The Smart Way to Build a Fat-Loss Diet

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Boston Testosterone

Core Medical Group

Article Written by Layne Norton and Sohee Lee 07/29/2015

Smart fat loss isn’t about seeing what you can survive. Crash dieting is a recipe for burnout, metabolic adaptation, and even fat gain. Layne Norton and Sohee Lee have a better way to earn results that last!

The wait is over! In our last article, “How Your Fat-Loss Diet Could Be Making You Fat,” we laid out the problems with the age-old “eat less and exercise more” mantra of fat loss. The more strictly you diet, and the more times you try to diet, the more efficient your metabolism becomes. This sounds encouraging at first, but it’s actually pretty grim. It means our bodies burn fewer calories for any given activity. This is great for survival purposes, but not for those of us who are intentionally attempting to shed body fat.

Further complicating things, your hunger level often increases during weight loss, satiety decreases, and the body desperately tries to shove you back up to your body-fat set point. This point, you may recall, is your body’s customary level of body fat. While you may think that hard training and strict dieting would inevitably push that point down, the popular yo-yo-diet model can actually push it up—meaning your body is trying to get fatter, not leaner.

When this happens—when, despite low calories, consistent workouts, and an overall diligent fitness program, forward progress of any kind is nowhere to be seen—the body is said to be “metabolically adapted.”

But not all hope is lost! As promised, here is how you can lower your body-fat set point, conquer metabolic adaptation, and find a fat-loss approach that lasts.


Preventing metabolic adaptation starts with setting up an appropriate diet in the first place. This starts with a single idea that you need to take to heart: Diet on as many calories as you can get away with while still making progress.

Less is not better; sustainable progress is better. For everybody, that is going to be a different number, and if you’re accustomed to the “diet on as few calories as possible” approach, it will probably take you some time and struggles to find yours.

If you’ve been restricting food but not counting calories—this is more common than you might think—then our first recommendation is to perform an honest audit of your current intake. Spend the next three days tracking your daily macronutrients—that is, number of grams of protein, carbs, and fats—and establish a caloric baseline. You can use the old pen-and-paper method, or utilize any of the popular nutrition-tracking apps like MyMacros+ or MyFitnessPal. More importantly, don’t change yet. Do your best to be as honest as possible about what and how much you truly eat.

Once you’ve got that number, it’s time to tweak it. Most people will find that dieting on a bodyweight multiplier of 12 for total calories is a good starting point. In other words, take your body weight in pounds and multiply that by 12 to determine your total intake for the day. So if you weigh 150 pounds, then 1,800 calories per day will be your goal for fat loss. If you started far lower than bodyweight-times-12 in the past, that could be precisely what led you down the road to adaptation.


So you’re systematically working your calories downward and seeing results. What next? Should you stay down there forever? Definitely not. Should you unhinge your jaw and Garfield your way through the nearest buffet? Not this time.

Consider approaching your diet like powerlifters approach peaking for a meet. If they know they can deadlift 700 for one rep, they don’t just hit that one rep over and over for every future workout. They touch it briefly and occasionally, then systematically work their way back down to a level where they can rack up plenty of quality reps. Truly strong people know that those easier reps are the ones that make the hard ones possible.

The dieting equivalent of this approach is the reverse diet. Reverse dieting is a method by which an individual methodically raises his or her calorie intake in order to bring a suppressed metabolism back up to speed, but without piling on excess body fat. This is ideal for those who would prefer not to have to hide in offseason sweatpants. Sohee discusses this further in her article, “4 Reasons Your Best Diet Might Be a Reverse Diet.”

Admittedly, there is currently no definitive research on reverse dieting. However, we’re confident that will change. Based on our observations from working with hundreds of clients—and ourselves—we’re convinced that raising calories slowly reduces fat accumulation in the long term.


The rate at which you choose to increase your calories in a reverse diet is highly dependent on you—your history, your comfort level, your goals, and your recent experiences. This point can’t be emphasized enough.

You may be wondering, “Can’t I just go back up to maintenance calories when I’m done dieting?” Here’s the problem: If maintenance calories were truly maintenance, you would by definition not gain weight. But in reality, metabolism is highly variable. What may have been your maintenance calories one month ago might have since changed. For this reason, we don’t recommend being so quick to spike your intake.

When considering how slowly or quickly to increase your caloric intake, ask yourself the following questions:

  • How low did my caloric intake drop?
  • What was my bodyweight multiplier by the end of the diet?
  • How do I feel at this current intake?
  • How much potential body-fat gain am I comfortable with?

The lower your calories, the crummier you feel, and the more lenient you are with a little extra cushion, the more aggressive you may want to be with your calorie bumps. Otherwise, if you’d prefer to take it slow and be a little more cautious, take the more conservative route.

What does this mean in action? Some people are just fine bumping up their carbohydrate and fat intake by 2-10 percent per week, while others benefit from a more aggressive rate. If you were in a steep caloric deficit at the conclusion of the diet, tossing in 200-500 calories right off the bat may be necessary.

Keep in mind that a reverse diet isn’t supposed to feel “slightly less awful.” Do it right, and you should actually feelgood, both physically and mentally. Wouldn’t that be a nice change?


Hopefully we’ve convinced you by now that the “on my diet/off my diet” dance is dooming your results. Adherence is how lasting results get achieved. And if you find that your dietary adherence has not been on point, consider shaking up your target macronutrient numbers.

For example, if you are consistently overshooting your carbohydrate intake because you find yourself feeling particularly depleted, why not simply bump up your target carbohydrate number? Rather than fight an uphill battle and try to force yourself to stick to a lower intake that leaves you feeling like dirt, look for ways to build confidence and momentum by increasing your adherence.

Remember, this isn’t supposed to be punishment! The more adherent you are, the more encouraged you will feel. And the more encouraged you feel, the more you’ll enjoy the journey. And at the end of the day, it’s crucial to fall in love with the process.

No matter how hard any of us might try, we can’t separate physiology from psychology. The two go hand in hand, and it would be irresponsible to ignore one side of the equation. Treat yourself right along the way, and you’ll earn better results and appreciate them more!

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Review Finds Little Evidence to Link Testosterone Therapy and Increased Cardiovascular Risk

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Staff scientists at the US Food and Drug Administration (FDA) have concluded that there’s no “convincing evidence” linking testosterone replacement therapy with adverse cardiovascular events.

Agency officials published this conclusion online after reviewing existing research on the subject and finding “major limitations” in two much-publicized studies that warn against testosterone along with a number of conflicting studies that suggest testosterone may protect the heart.

The lengthy review was intended to help members of two FDA advisory committees weigh the apparent risks and benefits of the drug, question witnesses who will address the topic at a public meeting on September 17 and consider what response, if any, the data warrant.

The committee could advocate anything from adding new safety warnings to testosterone products to narrowing the indication for the entire class of drugs to mandating post-market studies from all manufacturers. Or it could endorse the status quo.

“Given the limitations of the available data and the conflicting study results,” the review authors write, “the FDA has decided to seek advisory committee input on the potential risk of major adverse cardiac events attributable to testosterone therapy and how best to further evaluate such cardiovascular risk, should the advisory committee panel determine that one exists.”

The advisory committees will also consider whether existing research demonstrates that testosterone therapy provides any meaningful benefits for patients with age-related hypogonadism rather than specific problems in the testicles, hypothalamus or pituitary glands.

The FDA’s staff reviewed dozens of studies that associate testosterone replacement therapy with a wide range of benefits for older men: increased libido, improved sexual function, greater energy, fat loss, muscle gain, metabolic improvements and others.

On the other hand, the staff also found conflicting studies that found no significant association between testosterone use and some of those same benefits.

All the studies on both sides, moreover, suffered significant limitations. The large ones were retrospective and observational, often with many potential confounders. The randomized trials tended to be small, short and — in some cases — poorly structured.

“Aging men often experience many of the signs and symptoms that are associated with hypogonadism, including decreases in energy level, sexual function, bone mineral density, muscle mass and strength, and increases in fat mass. Whether these symptoms are a clinical consequence of the age-related decline in endogenous testosterone has not been established, and therefore, the need to replace testosterone in these older men remains debatable.”

Overall, the review authors write, “treatment benefits with testosterone replacement therapy for ‘age-related hypogonadism’ remain questionable, and there are no reliable data on the benefit in such a population.”

A separate review, conducted by a dozen firms that make testosterone replacement therapies and submitted to the FDA advisory committees, reached a considerably different conclusion.

“The data consistently support testosterone replacement therapy benefits on measures of lean mass, fat mass, and bone mineral density and architecture. Less consistently, data also suggest benefit with sexual function. Additionally, there is some evidence that suggests benefit with mood and fatigue.”

Still, the industry review acknowledges, “there are limitations to these data sets… One limitation is the relative absence of large controlled long-term studies, which makes it difficult to interpret the long-term clinical impact of testosterone replacement therapy.”   – See more at:

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Low Testosterone in Diabetic Men Tied to Vascular Risk

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Study finds Middle Aged Diabetic Men with Low Testosterone have a Sixfold Increase in Heart Disease.

In a cross-sectional study of men around 60 years old with type 2 diabetes, those with low total plasma testosterone levels had a sixfold higher risk for increased carotid artery intima media thickness (CIMT) and decreased endothelial function, compared with their peers with normal testosterone.

The study was published online October 16 in the Journal of Clinical Endocrinology & Metabolism.

The research identified that 31% of these middle-aged, overweight, diabetic men had low testosterone levels, and the latter was linked with a heightened level of atherosclerotic-disease risk markers, lead author Dr Javier Mauricio Farias told Medscape Medical News.

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Testosterone Helps to Bind Antidepressants in the Brain

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Moody? Depressed? Testosterone optimization can help.

Female sex hormones have a strong effect on the psyche. This has been confirmed by numerous scientific studies and by phenomena such as the “baby blues,” a bout of low mood following childbirth, or recurrent mood swings that occur prior to menstruation. However the male sex hormone testosterone also affects our mood and emotions, as well as our libido — and in a positive way.

In a study published in the journal Biological Psychiatry, researchers from the MedUni Vienna have now discovered a potential biological mechanism behind this relationship.

As they grow older and as their sex hormone output falls, men suffer more commonly from depression and some studies have already demonstrated a positive effect of testosterone supplementation on the moods of the test subjects. Now, the study led by Rupert Lanzenberger from the University Department of Psychiatry and Psychotherapy has demonstrated for the first time worldwide that testosterone increases the number of serotonin transporters (proteins) in the human brain. These proteins regulate the concentration of serotonin and are also the target for antidepressants.

Serotonin transporters increased after just four weeks of hormone therapy

As a model for investigating the effect of testosterone, the researchers from the MedUni Vienna chose hormone therapy given to transsexuals. Says primary author Georg Kranz: “Transsexuals are people who feel that they are living in the wrong body and who therefore want high doses of opposite gender hormone therapy to adapt their appearance to that of the other gender. Genetic women are given testosterone, while genetic men are given oestradiol and medications to suppress testosterone production.”

Using the imaging method of positron emission tomography (PET), the scientists together with Wolfgang Wadsak and Markus Mitterhauser from the Clinical Department of Nuclear Medicine and Ulrike Kaufmann from the University Department of Gynaecology have demonstrated that serotonin transporter levels in the brain are significantly higher after just four weeks of hormone therapy with testosterone and that they rise further if therapy continues. Moreover, a close relationship has also been demonstrated between testosterone levels in the blood and the concentration of serotonin transporters.

“The study has shown that testosterone increases the potential binding sites for commonly prescribed antidepressants such as SSRIs in the brain and therefore provides major insights into how sex hormones affect the human brain and gender differences in psychiatric illnesses,” says Siegfried Kasper, Head of the University Department of Psychiatry and Psychotherapy at the MedUni Vienna.

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Note: Material may have been edited for length and content. For further information, please contact the cited source.

Medical University of Vienna   press release


Georg S. Kranz, Wolfgang Wadsak, Ulrike Kaufmann, Markus Savli, Pia Baldinger, Gregor Gryglewski, Daniela Haeusler, Marie Spies, Markus Mitterhauser, Siegfried Kasper, Rupert Lanzenberger. High-Dose Testosterone Treatment Increases Serotonin Transporter Binding in Transgender People.   Biological Psychiatry, In Press January 2015. doi: 10.1016/j.biopsych.2014.09.010

Low Testosterone, Man Boobs and Dolly Parton….

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By Dr. Elliot Lach

Man Boobs

The article linked below as well as the references that are highlighted provide an easy to understand logic behind, visceral obesity as it relates to low T,high estrogen, prostate problems, wheat and bread consumption.

It’s a vicious cycle, low t results in increased visceral fat- which
increases aromatase- which increases estrogen and lowers testosterone, which contributes to prostate enlargement, which raises risk factors for early death, type 2 diabetes etc, etc.

This is one of the reasons I favor paying attention to estrogen production in obesity and in TRT and prescribing DIMM in men who are potentially going to be getting prostate hypertrophy, ie after age 45 plus or minus. – Dr. Elliot Lach…/…/the-dolly-parton-effect/

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Clinic: 781-269-5953
Direct: 617-869-7961
Fax: 617-336-3400