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As always before we start, I’m not a doctor so nothing here should be construed as medical advice – I’m just sharing my research and personal experience. Always consult with your medical practitioner in matters regarding your health.
My quest to be at a healthy weight
Gather round friends and let me tell you a story you’ve probably heard before or even told yourself.
I cannot for the life of me, lose weight.
Yes, I know you’ve heard it before, right? But in my case (and for many others) it’s a #truestory.
I’ve battled with my weight since pre-puberty. I have done just about every diet known to man kind, dabbled with the idea of weight loss surgery, done programs, been to fat camps – you name it. (You can check out my last failed attempt with the Fast 800 diet here).
I’ve bobbled up and down on the scales (mostly up) and argued with nutritionists and doctors over the food I eat and how I couldn’t possibly be fat if I was eating as healthy as I said I was.
Yet, here we are.
I won’t bore you with all the details but here are some of the highlights to bring you up to speed with where I am on the journey now.
I hit puberty at the age of 12 and that’s when my weight really started to go up – I had heavy and really inconsistent periods from the start. I gained a lot of weight and by the time I was a freshman in high school I was definitely one of the ‘fat girls.’
I went off to boarding school that first year of high school and I lost a ton of weight. Not in a healthy way – I basically starved myself and when I did it eat…it was junk. Lots and lots of carbs.
No one thought anything of it because most of the girls did. We were homesick and comfort eating. Plus junk food was easy to stash in our rooms.
I managed to stay at a reasonable weight for most of high school – I was on the ‘bigger’ side but I could live with it.
Fast forward to my early 20’s and my weight crept up a bit. I hit 23 and inadvertently started eating a low-carb diet and lost weight. Then I fell in love and it was down hill from there (lol).
I got married and slowly started gaining weight and then had my first baby. After that the weight stayed on. I went to my doctor after my first son as we were having a little trouble conceiving again and was diagnosed with PCOS.
He told me I was lucky to have had baby number one and it was probably unlikely I’d have another (FYI, he was extremely wrong there). He prescribed Metformin, told me to lose weight and sent me on my way.
Instead, I went home, did a ‘cleanse’ and fast (gee low-carb) and ended up pregnant again within 2 months. Unfortunately that also meant gaining more weight I couldn’t shift after the pregnancy.
When my second was 18 months old I discovered Atkins. I gave it a try and in 9 months lost over 30 kilos (that’s around 70 pounds). Unfortunately, my marriage fell into troubled times and I started eating poorly again and the weight piled on, and then some.
I spent many years in the very overweight range after that, had 2 more babies, both of which, brought gestational diabetes with them. The first time I was able to control it through diet and the second I had to take insulin.
After my daughter was born I tried a nutritional program and lost weight and felt great. Yes, there were shakes involved, but based on previous experience I knew it was cutting out sugar and grains that was making the biggest difference.
Of course, by this time the doctors also told me I was pre-diabetic and needed to be careful or I was sure to get Type 2 diabetes. Then I found myself pregnant again, and once again with gestational diabetes.
I cut right back on sugar and grains but still ended up needing insulin even though my diet was very good. Once #5 was born I was back to pre-diabetic status.
After dealing with symptoms of PCOS my whole life I suddenly found myself in my 40’s with completely regular periods for the first time ever, but struggled terribly with trying to lose weight.
I knew that cutting out carbs – especially grains and sugar made me feel so much better but the weight didn’t budge and I repeatedly gave up in frustration.
That brings us to the diagnosis of Insulin Resistance and where I find myself today, as a woman in her late 40’s who CANNOT LOSE weight.
Now let’s dig in to what insulin resistance means and how I’m approaching it with a fresh strategy.
What is Insulin?
Let’s start with the basics. Insulin is a hormone secreted by your pancreas and its main role is to help regulate the amount of glucose in your blood stream. Its primary role is to keep our blood glucose levels in a very tight range — called blood glucose homeostasis. When glucose levels rise, more insulin is secreted. When glucose levels fall, less insulin is secreted.
It also helps store glucose in your liver, fat, and muscles and finally, it regulates your body’s metabolism of carbohydrates, fats, and proteins.
When insulin levels are high, it stimulates fat cells to take up glucose and turn it into fat (lipogenesis). Then, when insulin is low, it enables the body to take the fat out of storage and use it for energy.
When you eat a meal that contains carbohydrates, the amount of blood sugar in your bloodstream increases. The cells in your pancreas sense this increase and release insulin into your blood.
Insulin then travels around your bloodstream, telling your cells to pick up the sugar from your blood and store the energy for later use. This process results in reducing your blood sugar levels and returning you to glucose homeostasis.
What is Insulin Resistance?
Over time, a high carb/sugar diet causes our cells to become resistant to insulin – which means the cells are unable to properly absorb sugar from the bloodstream.
Because the cells aren’t getting enough sugar, they don’t tell the pancreas to stop producing insulin.
So the pancreas keeps on producing insulin in an attempt to feed the cells. Excess insulin instructs your liver to manufacture fat while your appetite soars… and your metabolism dives.
Insulin enables glucose to be used by cells for fuel or stored as glycogen in muscle and liver cells. Falling levels of insulin let the liver know when to make more glucose (gluconeogenesis) and rising insulin levels let the liver know when to stop.
Under this condition, as your sugar levels rise, your pancreas produces even more insulin in an attempt to lower your blood sugar levels. This leads to high insulin levels in your blood, termed hyperinsulinemia.
Over time, your cells may become increasingly resistant to insulin, resulting in a rise in both insulin and blood sugar levels.
What Causes Insulin Resistance?
Genetic risk factors, environmental risk factors, and lifestyle factors have all been found to contribute to the development of insulin resistance.
While some people may be genetically more likely to develop insulin resistance, the biggest impact is thought to have come come from the change in our food environment in recent decades.
Convenience has been the catch cry of the food industry and these foods are loaded with simple carbohydrates which are then converted into large amounts of glucose that we may not need for energy, so they are stored as fat.
Your gut microbiota. Evidence suggests that a disruption in the bacterial environment in your gut can cause inflammation that exacerbates insulin resistance and other metabolic problems
Does MTHFR have an influence on Insulin Resistance?
There are no studies that make a direct correlation with MTHFR and insulin resistance. But I am still intrigued by the idea that it could have some influence. I do know that personally, being diagnosed with MTHFR helped me figure a lot out in regards to my own health. Things made a lot more sense once I started digging into my gene variants.
That said, scientists have determined many mechanisms and pathways that contribute to the development of insulin resistance. Interestingly, although we often think of insulin resistance in terms of the effect of insulin on glucose metabolism, one of the major causes is actually disordered fatty acid metabolism. MTHFR has been tied to disordered fatty acid metabolism but whether this is intrinsically tied to insulin resistance has yet to be determined.
The scientific evidence suggests that fatty acids inappropriately accumulate in muscle and liver which then interferes with their cells’ ability to respond to insulin and take up glucose. People with MTHFR can already have difficulty in metabolising fatty acids so there is a chance that having MTHFR can influence your propensity to insulin resistance.
MTHFR aside, how do excess fatty acids invade muscle and liver cells?
One mechanism involves the over-consumption of sugar, especially fructose, and particularly when eating excessive calories. This is thought to lead to excessive production of fat in the liver, which then leads to increased insulin resistance.
Basically the typical SAD (Standard American/Australian Diet) of excess carbohydrates, fats and calories leads to insulin resistance.
Finally, it’s important to understand the catch-22 that is elevated insulin itself may worsen insulin resistance. This creates a vicious cycle of insulin resistance and hyperinsulinemia likely made worse by ongoing calorie excess and weight gain.
How are PCOS, Metabolic Syndrome and Insulin Resistance Related?
The short answer would be yes because they all share the aspect of insulin resistance. That said you can have PCOS and not have insulin resistance but it more than likely you will. One of the main symptoms of Metabolic Syndrome is insulin resistance though you can have insulin resistance and not have full blow Metabolic Syndrome.
There are a ton of conditions that are associate with insulin resistance including:
- Non-alcoholic Fatty Liver Disease
- Cardiovascular disease
- Alzheimer’s disease
- Adaptive Insulin Resistance
Symptoms of Insulin Resistance and Getting Diagnosed
Here are some possible symptoms:
- Unshiftable weight gain
- Bulging belly or “beer belly”
- Cravings for sugar (especially after dinner)
- Bladder issues (especially at night)
- Brain fog
So how do you know if you are insulin resistant? Are there tests?
It can be difficult to be diagnosed as many doctors aren’t trained to look for it. They tend to head straight for diabetes testing and often that is years after blood sugar levels have already been elevated.
One of the earliest symptoms of insulin resistance is an every expanding waistline or belly fat even on normal weight people.
Greater the size of your waist in relation to your height can actually tell you a lot about your insulin sensitivity. For more information see this post here.
To get your ratio, just divide your waist measurement by your height. A waist-to-height ratio less than 0.5 indicates good insulin sensitivity, while a number higher than 0.5 indicates worsening insulin resistance.
Lucky me I’m both short and round – the classic apple shape.
Symptoms of Insulin Resistance:
Often there are no other symptoms than increased abdominal fat. Many people feel completely fine, while others experience things like high blood sugar, frequent urination, excessive thirst, fatigue and excessive hunger.
Other signs can be dark dry patches on the armpits, back of the neck, or around the groin (acanthosis nigricans). Skin tags can also be a sign in some people and is thought to be because insulin is actually a stimulator of cell growth.
Can You Reverse Insulin Resistance?
There is lots of evidence that suggests that you can reverse insulin resistance. The sooner you do the better chance you have of overcoming it. The longer you have it the more damage that occurs to your body so it’s something you should take care of as soon as you are aware of it.
According to Healthline “It’s fairly easy to reduce insulin resistance.” (I beg to differ…but hey, that’s just my experience).
According to the Healthline article –
“Interestingly, you can often completely reverse this condition by changing your lifestyle in the following ways:”
- Lose belly fat.
- Stop smoking.
- Reduce sugar intake.
- Eat well.
- Omega-3 fatty acids.
- Reduce stress.
- Donate blood.
- Intermittent fasting.
- A Low Carb Diet
How I’m Using This Information for My Own Health
I’m turning 50 next year and I can’t deal with the thought of entering another decade being unhealthy. I’ve stopped and started low carb/keto eating more times than I can count, but I decided to give it another go but am approaching things a little differently this time.
After doing a lot of research and reading of other peoples experiences I’m adding a good dose of patience to my plan. I think in the past I’ve given up too soon when I don’t see the quick results.
I looked over my past and considered things that worked for me and have cobbled together a plan that meshes those experiences with the new research I’ve done.
Hopefully I’ll be able to tackle this mountain and bring my health back into alignment. I need to hang around for all these kids I made!
You can follow my journey here on the blog and on my social media accounts.
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Clinical Biochemist Reviews 2005: Insulin and insulin resistance[overview article; ungraded]
Diabetes 2012: Banting lecture 2011 hyperinsulinemia: cause or consequence?[overview article; ungraded]
Clinical Biochemist Reviews 2005: Insulin and insulin resistance[overview article; ungraded]
Best Practice and Research Clinical Endocrinology and Metabolism 2006: Pathophysiology of insulin resistance[overview article; ungraded]
Nutrients. 2013 Mar; 5(3): 829–851. The Role of Gut Microbiota on Insulin Resistance. Published online 2013 Mar 12. doi: 10.3390/nu5030829
The information on this site has not been evaluated by the FDA or the TGA and is not to be taken as medical advice. I am not a doctor and only offer up the personal experience of my family. All material on this website is provided for information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this website, instead, readers should consult with the appropriate health professional in any matter relating to their health and well-being. Readers who fail to consult with the appropriate health professional assume the risk of any injuries.