 Hey everybody, Dr. O here. Welcome to the last video in the finding your fat loss sweet spot. So this video series has taught you the key ways to lose fat without losing muscle. Each of these topics will play a huge role in helping you find your fat loss sweet spot. That's what the whole series has been about. I also hope that you see that they work best when they're combined together. Sleep enhances the effects of exercise. Exercise enhances the effects of protein intake. Exercise also enhances sleep, et cetera, et cetera. So make sure you've watched the entire series and you're incorporating all five of these points. I'm really proud of the information that I've shared with you in this series. But how do you know if it's actually working? While the number on the scale can tell you if your overall weight is going up or down, it can't tell you if you're losing fat or muscle. So what are some ways to tell that you are probably or definitely losing lean mass along the way. So here, here are my 10 favorite ways to tell if your plan is leading to fat loss or lean mass loss. And this video is going to be a little bit longer on my typical videos. Typically in my course videos, I try to cover individual topics and here I'm going to hit all 10 of these points at the same time. So let me know if you like this longer video format or if you don't. So I'm going to tell you how I use each of these 10 things personally. Now I'm actually going to add a bonus tip at the end that's actually one of the main things that I test on a regular basis. So stay tuned for that. So let's go through these now. This is actually, this is the perfect time for me to make this video and go through these points because I'm actually running through this checklist myself right now. I'm in a pretty aggressive weight loss phase. So I spent the last few months focusing on building muscle and I was able to increase my lean mass by a couple more pounds. I'm up a total of 19 pounds now since my first dexa scan. But now my goal is to get down to my actual ultimate goal weight. I'm two and a half years from where I started and I reached my primary goal weight a long time ago. But now I'm aiming for that stretch goal, that like wish goal weight. And I'm on pace to be there by mid-December. What's honestly mind-boggling to me is that I'm actually going to weigh the same amount that I weighed when I was 11 years old by the end of this year. So keep rooting for me. Alright, so there's nuance with all these as well. So I'm going to try to make sense of them and how they kind of work in combination. So buckle up. This will be the definitive guide to maintaining or monitoring your lean mass to make sure that you are maintaining it. So start with number one, body composition testing. So we save the best for first because this is by far the most important. It's the only one that I ever really consider on its own. If you're losing fat, your body fat percentage should be dropping, right? It's a major problem if you're losing weight, but your body fat percentage is staying the same or going up. The best way to know how much fat and lean mass you have on your body is to get your body fat percentage tested. You literally will know the number, how much lean mass you have or fat free mass you have and then how much fat mass you have. There is no full-proof method, but by far my favorite is the DEXA scan. DEXA stands for dual energy x-ray absorptometry, but don't worry the dose of radiation is very low. It's safe. These x-rays can tell the difference between fat mass and fat free mass. So DEXA scans shouldn't be too hard to find in your area since they've been used for bone density testing for years. I think 1999 was the first time I ever had my bone density tested using a DEXA scan. I was in college. Mine cost me $30. I get one every three to four months. I get mine at actually an area women's health center because that's where the nearest machine is. My DEXA scans were what I used during my weight loss journey to see that I gained 15 pounds of lean mass while losing 180 pounds of fat in one year, as you can see here in my before and after pictures. My only regret is that I didn't get one until I'd already lost 50 pounds. Honestly, if I'm being honest, I didn't start tracking anything in the beginning because I assumed I would fail the same way that I had every other time I'd lost weight. Why go through all the trouble of monitoring and tracking if I'm just going to be back at my same weight or even heavier in six months anyway? I'm honestly not even sure if I weighed 414 pounds. I tell you that I lost 165 pounds in a year. 414 pounds was the last time I was weighed at my doctor's office. When I look at this picture, I actually think that my weight had gone up quite a bit, so I honestly don't know. But DEXA scans are not perfect, but they are considered the gold standard. So if you really want to know your body composition, I would say it's the best thing to do. The other cool thing about DEXA scans is you also get your bone density tested and it can also tell you where your fat and where your muscle is, but especially visceral fat. They can tell you how much abdominal fat or visceral fat you have. Super important because that's the fat that's most highly linked to chronic diseases. Alright, so I love DEXA, but DEXA isn't the only accurate tool out there. The in-body device here is growing in popularity. Underwater weighing was the gold standard when I was in college and then BOD pods like the one I have up here, they'll also work. In the hands of a trained technician, skin fold testing with calipers can work. Just look around your area, see what's available, and see what makes the most sense for you. Check your local gym, wellness centers, sports performance centers or talk to your doctor. What about these though? What about handheld devices or scales that tell you your body fat percentage? You do have to be careful if you trust these, right? These use a technology called bioelectrical impedance analysis or BIA. They run an electric current through your body. Muscle conducts electricity better than fat. So it estimates body fat based on this difference. So here's the major problem though. Hydration can have a major impact on these devices. If you're dehydrated, it's actually your body fat percentage is going to register higher than it would because muscle has a lot more water than fat. So if you're dehydrated, it's going to think you have more fat and less muscle than you actually do. These are not super accurate at all, right? I recommend using them but keeping the information in context. I would not use this as your primary way to know your body fat percentage unless you need to. I don't trust the numbers that it gives me, but I can use the data to notice trends, right? If it's going up or going down, I still might believe that even if I don't believe the actual number. So the best time to use these is right when you wake up after using the restroom, right? This will eliminate as many variables as possible. You don't want to be weighing or measuring yourself at different times of the day. I personally weigh myself and use my body fat scale two times per week, the morning after my longest fast. Excuse me. We got a new guinea pig and I think I'm a little bit allergic or getting used to it and the hey, excuse me, sorry. Okay, so number two, losing weight in the wrong places. And number three, a loss of muscle definition. These two are related. So I put them together. The muscles you train should be maintaining size or getting bigger while you're jiggly places like your belly is getting smaller. This is why I actually prefer taking measurements to using a scale. I think scales cause a lot of problems and I definitely do like measurements better. Now you have to note that there will be some loss of muscle size and definition with dieting, right? Or especially low carb dieting due to decreased muscle glycogen levels. If you've cut your calories or you've cut your carbs, your muscles are going to shrink a little bit. They're going to deflate. And that's because glycogen carries a lot of water with it. So you are going to lose a little bit of water from your muscles. So don't get nervous if you see some small changes early on when you first start losing weight, unless you start to look like the guy in this bottom picture here. Take measurements of anywhere you want really, but all the major parts of your body, right? Your chest, your thighs, your upper arms, but the most important places to measure are the waist for males and the waist and hips for females. You can feel confident that your plan is working as long as your waist and hip measurements are trending down with the scale. If that's happening, then you are losing fat. If you're going to be taking these measurements anyways, though, I do recommend also adding a neck measurement because then you can use the U.S. Navy Fat's body fat calculator to estimate your body fat percentage and see how that compares to your DEXA scan, your scale, etc. I covered the measurements in this video here. Legionathletics.com has my favorite body fat calculator that actually uses the U.S. Navy body fat measurements. This is also from Legionathletics.com. So while you're there, you can look at these pictures, but you can also progress photos to look for differences. Progress photos are an awesome idea. I work with countless people that don't notice how much their body has changed until they look at photos. So measurements and progress photos can really help you basically determine how dense your body is becoming. So these photos from Legionathletics are actually a really good place. You can kind of estimate your body fat percentage, have a loved one look at this and tell them where they think you fit these types of things. And then here's the images they have for females on the same site Legionathletics.com. All right, number four is a loss of strength. And number five, decreased physical performance. So basically strength and endurance, we're looking at decreases in exercise performance overall. If you're getting weaker and your workouts are leaving you gassed, you should consider that you're making some of the mistakes from the rest of the series, right? Losing way too quickly, not eating enough protein, not prioritizing sleep, etc. But there are buts with lots of these. Be sure to rule out other issues as well. Right, number one, are you properly hydrated with electrolytes? Your hydration needs change with diet and exercise, because low insulin levels are going to cause you to lose more sodium, for example. And you're going to be sweating more as well. So check out this video for more information about the importance of hydration with electrolytes. It will help you whether you use intermittent fasting or not. Number two, if you're fasting or cutting out carbs, it will take your body some time to adapt. Right, multiple studies have shown this, that when you put athletes on low carb diets, there is a transitional period where their performance decreases and then it kind of pops back up to where they were in the beginning. Your body will actually grow new mitochondria to help you become a better fat burner, but this process doesn't happen overnight. So if you see any dip in exercise performance, it doesn't mean you're losing lean mass. That's one of several reasons why you might be losing exercise performance. So if you can at least maintain your strength and your workouts are productive, then your lean mass is most likely safe. But don't expect to set any personal records or fly through your workouts though. You are still in a calorie deficit. I see a dip when I go from maintenance or actually being in calorie surplus. I do see a dip in my performance when I get into a calorie deficit, but then I can stay right there or I can kind of build back up. That's when I know that I'm good. Number six, speaking of workouts, poor workout recovery. Workout recovery is another great way to gauge the health of your lean mass, and that's because of this. Recovering from exercise involves an anabolic state of muscle protein synthesis. You want to be building yourself, repairing yourself. This is hard to do if you're in a catabolic state of muscle protein breakdown. So it typically takes me one to two days to completely recover from a heavy training session. I start to get nervous if it takes longer than that because then I'm wondering is my body in this catabolic breakdown state too often. And if it is, it one of the things that it could be catabolizing or breaking down is my lean mass. But there are buts here too, keep in mind. Number one, your recovery will still not be as good as when you're eating in a calorie surplus. If you're eating in a calorie surplus, you're in an anabolic state way more often. It totally makes sense. Number two, you may have some extra soreness if you make major changes to your workout program or come back after a break. We took a vacation in San Francisco and when I came back, I did the same workouts, but I was way more sorry even after a short break of a few days. Number three, you might just be beat up from training hard. Sometimes a de-load or recovery week is the answer. But overall, I would consider the fact that your lean mass is at risk if it's taking you longer and longer to recover from the same workouts. Number seven is poor sleep. We talk about sleep a lot around here, I know that. We've already covered how poor sleep and stress create an environment that makes it harder to lose fat and to hold on to muscle. Remember that we called stress and poor sleep anti-exercise, but the opposite is true as well. A program that is too aggressive to maintain lean mass will also cause a stress response and poor sleep. It's very hard to sleep in a high cortisol environment. But the key thing to note here is that I'm talking about new sleep issues, right? If you've always had sleep issues, then we can't say this is a problem. But if your sleep has been great, but all of a sudden you are having trouble falling asleep, staying asleep, or both, it's time to consider that your plan might just be a little too aggressive and it's leading to a stress response that's impacting your sleep. This is especially true if you are what's called tired and wired. That's a sign that high cortisol or your cortisol levels are out of whack. So what's tired and wired mean? You know this, like it's six o'clock and you can barely keep your eyes open. You're tired during the day when you don't want to be, but then you lay down and like the person in this picture, you lay down and you're staring at the ceiling wondering why you can't go to sleep. So you're tired when you don't want to be, you're wired when you want to be tired. That's what tired and wired means. But I have another button, right? I know there are lots of butts in this video. I told you there was tons of nuance here. That's why I don't trust any of these individually. I look at them all together. There are lots of things that could be causing sleep changes, right? So don't blame your fat loss program on your poor sleep until you've ruled out caffeine, alcohol, light exposure at night, other stressors, etc. Consider tracking your sleep as well. Maybe you noticed it, but I've started using an aura ring and it was love at first night, legitimately. I've always used an Apple Watch as my tracker, but I am in love with the aura ring here. It's really helping me to dial in my sleep. I'm noticing the little things that are actually impacting my sleep in ways that I never would have noticed before without tracking it. So I'm sleeping really well even though I'm in a pretty aggressive fat loss phase. So it must not be too aggressive. If I start to see changes with my heart rate variability or other issues with my sleep tracking, then I'll know maybe I'm in the deep end for a little bit too long. This video here has some tips for it to help you improve your sleep. I have an entire course on sleep. I really do think it's that important, right? I believe that sleep is the foundation to our health and our weight loss efforts. That's why I talk about it so much. I know that, you know, when I talk about sleep the videos aren't just popular and these kind of things, so I know it's not a huge topic for everyone, but I hope that it's reaching the people that really need it. I'm also working on some videos about how to deal with sleep issues caused by fasting and why you're in a fat loss diet. So stay tuned for those as well. Those are specific questions that I've received. People that are doing alternate day fasting or their, you know, body fat percentage is getting really low and they're having trouble sleeping, so I want to try to look into that, how we can specifically tackle that object, that objective. All right. Number eight is blood glucose changes. This is similar to the last point. If your fat loss plan is triggering a stress response, you may see a rise in your blood glucose. This is one that I personally do pay a lot of attention to. I almost always eat very low carb and I still typically do two, 36 hour fast per week. The only time I deviate from this plan is when I start to see my blood glucose creeping up. You know, my fasting glucose in the morning is generally a little bit higher. That's common when you're on low carb diets, but if I'm, if my blood glucose isn't going down or I start to see it climbing up throughout the day, then I get a little bit nervous about that. I will, if that happens, doesn't happen very often but if it does, I'll take a short break from my 36 hour fasts, add in a few more carbohydrates or both until my numbers return to where I like to see them. If you're wondering, I personally use a precision extra blood glucose meter, right? No affiliation or anything. I've also heard great things about the keto mojo. So why are they my two favorites? They're my two favorites because they can also test blood ketone levels. If you're already going to stick yourself and you're already going to use a blood glucose meter, you may as well get one that allows you to test your ketone levels as well. So speaking of ketones, if you are fasting or on a ketogenic diet, you should be tracking your ketone levels in my opinion. I test my blood ketones with the precision extra and then I also test my breath ketones with the biosense device that you see here. This is my personal favorite. I use it several times every day. I've used it for three years I think. So why? During a fast, your glucose level should be trending down and your ketone level should be trending up. So as long as I see that, I'm happy that I'm not losing lean mass. If they're not, if your glucose levels are climbing and your ketone levels are falling, this could mean that your body is breaking down lean mass for fuel instead of fat. Because if I'm burning fat, then my ketone levels are going to go up. If I'm burning carbs and I haven't been eating the carbs, that means that my body is making them and your body makes carbs by turning things like amino acids from proteins into glucose. So that's my concern. But this is only something that you should notice or care about if you're a real ketone lover like me, but if you're fasting or on a ketogenic diet. All right, number nine is increased hunger. Let's face it, you're going to be hungry sometimes when you're on an aggressive fat loss plan. Can't change that fact. That's not what I'm talking about. I'm talking about increased hunger becoming a new or worsening issue. So maybe you've always had some sort of background level of hunger, but you're seeing it really, really ramp up. This could be caused by poor sleep, life stress, etc. But one of the reasons this could be happening is that you're losing lean mass. Why? What's the science say? We've actually, we actually, we looked at this review in the first video of this series. Collateral fattening and body composition auto-regulation. It's determinants and significance for obesity predisposition. So let me read this quote. Under these conditions, persistent hyperphagia, so increased hunger leading to increased eating, driven by the need to complete the recovery of lean tissue, which is what we're trying to protect, will result in the excess fat deposition and fat overshooting. This means that a loss of lean mass will drive excess hunger to try to get you to gain it back. So losing fat won't drive your hunger up anywhere near the same way as losing lean mass. So if your hunger is just off the charts, it really, really could mean that your body is, is searching for calories to, to recover lost lean mass. So think about that. Consider taking a short diet break or a refeed if excess hunger is driving you mad. Right? That's what my stepson does when, when hunger is becoming an issue, he'll basically, you know, take a break, he'll eat at maintenance until his nighttime hunger returns to normal. And that's, that's a really great way to do it for some people. You can also try bumping your calories up on your eating days if you're using ADF. That's usually what I recommend for people that are doing alternate day fasting. Just don't fall off the rails. Obviously be careful. All right, number 10, the last from this list, one more drink is feeling run down. So how do you feel? Right? I'm asking you, how do you feel? Trust your body. Right? Weight loss is never easy. You will not feel perfect, but be on the lookout for clues that the juice just isn't worth the squeeze. Do you feel sluggish all day long? Are you dealing with brain fog? Do you have a dip in energy in the afternoon? Are you more irritable than normal? Right? If you feel like this guy in this picture, it might be time to tap the brakes a little bit. Okay. I promised you a bonus tip. Here it is. Test your metabolic rate. I love, I love this one, but I made a bonus tip because I know not everybody can do it. It is a great idea to monitor your metabolic rate while you are losing weight. Why? Because your lean mass is a major driver and determinant of your basal metabolic rate. How many calories you burn at rest every day. Most people do see a drop in their metabolic rate when they lose weight. There's literally less of you to take care of. But a large drop in metabolic rate is a sign that you are losing lean mass because muscle burns about three times, excuse me, three times more calories than fat. So here you see one of the scans that I've had done. I've had half a dozen or so now. You notice it's called indirect calorimetry, but the actual test itself is called the resting energy expenditure test. So you'll see here that it told me that I'm burning 2,392 calories per day. And that's, and you'll see it's right near my prediction, which is awesome because I've already told you that my metabolic rate went up 181 calories per day. But my resting energy expenditure was actually like 500 or 600 calories below my predicted when I started. So I was really able to heal my metabolism, but you can monitor your metabolism this way. So how did I do that? Right? How did I get my metabolic rate to go up 181 calories per day while losing 180 pounds of fat? I mean, that's basically unheard of. But I added 15 pounds of lean mass along the way. Right? So I love this test, but I put it as a bonus because I know it can be hard to find. So it can be tricky to find this test in some areas. I've tried to help people around the country and around the globe find these tests and I can't always do it. I'm lucky because I live near a sports performance center, so they actually run this test. But like my local hospital doesn't, my doctor couldn't get it for me. Look for... So in your area, look for what's called an REE, a resting energy expenditure test or just metabolic rate testing in your area. And you might also see it called indirect calorimetry, like you see at the top of the screen there. Okay. So we just covered my 10 favorite tips or signs to monitor your lean mass. I understand there's a lot of gray area around most of these points. That's why I kept saying but, but, but, and I wouldn't trust any one of these things except for body composition testing with a DEXA scan to let me know for sure whether I'm losing fat or lean mass. So it really is tricky, but look at them as a whole. If you're noticing several of these and they're new issues, then we at least know that you are putting your lean mass at risk. I'm not telling you you're losing lean mass, but you are putting it at risk. So what do we do? What do we do if we have failed some of these tests? Right? What do we do if we, our measurements are showing us that our muscles are getting smaller while our belly isn't? We're losing some strength. It's taking quite a bit longer to recover from our workouts and now we can't fall asleep at night. What do we do if we've failed some of these tests? We go back to the beginning. Right? That's the solution. That's what the rest of this video series has been all about. Right? If you're pulling all the right levers, you shouldn't end up in this place to begin with. And I'm living proof that this list works because I'm leaving breadcrumbs, low-carb breadcrumbs, to show you how I got where I am now. Right? I've now lost 200 pounds of fat. Last Dexascam was 199 pounds of fat, if I'm being honest, but I have lost weight since then. I haven't gone in for a new Dexascam yet. I've lost 28 inches around my waist. During that time, I've now added 19, 19 pounds of lean mass and counting, according to Dexascam. My metabolic rate, remember it's gone up 181 calories per day. I'll begin that test and it again, and I'll do a video when I do. I'm stronger and more physically fit than I've ever been in my life. I sleep better than I ever have and I now have objective measurements to back that up. I feel like a million bucks. So this is the exact opposite of what you see on this list because I found my fat loss sweet spot. So now I wish you the same level of success. I really, I hope that this series has helped you. Reach out if I can help in any way. Just so you know, my next series, I'm going to do a short series of videos on loose skin because that's one of the most common questions that I get or questions about loose skin. So if you get, if you made this far in the video and you have questions about loose skin, let me know so I can make sure it gets added to the video. But I hope this series has helped you. You have a wonderful day. Be blessed.