1. My HbA1c went up one point from 4.9 to 5.0. My C-Peptide and insulin are very low though. My fasting blood glucose is normal.
The term "HbA1c" refers to "glycated hemoglobin". When a protein within red blood cells, joins with glucose in the blood, it becomes ‘glycated’. Measuring this glycated hemoglobin (HbA1c), helps determine what your average blood glucose levels have been over a period of time, usually about three months.
However, this absolute number can be up for interpretation because other things can affect it. For instance, if your red blood cells have a longer half-life, your absolute HbA1C will tend to be higher. Glycation damages red blood cells so diabetics tend to have red blood cells with a shorter half-life. People without diabetes tend to have red blood cells with a longer half-life.
So, a point or two difference in your HbA1C is not really a big deal. If you are on low carb and are in remission from diabetes/metabolic syndrome, your HbA1C might go up a point or two in accordance with a longer red blood cell half-life.
2. My HbA1C and fasting blood glucose are higher than normal, but my insulin level is low, so this mean I am safe from diabetes.
That is ridiculous. Diabetes is a syndrome. This means there are several abnormalities present in it. It is not just one thing. That is why we always remind people that diabetes is not "a disease of high blood glucose". This is because high blood glucose alone does not signify diabetes, even though your doctor might give that one metric enough validity to diagnose you as such.
Diabetes is a condition of improper blood glucose regulation and for that to occur, multiple glucoregulatory and other metabolic systems, within the body, must fail. These systems are everything from the adrenals to the liver, to the fat cells, to the hypothalamus, and finally, to the mitochondria itself.
On this blog, we do not put that much weight on insulin levels and claim you do not have diabetes because your insulin is low. It doesn't work that way. Your pancreas can simply be "burned out" and no longer producing enough insulin to control its blood glucose correctly.
So, low insulin means nothing without a normal fasting/postprandial blood glucose and HbA1C. If your fasting blood glucose and HbA1C is above normal, you are presenting the symptoms which are typically found in the syndrome we call diabetes. You have to figure out what is happening to your metabolism and correct it right away.
3. I have a friend who does not want to be my friend anymore because I noticed and mentioned to her that she is extremely obese. It's not that I didn't realize she "knows" she weighs 400 pounds, but for me, it is like seeing someone bleeding and not trying to help them. I know you're not supposed to mention to obese people they are obese, but I see she is also setting her daughter up to have the same life she has. My friend told me that she has come to terms with her weight because she doesn't have the finances to "do anything about it." Does it cost a lot of money and doctors to lose weight? I think lack of finances are an excuse, but I could be wrong.
It didn't cost me any money to lose weight and I didn't have to see any doctor. So, "lack of finances" can very well be an excuse as overweight/obesity is a lifestyle choice. You can clearly see this playing out in how your friend is causing for her daughter to be obese as well by passing down the same lifestyle choices she has. This is why I don't like to push the idea that obesity is a "diet disease". It is not.
There are many things that play into the development and upkeep of obesity. I still remember my obese/diabetic friend who often displayed the type of attitude that kept her obese. She had a grocery store across the street from her house and when I told she could walk to it, her reply was "Why do I have to go walking to a store?". When I told her that she shouldn't eat the cake at the office party, her reply was "Why do I have to be the only one that can't eat cake at a party?". Her sense of entitlement was more important than her health.
This is not uncommon. I have seen it over and over in the obese. The stereotype of "gluttony and sloth", which is usually given to the overweight/obese person, is not entirely incorrect. There is some grain of truth in it, but it goes way beyond just "being lazy and eating too much". It is an attitude that affects every aspect of their life. This is why obesity is treated wit ha lifestyle approach.
But let's give the devil its due. This 400 lbs. person has probably been duped many times into "weight loss programs" that have failed. Her doctor has most likely failed her too. She probably has no clue why she is obese and has tried everything she can think of to reverse it until she simply gave up. She probably does believe that losing the amount of weight she would have to lose, would take a lot of money in expensive medical procedures and trainers to hold her hand through it. This is most likely because she does not have the ability to do what she has to do on her own, without being babysat. Remember, the weight loss programs she's most likely tried, took minimal effort on her part and promised her the world. I doubt she has the will to try something difficult. Most chronic dieters do not. They gravitate to “easy fixes”. This is why they always jump on every fad diet they come across.
Unfortunately, this type of situation cannot be fixed. You can't save people from themselves. One of the biggest hurdles in the treatment of obesity is behavioral. Oftentimes, that cannot be overcome.
4. Lily's Chocolates are everywhere now, and people are raving about them. It's the only chocolate accepted in some weight loss programs.
Chocolate is one of the few, if not the only, "novelty" that is allowed, as long as it's 85% cocoa and above. Normally the higher the cocoa percentage, the less sugar. Lily's Chocolates have allowed a lower percentage of cocoa because they don't contain sugar. Lily's uses stevia, not added sugar, so this has allowed "milk chocolate" to be put back on the menu.
There is only one problem with this. Like I have emphasized many times before, obesity is not a disease of one sole cause. It is a syndrome of many. Sugar is not the only thing that makes you fat. Hypothalamic disruption also makes you fat and nothing disrupts it more than the taste of sweet. This effect is irrespective of calories because just like sugar, calories aren't the only thing that makes you fat. Especially not the calories of one sole item.
So, like I suggested to someone else a few posts back, if you are the type of person that can keep their novelty eating under control, then Lily's is fine on occasion. If you are the type of person that cannot, then stay away from it altogether. Novelties are not required.
There are many ways to make Lily's chocolates obesogenic. First, they are already obesogenic on their own since they are just an energy dense "food" with no protein. That, in itself, is a gateway for fatness. Aside from the obesogenic profile that these items already have, they can become fat making steroids by simply:
- Eating them out of mealtimes (snacking)
- Eating them instead of proper meals (Lily's molten chocolate cake for dinner)
Both are obesogenic eating practices that are all too commonly done.
5. I lost a lot of weight on low carb. I enjoy the diet and decided to continue on it simply because it is convenient, and I really like the food selection. The problem is that even while following the same diet that got me to slim, I am starting to see my weight creeping up anyway. I wish I was slimmer and back to my lowest weight. My metabolic markers have remained stable, and I continue to be in remission of metabolic syndrome. I just don't like my current weight. I am about twenty-five to thirty pounds over what I was before and preferred.
I have gotten similar questions before, and the answer is always the same. The reason you are gaining weight is because you lost weight. In other words - leptin.
Leptin doesn't care about your diet. It doesn't care about its composition or its calories. All leptin cares about is that there was a challenge to the body's fat mass, and it will now purposely under express, in the brain, to prevent further fat loss and actually cause fat gain. You are experiencing what everyone will experience. All diets fail. The body is protective of its fat. That is the mechanism that keeps you from losing too much weight and dying. Body fat is the largest endocrine modulator in the body. It helps regulate a lot of necessary functions. The most important one is the prevention of death, during famine. Fat is very valuable to the body. It will sacrifice its muscle, for its fat.
For this reason, the only thing you can do now is to not get fatter. In other words, don't give up on your diet and end up tossing it because you feel it is no longer working and not worth the sacrifice. That is the absolute worse decision you can make at this point, but the most common one. Low leptin expression alongside "I feel scorned" chocolate cake are a recipe for disaster.
If the diet you are on got you to slim, then it's because it worked. It's not the diet that isn't working anymore. It's leptin that isn't cooperating anymore. Doubling down now, will only cause leptin to double down even further. You don't want to end up gaining everything back and then some. You have to maintain. Actually, the better word for that is to "control" because no one can maintain diddly squat. That's a lie. Leptin doesn't allow any weight maintenance. It's going to cause weight to go up, so you have to control that. Control is not changing your diet, adding some diet crap to it, extending your fasts or lowering more calories. All of that are main causes for weight rebound.
So, instead of struggling to get to the summit of the mountain (your lowest weight), try staying a few feet down (not overweight/obese). The higher up you are, the harder the fall. It's better to control your weight than be the size you wish you were. Like I have said before, you won't return to your lowest weight. Now your job is to prevent yourself from going back to your highest.
Your weight will stabilize at where your body feels comfortable. This shouldn't be obesity, of course. Obesity is never comfortable for the body. But it sure won't be your lowest weight. Where your weight eventually stabilizes is determined by many things, so there is no one hard line number to guide yourself by. It all depends on age, gender, metabolic state, hormonal state, previous history of obesity and activity level. All of those things control fat cell function.
Carrying around more body fat than you wish you had is not necessarily pathological, until it becomes overweight/obesity. So, don't fear that you have put on a few more pounds that you would like. As you can see, this hasn't affected your metabolic markers. They are still stable because the body doesn't consider itself to be over fat, though your eyes may beg to differ. Continue keeping metabolic markers stable as instability in blood glucose regulation is the engine towards obesity.
6. Snacks are allowed if they are low carb and low calorie.
We do not recommend "snacking". Snacking is an obesogenic habit to have, regardless of macronutrient composition or calories. Our metabolism was not designed for "grazing". We aren't ruminants. Snacking keeps you eating constantly which does not allow your body to regulate its blood glucose and insulin properly. This will eventually deteriorate the function of both over time.
Snacking was once seen as a good way to control weight because it was believed that having low calorie snacks between meals would prevent you from overeating at mealtimes. It didn't pan out that way, even though in the short term, snacking did produce results in some people. It did this by stimulating leptin expression in people who chronically dieted. When you are under chronic calorie restriction, an increase in calories produces weight loss for those who were leptin sensitive. This turned out to be an epic fail though, as chronic insulin dysfunction soon deteriorated this temporary increase in leptin expression and the weight began to pile on again.
If you cannot fast for 16/18 hours a day, then have three meals a day. Space them out so that you are not fasting for long periods of time, except for overnight. Remember when everyone ate breakfast, lunch and dinner, with nothing in between? Return to that.
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