You are either taking the diet seriously or not. There is no "in between".
2. Does hunger tend to decrease as a fast progresses?
Yes. This is because your metabolism increases in the beginning, and that’s when you feel hunger, but then it plummets as the fast continues and hunger seizes. There is no need to feel hunger if your energy output has slowed to a crawl. This is why many obese people are usually never hungry.
3. Can a diabetic restore their insulin sensitivity if they can keep their blood glucose low?
No, because you can keep blood glucose low and still have abnormal blood glucose regulation. Proper blood glucose regulation means the body produces its own glucose when needed and halts its production when not. That is the only way insulin sensitivity can be acquired.
As long as blood glucose regulation remains abnormal, insulin expression/release will also be abnormal and this in turn, further deteriorates blood glucose. So do not be lulled to sleep by low numbers. Usually the only low numbers a diabetic experiences is postprandial. They continue having Dawn Phenomenon and hyperglucagonemia.
4. Is it impossible to be able to lose excess body fat?
Yes. It is absolutely possible for a person to be unable to lose their excess body fat. This is called intractable obesity. This occurs when blood glucose regulation cannot be obtained and/or sustained for a long enough time to affect insulin and leptin expression/function.
There are multiple reasons for why this occurs. Some are:
- Hypothalamic damage - Leptin no longer communicates to the brain that there is excess body fat and so the brain never "sees" it. You can’t lose, what the brain can’t "see" because it simply won’t send the appropriate signal to the fat mass to burn it. There is some research being done on pharmaceuticals that might be able to treat this, but that is still in the future.
- Age - The older a person becomes the more they resist lifestyle changes. This causes for them to be unable to obtain proper blood glucose regulation as diet is not enough. Exercise can be very difficult for people who have limited mobility, due to a lifetime of metabolic dysfunction and being overweight/obese. But these aren’t the only issues that older people have to face. Changes in hormonal states and the way insulin behaves, as you get older, works against them as well.
- Habits - There are certain lifestyle factors that some people are unwilling to change such as stopping the intake of caffeine or the inability to eliminate sugar and grains. Keeping these items in the diet further interferes with proper blood glucose regulation.
- Length of metabolic dysfunction - Fat people only get fatter. Sarcopenic obesity, which simply means you are becoming more fat than muscle, makes you weaker by default and less able to build lean body mass due to insulin insensitivity. You need insulin to build muscle and synthesize glycogen. Insulin malfunction impedes both of these processes. Dysfunction of the thyroid and other hormonal axes effect metabolic rate and help further spare fat mass. All things that work against you.
5. Type II diabetics should avoid whey protein because of the insulin response.
The spike caused by whey protein, and any other type of protein, is exactly what a diabetic needs in order to regain the pulsatile function of their insulin. This is especially true after insulin goes back to lower levels during the overnight fast.
Spikes in insulin, control glucagon and eventually correct hyperglucagonemia if the person is controlling their blood glucose highs and lows with a low carb diet. So, the insulin spike caused by protein doesn’t have much of an effect on the insulin to glucagon ratio.
Carbohydrates, on the other hand, do not allow insulin to function in this way because the extra dietary glucose disrupts blood glucose worse and causes a prolonged insulin release. This extra insulin continues to affect blood glucose into fasting times, dropping it too low. This is the engine that keeps the condition going.
6. There are no "best" dietary and exercise protocols for people with obesity/metabolic syndrome/diabetes.
Though there is no one protocol that will guarantee remission, there are protocols that are better than others. Long term protocols are the only proper protocols for addressing obesity and metabolic dysfunction because you need to have a prolonged affect on blood glucose homeostasis in order to affect insulin and leptin expression/release. Short term treatments do not work.
The best diets for this are low carb diets. Carbohydrate restriction from 100 grams to 0 grams per day work by not introducing dietary glucose to a system that is already unable to regulate its own internal glucose. This helps normalize insulin expression/release and eventually improve leptin sensitivity.
Steady state exercise of long duration, like a 5 mile walk a day, does not contribute to the stress response and helps leptin/adiponectin ratios which help burn excess body fat. Exercise also helps you clear glucose without the need for insulin.