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I'd like to see starvation diets having a place in NHS support for obese type2s.

I'd just like to see some decent nutrition advice from the NHS like a variety of possible weight loss strategies (including of course ketogenic) rather than the idiocy of the Eatwell Guide/Plate, delete as appropriate, being the "recommended" way of eating.
 
I'm suspicious about any weight loss strategy being some kind of magic bullet.

I can't find any long term data which says you can be obese for years, then lose all the weight including the dangerous visceral fat, and keep it off easily. The reduction in resting metabolic rate seems to be the biggest obstacle, often combined with increased hunger hormones.

I can't see anyone avoiding this long-term. Not on calorie restriction, not on LCHF, not on keto, not on fasting. You can find short term studies which show promise, but the body seems remarkable at doing what it wants, and balancing things, over the long term when it comes to weight loss.

Over 20 days, alternate day fasting seems like the magic bullet for keeping the resting metabolism high. But over a year, it gets the same results as basic calorie restriction.

Even short term, you can find studies which show RMR reduces on fasting, especially if you do it for more than 3 days.

We can all put a label on our dietary approach, but I'll bet real money that no matter what approach we are using, if we've been obese for years and managed to lose a lot of weight, we'll get to a point where, if we are eating as much as we want, the weight loss will stall and we'll still have lots of visceral fat. While the person next to us who has never been obese will be able to eat a lot more to maintain the same weight, or if they are eating the same as us, they will be a lot thinner.

Wouldn't someone like Jason Fung be shouting it from the rooftops if he could find just one example of an obese person whose RMR had stayed the same over a couple of years of weight loss via keto and fasting? Instead he shows short-term studies such as the apparent increase in metabolic rate on alternate day fasting over 20 days, and brushes over the year-long study.

I'll bet there are a lot of big men on this forum who have lost a lot of weight using something like unrestricted LCHF, keto or fasting, have reached a point where the weight loss has practically stopped, but are only eating about 1600 calories a day even if they aren't counting them. That, unfortunately, seems to be the way it goes.

I think we need to expect it to be a battle, and not expect there to be any magic bullet.
 
Low carb heathy fats worked for me, it stopped R.H. got my Hba1c down to 43 without meds, got all my metabolic markers improved, got my BMI down from 27.5 to under 23. I am now the weight I was when I got married 56 years ago when I was 22.
and my weight is stable.

I hope you are giving it a fair try because you can't knock it till you've tried it!

It certainly works for me.
Derek

AdamJames said:
I'm suspicious about any weight loss strategy being some kind of magic bullet.

I can't find any long term data which says you can be obese for years, then lose all the weight including the dangerous visceral fat, and keep it off easily. The reduction in resting metabolic rate seems to be the biggest obstacle, often combined with increased hunger hormones.

I can't see anyone avoiding this long-term. Not on calorie restriction, not on LCHF, not on keto, not on fasting. You can find short term studies which show promise, but the body seems remarkable at doing what it wants, and balancing things, over the long term when it comes to weight loss.

Over 20 days, alternate day fasting seems like the magic bullet for keeping the resting metabolism high. But over a year, it gets the same results as basic calorie restriction.

Even short term, you can find studies which show RMR reduces on fasting, especially if you do it for more than 3 days.

We can all put a label on our dietary approach, but I'll bet real money that no matter what approach we are using, if we've been obese for years and managed to lose a lot of weight, we'll get to a point where, if we are eating as much as we want, the weight loss will stall and we'll still have lots of visceral fat. While the person next to us who has never been obese will be able to eat a lot more to maintain the same weight, or if they are eating the same as us, they will be a lot thinner.

Wouldn't someone like Jason Fung be shouting it from the rooftops if he could find just one example of an obese person whose RMR had stayed the same over a couple of years of weight loss via keto and fasting? Instead he shows short-term studies such as the apparent increase in metabolic rate on alternate day fasting over 20 days, and brushes over the year-long study.

I'll bet there are a lot of big men on this forum who have lost a lot of weight using something like unrestricted LCHF, keto or fasting, have reached a point where the weight loss has practically stopped, but are only eating about 1600 calories a day even if they aren't counting them. That, unfortunately, seems to be the way it goes.

I think we need to expect it to be a battle, and not expect there to be any magic bullet.
Click to expand...
 
lindisfel said:
Low carb heathy fats worked for me, it stopped R.H. got my Hba1c down to 43 without meds, got all my metabolic markers improved, got my BMI down from 27.5 to under 23. I am now the weight I was when I got married 56 years ago when I was 22.
and my weight is stable.

I hope you are giving it a fair try because you can't knock it till you've tried it!

It certainly works for me.
Derek
Click to expand...

I'm neither knocking nor promoting any approach, and I was thinking purely in terms of weight loss rather than blood sugars.

Re blood sugars, I got my HbA1c down from 90 to 42 in a few months by losing weight by various means, mainly stopping alcohol and the subsequent food binges that lead to, by getting out more, and by becoming carb-conscious. But I never stuck to any one approach for more than a week or so, as most of them seemed to work, given I was so overweight.

But I'm the example I was talking about: a big man who has lost a lot of weight and if I eat what I want, even on very low carbs and high fat, I stop losing weight.

I think if I want to push things to lose all the visceral fat, it's going to be one heck of a battle regardless of what approach I take, and I don't see a magic bullet.
 
Looks like this one is going to run and run!
The Newcastle Diet study did prove successful at reversing t2 so I suspect you may get your wish if your wish is to be offered 800 kcal meal replacement powders for 12 weeks?
Interestingly the villain of the lchf (Ancel Keys) did starvation diet studies on conscientious objectors. These starvation diets were 1,500 kcals daily i.e. the average kcal amount suggested to those trying to lose weight in the orthodox CICO fashion today. Results were that these healthy young men lost weight but also become obsessed with food then rapaidly regained their weight and more. Sound familiar?
We know that these methods work and why they work:
Bariatric surgery (lose the liver fat,change your hormone profile)
Fasting (lose the liver fat, change your hormone profile)
LCHF (ditto)
VlCD for 12 weeks though it requires re education and support to continue
Losing weight via calorie restriction also works but is hard to sustain and leads to a focus on calories not nutritional quality.
Sadly none of thee is orthodox therapy for metabolically ill people save the latter (advice from NHS dietician and./or ticket to Slimming World/Weight Watchers) thus we get the paradox of low fat diets/high fat people.
My fear is that those 800 calorie diet replacement powders will get prescribed and work but am worried that those people will not get enough re feeding information to sustain their t2 reversal.
 
ickihun said:
I'd like the nhs to make a start, at least to solving 2 elements.
Weight loss.... however way (we are all different).

Then maintenance to prevent obesity returning or becoming soooo dangerous and life threatening.

Starvation diet..... to starve the body from nutrients and forcing fat burning.
Supplements to prevent death.
Until no longer obese. Then maintenance.
Society is slowly snubbing fast foods and processed foods.
Not fast even for me.... I'm afraid.
Obese type2s need help now.

We are the exception, we members.
Low carb is a brilliant aid.

Even that would be something for the nhs to embrace.
Anything would be good, eh?
Click to expand...
I'm thinking that starvation could be substituted with ketosis?
 
archersuz said:
I went in Sainsbury yesterday and I had a sample of Magnum ice cream thrust at me - I had to say no politely and I really wanted to scream at the stupid woman. People think you're odd if you refuse something like that!
Click to expand...
why shouldnt most people have some ice-cream occasionally?
 
NicoleC1971 said:
Looks like this one is going to run and run!
The Newcastle Diet study did prove successful at reversing t2 so I suspect you may get your wish if your wish is to be offered 800 kcal meal replacement powders for 12 weeks?
Interestingly the villain of the lchf (Ancel Keys) did starvation diet studies on conscientious objectors. These starvation diets were 1,500 kcals daily i.e. the average kcal amount suggested to those trying to lose weight in the orthodox CICO fashion today. Results were that these healthy young men lost weight but also become obsessed with food then rapaidly regained their weight and more. Sound familiar?
We know that these methods work and why they work:
Bariatric surgery (lose the liver fat,change your hormone profile)
Fasting (lose the liver fat, change your hormone profile)
LCHF (ditto)
VlCD for 12 weeks though it requires re education and support to continue
Losing weight via calorie restriction also works but is hard to sustain and leads to a focus on calories not nutritional quality.
Sadly none of thee is orthodox therapy for metabolically ill people save the latter (advice from NHS dietician and./or ticket to Slimming World/Weight Watchers) thus we get the paradox of low fat diets/high fat people.
My fear is that those 800 calorie diet replacement powders will get prescribed and work but am worried that those people will not get enough re feeding information to sustain their t2 reversal.
Click to expand...

I still get tempted by the idea of the 'Newcastle Diet' sometimes. I'd have to stop my hobbies for a couple of months as there's no way I could go out hiking safely while doing that diet, plus it's very much an anti-exercise diet, you are supposed to do very little while on it. Exercise is even cautioned against after it due to the likelihood of over-eating after exercise, and I've discovered that I am a perfect example of that - hugely increasing my walking at weekends has made me really struggle with weight and blood sugar if I eat what feels right.

But right now for me is 'project fat adapted'. I've been on extremely low carbs for the last 36 hours, had plenty of fat, and if that helps me get through the next weekend of hiking where I 'eat what feels right' but of things like cheese and chorizo, and my weight and blood sugars decrease, then I'll stick with that until it stops working.

I don't feel strongly for or against most diets, but I do try to avoid 'diet religion'. It's easy to avoid - I just question everything and rather than looking for studies which reinforce my current ideas, I look for ones which counter them, and they always exist. I find that helps me pick things which 'hedge my bets' i.e. I've built up a picture of things which most studies agree are bad, and most agree are good.

Most of all it gives realistic expectations about what to expect years down the line, which is, in all cases, difficulty - at least if getting rid of visceral fat is important to me, which it is. Even if it does nothing for my glucose tolerance, I'd like to be thin so my hobbies get easier and more enjoyable.
 
and what about Re-feeding syndrome afterwards?

warning: most of the google articles on this are linked to concentration camp survivors.
 
archersuz said:
I had a warning 22 years ago when I had gestational diabetes - did I change my ways???? Slightly yes, but by following a low fat low calorie diet. I didn't exercise enough and I put on weight. look where I am now - knowledge is empowering but only if you act on it.
edit to change that last sentence to" knowledge is empowering but only if you CHOOSE to act on it"
Click to expand...
SNAP! Gestational diabetes 16 years ago, handled it with diet by eating a low GI diet, got sucked back into low fat/low calorie by ALL the diet clubs available - didn't exercise, small weight loss, big gain, small weight loss, big gain - bingo - obesity and type 2! There were some books out 16 years ago that talked about syndrome X and cutting carbs, but as a vegetarian, blinded by the media/party line on healthy eating I thought a low fat option would be the most feasible way forward. Then spent the last 16 years banging my head against a brick wall.
 
lucylocket61 said:
and what about Re-feeding syndrome afterwards?

warning: most of the google articles on this are linked to concentration camp survivors.
Click to expand...

Was that question for me, and about the ND?

If so my answer would be the same as always: it would be an immensely difficult obstacle to overcome. For an obese person to get truly thin, i.e. have a level of visceral fat which is deemed 'safe', and stay that way, is immensely difficult.
 
AdamJames said:
Was that question for me, and about the ND?

If so my answer would be the same as always: it would be an immensely difficult obstacle to overcome. For an obese person to get truly thin, i.e. have a level of visceral fat which is deemed 'safe', and stay that way, is immensely difficult.
Click to expand...
its was a general question about the possible consequences of starvation for any length of time. And sort of rhetorical, as the issue hasnt been mentioned yet.

From what I have read, many of those who starve for more than six months can have irreversible health issue which may not surface until later. So it seems to be swapping one problem for another and not good.
 
Did I mention that I recently discovered that I had had gestational diabetes with my last child, 23 years ago, and no-one told me even though it is on my notes? my last child was a whopper too, even though my previous ones werent and i am quite a tiny person underneath the fat. So many wasted years.....................

but then, I would have followed the NHS guidelines anyway, so maybe would have still ended up where I am.

I didnt put on weight with my last pregnancy, and lost what little I had when I fed him for a year. More clues missed.

It also seems that having has 7 miscarriages and one stillbirth was also a clue.

Thank goodness for this forum.
 
lucylocket61 said:
its was a general question about the possible consequences of starvation for any length of time. And sort of rhetorical, as the issue hasnt been mentioned yet.

From what I have read, many of those who starve for more than six months can have irreversible health issue which may not surface until later. So it seems to be swapping one problem for another and not good.
Click to expand...

I see. I guess that's where the definition of starvation has to be quite clear, and that's a very hard task especially with terms like 'starvation diet' sometimes being used in the media to describe emergency weight loss strategies which may in some cases be saving people's lives. I think I go along with @Guzzler's view that it's nice when words mean something, so we shouldn't be using terms like 'starvation diet' unless the diet is intended to kill or malnourish people.

Certainly I'd say people in concentration camps in WW2 were, to put it as mildly as possible, being abused, and for a very long time, and the people feeding them probably didn't really care if their prisoners stayed alive from one day to the next. I'd call that a starvation diet.

That's possibly a very different thing to eating 800 calories a day from food that's carefully designed to contain a good balance of vitamins, minerals and macro nutrients required to sustain life, for a brief period, and not being asked to plough fields and build structures while on it.

That's not to say that lessons can't be learned from the extreme and applied to the everyday - it's certainly right that anyone going on a VLCD should be made clear of what to expect, and sadly they aren't. You certainly don't see warnings about reduction in RMR and the likelihood of over-feeding afterwards on these 200-calorie meal replacement shakes.
 
AdamJames said:
I see. I guess that's where the definition of starvation has to be quite clear, and that's a very hard task especially with terms like 'starvation diet' sometimes being used in the media to describe emergency weight loss strategies which may in some cases be saving people's lives. I think I go along with @Guzzler's view that it's nice when words mean something, so we shouldn't be using terms like 'starvation diet' unless the diet is intended to kill or malnourish people.

Certainly I'd say people in concentration camps in WW2 were, to put it as mildly as possible, being abused, and for a very long time, and the people feeding them probably didn't really care if their prisoners stayed alive from one day to the next. I'd call that a starvation diet.

That's possibly a very different thing to eating 800 calories a day from food that's carefully designed to contain a good balance of vitamins, minerals and macro nutrients required to sustain life, for a brief period, and not being asked to plough fields and build structures while on it.

That's not to say that lessons can't be learned from the extreme and applied to the everyday - it's certainly right that anyone going on a VLCD should be made clear of what to expect, and sadly they aren't. You certainly don't see warnings about reduction in RMR and the likelihood of over-feeding afterwards on these 200-calorie meal replacement shakes.
Click to expand...
I did 2 months on 1000 calories a day - but stuck to under 50g of carbs the whole time which very quickly controlled my appetite - I think I'd have found it impossible on anything high carb or meal replacement based.
 
eggs11 said:
I did 2 months on 1000 calories a day - but stuck to under 50g of carbs the whole time which very quickly controlled my appetite - I think I'd have found it impossible on anything high carb or meal replacement based.
Click to expand...

An interesting thing about the ND is even if you use the easily available sugary meal replacement shakes, you can be on about 75g total carbs a day depending on what veg you use as the 'real food', which is still pretty low. When I did it for a few days I was getting about 100g carbs a day.

One thing that surprised me was just how good I felt after one of the shakes. I was expecting a drink with 20g carbs - sugar, no less - in it for breakfast to cause problems during the morning at work. In reality I felt fine - very mentally alert, not hungry, and didn't notice and 'sugar crashes'. I wondered if that was because they are crammed with a wide range of nutrients so I wasn't lacking much?

Anyway congratulations on your staying power, and relevant to this thread, how have you found things since you stopped the 1000 calories a day, and what do you eat these days?
 
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