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Maintenance Phase

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Last updated March 3, 2008


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Summary

Helpful Lists

Low Carb Vegetables

Starchy High Carb Vegetables

Low Sugar Fruits

Sample Menus

Notes and Tips

Beyond the Maintenance Phase


Summary

The maintenance phase (also known as Phase 3 created by Kevin Trudeau and the stabilization period) is the 3 week period after you finish your injections.  There are a few simple rules you must follow: you must weigh yourself every day, you must remain within 2 pounds of your last injection weight (either above or below), and you cannot eat sugars and starches.  It is extremely important to eat enough protein on this phase, many people eat at least 100 grams of true protein (about 400 grams weighed raw). If you go over the 2 pounds, you must do a steak day (this is explained in the protocol and in the tips and tricks page). We want to be clear that this 3 week period is crucial to the success of the diet. The entire phase is explained in Dr. Simeons Pounds & Inches, yet we compiled a list to help you out. Before we get to the list, read an excerpt from Pounds & Inches:

When the three days of dieting after the last injection are over, the patients are told that they may now eat anything they please, except sugar and starch, provided they faithfully observe one simple rule. This rule is that they must have their own portable bathroom-scale always at hand, particularly while traveling. They must without fail weigh themselves every morning as they get out of bed, having first emptied their bladder. If they are in the habit of having breakfast in bed, they must weigh before breakfast.

It takes about 3 weeks before the weight reached at the end of the treatment becomes stable, i.e. does not show violent fluctuations after an occasional excess. During this period patients must realize that the so-called carbohydrates, that is sugar, rice, bread, potatoes, pastries etc, are by far the most dangerous. If no carbohydrates whatsoever are eaten, fats can be indulged in somewhat more liberally and even small quantities of alcohol, such as a glass of wine with meals, does no harm, but as soon as fats and starch are combined things are very liable to get out of hand. This has to be observed very carefully during the first 3 weeks after the treatment is ended otherwise disappointments are almost sure to occur.


One last item before we begin: The day that you give yourself your last injection, you count 72 hours (continuing on the 500 VLCD for those 72 hours) from that moment and then you start the maintenance phase. That weight that you were the morning of your last injection is the weight that you use as a basis for your maintenance phase. Anything OVER two pounds from that weight calls for a steak day.

NOTE: The time period to begin this phase is not 3 days after your last injection, it is 72 hours! (For example, if you administer your last shot on Monday at 8 am, you will begin the maintenance phase on Thursday at 8 am.)

First thing, when beginning the 3 week maintenance phase, make sure to increase your calories to at least 1500. Don't try to continue the diet after the hCG is out of your system. Bear in mind, your weight will fluctuate the first week or two; this is normal. Do a steak day if you need to. The weight will eventually stabilize. Watch the starch and sugar religiously during the 3 weeks. Read labels. (Continue) eating organic food if possible. Eat whatever you want, without starch or sugar, during the maintenance phase. Make sure you are eating enough. Use healthy fats and dairy products to up your calorie intake if necessary. Drink enough water.


Helpful Lists

Click here for a place which describes fats; this is helpful to know what to introduce into your new maintenance diet.

Click here for a list of starches (including certain beans); this is helpful to know what you need to avoid.


Low Carb Vegetables
This list is roughly arranged from lowest to highest carbohydrate counts, but all are non-starchy and generally low in carbohydrates. Exact carb count depends on serving size. Remember when counting carbs in vegetables that the fiber is not counted, and can be subtracted from the total.

* Sprouts (bean, alfalfa, etc.)
* Greens – lettuces, spinach, chard, etc.
* Hearty Greens - collards, mustard greens, kale, etc.
* Radicchio and endive count as greens
* Herbs - parsley, cilantro, basil, rosemary, thyme, etc.
* Bok Choy
* Celery
* Radishes
* Sea Vegetables (Nori, etc)
* Broccoli
* Cauliflower
* Cabbage (or sauerkraut)
* Mushrooms
* Jicama
* Avocado
* Cucumber (or pickles without added sugars)
* Peppers (all kinds)
* Summer Squash (including zucchini)
* Scallions or green onions
* Asparagus
* Bamboo Shoots
* Leeks
* Brussels Sprouts
* Snow Peas (pods)
* Green Beans and Wax Beans
* Tomatoes
* Eggplant
* Artichoke Hearts
* Fennel
* Onions
* Okra
* Spaghetti Squash
* Celery Root (Celeriac)
* Carrots
* Turnip (see Carb Counts of Root Vegetables)
* Water Chestnuts
* Pumpkin

Starchy (High Carb) Vegetables
The main veggies to be avoided when reducing carbohydrates are the starchier vegetables:
* Beets
* Carrots (depends on diet)
* Corn
* Parsnips
* Peas
* Plantains
* Potatoes in all forms
* Winter Squashes (particularly acorn and butternut)

Choose Low Sugar Fruit
Fruit is an area where some of the low carb diets part company, as some depend more upon glycemic index or glycemic load (South Beach, Zone), while others just look at total carbs (Atkins, Protein Power). Also, some diets (Atkins, South Beach) don't allow fruit at all in the first phase. In general, your best bet fruits are these, but do check carb counts. These are sort of arranged by sugar content, taking volume and weight, into account. This is not an exhaustive list.

Good news: the fruits lowest in sugar are some of the highest in nutritional value, including antioxidants and other phytonutrients.

Fruits lowest in sugar:
* Rhubarb
* Strawberries
* Cranberries
* Raspberries
* Blackberries
* Blueberries
* Grapefruit
* Melons
* Apricots
* Plums
* Peaches
* Pears
* Guava
* Cherries
* Apples
* Papaya

Fruits fairly high in sugar:
* Grapes
* Tangerine
* Oranges
* Pineapple
* Kiwi

Fruits to be avoided in the maintenance phase:
* Bananas
* Dried Fruit
* Mango


Foods to Avoid:

Avoiding sugar simply means avoid cookies, cake, pie, candy, cupcakes, frosting, soft drinks, corn syrup, kool-aid, processed food, energy drinks, fruit juice, honey, yogurt, donuts, cookies, pudding, maple syrup, brownies, canned fruit in heavy syrup,  ice cream, cool whip, boxed breakfast cereals, breakfast bars, granola - nothing with sugar.

Be sure to read food labels, check to see if sugar is added into a product before you buy it.  Nearly every product in a can or box contains sugar in one of its many names.  The first five ingredients listed on an item is the majority of the product, so be sure that sugar is not in the top five.

Avoiding starch means avoid cornstarch, white flour, wheat flour, any flour, pasta, any bread or bread product, breadsticks, bagels, hamburger and hotdog buns, crackers, tortillas, oatmeal, rice, polenta, peas, corn, lentils, pita bread, pretzels, corn chips, potato chips, yams, potatoes, pancakes, muffins, nearly all root vegetables, any breading on fish, chicken, or other protein., beans, grains, acorn squash, butternut squash, cereals, granola, cereal bars, popcorn, biscuits, corn bread, taco shells, croutons, rice cakes, Cream of Wheat, corn meal, and some nuts.

Most restaurants and fast food places add sugar to nearly every product, so be wary of eating out all the time.  Other meats to watch out include deli meats, bacon, ham, prosciutto, sausage, and hotdogs. 

Do not eat processed cheese (i.e. Velveeta), it contains unnecessary sugars and starches.  Try not to eat processed anything for that matter.

99 Names for Sugar


Sample Menus

View a sample Phase 3 Menu here.

View a different Phase 3 Menu here.


Notes and Tips:

1. If you've got a Half Priced Bookstore in your area, go in and see if you can find any low carb cookbooks by Dana Carpender. She wrote 500 Low Carb Recipes and 500 More Low Carb Recipes and a lot of the recipes in those books would be Phase 3 friendly. Keep an eye on the ingredients and avoid the recipes with nuts, nut flours, bake mix, guar gum, molasses, honey, etc., or anything that could be a starch.

2. Also, Suzanne Somers has cookbooks which use Low Carb philosophy; you can also try Low Carb for Dummies. You can also check out the master of low carb--Dr. Atkins. These can help the culinary challenged.

3. It is important to remind you: eat at least double the protein you were eating on the protocol - at least 100 - 125 protein grams - that is not weight, but grams of pure protein.  On the protocol you averaged about 50 so at least double that so you won't be protein deficient.  If you get to a level of protein deficiency, be sure to do a steak and cheese day (as described in Simeons Pounds and Inches and here). 

5. You can find out the minimum calories you should be consuming here. It is your BMR (Basal Metabolic Rate), or the calories burned if you did absolutely nothing all day given your particular height, weight, and age. You can use your BMR for your lower range boundary, figuring that anything less than that creates a deficit in calories, which you don't want. Then, add another 300-400 calories to that figure (given that you don't stay in bed all day). It is important to eat enough calories because if you try to subsist on too few calories or "rabbit food," then your body will require that just to maintain. --JPS

6. It's a good idea to still write down what you are eating as you need to know where your set point is and identify "problem" foods.  Many people can stay around 1700 calories with absolutely no problem; be careful exceeding 2500 calories.  In addition, insufficient calories can also produce problems.  Listen to your body and watch its signs. 

7. Remember, Dr. Simeons said you can eat anything you want except sugars and starches. Follow one simple rule, watch the scale. This means exactly that, you can eat up to three fruits a day, including bananas - eat cottage cheese daily - sometimes two servings - and have avocado and feta with dinner. You can drink beer and wine. The only thing to try to maintain is a doubling of your protein from the VLCD as you don't want to become protein deficient. Some sample foods on this phase include: prime steak slathered in butter, lots of avocados, loads and loads of fresh fruit and vegetables; you can put butter on those vegetables and cheese at times. You can eat fresh shrimp and fresh fish, often baking it in butter, wine and herbs, You can drink white wine on a few occasions. You can cook your eggs in butter and make omelets with vegetables and a little cheese. Use olive oil, eat more dietary fat—it can be the key to maintenance. Overall, eat the good fats and the scale goes down, try to limit the fats and the scale goes up.

8. Many have found that the maintenance phase demonstrates a change in attitude toward food. For example, not getting a second helping of food, but just eating what is on your plate. People are not as hungry as they remember being pre-protocol.  Instead people eat because they need to eat, not because they have this overwhelming desire to stuff their mouths. People also find that they have ridden themselves of the emotional attachment to food.

9. Don’t be afraid if the food you loved before the VLCD no longer tastes the same or gives you the same feeling they gave you before. Sometimes, it can take almost 4 or 5 days to even start enjoying the food again. We believe it is because your body is so used to one way of eating, it takes awhile to adjust to the new way of eating again.

10. Be careful of introducing too many new foods at once. Try to introduce foods one at a time, so you can determine if a certain food causes a gain or loss. Some people have trouble with dairy or nuts. Our suggestion is to go with lean protein, fruit and vegetables during the first few days to balance out. Then, GRADUALLY introduce foods like nuts and dairy one at a time, so that if you react negatively it is easily identified.

11. Read the label on everything you introduce during this maintenance phase. Be sure there is no form of sugar in it or other additives (look for any -ose, corn syrup, MSG, etc.).

12.  It is important on this maintenance phase to look at the glycemic index of foods, rather than the carb count.  This specifically means that foods are ranked on the effect they have on your glucose levels.  These high glycemic foods are exactly what Dr. Simeons wants you to refrain from.  Check out this website for more information on glycemic levels.   

13. Be careful of yogurts which contain sugar regardless of soy or milk based. You can use organic PLAIN yogurt and then sweeten it with Stevia and add fruit to it (raspberries, strawberries, blueberries, or whatever else you are craving.)

14. Use common sense when selecting your food for the maintenance phase. Dr. Simeons really meant to avoid the obvious starches such as corn, potatoes, cereal, white flour, beans, pasta, bread, etc., and not starches in fruits/nuts.  You can follow Atkins, but use more protein than fat.

15. If you are having trouble stabilizing your weight, begin by reducing the fats a bit (i.e. cheese or oil) and increase protein and vegetables. Some people, especially women, seem to be sensitive to cheese and the sodium apparently increases water retention = nominal weight gain (though not fat gain).

16. Don't worry about weight fluctuations (within the 2 pounds or close to it) too much. Many people, have somewhat unstable weight for the first week to 10 days after transitioning from the hCG to maintenance (a few lucky ones don't). It is likely to stabilize for you in less than a week, don't get upset by the minor swings. 

17. Two important passages from Pounds & Inches to be aware of during this phase:

                                            · Beware of Over-enthusiasm

The other trouble which is frequently encountered immediately after treatment is again due to over-enthusiasm. Some patients cannot believe that they can eat fairly normally without regaining weight. They disregard the advice to eat anything they please except sugar and starch and want to play safe. They try more or less to continue the 500-Calorie diet on which they felt so well during treatment and make only minor variations, such as replacing the meat with an egg, cheese, or a glass of milk. To their horror they find that in spite of this bravura, their weight goes up. So, following instructions, they skip one meager lunch and at night eat only a little salad and drink a pot of unsweetened tea, becoming increasingly hungry and weak. The next morning they find that they have increased yet another pound. They feel terrible, and even the dreaded swelling of their ankles is back. Normally we check our patients one week after they have been eating freely, but these cases return in a few days. Either their eyes are filled with tears or they angrily imply that when we told them to eat normally we were just fooling them.

                                             · Protein deficiency

Here too, the explanation is quite simple. During treatment the patient has been only just above the verge of protein deficiency and has had the advantage of protein being fed back into his system from the breakdown of fatty tissue. Once the treatment is over there is no more hCG in the body and this process no longer takes place. Unless an adequate amount of protein is eaten as soon as the treatment is over, protein deficiency is bound to develop, and this inevitably causes the marked retention of water known as hunger- edema.

The treatment is very simple. The patient is told to eat two eggs for breakfast and a huge steak for lunch and dinner followed by a large helping of cheese and to phone through the weight the next morning. When these instructions are followed a stunned voice is heard to report that two lbs. have vanished overnight, that the ankles are normal but that sleep was disturbed, owing to an extraordinary need to pass large quantities of water. The patient having learned this lesson usually has no further trouble.


18. If you plan on doing a second (or third) round to lose more weight, remember that Dr. Simeons recommends a 6 week break, followed by 8 weeks, followed by 10 weeks, etc. Some people have chosen to limit the break to 3 weeks (going from the maintenance phase right back to the  injections). Dr. Simeons recommends this break to prevent immunity, but it is ultimately up to you how long your break is; you will see how the hCG reacts to the amount of time you chose to break for.

19. If you need recipes and information on low carbohydrate eating, there is a very good Yahoo group with hundreds of low carb recipes in the archives. It is a NO chat group-recipes only. Find it here. There are also a multitude of recipe websites online. Many you can search for free. Do a web search for low carb recipes. Also, check out the Low Carb Resources website for lots of information on low carb dieting, including recipes.

20.  For those who are experiencing fluid fluctuations, you can combat it with drinking a lot of water (more than 2 liters), drinking corn silk tea, taking Epsom salt baths, and watching your salt intake.  You can increase protein, use fiber, magnesium as additional weapons for weight fluctuations.   

21.  Stay away from the surgery liqueurs (Bailey's, Chocolate, Amaretto, etc.)

22.  Do NOT try to lose additional weight during this period.  Dr. Simeons states that you will lose weight from your structural and reserve fat, rather than the abnormal fat, which you do NOT want to do.  In addition, the hypothalamus needs time to adjust to the new "set" weight if it is to be considered your "normal" weight.  If you do not allow this 3-week period of maintaining the last injection weight, it may be much easier to gain weight in the future. 


After 3 week Maintenance Phase

1. After you finish the 3 week maintenance phase, be sure to add your carbs back in slowly. Take note of what makes you gain weight. Start with healthy low glycemic carb like oatmeal and Ezekiel break or sweet potatoes or brown rice.  You can also print out a chart of foods which has low glycemic foods on it here which can be used after you finish the maintenance phase.

2. Keep drinking your water and teas. If you've managed to refrain from diet coke and processed food...continue. This will contribute to successful maintenance.

3. Be sure to continue to watch the scale and remain within 2 pounds of the last injection weight.  If at ANY point you are above 2 pounds, immediately do a steak day.  

4. You can now eat or drink any foods you wish. Continue to weigh daily and see how the various foods you introduce effect your weight. Adjust your intake in accordance with what you discover about your own unique response to foods.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 


 

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