Lost 90lbs, 120lbs, then 150lbs....now fatter than ever! Is there really hope for those over 400lbs?

Here are some immediate thoughts I have for you. Yes, losing weight (and more importantly, maintaining that loss!) is critically important. And yes, I have seen people with morbid, long-term obesity maintain weight loss. Here are some things to think about:

1. You say you are doing keto right now. Have you always done "fad" diets like that? For most people, they can work in the short-term, but they are never going to show you how to have a healthy relationship with food that helps you manage your hunger appropriately.
2. Feeling "hungry" can be a lot of different things. Are you really thirsty? How are you emotions? Are you bored, frustrated, sad, etc? Is your hunger a habit, i.e. every time your stomach feels a little empty, you think it means that you are very hungry? Have you ever learned how to distinguish "real" hunger?
3. Have you looked into medical reasons? Are there thyroid issues at play (lots of people have undiagnosed thyroid issues that just barely meet "normal" thresholds on standard tests). How are you hormones? As a woman, our hormones do so much in our fullness cues among many other weird things.

It's frustrating to feel like you've always been heavy, you'll always be heavy. It doesn't have to be that way, but it often times takes some real digging to get the root of why you can't maintain a weight loss. Best of luck to you!

ChefMader, sure there is hope. At 65, and morbidly obese, I finally realized I was just not able to eat most carbohydrates. Low glycemic index or low glycemic load carbs are only slightly better. I'd eat because it was time to eat, even though I wasn't hungry sometimes, but a normal meal for an American (with plenty of carbs) would find me starving right after I ate. Sometimes for hours. So I would eat more until I was sated or snack here and there until the next meal. Seemed I was always hungry and sleepy right after eating. Most people never experience that overpowering craving to fill that need and think people like you and me just lack willpower.

After cutting my carb intake drastically for only a couple of months, I began to sense (what I think) jdsass82 mentioned in #2 of her things to think about. What I had thought was hunger after a meal was really carb cravings. I don't know if that is because I have metabolic syndrome, or insulin resistance, or leptin resistance, hypothyroid or something else. My doctor, who I see regularly, just kept prescribing hypertension meds telling me to exercise more and eat less. All I know is that by staying away from sugars, most breads, potatoes, grains and almost all fruits I no longer experience that "need to eat NOW" sensation that I had no control over. The times I sense hunger now don't really seem to be much of a hunger and is much, much easier to just ignore until the next feeding. YMMV

I don't think I will ever be able to go back to many of the foods that were once foundations of my diet. The trade off is worth it for me. I've read that carb sensitivity can be reduced over time. I've tried reintroducing things like bananas and oatmeal (steel cut) with a handful of blue berries back into my diet, but they still bring back those cravings. You'll just need to try different foods to see what your system works with the best. True Keto is very strict. Logging macros and making sure you get enough of the right micronutrients are a must do. Every day. Every meal. Moderate increase in movement pays off big time. I don't want to doomsday you, but you are approaching that part of your life where the weight you have always been able to support is going to be too much for your body and you will lose the mobility you need to stay healthy. Please don't think you can "work off weight". Increased movement will keep your basal metabolic rate up and light lifting will help to maintain muscle mass.

Good luck and health to you.

@ChefMader

All of those days and months of hard work are still there. Standing. Counting.

Every day that you add, consecutive or single days, minutes...matter. You just need to go back and recapture yourself. It's not about being perfect but changing habits little by little. Every time you met an emotional/mental and physical goal of not letting food control your life...you were sliding into a better quality of life and health.

Don't hesitate. Get right back in the groove. If you kept a diary or journal, go back and pick up that momentum and inspiration. When you were moderating your portions, you must have felt a personal high from that peace of mind. A high from your success.

You choose. You decide. You can pick that momentum right back UP. Close your eyes and remember how you felt after 150 lbs were gone. Really imagine it. You've been on food jag. Ahhh, what the heck, I am going to eat it all state of mind. Now, you're going to tighten your portions up and rein it all back in. You can put an end to these curve balls and reaching out to others is a good first step.

Try the Beck Diet Solution. It's not a diet but a way to change your thinking.

I just hit 50 pounds today. Yeah baby!!!

Yes. And I believe you have finally hit upon the best way for you with going keto. Just do it the right way. I am going to get a lot of push back here but I am old and do not care about the hive mind...

Eat keto. Try your very best to eat as close to paleo with it as you can. Just... eat healthy foods. Do not sweat the calories, macros etc right now. You have plenty of weight to lose and just developing good eating habits is way more important right now than weighing and measuring stuff. Eat only foods that are good for you.

There is a lot of evidence that for people with a lot of weight to lose any sort of aggressive calorie restriction leads to short term success and long term failure. What's worse is that with each cycle the restriction has to be more aggressive to attain the same results. Break that cycle by just eating healthy foods.

Move as much as you can. I am not going to sit here and tell you to watch some YouTube channel or that you have to do this exact program. Just move as much as you can. You know your body and realistically you may not be in a place where jumping into an actual workout program is the right decision. But moving always is. Walk. Park at the end of the parking lot when you go somewhere and walk to the door. Take the stairs when you can. Just every little thing. It is not about how many calories you burn walking from the furthest away parking space. It is about developing the habit of movement. It is about changing your thought process on things like simply walking into the store. First you make a point of parking at the far end of the lot. Then you just park wherever because it no longer matters where you park. Just like the food. Eat healthy foods. At some point, a hundred or maybe two hundred pounds from now, you start to think about weighing and measuring. For now just develop the habit of healthy foods. Eating too much roasted chicken or too much asparagus is not going to make you gain fat. Just.... only eat things that are good for you.

Stay out of the keto and paleo groups. Just avoid them. They all start with good intentions and end up plagued by idiots with ever evolving purity tests. "You're not really keto if you eat X" "You're not really keto unless you pee on this strip of paper and it turns blue" No thank you. Do not think in tribal terms. This is about you, ok? It is not about some chuckle head on the internet who thinks you need to rise to their definition of whatever. Given the situation you laid out in your original post, this is not about a program or a diet. Not right now. Right now it has to be about just forming habits.

Eating too much roasted chicken or too much asparagus is not going to make you gain fat. Just.... only eat things that are good for you.

My only quibble. You can, in fact, gain by overeating healthy food. It may be more difficult but it's possible.

There's always hope. But habitual behavior is what will dictate whether you lose and/or regain. So many heavy people revert back to old habits after a little success believing they deserve it. But here to tell you that your health doesn't negotiate. If you don't change, your body will let you down.

A.C.E. Certified Personal and Group Fitness Trainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 30 years and have studied kinesiology and nutrition

Not sure what you are really after here. I have been where you are (at 300 pounds at one point) and have lost, gained, lost, gained......and so on. I have tried Adkins, Keto and other fad plans/diets. My opinion, they are all garbage. They are not sustainable. What it came down to for me was just owning it and taking the responsibility without excuses. Eat good foods (cut out excessive sugar and empty carbohydrates) and like another person posted, move as much as you can every time you can. Stay with it and it will work. Don't get depressed or seek validation from other people. Stop playing games, just own it and do what you need to do.