001

[5] The Effects of Brazilian Jiu-Jitsu on Body Composition, Health Fitness, Functional Movement Screening in non-Elite Healthy Young Adults Asian J Kinesiol. 2021;23(3):29-37.   Published online July 31, 2021 DOI: https://doi.org/10.15758/ajk.2021.23.3.29

[6] Rachel Freire. Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition, Volume 69, 2020. https://doi.org/10.1016/j.nut.2019.07.001.

[7] Nunes, E. A., Colenso‐Semple, L., McKellar, S. R., Yau, T., Ali, M. U., Fitzpatrick‐Lewis, D., Sherifali, D., Gaudichon, C., Tomé, D., Atherton, P. J., Robles, M. C., Naranjo‐Modad, S., Braun, M., Landi, F., & Phillips, S. M. (2022). Systematic review and meta‐analysis of protein intake to support muscle mass and function in healthy adults. Journal of Cachexia, Sarcopenia and Muscle, 13(2), 795–810. https://doi.org/10.1002/jcsm.12922

[8] Ali Kohanmoo, Shiva Faghih, Masoumeh Akhlaghi. Effect of short- and long-term protein consumption on appetite and appetite-regulating gastrointestinal hormones, a systematic review and meta-analysis of randomized controlled trials. Physiology & Behavior, Volume 226, 2020, 113123. https://doi.org/10.1016/j.physbeh.2020.113123.

[9] Protein intake for optimal muscle maintenance. (n.d.). https://www.acsm.org/docs/default-source/files-for-resource-library/protein-intake-for-optimal-muscle-maintenance.pdf

[10] Murphy, C., & Koehler, K. (2021). Energy deficiency impairs resistance training gains in lean mass but not strength: A meta‐analysis and meta‐regression. Scandinavian Journal of Medicine & Science in Sports, 32(1), 125–137. https://doi.org/10.1111/sms.14075

[11] Golzarand, M., Salari-Moghaddam, A., & Mirmiran, P. (2021). Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies. Critical Reviews in Food Science and Nutrition, 62(29), 8078–8098. https://doi.org/10.1080/10408398.2021.1925221

[12] Zheng D, Yuan X, Ma C, et al. Alcohol consumption and sleep quality: a community-based study. Public Health Nutrition. 2021;24(15):4851-4858. doi:10.1017/S1368980020004553

[13] Papatriantafyllou E, Efthymiou D, Zoumbaneas E, Popescu CA, Vassilopoulou E. Sleep Deprivation: Effects on Weight Loss and Weight Loss Maintenance. Nutrients. 2022; 14(8):1549. https://doi.org/10.3390/nu14081549

[14] Dicken SJ, Batterham RL. The Role of Diet Quality in Mediating the Association between Ultra-Processed Food Intake, Obesity and Health-Related Outcomes: A Review of Prospective Cohort Studies. Nutrients. 2022; 14(1):23. https://doi.org/10.3390/nu14010023