Longtime Weight-loss-stall Broken (with IF & metformin)

[AloeSvea]

Hi y’all. I wanted to share my experience with breaking a weight loss stall via 2-3 different paths. (This is part of a ‘triptych’ – including posts in fasting and metformin sub-forums.)

This is as a normal-weighted person, since diagnosis, post first moderate carbing, then consistently low-carbing ever after. BMI of 24ish, consistently for the 8ish years since, until recently, now in BMI 22ish range.

At diagnosis I would have had a BMI around 30-33 – I am not sure which as I did not weigh myself. Post diagnosis - went on an elimination diet of wheat. And – oh boy – what a quick difference it made. Needless to say – I have been as wheat-free as I can control (bar hidden wheat) since the elimination diet, via Paleo Way Of Eating, then LCHF, that shrunk my big gut so phenomenally, eight years ago. (Yes, a la Dr William Davis of ‘Wheat Belly’ fame if anyone wants to follow up on that.)

I am a ‘going off wheat and sugar products gave me normal weight back’ person, as soon as I was diagnosed and immediately changed my diet. (I also am a high exercise-responder due to my build. And I also walked a lot post diagnosis, abnormally ‘a lot’.)

In attempting to achieve remission, according to the personal fat threshold theory, and fatty liver (and fatty pancreas) theory a la Prof Taylor, supported by Dr Fung, I am always on the lookout for improved blood glucose regulation via getting closer to a lean build. I did a Very Low Calorie Diet (VLCD) a couple of times, 2 months a piece.

After the three changes/treatments below, I dropped some weight that had been resisting – as in losing and then regaining. So I thought I would share in case it helps someone else wanting to check out the impact of weight loss on T2D and their general health.

Anyway, the treatments that led to a weight-loss stall being broken -

The treatment paths were:

• Taking metformin, and obviously being a person who it affects as an appetite suppressant (via probably hunger-hormone lowering, suppressing some gluconeogenesis via insulin lowering/signaling, and intermittent nausea continuously, and the early on some violent vomiting which ceased after a couple of months, thank goodness.)
• Embarking on a ‘sunrise to sunset’ time of eating window as an intermittent fasting (IF)regime (about 10-12 hours on, 12-14 hours off)
• As part of the sunrise to sunset IF regime - lowering the amount of alcohol consumed by me (specifically – wine) not drinking calorific drinks post sunset five nights out of 7)

This was undertaken in a 6-8 month period at time of keying. (6-7 months IF, 8-9 months metformin.)

Six months after my diagnosis I tried a Very Low Calorie Diet (VLCD) to see if I could hit to below my personal fat threshold, even though I suspected it was very lean (note – lean! Not ‘skeletor’-like as someone, albeit a wonderful someone on the forum suggested! I have a muscular build.) This was in order to try for remission. I got to a bmi of 22, but this was not sustained, the same as when I tried it again three-four years later. The smallest waist size, on the second VLCD was a waist height ratio of .45, and that was not sustained. (It was usually between .47 and .49 once normal weighted post diagnosis as a lower carber).

Since I was knocked out of partial remission in the intermediate hyperglycemia range, back into full-blown diabetes, I have been trying to hit my diabetes hard, trying different strategies to lower my BG, so I relented and went for metformin, which I had been saving for such an ‘occasion’. A couple of months later I started a window of eating IF regime and cutting down on wine consumption as part of that. (A girlfriend had told me I might be surprised how calorific/fattening wine was, and I had to text her and tell her how right she was, and how sad that was.) I have written on my positive experience with sunrise to sunset IFing in the Fasting sub-forum.

The big surprise was the weight drop. I had lost between 5 and 8 kg (I don’t know exactly as my old scales had broken and I had not replaced them.) I got down to 2kg lighter than after two months of a semi-starvation diet!

More weight loss after two months taking a pill twice a day, than being on a semi-starvation diet for two months! If only I had known that metformin would affect me like this! (As an aid to weight loss.) (I read that it does sometimes have that effect, I just did not reckon it would on me for some reason.)

Would I rather take a couple of pills twice a day, eat from sunrise to sunset, than eat tiny meals and be hungry for two months? Oh yes!! (But I do not see metformin taking as any way permanent – I see it as a metabolic shake up to take when I need it. Note – this is not how your average GP sees it.)

But, my waist size was still 1cm more than at the end of the semi-starvation diet.

Until - After three and a half months I got to have another laugh, this time at my waist size – as it was smaller as well –less 1cm than at the end of the second semi-starvation diet (my name for the Newcastle Diet using food).

This time it was metformin, the window of eating regime, and cutting down on wine consumption, (five months of metformin, four months of the eating window) that I put it down to.

How do I feel at getting over that weight loss stall at last? Well, relieved that it could actually be done.

By September – weight stabilised with the bmi of 22. Waist height ratio – still .44.

October – ditto.

November update – my waist is the same but I have gained a half kilo in muscle due to a temp-job which gained me some good abdominal muscles (for an old broad), and some neat new front thigh muscles. It was just a temp job, so don’t know how long I will keep the new muscles. (This is why BMI, if you are gaining and losing muscle is notoriously dodgey for following the body fat…I am now with a BMI of 22.5, but same waist size under those new abs.)

I hope this adds to the body of knowledge we have on weight loss methods with T2D.

 

[AloeSvea]

Weighing in on the BMI versus waist-height ratio argument - those abdominal muscles now unused have gone, my thigh muscles still hanging in there, and my waist size has remained the same through thick and thin. So, now my BMI is back down to 22.1, ab-less.

Waist size remained consistent pre and post Xmas food 4-5 day hiatus (not my blood glucose, judging from the change in my Fasting Blood Glucose readings, just now returned to my normal). So hanging in there at .44.

Pre-Xmas HBA1c saw not a drop, but a rise of one number (from 47 to 48), so no steady decrease, as I was hoping for. Still in the 'intermediate hyperglycemia' zone, so I am grateful for blood-glucose mercies large and small. But going the wrong way is always a worry.

How to explain the slight increase? Along with muscles, the temp job I was doing had a training regime I called 'boot camp'. It was very stressful in a way I like the least and bound to be cortisol (stress hormone) and therefore blood glucose raising material. Too bad! So gains and losses, and when it's our metabolisms - it all counts alas. Good and bad.

 

[AloeSvea]

Just adding-in on weight issues, waist issues, and for me Fasting Blood Glucose (FBG) as tying in to potential HBA1c levels.

The effect of hot/warm and humid weather on weight.

It's the height of summer now where I am, and the torrential rains and unseasonal cooler clime has largely receded from my own fair isles. And as often noted, and noticed - one eats less in warmer weather. Just too hot and bothered to - much nicer sitting in a breeze drinking liquid (my cats feel the same way.) Especially if humid?

So, a drop in half a kilo - not much, but brings me down to a round number - a BMI of 22. Waist and hip measurement with a waist height ratio around .44-.45, still.

This has no bearing on my FBGs, alas. So I doubt that it will lower my HBA1c. I would prefer my numbers in that regard to be lower 40s, to give me wiggle room/a buffer in terms of my blood glucose intermediate hyperglycemia status/state of BG functioning. Right now, with 48, I have little of that. (50 is the number/level for full-blown diabetes in Aotearoa/NZ.)

And alas for me, as I have suspected for some time now, I have had too much damage to crucial parts of my blood glucose regulating system for shrunk fat cells, and a defatted liver and pancreas to have any dramatic and sustained effect on my BG system. I can sustain intermediate hyperglycemia unless something dramatic from the outside, in my case - in the form of the vaxx for the vile virus, and loaded stress hormones for years, has a negative impact on my BG system. I am assuming it is damage at mitochondria and gene level (a la Jenny Ruhl analysis), that gives me the basically permanent insulin resistance at a high level.

I am a poster-gal for sustained significant weight loss as a type two. Too bad in my case weight loss does not have a dramatic effect on my HBA1cs, in terms of remission, and once at an intermediate hyperglycemic (prediabetes ) level, I must 'work' hard to keep it in the 40s. And ride the waves of things like global pandemics and recessions, and other detrimental factors.

 

[AloeSvea]

Weighing in on impacts on weight of various things.

Dropped another point to a BMI of 21 - about a kg. Recently for me, stress and increased physical work re strength resistance (lifting and carrying things is related to the stressful events), and, a much-previously-worked-on back molar popped out, and while I wait for a dentists appointment eating is a very 'mindful' affair - drats and drag. It's currently too hard to eat heartily. Combined with much increased humidity as my country has untold water evaporating over the horizon, getting over extreme weather events in this strange summer, adds to the decreasing desire for a hearty meal (which is usually more my thing). Oh, and I inherited a much more exacting bathroom scales.

I observe that once that weight loss stall happened of 5-8kg, dropping another few kilos, at least to me, happens on the spin of a dime. (Not that dental problems are - unproblematic!)

Will add, I look fit and healthy still. (The healthy bit is not reflective of my poor dysregulated blood glucose system of course!) There is no bunk from me about being too thin, or me being concerned I will lose 'too much' weight on this journey. For me to hit Prof Taylor's ideal personal fat threshold of being the same weight as in your late teens - I cannot ever see that happening with me. And for me, hitting that - another 7kg! - would in all likelihood mean nothing to my poor metabolically deranged body. Lucky those who dramatic weight loss does send them into remission/lovely HBA1cs in the 30s, but that is not how my T2D is expressed, sadly.

 

[AloeSvea]

Continuing with some more weight loss - another kg or two or few. (And another BMI number - 20.8 now.) But no effect on my FBG, which is in fact higher than it was a few months and kilos ago. Disappointing but not surprising, as I have been describing myself as having weight-loss resistant type two for a longish while. It really is still true. Darn it.

I have to fit the outdoor exercise (for me, walking and yardwork) in around the rainfall and extreme weather events, so exercise has been lower than usual. Especially for the summer, which is usually a great outdoors time. (I mention exercise as my FBGs respond a lot to physical activity, in a positive way, as in lowering them, which I have not been getting due to extreme unseasonal weather.)

But storms well and truly gone, along with another kilo or so, and now the sun is back. So will be interesting to see if those few kilos come back too?

 

[AloeSvea]

With the return of the sun, and good outdoors weather, resuming my usual walking routine, combined with the IF routine being easier to follow along with normal calendar days/working week post national emergency in my environs at least, I have noticed an improvement in my FBGs - this not to do with weight loss then, but decidedly - physical activity. (My FBGs are not anywhere normal/healthy, so it is, for me, about as good as I can get, which is in upper 6's, or low 7s._

Sigh. (Because what a bore that physical activity affects me so re FBGs! Much easier if it was the metformin, the IF, and the weight loss, both which are relatively easy treatment forms for me these days this-regimen days.) (Keeping up physical fitness? Obviously very important. But not so easy, of course.)

 

[AloeSvea]

An update on current weight loss - 3-4 kg over three weeks, with significant muscle gain. (For an old broad!)

Two months off metformin. Very happy about that. Still on the sunrise to sunset 5 days a week window of eating (and calorific drinking) regime. That seems to be a goodie for me, still. For Weight maintenance. And allows metabolic flexibility for me, obviously, with changes in life circumstances.

Eating really good food - about half a plate of quality meat and kaimoana/sea food, half plate of veges, not always above ground. I like my store bought low-carb/keto bread, and no-grainola of a morning, with bacon and eggs later on - 2 breakfasts German style. (I have always had a hearty appetite, as all physical-working members of my immediate family have.) Not sure as to my current carb count. Maybe anywhere between 20 and 50g a day? Maybe higher? I should keep a record a few days to check that. Haven't done that for many many many years.

Re the current weight loss - quite a big one, relatively speaking (this is within the normal weight/normal BMI range) in three weeks, and this morning registered enormous surprise that the weight has dropped, again, still. The first time I have hit the 50s kg-wise since youth. So my BMI just hit 20.2, from a drop to 20.4 last week from a steady IFing BMI 21-22 for a long time. This is on taking a new contract involving heavy lifting, not enough time to have leisurely meals (and when I do have the time - I'm too tired, and wanting to go out and play more than eat popcorn in front of the tele - something I also really like to do.)

Cut down on snacking on nuts (not to enough time to eat them in a leisurely fashion!), and the carrot and lentil chips I was really enjoying, and my popcorn (small amounts at a time but still packed a bit of a carb punch for one on a LCHF WOE). Still relying on my stevia sweetened milk chocolate (Well Naturally brand) to get me through! A couple of pieces a day.

Lots of coffee, lots of tea, in the morning, lots of herb tea the rest of the day and night. Lots of sparkling water. A wee glass of dry red a few nights a week with linner/dinner. More on the bubbles on my weekends and socialising. (My experience of waist size and food and drink is that the alcohol drinks can really make a difference, sadly.)

So, even with the muscle development, I have clearly lost a bit of padding, with the weight loss of between three and four kilos. So def lean and muscular (for an old broad) at the mo'. I can see it clearly on my body. As in the significant muscle gain. Some walking every day (no hiking any more thanks to a bung arthritic ankle, alas.)

What does that mean for my blood glucose? Sadly, I remain resistant regarding my blood glucose regulation and health, to weight loss. So my fate seems sealed for me being the go-to Forum example of this . Obviously something in my BG system is seriously broken, and permanently it seems (I have known this for some years), and the decrease in my fat cell size, and gain in the muscle does not affect my fasting blood glucose positively these days. Post walking (in the city), my BG does not register a significant drop, or any drop, now.

With too high FBG - my BG is in the 7s all day. But - the muscles are fun! I have always enjoyed them. Easy come, and for me - not so easy go. Unlike body fat!