TYPE 1: My Transformation From "Overweight" to "Obese"

A few members had asked questions about gaining weight as a type 1 diabetic. I decided to make my own thread sharing my progress rather than derail other people's threads. I put this in the type 1 section because I think it is specific to people with low/no insulin production. If it's better served in the Exercise section, please forgive me.

Thread title: I meant it as a joke. Its a reference to the Body Mass Index which I'm personally find useless.

Quick background: I am a honeymooner. I was diagnosed September 2nd 2015. My situation is very unique and you should not try to imitate it for yourself. What I'm discussing is the relationship between insulin and weight gain. The actual units are meant as reference points to compare my results.

When I was diagnosed a little over 2 months ago I weighed about 175-180pounds. That may sound healthy (or even overweight) to some, but I was most certainly underweight and sickly looking.

Fast forward to today and I now weigh about 210 pounds. That's a very comfortable weight for me and I feel very healthy. However, my current goal is to achieve <10% body fat and stay above 200 pounds.

What I did to gain weight: I'm a firm believer that insulin is the key to weight gain and/or weight loss. While gaining weight, I was taking 24 units of Levemir (12units twice a day) and 3-6 units of Novolog to correct for meals. Immediately before and immediately after working out were the times I ate most of my carbohydrates which also meant giving myself insulin at those times. I rarely ate carbs late in the evening (I workout in the mornings) as I wanted to ensure that I gained healthy weight (as much muscle as possible).

Side note: I am a former competitive powerlifter, college baseball player, and throughout my life I have always had quite a bit of lean mass (muscle).

What I'm doing to lose body fat (Again, please note my disclaimer. This is NOT something anyone should try): following the concept that insulin and body weight are correlated, I have drastically reduced my insulin intake. In order to do this, I have significantly lowered my carbohydrate intake (35-40g/day) and increased my cardio (in addition to my heavy weight lifting). As a result, I have reduced my basal insulin from 24units/day down to 4units and I haven't taken any bolus insulin in two weeks (again, I'm a honeymooner). I have made sure that my glucose levels have not suffered as a result. I have a Dexcom G5 and I manually test 6-8 times a day. My two week average is 6.2 mmol/l to put it into perspective.

I attached a few pictures to share my progress. The most recent picture was taken yesterday 11/9

tim2000s said:

What you're doing reflects what I did last year and the programme that the gym I use recommends. They focus on managing hormonal response, with the key being reduction in insulin to reduce body fat. As a result, in the body fat loss phases, they apply the metabolic diet and German Body Composition training to "fat burn" as much as possible, keeping people on really low carb levels (sub-30g).
It worked very well for me last year, and I use it when I want to lose body fat. Of course, you also have to avoid alcohol in these phases as it affects the liver's ability to process fat effectively!

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Fortunately, I lost interest in drinking alcohol about a year ago. I do enjoy a nice glass of wine or craft beer, but the only time I drink alcohol is when someone puts it in front of me. Since my diagnosis two months ago, I haven't had even a drop of alcohol.

JBlaza said:

For the low carb amounts of 30-40g, are you including carbs from salad and green veg in this?

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I do not. That's largely due to the high fiber content of spinnach and other green vegetables I eat. Our bodies do not have the ability to convert fiber into useable energy so I don't count it.

Ultimately, this is a short-term approach for me and I have no intention of maintaining a low-carb diet in the long run. Health and Fitness is a major part of my life, but it isn't the only priority in my life. Without a doubt, low-carb diets work for me, but the cultural trade-offs aren't worth it long-term. I want to be able to enjoy the occasional holiday dinner or bowl of ice cream without feeling like I'm ruining weeks worth of progress.

RuthW said:

I'm interested in your diet. You reduced carbs to reduce fat. I get that. But does that mean an overall reduction in calories, or did you replace carbs with something else? How much protein did you eat per day? Did you time the eating of protein in the same way as carbs?

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I'm still playing with my macros a bit, but currently they look like:
Protein: 200g (35%)
Fat: 150g (58%)
Carbs: <40g (7%)
Total Calories: ~2300 (my daily maintenance usually hovers around 3000)

The only intentional change I've made is a reduction in carbohydrates.
I've always targeted 1g of protein per 1 pound of bodyweight
My fat intake has increased slightly, but not more than 10-15g/day

I realize what I'm doing is a bit less conventional, and I do expect to modify my approach based on results. However, right now I'm trying to change only one variable at a time. So far that has been the carb reduction. Again, my goal is not weight loss, but weight TRANSFER (less fat, more muscle).

In regards to my protein intake: I basically approach(ed) it like you would basal/bolus insulin. When I was trying to gain weight I would use milk/casein protein as "basal" protein as it's digested slower and over a longer period of time. In particular, I'd drink a glass of milk just before bed since I obviously can't eat while sleeping. I've since stopped that as milk unfortunately has too many carbs for what I'm trying to do. They do make casein protein isolate, but I haven't "invested" in it just yet.

I drink whey protein before/after my workouts because it's digested very rapidly and I wanted to have protein in my system during and immediately after my workouts. In all honesty, I think supplements are mostly a waste of money, but I'd rather "have it and not need it" than "need it and not have it" in my system.

RuthW said:

Mmm. I am beginning to think that all my life I may have been eating too little protein. I know women don't bulk up like men, but no matter what I have done, from running to karate to weights, I have never, ever put on weight, only lost it. And my BMI has always been 'normal'. I know you don't rate BMI (and it doesn't apply to short people, or extremely muscular people, etc) but I am of the body type where it does correspond with under- and over-weight.

I don't know if I can handle the amount of protein I should eat!

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I know many women in my family have that issue. Most of them eat very healthy and exercise regularly but it's almost all fruits/vegetables and cardio. My mother is tall and thin and well within the "normal" range for the BMI. However, she doesn't eat nearly enough protein and I can't get her to start lifting weights. As a result, she has very little muscle mass which means when I visit she's either freezing cold in the house or I'm sweating like crazy.

The other thing to consider is keeping osteoporosis at bay. That eventually becomes a big concern for many women. Heavier weight lifting and increased muscle mass has proven to combat that.

UPDATE: Relevant to this thread and discussion. I've now gone 50 hrs without a drop of insulin. My 2-week average glucose levels have continued to drop (currently show 6.0mmol/l down from 6.4mmol/l).

-I've reduced my carbs from about 250-300g/day down to about 30g/day
-yes, I am in ketosis (confirmed with ketone testing strips)
-my activity levels are high by most people's standards (heavy weight lifting, I run ~25km/week, and other various outside activities)
-I eat 6-7 meals a day to avoid large spikes
-Energy levels are unchanged which I find odd given my past experience with LCHF diets. However, the last time I did one, I was a college athlete and exercised more than 4hrs/day.
-only side effects are the bowel issues (which I knew to expect) but very minor

To put it into perspective, my a1c was 13.2 when I was first diagnosed on September 2nd 2015

Edit- I'm attaching a screenshot of my dexcom trend graph to share my progress. I'm in the US so my results are in mg/dL. Remember to just divide by 18 to convert into mmol/l

nicolabarnett said:

Do you use My Fitness Pal to work out all your macros ?

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To answer your question: I used to, but don’t anymore. I think MFP and similar apps are great, but I never seemed to benefit from them, personally. I have a hard time keeping a consistent log of what I eat, and the brands of foods I buy always seem to differ from the nutrition facts I see in MFP.

What I do instead is incredibly boring and most people would probably hate it:

-I eat pretty much the same foods every day for a month, change to new foods and eat those for the next month, and continue until my goal isn’t cutting/losing weight.

-In the first week, I measure everything out with a food scale. After that, I start to memorize how much of each food I need and what the proper portion size looks like. Consequently, there may be slight variations day-to-day, but not more than 100 or so calories (less than 5% margin of error).

-Doing this allows me to remove the “pleasure” feeling that I tend to associate with food. I think I’m weird in that regard, but I essentially have to trick myself into forgetting what good food tastes like. It’s what works for me mentally.