Most patients lose and maintain their first 20 pounds by restricting carbohydrates. The second 20 pounds is harder, because you not only have to restrict carbohydrates, you also have to restrict calories. I cannot understate the damage that has been done to the American diet, by the insane notion that you can freely feed on a low carbohydrate diet, that you can eat all the protein and fat, all the dead animals and butter you want – and lose weight. At some point, calories count. You absolutely, positively cannot eat as much as you want on a low carb diet, and lose weight. You are restricting carbohydrates. You are making and effort and sacrifice, not to eat the carbohydrates you want. In exchange for this sacrifice, you should lose weight. In order to lose weight, keep your calories under 1000 a day.