Weightloss stalled

lorib64 said:

Hello. I have type 2 diabetes. I have been on a medically supervised keto diet program (Virta) since Feb. I was losing weight slowly until June. My labs were good so they took me off Januvia. I still take metformin. It took awhile for my glucose to stabilize with the med change, but it is fine now. I am 57F 5'5" 160 lbs

My doctors are pleased with my progress but I am frustrated by my weight. I am getting close to a normal BMI but I have a lot of abdominal fat. I sometimes get really hungry at night. Like there is a pit in my stomach that can't be filled. I eat snacks, like nuts and try to ignore it. I don't know if this is binge eating. It is fairly new, few months I have been getting these hunger pangs.

I take psych meds too. I asked my psychiatrist about reducing meds but he does not think that would be a good idea.

My insurance changes in Jan and I will be off Virta. I will still do keto but without the support team. I looked into a weightloss center that has a VLCD program. You have to buy their food for the start and then transition to regular food. It is expensive. It can be a year long program but I can only afford the first 3 months and then transition to a regular diet on my own. I don't even know if I could do VLCD with my hunger.

I log my food on MyFitnessPal. I weigh most things, but some I estimate. I am getting better at logging but I think I forget some foods. I am pretty sedentary. I do walk some at work and walk our dog. I have time to be more active, I just get tired. I usually skip breakfast and eat 2 meals. I don't know if I should be eating more earlier in the day so I don't get so hungry at night.

I measure glucose and ketones daily. Glucose is okay. But I am having trouble staying in ketosis. That is new. I must be going over carbs. I have my goal on MFP set for 1200 calories + exercise from Fitbit.

Any suggestions? I am sticking with keto since it is helping with diabetes.

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Hi @lorib64 ,

This forum has a thread called What Have You Eaten Today: https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ If you start participating there, it could well serve as the support you'd otherwise get through a weightloss center or Virta. Lots of support, knowledgeable people and best of all, it's free. And no required meals to purchase.

My weight's a bit up and down too, I never quite get to a normal BMI. That's between a wonky thyroid, being a woman of a certain age (the moment I hit 40, the weight loss that came relatively easy once I discovered low carb, became a daily struggle. Thanks, hormones!), and medication often doesn't help either. A lot of antidepressants have weight gain as a side effect, but if you need it, you need it. Sometimes we just have to work with what we've got. The important thing is to keep your blood sugars in a good range, and though I appreciate weight loss would be nice (understatement, as I was cursing at the scales this morning too), that's the part that'll prevent complications in the future.

How are you measuring ketones? If it's with a blood test, they're accurate, but if it's with urine sticks, then ketones don't show up much anymore after a while of low carbing.

As for being too tired for walks, that could be depression, the medication you're on, or anything, really... But if you can manage an extra 10 minutes on top of walking the dog for instance, well, everything helps. A stroll up and down the street added to the normal regime, when you have a moment. You don't absolutely have to, and if your blood sugars are alright, there's no need for the extra walks... But for my own clinical depression/borderline personality disorder/anxiety, I find being outside does make me feel better about life in general, even if it's just temporary. It only helps for me if I have a camera with me though: I'm more present in the surroundings, I'll notice cats, birds of prey, ladybugs, flowers... The walks take me out of my head some, you know? And having a camera with me (or a phone) helps me to see those things and experience them more. Just an idea, nothing you have to do something with. What works for one, may not work for another. Just, you know... Give yourself a break. You sound like you're kicking yourself around some.

My husband's waiting for me to finish up here, but.... If you want support with keto, there's places right here on the forum that'll be near to what you're looking for, except it won't be face-to-face. You don't have to do anything alone, and you don't have to spend an arm and a leg.

Hugs,
Jo

Hi . I am a trainer so here's my observations:
I hope you can make the most of your success so far and work out a way forward without Virta. As JoK has suggested there are plenty of ideas on what to eat on this site or others such as Diet Doctor (small fee for full access). DD does bespoke diet plans if you'd like that extra support.
More importantly your weight loss stall and hunger is likely caused by dropping too low on calories . I am not surprised you are too tired to exercise (not that this will directly impact your weight) as 1200 is starvation rations whether keto or not. It is unlikely you are getting all of the vitamins and minerals you need on this amount of energy too which will also cause or exacerbate mental health problems.
Your body is using ketones to fuel you so perhaps there are less of them to pee out if that is how you are testing. I would not obsess about those numbers anyway; it is normal for humans to drift in and out of ketosis as we eat then fast. I think you need to feel energised and healthy enough to get out in the sun or fresh air at least more than get into some perfect weight range!
Last point is that dairy can cause inflammation issues causing you to retain weight so it is worth seeing if cutting it out helps though I doubt you are having much cheese etc. on 1200 kcals.

How long have you been dieting? If you’ve been dieting for many months, I would consider taking a diet break. Add in a couple eggs for breakfast, something nutritious. Drop to about 1400 calories after your energy returns, if you start feeling drained, go back up to 1700.

that’s pretty much what I do, 5 days on lower calories, ease up on the weekends.

I am eating a low carbohydrate diet and my waist is shrinking.
I don't restrict calories as that has never worked in the last half century so I doubt it will ever work for me.
When in ketosis I am not hungry, I have lots of energy and endurance.
If anyone is offering to help you lose weight if you buy their really expensive food substitutes then I do wonder just how motivated are they to have you succeed on a permanent basis, and how will you ever learn to sort things out for yourself if you are never having to make your own choices.

What are you actually eating and drinking?

lorib64 said:

When I get hungry at night I go for things that are easy to grab and eat, like more nuts.

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This sentence seemed to stand out as a possible cause of your stall. Maybe adding more fats to your meals will stop you feeling so hungry, snacking especially on nuts is not going to help with weight loss