Monday, November 14

The Truth About Super Obesity and Weight Loss

A little background on me and general stuff, before we begin.

I lost 170# on low-carb, which migrated to grain-free whole-foods a-little-dairy fairly primal, minus the 'grass-fed' element which is not do-able for me for several combined reasons. I have re-lost the last 50-100# of that repeatedly. I am, by category, 'super-obese'. When it comes to being fat, there is overweight, obese, severely obese, morbidly obese, and super obese. These are based on body fat percentage.

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I have come to understand that my expectations and my plans and my approach to eating, were not realistic.

I have come to understand that my experience, with the normal human variations, is echoed throughout basically all super-obese and many (not all!) of the higher-edge morbidly-obese people I have met in in person or online. I have also come to understand that what the science experts say, and the stats about fat loss and fat regain, echo my experience.

In short, if you remove the starry-eyed hope from the equation, you realize that pretty much all the facts from all directions say the same thing.

That's what this post is about. At the end, I have suggestions.




Take the best eating plans out there, for health, for sanity, for satiation, for nutrition: which for me amounts to basically "from moderate to zero carb depending on the person, grain-free, legume-free, minimal-fruits, whole-foods" eating plans.

Expect to lose fat. Whether you keep that weight off is another story entirely, but you can lose it.

If you are super-obese, expect to lose 'some' weight. Probably a lot less than you'd expect.

They're good plans. It's just a matter of inappropriate expectations.

I've come to consider these truisms.

1. Eating few carbs, with not-excessive calories, in whole unprocessed foods, does not solve super-obesity. It very rarely solves morbid obesity either, but that does happen sometimes.

There is no known solution for super-obesity. In fact, even severe gastric bypass will still only take off about the same weight you could lose just by eating awesome LC food, without screwing yourself up for life with nutrient absorption and other problems, so you might as well just eat decently instead.

2. The odds of losing all your extra fat are inversely proportional to the degree of your highest-weight bodyfat percentage. The odds of your keeping it off are very poor no matter what your starting weight, but are more remote in direct proportion to your highest bodyfat percentage.

The fat your body is likely to allow you to lose will still leave you severely if not morbidly obese. Women: up to 200 pounds, +/- around 20. Men: Up to 300 pounds, +/- around 20. It might be less. This is what can probably be 'affected'.

You will find that eating well (if you stay away from grains/fructose) is easy and in fact hunger is not only not an issue, but eating enough is. These kind of eating plans aren't hard. The food is awesome.

You will have energy while losing weight, which will change your life.

You will return to having none when you are not losing weight, which will screw it up again.

You can eat carbs for some energy then, when you must because lack of fat loss means you have no energy and makes you feel crappy if your carbs are too low. The body regains weight at truly breathtaking speed.

It's a cycle. It's predictable. You can see it coming. Feel it changing. You can plan for it.

You just can't do anything about it.

It's a Flowers for Algernon tragedy, except with bodyfat.

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I know most people don't want to believe it because they hope it's not true for them.  I know the rest either figure their eating plan surely works perfectly for everybody, and/or works indefinitely when it does, or that -- especially given I'm a fatso after all -- I'm probably just lying.

(I saw a study recently that said not only did the half of the subjects that were obese lie about their intake (yes. All of them. yes. Just their half. Really.) but they all lied even to the same caloric number as well, I think it was. Given variations in gut bacteria and the inaccuracy of estimates and variability of people, I don't even know how this could be done group-wide on purpose. I mean -- Seriously? When is this going to start to seem unlikely to someone? I do believe in doubly-labeled water in trials (which this was). I do believe people do lie or mis-remember their food. But I also believe there has got to be something else going on with how we evaluate this.)

Now, for weight regain, I assume we are talking about a subconsciously driven increase in food intake behind this. It doesn't matter, since asking someone to willpower through a few million years of evolution is just retarded. So it amounts to the same thing: if the body wants to put the fat back on it's going to, period. We can set the stage and the play by our food, and supplements, and exercise (if you have the energy), and state of mind, but that is all we can do.

The decision about weight, not entirely in the next few hours but definitely in the medium never mind long term, is still the body's, in the end, not yours. You can only kid yourself that it's yours when your body isn't one-upping you in a debate about it.

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You don't have to believe me: look at the facts, at the stats, at the research. Objective reality supports this as true, even aside from my experience or yours. It's just that most of us in food-related social areas online are too busy 'hoping' to want to pay much attention to ugly facts.

All food-related social groups online, even the ones I like best, are Disney-esque. We all want, expect, demand, happy endings.  We hide our eyes or leave the theatre of attention if we don't see one coming. Nobody talks about anything else but the positive.

If they do, either they are at best ignored or at worst cast from the tribe-of-blog, or it's implied that lack of success is rare and must be that someone didn't really stick with it, or do it right, or hard enough, or perfectly enough.

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There is a part of my mind that overrides objectivity. It rationalizes that even if I'm deluded, feeling better about things has its own positive element, and hope has a stand-alone value. So I tell myself:

Perhaps these eating plans work better for the super-obese if you have more 'perfect' food. The kind only wealthier people have. Everything grass-fed for example. Maybe then, some miracle would occur to make the equation work totally differently. Of course I realize that we could 'what if' every meal, forever, based on that movable goalpost of somehow-more-perfect.

But when I separate my hope and faith and wishing from the more objective part of myself, and I look at what I've seen with nearly everyone of great size online for 5 years, this appears to be the reality:

People can lose 200-300 pounds (+/- 20, the lower # for women, the higher # for men, with some variance for height/high-weight), before their body simply quits losing fat. It just stops.

I don't mean it's that long before they give up. If they seemed to give up, it's because what they were doing that was working, quit working, and eventually if you aren't insane, you quit repeatedly doing the same thing while expecting a different result.

As an online loose group community, we all assume that if someone quits losing fat it's because they gave up or messed up. We want to assume that, because it gives us hope. If it can just be the fault of the individual, it means it's possible. We can do it because we'll do better.

Does the body 'want' something to happen? I'm not comfortable talking about the body like it's a whole motive of intent on its own but then, I'm in a situation where it feels like that frankly. It does seem it has a certain homeostasis and possibly this is more severe the larger the person.

There are two variables: your food intake behavior, or how your body handles the food arranged by your behavior. Frankly it seems like if your body can't change one it can change the other.

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Eating plan social groups on the internet (generally in the blogosphere, sometimes forums), operate like casual cliques, by sheer force of mutual longing as much as anything else.

If something doesn't work for a person, others will tell them how they obviously can't be doing it right, how it can't be so, or worst case how they are just either (a) a moron or (b) lying about it and/or a troll.

This is not just applied to the overall situation of losing weight on a plan, but also to the assumption that the plan works 'indefinitely' for everyone (since sometimes, the people commenting and getting slapped around a little, were actually the success stories earlier).

It's a body-based cargo cult around food. If you build it, they will come. If you eat this and supplement that and exercise like-so, you too can be beautiful and/or at least cool with the credentialed, like our mascot who owns the blog.

I am seldom anything but positive especially on other peoples' blogs. So this is not based on anything I have said but observation of what I see happening with (and to) others.

When people are very successful on an eating plan, they're held up as a testimonial for the cause. When people who are very successful abruptly cease to be, well, nobody knows what to think about that. Including the people it's happening to.

Especially them. Because nobody said that could, let alone would happen. That would have been a dose of realism in a Disney world, we can't have that. Everyone implies it can't be an actual body issue; it's clearly some moral / discipline / honesty fail on their part. It's their fault because they ate dairy or a low-carb product or they didn't do intermittant fasting or ...

Funny isn't it, that you can escape the blame-game of modern society with a group of better enlightened people in the lowcarb - paleo - zerocarb - primal eating groups, who far better understand (in general) the issues of adiposity and food chemicals and so on, but it's still there, it's just lurking at the far edge of fat, waiting to be applied to the person who becomes an outsider once keeping the faith in that plan as a solution is gone for them. Psychology doesn't change, the application point of it just moves over a little.

Everyone is sure that they ate meat and lost weight and so if you do too, you will too, and if you say it stops working for you, you're not losing weight, you feel horrible eating that way now, well you're just not trying, or you're (I am not making this up) probably eating too many almonds or something.

There are a tiny % of morbidly obese people who lost the weight and have kept all of it off. Even in their own class, the statistic is incredibly rare and precious. Very inspiring. There are a few more who have kept 'some' of it off. But even these people are not necessarily in the same body-response group as the super obese. In practice at least, it does rather seem like there is a sort of strata, or bandwidth of category, in how bodies respond. My totally unscientific observation over time is that it it seems tied at least somewhat to bodyfat % from the person's highest-weight. No matter at what weight they began eating lowcarb/primal.

Spend years on the internet in areas where super obese people come and go and talk about their results and you realize it is such a pattern that it is THE pattern.  There isn't another pattern. That's it. This is  reality.

All the just-not-mentioning-it from experts is either because they are still back in the dark ages thinking you just aren't trying hard enough, or because it isn't the upbeat keep-the-faith profile they must maintain in public, or maybe they just plain don't want to depress everybody, or dissuade the people who need to eat well most, from bothering to try at all.

Or maybe they just don't really know.

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Generally, the public assumes the super obese are no different than anybody else when it comes to metabolism, just fatter. But this context also says that anything can happen, as the faith of the day. There will be rainbows, and someday, with enough primal paleo lowcarb food, you too can be a size... er, ok, well maybe a size 14, not a size 8, but it'll work out ok even if not as ideally as you hope.

Even on the rare occasion it's acknowledged weight loss may be a bit incomplete or imperfect for really big people, it's always made to sound like you know, you might have to accept a few sizes of difference. It's presented more like those last 20 or even 30 pounds might not get powered through. Nothing is ever specific or stark enough to indicate otherwise, let alone that it may well be drastically otherwise.

It's not anybody's fault the human body is what it is or behaves like that. The body is awesome, I'm sure it has got excellent reasons for this, we just don't happen to understand them yet.

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I think if I hadn't built an edifice of hope on believing I could lose even the majority of fat, it would have been less traumatic.

The biggest thing is that "demoralized despair" would not have ruined me many times if I had understood that this just IS the way it IS. I could have focused differently, if I had known.

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Stages of Weight-Loss Reality for the Super-Obese

I actually thought it was possible. I lost so much weight so fast. I was so happy. I thought I had proof. I thought I knew what worked. For the first time in a couple decades I had hope. I was even proud.

For the first time in that long I had ENERGY. To make dinner, never mind get involved with life, clean the cupboards and lift weights and move brick in the yard. That alone was worth its own  glory. Hell, I would trade body size wishes for some energy, that is the primary issue.

I actually started making plans for having a life. I started thinking about things I had protected myself from thinking about before, because they'd seemed impossible. I felt so good, I was sure there were no limits.

It was honest to god the most exciting thing imaginable.

That's stage 1.

Stage 2: The "WTF?!" moment. What the... wait, what happened?

Stage 3: That horrible growing fear that maybe you were wrong. You KNEW it was too good to be true. Should you have known better? But no, but it couldn't be, but this works, it really does, it's just keeping-on, right, it will work again, if I just keep doing it, keep doing what totally isn't working now, but doing it harder, yes that's it. I will eat LOWER carb... I will eat ZERO carb... anything worth doing, is worth overdoing, I will cut out all foods but beef-chicken-eggs and supplements and drink a gallon of water a day, I'll find every way I can to do it more and do it harder!

Stage 4: The adaptive response. OK, that's just not working and I can't do it any harder. I'm not losing fat and I feel like crap, I could deal with one or the other but not both. So what else is an option? Small meals big meals intermittant fasting days high fat low fat coconut oil is the answer days zero carb cycling carb higher carb lower carb no gluten no dairy no legumes no nuts extra water let's just fast a day or two a week yes that's the ticket, there's got to be an answer, it's just a matter of looking, please god let there be an answer, surely it's here, I've had 35 variants looking for a solution but I know there are more --

-- and suddenly you've become a primal paleo lowcarb yo-yo dieter even if you never even dieted before.

Stage 5: Then you almost wish you hadn't hoped in the first place. Hope HURTS when it's crushed.

Rinse. Repeat.

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All this is because in our mindset based on faith, we assume there IS an answer. That even though there are few to no 5 year success stories in this class III category, that this doesn't reflect reality, there's probably just not many sure but I'll be an exception.

That even though world experts like Dr. Jeffrey Friedman actually have spelled out publicly precisely this experience, that it'll be different for me.

He could not have made it any clearer: the body of people who were huge, lost tons of weight, at which point they were still obese or morbidly obese, but then just stopped losing fat. No matter what, even when in a metabolic ward eating 700 calories a day as one example.

The body has a limit to the fat loss it will allow and that is that. It's a very high limit so it doesn't affect most people.  People who are much past the morbid-obesity point, run into it. Here's humor of a sort: If they're just somewhat past that point, they might merely think it's a problem with the last 15-30 pounds, and everyone says to them, "well gosh that is what your body is happy with," or whatever.

If they are still 100-200# over any sane weight, that excuse is obviously not going to work, since nobody is suggesting 200# overweight is healthy and your body's good with that. Yet it's actually the same situation.

But socially, whether people will tell you that it's your body's choice, versus your screwing things up in some way, depends on whether you tell them how much weight is 'left' to lose to be lean. Even though the equation and experience doesn't change based on that.

At that point, you see that there's something else going on. According to Dr. Friedman, nobody actually knows what's going on or why. Nobody knows why people really huge can lose a whole lot of weight but then, even still morbidly obese in some cases for example, fat loss just stops.

And obviously, when you no longer have fat cells dumping their energy into your blood constantly, your energy level changes too.

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I'm less disappointed in the fat loss part, than in the part where I haven't motive energy.

The bipedal walrus body is just horribly inconvenient and a social nightmare. That part I can deal with better; the energy void, though, is devastating, life-wide. You have no functional life if you have no energy.

My biggest issue currently, is a cycle:

1 - what appears to be an adipose-cell fog of leptin (a superstitious guess, this just makes sense to me) that makes me have no appetite 95% of the time (a situation I've had for years and years)

2 - no motive energy at all makes it very difficult to force myself to even walk to the kitchen never mind cook, especially as I am not hungry

3 - which eventually results in body nutrient-famine response punching through that fog and driving me to eat, specifically targeted at the most immediate and intense energy sources.

It would be extreme binge-behavior, and can be if I don't plan in advance for its inevitability and have things on hand. If I get immediately to saturated fats and a little protein and stuff it down me before my body (which is basically freaking out) starts eating everything carby/sweet in sight at high speed, I'm ok. I'm pretty good at heading it off at the pass, cheese is my friend for that.

While it calms down, I have time to cook something substantial. I can eat for a few days then, have just slightly more energy during that time to get up and cook, or more like a slight glow-reminder of it, anyway, and slightly more desire to eat.

Then the bare hint of energy fades and the appetite drops and the whole cycle begins again.

This is because I am not on an eating plan. If I were, I'd be forcing myself to eat according to plan.

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I have come to believe that the super obese are all in pretty much the same situation as a generality, at least.

I feel like nobody is being forthright about this, I mean the experts we all read. There are a few likely good reasons. But either way, nobody is giving people of this size reasonable expectations.

With the super obese, we're talking about a predictable profile. Not just one person here or there that we can assume is screwing it up. It isn't, for example, just me; I can't be responsible for why gastric bypass patients in the science lab have, interestingly, about the same experience I've had, even though I've lost my weight through "eating well" instead of through surgery and starvation. I can't be responsible for what I see in others online with the same experience who even have different eating plans, or went a shorter or longer time, more or less weight, before basically the same thing happened.

And while I'm at it, I'd just like to add that this profile is not limited to the super-obese, it merely appears to be the 'given' for them. It is the norm not the exception in the morbidly obese strata as well, but there ARE exceptions in that bandwidth, there are people who lose 'all' their excess weight and actually maintain that -- they are rare but it does happen. (There is a larger % in that strata that do lose and keep off 'some' fat - a lot of it. So that one at least has more hope.) And this profile is 'not uncommon' although it's not the norm in the severely (but not morbidly) obese strata -- I use these groupings only for convenience.

So, to me this does indicate that the human body has some variation in when/why/how it applies this "cessation of fat loss without regard to food intake/exercise/etc." experience. The experience is not limited to the super-obese, it's just almost-if-not-entirely inevitable with them.

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There are things that seem to come with this body size, experiences, that may not be the same as people with less fat lost. People have symptoms, body changes, and don't know what to do about it or what it means. Sadly, if you report such things, you're told you're wrong, that it isn't happening as you report. So... what? You're an idiot? You're lying?

One small example of several: after losing a LOT of weight, one can develop reactive hypoglycemia, even to nearly zero carb meals. Allegedly, this just doesn't happen on low-carb. I've seen it stated flatly more than once, and in direct response to someone who just freaking said plainly it did, no invalidation there...

I'm not diabetic, but I bought a blood glucose monitor specifically to figure out this issue. Was I hallucinating, when I'd nearly pass out from the blood sugar drop, after the bacon or sausage and eggs breakfast? The same one I'd eaten through losing about 130# at that point, now suddenly affecting me like a megadose of pasta would have at my highest weight and worst insulin resistance state?

So I checked. Hey! My monitor was hallucinating right alongside me! I consider its readings a more objective answer to the question. Obviously, for me, it does happen, even on lowcarb, hell even on what most people call zero carb.

This does not make me confused about what I really ate, or unable to count to 5 carbs, an idiot or a liar or whatever. It just means that this legitimately does happen.

It also happens for other people, who are the ones I've seen talking about it online (I haven't brought it up in blog comments, but others have). That becomes the one-white-crow theory of course; if it happens for anybody, then obviously it IS possible.

To me, the 'anomalies' in any science are the most interesting questions. It opens the door to understanding something that obviously, we don't yet. Why does this happen? Why does it seem to happen to people who have lost > 100# for example? Why does it seem to more often be reported when a food like eggs are involved?

(Note: Dr. Ray Peat actually has the solution to this, but you won't like it. Orange juice is tasty suicide, in the food world I've been indoctrinated with (although RP says fructose is deadly in combination with PUFA, but not for example without it). What I found impressive was that he knew about it, and had already written about it, while other experts were just telling people their reported experience of it didn't happen.)

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It is socially awkward when experts talk the facts. Like there being in many folks an obvious but weird cap on fat loss, as Dr. Friedman talked about. Or there being, in pretty much everyone, no known solution to avoid weight regain, as Dr. Sharma talked about.

I have only my experience. It just so happens I see it echoed all over, pretty much universally in people who began super-obese, and then in smaller but still significant percentage in the morbidly obese group.

Some dysfunctional element on the part of people who don't want it to be true--that includes everyone, that includes me--makes it the thing nobody talks about.

Good eating does not solve super obesity as a problem because nothing does. That's the way it is.

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I am forcing myself to say it publicly so it will get said.

I expect that this will make people mad, and they'll say, you shouldn't demoralize others.

Or, "just because it's that way for you doesn't mean it is for all." We all want to hope so.

I would rather people tell me the truth than just make me feel better, especially when we're talking about some very physically, emotionally, and even financially powerful stuff involved with years of effort at weight loss. So, I want others in my situation to have an honest reality check.

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So what's it mean? Should morbid to super obese people not even try?  It doesn't mean that at all.

It means that the end-result experience will be different from people trying to lose 30#, generally, and that, if we know this in advance, our approach to the experience can also be different, which hopefully will improve and extend both the initial experience and the end result for people of great size.


1. Definitely people should make an effort to eat well. Even if you didn't lose a single pound, and you will for sure, you would still be way healthier, minus a variety of medical symptoms, improve your body in other ways, it is still well worth the effort. Eat better or die, it's a pretty simple choice. Life extension is really the primary thing here. Every harmful thing you put in your body, every medicine you have to take for some symptom, is shortening your life.

It took me less than 3 weeks on meat/eggs/cheese lowcarb to discover that my severe asthma, severe allergies, severe acid reflux, acne, brain-fog, bloating, and more were gone. It was amazing. As much of that was due to wiping out gluten as carbs, I might add. But even if nothing else had ever happened, this alone would have been totally invaluable.


2. Supplement the hell out of yourself from day 1. I don't care if you don't think you need it or people assure you that just eating meat and a multi-V is plenty. You've  probably years of profoundly, crisis-level nutrient-depletion if you are morbidly or super obese. Even if that weren't so, research shows your bigger body needs more nutrients. Anyway, so what? As long as you are not overdosing on the very few things that have a known upper limit, then why would it hurt? And if it IS needed, it could make a huge difference.

In my next post I'm going to give a summary of the general supplement recommendations I have collected over time for alleged best health and weight loss, from sources I respect. It'll be up to the reader to go look at the blog links I will provide, see what and how much they (or your own people) recommend, I'm not providing specifics on purpose. But I will outline the map of what's included, so you know what to search on. Bear in mind that everything in the body works together. Supplementing any one thing without the others may result in even more imbalance. (Probably much less an issue for things most people dearly need, like magnesium, Omega 3's, K2 and D3, than things some people are already too high in, like iron.)


3. It's so easy to drop low in calories, not be hungry, live on meat, lose weight and feel awesome about all of that. This may actually be an even bigger issue with bigger people because you're more likely to lose larger amounts of weight faster, than leaner people -- for awhile, of course. Not indefinitely.

Force yourself to eat more good fats and more calories, to have the maximum amount of nutrition possible in each day without gaining weight and hopefully while losing as slowly as possible. This is only my superstition, but I feel the body might react with less 'resistance/panic' to high pound weight loss if it's more gradual and there's plenty of calories and lots of nutrients coming in, than it does when it's a massive fast lost, the person is chronically undereating, and the nutrient profile is very skewed by limited food range. Doing this won't necessarily prevent a cessation of fat loss, or the regain-response; these seem to be fairly unavoidable. But it might allow the total weight coming off to go on longer/be greater, which to me seems good.


4. Shift your thinking about it, this is the most important thing. For the super-obese, the goal is completely different. The goal isn't to lose as much weight as possible, as fast as possible. That idea is based on the thought that once this happens, then wherever you are, is where you stay, and you live happily ever after. That's not the reality here.

The destination of even "most" of one's fat lost, is unlikely (if not impossible) to reach for the super obese. And whatever (usually still extremely fat) point one reaches when the fat loss stops, that usually just means the end of the road, and at that point your body will be pushing regain through one or more avenues.

This doesn't mean it's hopeless, it just means that your focus needs to be different. In this case, weight loss is truly an example of where the "journey" is the thing to enjoy.

Fat loss = energy to really fat people. One of the primary problems super obese people have is no freaking energy. This is fairly obvious, as the energy is being stored. The best part about losing weight when you are super obese isn't that you are losing weight. It's that while you're losing weight, you have some degree of energy, because your body is dumping fat cells (energy) into the bloodstream.


So the goal is not thin-ness, it is functional motive energy. With that energy, you can 'have a life' to whatever degree possible, and that might include getting in much better physical shape for example. Without that energy you are treading water, at best.

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Let us say that your body is going to allow you to lose, 190 pounds, to just pick a number. Now, you can lose it as fast as possible, and have lots of energy during that time; or you can eat as many carbs/calories as lets you lose weight, but no less because that increases the degree of ketosis and weight loss, and you want to take what amounts to the maximum possible time to lose what your body allows.

With the latter approach, you have some energy. You have it for as long a time as possible, while you go through the fat loss.

And as an added bonus, if #3 turns out to have any validity, this way you might even get to have even longer in the loss period, and lose even more of that fat, as a result. In fact, since your carbs and calories are also higher in this model, if #3 has any validity, this #4 would add to it even more.

With every pound you reduce from wherever you are (even if this is happening in the 15th cycle), you are a little more limber, a little more strong/light by comparison. It's all good.

The weight-loss period itself -- not the end goal but the period during which it occurs -- needs to be the actual focus. If it's slow, as long as you have a little bit of energy, it's good. The measure of 'adjustment' of your macronutrient intake should be based on what makes you feel fairly decent.

When I thought that I could lose most my extra fat, my big drive was to do so, intensely. Now that I understand that this is just plain not going to happen, and that there is pretty much some body-allowance for fat loss quantity, and then a return-reaction that most likely will increase the weight again (doesn't have to be the full amount of course--there IS a 'degree' of success possible here), now I understand that the period during which I am losing weight is the best part.

I would rather spend 2 years losing the same amount of weight, as 4 months, because that means I had two years of some energy to live my life with, before it changed. Even if not a ton of energy, even 'a little' is more than most super obese people have.

It is not healthy to lose/regain weight repeatedly. One can only hope that doing so as slowly as possible in both directions, will reduce the degree of harm.

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I believe that if I had gone into this with realistic expectations, and if I had taken the approach I outlined above as a result, that my body might have allowed somewhat more fat loss overall, that I would have spent much longer in the happy phase of feeling decent, that I would not have stressed my body remotely as much with fast lost, and with under-calories, and with under-supplementation, that I would not have essentially become a low-carb/primal 'yo-yo dieter' in my desperate attempt to find something "else", some tweak of better-perfection, to restore the initial loss and energy level.

I would not have gone through a lot of trauma of having to radically readjust expectations. For those who think this is a little thing, I'm here to tell you that super-obesity is the health equivalent of being in a wheelchair -- worse, in some respects, since even people in a wheelchair can have the motive energy and enthusiasm to make dinner or attend the kid's soccor game, and the social reaction to someone normal looking in a wheelchair is probably better than the social reaction to someone who weighs 450#. You'll just have to trust me on this one.

Thinking this problem is fixable, then suffering the cycles of trauma because apparently you're just not good enough or your plan isn't perfect enough, only to finally realize--from looking at the stats, listening to the experts, and observing people in the same situation around you for years--that actually... it isn't fixable -- well that sucks.

There is a degree of "flexible" in the middle that you are welcome to go down through, and your body will arrange your coming back up through also, and then you can attempt to go down through again -- well, that's what there is to work with. If you know that, you can actually work best with it and get the maximum happiness and health from it with the minimum harm. If you don't know, you just harm your health worse and suffer instead, because you have a completely different goal, and you think the way it's working is that you aren't trying hard enough or not trying the right thing or it isn't perfect enough or whatever.

So this is not what anybody wants to hear. Even me. But this is the truth.

The Fat Acceptance people will probably say they knew this already and it supports their point.

I am not depressed. I am disappointed but I'm moving past that. You know, life is what it is. I could be dead of disease, and were it not for my body's ability to allow unbelievable amounts of fat storage, I'm sure I would be. I could have lost limbs or be paralyzed, or be in chronic pain, or be stuck in some starving or war-torn country, or have my body and mind forever screwed up by horrible combat experiences -- the whole world is filled with people in situations who deal with it every damn minute, hour, day.

I am huge and have no energy. I say I have no money but compared to most of the people in the world, my good job and teen I have a good relationship with and the kitties and the garden and the 3 bedroom tract home in nowhere Oklahoma, are a combined wealth beyond imaging. Frankly, comparatively, my situation is pretty damn good. It just isn't as good as some others. I'm not going to complain.

To a great degree I feel it is slightly late for me to be attempting to explore the different-approach to all this that I outlined above. I have already dug my hole in deeper with the way I have behaved with fat loss and my attempts at it over the last 5 years. But, I am ever the optimist. I'm going to take my own advice, and see if I can find a max-carbs max-calories max-supplement plan that allows a very slow fat loss with some residual energy side effect, so I can at least have more of a life than my weight-related energy-depletion otherwise allows.

PJ

30 comments:

Muchadoaboutnothing said...

I am in the process of losing weight on low carb and reading this has been a bit depressing (I was 437lbs when I started losing 6 1/2 years ago, down to 258 so far) but I think you're right. We need to have more realistic expectations about weight loss.

Anonymous said...

http://diabetesupdate.blogspot.com/2009/02/type-2-diet-poll-results.html

"So most people who maintained maintained a weight loss that was between 9% and 31% of their starting weight.

This is probably the most important statistic of all as it gives you a very good idea of what a realistic weight loss is that you can expect to maintain."

PJ said...

Anon: Thanks for that! Though I assume you realize that self-reporting polls are forums are going to be profoundly skewed toward positive responders (even the forum itself is) (and it was not about morbid/super obese; as noted this issue of fat loss never mind maintenance appears to just get worse the heavier one it). Still that is an interesting poll, thanks for the link (I hadn't seen that blog before, I will read some more there).

Much: Congratulations you've done a truly awesome job! Sounds like it's gone slowly overall which might be good. If there is anything likely to move it more than anything else, or at least keep it off, maybe both, it is "longterm persistence." By which I mean many years... as you've put in several already.

PJ

KMG said...

On the other end of the spectrum, I have seen many raw foodists go through this same thing of feeling great for months or even years, and then getting incredibly ill. They're then told that they're doing it "Wrong" somehow, even though they'd been poster children for the movement before, and it initiates a frantic and fruitless (no pun intended) attempt to alter the plan in whatever way will restore their former glory. The level of vitriol directed at "defectors" is unbelievable. "No, this is The Right Way to eat for EVERYONE and therefore you are a liar, a fraud, or a secret agent of the Dairy Council!"

I don't see how there can ever be a right way for everyone, because life damages our bodies in endlessly variable ways through toxins, pathogens, overuse, etc. And although our issues aren't the same, I have experienced a lot of those stages you mentioned on this lonely path to figuring out how to be healthy ... including the acceptance that I might never be healthy again.

So thank you for having the courage to reach your own unpopular conclusions and share them. And on a metaphysical level, I find that great change often comes once we find ourselves truly ok with life remaining in its imperfect state.

PJ said...

K! I've missed you.

Yeah - psychology doesn't change, no matter what the eating plan. I don't think any of the food camps can compete with the vegans for terror tactics, but then, maybe that's because subconsciously their body knows: if I kill him, I could eat him. No body to hide! ;-) But they've all got a big dose of the same thing.

Completely revamping my concepts to instead eat "as much as" possible in carbs-calories "without gaining weight" (and preferably while losing slowly), is going to be a major pain in the butt.

I've just finished changing my blog display. I'm taking weight loss references off it. People should eat to be healthy for them anyway, first and foremost.

I was doing a few weeks on a halfway version (because I don't have grass-fed meats which is central to it) of Ray Peat's suggestions, and it was like, "OMG I ate a potato fried in coconut oil. Earlier I had a glass of fresh orange juice. I'm drinking whole milk. OMG! I'm going to DIE!"

I realized how much 5 years of low-carb / whole-foods has affected me, that something like "I need to eat a potato now" nearly made me feel like I was being coerced into some kind of criminal activity. ;-)

I have a hard time eating period, never mind eating minimal calories, so how I'm going to swing maximal calories is beyond me... I'm still working on that. First the plan, then the details. I suppose I need to buy stock in tropicaltraditions.com where I get my coconut oil.

Don't be a stranger. Oh wait. I owe YOU an email. Ahem, ok, never mind.

PJ

Orodemniades said...

You know you're awesome, right? I'm just in the death fat camp (morbid) but I think your article explains where I'm at now and why I seem to be unable to stick to paleo. (having said that, I'm poor and feeding, clothing, and housing 3 people on less than $1000 a month, net)

I have a chronic pain issue unrelated to weight that no one's able to explain, I'm currently in therapy for anxiety and panic attacks, we're trying for another baby (time, people, time), sleep, who needs it yadda yadda yadda. I don't even know why I wrote all of that - venting, I guess, for which I apologize.

I'd also like to say that for some of, there was never any rapid weight loss to begin with. Frex, the first 4 months I went lc Atkins, unfortunately) I lost...nothing. Not a single pound. The more I exercised, the longer I would stall. Stop exercising and there might be some shifting. All in all it took 4 1/2 years to loose 50lbs - which I've since regained after deliberately going off plan. Moved countries, started in on my nemesis, wheat, and, well, let's just say that now I'm the fattest I've ever been.

But I like your cycles as posted here. It makes sense and, hopefully, will lead me to being less depressed about myself, or beating myself up about something I have no control over.

PJ said...

That is a lot of stuff to deal with at once and not remotely enough money my gosh!

Weirdly, I actually feel BETTER after posting this. I mean actually more inspired than I was. Maybe you have to hit the bottom first, or maybe it's just that I finally feel like I'm in the camp of "realism" and I find that easier to deal with than "the unknown mystery in a blackbox body."

It's still unknown, but working on getting max nutrition per day (as long as weight doesn't rise) vs. being lucky to make minimums, is a different approach. It might not work, for time/energy/money reasons. But it's something different than I've done before, so it seems like, anything different is good.

I had some content I removed from this post which talked about a period where I had eaten horribly and gained tons of weight.

When that happened, I had chronic lung infections (gluten) that nearly killed me, I had serious sleep apnea issues, the combination meant I was profoundly low on O2, I was working insane hours, single mom to a small kid, and I see in retrospect that a lot of my fast food megacrappy eating was just flat out trying to get enough energy to survive. I actually forgive myself a little more now. You know, we live, we learn.

You have a lot of stuff that has probably contributed to the last upcycle. But that's one more cycle of learning that can make the next one hopefully go a little better!

PJ

Anonymous said...

PJ, this is an awesome post, and I love you for writing it.

While reading through it, I started thinking that you show all the signs of having an insulinoma. Have you been checked for this? Just a thought.

PJ said...

No, haven't checked for tumors on organs, I admit. I don't feel like I show signs of being any different than the other super-obese people I have run into. If I seemed markedly diff in some way I might think there was something specifically up with me (I mean more than whatever the obvious is that lets a person ever get that huge to begin with).

There is a thread about this post on the ACL forum with some interesting comments. http://forum.lowcarber.org/showthread.php?t=435447

Strangely, this post must have been hitting bottom because I feel oddly cheered up. I guess maybe like you don't have anything to fear anymore when you accept that it might just suck and then go forth to make the best of it, whatever is possible, instead of constantly feeling angst about it.

I have to walk to the store. Isn't Autumn lovely? Although it's getting pretty freaking cold now...

PJ

Anonymous said...

Re the insulinoma comment, the thing that rings alarm bells for me is your having hypoglycemic episodes after a vlc/zc meal. Your insulin levels must be WAYYYY too high for that to happen, and if long periods of vlc is not bringing insulin down, there is something very wrong, and one obvious answer is an insulinoma.

WereBear said...

One thing that really rang true (and hopeful!) is your determination to get healthy first; and then let whatever else will fall into line, fall.

Because your conclusions seem rock-solid to me; something was wrong somewhere for you to have gotten where you are now... without dying.

State of medicine being what it is; you actually have the best shot at figuring it out, because you are not blindered by prejudice, you are not sidetracked by "that can't be" and so have the best take on the problem.

My sincere hope there's something wrong that can be fixed, ya know?

PJ said...

Well, the reactive hypoglycemia did not begin until I had lost about 130#. I responded as you'd expect until then.

I have tested my blood sugar during a fast from one evening to another, and from the minute I woke up until the time I finally ate something late at night -- I didn't even drink water until evening -- my blood sugar went from ridiculously low to higher in mountain-like V's all over the graph (which I tried to find to link here but can't right now).

So it's not that I'm either putting out constantly too much or constantly too little. It's just 'reaction' goes too high, drops too low, then adrenalin/cortisol kicks in when it's too low which sends it up again, not an atypical profile for insulin resistance.

We'll have to hope it's not some disease because getting me into a doctor to look for cancer has less chance of happening than fairies arriving in the night to grant me thin thighs. ;-)

In retrospect I feel I know what dominantly contributed to massive fast weight gain. I don't know but assume genetics are what 'allowed' it instead of my getting ill, obvious disease, or having a nervous breakdown. I expect every organ is very taxed, body is long term nutrient deprived, and that these issues as well as ongoing decently high calories probably need to be resolved as a primary, no matter what else I do.

Mind you, that doesn't change my mind on the details. I still think the chance of me as a woman losing more than 200# +/- 20# is unlikely to the point of unreasonable to expect. (Nothing is impossible. But some expectations are unreasonable.) But I would be pretty damn happy for that much loss, and I got fairly near to that before coming back up (and down, and up, repeatedly).

So I accept there's likely a limit and I'll likely go up and down, what I would like to do now is see if I can intentionally control that process, to make the going-down cycle longer (to extend the energy and potentially the amount the body's willing to lose), to make the going-up cycle longer (accepting it's going to happen, so not freaking out when it begins and ending up offplan entirely because I'm so demoralized), and to make both sides of the cycle much more focused on maximum nutrition.

ItsTheWooo said...

Assuming your perceptions are correct, it seems then that you should focus on finding a work around for the defect that occurs in this phase:

You will return to having none when you are not losing weight, which will screw it up again.

It appears that this phase - lack of ability to lose more body fat - is the catalyst for cheating (eating carbs) and thus rapid weight regain.

Have you ever experimented with an insulin suppressive medication such as somatostatin/octreotide, or metformin? What you describes sounds supsiciously like severe insulin resistance, to the point where your insulin levels are not able to be reduced enough via carb restriction alone. This then results in fatigue and hunger after you lose x amount of weight... because, once you reach x amount of weight loss, your fat cells have shrunk more than your insulin has reduced, therefore you have a deficit of FFAs from fat tissue due to inappropriate high insulin. This inappropriately high insulin leads to an inability to lose more weight, with symptomatic fatigue and hunger, which leads to eating carbs for energy.

Some people, who are severely insulin resistant, will not have palliation via low carb diet alone. As a registered nurse I have taken care of bed bound super obese people - these people require tons and tons of basal insulin even if they are eating nothing at all. It seems to me, the problem here is the person is so extremely insulin resistant that their insulin requirements are overwhelming, which keeps them from diabetes but it also keeps them extremely obese as it prevents normal fat oxidation/FFA release during food restriction.
There is an imbalance of insulin sensitivity; the fat tissue is inappropriately sensitive relative to liver and skeletal muscle. The person easily develops diabetes when their insulin levels decrease, but if the insulin levels are increased they are extremely obese.


I was a morbidly obese person but I have always suspected that my insulin resistance actually isn't that extreme - I have always suspected my primary disorder is insulin hypersecretion, not unlike an insulinoma patient, my metabolism is relatively normal, the problem is that my pancreas is like HI INSULIN HERES A LOT OF IT. This explains why my fasting sugar is always low and I easily develop hypoglycemia, and I have signs of hyperinsulinemia (generalized subcutaneous obesity, PCOS, acanthosis nigricans, hypoglycemia), but no signs of insulin resistance (e.g. abdominal obesity, hyperglycemia). I am positive for all signs of insulin excess but negative for all signs of insulin resistance.


This is why I am able to easily lose tons of weight, effortlessly, on low carb... my metabolism works pretty normally, if I do not eat food that asks for insulin release too much. My stomach is extremely flat, I have like no abdominal fat. I have no signs of insulin resistance, but tons of signs of insulin excess (when fat).

The problem, as i see it, is that my body does not seem to process glucose normally. I am NOT resistant to insulin, I am glucose intolerant. THis is a slight difference. The difference is that when my cells try to oxidize glucose, something goes wrong, which results in inappropriate high blood sugar and a swift release of insulin. My insulin sensitivity, being otherwise normal, means that my glucose plummets quickly and I am very hungry and gain body fat (due to insulin sensitive fat cells). If I were insulin resistant, I would not have hypoglycemia, I would have more significant hyperglycemia, and I would have evidence of visceral fat accumulation which is consistent with insulin resistance in adipocytes.

ItsTheWooo said...

(pt 2)


Reading your story I wonder if perhaps you would benefit from medical interventions to address extreme insulin resistance...


Reading further down you rpost, it seems like exessive insulin proeduction is precisely the disorder you have. It is very very abnormal to have hypoglycemia after eating bacon and eggs.

It appears that you have a very significant endocrine/metabolic disorder and I feel sorry that you have not found the answer yet. It's a shame that when doctors see a fat person, they think "gluttony, nothing further to investigate" when in reality there is a physiologically real issue at hand - one that might be able to be treated and resolved.


THe point I am making is this: Do not give up hope. The solution is not complacence and acceptance, the solution is to look at your situation in a novel way. Diet and supplements are not all there is. YOu need to look to modern medicine for answers.


You have proven to yourself that standard carb reduction is not enough to resolve your hyperinsulinemia and insulin hypersecretion.

You have proven to yourself, that after you lose a certain amount of fat, you start getting signs of low blood sugar which is suggestive of defective fat oxidation and high insulin. Fat oxidation + low insulin will prevent low blood sugar.


I would suggest possibly being screened for an insulinoma, as a first course of action. It's happened before, tremendously obese people get bariatric surgery only to discover they have inappropriate hypoglycemia when they are not allowed to eat anylonger. Further tests of insulin and proinsulin and cpeptide and ketones reveals the truth: chronicly elevated insulin, leading to chronically suppressed fat oxidation and blood sugar. You may be one of these people.

Or, you may just have garden variety severe insulin resistance. Symptomatically, it's not much different than an insulinoma: severe obesity and an inability to oxidize fat at rest is going to be the result of chronically elevated insulin due to severe insulin resistance.

Dieting harder or more is not going to help... if I were in this situation I would be doing all the research I could regarding theraputics for hyperinsulinemia.

I don't see the solution as to say "it is the way it is" and to just keep dieting. Modern medicine may be able to help you. Insulinomas are treated via surgery, and there are many medications available which can suppress insulin levels / improve sensitivity to insulin.

I think it's good to have realistic expectations, but the solution to an inability to diet successfully should not be to just accept illness (and, hypoglycemia after eating eggs + bacon, in spite of ample body fat, suggests a defect and IS ILLNESS).

This, I think, is the problem with paleo thinking: an irrational belief all diseases can be treated "naturally". I personally do not like the paleo theory of things, and I think it is irrational to assume conditions should always have natural solutions. MOdern science and medicine is a fabulous thing, the only problem is when it is used stupidly or greedily. We can save lives and easily cure illnesses today, if only the doctor knows what he is doing. Tubers and rice and nuts and berries are not going to cure an illness, but modern antibiotics will. Medicine is not a bad thing. Sometimes medicine is the only thing that can help us.

If diet fails to work, the next logical step should be modern medicine.
Look at your condition from a new perspective, there might be solutions out there you have not yet discovered. Look beyond the trivial, small and obvious (diet). There is so so so so so so much more you can do for inappropriately high insulin besides avoid eating carbs.

PJ said...

Hi again Woo,

Thanks for the feedback, I appreciate the time you spent on that.

You know, here's the thing: I don't think I am exceptional. I think that within the bandwidth of people "my size," I am pretty much just like they are. I do not see anything specifically different when I lurkedly-stalk others my size to see their body reactions.

Now, unless tumors account for everybody who is ~200++# over their desirable bodyweight -- and I just have a hard time believing this -- then I should be in some different category of experience.

(I've come to suspect, from research refs on everything from hunger to exercise, that a person's highest bodyfat% is the driver of everything, not what they are today. So when I am at 380 my body is behaving the same as when I was 520 except that a) less filled fat cells, which makes some diff, and b) usually at that point I've been seriously LC-ing, so some diffs related to that. But otherwise, there seems to be plenty of evidence that whatever top point you reach, is what the body is ever-striving to use as a guideline.)

So for example, I've seen reference to reactive hyperglycemia after a super LC meal in *lots* of people online in the last 5 years -- most having lost a whole lot of weight when that kicks in, some others not. It seems like the popular opinion is that this can't happen on LC and if this happens, it means something is so profoundly wrong (e.g. a tumor) it's startling.

But after all these years and quite a few people reporting this, I am unwilling to believe they ALL have tumors. This just seems profoundly unlikely to me, is all. So, I'm unlikely to believe I do simply because I have the same experience a lot of other people do. If my experience were significantly different, it might seem more likely.

Also, as another graph I did somewhere showed, I got serious hypoglycemia even when NOT EATING AT ALL. My blood sugar went up and down like mountains all day. After talking with some experts about it though, and given my weight and IR, I found this is actually not unusual -- it drops with no intake, but then adrenalin/cortisol kick it up when it eventually drops too low, which tends to take it too high since I'm IR and put out a lot, which then causes it to fall too low, and so on, in a cycle.

So if I have a similar experience with NO food as to food, and if there is a fairly logical explanation for why it's working this way, I just don't see the need to suspect that there is something markedly different about my body compared to other severely obese persons.

Of course, I suppose it IS possible that every severely obese person has some disease/tumor making them that way. But it would be difficult to justify that theory, given that people get there slow or fast and we can track their food intake to probably-why. We can't track why they DON'T lose weight and should often, when undertaking calories, but we can usually track why they gain.

Running out of room ...

PJ said...

(cont)

fyi I'm not 'still dieting' I'm merely eating well.

I changed my blog to say so. I don't have a focus on fat loss anymore. What I know is that when I eat well, generally it will come off, then it will go back on, then it will come off. Probably that middle thing is driven by subconscious increase in food intake but I'm not going to try and out-willpower millions of years of evolution, science stats alone make it obvious that is pointless. So, slowing down the loss period (during which I have energy) and slowing down and improving (by experiment) the gain period (during which I have less energy) seems like the answer -- I agree you're right, it's that period that is the obvious point in need of a solution.

The thing is, we could theorize about how my body is different than 'normal' bodies so it must be "just me" but this is exactly the trap that every severely obese person gets stuck in: for every freakin one of us it is allegedly "just us."

But it's not just us as individuals. It's as an entire group it appears, if 5 years of extensive following other people my size online is an indicator, and if research about weight loss after gastric bypass is an indicator, and if research about biochemical states after weight loss is an indicator. Those things aren't about me.

In other words, the 'theory' of what's wrong would need to explain the larger set of evidence, or at least stand a chance at it.

I didn't come to any conclusion based solely on my own experience, for the very reason that I am only one person. I came to it following years of reading research and discussion and other SO people sharing. Every piece of data I find points to the same thing, but empirical laymen reports and research. There aren't any exceptions or qualifiers to use for rationalizing why it isn't so, as a result. At this point I would be irrational to take the sheer amount of evidence ALL the same and somehow think it didn't mean anything.

I do agree it's possible that dietary intake is not enough to 'deal with' severe obesity. However, I have yet to see a single person of my weight class helped by turning to medicine (although I have seen some people helped by the drug Metformin, that is the one exception); I have seen extensive numbers of them profoundly harmed, by turning to the medical world for help, though (mostly by the idea they need to be gutted to allegedly prevent eating so much). I have a bias. As well as an income limit.

It may be there is a truly improbable, even surreal lack of anybody with a success story (5 years is the minimum term or I have a "wait and see" tag on it) online, despite being plenty of them existing, but this seems highly unlikely.

PJ

Greta said...

Wow, that was hard to read, but I really needed to hear that. I have been scared to death that I would hit that place again where the weight loss would stop and nothing I did would make it move. Nothing. But you've made me realize that it's going to happen, and I need to change how I deal with it. Reality bites, doesn't it.

Kisha said...

From KMJ
"So thank you for having the courage to reach your own unpopular conclusions and share them. And on a metaphysical level, I find that great change often comes once we find ourselves truly ok with life remaining in its imperfect state."

From Kisha:
This pretty much sum's up what I wanted to say. I sat down thinking this would be a short post. Then realized I wasn't getting down the page very fast. Although, I kept reading. The honesty grabbed me and kept me reading.

I defiantly think that there is a point that it becomes more difficult. Being one who has a hard time accepting herself the way she is (especially when I fail) I could use a pep talk in knowing that I am doing what I can, what I know, and it's all OK!

I know low carb works. I know (for the most part) why it works. But there is so much that isn't studied or even evaluated honestly. Unfortunately this day and age people are stuck in the mainstream think tank and can't remove their arse's out of it, so they can actually think for themselves.

Thank you for being a person who chose to think for yourself. God Bless you... And I wish you happiness in what ever you do.

Thanks for the post.
Sincerely ~ Kisha

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Anonymous said...

Thank you so much for that post. I stumbled on it looking for reasons why. I lost 40 pounds last year on LC. I have to lose another 20 before my surgeon will operate on me and get rid of my colostomy I got a bit over a year ago.

I'm stuck at 240. STUCK. I make it a few days LC/Paleo and I break, with a craving for carbs that can best be described as an itch from hell on your back.

I too had the hypo episodes again and again during strict LC. I thought it was just me. I also stalled and went from 3-4 pounds a week to none. For months. My doc thought I was yanking his chain when I said I didn't cheat...I keep meticulous records on everything. He should try doing this if he thinks it's so flipping easy. Exercise made me gain. NO carbs, no loss. I couldn't win, so I stopped till deadline time - which is now.

So, for now, it's diet time until I see the doc in Aug. so I can get this damn ostomy reversed in Oct. LC, again. And I have no clue what I'm going to do about the cravings. If I eat any fruit/sweet tasting things, my BG levels go waaay up and crash into the 50's. So, strict on the diet till I'm over the surgery mess and after that...Live with my body as it is for a while.

gardenerG said...

Has anyone tried changing their gut flora? I would purge the existing crew with this:
http://www.ariseandshine.com/cleansing/cleanse-14.html

(it includes probiotics and betonite clay)

And then I would be *very* scrupulous of what I ate - ie. no sugar, grains, alcohol, very moderate fruits excepts berries, etc. going forward. I'd do lemon-water fast to shrink the stomach and then do 2 meals a day in a 8 hour window of nutrient dense food (and low glycemic) - each meal would have to fit in a take-out oriental restaurant container.

(disclaimer, I'm not obese. I was just here to read about RBTI)

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Anonymous said...

I've spent the first 63 years of my life in yo-yo dieting, trying the next latest-greatest, learning more (I have a BS in nutrition & have kept current.) As I approached morbidly obese last year, I drew the line in the sand. I'd changed to plant-based, but what was "the ticket?" After earning a certification in Food over Medicine from the Wellness Forum, I was floored! I could no longer overlook the consensus shown by meta-analyses of the whole body of research: so I sucked up my disbelief and replaced it with science. I have now been enjoying a (WARNING-graphic word approaching) STARCH-based diet for 7 months. During a VERY stressful period I was able to continue it for the most part, and didn't gain an ounce. I tweaked it and paid more attention once the stress had calmed and now am back to steady loss. The very thing I couldn't have believed could work, is. My Chiro is a super-fit jock....he has been using the same diet and is leaner and stronger than ever before! I don't know if it could make a difference for all those things we angst about, but at least you'll be happy and satisfied eating the foods humans apparently were designed to eat! See what you think of John McDougall's Starch Solution. Check out Dr Pam Popper on Dr Pam's News Channel on YouTube. Look up Chef Del Sroufe on facebook....he WAS Super-Obese. MAYBE this info could be useful. Sending you love and light. E-Healer

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