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Dr. James Carlson is a board certified family physician with multiple degrees … biochemistry and molecular cellular biology from Cornell University, an MBA from Regis University, and a Juris Doctorate from Concord University. And that’s in addition to his medical education at the NY College of Osteopathic Medicine. Dr. Carlson is one of those smart guys I like, one that, like Dr. Eades, has actually had a medical practice with real patients and real mysteries to solve.

His blog post today covers a subject that many low carb dieters wonder about: for some reason, they stop losing weight, even though they have not increased their carb intake. In forums, these people are often told they are “cheating”, perhaps without knowing it. But I’m always struck with how much this kind of “advice” resembles the justifications for the failed low-fat diet: if you can’t stay on the diet, its your fault.

Dr. Carlson does a good job of describing a situation where protein can be made into glucose:

Ok, so back to protein. Yes, one can definitely over consume protein, allowing the glucogenic amino acids to be converted to glucose, this can cause a sugar rise, subsequent release of insulin and that is what is causing your weight loss stall or possibly weight gain.

There’s a lot more there about a topic most low carbers have heard, gluconeogenesis, and one they probably haven’t, glyceroneogenesis. Follow the link to read it all.

So why would a careful low carber, who has been losing steadily and eating all the right things, suddenly stop losing? Nothing has changed, right? Wrong.

No, the dieter isn’t necessarily cheating. The dieter has lost 20 or 30 pounds. I have lost 30 pounds, about 13% of my pre-diet body weight. And when I started the diet, I calculated my protein requirement based in large part upon … my weight. That’s what has changed.

So, for the low carb dieter who has lost weight, its back to the tables and charts to re-calculate what their protein requirement is; for most people, it will be less than before. While weight lifters may have more lean body mass, most of us will have less calculated lean body mass. I don’t think we are actually losing muscle. And while I’m not absolutely certain on this point, I think the charts and measurements we use have a built-in variation that gets more and more accurate as we reduce our body fat percentage.