On my Facebook page I made this post after meeting a new patient:

This was met with much applause, but there were some who made reference to some individuals actually LOSING weight while STILL eating McDonald’s. This led me to make this silly meme:

I was being a tad extreme of course. The TRUTH is that you sure CAN eat fast food and lose weight. It may not be optimal, but if you just can’t get yourself to cook at home or select easily made meals from the grocery store, then maybe it is an option.

Many had heard of John Cisna and his McDonald’s weight loss story. Are there others like him who were successful eating fast food while losing weight? Yes. Many in fact. Here is the story of Trevor (the guy in the before and after picture). He reached out to me after seeing the meme above and wanted to discuss how he still ate fast food during his journey:

I struggled with obesity most of my life up until last year. I am 24 years of age, 5’8″, currently weigh 180 lbs and at my heaviest was 311 lbs. I still plan to lose another 30 lbs of at or more. It was during my Biology 100 class that I decided to take my life into my own hands. My first year of college I was eating fast food twice a day, sometimes three. I was raised to think that McDonald’s was the best food option ever since I was a young boy, so when I ate it it made me feel happy. I was definitely eating to suppress my feelings, and after I started dieting discovered that eating and my emotions where just a viscous cycle. The more I ate the better I felt, at first. And then started to feel worse so I would eat more again to suppress that feeling. My first step to successfully losing weight was taking initiative. One day in my BIO 100 class it just clicked that I needed to get healthy. I started by eating low calorie, and after I was comfortable with portion sizes and reasonable meal times I found out about the ketogenic diet. This diet consists of low carb, high fat, and moderate protein. While on this diet the body becomes keto adapted, which means that your body starts using your fat for energy instead of the normal stored carbs/sugar (glucose) that would normally be there other wise. So, by cutting out carbs your body is forced to burn fat instead. Other than the faster weight loss from the low carb diet, I also felt a lot less hungry. I have found that even now if I try to eat a small amount of unhealthy carbs like chips or sugar, I end up on a binge. So I have found that it works better for me to just stay away from bad foods all together and stick to fibrous green vegetables and protein. The part of my weight loss that I am most proud of is not the weight loss itself, but the knowledge I have gained along the way. I now know how my body uses food for energy and what I should be eating to maintain a healthy body. I also take multivitamins and exercise on a daily basis. I love cardio but gaining muscle also makes the body feel a lot better and also increases metabolism. As for still eating fast food now, specifically McDonalds, I stick to the low carb route. In order to do this without ordering salad I need to modify specific menu items. Some examples are removing the bun from popular sandwiches such as McDoubles, Quarter Pounders, or even sausage McMuffins during breakfast. It can get tough when using McDonald’s as a food source because the aroma and atmosphere bring back those cravings that I used to have in my past lifestyle. In these days I try to avoid fast food if possible because even without he buns the food is still high in calories. I also eat at other fast food places. At Wendy’s I would order Baconators with no buns, ketchup, or mayo. At Taco Bell I order the Cantina Bowl which is like a taco salad but without chips, and it comes with guacamole (which I love and eat a lot of). At Chipotle I get a burrito bowl without beans or rice, so it ends up being lettuce, salsa, protein of choice, sour cream, cheese, and I always add guac. No matter which fast food place you are choosing there is a way to find a lower carb/calorie option. It’s like a never ending experiment to find healthy fast food choices. I have spent a lot of time staring at menus and it gets easier to find the healthier options as I learn more! I also lost all of this weight without surgery. A lot of people think that it takes surgery to succeed at losing this much weight in this amount of time. I am living proof that this isn’t true, and I would suggest for anyone who wants to live a long, happy, and healthy life to start now. The difference in my physical health, and my emotion and mental health is amazing. I feel like a whole new person. My mental processes seem to be a lot clearer and I am only tired when I should be (bed time).

Okay so Trevor didn’t live off fast food, but he did incorporate it into his diet and found a way to make it work for him (low carb ketogenic diet). Unfortunately we don’t have before and after lab values to share, but I would guess many of his markers would have improved with the weight loss alone. I would caution going the low carb high saturated fat diet route as opposed to high monounsaturated (nuts, olive oil, avocados, etc) as many people will develop high levels of LDL particles (apoB) in their blood.

In my book The Fat Loss Prescription (Get through Amazon here , and PDF here ), I discuss how total energy balance (energy in vs. out) matters most when it comes to weight. Yes food quality does matter for weight loss and plays a big role in how that energy (calories) is absorbed and used, but you can still eat those “unhealthier” foods and lose weight.

Is including fast food into your diet optimal for health? No. Food quality still matters for health. However, with a big picture view, you can see how Trevor made it work for him. Here is how I handle this in the clinic:

Patient eats fast food most days of the week