Great Trigs but still overweight


I am a pre-diabetic (A1c varies between 5.3 to 5.8), almost 50 year old woman. I have been following a high fat, moderate protein, low carb, no grain, whole foods lifestyle for almost 4 years. I also lift weights, do HIIT, yoga, meditation, Zumba, hike, walk, garden multiple times each week. And I eat out of my garden, and make my own bone broth, and eat lots of Offal, and only pasture, and shop at the farmer’s market, etc… And, yes, I have tried taking everything out of my diet for a while (dairy, caffeine, nuts, etc…). And I am very careful about my fats–render my own lard, grassfed butter, pastured tallow, extra virgin olive oil, etc… And I don’t eat grains–even gluten-free ones. And I eat fermented foods everyday, including Keifer that I make myself from pastured, raw dairy. Finally, I feel great–all the time. I just go and go and feel very, very healthy. I am never hungry until mealtime, and I never have food cravings or overeat. My problem: although all my health measures except blood sugar (fasting insulin 10 and fasting glucose 115 and A1c goes between 5.3 and 5.8) are doing great (trigs in the 40s, HDL 80s, low C-reactive protein, etc…), I have only gained weight as I grew healthier (which I assume is insulin resistance). And my weight just keeps increasing. I now weight more than I did at the peak of each of my 3 pregnancies. I have never been overweight before this. (I am 5’8" and 215 lbs–35 pounds heavier than I was when I started low carb 4 years ago–but remember, all my health issues have gone away! Only now I am listed as obese which a new health issue for me). Has anyone else experienced weight gain along with improved health? Can’t seem to figure out how to kick this insulin resistance. I have tried Metformin before with no luck–but was only on it for a few weeks. I got back on it last week to try again–am paying extra to get Glucophage which doesn’t bother my stomach. I am so frustrated because I cannot seem to overcome the insulin resistance!!! (My mom was a Type 1, and so I know that my complaining is really ridiculous, but I am reaching out just in case someone else has some info that might help me)…


Your feelings are not ridiculous. It sounds like you are trying very hard to do everything right. I’d like to first remind you that your weight isn’t the thing that determines your health. You can be perfectly healthy and fit and still be overweight. And the fact that all your health markers are great says you have done a great job.

That being said, here are some suggestions that might help with weight. First, reduce protein, Bernstein always recommends modulating protein for weight loss/gain. Second, you might consider some Intermittent Fasting. And finally if you would consider some more medication the SGLT2 drugs like Invokana (as well as the GLP-1 drugs) all have been found to encourage weight loss. Invokana is also available in a combination with Glucophage (yes, apparently the branded version) called Invokamet.

1 Like

Thank you, Brian. I will try out your suggestions. Thanks for taking the time and care to share this information with me.