I'd love some weight loss help.

macchiatto

I apologize in advance that this is long; providing some history. Ihave done way too much yoyo-ing weight-wise in my adult life within a 30-lb range. In the past, I did a variety of things that worked (the Zone Diet, Weight Watchers, etc.) I've done MFP off and on but honestly, I've never had long-term success with tracking even with a lot of macro adjusting.

In recent years, the one thing that seemed to work was the Dukan Diet. I lost weight and reversed my prediabetes with it a few years ago, then 2 years ago I lost another 10 lbs. Over the past year thanks to an MS med change, I gained 20 lbs and this time around, I am struggling a LOT more to lose weight. I tried LCHF (after reading about it on here) and lost about 2 lbs but then plateaued. I wasn't super low; 80-100 gm carbs/day. Then recently I tried Dukan--which has worked for me in the recent past--and lost just a few lbs and then plateaued again, which has never happened to me with Dukan.

I'm really frustrated by the extra 20 lbs and having so few clothes that fit. I can't afford a new wardrobe and I'm back up to my "prediabetes" weight. Further problem is I'm in a 6-month "Transformer" DietBet. I won Round 1, barely, but just lost Round 2. It's a $25/mo bet for 6 months so I have added motivation to quickly figure out something that *will* work for me now.

Suggestions for me as a PCOSer? Should I try keto? Or what approach/macros would you recommend to start with? I do need to eat carbs with breakfast b/c of my MS drug (1 pc of toast, 1/2 c. of oatmeal, sth like that) but beyond that I'm open. What is most likely to work without leaving me feeling hungry all the time (usually my biggest struggle)?

Dragonwolf

One thing I've learned throughout my time doing this is that there seems to be a "mire" at the "moderate" levels of both fat and carbohydrates where weight loss is often hindered, and health problems are their strongest. For whatever reason, this mire seems to not exist if you go very low carb or very low fat. It's really bizarre to see stories of people reversing their diabetes on a diet of almost nothing but white rice and refined sugar, let me tell you.

The question then becomes, what's the better option for long term sustainability? Going back to that mire will undo most, if not all, of the progress made going to either extreme. I'm personally of the opinion that low carb, high fat (LCHF) is the better way to go, due to the mechanisms and the body's requirement for sufficient fat for making vitamin D and utilizing vitamins A, E, and K, but if the Dukan diet (which is arguably low fat, even in the most liberal phase) works for you, go for it.

Here's my experience. I'm not saying you have to do it, but it might provide you with some ideas.

For several years, I had tried to lose weight using the standard MFP way, only slightly modified to increase protein. It worked for a short time after I had my son (I think because I was still "under the influence" of the pregnancy/lactation hormones), but then stopped. I found myself hungry all the time and had issues keeping my calories down to the target level, and my weight was creeping up from my lowest weight right after I had my son (I had started losing the weight with the help of the Metformin and managed to lose about 60 pounds, but then gained a bunch of it back in the following years).

Then, a few years ago, I decided to dive into the Paleo-style way of eating (specifically, the Primal Blueprint, which is higher fat and allows for dairy). Doing that stopped the weight gain, cleared a lot of the acne up, and eliminated my chronic headaches and indigestion/heartburn. What it did was great, but it still didn't help me lose weight, even with vigorous exercise. I also found my headache/migraine trigger (namely, heavy starches and especially anything made with wheat flour; I think the latter is the compound effect, since the starch itself is a trigger and I think the wheat exacerbates things).

Finally, earlier this year, I decided to try an "extreme" way of eating -- drop all plant products and eat only animal-based foods. Meat, eggs, and high-fat dairy were fair game (though the diary should be more moderated), and everything else was off limits. I had seen a couple people doing it and finding success with it (one being a long term follower of this way of eating), and figured I had nothing to lose by trying it. The results were astounding -- my acne cleared up even more and most importantly I lost weight! A full 30 pounds, in fact! Unfortunately, life, and later Metformin, interfered and I fell off the wagon and have had trouble getting back on (the Metformin was causing food aversions and made me sick at so much as the thought of eating meat), and I've gained some of the weight back, but during that time, it was glorious! My body rejoiced when I first started it and I did well, physically, while following it. My bloodwork was better across the board, too. Insulin was down 20 points (33 to 13 units), glucose was down 30 (110 to 83mg/dL), and nearly all the tests that indicate PCOS were nearly in the "normal" ranges (I never had recent "before" results, so no comparisons). As strange as it sounds, it was actually easy to sustain, and the simplicity was awesome. I had fallen off it primarily due to the food aversions from the Metformin (though, unfortunately, some events where I didn't have much control over the food and had to be in "do the best I can with what's available" mode masked that connection until recently). It seems that, for me, at least, my body doesn't like plant material in general (which is a shame, because I like a number of vegetables, but I like a healthy body better).

As for execution of it, if you did well on Dukan, you might do well on a carnivorous diet (it's commonly known as "zero carb," though ZC is generally a very specific version of it that is only beef and water, those of us who include other stuff, like bone broth, eggs, and dairy, generally refer to it as carnivorous). It's basically like the "attack" phase of Dukan, except you're not limited to the ultra lean stuff (and, in fact, the fatter stuff, like ribeyes and prime rib, are favored and encouraged, because the fat is a big factor in keeping healthy).

If you'd like to learn more, feel free to hop over to the low carb group -- http://community.myfitnesspal.com/en/group/394-low-carber-daily-forum-the-lcd-group -- and ask some questions. There are a few of us who eat that way, and we'll be able to answer any questions you may have. If you want to stick to Dukan, I believe there are a few people on the board who do it, too, so you can talk about it, too.

As for the MS drugs, as I recall, the carbs at breakfast was only "mandatory" inasmuch as you seem to do better with them with that particular one, right? Have you tried it with a breakfast of eggs, instead? Just a thought, though I recall you mentioning you'll be switching to one with fewer GI side effects, so it might be worth waiting until you do that.

macchiatto

Thanks so much for your input! I really appreciate it. That's helpful.

After finding this group, I hadn't planned to go back to Dukan (once I read that dropping fat AND carbs is a bad idea). I think the reason my previous LCHF attempt wasn't working is that I really just wasn't going low-carb enough. I was basing my number more on the carbs I'd been able to get away with when I had Dukan success in the past. What you said about the mire and moderate approaches makes sense to me.

Actually just since writing the OP, after researching that night I ended up deciding to try a more keto approach. The articles I found describing it suggested trying to stay under 20 gm net carbs/day, which I'm trying. I adjusted my macros to 10% C, 60% F, 30% P. I'm only on day 2 but it's going well and the scale dropped down 2.8 lbs overnight even though I ended up with more carbs (I think 46 gm total, 29 gm net carbs ... made a mistake of eating leftover soup *before* calculating the nutrition facts). I know you seriously can't go by one day but on my recent attempt at the Dukan Attack phase, the scale was barely budging. I think I'll try this for a bit and see how it goes but I'll look into the other things you mentioned as well.

I just found the LCD group yesterday (through another thread on here) and it is awesome! So helpful and informative; I think that will be really helpful as I explore my options. I'm convinced by this point that some form of low-carb diet is the only way I can lose weight (and I think I'll probably always need to stay at least "lower carb" to maintain) so it's great to have a place where I can explore all the different LC options as I experiment and figure out what works for me now.

Re the breakfast of eggs, yes, I did try the med with a breakfast of eggs and it did bother my stomach. Right now I'm doing eggs scrambled with butter in a low-carb tortilla and that seems to be working and once I go grocery shopping to get more keto-friendly foods, I think I can do OK staying under the 20 gm/day net carbs.

Will you be able to go back off the Met? That's great you found something that was finally working for you; I hope you're able to get back to it!

Dragonwolf

I'm stopping the Met regardless of what the doctor says. I'll take a "restricted" diet (that doesn't feel restrictive to me, usually) over food aversions and backsliding any day of the week.

Even if it is the "honeymoon phase," it's great to see some movement in the scale, especially after so long of struggling! Good luck!

macchiatto

I don't blame you; I'd do the same thing, especially if you were finally seeing some progress on the scale!
And thanks!

stefne888

Keto/Low Carb is the only thing that has worked for me. I do not feel like I want to eat constantly while doing so. I try my best to stay under 40g net carbs a day but always shooting to go as low as possible. Some days it is just not doable so I still try to stay under 40g.

macchiatto

Thank you! I've been on keto since 11/2 and have lost 8 lbs so far! Happy to see some progress. I have experimented a bit but try to stay under 50 total/30 net. I might increase that a bit as I get closer to goal.

A_Dabauer

The thing about PCOS is I find it's a moving target. I lost most of my weight, about 40 pounds, on moderate carb (50-70g/day), but then plateaued for about 7 months. Even when I dropped to keto (20g carbs) I wasn't losing. I've had to introduce calorie cycling (overall net calorie deficit but some days you eat in a surplus) and have lost about 10 pounds since introducing that. I'm still doing low carb (30-50g/day) even on my high calorie days.

My point is that something may work for a time, but then it stops. I don't think there is one right way to do this, only the way that's working at the moment! lol