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Old 05-05-2013, 09:07 PM   #1
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Six Months and no weight loss

I've been following the Atkins Induction (No Starch, No Sugar Plan) for six months.

95% of the time I eat less than 20g of carbs, 100-125g of protein, and the rest fat. I eat NO fake foods--no bars, no shakes, no artificial sweeteners. Almost everything I eat is high quality real food. My calorie intake is between 1800 and 2200 calories/day.

I've cut back on dairy and nuts.

I'm in my mid 50's, 5'8" and weigh 305.

I have never been in ketosis. (I use the blood ketone meter and it has only once gone above 1.0)

In all this time, I have gained 5 lbs.

I had a full blood workup and everything was normal except slightly high cholesterol and triglycerides. I am diabetic but take no meds for it. My fasting BG is usually under 140. I do take one med for a digestive disorder and even stopped that for a month thinking it might be a factor but there was no change.

I'm at a loss. Just being told to be patient is tiring. It's been six months.

Anyone have any ideas?
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Old 05-06-2013, 07:57 AM   #2
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I know others will have other advice. After 6 months, and having tried other avenues, I would try the 3 day fat fast from DANDR.

Do you monitor your BS regularly?

It is possible being diabetic that you are still having swings in your bs that *might* be interfering with ketosis. It is possible you are eating too much protein. I eat around the same amount of protein most days, I am 35 and very active though. (2+ hours of exercise)

Could you post a sample menu or have you done that here previously?
There could be something you are eating that is causing some problems for you as well. Some acceptable foods can still slow and/or stall.

The fat fast, might help you to see that you can lose weight and to get into ketosis. Dr Atkins recommended a strict induction for two weeks after the fat fast, so you may be able to determine if there is something you are eating or doing that is causing you to barely/rarely hit ketosis as you add foods back.
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Old 05-06-2013, 08:33 AM   #3
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I found another post by you from a couple months ago, I missed the part where you are a man. It is possible that you are plain eating too few calories and causing a cycle of starvation?
I weigh, at this point, somewhere just over 300#, although I am a 5'5' woman. I eat about 3000 calories a day on average. For me though, I have 1-2 days a week that I eat quite a bit more, due to a much higher energy need on those days based on exercise. I deliver newpapers, so on Sunday, it is a lot more work, for example last Sunday I logged 8 miles on my pedometer, and about half of those were definitely in a state of strong aerobic activity. I have learned that if I don't eat a lot of fat the day before and the day of, I feel like I'm starving until Tuesday evening. I have broken it up and consume about 4500 calories Saturday and Sunday. the extra calories coming from fats, not added protein. (think spoonfuls of mayonnaise lol), I then have a couple rebound days where I am not as hungry and eat about 2000 calories.

But by tracking it, I know that in a week, I average about 3000 - 3500 calories a day. When I am carefully following induction, I lose about 2-3 pounds a week.

I recently had a great lesson from DH's endo on how the pancreas and liver function together to control blood sugar. The liver senses how much insulin is active. Now lets say you have impaired insulin production (type 2 diabetes) with insulin resistance.

You eat something. Your pancreas releases insulin for what you ate, but because you are insulin resistant, it wasn't enough, so your pancreas releases MORE insulin.( or depending on how damaged your pancreas is, it can't release enough at all) Now your BS go down. Your insulin levels then drop as your body uses the insulin to put the BS away. Then your liver senses your insulin levels dropping and releases and converts stored glycogen into glucose. You don't have to eat carbs for your liver to store glycogen, your body can make it from protein, either dietary or lean muscle mass if you are not eating enough protein.

I understand completely not wanting to take additional medication. I know that there are some things you can add to your diet that will increase your insulin sensitivity, cinnamon and omega 3s are the ones that come to mind off the top of my head.


The other question I had, is do you drink plenty of water? DH low carbs with me, but we have both noticed, that he only loses weight when he is drinking plenty of water.
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Old 05-06-2013, 08:58 AM   #4
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first of all, can you stop thinking that not taking meds for your diabetes is a good thing, that it means your diabetes is less bad or something? you will almost certainly do better with meds. it's just a self inflicted wound to avoid them at this point.

Metformin might help you lose weight. probably best to ask for the extended release, which tends to be less hard on the digestion. start with just 500mg or so, and then work up to the highest dose you can tolerate. it's WORTH dealing with the digestive issues for a month. they almost always go away with time.

at the risk of offending, are you being really careful with your carbs and calories? if you don't weigh everything it's easy to eat twice what you think you are eating. portion creep is just almost impossible to avoid.

if you get on the metformin and make sure your calories and carbs are what you say, then the next two things to address are: possibly too much protein and too many calories.

you might want to get your insulin level checked. I have a similar problem to what you talk about, but it's incredibly rare. If your insulin level is VERY VERY high, send me a private message to discuss it, ok?

good luck!
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Old 05-06-2013, 08:59 AM   #5
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My doctor, who specializes in low carb diets, and has been mentioned on this board, actually said I was eating too much and should be down to 1600 calories/day.

He wants me to stay on the original Atkins induction which is 20g or less of real carbs, not net carbs.

I only drink water, coffee or tea (both unsweetened with a little cream.)

I'm also limited, per day, to 2T cream, 2T mayo, 4oz cheese, 6 olives, and 1/2 avocado. For extra fat he wants me to limit it to natural saturated fat, butter, bacon, olive oil and coconut oil.

Of course, he keeps saying I shouldn't be hungry even though I still am. Instead of trying to figure out why it's not working for me, all he says is: "This diet works."

As you can imagine, I'm not running back to see him.

I can't take Metformin as it give me bad digestive problems. My insulin is in the normal range albeit at the top of that range. And, the doctor said with this WOE I shouldn't have to take any drugs for diabetes.

I weigh and measure everything so I know exactly what I'm eating. I've been mostly between 1800 and 2200 calories/day although I'm always being yelled at by the "low carb police" because they say I'm not supposed to count calories.

As for protein, my LBW is about 180. (I had it tested.) So, my protein range should be 108-180grams/day. I try to keep it closer to the lower range.

There is so much contradiction with this WOE it's ridiculous. Count calories, don't count calories. Count protein, eat as much as you like. etc. etc. etc.

Last edited by BuzzB; 05-06-2013 at 09:05 AM..
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Old 05-06-2013, 09:57 AM   #6
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First of all, I would like to thank you because you're the person who pointed me to the affordable blood ketone meter a few months ago. Thanks, I really appreciate it!

I don't know if this will help but I have an observation: Are you exercising? Or has your doctor suggested exercise? I don't mean as a route to burn additional calories, but to aid in fatty acid transport and insulin sensitivity.

You've been weighing and measuring your food. You've been eating at a caloric deficit. You've kept carbs in the ketogenic range for a sustained period of time. Those actions *should* work but since they have *not* worked, perhaps there is a problem with a different fat loss mechanism. Eating a ketogenic diet and/or eating at a caloric deficit promotes bodyfat loss because those actions promote the release of bodyfat from storage. But releasing stored fat -- especially in obese bodies and in bodies that have irregular insulin patterns -- is only part of the fat loss equation. Released bodyfat can be restored (reesterified) to fat cells after it has been released, and insulin plays a major role in this process. As noted in this study:
The absolute rate of primary FFA reesterification was not affected by the increase in insulin concentration, but the proportion of FFA molecules undergoing primary reesterification doubled over the physiological portion of the insulin dose-response curve (from 0.23 +/- 0.06 to 0.44 +/- 0.07, P < 0.05). This served to magnify insulin suppression of FFA R(a) twofold. In conclusion, insulin regulates FFA R(a) by inhibition of lipolysis while maintaining a constant rate of primary FFA reesterification.

Regulation of free fatty acid metabolism by insulin in humans: role of lipolysis and reesterification.
Regulation of free fatty acid metabolism by ins... [Am J Physiol. 1992] - PubMed - NCBI
There's a lot of research on exercise and its impact on insulin sensitivity:
The findings reported by Duncan et al. (12) add to a growing body of literature indicating that exercise with or without weight loss improves insulin sensitivity. As already noted, it is well established that acute exercise is associated with substantial improvement in insulin sensitivity independent of any change in cardiorespiratory fitness or body composition.

Does Exercise Without Weight Loss Improve Insulin Sensitivity?
Does Exercise Without Weight Loss Improve Insulin Sensitivity?
Exercise could potentially help in two ways: (1) Hormonal responses to exercise increase insulin sensitivity in muscle tissue and (2) exercise that increases circulation can help by moving fatty acids away from storage sites and deliver the released fat to tissues that will burn the fuel. Exercise has not been established to be a *solution* for obesity but, when dramatic dietary changes fail to produce results, perhaps exercise can address some of the underlying physiological problems.

Just a thought!
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Old 05-06-2013, 10:10 AM   #7
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I've been thinking the same thing about exercise.

My doctor actually suggested I not exercise until I get some weight down and get into ketosis because exercise may increase my hunger.

I'm old enough to remember the days prior to the "low fat" craze. The suggestions to lose weight were simple: cut out bread and potatoes (meaning starch and sugar), and move a bit more. People used butter, there was only one type of milk (whole) and portions were a lot smaller. Oh, and most of the food we ate was real--not fake. They didn't measure fat grams, or carb grams, or protein grams, they just cut out starch and sugar and moved a bit more.

Maybe the old, simple ways were actually best--before scientists got their hands on everything.

Last edited by BuzzB; 05-06-2013 at 10:11 AM..
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Old 05-06-2013, 11:43 AM   #8
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Quote:
Originally Posted by BuzzB View Post
My doctor, who specializes in low carb diets, and has been mentioned on this board, actually said I was eating too much and should be down to 1600 calories/day.

He wants me to stay on the original Atkins induction which is 20g or less of real carbs, not net carbs.
In the original atkins book, I believe you started with 2 small salads and lots of fats and meats, around 10g carbs. In DANDR induction is 20 net carbs. I lose best on about 15 net for example.

Quote:
Originally Posted by BuzzB View Post
I only drink water, coffee or tea (both unsweetened with a little cream.)
I've heard that some people have problems with caffeine, and Atkins says no caffeine as it can cause BS issues. I do lots of espresso, though and no issues for me, or at least I'm still losing weight.

Quote:
Originally Posted by BuzzB View Post
Of course, he keeps saying I shouldn't be hungry even though I still am. Instead of trying to figure out why it's not working for me, all he says is: "This diet works."

As you can imagine, I'm not running back to see him.

There is so much contradiction with this WOE it's ridiculous. Count calories, don't count calories. Count protein, eat as much as you like. etc. etc. etc.
Do you have a copy of DANDR? Maybe try the diet "by the book" rather than a Doctor's modified version? I know it can be confusing reading on here, because there are several varieties of LC and people have to tweak Atkins even to fit them. For example, I can't have cream everyday unless I want to dramatically slow weight loss. ( I have it anyways a couple times a month with before mentioned espresso).

Quote:
Originally Posted by Trillex View Post

I don't know if this will help but I have an observation: Are you exercising? Or has your doctor suggested exercise? I don't mean as a route to burn additional calories, but to aid in fatty acid transport and insulin sensitivity.

You've been weighing and measuring your food. You've been eating at a caloric deficit. You've kept carbs in the ketogenic range for a sustained period of time. Those actions *should* work but since they have *not* worked, perhaps there is a problem with a different fat loss mechanism. Eating a ketogenic diet and/or eating at a caloric deficit promotes bodyfat loss because those actions promote the release of bodyfat from storage. But releasing stored fat -- especially in obese bodies and in bodies that have irregular insulin patterns -- is only part of the fat loss equation. Released bodyfat can be restored (reesterified) to fat cells after it has been released, and insulin plays a major role in this process. As noted in this study:
The absolute rate of primary FFA reesterification was not affected by the increase in insulin concentration, but the proportion of FFA molecules undergoing primary reesterification doubled over the physiological portion of the insulin dose-response curve (from 0.23 +/- 0.06 to 0.44 +/- 0.07, P < 0.05). This served to magnify insulin suppression of FFA R(a) twofold. In conclusion, insulin regulates FFA R(a) by inhibition of lipolysis while maintaining a constant rate of primary FFA reesterification.

Regulation of free fatty acid metabolism by insulin in humans: role of lipolysis and reesterification.
Regulation of free fatty acid metabolism by ins... [Am J Physiol. 1992] - PubMed - NCBI
Nice! I think this goes nicely with what I just learned from DH endo. More info to file away in the brain, for recall later when I can't remember where I read it! lol.
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Old 05-06-2013, 11:53 AM   #9
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What is DANDR? If it's one of the Atkins books, which year?

My doctor worked with Dr. Atkins and the diet I'm on is the plan prior to the current one. They have so many different names it's confusing.

As for caffeine, I'm limited to 3 servings a day. Cream is okay as long as I limit to 2T/day.

I am limited to no more than 20 carbs a day. Not net carbs, actual carbs. Two cups of greens, one cup of other non-starchy vegetables.
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Old 05-06-2013, 04:59 PM   #10
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Dr. Atkin's New Diet Revolution = DANDR.

Honestly, I don't know much about the current book. I have the edition with the white cover published in 2002.

haha, I would be okay with three servings, as long as a serving is a quad shot
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Old 05-07-2013, 12:15 PM   #11
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Have you had your testosterone levels checked? As we get older and heavier, testosterone levels plummet. Even if your libido is fine, you can still have low testosterone levels.

If you can start walking 10-15 minutes per day, without injury and adding any more calories, it may help. You'd be surprised how quickly your strength and endurance will increase. Like your doc says though, you can't increase the caloric intake!

Or, get a pedometer and see how many steps per day you are taking. I go for 10,000 steps per day minimum. If you are sedentary you are probably only getting 2-3K steps per day.

The difference between 3K steps per day and 10K steps per day equals about 40-50lbs per year in burned calories! If 10K is too much, start lower and work your way up. The new pedometers with accelerometers upload via bluetooth to your smartphone to track your daily progress.
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Old 05-07-2013, 12:20 PM   #12
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Thanks. Yes, I've realized the one component that I haven't changed/tried in years is regular exercise.

I've dusted off the exercise bike ad it's waiting for me. And if I should get bored of that, my subdivision has a full gym.

Now I just have to get motivated.
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Old 05-08-2013, 01:09 PM   #13
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Along the same lines as the testosterone question, have you seen an endocrinologist and/or had your various hormone levels checked?

There are people who absolutely starve themselves and GAIN weight- because they have Cushing's or another hormonal imbalance. Thyroid, too. Of course, they have a hell of a time finding a doctor who believes them and orders the appropriate tests.

You really should have lost at least some weight, exercise or no. I think something else might be going on. Find someone who will listen to you...
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Old 05-10-2013, 04:28 PM   #14
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I think that your doctor is telling you all the correct things.
Why does he think you aren't losing weight?
Can we see some sample eating days?
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Old 05-10-2013, 04:48 PM   #15
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He thinks I'm cheating and not telling him what I ate.

He does the following:

1) He asks if I get hungry. When I say I do, he says "you're not supposed to be hungry." (Yeah, but I am.)
2)He'll look at my detailed list of foods for each day and say things like: "You had one too many tablespoons of cream" or "One too many tablespoons of mayo."
3) When I ask why it isn't working he says it's the exact diet Dr. Atkins used, it's helped over 66,000 people and it works. And leaves it at that.

BTW--nothing in my blood tests showed anything that could cause this problem.

I haven't gone back to see him in 3 months. Why waste money?

An average day is:

Breakfast:

Coffee (2c)
Cream--1T
2 Eggs
1T butter
2-3 slices of bacon or sausage (uncured)

Lunch:

1 cup of leafy greens
1/2 cup of approved vegies
4-6 ounces of protein
2-3 T of added fat--usually olive oil--for salad
1t vinegar
1T butter for vegies
Avocado (1/2)
Coffee--1 cup w/1/2 T cream

Dinner--same as lunch just a larger portion of protein(6-8 ounces)

Snacks:

Olives soaked in oil
Tea with 1/2t cream
sliced uncured meat
Small cans of sardines, tuna or salmon (All packed in oil)


It averages: Carbs--under 20g, Protein--between 100 and 125g, and the rest fat.
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Old 05-11-2013, 10:44 AM   #16
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3) When I ask why it isn't working he says it's the exact diet Dr. Atkins used, it's helped over 66,000 people and it works. And leaves it at that.

I still recommend getting the book. You are eating atkins induction, but Atkins did not say to limit meats and fats. You can get it for about $7 with shipping on amazon

Rule number 6 of induction: Adjust the quantity you eat to suit your appetite. When hungry eat the amount (of acceptable foods) that allow you to feel satisfied, not stuffed. When not hungry eat a small controlled carb snack.


And Olives, avocados, and cream are what Dr Atkins considered "special category foods. ". . . each day you can eat 10 to 20 olives, half a small avocado OR 1 oz sour cream OR 3 ounces cream. . . "
because these things can stall you.

In the Next chapter it talks about reviewing your time on Atkins. The first question you ask yourself, is am i still hungry?
And Dr. Atkins says, if you are feeling hungry, you are not eating enough.

There is also a chapter about Metabolic resistance, and strategies for overcoming extreme resistance to weight loss while low carbing.
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Old 05-13-2013, 07:00 AM   #17
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some suggestions

I would suggest you track your sodium intake. As we age the amount of sodium we should consume is lower than 2500 mg per day recommended on many websites.

Also get the atkins book and read the chapter 20 and 24. These chapters are all about metabolic resistance.

In the atkins book it also mentions drinking eight glasses of water. Are you drinking all the water? The water helped me when my weight loss slowed.

Hope this helps

Lorraine
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Old 05-13-2013, 09:45 AM   #18
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This is what it says for induction regarding olives etc:

"6.In a typical day, you can have up to 4 ounces of most cheese (but not cottage cheese or ricotta), 10 black or 20 green olives, half a Haas avocado (the kind with a blackish pebbly skin), an ounce of sour cream or 2–3 tablespoons of cream, and up to 3 tablespoons of lemon or lime juice. The carbs in these foods must be counted in your 20 grams of Net Carbs."

It doesn't say OR so is that what it really means? If so, I haven't been doing it right, but I'm still losing. ??
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Old 05-14-2013, 06:40 AM   #19
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I've always read it to mean, either/or. But as I read it carefully, and another section, it IS the cream/sour cream that is either/or! But he does still mention that these things (olives, avocado, and cream) can slow/stall some people and if so, may need to be avoided at first.
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