By the time your patients move to Phase 3 of the Atkins Diet, they should be in control of their appetite and about 10 pounds from their goal weight. Many of them are probably enjoying a fairly wide array of carbohydrate foods. Others have had a very different experience. In this phase, in addition to dropping those final pounds of excess fat, each individual will identify his own tolerance for carbohydrates—as well as which foods he can and cannot handle. Achieving the following five objectives is key to sustainable weight loss.
Objective 1: Lose the Last 10 Pounds—Slowly
When it comes to shedding the last pounds, slower is definitely better. Deliberately slowing the pace of weight loss allows a patient to segue into a permanent way of eating. It may take several months to reach goal weight, losing perhaps just half a pound a week. Hard as it may be, this snail’s pace is more likely to produce the desired results. If your patients rush to shed those last pesky pounds, they may never learn what they need to do to keep them off for good.
Objective 2: Test Carb Tolerance
In Ongoing Weight Loss (OWL), each of your Atkins patients should have found his or her own carbohydrate threshold, known as Carbohydrate Level for Losing (CLL). As they move to Pre-Maintenance, they can try to push that number a bit higher as they slow the pace of weight loss. Some people can raise that number significantly; others can’t budge it or can edge it up only slightly. To find out, they will increase their daily carb intake in increments of 10 grams of Net Carbs every week or every few weeks. If weight loss stalls and/or extreme hunger or cravings return, they should step back 10 grams. Some people find that the CLL they discovered in OWL is where they’ll need to stay until all excess weight has been lost.
Objective 3: Test Tolerance for Additional Foods
This phase represents an opportunity to reintroduce the whole-food carbohydrates that have been off-limits until now: higher glycemic fruit, starchy vegetables and whole grains. Some people can eat all these foods; others can eat only some, eat them only in small portions or only rarely. Others find they do best when they simply stay away from higher-carb foods that might cause weight regain or make it difficult to stay in control. In Phase 3, each person learns what works—and what doesn’t work—for him.
Objective 4: Find One’s ACE
Once goal weight is achieved, the next objective is obviously to maintain equilibrium—meaning neither losing nor gaining weight. The number of daily grams of Net Carbs that allows this is one’s Atkins Carbohydrate Equilibrium, or ACE, for short. It may be just 5 grams above one’s CLL or it may be 20 or 30 or more grams higher. Like the CLL, it is a highly personal number.
Objective 5: Maintain Control—and Weight
The final objective before moving on to Phase 4 is to hold weight steady for one month. To do so, advise your patients to stay at or just below their ACE and weight should stabilize. During this dress rehearsal for Lifetime Maintenance, they can continue to climb the Carb Ladder and introduce new foods—as long as they don’t go above their ACE, but they must pay careful attention both to their weight and their appetite. If a food revives old cravings or causes cravings for more carbs, they should back off immediately.
Impress upon your patients that their real goal isn't just to lose weight, but to keep it off—from now on. That's what Pre-Maintenance is all about. It’s a period in which to fine-tune eating new habits until they become automatic.