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Diabetic eating low carb but not losing weight

I've been reducing carbs since last summer but have been really trying to eat a maximum of 75 or less grams daily since Jan. I. I've done this to get better control of my out of control Type 2 diabetes. I've done well dropping my A1C from almost 9 to about 6.5. My endocrinologist is pleased with my progress. What has surprised me is that I have't lost weight. Oh, maybe a couple of pounds in the first few weeks but that's all. I'm not that disappointed because getting my diabetes under control was and will continue to be Job#1 but I see all these claims of dramatic weight loss on low carb diets. I do not count calories or limit portion size. The calories from reduced carbs have been replaced by more protein & fat. Why am I not losing weight? I take a considerable amount of insulin and live a fairly sedentary life. Is it still all about calories or am I missing something? Thanks for your help!

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  1. Hm. Good question. I know when I first jumped on the low-carb wagon, back in 04 or whenever that South Beach diet was all the rage, I lost nothing. Zip. Zilch. While friends around me were dropping poundage like crazy, I'd lose a couple one week and then gain them back the next. Drove me positively nuts, as I was following that idiotic induction phase to the tee and was eating scrambled eggs for breakfast every goddamn day.

    So I understand your frustration.

    For some reason, when I cut out starches again a couple of years ago (but also cutting down on portion sizes), I lost about 16-18 lbs. over the course of a year.

    Not fast, but effectively gone. Maybe it just takes longer than you thought it would?

    33 Replies
    1. re: linguafood

      I've never been good @ eating a lesser amount of food than what satisfies me. There's a point where, if I eat one mouthful more or less, I feel uncomfortably stuffed or famished. Are all people wired this way? It seems that some people's appetites shut off @ a point that cause them to store minimal fat while other people are not sated until they eat an amount that causes them to store a lot of fat?

      1. re: zackly

        I've always heard that one should stop eating before feeling really full. That in a short time you WILL be sated.

        1. re: c oliver

          I never eat til full or stuffed. Only until I'm no longer hungry. But many folks with endocrine disorders never get the satiety signal or the appetite suppression that is typical of low carb.

          1. re: c oliver

            i heard that too, but when i actually tried it my weight BALLOONED UP.

            lesson that i learned: don't believe everything you hear.

          2. re: zackly

            Try to eat slower. You need to give your body time to realize when it's full.

            My man and I used to eat like wolves -- fast and furious. Once you slow down, you'll notice that you are full before you can overeat. Sounds simple, but it's true.

            1. re: linguafood

              Not always, though. But it's good advice anyway.

            2. re: zackly

              There are some people who can eat huge amounts of food and still never feel full. Me, for example. For me, it's due to my genetic collagen defect, Ehlers Danlos. Collagen is in the digestive system and allows the muscles to expand and contract. With Ehlers Danlos, our collagen is defective and allows the digestive system to expand much more than normal people's, hence not feeling full.

              If I recall correctly, this showed up on an episode of Royal Pains with a woman (I think) who was a competitor in food eating contests.

              1. re: zackly

                If you "full" sensor is out of whack, you need to use your mind. Weigh and measure out portions. Drink 1-2 glasses of water 15-20 minutes before you eat. Adopt more mindful eating (the book I mention elsewhere includes this). Actively seek out practices that might help, and give them a solid, honest try.

                1. re: Enso

                  Of course.

                  My point is that the "eat until you feel satiated" does not apply to everyone.

                  1. re: LMAshton

                    Yeah, but the slower you eat, the likelier you are to be satiated sooner rather than later.

                    1. re: linguafood

                      When I was a kid, my grandfather used to say " eat slow, and pack it tight".

                      Good advice, but I try not to pack it too tight these days :)

                      1. re: sedimental

                        Yes, you gotta keep it a bit loose to get all the good stuff in.

              2. re: linguafood

                I was skinny when I began low carbing, but extremely insulin resistant. I gained when I tried Atkins induction levels. One thing most folks don't know about ketogenic diets is that they drop your active T3 thyroid hormone a lot, and for folks like me who were borderline, that was trouble in more ways than one.

                In Protein Power, the Eades did discuss this and the need for Cytomel for some of their patients.

                1. re: mcf

                  I never did that ketosis crap, but followed the SB induction phase to a t. With zero effects.

                  My guess is my weight loss was a combination of cutting out starches for the most part and portion control. And not snacking every night :-)

                  I still occasionally eat pizza, pasta, bread, etc. when I am in the mood for those (though, to be honest, I am "in the mood for pasta" most every day), since I am not doing this for "health" reasons.

                  1. re: linguafood

                    If you ate under 100 grams of carbs per day you did that "ketosis crap." Actually if you ever lose body fat, you've done ketosis. Also during sleep.

                    I never miss pasta or crave pizza or bagels, but I make room for an occasional dessert.

                    I don't do portion control, calories, either, though I did scrupulously document my diet for years to figure out what worked for me and my health.

                    1. re: mcf

                      Well, I don't know if I ate under 100 grams of carbs, as I didn't actually *count* carbs. In any event, it had zero effect on weight loss back then, but perhaps my body chemistry has changed in the meantime.

                      Or it's simply a combination of the factors I mentioned in my earlier post: smaller portions, very few starches, cutting down on snacking, etc.

                      1. re: linguafood

                        Under normal circumstances, those changes would definitely help a LOT. When I started out, it was really gradual, I got benefits immediately, but not enough, so over years of experimentation and testing and documenting, ended up resigned to learning to live extremely low carb.

                        Now I love it and can't imagine eating starches for a meal, or even a side dish. I love the way I eat now, and in my case, it's critical to my (and the OP's) health.

                        1. re: mcf

                          This is so true! I have periodic carb up days to fuel workouts because I follow a low carb diet more out of choice and I dread them.

                          1. re: fldhkybnva

                            I know that endurance athletes have adapted after three weeks of ketogenic diet with no loss of performance. Other folks say they bonk without some carbs, but many don't eat them, they stay in ketosis (bodybuilders) by sipping dextrose drink only enough to fuel a workout during the workout. Would that work for you?

                            1. re: mcf

                              I definitely do NOT have success working out while on ketogenic levels of carbs (for me, that's 20-25g a day). My endurance is reasonable, but my weight refuses to budge. Bringing my carb intake up to closer to 75-100g a day (and reducing fat to make sure my caloric intake stays approximately steady) will allow me to lose weight, although slowly. And when I say working out, I mean an hour or so a day of heavy weightlifting and/or HIIT cardio training.

                              When I first began low-carbing, I lost weight quickly, but I also found that I needed to stay at 25g a day or less of carbs to do so (I wasn't working out at the time). I was in my early 20s then, though, and this approach no longer really works for weight loss (though it does for maintenance).

                              1. re: mcf

                                My endurance doesn't suffer at all, I actually think it improves which most studies show. However, picking a couple hundred lbs off the ground repeatedly doesn't work well on 20 g of carbs a day. Ketosis seems to improve most athletic performance except anaerobic activities like weightlifting and sprinting. There's no way to get around the fact that you just need glycogen for those activities.

                                You're describing the TKD - targeted ketogenic diet, I prefer CKD because I work out at 530am and don't want to wake up early to eat pre-workout carbs.

                                1. re: fldhkybnva

                                  Couple hundred? That reminds me of a 40 y.o. friend I had who had to work out with a 21 y.o. guy to find anyone who could lift with her.

                                  They got up to benching 225 together, and she leg pressed 800.

                                  Color me impressed!

                                  1. re: mcf

                                    Thanks, yea there aren't many women around in the weight room but when I can I try to convince them that they can lift more than they think.

                                    1. re: fldhkybnva

                                      You remind me of Krista from Stumptuous.com

                                      The person I referred to went from bored stay at home mom to competitive body builder, all natural.

                                      1. re: mcf

                                        Too bad she was bored. I've never heard of a stay at home parent being bored :)

                                        1. re: c oliver

                                          VERY self absorbed. And only one kid. I guess you never read The Feminine Mystique?

                                          1. re: mcf

                                            Yeah. Fifty years ago. In my 'crowd,' the times changed long ago.

                                            1. re: c oliver

                                              Options changed, but a lot of what was true of the experience remains. And this began 30 years ago.

                                              This is very OT, the OP deserves better.

                                        2. re: mcf

                                          That'd be my dream. Human physiology is a passion of mine. I guess that makes sense since I tortured myself with med school :) but metabolism in particular fascinates me. Actually the best part of the carb ups is thinking about the metabolic pathways behind it all and using that knowledge to time nutrients appropriately so they go where they will be most useful.

                                          1. re: fldhkybnva

                                            The more I read and learn endocrinology, the less I know! My endo is a full time researcher and academic dept chief with a sort of ad hoc specialty practice, just briliant, but even he can't get to everything, with his wide scope of research.

                                            So much feedback, reverse feedback, transporter proteins, receptor variability among and within kindreds, etc.

                                            And I'm a freak; suspect partial and selective glucocorticoid resistance syndrome on maternal side. For the most part, without any apparent outward signs but it's very dominant in everyone sharing that side.

                                  2. re: mcf

                                    My husband has been intermittent fasting for over a year now and works out (intensely) 5 days a week before eating. He feels he has more energy than when he fueled pre-meal (strength training, not cardio). I tried doing it for a while but it was too difficult to control my bg in a fasted state while working out. My blood sugar would spike from the glycogen release. :(

                                    1. re: lynnlato

                                      You're type 1, right, IIRC? Sounds like your liver is protecting you from exercise induced hypos by dumping glucose into your system.

                    2. How overweight are you? Is it possible that you are not necesarily overweight and have litle weight to lose. If you are overweight maybe could add in a twenty minute walk every day you might find the weight comes off faster.

                      4 Replies
                      1. re: SIMIHOUND

                        I'm overweight! My BMI is about 30. 5'10" 240 lbs. Unfortunately (or maybe fortunately) I'm not supposed to walk or do much exercise because I have a slow healing foot wound.

                        1. re: zackly

                          That will improve a lot once you get better control, typically.

                          My diet reversed long standing kidney and nerve damage.
                          Diabetes damage can be reversed. Just keep at it, it's a marathon, not a sprint. :-)

                          I bet you could do some stretching or yoga with tapes, or a recumbent cycle with the weight off your foot?

                          How about PT, is that available to you? Will your doc refer you if you ask?

                          1. re: mcf

                            A friend has done very well since her foot injuries with sit down boxing training .

                      2. Calories are not all the same but calories matter. In general, low carb is a strategy to reduce calories. You still have to reduce overall calories this is one of the biggest myths associated with low carb eating.

                        Also it is common for many, especially women, to not lose weight for a while, even weeks and then all of a sudden lose weight - it's often referred to as "the whoosh."

                        4 Replies
                          1. re: fldhkybnva

                            I actually increased my calories 50% on low carb and maintained the same weight as I did on 800 high carb, low fat calories per day, same as research demonstrates is typical.

                            Generally, low carb restricts appetite, but not calories. But it's true that for many morbidly obese folks especially, Atkins induction levels are the first time in their lives that they find it difficult to take in enough calories due to appetite suppression by the diet.

                            1. re: mcf

                              800 calories a day is not much food. A 50% increase is bringing it back to a somewhat reasonable level which was still probably a deficit for you.

                              "Atkins induction levels are the first time in their lives that they find it difficult to take in enough calories due to appetite suppression by the diet." So calories matter? They eat less so they lose weight.

                              1. re: fldhkybnva

                                I know it's not much food, but even obese teens eating 50% more calories compared to low fat, high carb kids lost nearly twice the weight. And the low carb kids were not restricted, they ate what they felt like. I no longer have the full text, but in this study, the low carb kids ate 50% more calories, as I recall, and lost twice the weight, with better lipids, too. They were told to eat when hungry, no limitations.http://www.sciencedirect.com/science/...

                                I'm saying I don't think calorie reduction plays any role in a low carb or ketogenic diet, except for the appestat reset most folks get. But the science is there. The calories are not lower even though the appetite is, because of the fat added when carbs are restricted. Eating less or less often doesn't equate to eating less calories.

                                Calorie restriction is not required in low carb in less obese folks. Those were folks eating many thousands of calories a day extra, I'm referring only to a subset, folks north of 400 lbs for the most part, as I recall. But caloric reduction is not required to maintain or lose on on low carb, studies show.

                                800 was my maintenance level!! I didn't know I had HPA axis disease, could not believe I couldn't lose weight even going that low, so I weighed my food, documented even a tsp of cottage cheese at a time. I was on steroids and also, apparently, was busy developing a pituitary adenoma. For many folks, thyroid, cortisol, subclinical Cushings are at the root of their type 2 DM or weight issues.

                                Endocrine science is incredibly full of disparate influences, from receptor action for every hormone and levels produced, etc. So odd, but I lose weight easily in a steroid high rather than lows.

                          2. if you're eating that low carb and using a lot of insulin, you should consult an endocrinologist. They never consider it, but Cushing's syndrome or disease is a common undiagnosed cause of type 2 that is hard to control. A lot of insulin is going to make it hard to lose weight.

                            Also, very low carb does drop active T3 thyroid, if you're a tad low, that makes losing hard.

                            Some folks find that they don't lose, but if they were very overweight to start, they drop fat while adding muscle, which weighs more than fat. Using a reference pair of jeans to see if they're getting looser, or doing tape measures monthly can help, too, to check this out.

                            And you may need to dial back how much you're eating.

                            http://newsok.com/thyroid-hormone-cou...

                            http://www.proteinpower.com/forum/for...

                            6 Replies
                            1. re: mcf

                              Isn't endocrinology the specialty that treats diabetes?

                              1. re: c oliver

                                Yes, but like all doctors, they don't get paid to think, no billing code for it. They just pile on the prescriptions without thinking about how much harm they may be doing by not thinking about why treatment isn't having the usual effects.

                                And they don't bother drilling down into the research that I and many other proactive folks read, just get executive summaries and drug company paid CMEs.

                                1. re: mcf

                                  Sorry, I was referring to your recommendation to see an endocrinologist.

                                  I'm sorry you have that experience with traditional medicine. I don't but I have a good bit of medical background and fully participate in my health care. And every doctor I've ever had has been happy that I do.

                                  1. re: c oliver

                                    How does that contribute to the OP's problem? The OP's doc is completely missing GIANT clues. And in my long, storied medical history, and that of hundreds of folks whose care I managed, that's typical,

                                    I may be forgetting something, but are you a diabetic eating low carb?

                                    The OP is not responding to diabetic medicine or a diet that controls hunger, lowers weight and insulin requirements UNLESS there is another disorder present.

                                    1. re: c oliver

                                      Huh? You suggested the endocrinologist but then said among other things "doctors don't get paid to think." So do you think OP should see an endocrinologist? OP is already seeing an endocrinologist. I suggest that this thread has once again sunk down to the level of anonymous strangers giving medical advice.

                                      1. re: c oliver

                                        The OP is a diabetic asking other diabetics who have had the same diet for longer what the issues might be that lead to lack of weight loss.

                                        I have offered low carb advice and suggested a specialist, which it turns out the OP has. Many diabetics do not.

                                        Do you have any experience as a diabetic low carber to share with the OP?

                              2. Thank you for your advice and keep it coming!
                                I've tried all the dieting "tricks"like eating less, waiting a half hour then eating more only if I'm still hungry, eating slower, eating many small meals etc. Like I said, for me anyway, there is a small comfort zone where I feel full but not hungry or stuffed. I trust my endocrinologist is up on all things related. A sharp cookie, she is a Yale grad and I think might be on the staff @ Yale/New Haven. She is very inquisitive and open to new ideas too.The best thing about her is that she doesn't preach just deals with each patient based on the reality of the situation. When I was doing nothing for myself (diet or exercise)but take insulin she dealt with that the best she could. I've had my blood tested at least a dozen times in the last couple months in and out of the hospital. Other than slightly diminished kidney function I'm OK. I used to be able to lose weight pretty easily through diet and exercise until my fifties. At 64 y/o its a different story.

                                11 Replies
                                1. re: zackly

                                  I understand it changes with age. Insulin sensitiivity drops off precipitously starting around age 40. And it sounds as if you've been using a lot of insulin, which can also desensitize your receptors.

                                  It takes 3 mos to see a complete adaptation hormonally to changes you make. So if you've been using a lot of insulin a long time, give it a bit and see if your sensitivity improves and you can lower the insulin, which really drives appetite through the roof.

                                  You might consider dropping those carbs to 40 or 50, too, and saving them for after 4 p.m. Blood sugar doesn't rise as much if you avoid carbs completely in the morning and early p.m.. Make sure to use your insulin as rx'ed for carb changes.

                                  If none of that helps and things don't get better with low carb after 3 mos, really ask your endo about thyroid and cortisol levels.

                                  And good for you for getting so proactive about your DM!

                                  Here's some more advice: get moving, even a little at first. A small walk, a swim at the Y, maybe, some light gardening, maybe you have a dog to walk a few times a day? Or any activity you think you might enjoy.

                                  1. re: mcf

                                    MCF-believe it or not there was a time in my life when I used to run 30-40 miles a week and play basketball many nights a week. I've ran a marathon in 1981 & have biked several centuries (100 miles). I just got away from sports & fitness over the last 10 years as life's responsibilities increased. Once my foot heals I will get back to exercise. I forgot to mention that my wife who was, at most, 10# over her perfect weight started eating low carbs with me. She is not as strict as I am and "cheats" occasionally eating pasta, rice, bread & potatoes. The weight flew off her.She lost most of those extra 10# quickly. Go figure! She has a much smaller appetite than I do.

                                    1. re: zackly

                                      Let me ask a very simple question. How does your doctor feel about your weight and your efforts to lose some?

                                      1. re: c oliver

                                        My endocrinologist doesn't hassle me about my weight but all my doctors stress that if I lose weight it should help my diabetes (and overall health) improve . They stress more eating a good diet, getting active & keeping my blood sugar in check.

                                        1. re: zackly

                                          Sounds like once your foot heals, you'll be able to do more. And with the good weather and better food available in the coming months, you're headed in the right direction. Doctors, good ones anyway (and it sounds like you've got good ones), won't hesitate to tell you if you're getting into dangerous waters. I'd listen to them. Best of luck.

                                          1. re: c oliver

                                            He's been in those waters for years, that's why he has a non healing wound.

                                            1. re: mcf

                                              "slow healing" isn't the same as "non healing."

                                          2. re: zackly

                                            Has she ever suggested testing all your hormonal status for clues to your lack of appestat or glucose control with high levels of insulin? If she's as good as you say she is, she won't mind you asking.

                                        2. re: zackly

                                          I believe you! Once you feel better and heal up, you know how to get fit, too, so you have an advantage of having athletic experience to guide you.

                                        3. re: mcf

                                          I was going to suggest dropping the carb intake further, too - many people who try Atkins (including me and my husband) find that staying under 20 or 25g a day is the only way to lose, although one can often maintain on fairly generous levels. I know a lot of people who had no success on South Beach because of this - even in the induction stage, South Beach allows probably 50+g a day, which is just too many for a lot of people.

                                          1. re: biondanonima

                                            Yes, not only is it too many for some folks, but it's high enough that it doesn't shut down carb and sugar cravings the way, say, Atkins induction levels typically do.

                                            I worried that suggesting a larger cut might be discouraging, though I suspect as you do, that the results might be very rewarding.