Advice for those looking to lose weight the scientific way

[Knowledge]

I am posting here a modified post I made in another thread. I would like to note that while I am not a doctor nor am I a nutritionist, I am a doctoral student in Neuroscience and have enough scientific literature understanding to talk about what the medical community has been saying about "dieting" in general. In reality I am not here to lecture or preach, but to motivate and encourage others with my own results!

Also for those who advocate calorie counting,I am not agains this! In reality calorie counting is very very important and I still count calories myself. But you must acknowledge the scientific literature in the last decade suggests that hormonally, a calorie is not a calorie, because your body does not treat every calorie the same (ie sugar vs fat are metabolized by completely different processes which have opposite physiological effects on the body!)

6 years ago I decided to do the "Atkins Low-Carb" diet which you may have heard of or may have heard many myths about. (to dispel those myths please read this: http://www.controlcarb.com/ccn-myths.htm)

My issue was being a teenager at the time, I did not understand the science behind it. So after losing 100 lbs in 1 year what did I do? I went back to eating refined carbs and added sugar, surely gaining all the weight back plus more. This time I am determined to do it differently, and now that I understand the science behind it I hope this can help both you and I maintain that weight.

I began my low-carb diet on 1/3/15 and in the 4 weeks I've lost nearly 23 lbs (out of a goal weight loss of 120 lbs). Of this, 7 lbs was water weight, and 16 lbs is pure fat (I measure my body fat as well as weight).

Let me share with you how I got there and some tips I have - I'm not lecturing here just trying to share the knowledge I've gained over the last few months on the topic  

I know weight loss can be hard, but I should say if you haven't already look into a low-carb diet. I know it used to be considered a "fad" but a lot of science has been published since. To give you a quick idea, the Atkins diet was recently put against 4 other popular diets, ranging from a vegetable/fruit only diet to the traditional low-fat diet. Not only did Atkins come out on top in terms of overall weight loss, but the participants on the Atkins diet lost the most weight the quickest and were able to stick with the program the longest.

What's the science behind it? Basically it goes like this: We eat carbs on a daily basis, from bread to cereals to grains to chips. To your body, a carb is a carb, doesn't matter where it comes from. What does your body convert carbs to? Sugar. So if you eat a bagel for breakfast you might as well have downed a soda because your body in the end will convert it all to sugar.

All these carbs drive an insulin overproduction response. Insulin's first step is to provide that sugar to your muscles, but if you're like 99% of people in the world who aren't running a marathon, your muscles are full. So Insulin then converts the sugar into fat (via the liver). So this is the issue! Trying to lose weight on a calorie restriction while eating a diet composed of carbs makes it very difficult! I think we can all agree how hard this is!

Complicating matters even further, studies have shown that Insulin blocks the Leptin hormone from signaling your brain when you are full. So a high-carb diet, driving overproduction of Insulin, is one of the reasons why so many of us can never seem to get full even after eating a big meal! One thing about Atkins is because it is a high-fat diet (again this isn't dangerous especially if you are eating monounsaturated good fats -> I highly suggest you watch this video by Dr. Jonny Bowden on the topic of Cholesterol and fat: https://www.youtube.com/watch?v=YGOpjPNtjes

Because it is a high fat diet, your body will produce a TON of Leptin signal to your brain. And because you are not eating sugar, you have no Insulin response, so you get full very very fast on very little food and your hormone signal for telling your brain when you're full works like it's supposed to!

Obviously cutting out added sugars is a must, so it is good to take that first step. But a low-carb diet takes it to the other end. What ends up happening is you restrict your carb intake to 20 grams a day. What this does is force the body to burn its own fat for fuel. Why? When you don't have enough sugar intake (ie carbs), your insulin levels remain very low. In response to this, your body begins to produce ketones (don't confuse this with ketoacidosis in diabetics, two completely different things that have different resons for coming about!). 

The reason for ketones is because Insulin is needed to provide cells with energy from your diet. Without Insulin, your body gets its fuel using Ketones. Ketones burn your own fat for energy! How is that for a diet?

Lots of studies have looked at comparing low-carb diets from 30g of carbs a day up to 110 g of carbs a day. What they found is the more carbs you eat in a day, the more the ratio of your fat to muscle loss increases. For example, on a 20-30g carb restricted diet, you will lose somewhere in the range of 2-4 lbs of fat a week, 99% being from fat and 1% being from lean muscle. At 110g of carbs a day, you lose 2.5 lbs of fat a week, only 70% from fat and 30% being from lean muscle.

So on a low carb diet not only do you burn fat faster, you will burn MORE fat than muscle, especially on a 20g carb restriction.

I am a big fan of the Atkins diet because I have lost 100 lbs on it in the past in less than 1 year. Unfortunately I treated it as a diet and not a life-style change and I gained that weight back. This time I am determined to make it a permanent change and eliminate added sugars from my diet even after losing the weight.

Atkins also allows you to add carbs back as you progress through the diet so you won't be on 20g permanently!

Dr. Atkins tells in his book not to count calories. The reason for this is because it's impossible to overeat on the Atkins diet, because you are always so full. I tried counting once for the sake of it and I could barely eat more than 2000 calories a day, usually hovering around 1400 calories (And at no point was I starving). I dare you to try to a eat 3000 calories on a high-fat low-carb diet, you will probably puke before you can.

Sorry for the long post! My message is here for all those on the same path as me looking to lose weight, but now we have the scientific understanding as to why not all diets are the same and its important for us to be open minded about this

Lastly, in addition to Dr. Jonny Bowden's Great Cholesterol Myth video, I highly recommend you watch this video on Insulin and Leptin produced by the University of California:

https://www.youtube.com/watch?v=Yo3TRbkIrow

[Knowledge]

Also if you like to read, Dr. Bowden has a really great book recently published called "Living Low Carb: Controlled-Carbohydrate Eating for Long-Term Weight Loss". In it he brings forth the science up to 2013 and explains many of the common myths and put forth the reasons for low-carb health wise. He also reviews 23 of the most popular low-carb diets including Atkins to really give a nice comparison and overview of each diets' strength and weakness. He also has another book called "The Great Cholesterol Myth: Why Lowering Your Cholesterol Won't Prevent Heart Disease-and the Statin-Free Plan That Will" that I've heard is stellar.

Of course the original 2002 Dr. Atkins New Diet Revolution is also a great read if you haven't read it and also explains a lot of the science. The three books really complement each other pretty well and go a long way to re-educating us about the realities of our dietary intakes.

Also wanted to mention that we have become accustomed to associating Fat as bad. The reality is your body digests the fat into glycerol and fatty acid chains which it uses to make glucose for your cells. Fat does not associate with bad health!

Lots of literature has come out in the last 10 years or so that points to Fat actually reducing Heart Disease rather than increasing it. On a low-carb diet I usually average 60-75% daily fat intake, with 20-30% protein, and maybe 5% carbs. This is inline with what the medical literature actually suggests is best for you (Carbs have been linked more recently to heart disease, increasing LDL, and of course diabetes).

We've been misled for so many years by the FDA and the American Heart Association that its really a shame. Even Saturated fat is no longer the enemy as many have preached before. And Cholesterol in your serum from your diet (like eggs) is NOT bad for you. Even the American Heart Association is beginning to change its stance.

I do also want to note that a lot of studies have shown that when patients are placed on a low-carb high-fat diet, and others placed on a high-carb low-fat diet, their blood results are opposite! The low-carb high-fat patients decreased LDL (bad cholesterol), increased HDL (good cholesterol), decreased triglycerides, and had no change in blood pressure.

You know what happened to the low-fat high-carb patients? LDL increased, HDL decreased, Triglycerides increased. I know it is not what we have been taught, but times are changing and science is advancing in this field. What Dr. Atkins taught 40 years ago is only now becoming a scientific reality.

Also Dr. Bowden will explain in the lecture that Cholesterol is not just HDL and LDL as we've been taught, but rather their are components of LDL that are good and bad and it's important to recognize the difference.

[Brifit4life]

wow so much info!! Thanks so much!! I have been trying to figure what I want to do next as far as the healthiest choice in life. I dont't remember sticking to the atkins diet that long but i remember something good around that time when i was on it... so long ago. I am going to do some research when i get home!! Thanks!!! I am excited, I may have to get back to that atkins lifestyle. Only thing that sucks is ill have to change up my smoothies... there are so many carbs in it! From the banana to the fruit... i really like my smoothies, maybe replace it with low carb yogurt, ill figure it out. grrrr

[Knowledge]

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@Brifit4life wrote:

wow so much info!! Thanks so much!! I have been trying to figure what I want to do next as far as the healthiest choice in life. I dont't remember sticking to the atkins diet that long but i remember something good around that time when i was on it... so long ago. I am going to do some research when i get home!! Thanks!!! I am excited, I may have to get back to that atkins lifestyle. Only thing that sucks is ill have to change up my smoothies... there are so many carbs in it! From the banana to the fruit... i really like my smoothies, maybe replace it with low carb yogurt, ill figure it out. grrrr

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If you're not looking to lose weight but rather just remain healthy you don't have to get rid of all the fruit! Most studies have shown you can benefit from increased cardiovascular health on up to 110g of Carbs a day! The restriction of 20g is really just phase 1 of 4 phases on Atkins, and it's the most rigorous for those looking to lose a lot of weight like myself. But for most people looking for a healthy lifestyle they can eat around 100-110g of Carbs a day, cut out refined and processed sugar (including refined flour, etc) and still be healthy and may even lose a few of those stubborn pounds.

But do count the carbs, because fruit does have a lot so if you have a little too many smoothies you can go over 100g easily 🙂

[_daniel_]

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@Knowledge wrote:

On a low-carb diet I usually average 60-75% daily fat intake, with 20-30% protein, and maybe 5% carbs. This is inline with what the medical literature actually suggests is best for you (Carbs have been linked more recently to heart disease, increasing LDL, and of course diabetes). 

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It's very easy for people to claim that the science, or the medical literature, or the latest studies suggest that such and such a macronutrient ratio is best, but that doesn't make it a fact.  Claims are a dime a dozen on the internet.

The National Academy of Sciences (NAS) lists Acceptable Macronutrient Distribution Ranges for Adults (as a percentage of Calories) as follows:

 - Protein: 10-35%
 - Fat: 20-35%
 - Carbohydrate: 45-65%

When the NAS reviews the science and changes their recommendations to match Dr. Atkins, then I'll sit up and listen. In the mean time, I have no problem creating healthy, well balanced meals that fall within the very flexible range the NAS recommends. In my book, carbs are not the enemy and 75% daily fat intake just sounds unappetizing. 

I like Michaels Pollan's 7 Words & 7 Rules for Eating:

Pollan says everything he's learned about food and health can be summed up in seven words: "Eat food, not too much, mostly plants." Probably the first two words are most important. "Eat food" means to eat real food -- vegetables, fruits, whole grains, and, yes, fish and meat -- and to avoid what Pollan calls "edible food-like substances."

Here's how:

1. Don't eat anything your great grandmother wouldn't recognize as food. "When you pick up that box of portable yogurt tubes, or eat something with 15 ingredients you can't pronounce, ask yourself, "What are those things doing there?" Pollan says.
2. Don’t eat anything with more than five ingredients, or ingredients you can't pronounce.
3. Stay out of the middle of the supermarket; shop on the perimeter of the store. Real food tends to be on the outer edge of the store near the loading docks, where it can be replaced with fresh foods when it goes bad.
4.  Don't eat anything that won't eventually rot. "There are exceptions -- honey -- but as a rule, things like Twinkies that never go bad aren't food," Pollan says.
5. It is not just what you eat but how you eat. "Always leave the table a little hungry," Pollan says. "Many cultures have rules that you stop eating before you are full. In Japan, they say eat until you are four-fifths full. Islamic culture has a similar rule, and in German culture they say, 'Tie off the sack before it's full.'"
6. Families traditionally ate together, around a table and not a TV, at regular meal times. It's a good tradition. Enjoy meals with the people you love. "Remember when eating between meals felt wrong?" Pollan asks.
7. Don't buy food where you buy your gasoline. In the U.S., 20% of food is eaten in the car.

[Knowledge]

I appreciate your response and will not disagree with your recommendations. However not willing to accept science as it evolves in my opinion is not wise, but it is your choice to make. If we all sit around and wait for these organizations to begin endorsing new food pyramids and new dietary changes we will be long dead before it happens. Reality is it takes a long time for these bodies to make decisions on such changes, even if the evidence has been shown in a decade or more. Usually it takes 30-50 years before such drastic changes become accepted by society, but that is how science has always been.

My point is this: dozens of studies published in high-tier generals have shown the benefits of a high-fat low-carb diet vs a low-fat high-carb diet on immediate blood tests (changes that can be seen within 1-3 months). It's only a matter of time until we wake up to the obesity reality around us. Lowering our dietary fat intake in the last 50 years has made us more obese, because we've compensated that loss of fat with added sugar in order to make food taste better since it tastes like crap without any fat.

I am not disagreeing with you. Eating whole natural foods, fruits, vegetables, etc, IS a low-carb diet in essence. Low-carb is not 20g a day, that is for weight loss. Low-carb restriction is around 110g a day which is what you would eat by eating whole foods and avoiding processed and refined foods.

[_daniel_]

You seem to be assuming that because “dozens of studies published in high-tier generals have shown the benefits of a high-fat low-carb diet vs a low-fat high-carb diet on immediate blood tests” that the science of nutrition has undergone a revolution. 

First of all, I’m not arguing in favor of low-fat + high carbs, nor is the NAS. What I see in their recommendations is a balanced diet. I too am in favor of balance.

Second, I think you are cherry picking studies. Classic mistake. What about all the studies that you don’t know about, that don’t support your theories?  

This is where organizations like the NAS fill an important role. They bring together large groups of experts to look at thousands of relevant studies (not just a couple dozen), and they look at them with deep expertise in all the science involved, and the ability to distinguish high quality studies from low quality studies. 

And the NAS is not alone in this. I’m just using them as an example. There a lots of reputable scientific organizations that bring deep expertise and experience to evaluating nutritional claims. For another example, I’ve had positive experience with University based organizations such as http://www.berkeleywellness.com/, http://www.hsph.harvard.edu/nutritionsource/, and http://www.nutritionletter.tufts.edu/.

I'm pretty sure they too recommend a balanced approach to nutrition. 

One more example of balanced, and then I’m going to shut up. I recently started playing with My Fitness Pal, and this is what they recommend for me.  (carbs, fat, and protein are in grams)

Also balanced, reasonable, common sensical, and consistent with established guidelines by reputable organizations. Or so it seems to me.  

Take care. 

[Brifit4life]

I want to lose about 15-20 lbs... so 110 carbs is good or less?

[Knowledge]

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@Brifit4life wrote:
I want to lose about 15-20 lbs... so 110 carbs is good or less?

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Depends on how fast you want to lose them and how long you want to keep them off. 110g gives you the flexbility to eat more fruits and veggies and allows you to maintain your weight more easily after you lose the weight. You will lose weight much quicker at 20-30g of carbs a day, but its also harder for many people because at this point you're eating mostly protein, cheese, eggs, and non-starchy veggies.

Usually though when going low-carb it's recommended to try to stay at 20g for 2 weeks and then go from there. What this does is put your body in ketosis where it begins producing ketones and allows you to jump-start fat burning. Then you can slowly increase the carbs to 90-110g of carbs to allow more fruits and veggies and will allow you to basically maintain weight loss but still live comfortably (and hopefully maintain the weight you lost after too!).

The important thing is on either 20g or 110g you have to get rid of all refined sugar and flour. This is hardest part, but once you stick with it for 2 weeks you'll see all that weight come off and you'll be motivated enough to continue 🙂

Your insulin will thank you too as your receptors will start becoming desensitized and return to normal levels as most of us have pretty much put ourselves in insulin resistance from all those years of eating all that refined sugar!

[Marcy]

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@_daniel_ wrote:

3. Stay out of the middle of the supermarket; shop on the perimeter of the store. Real food tends to be on the outer edge of the store near the loading docks, where it can be replaced with fresh foods when it goes bad.  

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This made me chuckle because it is so true if not a bit sad.  However, I recommend the middle of the supermarket. The center isles are good for getting extra steps.

[Knowledge]

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@Marcy wrote:

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@_daniel_ wrote:

3. Stay out of the middle of the supermarket; shop on the perimeter of the store. Real food tends to be on the outer edge of the store near the loading docks, where it can be replaced with fresh foods when it goes bad.  

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This made me chuckle because it is so true if not a bit sad.  However, I recommend the middle of the supermarket. The center isles are good for getting extra steps.

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Haha 🙂

[Dominique]

Carbs seem to have a bad name, but they don't need to. There's nothing wrong with carbs, except that it's indeed very easy to overeat them (because they're so yummy). Low-carb diets are well suited for sedentary people. Most active people should have no problems eating carbs, and by "active", I don't mean being a marathon runner (besides, most marathon runners don't run a marathon every day).

In the end, any diet that create a caloric deficit will have you lose weight. It can be low-carb/high-fat, but it can be any other mix of macronutrients as well. You often read that you can't "out-exercise"  a bad diet, which is certainly true. However, it's quite easy to turn a caloric surplus into a caloric deficit by being more active, and Fitbit is an excellent way to achieve that.

One problem I'd have with a low-carb diet is that it makes it pretty difficult to have a normal social life. How can you eat out, visit friends, have meals with your family etc. if you can't exceed 100 grams per day (not to mention 20-50 grams)?

[Dominique]

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@Knowledge wrote:

Lots of studies have looked at comparing low-carb diets from 30g of carbs a day up to 110 g of carbs a day. What they found is the more carbs you eat in a day, the more the ratio of your fat to muscle loss increases. For example, on a 20-30g carb restricted diet, you will lose somewhere in the range of 2-4 lbs of fat a week, 99% being from fat and 1% being from lean muscle. At 110g of carbs a day, you lose 2.5 lbs of fat a week, only 70% from fat and 30% being from lean muscle.

So on a low carb diet not only do you burn fat faster, you will burn MORE fat than muscle, especially on a 20g carb restriction.

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Muscle loss occurs when muscles are not used, ie. not needed. Just witness what happens if you break your arm or leg and it's in plaster for several weeks: it will shrink. There is therefore an obvious solution (besides eating max. 20 grams of carbs) in order to minimise muscle loss: use them, ie. do strength training.

[Knowledge]

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@Dominique wrote:

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@Knowledge wrote:

Lots of studies have looked at comparing low-carb diets from 30g of carbs a day up to 110 g of carbs a day. What they found is the more carbs you eat in a day, the more the ratio of your fat to muscle loss increases. For example, on a 20-30g carb restricted diet, you will lose somewhere in the range of 2-4 lbs of fat a week, 99% being from fat and 1% being from lean muscle. At 110g of carbs a day, you lose 2.5 lbs of fat a week, only 70% from fat and 30% being from lean muscle.

So on a low carb diet not only do you burn fat faster, you will burn MORE fat than muscle, especially on a 20g carb restriction.

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Muscle loss occurs when muscles are not used, ie. not needed. Just witness what happens if you break your arm or leg and it's in plaster for several weeks: it will shrink. There is therefore an obvious solution (besides eating max. 20 grams of carbs) in order to minimise muscle loss: use them, ie. do strength training.

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Yes but losing muscle during diet and losing muscle by not using your muscles are two separate things. Low-carb diets advocate strength training as part of your weekly exercise regimen.

The point I was making is that diets are notorious for using lean muscle tissue as part of the fuel to power your bodies metabolism when you're eating a calorie deficit. A low-carb diet has been shown to use virtually no lean muscle mass because of ketones. Obviously not doing strength training will decrease muscle mass whether you're on a diet or not! 🙂

[Knowledge]

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@Dominique wrote:

Carbs seem to have a bad name, but they don't need to. There's nothing wrong with carbs, except that it's indeed very easy to overeat them (because they're so yummy). Low-carb diets are well suited for sedentary people. Most active people should have no problems eating carbs, and by "active", I don't mean being a marathon runner (besides, most marathon runners don't run a marathon every day).

In the end, any diet that create a caloric deficit will have you lose weight. It can be low-carb/high-fat, but it can be any other mix of macronutrients as well. You often read that you can't "out-exercise"  a bad diet, which is certainly true. However, it's quite easy to turn a caloric surplus into a caloric deficit by being more active, and Fitbit is an excellent way to achieve that.

One problem I'd have with a low-carb diet is that it makes it pretty difficult to have a normal social life. How can you eat out, visit friends, have meals with your family etc. if you can't exceed 100 grams per day (not to mention 20-50 grams)?

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You make good points. I think the reason low-carb is advocated as a solution to our obesity epidemic is because many Americans are not active. If you are extremely active carbs will not harm you. If you're sedentary you will just raise your blood sugar, induce insulin resistance, and eventually get diabetes as well as other metabolic disorders. 

And with a low-carb diet yes you are making a calorie deficit to lose weight, but the difference is your body is going to respond better to your hunger hormones because you don't have over production of insulin (remember, Insulin blocks signalling of Leptin, which you need to feel full). So the end result is you eat less and get full faster and longer as fat takes longer to digest than carbs do. Ketones have an important role too as Dr. Atkins labeled it the "metabolic advantage" of low-carb diets.

And I would argue I can very easily live on 20g and be social. Virtually every restaurant sell protein meals like steak, roast chicken, fish, salmon, etc. Not everything needs to be eaten with rice/pasta or breaded. Same thing with family. If they made chicken alfredo, I will eat the chicken and leave out the pasta. And because of the high fat intake you get full very fast and don't have to eat a large portion.

[captjim]

Thankyou for your post.  I have been counting calories and lost 30 pounds since January and have lost 30 pounds since Christmass last year.   What help myself is  the fitbit charge HR i recieved for Christmass. Last year i retired and was overwieght by a few pounds ( 192),  with a heart problems (taking Metoprolol 2 to 3 times a day).  After using my fitbit and excising and watching what i eat I am now 162 pounds and only need to take Metoprolol once a day ( the odd time twice).     

Plus after reading the above post,  i have notice i have cut down on Carbs / sugars not knowing the exact reason.   

I have notice there calories with very little nutrition  and foods with a lot of nutrition with a small amount of calories.   Example vegitables Letuce, Cabage , beans , tomatoes.  And then there are fruites like tomatoes , apples, oranges.   Although some fruits have sugars.    With the atkins diet do you have to cut out fruits and vegitables ?    And has anyone have info on the mediterranean diet ? 

[Dominique]

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@Knowledge wrote:

This time I am determined to do it differently, and now that I understand the science behind it I hope this can help both you and I maintain that weight.

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Since 1.5 years has elapsed since this fascinating discussion was started, it would be interesting to hear how @Knowledge has fared with his diet: have you sticked to Atkins / low-carb? if so, have you been able to maintain or lose with it?

I’m personally skeptical about our abilities to "manipulate" our hormones (insulin, leptin, ghrelin etc.) via our diet, whether it’s intermittent fasting, low-carb or whatever, and "trick" our body into losing weight. I prefer to believe in good old energy balance: whatever diet you can adhere to that will result in a sustainable deficit will lead to weight loss. 

[Knowledge]

Hi @Dominique, Just saw your post! Ok time for an update. From January 2015 through December 2015 I was extremely diligent on my "diet". I was eating an average of 1500-2300 calories per day and losing on average 2-4 lbs/week. My starting weight in January of 2015 was 306 lbs and my weight loss "low" was 205 lbs in December of 2015. That is roughly 101 lbs in 12 months, an average of 8.4 lbs/month. The majority of the weight came off earlier on obviously and slowed in the last 4 months of 2015. Then during Christmas break I visited my family and decided to "treat" myself. Only I really went overboard (probably eating an average of 4000 calories a day for 3 weeks) and had little to no exercise. I subsequently put on 15 lbs, of which 10 were fat. 10 lbs in 21 days is really not hard to do, that is a caloric intake of 1667 calories more than I was burning per day, something easily done when not watching what you eat.

2016 was a rough year for me, I could not go back to my original diet because of a stressful work life. A lot of stressful things happened this year which I don't want to talk about publicly but they did impact my diet significantly. I did not have the time to maticulously count my caloric intake and quiet frankly I found comfort in "comfort foods". I tried to avoid simple carbs and tried to eat mostly complex carbs like sweet potatoes, brown rice, whole wheat bread, etc (little did I know these are actually still simple carbs mostly...). By the end of 2016 I had gained back roughly 35 lbs of fat, and 10 lbs of water weight. Those 35 lbs creeped up on me. The average caloric intake surplus was only 320 calories per day! So yes just a tiny extra per day can add up. I have to say my exercise was very good. I was doing an average of 30 minutes of cardio everyday and weight lifting 3-4x a week. I was not at all inactive, but my diet was crap.

I've realized the only way for me to control my cravings is to cut out the carbs. So as of last week I have been cleansing myself with my original diet that worked and today is day #8. Lost about 7lbs of pure water weight and hoping to control the weight loss here on out. The good news is I am only 249 lbs right now, far below my starting 306 lbs back in January of 2015. Weight is a struggle for those that have insulin resistance like myself, but I believe as long as I don't let myself go I can keep it managed. So there's your update 🙂