How to Help Your Patients With Their Fat Loss Resolutions

by Dr. Jade Teta ND | Follow on Twitter

The number one New Year’s Resolution is to lose weight. How will you help your patients get long-lasting results?

From the editor: Weight loss is the most common New Year’s Resolution. More specifically, fat loss. However, we know that quick fixes don’t work, while extreme dieting and exercise regiments are unsustainable and sometimes dangerous. Other times, all attempts to add in supplements or improve diet and lifestyle seem to make no changes at all.

Fat loss patients can be the most challenging and frustrating. Take a page out of Dr. Jade Teta’s book on metabolism and get your patients the results they want.

YOUR METABOLISM CHANGES AND ADAPTS. It is not static and predictable.  This simple understanding can free you forever from the trap of dieting.  You know what I am talking about, the never ending search for the “perfect diet?”

There is no perfect diet for you to find.  Instead you need to create the perfect diet for you. There is only one problem with that:  the perfect diet for you changes because your metabolism changes in response to your environment.  Understanding how it changes is key to becoming a metabolic detective and leaving the dieting mentality behind.

So today I am going to teach you one of the most useful clinical tools we use at the Metabolic Effect clinic.  We teach this concept to almost all our clients.  It is a little bit of an advanced topic, so we don’t teach it first, but eventually we get around to helping our patients/clients understand this concept.

By the way…if the idea of Metabolic Compensation is new to you, you may want to read this blog first.

Your life and metabolism change.

Here is the thing, life is a constant series of continual changes. Nothing is completely repeatable and predictable. And one of the major functions of the metabolism, if not the major function, is to help you adapt and react to your environment.

Stress, sleep deprivation, menses, pregnancy, menopause, andropause, periods of overeating, periods of under-eating, times of intense and frequent exercise and times of relaxation and recovery.  There is a natural rhythm to life, and not only is this useful to know, but it can be extremely beneficial to your metabolism and your ability to get results. But you have to understand how it works and how to deal with it.

Before I get into this you will need to first put your health and fitness biases aside.  You know the ones I am talking about.  Things like:  “you must eat breakfast”, or “you have to eat a certain number of meals per day”, or “you should never do this type of exercise or eat this type of food”.

Your metabolism does not care about your self-imposed rules.  It will keep doing what it does whether you are savvy to it or not.  What I have learned through years of study, and more importantly, tens of thousands of client contacts is this:


That is the only real rule of health and fitness. But to do what works for you, you need to understand how to find what works for you.


Metabolic Effect has become famous for our HEC concept.  HEC is an acronym that stands for hunger, energy and cravings. These are biofeedback sensations that clue you in to how your metabolism is doing and how it is reacting.

We have a catchy rhyme for you to remember how to use it.  HEC is pronounced as “heck” and it rhymes with check.  When “your HEC is in check”, as we like to say, your metabolism is likely balanced and stable. When “HEC it is not in check”, that is an indication your metabolism is switching gears and trying to adapt.

How does the metabolism adapt to dieting?  It almost always will fight back against you and defend its body fat stores.  So when you cut calories and exercise more your body throws HEC out of check and slows metabolic rate.  We call this “The Law Of Metabolic Compensation.”

We call it a law, because it is one of the most predictable and undisputed phenomena in all of weight loss research. Researchers call part of this compensation “adaptive thermogenesis.”

By understanding HEC, and other biofeedback sensations, you can begin to easily and naturally decipher and react to your metabolism.  This allows you to break through weight loss plateaus, easily manage different life events and circumstances and be able to deliver results in muscle gain and fat loss.

 There is only one true rule of health and fitness: Do What Works For You!” <– Tweetable

An example

Early this year I took a trip to the UK. My intention for the trip was to follow an “eat less, exercise less” approach. I was going to be conducting lectures all day and this strategy is a great one to keep HEC in check.

Many people are unaware that “eating less and exercising more”, the way most weight loss seeker are taught is one of the best ways to throw HEC out of check. Done past a few days this strategy almost always backfires and results in severe metabolic compensation.

“Eating less and exercising more”, is one of the best ways to throw HEC (and your metabolism) out of check. <– Click to Tweet

Eating less and exercising less (ELEL), as well as eating more and exercising more (EMEM), makes this metabolic compensation less likely.  Since I was busy and did not have time for a ton of exercise I chose the eat less and exercise less approach. Team ELEL for the win.

So that was my intention. But over several days of eight-hour lectures, and not sleeping very well, I felt my HEC going out of check.

You have probably heard me say before that sleep and stress don’t have calories, but they definitely impact how much you eat and what you crave to eat?  The reason they do that is because of hormones.

In particular the stress hormone cortisol is notorious for disrupting HEC.  Needless to say, as soon as the stress and sleepless nights hit, my HEC was no longer in check and I knew I had to make an adjustment.

I set out on this trip to follow an eat less, exercise less approach.  I was doing great with it until my HEC got out of control.  Then I found myself in an eat more, exercise less situation, which can be a recipe for weight gain. But it also can be an opportunity to work with the metabolism.

Let me explain.

A Conscious Choice

I traveled to the UK with my wife Jill and my best friend Gary.  They both saw I was slipping into the eat more, exercise less scenario and asked what my approach was going to be.

I told them I was just going to enjoy myself and take the opportunity to eat some good chocolate, get some great Indian food (London is known for it), get some great fish and chips (I did), and drink a lot of good English beer.  In other words, I did not stress about it and I just went with it.

You may be surprised to learn that taking this approach can actually be good for your metabolism every once and awhile, as long as it is short lived. Which is the real reason I made the switch.

The 4 Metabolic Toggles

I like to think of the metabolism as having 4 metabolic “toggle switches” that you can switch on or off to keep you from moving too far into compensation mode.

The eat less, exercise less (ELEL) and the eat more exercise, more model (EMEM) are by far the best to use because they are the most 4_togglesbalancing to your metabolism.   You can follow them for much longer.

The eat less, exercise more (ELEM) and the eat more, exercise less model (EMEL) are far less beneficial. But used smartly can also play an important role.

Keep in mind to lose weight you need a calorie deficit and hormonal balance.  All these approaches, except EMEL can be manipulated to create a calorie deficit.

The first two are able to help you achieve a low calorie state AND hormonal balance.  ELEM can create a calorie deficit but throws hormonal balance, or HEC, out of check if done for too long.  The EMEL puts you in caloric excess and may or may not throw HEC out of check.

The point is that using them all together, when needed or when life circumstances dictate, can keep the metabolism from moving into conservation mode.  When you cut calories the metabolism slows down as you know.  But what you may not know is that when you raise calories, the metabolism speeds up and HEC can often be regulated.

Just so you know, these metabolic adjustments up and down are highly variable and individual.

I decided to consciously use the EMEL model to reverse any metabolic compensation that I had induced.  And it worked best with the stress I was under and the life circumstances I found myself in (i.e. busy long days and lots of food).

Stopping Metabolic Compensation

The thing to understand about the metabolism is that it is always compensating and adapting.  Changes in HEC clue you into these changes. What you want to do is minimize this compensation the best you can. When my HEC went out of check, it was a signal for me to change something.

Metabolic compensation means the metabolism is slowing down and that typically means weight loss will be more difficult later.  This is why the eat less, exercise more diet approach ends up causing 95% of people to regain the weight and 66% to end up fatter.

One great way to slow or reverse this metabolic compensation is to switch between the 4 metabolic toggles.  If you are following one approach, and your HEC starts getting out of check, switching to one of the other three can sometimes be helpful. Its like “tricking your metabolism” or “keeping it on it’s toes”.

Now can you see why I made the switch to EMEL?  Because I knew when I got back home I would be back to my routine and working out.  I used the little hiatus to push my metabolism out of compensation mode.  This way rather than being primed to store fat when I returned, I was instead primed to burn it. And there was some benefit to my psyche as well since I got to enjoy myself a bit more than usual.

TWEET THIS –> The eat less, exercise more diet approach ends up causing 95% of people to regain the weight and 66% to end up fatter.

The Trick

There is one caveat with using this approach.  The eat less, exercise less and the eat more, exercise more approaches are both better at balancing HEC.  Because of that they are easier to control and always your best option for long periods of time.

The eat less, exercise more and the eat more, exercise less are notorious for throwing HEC way out of control.  For some, this can be too much to manage and result in weeks or months of not being able to get back on track.

I took the approach I did because I am fairly well practiced at it and was confident I would be able to get back on track.  Part of the reason I was so confident is that I was on an entirely different routine in the UK and was returning to a more stable and structured routine when I got back.

So, if you are ever going to use this approach just follow a few simple rules.

  1. Don’t do it longer than a week and preferably just a long weekend.  Otherwise you risk gaining too much fat and causing the reverse effect you were after.
  2. Next, it is best to do in unfamiliar situations rather than doing it in familiar ones.  You want your long-term lifestyle regimes to be more oriented towards eat less, exercise less or eat more, exercise more.  They work best for the long-haul.

Some questions you may have:

Question: Do we know how long it takes for the body to respond to lowered calorie intake with slowed metabolic rate?

AnswerThis study suggests it happens as soon as 4 days. And this study also confirms metabolic compensation starts to occur around 3-4 days when following the standard ELEM approach. This is why a weekday/weekend approach is often one we use with clients. ELEM during the week and then EMEL or EMEM during the weekend.

Or even better, ELEL during the weekday and EMEM during the weekend.  Or any combo that suits your particular life situation and personal preferences.  By the way, while we do have studies to give us rough numbers, my clinical experience tells me this is highly variable from person to person.  This is why HEC is such an important tool and why we came up with it to guide clients.

Question: Do we know how fast the body responds to higher calorie intake with increased metabolic rate?

Answer: This is difficult to know. What we do know is that there is great variation among different people and that lean individuals respond more/better than the obese (see this study). A more recent study shows that 24hours of substantial excess calories (and higher protein) generated a higher metabolic rate in 1 day (this study).

This is great to know as 1 “cheat day” may be able to completely reverse the lowered metabolic rate of dieting.  In the study above, the researchers used an 11 by 3 approach.  11 days of “dieting” and then 3 days of eating whatever the subjects wanted.  This approach resulted in greater weight loss and most importantly no metabolic decline over 12 weeks.

Question: How much does the metabolic rate decline on average?

Answer: This is difficult to say since there are different components of metabolism. For example:

  • RMR or resting metabolic rate (aka REE or resting energy expenditure)
  • TEF or thermic effect of food
  • NEAT or non-exercise associated thermogenesis
  • TEA or thermic effect of activity

But studies suggest a decline in 300 cals (for all components combined) on average in 8-12 week studies. And these studies also suggest most of this decline comes from reductions in NEAT & TEA (sort of counter-intuitive right?).  In shorter studies (4-6 weeks), like this one, it was shown resting metabolic rate declined by 60-100 cals per day.

So based on the above extra tidbits, we MAY be able to say the following related to these food cycling strategies (metabolic toggle switches):

  • lean people probably respond better to this approach than the obese. But I have found clinically cycling between approaches is highly successful in all types and in fact better than “traditional dieting”.
  • higher protein intake when underfeeding and over feeding likely helps. Research hints the protein adequacy of the diet helps the approach work better. So when in eating more or eating less states, make sure you still prioritize protein intake.
  • there is substantial variation between people in their metabolisms ability to compensate up or down.  This is why HEC is so important to grasp, understand and use
  • This takes practice and is an advanced strategy. Many beginners simply cannot make it back from a period of EMEL.  Be careful that a cheat day, or few days, does not turn into a few weeks or months.
  • ELEL and EMEM by far have much less metabolic compensation associated with them in my clinical experience.  However, the metabolism will still compensate, so be ready to switch in between these two (best) or to either ELEM or EMEL (not as good and a bit more risky)
  • I would limit periods of ELEM or EMEL to 1 to 14 days max. This is based on clinical experience.
About the Author
Dr. Jade Teta ND

Dr. Jade Teta is an integrative physician specializing in natural health, fitness and body transformation. He is the co-author of The Metabolic Effect Diet. He completed his undergraduate training at North Carolina State University, earning a bachelors of science in biochemistry. He then went on to study at Bastyr University in Seattle, Washington completing his doctorate in Naturopathic medicine. Dr. Teta has worked in the fitness and weight loss fields for over 20 years, and is the co-developer of the rest-based training system for personal training and group exercise. He is also the co-founder of the Naturopathic Health Clinic of North Carolina and of the health, fitness and international fat loss company, Metabolic Effect. His background in natural medicine, along with his fitness expertise, has defined his healthcare specialties of hormonal weight loss and functional medicine approaches to chronic disease.