Friday, September 14, 2007

Living with Insulin Resistance (Nine Months after Diagnosis)

Nine months ago, I was diagnosed with insulin resistance, a subset condition of Syndrome X, and a pre-diabetic condition in which a person's insulin levels are elevated and, ultimately, become ineffective. The result: increasingly, the body becomes immune to its own insulin. Eventually, the condition can result in Type 2 diabetes.

Fortunately, my condition was diagnosed before I developed diabetes.

My doctor placed me on a low carb diet, based on the Protein Power diet, which I have mostly been following since December 2006. I say "mostly," because I have had my bad days, though not that many. I just chalk it up to being human and move on; I am able to do this because this dietary change has turned out to be the right one for me, so I'm able to go back to eating normally without a lot of guilt and without the fear that I have "forever fallen off the food cart."

This is not a sales pitch (I have nothing to sell); I'm a firm believer in the concept that our bodies are unique and metabolize nutrients in unique ways.

Having said that, I suspect that insulin resistance and Syndrome X people are vastly under diagnosed, though, for the past year, the media have covered the condition fairly well, and the low carb diet as a medical tool (as opposed to just another weight loss diet) has become more mainstream.

Syndrome X people tend to be overweight or obese (well, that covers about one-third of the general U.S. population), but X people tend to carry much of their weight around the middle. In fact, women with a waist measurement more than 35 inches around and men, 40 inches are particularly at risk.

Other signs and symptoms of Syndrome X:

The starred areas denote my symptoms, most of which could have been explained away by other causes, but my difficulty losing weight and inability to keep it off have always stumped me. For most of my life, I have been on the diet merry-go-round: go on a diet, stick to it for a few months, lose some weight, fall off the diet in a big way, binge for the next two years or so, gain all of my weight back (and then some), go on a diet--well, you get the point.

Insulin resistant people tend to ride this wild merry-go-round, mostly because their doctors and diet programs put them on the wrong diet: a low fat, low protein, and high carb diet, which, in fact, exacerbates the problem and hoodwinks the body into thinking it's starving. The appestat cranks up, and like our need for sleep, the body sends out a powerful signal to eat, eat, and eat, even in the face of evidence that we don't need more food. Hunger is a difficult signal to ignore and has nothing to do with "will power."

Instead, insulin resistant people should be eating a low carb, higher fat, and high protein diet, something similar to the Protein Power diet, although one's doctor should be the person who decides what is best for his/her patient.

Nine months ago, I went on the strictest version of PP diet, but I eventually discovered (through trial and error) that if I occasionally eat 15 or even 20 grams of carb at one time, I'm okay, and seem to stay within my dietary guidelines. But if I pig out on carbs, my body tells me, "whoa": I get extremely groggy and somewhat depressed, and I just have to sleep it off and start a new day.

Last December, I was desperate and went to a diet clinic to discuss the possibility of a gastric bypass surgery, although I realized that I probably would not qualify (I was "only" 70 pounds overweight). I wanted to do something before my weight climbed to the point where it could kill me. Instead, I was put on just another diet (so I thought).

I had tried high protein diets before, but always fell off because I prefer carbs over protein and thought I should work within my preferences. Also, high protein diets are difficult to start; it took my body a good three months to adjust, and most people stop before that. My doctor and husband encouraged me to stick it out and give the new dietary change a chance to work.

Well, for me, the high protein/low carb diet works; I haven't lost weight fast. In fact, weight loss has been strictly secondary. I wanted a life diet that worked for the long haul and didn't leave me hungry all the time.

Do I miss some of my favorite foods? Of course, but I don't crave them like I once did because I allow myself an occasional treat. Also, I have discovered some "new" favorites that have replaced the old high carbs, such as sunflower seeds (in the shell) in place of buttered popcorn. The calorie count is about the same, but sunflower seeds don't kick in that insulin spike.

Some trial and error discoveries:

  • For a treat, eat an occasional favorite high carb and/or sugary food.
  • Never try to make up for a binge by depriving yourself later. That tactic almost never works (at least for me). The next day, begin eating as you normally do.
  • Don't starve. Always eat when you're hungry. Some days I'm hungrier than other days, and it does no good to ignore those bodily signals. When one truly listens to one's body, one will rarely go wrong.
  • Never compare your weight loss with someone else's; everyone loses at different speeds. I always cringe at those competitive weight loss TV programs because our bodies are programmed to deal with metabolism, food intake/outtake, and exercise differently.
  • Tough out those plateaus; they are inevitable, but eventually, the weight comes off. I tend to lose in a "stair step" fashion. I'll stay the same for a month or more, and then 5-7 pounds will slide right off.
  • Make good health your first priority, weight loss secondary.

My weight loss progress has been satisfying but not fast: about 40 pounds since December; I have about 30 pounds to go, but I'm taking it slow and easy. Although I'm still overweight, I feel comfortable in my own skin. I have no compelling reason to lose weight for a certain event or in a certain time frame--I'm in this for the rest of my life!

I'm trusting that if I treat my body well, I should trust that it will treat me well for years to come.

Best, Jennifer

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