The Captain
lost 50 pounds over a couple of years and got rid of all the chronic diseases and stopped taking the eight medications that were supposed to be for life. You have to overcome your doctor’s outdated medicine. The last time I went to see a cardiologist he wanted to keep me on statins. I showed him the latest blood test that said I did not need it. I asked him why he was prescribing it. “Just to be on the safe side” was his lame answer. I replied that in that case I would not be taking statins. He said, “OK.”
Congrats on losing the weight etc...
I have done the same 50 lbs off as well. I can come off of metformin and a statin. I am off the BP med. But I kept some of the metformin and the statin. Notice you are still peeing all the time? Yep once a diabetic always a diabetic. I am very pleased with where I am now, but my chest arteries have some plaque and calcium build up. The statin and metformin during this period with my new lower weight can afford me to clean up my arteries.
Captain you are blowing your chance at cleaning up your arteries. That is what the doctor wanted to do with you.
Your glucose level can be normal and even your hemoglobin A1C (long term glucose average)
Yeah. HbA1C is treated by many doctors as if it was a definite indicator for prediabetes/early diabetes, even though it’s dubious whether it’s even as good an indicator as fasting serum glucose (assuming the test is handled properly).
Yeah. HbA1C is treated by many doctors as if it was a definite indicator for prediabetes/early diabetes, even though it’s dubious whether it’s even as good an indicator as fasting serum glucose (assuming the test is handled properly).
My internist participates in a local annual health video conference. His usual topic is health and diet. He mentioned various labs to test for diabetes/prediabetes and then mentioned he started prescribing continuous glucose monitoring devices. You get real time results and see how you react do different activities and different meals.
I’ve seen a few athletes wearing them during various fitness events from long endurance runs to high intensity fitness/weightlifting competitions to help with in competition fueling and recovery.
I’ve noticed that there’s been quite a heavy promotion of these devices to non-diabetics…for biohacking and sports mainly …for about 5 or 6 years or so now along with a few high profile athletes promoting them. Part of me thinks it’s technology looking for value in the absence of evidence. The Quantified Self part of me thinks you won’t find evidence until you start looking. I’ve been a bit more interested in whether/when the technology will become part of a regular “wearable”.
Not so much for the actual glucose reading itself but rather if the readings could act as a surrogate marker for circulating insulin levels/insulin resistance. I’ve been wondering “what if…” with regard to my own metabolic health for
a while now, largely as a result of subscribing to a couple of longevity websites that bang on about this. Rather than wait for a development that may never come, I asked my primary care physician if she could see fit to add a circulating insulin test to the Usual Suspects at my most recent physical so I could stop wondering…or act now, if necessary. I don’t know why this isn’t done more frequently with the first hint of departure from healthy homeostasis. I’m assuming that insurance companies don’t reimburse for it in the absence of rising A1c or fasting glucose etc… which is kind of a bit late in the game… and that physicians are a bit inhibited to suggest a test that would be an out of pocket expense.
You can use the blood glucose/ketones level
obtained with a finger prick test as a proxy for circulating insulin levels.
A level below 100 is getting into ketosis and below 70 will be weight loss.
Typically to hit these levels a person eating SAD will need a water fast for 48 hours.
However, a low carb diet, not a keto diet but one low on processed foods and grains, will provide this type of ration in as little as a 12 hour fast. In other words, eat real food, any food with less than five ingredients on the label. No sweeteners of any sort, and eat dinner then no snacks and then eat breakfast 12 hours after the last bite of food was eaten.
It really is simple, but for me at least, very difficult.
Quazulight…I think you misunderstood my rationale for looking at my circulating insulin. Thanks to a diet somewhat similar to your description…but not low carb enough for nutritional ketosis…for close to half a century (more if you count my years living at home on my mum’s watch) I really didn’t have any need for wondering based on all the regular parameters. It was more of an overexhuberant desire to be proactive and nip any tendency in the bud.
Also wondering in a theoretical sense if use of, say, continuous read glucose monitors or other real time sensing devices are likely to have an impact on preventing even pre-diabetes in the demographic that’s on the way there but not quite yet.
Type 2 diabetes is reversible, but not curable. That is a belief system, but not the science experience. Gain back the 50 pounds and you will find it’s still there. That’s what the Docs and science told me, and it’s what happened when I gained the weight back. I researched my Statin and kept it. I stopped Lisinopril, but went back on after a conversation with my Endocrinologist, rethinking through the family medical history, and some research. I wish I could lose 50 pounds and drop all the meds. Good job!
I like just about none of the diet advice here. The reason most people are very unsuccessful dieting with any of the low carb advice. It is also misnomers about the food building blocks involved in recommending a low carb diet.
I did Noom. The success rate is ultra high, almost ten percent succeed in something close to what I did. But not nearly as much. I lost 50 pounds for over a year now.
The problem with other diets is the dieters learn to eat more calories pretty quickly.
Noom focuses on people monitoring their calories and modifying the qualities of the food they eat.
Some of the suggestions here that all you need to do…yeah it worked for several of us that we have lost major amounts of weight but we are a very small minority of people to have done it at all.
The biggest behavioral change I need when losing weight is simply an early bedtime.
Well, every weight loss diet works…if it works and for while it works…by folk modifying their eating habits and ultimately consuming less energy than they expend. The various diets around are just different routes to the end goal.
I doubt dieters need to learn to eat more calories after a period of restriction it comes naturally whether it’s a case of “post starvation hyperphagia” or simply that old habits die hard.
I did not make myself clear. By far and a way most dieters totally fail and more often than not add more weight on than they started with.
I think we need to start there.
Because if we are seeking a path to success then we need to discuss the much more common pitfalls.
Another way to measure this, there are several doctors posting here. If the doctors pipe up with how many patients they have seen to ever lose considerably weight over a long time period you would get the scale of the failure.
Dad in a career starting at age 16 in medical school Trinity Dublin, retiring at age 82 two Christmases ago…one patient lost considerable weight, two had bariatric surgery and kept the weight off and two had bariatric surgery and gained the weight and more. The last being the worst of outcomes weight wise.
That is a common medical practice batting score for an entire career.
For Noom to get somewhere in the 8% success category is amazing.
Most people using the low carb approach will gain weight in time. Several things go wrong, the diet cuts out something but then the eater will find more to eat elsewhere or when carbs are reintroduced it fails again as more calories. Usually given time people gain weight.
Counting calories was one of the early approaches that always failed. Similar reasons. But with an app in your phone to monitor several times a day the success rate has gone up. With ten minutes per day studying the lessons on healthier eating the habits change in some people.
Well, was a dentist and, in addition, a fitness instructor/personal trainer by avocation (in Emeritus mode for both) so I’ve had plenty of experience of discussing one on one dietary habits and commitment to change etc and one big difference between your Noom vs. what happens in a doctor’s office with dietary advice is…$$$bucks.
Take your dad, for instance. What was his field? Unless it was specifically geared towards weight management, I’ll wager most of the folk making appointments with him were for something other than specifically dietary advice. I suspect that his patients’ experience was quite different from yours with Noom.
The fact that Noom is a weight management specific programme and has a fee attached means that already there’s a selection bias toward folk who recognise they have a problem and require assistance to address this. Not unlike a good many of my my class members/PT clients who engaged my services specifically for some form of weight-loss (specifically fat loss)
That’s the wrong way to look at it and it stems from the mistaken view that type 2 diabetes is a disease. If there is something wrong with your body like the pancreas not producing insulin, you have a disease. If you are attacked by bacteria or viruses like tuberculosis you have a disease. Type 1 diabetes is not yet curable, bacterial diseases are preventable and curable. Type 2 diabetes is more akin to poisoning, voluntary poisoning, you get type 2 diabetes from eating crap, lots of crap. You reverse type 2 diabetes by stopping the intake of the poison. Restart the poison and you restart the type 2 diabetes.
I went from over 90 Kgs. to 70 Kgs. and the great variety of food in Portugal has me back to 75.5 Kgs. even while avoiding highly processed packaged foods and I have not been able to shed the extra 12 pounds. No sign of type 2 diabetes but I’m short of breath more than before. After 5 years not not seeing a doctor and not taking any medications, I going for a checkup this week.
The Captain
I even bought a gorgeous electronic bathroom scale which tells me I’m stuck at +or- 75+ Kgs.
I have never talked about Type 1, only Type 2, and Type 2 is not curable, but you have stated it is curable. Type 2 is reversible, but if you follow what I have told you, if you gain back the weight and don’t exercise, Type 2 will come back. If you were cured, it would NOT come back. Therefore you were not cured. Right now, as you read this, you are not cured. Look up medical definitions of disease, here’s one: disease
(dĭ-zēz′)
n.
An abnormal condition of a part, organ, or system of an organ-ism resulting from various causes, such as infection, inflammation, environmental factors, or genetic defect, and characterized by an identifiable group of signs, symptoms, or both.
The Med definition is much broader than what you seem to imply. There are actually four different types of Type 2 diabetes. Mine is partly genetic, all the males in the family line get it. Now there was some talk that if you became athletic and diet conscious it may never appear, but I think that idea has gone by the wayside. You somehow seem to attribute something magical to not using the word disease. There’s no magic. Your idea of disease is too narrow. I cut and paste the “chronic disease” part from a medical site. Google around. Medicine accepts it, get with it.
What are you using to judge whether or not you have signs of metabolic dysfunction/T2D?
Most of the investigation that determines these conditions require a level of testing that isn’t available over the counter.
I’m sure that there are individuals whose lifestyle choices have helped them into this state and all they need to do is improve those choices to cure themselves quite literally…i.e. to have the same metabolic flexibility and overall health they would’ve had if they hadn’t become fat and diabetic in the first place. Lucky them with that genetic make-up but I suspect that they’re few and far between. For most folk who’ve gone this route, if they adopt and maintain decent reversal habits before irreparable damage has been done, it’s possible to manage and control the disease (or whatever you want to call it) but not eliminate all traces.
A good percentage of his patients recognized they had major weight problems. He never treated anyone for obesity. It was not his speciality. Very large numbers or a very high percentage of the people with the problems sought out various programs and books. The failure rate is what my dad saw. The failure rate is what all the doctors have been seeing.
My dad was a shrink.
My BIL is an endocrinologist who has seen exactly the same. He does not treat people for obesity which is a good idea. Instead he sends the patients to batteries of trained professionals for weight loss. He sees what my dad has seen for decades.
I am a huge exception. Excuse the oxymoron. Noom’s batting average for a smaller weight loss than my 50 pounds is around 8%. My sister also lost 28 pounds. We both had more going for us than most people. One thing our Irish mother as an immigrant was still cooking peasant food, meaning we were eating boiled everything and anything as we grew up. I did not have a scrap of fat on me except at age 13 and then again at age 17 when I started working in a restaurant.
My experience with “metabolic dysfunction/T2D” which is not clinical evidence and the reason I’m going for a checkup.
A doctor friend of mine used to say that you are not sick until you think you are sick. I realize this might upset the expert medical community but the expert medical community’s job is not to run our lives. Criminal exhibit NumberONE, so called medical doctor FAUCHI!
Well, I sure hope your friend’s doctorate was in Art History or something similar else he’d be a total menace as a physician with that notion in this day and age. I’d like to hear his explanation for, say Sudden Cardiac Death in a 45 year old as a first sign of coronary artery disease or stroke at the same age from undiagnosed high blood pressure.
That’s great and I’m certainly not being dismissive of your success but, in dismissing the value of other folks’ chosen diets, you’re almost comparing apples with vacuum cleaners.
Your dad would probably be able to explain it better than I, but having the constant accountability reminders that programmes like NOOM provide AND the extra reinforcement that comes from a monthly membership fee is well recognised as leading to a greater success with weight loss…with pretty much any diet.
A poster on the Health and Nutrition board a while back mentioned what sounds like a similar prograame called PhD that his wife had found successful for the first time…at least in the early days. It’s a nifty way to harness the power of psychology which is at least as important as the physiology of weight loss approaches.
The real success will show itself if/when the programme members choose to discontinue with the service (for whatever reason) and are left to their own accountability like the folks who aren’t using such tools.
The reality is Noom is not successful, 8% sucks. They do eventually easy into letting it slip here and there that small numbers do lose weight. But about 92% walk away with zip or worse they gain the weight and more back.
The biggest failure of Noom is in the message board system. The first thing obese people do is to start to do heavy exercise. Big mistake for most of them. They either get hungrier or when they get tired for whatever reasons with the exercise routine they gain the weight back. That is where the majority of Noomers fail.
They share their exercise routines obsessively.
That is just my opinion but I have been around the group message boards there for about a year total. Very few are really losing weight. Yes most are die hard heavy exercising.
The other big failure is how ingrained our culture is. People trade recipes in the groups. Those recipes are substitutes for cheese wiz. After two or three generations of junk foods people substitute junk for junk.
These failures go to the counselors. There is no directly telling people what wont work. The counselors can not be parents. So 92% fail.
The cost is very low. It is okay. The program is not in any way a rip off.
Considering the costs if you put my sister or me up on an actuarial table(s) and figured out the benefits to us and our respective insurance companies, the results would be that each of us made by far the best investments of our entire lives working with the Noom app.
adding the psych part is nice for the first two months. It is like searching for the right tools at first. It is all about dieting tools at that point. Then like searching for a crutch that is evasive. Then half but(ted) nonsense about almost anything you can think of. The truth about individual psychology is best summed up by Zorba the Greek, “the full catastrophe”…of being human. Meaning we can tuck in the bed corner nicely or write with nice prose but we remain in our messes.
Well that’s not your imagination. When trying to create energy deficits with diet and exercise, you really have to be fairly crafty …and fit. The big mistake that novices make is to overestimate just how much energy they’re expending , work too hard for their level of fitnes…oftentimes making themselves really hungry AND overtired into the bargain. So, those hunger pangs on the way home from the gym have them swerving into the local Starbucks drive through for a giganto caramel macchiato (at the minimum) and then be resting up for the rest of the day…ultimately not increasing their total daily energy expenditure by much but eating a heck of a lot. Compensatory behaviour will scupper the best laid plans.
It was round about this time of year that I started to plan ahead for the New Year Resolutionaries at the gym along with my fellow group exercise instructors. It was very hard to try to balance folks’ hopes and expectations with the reality of what they could achieve as novice trainees. As with anything, exercise has the potential for being a very successful weight management tool…along with the list of positives that don’t show up on the scale…but you have to do it right and that takes patience and planning for the long haul.
I researched my Statin and kept it. I stopped Lisinopril, but went back on after a conversation with my Endocrinologist, rethinking through the family medical history, and some research. I wish I could lose 50 pounds and drop all the meds. Good job!