My personal experience using LCHF diet and diet medicine to deal with weight regain after hitting plateau

I lost 30 pounds on Invokana 

Then started Atkins Induction phase 20 g CARB/d. 
Lost another 10 pounds in a week. 

Strangely this week I also felt the initial effects of nausea, early satiety of Victoza again. 

1-6-11 #LCHF No wt. loss 258 lbs


1-12  #Victoza caused 5 lb wt. loss 

5-12 # Insulin gained to 265 lbs

3-14  Started Invokana, 
10-14 wt. down to 235 lbs on Invokana

6-23-15  weigh in at Obesity Clinic. 244 lbs
 I Started  Qsymia

# Atkins Induction 20 g CHO/d 10-20-14

NK 1.6 10-29-14, then
Victoza suddenly seems to have side effects again with Nausea, early satiety last 5 days. 224 lbs. on 12-2-14

 On LCHF diet I simply avoid carbs as best I can.

I came back from Hawaii on March 1, 2014 and weighed in at 265.  

This is the closest I got back to my highest weight of 280 in March 2006.

I attribute both high weights to Insulin.
  

On March 4, 2014, I started Invokana and stopped Insulin.

My glucose immediately improved going down below 150.

 I also lost weight without changing diet or exercise. I was 239.5 lbs
 before leaving for Europe on Aug. 17, 2014.

Last week on, Oct 8, 2014. I came back from a 30 day cruise and I lost two more pounds to be at a new recent low of 237.
I ate well, tried to limit carbs, and drank alcohol each night 
but I tried to walk 10,000 steps a day.

After a week of following LCHF more carefully at home, I am down to 233.5.

On Oct 20, I started Induction phase again of Atkins
 which means I tried to eat less than 20 g CHO.

 I also stopped alcohol.  On Oct. 27
 I am down to 229 pounds.

I had my lab taken this morning. My lab data here

Update 11-1-14

Interesting development as of 10-30-14.  My Victoza is decreasing my appetite with some nausea and a tired feeling similar to when I first started the injections in Jan. 2011.  Has the improved ratio of my body fat to lean muscle improved to the point that the hormone is more effective or my central adipose tissue is producing less hormones to induce insulin resistance? My weight is down to 224 pounds. I am in the land of temptation NOLA.

Update 11-19-14

Intermittent epigastric pain.  3/10 lasting a minute or two.  

Update 4-8-15 

I have been traveling for the last 3 months.
 I circumnavigated the world.  46 of the travel days was on Oceania cruise.
The good news is I am at 233 lbs.
I was 231 lbs when I left Florida on Dec 30.

I follow Atkins or LCHF in general.
 I am not hungry.
 I probably walk more than I do at Kansas.
 My high intensity interval training is walking the stairs on the ship.
 No weight lifting and I ran out of testosterone 2 months ago.
 I continued Victoza, Invokana, metaformin, Actos,  and atorvastatin 10mg faithfully.

My LDLc was: 71, 
non-HDLc 85, 
Triglycerides 68, 
HDLc 68.  
I am awaiting Hgb A1c and Liposcience profile for advanced lipid testing.  see Metrics on 60% fat link.

My last month was in Hawaii.  Maui always presents the greatest challenge to my LCHF diet and exercise. 

I had frequent pasta on the cruise but I mitigated those carbs with walking almost after every meal and walking stairs.   I did drink a lot of alcohol.  I am after all trying to be a Bon Vivant.  

I have been having some epigastric pain since Nov.  It started after a large steak.  I had a EGD or gastroscope in Dec.  Despite 12 hours fasting I still had food in my stomach.  I believe my gastroparesis is more from Victoza than diabetes.  

I felt better in Jan while taking tetracycline for Malaria prevention.  I have diverticulitis and perhaps this antibiotic made the pain better? 

However after a very large spicy meal in Sydney I had what I thought was diverticulitis in my left lower quadrant. It was very different from the epigastric pain and was better after 3 days of resuming tetracycline.  

I had a normal ultrasound of abdomen in Dec. and my amylase and liver function blood tests are normal.   When I peaked my alcohol consumption while on the premium drink package for 16 days from Sydney to Auckland on Oceania I had no abdominal pain. I had at least 10 drinks a day.

UPDATE July 16, 2015

Despite stopping Victoza, I continued to have vague epigastric discomfort intermittently.  No nausea, not related to ETOH.  I had a contrast CT scan of abdomen/pelvis which showed diverticulosis and small hiatal hernia. 

On June 24, 2015 I started the lowest dose of Qysmia. I was 241 pounds.  The only change in my diet and exercise was to decrease my ETOH to 4oz week.  After 3 weeks I lost 6 pounds. 

I am on the next higher dose of Qysmia and have started a Trans-Canadian train trip followed by a 29 day Land of the Midnight Sun cruise.  The Saga of Topeka Tubby continues. 

 UPDATE 9-6-15

I just returned from a 28 day cruise on Holland America.  It was part of a 54 day vacation.  
When I left for Canada on July 14 I weighed 235.5 lbs.  
On August 11 I ran out of Qsymia.  I resumed Victoza on August 14 to replace the Qsymia and ran out of it on Aug 29.
I weighed 240 lbs  first day back in the states on Sept. 1 in NYC.  
I ate a lot of carbs in NYC.  I weighed 245 lbs back in Kansas today 9-6-15.
I hope that now I can resume my LCHF diet that I will rapidly get back to 240 lbs. 
Most interesting is that the mild abdominal pain came back on Victoza.  This is the only diet medicine that has abdominal pain as a side effect?

I am 63 years old.  I lost 80 after going on 1500 calorie diet and one hour exercise a day in 2007.  I gained 50 lbs back despite 2 hours of exercise a day.  I did not want to go back to a sub-starvation lifestyle.  LCHF since 1-11 has allowed me to enjoy my life without further weight gain.  Invokana and Victoza have helped me lose another 30 pounds recently.  

My goal is to get off Actos.  I decreased my dose today (9-6-15) from 45mg to 30 mg. 


UPDATE 5-12-18

Still on Low Carbohydrate High Fat diet. 
Usually run 205 to 211 lbs. 

Trying to gain muscle mass with little weight gain. 
 Try to eat 150 grams of protein a day.  
Try to lift weights everyday alternating 
upper body on even days and 
lower body on odd days. 
 I try to do 25 repetitions with lowest weight or till my muscle burns on last 3 reps.  
I try to get up to 3 sets but with breaks in the routine I have not been able to get to that many sets.  After two weeks I get to two sets.  

Saropenia at 66 years old is what I am trying to avoid.  
Unfortunately with large weight loss is also large muscle loss.  
I only learned about high protein with high repetition resistance training last year. 

Older men lose much of their muscle mass in their legs.  Fortunately for me I do better with lower body exercises can do more sets sooner. 

My goal is to decrease my visceral fat from 15 to 9 while not losing muscle mass. (my body composition scale at home can read this for me)

In simpler terms, I want my waist to go from 41" to 39".

If I am not on strict LCHF diet, my fasting glucose will go up to 180.  I am happy with  150 and a Hgb A1c of 6.5.

Insulin always makes me gain a lot of weight.  

I went off Actos and my FG shot up to 300.  
I did lose 5-10 lbs. 

I went on Invokana and Victoza.  I had already been on metformin. 

LCHF has not caused weight loss despite being in serum nutritional ketosis.  

Diet medications caused weight loss and definitely not exercise.
 Yoni Freedman taught me you can't outrun your fork and Eric Westman echoed that at a meeting. 
Obesity specialist clinic know this.  Guidelines don't know it yet. 

I am happy on Low Carb High Fat as I am never hungry and my diet medications, now Belviq, keeps the hunger at bay despite low leptin due to being reduced obese with billions of fat cells the never go away. 

205-210 lbs is a good weight.  I just want to see if I can improve my insulin resistance with loss of visceral fat and not muscle loss. 

UPDATE 9-5-18
I was on a seven day cruise out of Paris to Normandy.  Very nice. Great drink package and met good Australian drinking buddies. Good time. I keep on LCHF on cruise with occasional bite of ice cream. 
I stopped lifting weights on this trip and since the trip.  I have been disappointed with trying to get more muscle with  less fat. I ate 200 gram protein a day and got up to two sets of 25 reps.  Increased weight as it got easier so that I would feel the burn in the last few repetitions. At 66 yo I am on testosterone 100mg/d yet it is an effort and while I did look better, my weight went up as I was on low dose Actos to improve my FBS.  No real difference in FBS, around 150.
I will still lift weights and walk 20 minutes a day for health. However in accordance with my Bon Vivant diet I will not push the protein (at least 110 g/d) high fat and try not to eat any carbs.  I am not hungry on meds. 
This last week I had diverticulitis.  I took flagyl and bactrim.  Flagyl causes an antabuse reaction so I have not drank any alcohol for last 8 days. 

DATE           Weight    Glucose   Ketones

6-30-2018           209.6            164               0.6

9-5- 2018             211.4            170              1.3

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