Thursday, June 13, 2019

Retrospective #118: “Nobody Weighs 375 Pounds”

This quote was said to me in conversation as I was rattling on about my “discovery” in August 2002 that I weighed 375 pounds. It was said with a slightly upturned lip and a wry smile that I interpreted to mean both disbelief and admiration. Regardless, it was true. I once weighed 375 pounds, and it was the beginning of a beautiful story.
For about a year my doctor’s nursing staff had been unable to weigh me because the office scale only went to 350 pounds. So, on my way to work on the day of my next scheduled appointment, I stopped at the Fulton Fish Market in NYC and asked permission to weigh myself on a wholesaler’s certified platform scale. I was stunned. The shock was genuine, and I came to my appointment with my doctor that day motivated to lose weight. 
Then, as I walked into my doctor’s office, he saw me and said, “Have I got a diet for you!” So, I was motivated – TO LOSE WEIGHT. It never occurred to me, or him at first, that this would be beneficial to my blood sugar regulation, or my lipid (cholesterol) health. But as we walked down the hall to schedule my next appointment, he put his hand on my shoulder and said, “Dan, this might be good for your diabetes too.” Boy, was that an understatement!
Regular readers have heard this story before, so I will be brief. Six weeks earlier my doctor had read the New York Times Sunday Magazine cover story, “What If It’s All Been a Big Fat Lie,” by Gary Taubes. He tried the diet described and lost 17 pounds, so he recommended I try it too, TO LOSE WEIGHT. The diet was Very Low Carb (20g/d), which virtually eliminated carbohydrates from my diet. On the first day I had a hypo and called my doctor. In the course of that first week, he told me first to eliminate one med and then to cut the other two meds, on which I was maxed-out, in half, TWICE. A few years later, I completely titrated off one of the two but continued on Metformin (500mg).
As I stayed on this Very Low Carb diet, cholesterol panel improved very dramatically. My HDL cholesterol more than doubled from average 39 to average 84, and my triglycerides were reduced by two-thirds from about 135 to 49, where they have remained ever since. Oh, and did I mention? I LOST 170 POUNDS. As a result, of course, my blood pressure also came down from 130/90 to 110/70 on the same meds, and my inflammation marker (C-Reactive Protein) greatly improved. Finally, my A1c’s are now mid-5s with fasting blood glucose (FBG) usually 80s and 90s.
So, is my Type 2 diabetes cured? No! Metabolically speaking, I will always have a broken, disregulated glucose metabolism. I still have Insulin Resistance “in spades.” There’s no denying that. I could weigh 375 pounds again. But, so long as I continue to eat Very Low Carb, my type 2 diabetes is and will remain in remission, undetected and virtually undetectable to any clinician or laboratory test routinely administered in an office visit by an unsuspecting clinician. And a knowing clinician, would say, because my A1c is less than 5.7%, that I am clinically non-diabetic.
But, if I returned to eating a “balanced” diet, as the Dietary Guidelines recommends, my blood glucose would go immediately “out of control,” and I would again become progressively dependent on anti-diabetic medications, eventually becoming an insulin-dependent Type 2. The “balanced” diet is high carbohydrate (55% to 60% by calorie). The Nutrition Facts panel on processed food packaging shows it. The RDAs are based on 60% carbs, or 1,200 carb calories, on a 2,000 calorie a day diet. Check it out, if you don’t believe me. In addition, my lipids, which are stellar, would return to borderline or worse, and my doctor would be aggressively pushing me to take a statin.
But best of all, I think, is the certainty that eating Very Low Carb, which unavoidably means eating high fat, is a very good way to lose weight. That is why my cardiologist doctor, who tried it himself, recommended it to me. It worked as a WEIGHT LOSS DIET, for him and for me. It just happens that I was also a Type 2 diabetic.
If you are Pre-diabetic, or a diagnosed Type 2, or even just a little overweight, Very Low Carb, or even Low Carb, will do the same for you. Eating VLC will “regularize” your blood sugar, making it more stable, and thus make it easy to lose weight without feeling hungry. Spoiler alert: you aren’t hungry because your body is satisfied when it is feeding on its own fat stores. And eating Very Low Carb (and therefore high fat) will improve your blood pressure and your blood lipids (cholesterol), especially HDL and triglycerides. So, dear reader, why not try it?

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