This week has been 19 months since I started a low carbohydrate lifestyle and 10 months since I began following a ketogenic diet with my doctor’s and endocrinologist’s oversight and I’m very close to reaching most, if not all of my health and weight loss goals. Here’s an update.
When I began my health and weight loss ‘journey’, I had 30 lbs to lose to get to the preliminary weight goal that I set for myself — which was still in the overweight classification, but was the only goal that seemed theoretically attainable at the time.
When one is obese, it's difficult to imagine being anything but "only overweight", even for a Dietitian. As I do with my clients, I set a preliminary weight target that seemed it may be attainable.
I reached my preliminary goal weight in February of this year and said to myself “okay, now what“? My waist circumference was still not 1/2 my height (associated with the lowest risk of cardiovascular disease, described in this article) so I carried on.
So far this year, I’ve lost 15 additional pounds and 4 more inches off my waist.
As I jokingly quipped on social media recently;
“my waist circumference is FINALLY half the height I was before I started shrinking… does that count?”
Based on my current height (an inch less than I was as a younger adult), I have another inch to lose. I’m so close!
I’m also 10 pounds from the weight I was before I had children — and given my twins will be 26 years old soon and my singleton will be 25 at Christmas, achieving my “pre-baby weight” has been a long time coming!
What We Believe is What We Achieve
I realized yesterday that what we believe is possible has a lot to do with what we achieve.
There are a handful of life goals that I thought I’d never achieve because I didn’t believe they were attainable, but after a few years of using a low carb approach with my clients and seeing their success, I started “practicing what I teach”… and here I am, 10 pounds from the weight I was before I had children. With having had twins and then a singleton within 14 months of each other, that is a lot of weight that was not lost previously by trying to cut calories and exercise more…plus the added weight I gained from eating foods that were a mixture of fat and carbohydrates because they were irresistible.
For the last number of months I have been steadily losing inches off my waist but without losing any weight at all. I knew that as long as I was losing either inches or pounds, I was not at a “plateau”, so I carried on.
September 15th, a little less than month ago, I had the opportunity to hear Dr. Eric Westman speak in Vancouver on the ketogenic diet that he uses in his clinical practice.
Dr. Westman is Associate Professor of Medicine at Duke University Health System and the Director of the Duke Lifestyle Medicine Clinic and is an internationally known researcher specializing in low-carbohydrate nutrition. Dr. Westman is currently the Vice-President of the American Society of Bariatric Physicians and a fellow of the Obesity Society and the Society of General Internal Medicine and has co-authored three books to date, including The New Atkins for a New You (co-authored with Dr. Stephen Phinney and Dr. Jeff Volek).
I welcomed the opportunity to learn from someone that has been following a ketogenic lifestyle, researching and publishing about it and teaching it to his patients for many years.
One of things I learned was a very practical way to determine one’s idea body weight. According to Dr. Westman, it’s the adult weight that a person felt and looked their best at. The other thing that I learned was in his approach to following a strict ketogenic diet, there is a need to eliminate fruit and nuts. More on that later…
I began to think about what was the adult weight I felt and looked my best?
I came up with what that weight was and thought to myself; “What? Really? That’s very…low!” To try to look at it more objectively, I asked myself if that weight was either unrealistic or unattainable.
My ‘best’ adult body weight is 18 pounds more than my lowest adult body weight (where overweight family members were concerned I had an eating disorder!) but is 5 pounds less than the weight I was before I had my children, including multiples. I concluded that this weight seems both attainable and realistic.
When I calculate my Ideal Body Weight, it’s the weight I was at 21 years old when family members worried about me and which was only sustained for a very short time before my wedding. It was certainly not where my natural set point was when I was physical active and fit. That weight was where I looked and felt my best. Dr. Westman’s method made sense for me.
Calculated Ideal Body Weight
I’ve always found that calculated Ideal Body Weight (IBW) based on established formulas to be a discouraging and unattainable goal for my overweight or obese clients.
Ideal Body Weight (IBW) Formulas
Men: 50 kg + 2.3 kg for each inch over 5 feet
Women: 45.5 kg + 2.3 kg for each inch over 5 feet
Clinically, I’ve tended to use Adjusted Body Weight (ABW) as “ideal” with my overweight and obese clients as it is applicable if a person’s Actual Body Weight (what they currently weigh) is greater than 30% of the calculated Ideal Body Weight (IBW). To most, if not all of my overweight and obese clients, achieving Adjusted Body Weight usually seems like a Technicolor dream.
Adjusted Body Weight Formulas
Men and Women: IBW + 0.4 (actual weight – IBW)
For me, my Adjusted Body Weight is also the adult body weight that I felt and looked my best at so that is my next goal.
Using Dr. Westman’s method of aiming for the adult weight that I felt and looked my best, which is also my Adjusted Body Weight, I still have ~15 pounds to lose.
The Exercise Factor
Something else I needed to factor in to my weight loss plan is the “exercise factor“. Now that my eating is no longer driven by cravings for carbohydrate, made worse by high insulin levels, I am naturally “eating less and moving more“; which is a natural outcome of eating a low carbohydrate diet, not a means to an end! I am ABLE to move more BECAUSE I am eating less!
For the last 6 weeks, I’ve been doing resistance training 4-5 times per week (using body weight, resistance bands and dumbbells and barbells) and this is resulting in me building and toning muscle.
I expected that my weight loss would be slowed because muscle is heavier, but that’s not actually happening.
Strict Ketogenic Diet – Dr. Eric Westman’s Approach
Since January (i.e. for the last 10 months) I have necessarily been following a ketogenic diet in order to lower my blood sugar to below the Diabetic range, eliminate high blood pressure and to achieve and maintain a waist circumference that is half my height. As I’ve told many of my clients, my level of carbohydrate intake is significantly lower than any Meal Plans that I have designed for others and this is because of the degree of metabolic disruption I had previously caused myself. I had been Type 2 Diabetic for 10 years, was obese and worse, was in complete denial about the health risk to myself until March 5, 2017 when this ‘journey’ began.
Dr. Westman taught at the conference was that in the weight-loss phase of a strictly ketogenic diet he recommends that his patients stick to real protein foods (meat, poultry, fish and shellfish and eggs), salad greens and low carbohydrate vegetables, plus limited quantities of healthy fats and oils, cheese and cream. What isn’t included in this phase of the ketogenic diet he has his patients follow is fruit and nuts, not even on salad.
Since I saw Dr. Westman speak on September 15th, I gave up nuts and fruit and since then, I’ve since lost 2 pounds and another 1/2 inch off my waist.
Effect on Blood Glucose
The effect of giving up fruit on blood glucose is also observable.
During July and August it was local blueberry and blackberry season and I ate far too many, way too often. I justified that they are good antioxidants, which they are, but they are not ideal foods for someone like myself who’s been Type 2 Diabetic for 10 years…at least not at this stage of my metabolic reversal.
As can be seen in the graph of my own glucometer readings (above) my average blood glucose in July and August was 6.3 mmol/l (114 mg/dl). Since September 15th, I’ve cut out all fruit, not even a few berries on my salad and I no longer reach for nuts as part of a mid-day meal, but a hard boiled egg or hard cheese or fish, instead. My average blood glucose has dropped to 5.1 mmol/L (92 mg/dl).
Based on the literature, about half of this effect is due to the Metfomin that I continue to take (protective measure given the Alzheimer’s diagnosis of my father and family history of cardiovascular disease) and the other half is due to me having stopped eating fruit.
I am currently achieving normal blood sugar levels, which is amazing! Both my endocrinologist and I hope that in time she can withdraw the recently prescribed Metformin and I will be able to sustain my blood glucose with diet alone, once my liver and pancreas have more fully healed. Time will tell. In the meantime, I am doing everything I can do to get well and stay well.
NOTE: Keep in mind, these are my (n=1, sample set of 1) results based on my specific medical history and metabolic conditions. Since everybody's needs are different, there is no one-size-fits-all "low carb" diet for everyone.
Perhaps you wonder how a carefully-designed low carbohydrate diet could help you improve symptoms of Type 2 Diabetes, lower high blood pressure or simply lose weight? Please send me a note using the “Contact Me” form above to find out more.
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