Please, Help Me!

Type 1 and LADA
1

One would think that taking in a pittance of calories a day would result in rapid and large amounts of weight loss, right? Especially if one is active while not eating much..and what they eat is very healthy. So why have I not been able to lose one pound?!

WTF, mate?!

Let me give you the rundown of my situation. I am type 1 diabetic with a lot of complications of diabetes. I have been following Dr. Bernstein's teachings since early November and during November I was able to regulate my blood sugar very well and lost almost 20 pounds. December I fell off track and gained several pounds back and suffered many high blood sugars, so bleh to December. January I was back on track, regulated my blood sugars very well, eating very little but very healthy, exercising a lot more (but still not as much as I need to), but have not been able to lose not even one frickin' pound!

Here is a general rundown of an average nutrition in an average day for me:

Daily totals (spread out over the day of course):

Calories: 666 Maybe it's the number that's cursing me!

Protein: 27g

Carbohydrate: 36g

I have no energy issues, I never feel hungry and rarely have cravings anymore. I require an average of 20 units of N per day and an average of 7 units of R per day. I drink an average of 72 ounces of water a day, and 1 liter of diet soda. Occasionally, but not on a daily basis, I drink tea without anything added, and coffee (black).

For reference, I did some research on several websites, and reviewed Dr. Bernstein's recommendations and as follows is what I determined is healthy for me, and only me, according to my lifestyle, biology, health issues, etc.

Calories: 1300-1500

Protein: 46g

Carbohydrate: No more than 30

I also use many herbs and spices in my cooking (no nutritional value, just lovely flavor). I also take many nutritional supplements:

Cinnamon

Evening Primrose Oil

Fish Oil

Red Yeast Rice

Vitamin B12

Magnesium

So, please, can someone shine some light on why I can't lose weight?! My only suspicion here is that I might have PCOS.

2

Are you taking any prescription medications? In my case, my rheumy changed my Lyrica to Topamax for peripheral neuropathy. He also reduced my dosage of prednisone and increased my Remicade infusion for my rheumatoid arthritis. However, the prednisone adversely affects my diabetes.

I was doing all the right things of eating a low carb diet and trying to exercise, but my RA was still out of control (and still is, but slowly getting better). Now, my BGs are creeping upwards. My endo says it's not surprising that the RA and diabetes are opposite of each other.

3

I take several prescription meds but I haven't found any weight related side effects listed for any of them. Plavix, Lisinopril, Pravastatin, Gabapentin, Metoprolol. And of course insulin which can cause weight gain when in large amounts.

4

We are often told that weight gain/loss is just a matter of calories. Well I don't believe that. First, weight loss (particularly fat loss) is regulated by certain hormones, including insulin. Guess what, any excess insulin in our bodies impairs fat loss. And then to top it all off if we restrict calories too much our bodies just slow down to adjust. Many "experts" advise you to not excessively restrict carbs because of this.

But also please understand, weight loss often occurs incrementally over time. You may reach plateaus and then for some unknown reason gain or hopefully lose weight.

Maybe you have PCOS, which does generally present with marked insulin resistance. PCOS can make weight loss difficult and is often treated successfully with metformin. It wouldn't hurt talking with your doctor about it. Metformin is a very safe drug (although some of the gastric side effects can be explosive). It is also generic and inexpensive.

5

Metoprolol does cause swelling of the lower extremities. Are you sure you are gaining weight and not retaining fluid or swelling? Have you talked with your cardiologist or endo about your weight gain? For me, I was swelling and retaining fluids in my ankles and abdomen. Even with a diuretic I was retaining fluids--thankfully it wasn't linked to my BP meds based on my cardiologist assessment. It was the prednisone. But by a fluke another doctor also found that the Lyrica was causing major problems for me.

There may be some contraindications between your meds as well.

6

Thanks, and yes, my plan is to ask my doctor to go on Metformin because I suspect I am mildly insulin resistant and may have PCOS. It's just frustrating because I really need to lose weight for many health reasons, but my stupid health issues are making it hard to do what I need to help them! Such a horrible cycle I'm stuck in!

7

You don't list any fat totals in your daily diet. Are you restricting fat? The Bernstein diet is a low carb, normal protein and high fat diet.

On an insulin total daily dose (TDD) of 27 units, I can't imagine that you are insulin resistant. The text book definition of insulin resistance is a TDD > 0.5 units per kilogram of body weight. A kilogram is about 2.2 pounds.

I don't know the answer to why you can't lose body weight but I've read that the body gets pretty smart about holding onto body weight if it thinks your are experiencing a famine. A high percentage of daily calories burned is driven by your "basic metabolic burn rate" and your body may be adjusting this number to compensate for the lack of daily calories. Less than 700 calories per day is a starvation diet.

Have you tried limiting or even eliminating your diet soft drinks? I read some counter-intuitive findings that diet soda consumption can make weight loss harder.

8

Have you ever thought about intermittent fasting? I do one 24-fast each week. I fast from after dinner one day until dinner the next. I only eat two meals per day, so I just skip one breakfast and snacks.

There's lots written about intermittent fasting (IF) online and there are many variations. It doesn't take much willpower for me and you may find it useful.

9

If you google "concentration camp diets", the inmates were fed c. 800 calories, which wasn't enough for them. I think you should up your calories. If you don't eat enough, you can impair your metabolism and stop losing weight. I have found that when I increase my protein %age to between 40-50%, I will be able to lose weight pretty readily but I'm still eating 1800-2000 calories/ day. I have a hard time sustaining that as it involves eating cans of tuna, protein shakes, multiple hunks of meat, etc. but I throw in lots of spinach, brussels sprouts, onions, shallots, etc. to try to get add in nutritive foods and I don't feel too hungry most of the time.

10

I eat about 54g of fat per day. According to the math, you are correct about me not being insulin resistant. I had based my suspicion on the evidence that considering how little I eat and how much I exercise, it just seems that I need too much insulin to keep my BG regulated. But I did not use any math to come to this conclusion, it was simply personal opinion. Thanks for the equation. I do have one day per week where I allow myself to "binge" a bit. But the sole reason I don't eat much isn't so much a set diet but the fact that I have very little appetite (I don't know why). I started the Bernstein diet when I was having a lot of trouble with cravings and overeating, but since I've gotten my BG under much better control I've lost my appetite.

As for the diet soda...I have considered giving it up, but that is my last remaining vice, LOL. I have cut it down by half, though. I used to drink at least two liters per day. Maybe, slowly, I'll just naturally give it up. :)

11

I'll look into it, thanks.

12

I hear you on enjoying your dwindling list of vices. I drink a lot of coffee each day. I don't see much effect on my BGs and the medical literature goes back and forth whether it's good for us. I grew up with a huge Coca-Cola habit. Then I transitioned to Diet Coke, then sparkling water with a twist of lime. Now I only drink that on occasion, like airplane flights.

13

Diet soda is the worst thing if you are a heart/BP patient. If you can make 3 days without it. You will see the at least 2 lbs. go within those 3 days. And it is water weight--fluid retention.

To date I've lost 60+ lbs. (but that's a whole another story).

14

When my mom was diagnosed almost 40 years ago, her doctor told her it was better for her to just drink a small real ginger ale than a diet coke. Now with dialysis, the kidney specialist let's her have a small amount of 7-up or Sprite. It's the 7-up doesn't affect her BGs as much as the Sprite. Whoa Baby!

I'm going back to green tea.

15

Tamra, have you had your thyroid checked? Hypothyroidism is very common in Type 1's and can cause weight gain or make weight loss very difficult.

16

I don't think I've had my thyroid checked but I'll bring it up with my doctor at my next visit. Thanks.

17

No way is less than 700 calories a day enough for you!! Your body is probably in starvation mode and is holding onto anything and everything you put into it, and probably converting anything you eat into fat stores. You need more calories, for sure, especially if you are exercising regularly. I hope you get it figured out…I know weight loss can be a frustrating journey!

18

I think it might be the soda. Soda has a lot of salt in it in the form of sodium bicarbonate. You are probably retaining water. I would quit the soda and I bet you feel a lot better and drop some weight. Salt is not good for high BP or heart disease.

19

tamara, my daughter used to restrict her calories a lot as a teen. then she got so thin that her period stopped, which scared her into regaining the weight quickly. one way she regained automatically is she stopped moving around. i remember her laying down and watching TV perfectly still. it was weird. the weight came back fast. and then it was more than she wanted to come back, but now it is harder for her to lose. maybe losing the 20 lbs fast and then regaining a lot fast has put you into another mode as people have said. do you find yourself moving around less? if so, that might be a sign that your body thinks it has to defend itself from starvation. as for intermittent fasting, one of the founders of the idea, art de vany, has recently changed his position on the number of hours needed to make intermittent fasting successful- i think it was something like 15 to 18hours, which included sleeping.

i found what art de vany wrote on his facebook:

Fasting. “No fast should ever be longer than 24 hours. About 16 hours is right for reasons I won’t go into. More than 24 hours without protein shuts down the synthesis of glutathione and deprives your liver of the ability to detoxify all those toxins that are released when you fast. Glutathione is the primary detoxifier in both phase 1 and phase 2 detoxification. Fat is the primary sink for toxins.”

20

No, I'm not less active. In fact I am more active than I have been in years. I have a lot of energy now, I think because of my improved blood sugar and health. I don't intentionally restrict my calories, I actually didn't realize how few calories I was taking in until I sat down to review my diet and try to figure out why I wasn't losing weight. The reason behind the few calories is because I have no appetite. For some reason when I got my blood sugars under control my appetite went from extreme to zero.