Alternatively, does this describe your situation?

- You were able to lose weight in Induction but can't seem to budge in OWL.- The greater choice of foods is creating problems with cravings and unreasonable hunger.- You may have even regained some lost pounds in OWL.

If so, you may be someone who is particularly sensitive to carbohydrates and has to keep his/her carb intake low indefinitely. If your weight loss has stalled for more than four weeks and you're experiencing symptoms that are making it difficult to stay with OWL, this is not the time to consider moving to another phase. You've probably reached your Atkins Carbohydrate Equilibrium (ACE)-or exceeded it-sooner than you expected. Just to be clear, your CLL is the daily carb intake level that lets you keep losing weight, and your ACE is the level that lets you hold your weight stable. For some people, these two numbers can be pretty low and close together, 30 and 45 grams, for example. Say you've reached a daily intake of 40 grams of Net Carbs. If you're still losing weight but are experiencing hunger, this level may be destabilizing indicators that you'd recently brought under control.

When you b.u.mp up against your ACE before reaching your goal, it means that the metabolic bully is back and needs to be dispatched. Here's how. Drop back 5 grams for one or two weeks. If you feel no better and are still not losing, drop back another 5 grams. A better CLL for you may be 35 or even 30 grams or less. Look at your foods as well. If, for example, you've recently added berries and suspect that they may be the culprit, eat them a couple of times a week instead of every day. Add no new food groups until you feel better. Once you stabilize, you can continue to try to add new OWL foods as long as both your weight loss and your overall feelings of well-being remain. When you're 10 pounds from your goal weight, move to Pre-Maintenance.

However, if you're consuming somewhere between 25 and 50 grams of Net Carbs, cannot increase your CLL, and are 10 pounds from your goal weight, there's no point in trying to introduce foods higher on the carb ladder. Instead, stay in OWL until you reach your goal weight, maintain it for a month, and then follow the lower-carb approach to Lifetime Maintenance designed for people who are more sensitive to carbs. You may need to back down on carbs and increase your fat intake. Don't feel bad if you find that your CLL is quite low. Instead, be grateful that Atkins allows you to find the individualized level that will allow your body to correct or stabilize the underlying condition and keep the bully at bay.

We'll conclude this chapter with a brief recap of OWL.

- Begin OWL at 25 grams of Net Carbs per day.- Increase your intake in increments of 5 grams at the pace that is comfortable for you, listening carefully to your body's signals as well as charting your weight loss progress.- Reintroduce carbohydrate foods in the following order: nuts and seeds, berries and a few other low-carb fruits, additional dairy products, vegetable juices, and legumes, understanding that not everyone can reintroduce all these foods.- Continue to consume the recommended amounts of protein and plenty of natural fats and to count your carbs.- Continue to drink about eight gla.s.ses of water and other acceptable fluids and to maintain your sodium intake with sufficient broth, salt, or soy sauce as long as you are consuming 50 grams or less of Net Carbs per day.- Use certain low-carb products in moderation if you can handle them.- Continue to take your daily multivitamin/multimineral and omega-3 supplements.- Continue or begin to be active or exercise if you can do so comfortably.- Understand that weight loss moves erratically and you may experience plateaus.

Even if you're not moving on to Pre-Maintenance yet or at all, do make a point of reading the next chapter. Meanwhile, read about Jessie Hummel's return to health and vigor thanks to losing weight on Atkins.

SUCCESS STORY 8.

BACK IN SHAPE.

When he couldn't squeeze into an old suit, Jessie Hummel realized it was time to do something about his weight. Three years later, both his excess weight and his bad habits are history.

VITAL STATISTICS.

Current phase: Lifetime MaintenanceDaily Net Carb intake: 6070 gramsAge: 65Height: 6 feetBefore weight: 228 poundsCurrent weight: 194 poundsWeight lost: 34 pounds Had you always had problems with your weight?

No. Until I reached my 60s, I had never dieted a day in my life. But when I turned 60, my metabolism changed and I retained weight. The hardest part of being heavy was looking in the mirror, but the defining moment came when I wanted to wear my black suit to funeral services for one of my brothers-in-law and found that I couldn't squeeze into it. At the service some people who hadn't seen me in years commented to my wife, "Jessie looks the same except he's fatter."

What made you decide on Atkins?

When I was younger, I knew about Atkins, but it was my wife who suggested I try it because she knows how much I enjoy my evening c.o.c.ktail. Even though you can add alcohol in Ongoing Weight Loss, I didn't have a drink until I reached my goal weight. And I haven't had any sugar or bread since I've been on the Atkins Diet.

Did you have any health issues that were factors?

Several years back, carrying around the extra pounds, my left knee went chronic on me with pain and discomfort. My "saw bones" said, "Welcome to arthritis," which I could trace back to my youth. Well, once I had lost the weight, which took about four months, my knees no longer hurt. My doctor was fine with my doing Atkins, but he did want to check my cholesterol every six months, and my readings have been fine. Now he tests it just once a year.

What was the most difficult thing for you?

This will sound strange, but it was hard for me to eat three times a day. I never used to eat breakfast or even lunch unless I had a business meeting. I just wasn't hungry, but I knew it was important to eat regularly. Even now, I usually just have an Atkins bar for lunch.

How about exercise?

After losing weight, I started a daily aerobic fitness program that works about 80 percent of my body. Now that I'm retired, my pa.s.sion is swimming, which is excellent exercise. I have to swim every day. Fortunately, we live in Florida and have a heated pool, but getting in and out of it in the winter is still a challenge. I'm in as good shape as when I was in the military years ago.

What inspired you to stick with the program?

I'm a self-motivator, but while I was losing pounds, weighing myself once every week helped. I also changed my habits so that things I did for years like late-night snacking are no longer a part of my life. Now that I'm at my goal weight, wearing trousers with a 36-inch waist, down from 42, is a daily reminder of what I've achieved. Even though my wife is a terrific cook and from time to time she tempts me with certain dishes, I just say no.

Have you had any trouble maintaining your weight?

No. Based upon my weekly weigh-in, I adjust my carb intake within a 10-gram range so that I never put on more than a couple of pounds, which I then take off immediately.

What advice can you offer other people?

Give away your old clothes that no longer fit. Establish new habits. Find a form of exercise you love to do and do it.

Chapter 9.

INTO THE HOME STRETCH: PRE-MAINTENANCE.

The last few pounds and inches are often the most stubborn to let go, particularly if you try to advance your carb intake too quickly. This phase could take as long as three months or even more, but that's fine. Now is the time to think like a tortoise, not like a hare.

For those of you who began Atkins in Induction or Ongoing Weight Loss (OWL), the end is in sight. (Of course, you know that "the end" is really only the beginning of your new lifestyle.) If your goal was to slim down, it's within your grasp. If you were determined to lower your blood pressure and your blood sugar and insulin levels or improve your cholesterol and triglyceride levels, your indicators should show marked improvement. Just for fun, flip back through some of the entries in your diet journal to remind yourself of how far you've come in the last several months (or weeks, if your objectives were small). Your achievements are the result of keeping your eye on the big picture, feeding your body in a way that minimizes temptation, and not letting minor setbacks derail you.

Let's put one issue to rest. Many people don't understand why Atkins is made up of four phases instead of three. Once you reach your goal, you're done, right? Wrong! Difficult as losing weight is, it pales in comparison to the challenge of maintaining your healthy new weight. Almost anyone can stick with any diet for weeks-or even months. But permanently changing your way of eating is much more difficult. That's why Phase 3, Pre-Maintenance, and Phase 4, Lifetime Maintenance, are distinct. In Phase 3, you'll attain your goal weight and then make sure that you can stay right there for a month. (Some people remain in Ongoing Weight Loss, or OWL, until they reach their goal weight, as discussed in the last chapter.) This dress rehearsal prepares you for the real show, the rest of your life in Lifetime Maintenance. Regard Pre-Maintenance as the beginning of your transition to a permanent and sustainable way of eating.

Whether the Carbohydrate Level for Losing (CLL) that you found in OWL is 30 or 80 grams of Net Carbs, you've obviously hit upon a mix of nutrients that works for you, at least for weight loss. Give yourself a round of applause as you begin to whittle away those last few pounds and inches and normalize your health indicators. Check out the Phase 3 meal plans in part III part III to get an idea of how you're likely to be eating in Phase 3, in which many of you will have the opportunity to test the waters with the remaining carbohydrate food groups. These include fruits other than berries, starchy vegetables, and whole grains. Which is not to say that you to get an idea of how you're likely to be eating in Phase 3, in which many of you will have the opportunity to test the waters with the remaining carbohydrate food groups. These include fruits other than berries, starchy vegetables, and whole grains. Which is not to say that you have have to eat these foods or even that you to eat these foods or even that you can can eat them. eat them.

You'll explore your tolerances for foods higher on the carb ladder as you increase your overall carb intake (generally in 10-gram increments) until you reach and maintain your goal weight for a month. Although this seems like a relatively small goal, particularly if you've already trimmed a substantial amount of extra weight, the last few pounds and inches are often the most stubborn to let go, particularly if you try to advance your carb intake too quickly. This phase could take as long as three months or even more, but that's fine. Now is the time to think like a tortoise, not like a hare. But first, time for a reality check.

Are you impatient to reach your goal?

Of course you are. It's natural to want to cross the final hurdles when the finish line is in sight. But it's important to understand that achieving your goal weight is only one battle in the war that you'll be waging for permanent weight management. In addition to saying good-bye to those final 10 pounds of excess fat, you want to identify your overall tolerance for carbohydrates, as well as which foods you can and cannot handle. In this phase you'll fine-tune those two concepts. Hard as it may be at this crucial time, keep your focus on the process, which will naturally lead to your desired results. If you rush to shed those last pesky pounds, you may never learn what you need to know to keep them off for good.

Are you champing at the bit to get back to your old way of eating?

If you're feeling deprived and looking forward to revisiting all your old food friends as soon as possible, you're cruising for a bruising. Unless you're blessed with superhuman powers of self-control or the metabolism of a superhero-in which case we doubt you'd be reading this book-it's simply unrealistic to think you can drop weight and/or get your blood sugar, blood pressure, and lipids under control and then return to your old way of eating without repercussions. In fact, no matter how you lose weight, abandoning your new way of eating once you reach your goal almost inevitably leads to weight regain. If you return to a high-carb diet-usually laden with heavily processed foods-you'll also likely experience the attendant health problems we've already mentioned and will discuss in detail in part IV part IV. In this chapter, we'll help you define a reasonable reasonable way to eat on a regular basis. If you plan to celebrate reaching your goal with pasta, French fries, and jelly doughnuts, why are you wasting your time slimming down on Atkins? You'll simply be hopping back onto the diet seesaw. Those of you who previously achieved your goal weight on Atkins only to gain back the weight have learned this lesson the hard way. Again, Pre-Maintenance trains you for a lifetime way of eating. way to eat on a regular basis. If you plan to celebrate reaching your goal with pasta, French fries, and jelly doughnuts, why are you wasting your time slimming down on Atkins? You'll simply be hopping back onto the diet seesaw. Those of you who previously achieved your goal weight on Atkins only to gain back the weight have learned this lesson the hard way. Again, Pre-Maintenance trains you for a lifetime way of eating.

Have you achieved good results to date, but only with considerable effort?

You may have lost pounds, only to gain some of them back. If you've followed the program to the letter and found that certain foods reawakened cravings, you may have moved beyond your Carbohydrate Level for Losing (CLL). Or you may have progressed too quickly. As you now know, both can reawaken the sleeping metabolic bully. Frustrating as these experiences have surely been, the silver lining is that they've given you valuable information on what you can and cannot eat. Knowledge is power. Even if you don't like everything you've learned, your hard-earned education about your body's response to carbohydrates will allow you to work within its comfort range-and put you, not that box of cookies or slice of pizza, in control.

Was your experience in OWL an exercise in frustration?

You may have found that reintroducing certain foods stalled your weight loss or actually made you regain a few pounds. Perhaps you became reacquainted with some of the old familiar demons: cravings, out-of-control appet.i.te, and midafternoon fatigue. Maybe you felt that you'd jumped back on that blood sugar roller coaster. Like it or not, it may be that your body is particularly sensitive to carbohydrates and you'll have to continue to keep your intake low to avoid regaining weight and experiencing other harmful metabolic effects. You may need to heal your metabolism by continuing at a relatively low-carb level for the foreseeable future. As you'll learn in the next chapter, we've tailored Lifetime Maintenance to provide a version that allows you to safely keep your carb intake at no more than 50 grams of Net Carbs.

BEGINNING IN PRE-MAINTENANCE.

If you're starting out with 10 to 20 pounds to lose or are presently happy with your weight and are changing your diet for health reasons, you may start in this phase at 40 grams of Net Carbs a day, increasing by 10-gram weekly increments until you approach your Atkins Carbohydrate Equilibrium (ACE), discussed below. If weight is not your issue, you'll know that you've exceeded your ACE when you develop cravings or unreasonable hunger, your energy level drops, or your health indicators stop improving or revert to previous levels. Read the preceding chapters on Induction and Ongoing Weight Loss (OWL), and follow the guidelines described above. If you have more weight to lose but are unwilling to limit your food choices and willing to trade off with a slower pace of weight loss, you can also start in this phase. Understand, however, that moving through the four phases maximizes fat burning, even if you spend relatively little time in the earlier ones. If you see no (or unsatisfactory) results on Pre-Maintenance after two weeks, you should probably start over in OWL at 30 grams of Net Carbs.

Vegans or vegetarians with modest weight loss goals or those who simply want to feel better and more energetic may also start Atkins in Pre-Maintenance, as discussed below.

WHAT TO EXPECT IN PRE-MAINTENANCE.

As you increase your carb intake and home in on your goal weight, you may lose an average of as little as a half pound a week, which is perfectly natural. All the while, you'll be learning the eating habits that will guide you for the rest of your life. As in OWL, you'll experiment as you figure out what you can and can't eat. This process of testing your limits or even temporarily backing off-using your weight change as the imperfect indicator you now know it is-is all part of the learning curve.

There's a good likelihood that at some point you'll find yourself on a plateau. If you experienced one or more of the inexplicable cessations of weight loss in OWL, you'll know what to do. If you haven't plateaued before, go back to "Hitting a Plateau" on page 128 and carefully reread that section. Dealing patiently with and learning from a plateau is essential to your continued success. (If you seem to be getting nowhere despite following these suggestions, it's likely that you've happened upon your ACE prematurely and need to drop back 10 to 20 grams of Net Carbs to continue losing.) After all, your ultimate success in Lifetime Maintenance is achieving a permanent plateau-aka your goal weight. You may get discouraged and be tempted to revert to OWL (or even Induction) to banish those last pesky pounds ASAP. Don't do it! Pre-Maintenance is where you learn how to eat in the real world of family dinners, business lunches, holiday gatherings, vacations, and myriad other occasions in which food plays a major role.

THE BASICS OF PRE-MAINTENANCE.

Now that you're in Phase 3, you'll still follow pretty much the same drill you have until now to stay in a fat-burning mode. You must know it by heart by now: count your carbs, and be sure that 12 to 15 grams of your total daily Net Carb intake is made up of foundation vegetables. They'll continue to be the platform upon which you build as you add back new carbohydrate foods. Also, keep eating the recommended amounts of protein and sufficient natural fats to feel satisfied at the end of each meal. Continue to drink plenty of water and other acceptable beverages, consume enough salt, broth, or soy sauce (unless you take diuretics) if your Net Carb intake is 50 grams or less, and take your supplements.

So what's different? You'll slowly increase your daily Net Carb intake in 10-gram increments as long as weight loss continues and follow the Pre-Maintenance meal plans in part III part III. In effect, you're swapping the pace of your weight loss for a slightly higher CLL. But if this brings your weight loss to a grinding halt or you gain back a pound or so that remains longer than a week, simply drop back 10 grams. Stay there for a couple of weeks, and if slight weight loss resumes, try increasing your carb intake by 5 grams to see if you get the same reaction you did with a 10-gram increase. You may wind up remaining at the same CLL that you were at in OWL, even as you reintroduce some of the acceptable foods for this phase. Once you exceed 50 grams of Net Carbs, you need not continue to consume salty broth, soy sauce, or a half teaspoon of salt each day.

ACCEPTABLE FOODS FOR PRE-MAINTENANCE.

In addition to the foods you can eat in Induction and OWL, the following foods are acceptable in Pre-Maintenance-if your metabolism can tolerate them. You can also add small portions of whole milk (4 ounces contain almost 6 grams of Net Carbs) or b.u.t.termilk, but not skim, nonfat, or low-fat types. If you're lactose-intolerant, you can have lactose-free dairy products or b.u.t.termilk (also in 4-ounce portions). Eat nothing that isn't on these three lists unless you know the carb count and the ingredients (including added sugars). Follow the carb ladder (page 120), starting with legumes, unless you've already reintroduced them in OWL-as vegetarians and vegans almost certainly have.

LEGUMES.

Though legumes are relatively high in carbs, they also contain lots of fiber and contribute protein to meals. Introduce them one by one and in small portions. If you love a bowl of lentil soup on a chilly day, a side dish of steamed edamame, or a snack of hummus, this step will make you a happy camper. If beans are not your thing, simply skip this group of carbohydrate foods. (For a list of legumes with carb counts, see page 125.) OTHER FRUITS.

a.s.suming you didn't have trouble reintroducing moderate portions of berries, cherries, and melon in OWL, you can now experiment with other fruits. As you'll see below, carb counts vary significantly. Remember that all fruit is high in sugar and should be treated as a garnish. Start by introducing portions of no more than a half cup of such relatively low-carb fresh fruits as plums, peaches, apples, tangerines, and kiwis. One small ripe banana, on the other hand, packs about 21 grams of Net Carbs and its close relative, the plantain, even more. Avoid canned fruit. Even fruit packed in juice concentrate or "lite" syrup is swimming in added sugar.

Continue to stay away from fruit juice, other than lemon and lime juice. A cup of unsweetened unsweetened apple juice, for example, racks up 29 grams of Net Carbs, and orange juice (even freshly squeezed) is a close runner-up. Without the fiber to slow its absorption, fruit juice hits your metabolism like a sledgehammer. Likewise, drying fruit, including apricots, raisins, prunes, and apple slices, concentrates the sugars, elevating their carb count. But as you can see in this table, there are lots of fruit choices that come in at less than 10 grams of Net Carbs per portion. The following carb counts are for fresh fruit. apple juice, for example, racks up 29 grams of Net Carbs, and orange juice (even freshly squeezed) is a close runner-up. Without the fiber to slow its absorption, fruit juice hits your metabolism like a sledgehammer. Likewise, drying fruit, including apricots, raisins, prunes, and apple slices, concentrates the sugars, elevating their carb count. But as you can see in this table, there are lots of fruit choices that come in at less than 10 grams of Net Carbs per portion. The following carb counts are for fresh fruit.

Fruit serving size Grams of Net Carbs Apple medium 8.7.

Apricot 3 medium 9.2.

Banana 1 small 21.2.

Carambola (Star fruit) cup sliced 2.8.

Cherimoya cup 24.3.

Figs, fresh 1 small fruit 6.4.

Grapes, green cup 13.7.

Grapes, purple Concord cup 7.4.

Grapes, red cup 13.4.

Grapefruit, red fruit 7.9.

Grapefruit, white fruit 8.6.

Guava cup 5.3.

Kiwi 1 fruit 8.7.

k.u.mquat fruits 7.5.

Loquat 10 fruits 14.2.

Lychee cup 14.5.

Mango cup 12.5.

Orange 1 medium fruit 12.9.

Orange sections cup 8.4.

Nectarine 1 medium fruit 13.8.

Papaya small fruit 6.1.

Pa.s.sion fruit cup 7.7.

Peach 1 small fruit 7.2.

Pear, Bartlett 1 medium fruit 21.1.

Pear, Bosc 1 small fruit 17.7.

Persimmon fruit 12.6.

Pineapple cup 8.7.

Plantain cup

21.0.

Plum 1 small fruit 3.3.

Pomegranate fruit 6.4.

Quince 1 fruit 12.3.

Tangerine 1 fruit 6.2.

Watermelon cup b.a.l.l.s 5.1.

STARCHY VEGETABLES.