A recent study from Dr. Sarah Hallberg and colleagues at Virta Health, a company that provides treatment for the reversal of type 2 diabetes, reports that their program promoting carbohydrate reduction normalizes blood sugar in over 50% of people with prediabetes.

In 2019, we promoted the impressive results from studies by Dr. Sarah Hallberg and her team at Virta, demonstrating the effectiveness of their ketogenic diet intervention for treating type 2 diabetes. Now, they have similar findings for those with prediabetes.

Their most recent intervention utilized an app-based coaching program, promoting a diet with fewer than 30 grams of total carbs, at least 1.5 grams per kilo of protein, and consumption of dietary fat to satiety.

At two years, the authors note 75% retention, which is excellent when it comes to a nutritional intervention. They compare their findings to the much lower retention displayed in the National Diabetes Prevention Program.

The authors also report that 52.3% of participants achieved a normal blood sugar level at two years. On average, participants lost 12 kilos (11% of their initial body weight) and saw significant improvements in their high-density lipoprotein (HDL), triglycerides, liver function, and fasting insulin levels.

Since this is not a randomized study, there is no control group for comparison. Therefore, we cannot claim that a ketogenic diet is more effective than other diets for prediabetes.

However, we can conclude that a low-carbohydrate diet — with adequate protein — is an effective option for impressive weight loss and prediabetes treatment.

We can also conclude that those who follow the prescribed diet and participate in their care model have excellent compliance at two years.

The timing of these results juxtaposes nicely with the recent results published in The New England Journal of Medicine (NEJM) and The Journal of the American Medical Association (JAMA), showing an impressive 15% average weight loss benefit from semaglutide, a GLP-1 agonist medication.

These studies also reported a 0.5% decrease in A1c (a marker reflecting average blood glucose levels for the past three months) and improved triglycerides and serum insulin.

Together, the Virta health trial and the semaglutide trials demonstrate the importance of weight loss for improving metabolic health. However, semaglutide comes with side effects in 80% of people in the studies.

Fortunately, side effects were not severe in most people. But the high rate of participants who experienced them leads us to question whether individuals may be “better off” taking medication or trying a low-carb intervention program, such as the one used by Virta.

At Diet Doctor, we believe everyone deserves the support and encouragement to succeed with natural healthy weight loss. If extra support is needed, weight loss medications and even surgery are viable options.

As we have seen repeatedly, prioritizing protein and reducing carbohydrates can help many people succeed without medication or surgery.

Thanks for reading,
Bret Scher MD FACC

Earlier

Metabolic health is a better predictor of heart disease risk than LDL

Keto diet improved PCOS and NAFLD better than medical therapy

Does keto only work for six months?

Dr. Tony Hampton is a family physician on the South Side of Chicago. He is writing a monthly column for Diet Doctor. This is his fifth column.

When I was a young doctor in training, going more than 24 hours without sleep was expected. It proved that you were tough and strong, that you could handle the demanding pace of medicine.

We’d boast about how long we’d been awake, but then driving home from work I’d almost fall asleep at a stoplight. I’d struggle to stay awake when a patient gave their medical history. Going without enough sleep wasn’t good— for me and my health, for my patients, or for how I was interacting with the world!

Over the years I’ve heard a lot of people — patients, business people, celebrities — brag about how they just need four or five hours of sleep as if it’s a superpower.

But the real superpower, for your health and your weight, is to prioritize your sleep. That means you should be doing everything you can to get a good night’s sleep so that you wake up rested and refreshed.

For most people that is getting somewhere between 7 and 9 hours of shut-eye. Babies, young children, and teens need even more.

If you’ve been reading my columns here at Diet Doctor you know that I always tell patients to make sure to protect their NEST. The S in NEST acronym stands for both stress and sleep, which are two sides of the same coin. (To recap, the letters are: Nutrition, Exercise, Stress/Sleep, Thoughts/Trauma.)

This column is going to focus on why sleep is so necessary for health and happiness, and even for weight control. It will also give some tips for how you know if you are getting enough and what to do to get a better night’s sleep.

Finally, it will highlight when you might need to seek help for sleep problems like sleep apnea, chronic insomnia, and other sleep disorders.

As essential as breathing

Did you know that you can go about three minutes without air, about four days without water, and only about nine days without sleep?

Our need for sleep is more immediate than food. We can last much longer without eating, but most people will start having physical and cognitive difficulties by 48 hours and outright hallucinations by 72 hours without sleep.

Why is sleep so essential? For something that takes up a third of our life, sleep still holds a lot of mysteries. But we do know that many biological repair processes and basic maintenance of body functions take place during sleep. We make antibodies, clear infections, get rid of cellular waste, rest and restore our brain, and boost our immune system.

When you don’t get enough sleep your immune system weakens, inflammation increases, and brain function is undermined. You’re apt to be irritable, forgetful, and make poor decisions after even one night of bad sleep.

A brain that is regularly deprived of sleep may also lead to depression, anxiety, or other mental health issues. While it is not confirmed, it’s suggested that chronic sleep deprivation may even play a role in future cognitive impairment, such as increasing the risk for Alzheimer’s disease.

How does poor sleep contribute to obesity, diabetes, and metabolic issues? It’s known that lack of sleep raises the stress hormone cortisol and increases glucose production, which raises your blood sugar.

Studies have shown that markers of increased insulin resistance appear after just one night of partial sleep deprivation. Symptoms of prediabetes can arise with as little as five days of sleep disturbances. Blood pressure also increases with sleep deprivation.

Other studies show that when you are sleep deprived, the hunger hormone ghrelin increases while leptin decreases, which leads to increased hunger and cravings. You are more apt to overeat, especially on unhealthy foods, to consume more calories, and to experience emotional or stress eating when you are sleep deprived.

So it’s clear: getting enough sleep is one of the top things our bodies need to thrive and survive.

Are you getting enough sleep?

Patients are often very concerned about whether they’re getting enough good-quality sleep. Not everyone needs the same amount. Here are some ways to tell if you’re getting enough:

You don’t need an alarm clock to wake up

You wake up on weekdays and weekends at the same time

You’re not tired when driving, reading, or watching a movie during the day

Your memory and concentration are okay

You’re not always hungry and having cravings.

You feel generally refreshed and revived after a night of sleep.

In addition, if you find yourself being irritable and angry, or easily upset you may not be well-rested.

Don’t fret if you get one or two nights without good sleep. One way to undermine your sleep quality is to be overly worried and stressed about your sleep.

Just prioritize getting to bed at a good time and follow some good sleep habits, as outlined in the next section.

How to improve sleep

There are a number of proven ways to get a better night’s sleep. These largely involve setting up a relaxing sleep routine and creating a better sleep environment. Some of these are done right before bed, but some are done during the day in order to set you up for a night of better sleep.

Establish a sleep routine:

• Go to bed and wake up at the same time, seven days a week, to establish a circadian rhythm.
• Have a relaxing pre-bed ritual that readies you for sleep. This can be as simple as brushing your teeth and washing your face, dimming the lights; or can include breathing exercises or meditation.
• A warm bath before bed can help some people relax and sleep more soundly.
• Jot worries, “to-do” lists, or other repetitive thoughts on a pad beside the bed to get them out of your head. (If you wake up in the middle of the night worrying, jot worries on the pad.)
• Avoid any provoking or upsetting activities close to bedtime, which can include scary books or movies, arguments, work emails, etc.
• If you are having trouble falling asleep or going back to sleep after awakening, do not lie in bed worrying. Do something relaxing until you feel tired.
• Consider taking a magnesium supplement before bed to help relax muscles and prevent leg cramps. A magnesium cream that is massaged into muscles can help, too.

Watch what you eat and drink:

• Stop caffeine by 2 pm, or by noon, if caffeine sensitive — remember it’s not just coffee but tea, chocolate, and some energy drinks.
• Stop alcohol at least three hours before bedtime – it disrupts sleep quality.
• Stop eating at least three hours before bedtime.
• Drink water earlier in the day, and avoid drinking it and other fluids too close to bedtime.

Create a positive sleep environment

• Have a cool, dark room with a comfortable bed, pillows, and bed coverings.
• If noise and light disrupt your sleep, use earplugs or a white noise machine; wear eyeshades or invest in blackout curtains.
• Blue light from device screens is a known sleep disruptor. Try to stop all screens at least 30 minutes before bedtime.

Do daytime activities for better nights

• Get regular exercise during the week, but stop vigorous exercise at least four hours prior to bedtime.
• Get exposure to sunlight in the morning or use a “light therapy box” or “mood light.” Natural light resets your circadian rhythm.
• If stress is impacting your sleep, check out my column last month about ways to manage stress.

When to see your doctor

Some sleep issues may need some help or further assessment from your family doctor.

Sometimes a short-term prescription for a sleeping pill — less than two weeks — is appropriate and can get people through stressful situations and help them get back into a good sleep pattern. The death of a loved one, a health crisis, even recovering from severe jet lag, might need one or two nights of a prescription sleep medication. But do avoid using sleep pills long-term.

Chronic insomnia that is getting worse, suspected sleep apnea, restless leg syndrome, and excessive daytime sleepiness are examples of sleep issues that benefit from a medical assessment.

If you share your bed with a partner, often he or she will be the one who lets you know you should get a sleep assessment. They may be the ones disturbed by the excessive snoring and disrupted breathing of sleep apnea or kicked by a restless leg.

I no longer brag about going hours without any sleep. Now I love sleeping. I make sure I get to bed by 9:30 pm every night and wake at 4:30 am each morning. That’s what works best for me and my busy life.

If I’ve had a bad night’s sleep, I don’t worry about it, I just try to prioritize sleep the next night.

You might have to experiment to find out what bedtime and rising time works best for you and what creates a reliable sleep routine.

The US National Sleep Foundation has lots of articles and in-depth tips to help improve your sleep quality and establish effective sleep habits.

As well, many apps can help with sleep and relaxation such as Headspace, Calm, Slumber, Sleep Cycle, and more.

I hope these tips help you get a better night’s sleep.

If you are interested in learning even more about sleep, check out ,my podcast interview on March 26 with sleep expert Dr. Michael Breus. He shares the importance of knowing your “chronotype”— whether you are a lark or an owl or something in between — as a key to helping you optimize your sleep.

Until next month, remember to protect your NEST.

/Dr. Tony Hampton

After fighting to get to an ideal weight by following the dietary guidelines, Linda’s hard-earned progress was erased after a stressful move.

She and Tom, her husband, entered a cooking, baking, and eating cycle, and everything started to revolve around food.

But then, Tom was diagnosed with type 2 diabetes, and they realized they needed to make a change.

With each doctor’s appointment, Tom was advised to cut down more and more on carbs. Soon, after doing some research on their own, the couple decided to take the full step and go on a keto diet together.

“Nine months after beginning the journey, our combined weight loss was 86 pounds (39 kilos),” Linda says. But more importantly, Tom reversed his type 2 diabetes. Keep reading to learn about all the ways in which Linda and Tom’s lives have changed.

The story has been lightly edited for length and clarity.

Linda and Tom’s story

Those of us who have had struggles with our weight are familiar with the scale’s ups and downs. We lost and gained back the same pounds over and over. We tried and tried but couldn’t seem to keep the weight off.

After moving from Lincoln, Nebraska to South Carolina in April of 2009, I hoped to reach my goal weight within a few months. The nurse practitioner that had been with me on my weight loss journey had set a reasonable goal for my ideal number. The day we moved, I was 7 pounds (3 kilos) shy of that goal.

In Lincoln, I had participated in First Place 4 Health at Lincoln Berean Church. The program when I first started was based on the Diabetes exchange plan. The food plan was later updated and used the USDA food guidelines. Yes, I lost weight. Yes, I exercised. But! Every night I went to bed hungry!! I remember telling myself that “this too shall pass” and “no pain, no gain.”

The moving day was upon us. After living in the same house for 32 years and never having lived anywhere but in Nebraska, we were setting out on a great adventure. Everything changed… the climate, the culture, and yes, my weight. Having read somewhere that change adds stress and stress adds pounds because you nibble away at whatever you have within reach, I gained back everything I had lost plus a few more.

We had rented a townhouse to live in while our house was being built. We did the usual new-to-the-area things, joining the Newcomers Club, visiting churches, driving around to become familiar with the stores, library, post office, etc. We had free time. Yes, we went out to the construction site quite frequently, but we still had time. So, I cooked, baked, and we ate! I am not a great cook, but I genuinely like to cook. Baking had always been fun. Cinnamon rolls, bread, French baguettes, cream puffs, pies, cakes, cookies, and more.

Six months later, none of my clothes fit! During that time, we had joined a Friday hikers club. We hiked to some of the waterfalls in the area. On one of those hikes, Tom, my husband, became quite winded and was unable to continue. When we returned home, he went in to see the doctor and learned he was hypertensive. He was prescribed high blood pressure medication, and we dropped out of the hikers club and Newcomers Club.

We moved into the house and the cooking, baking, and eating cycle continued. Family, friends, former co-workers began visiting us in our new home. We joked that we were bed and breakfast… even came up with the name, “T & L’s B & B,” which later updated to “T & L’s B & B 4 F & F” (for family and friends)

Life began to revolve around food. We became immersed in the culture of the South. We learned how to make jambalaya, shrimp and grits, gumbo, pulled pork, brisket, red beans and rice, banana pudding, coconut cake, turnip greens, okra, collards, and grits in a variety of ways. The weight gain continued.

The wake-up call began with one of Tom’s doctor appointments. He was diagnosed as pre-diabetic. He was encouraged to lose weight. On a subsequent visit, he was given the type 2 diabetes diagnosis and prescribed metformin. He was also scheduled to meet with a diabetes counselor at the local hospital.

He came home with a blood testing monitor and an eating plan based on the USDA guidelines. His “healthy eating plan” allowed 45 to 60 grams of carbohydrates per meal. We adjusted our eating to fit his new plan.

On his next doctor’s visit, he was advised to quit the five whites: white potatoes, white rice, flour, sugar, and pasta. We made that adjustment.

The next visit was to “reduce carbohydrates to 50 grams per day.” Another change. On the next visit, they told him that if he were serious about losing weight, dropping to 30 grams of carbohydrates would help.

I had begun searching in earnest at both the library and on the internet for guidance on food, meal plans, recipes… something to move us in the right direction. I found the health and wellness section of Duke University’s website and read about studies based on three specific diets. The Mediterranean diet, the high-carb, low-calorie diet, and a low-carb, high-fat (LCHF) diet were studied, evaluated, and researched.

We found a few more websites about low-carb dieting, so we began incorporating this into our way of eating. Every food we prepared needed to have the carb count calculated. This was in February of 2016. We needed to re-learn what “healthful eating” was, and we made a lot of changes. Changing 40+ years of eating preferences and modern-day beliefs about fat, food, and calories was mind-boggling. It was six months in before we felt comfortable accepting invitations out for a meal.

Tom was “melting” off weight! My weight loss was slow… most of the time, it was half of his. Nine months after beginning the journey, our combined weight loss was 86 pounds (39 kilos). We have both kept it off. We celebrated the start of our third year on this journey. Tom is no longer considered a person with type 2 diabetes. He is off medication for it, also off cholesterol meds and high blood pressure medication, although he does still take a diuretic. He is my “energizer bunny”… each day, he accomplishes more by 10 AM than most guys do all day. He feels good, sleeps well, and still eats whatever I make.

How has my life changed since we started this new “way of eating”? Meals are simplified, we eat from foods found on the grocery store’s perimeter, and we eat fresh, seasonally available food that usually doesn’t require an ingredient panel. We eat when hungry and stop when satisfied. I don’t go to bed hungry, I no longer have cravings, my acid reflux is gone, the intestinal distress is gone, and my significant knee pain is gone.

A side note here on that… in 2013, I began having knee pain going down steps. The doctor’s recommendation was glucosamine chondroitin, a pain reliever for joint pain. The pills caused severe intestinal distress. On the next visit, he suggested joint juice, which I did try and achieved considerable success at pain reduction over the next two and a half years. I experienced unpleasant side effects, but since the knee pain improved, I figured it was a trade-off. Once we started the low-carb diet, I quit taking the joint juice. My knee pain never returned.

The eating method that has worked successfully in our lives is probably best known as the ketogenic diet—less than 20 grams of carbohydrates per day. Our macronutrients (carbohydrates, proteins, and fat) are what we monitor. We don’t count calories. We know what we can eat and what we shouldn’t eat. We know if we go back to eating the way we were before, we will feel lousy!

Once again, I feel that I have free time! This way of eating requires less time in the kitchen, less cleanup, and simplified shopping.

Doctors prescribe medications for whatever ails you. Big pharmaceutical companies do not want CURES… they want CUSTOMERS. We are grateful to Dr. Newton for encouraging Tom to begin this journey to wellness. We chose to change. We choose to take ownership of our health. Yes, we are going against the mainstream of what we have all been told over the years.

What do we eat? We eat beef, pork, fish, poultry, venison, lamb, and rabbit. We eat eggs, bacon, sausage, and ham. We enjoy avocados, leafy greens, broccoli, asparagus, cabbage, Brussels sprouts, cucumbers, tomatoes, and squash. We snack on cheese, nuts, olives, and Canadian bacon. Tom enjoys pork rinds. We drink water, lots of water! 64 ounces (1.9 liters) minimum each day. We enjoy cream in our coffee, whipped cream with berries, and we use real butter!

As we enter into this season of life, we are exploring new hobbies and interests. We keep busy. I stay out of the kitchen, and any new hobby will not involve food. We eat to live; we don’t live to eat. There have been days where we have actually forgotten to eat! We have begun to listen to our bodies and wait for hunger cues before eating. Mindless eating is a thing of the past. We practice mindful eating. Nourishing our bodies with foods that fuel our system.

We get asked questions about how we did it, what we eat, and whether we miss certain foods. We needed to change. Yes, we gave up some food, but what we gained is so much more!

Comment

Congrats on your incredible success, Linda and Tom! I am so thankful you found your own path to success, and you had an educated doctor to help you on your way. Thanks for sharing your message and keep up the great work!
Best,
/ Dr. Bret Scher

More success stories

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How does a low-carb, high-fat (LCHF) diet impact your blood sugar levels? Nick sent us a beautiful graph of his results from his continuous glucose monitor (CGM).

Since switching to LCHF, Nick’s blood sugar is much more stable than it was on the American Diabetes Association (ADA) diet, and the lines demonstrate this. He also lost 45 pounds (20 kilos).

Here, Nick shares his story, which has been lightly edited for length and clarity.

What’s your name, age, and where do you live?
My name is Nick, and I’m from Georgia, USA.

How did you discover keto or low carb?
I am 62 and I’ve had type 2 diabetes for 29 years. The doctor who diagnosed me in 1991 told me my sugar was 248 mg/dl (13.8 mmol/L), put me on Glucotrol, and told me to come back in three months for a check-up. He explained nothing about the disease.

I was put on insulin three years later. I’ve kept my diabetes closely monitored for the last 15 years but had issues that I assumed were just part of the disease. My weight hovered around 210 pounds (95 kilos) for most of those years.

I experienced roller coaster blood sugars (lows in the 40s and highs near 300 mg/dl – 2.2 to 16.7 mmol/L), snacked between meals and before bedtime, consumed 150 grams of carbs per day (because the American Diabetes Association said I could), used 60 units of insulin per day and climbing. My HbA1c ran in the upper six range. I had trouble sleeping at night, used 80 mg per day of acid reflux meds, and joint pain became a part of my life. I exercised, but that was a challenge because of blood sugar lows and highs.

I have researched diabetes since my diagnosis. I thought I was doing as well as possible, checking my sugar eight times a day and following the ADA’s advice. I began continuous glucose monitoring in June 2020, and I discovered that I was not doing as well as I thought. The continuous glucose monitoring revealed that I had some pretty bad post-meal spikes in my blood sugar.

I have been using an insulin pump for 21 years and in June 2020 got a new pump. The nurse/diabetes educator who trained me on my new pump recommended that I read Dr. Richard Bernstein’s book, Diabetes Solution. After reading the book and discovering Diet Doctor, my life changed!

I’ve been living the low-carb, high-fat (LCHF) lifestyle for over six months now, and my blood sugar is very constant, my Hb1Ac is 5.6, my joint inflammation is gone, I’m off acid reflux meds, and I sleep all night. I weigh 172 pounds (78 kilos) now and wear size 32 inch (81 cm) pants!

What does a typical day of eating look like for you now?
I never imagined that I could turn my health situation around. Before, I based my eating habits on pleasure and misinformation. Now I eat for health, enjoy delicious foods, and eat until I am full.

I eat an average of 18 grams of carbs per day from fibrous vegetables, berries, and nuts. I enjoy plenty of fat and salt and eat no more grains or other bad carbs. No more highly processed foods or oils. I never eat snacks because I’m never hungry between meals.

My blood pressure averages 112/68 on less medication.

Having type 2 diabetes, I assumed I could never fast. Not true. I skip meals regularly and only eat when I’m hungry. I can now exercise without blood sugar issues and never run out of fuel! Exercise is essential for the body and mind. I walk when possible and carry 3-pound weights as I walk. When the weather is bad, I use a recumbent bicycle and small dumbbells for upper body toning.

What are your top three tips for people starting low carb?
If you are new to LCHF or keto, I will give the following insights:

1. Anything you want bad enough, you can make happen.
2. Eat for your health, which requires a different perspective and discipline. Life is not about going from one pleasure to the next, even though I discovered how to make delicious keto recipes!
3. There is plenty of help out there, like Diet Doctor. Since my journey began, I have logged seven pages of citations and references from practicing physicians, scientists, and investigative journalists. The evidence is too overwhelming to deny!

Comment

Thanks for sharing your success with us, Nick! Your CGM pictures are truly worth “a thousand words.” I am so glad you found the diet that works for you — not just for your weight but for your health as well. Keep up the great work!

Best,
/ Dr. Bret Scher

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Diet and lifestyle changes can be powerful treatments!

With the help of a keto diet, Marie-Jeanne is down 64 pounds (29 kilos) compared to her highest weight. But most importantly, she has greatly improved her type 2 diabetes and reduced the amount of medication that she needs.

Here, Marie-Jeanne shares her story, which has been lightly edited for length and clarity.

Marie-Jeanne’s story

I am Marie-Jeanne, a 66-(nearly 67!)-year-old retired secretary, living in Belgium.

I was diagnosed with type 2 diabetes about 15 years ago. At that time, I weighed 258 pounds (117 kilos) at 5 foot 5 (167 cm). I started, like most people with type 2 diabetes, with oral medication. That, of course, had to be increased, and then I went on insulin injections.

After some research, I found the person I like to call my “dear, dear diabetes specialist.” A Professor, no less. What a great man! He explained everything in detail and so clearly. He prescribed the latest insulin injection at that time.

Well, to cut this story short, that injection saved me. My appetite decreased: my plates suddenly were only half full. This injection also caused nausea, loss of the sense of smell and taste, BUT well worth it for a loss of about 44 pounds (20 kilos)!

After my dear Professor retired, I searched in my area for another specialist. I found someone, but it did not work out between us.

That is when what I call “THE SEARCH” began… I watched a video series by a gentleman who had lost all his overweight and reversed his type 2 diabetes (I forget his name, sorry). So, here was living proof that you could do it! In this series, he spoke to Dr. Jason Fung. I then watched some of Dr. Fung’s videos, and that in turn led me to Diet Doctor.

I started in August 2019. No need to tell you that I have not looked back since. My current weight is 194 pounds (88 kilos), there is still a way to go to my goal weight of 165 to 172 pounds (75 to 78 kilos), but I am hanging in there. My oral medication went from 850 to 500 mg two times per day, Jardiance was stopped completely, and I was able to halve my depression medication!

My body changed so very, very much and is still changing. I lost inches off my waist, bust, and hips. After a while, I also incorporated intermittent fasting. Of course, there have been ups and downs; I am only human. But whatever happens, I get right back on track and stick with Diet Doctor.

I don’t consider keto a diet, it is a way of life!

Breakfast these days is usually eggs and bacon or eggs and avocado. For lunch, I typically have any meat, gem lettuces, and my absolute favorite cauliflower mash, which I make with either cream or butter (sometimes both!) or cream cheese. In the evenings, if and when I’m hungry, I have a little salad or greek yogurt with blueberries. That’s it. I have no regular recipes as a go-to. Instead, I browse through the recipes and choose this one or that one, depending on my mood and what I fancy.

My tip for beginners is to take it one day at a time. In the beginning, I printed out the recipes from my meal plan and followed them to the letter.

Another top tip: only shop for two days at a time. Then, after some time, you’ll know the quantities needed for just one meal down pat. After doing this for a while, I started to be a bit more inventive and making traditional Belgian recipes keto-friendly. Like chicons au gratin: chicory pre-cooked then wrapped in ham, covered in the Diet Doctor Hollandaise sauce and with cheese sprinkled over and baked in the oven.

The most important tip I can give any beginner is: STAY OFF THE SCALES! I “felt” myself becoming slimmer, my clothes were looser, and I felt so much better. My body was telling me exactly what was going on; I didn’t need any “scale confirmation” for that.

I hope this post has allowed you to get to know me a little better, and I look forward to sharing this journey with you all!!

Comment

Thanks for sharing your story with us Marie-Jeanne. I especially like how you emphasize that this is a lifestyle, not a diet. It may seem easy to say, but it is such an important component of long-term success. And I appreciate how you can measure your victories without a scale. Keep up the great work!
Best,
/ Dr. Bret Scher

More success stories

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Meet Terri: 200 pounds (91 kilos) lost, type 2 diabetes reversed, mental health greatly improved, and psoriatic arthritis gone. These are the results that Terri has gotten from a low carb diet.

“My energy is great, and I feel at least 25 or 30 years younger than I am!,” Terri says.

Over time, Terri has found that a strict carnivore diet, a low carb diet based only on animal products, suited her the best.

In this interview, Terri shares her story, which has been edited for length and clarity.

What’s your name, age, and where do you live?
I’m Terri from Ontario, Canada, and I’m 64 years old.

I went on my first diet at nine years old and was on the diet roller-coaster for the next 50+years.

In 2011, I started low carb. Over time, I realized that I needed to lower carbs even more, resolve persistent health issues, and continue losing weight. I got to where I was only eating 10 grams of carbs per day, but I still struggled to lose more than half a pound per week. Taking my carbs even lower got the weight moving again, but I find that I need to stick to mainly carnivore for weight loss and maintenance.

How did you discover low carb?
I first heard about low carb when Dr. Robert Atkins came out with his book (the ’90s version), but I didn’t really do a deep dive into why low carb was the way to go for me, and after a short try, I drifted back to my old eating habits.

Then I read Dr. Michael Ede’s Protein Power in early 2011 and decided to try low carb again.

I did well and lost 120 pounds (54 kilos), but then I made the terrible mistake of thinking I could have moderate amounts of bread and pasta again. You can guess what happened: I gained back about 90 pounds [41 kilos] in short order, and that weight gain lasted until the fall of 2016.

In January 2017, I knew it was do-or-die time. I finally had to get it right, or I felt I might not be around for many more years.

I was over 325 pounds (147 kilos) at my highest weight at just 5 foot 2 inches (157 cm). I was recently diagnosed with type 2 diabetes, which resulted from poor eating and from taking the maximum allowable dose of Quetiapine, also known as Seroquel, (for my mental health).

I also battled psoriatic arthritis, general rashes, and frustrating itchiness. I had IBS-D, severely damaged discs in my back from the weight, and had already had a heart attack at 53.

Depression and an anxiety disorder (with agoraphobia) were problems since my teens but were especially crippling in my 50s, as I was going through menopause.

What were you eating before making this lifestyle change?
I followed the standard American diet (SAD diet) of whole grains, veggies, fruit, pasta, rice, beans, some meat, fast food, etc.

In what ways has your health improved?
I’ve lost over 200 pounds (91 kilos), reversed type 2 diabetes, and no longer have psoriatic arthritis. My skin improved nearly 100%, my lab results are better than they have ever been in my life, and my depression and anxiety are more manageable than I ever thought possible.

My energy is great, and I feel at least 25 or 30 years younger than I am.

What does a typical day of eating look like for you now?
I eat once a day (OMAD) 95% of the time, so I’m fasting for about 22-23 hours each day. I don’t do cheat days or eat anything that tastes sweet, whether from sugar or artificial sweeteners. I eat mainly beef, lamb, liver, and eggs, plus some days I’ll have pork, chicken, or seafood. I have two cups of decaf coffee in the morning, then water and/or very weak herbal tea (chamomile or sleep time diluted).

Have you made any mistakes on your journey (which you’ve learned from)?
Thinking I could eat a “controlled” amount of carbs each day was a big mistake. When I eat carbs or drink alcohol, I crave more and more carbs, so I have to avoid them.

I no longer eat dairy, grains, sugar, sweeteners, fruit, or alcohol. Still, I never say never with certain things, and I may have a couple of wild strawberries if I find some on the ground or a few slices of cucumber in the summer for something cool with my meat, but only rarely.

I may have a drink again one day, but I’m just not sure I even want to get into it again, as it always made me crave carbs like crazy. Besides, if I’m honest about it, I’ve had the very best times in my life while being completely sober.

Do you think exercise is necessary for success on low carb?
I injured my Achilles tendon when I first started low carb in 2011, so I lost most of my weight with no exercise.

Now, I walk 3 to 5 days per week (about 6 kilometers or 3.7 miles) and lift 10-pound (5-kilo) weights a few times per week. But nothing heavy duty, exercise-wise.

I believe exercise is excellent for general health and well-being, but not so much for weight loss. I do it because it feels great to be out in nature and feeling stronger and more energetic.

What are your top three tips for people starting low carb?

1. Follow the rebels, i.e., sites like Diet Doctor and any doctor or expert who has gone against the mainstream medical community: Ben Bikman, Gary Fettke, Keto Endurance, Shawn Baker, Ted Naiman, Nina Teicholz, Amy Berger, Amber O´Hearn, Gary Taubes, and more.
2. Figure out what works best for you. Asking someone else to tell you exactly what to eat may feel comforting, but it may not be right for you. Think of it like an elimination diet where you take away the foods you suspect are causing your problems and go from there. Think progress, not perfection.
3. Even if you’re just barely losing a pound a week, stick with it and be grateful for every pound lost and give yourself plenty of encouragement and support along the way. You WILL get there, and it will be so worth it.

Comment

Thanks for sharing your incredible success with us, Terri! I really like your advice to think about progress, not perfection, and to be grateful for all the small victories. That’s great advice I hope others can learn from. Keep up the great work!

Best,
/ Dr. Bret Scher

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Calvin has told his keto diet success story twice before and now he’s back to update Diet Doctor readers on even more of his incredible progress.

In 2017, Calvin was our most popular success story. He described how within two weeks of starting a keto diet he came off all insulin for his type 2 diabetes and soon had normalized his blood sugar.

In 2018 he was back with another update, describing how he had lost 140 pounds (63.5 kilos) but then stalled. He told how he got the scale moving again with information from Diet Doctor and by more closely tracking his food intake.

In this interview, Calvin summarizes his entire 3.5-year keto journey and shares how, so far, he has lost more than 160 pounds, reversed his diabetes, as well as come off all medications, including most recently both his high blood pressure medications. He feels better than ever.

“I honestly think that if I had not found Diet Doctor when I did, I would be dead by now. Diet Doctor saved my life and I thank God for leading me to it.”

His story has been edited for length and clarity.

What’s your name, age, and where do you live?
I’m Calvin, age 64. I live in Chesapeake, Virginia. I’ve now been three and a half years on the keto diet and I am doing better than ever.

How did you discover keto or low carb?
In October 2017 I got the diagnosis of type 2 diabetes. My blood sugar was so high, 519 mg/dl (28.5 mmol/L), that it was a medical emergency. The lab doing my blood test called me at work and told me I needed to go to my doctor immediately. My endocrinologist said he had never seen blood sugar that high in someone who was not in a diabetic coma.

I started insulin injections that day and was faced with at least four injections a day into my abdomen. I was put on all these medications. I felt shocked and overwhelmed. I did not want to take insulin shots for the rest of my life.

I am a Pastor so I prayed to God to show me another way. I prayed for him to give me an answer, to give me a path.

The next day I was searching the internet and I found Diet Doctor. And it truly was the answer to my prayers.

Did you have any health or weight struggles before going low carb or keto?
I had been feeling unwell for years, but I thought that was just a normal part of aging. I had steadily put on weight over the years. When I was diagnosed with diabetes I was 383 pounds (174 kilos).

My feet hurt, a real deep pain, and were numb and tingly. My knees hurt and I found it hard to walk or stand for long. I was sleeping poorly. I was constantly thirsty and always needing to urinate. I had no energy. I had brain fog.

I was on two medications for high blood pressure, and then drugs for diabetes. I didn’t know how sick I was or how horrible I felt until I adopted keto and began to feel so much better.

It wasn’t a normal part of aging at all, it was my diet. I had been sick for so long I didn’t know what it felt like to feel good. Now I do!

What were you eating before making this lifestyle change?
I had heard that I should cut out sugar, so in previous years I had stopped drinking any pop or eating any fast food and I had managed to lose some weight by doing that.

But I had heard fruit and grains were healthy so I was eating a ton of fresh fruit every day, and lots of grains and low-fat food.

When did you start low carb or keto?
I started in October 2017, right after I found the Diet Doctor website.

I watched all the videos, read the success stories. I learned everything I could. I explored all the Diet Doctor recipes.

My wife and I loved dishes like the Tex Mex casserole. I couldn’t believe how delicious and filling all the food was. It wasn’t like diet food. And before long I was making my own recipes

In what ways has your health improved?
It is incredible. Within two weeks of starting keto I was off the insulin. And over the last three-and-a-half years I have come off more and more medication. I am off all diabetes medication. I just don’t have diabetes anymore. My blood sugar is great.

This spring, I finally came off my two blood pressure medications — my blood pressure had become too low on the drugs! Now my blood pressure is always in the normal range without any drugs at all.

I had set the target of getting to a weight of 240 pounds (109 kilos). When I was 383 pounds (174 kilos) that seemed like an impossible target to reach. But now I am at 220 pounds (100 kilos), which is lighter than when I got married more than 30 years ago. I can fit into a shirt I wore 30 years ago.

I don’t know if this will now be my final weight or if I will continue losing. I am 5’10” (178 cm) so who knows, I might go even lower. I will just see what happens.

But apart from getting off all medications and losing so much weight, I just feel fantastic. As soon as I started keto I felt this burst of energy come over me. I now have energy to do whatever I need to do. I’ve got a couple of new grandchildren so it is really nice to actually have energy to interact with them.

Even cognitive functions seemed easier. My brain is clear – it is like I have mental superpowers.

My feet no longer hurt and all the numbness and tingling are gone. My knees feel great. And, this is odd, but I have really noticed that my skin is so much better, it’s soft and supple – it was like it was all dried out before. It is amazing.

I will turn 65 in the fall but I feel 20 years younger.

What does a typical day of eating and/or fasting look like for you now?
I usually just eat two meals a day. I will usually have breakfast of something like eggs and bacon with a cup of coffee with a bit of heavy cream. That will keep me all day.

I usually skip lunch and just eat a keto dinner, one of the Diet Doctor recipes or some recipe that I have created myself. It usually features a meat protein with lots of vegetables.

I no longer eat any fruits or grains – that was killing me and making my blood sugar so high. I eat a lot of eggs, cheese, meats, and above-ground vegetables. I find the food very satisfying and easy to do. I will eat this way for the rest of my life.

Have you made any mistakes on your journey (which you’ve learned from)?
My mother died in the winter of 2019 and that was hard. It wasn’t like a full depression or anything, but I was just really sad. And at times like that you want what you think are comfort foods. I was grieving and I turned to my old comfort food. So I went off the diet for a few months.

I understood why it was happening. But soon I was gaining weight and feeling very unwell again. And after a few months I realized I didn’t want those foods anymore. So I decided to go back to keto. When I started again the weight came off and I felt better.

I want to be honest with people about this kind of thing. It takes a while to get healthy habits going and we can slip back into unhealthy habits. And there is usually a reason. And then when you are honest about it, you know why it is happening, you can get back to the healthy habit.

Sometimes, especially at a church function, I will now have something high carb that someone has made – a piece of cake or pie. I’ll just have a bite. I really don’t want it. A bite is enough and then it’s right back to keto eating. I have tested my blood sugar at those times and my blood sugar returns to normal very fast, so that is great. But I don’t want to eat that way for long.

I really enjoy tracking everything. I test my blood sugar a few times a day because it is fun for me to see where I’m at. I track all my lab tests so I can show my doctors my progress too.

Do you think exercise is necessary for success on low carb?
When I started in October 2017 I felt too unwell to do any exercise.

As you start feeling so much better and losing all the extra weight, you just feel so much more comfortable moving and doing things.

I lost all the weight without going to the gym or doing heavy exercise – it was all my diet – so it is not necessary to exercise to lose weight.

But I now walk a lot with my wife in a local botanical garden, which I really love to do. I am also trying to do a little bit of high-intensity interval training (HIIT) – nothing too much, but just doing bursts of activity. When you feel good, you want to move.

What are your top three tips for people starting low carb?
Well, my top tip is to go to Diet Doctor, join it, and follow everything it says.

I honestly think that if I had not found Diet Doctor when I did, I would be dead by now. Diet Doctor saved my life and I thank God for leading me to it. I will be a Diet Doctor member for life!

I often get texts and emails from people who say “Your weight loss has really inspired me, can you give me some tips?” And I always say: “Go to dietdoctor.com, join the Two-Week Challenge. That’s where to start. Then follow the recipes, the meal plans. Diet Doctor makes it easy.

My second tip is also about Diet Doctor: If you need motivation or inspiration, read the success stories because everyone can find someone who is just like them. I hope that some people see themselves in my story. I want older people, those in their 60s like me, who have had years of bad health and weight gain, to know that it is not too late. You can still have amazing results. It is not medications that will fix you, it is food that fixes you.

My third tip is to keep track of all your health metrics like blood sugar, blood pressure, lab test results. That really helps you measure your progress and keep you inspired, at least it does for me. It also makes it easy to show your doctor and to get them on board. My endocrinologist was so amazed at my progress that he actually went to Diet Doctor to learn more.

Comment

Congrats on your amazing success, Calvin! I am thrilled that Diet Doctor played a role in transforming your health and giving you your life back. Keep up the great work, and keep sharing your story as an example of the power of a healthy lifestyle.
Best,
/ Dr. Bret Scher

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When Kathy first discovered a low carb diet, it was a life-changing revelation.

After decades of struggle with weight and high blood sugar, she was able to get out of the morbid obesity range and reverse her type 2 diabetes.

But after a while, she found herself eating too much fat and over-eating low carb, high-fat treats. During a difficult time in her life, she regained almost all her lost weight.

But when her physician, Dr. Ted Naiman, started recommending a higher protein, lower carb plan, she decided to double her protein intake.

The result was 130 pounds (60 kilos) lost to date and revitalization of her health.

“Combining higher protein with intermittent fasting worked like gangbusters,” Kathy says.

Kathy’s story has been edited for length and clarity.

What’s your name, age, and where do you live?
I’m Kathy, age 56, and I live near Seattle, WA.

How did you decide to do low carb or keto?
Luckily, I live near the clinic where Dr. Ted Naiman works as a primary care physician. After my old doctor left the practice, the clinic placed me in an open appointment to see Dr. Naiman.

When he walked in, I was disappointed at how young he looked, but I quickly forgot all about that. He’s somehow really laid-back but intensely engaging. I wasn’t up for another lecture about my weight and worsening diabetes, but I sat up and paid attention when he started to say things that were shocking and new to me.

He went over all the ways I was manifesting “metabolic syndrome.” (My face got a little hot at that.) But he quickly moved to how I could turn this all around with a low carbohydrate diet. (What? Isn’t that supposed to be the diet that will kill you?! LOL).

He described the post-meal hunger crashes I was having and how nixing carbs would resolve this. He adjusted my medications and added metformin, which is known to cause weight loss or counter weight gain induced by other medications. He also added Wellbutrin (which years later became part of the formulation for the weight-loss drug Contrave) but I only took Wellbutrin for about six months. He suggested low carb books and resources for me.

His solutions netted a quick 10-pound weight loss in just a few weeks. Suddenly I felt empowered. I felt motivated.

That first appointment represents one of those moments that completely changed the trajectory of my life.

But I actually have two legs of my low carb journey. On the first one, I managed to get out of the morbid obesity range to the obese range, and my A1c dropped out of the diabetic range to pre-diabetic.

However, during a long stretch of difficult circumstances including the tragic death of my husband, I went through extreme swings in my weight. I came out of all that nearly back to square one. (I regained nearly all the weight between 2015 and 2017).

The second leg of my low carb journey started in 2019 after Dr. Naiman revised his recommendations to a higher protein approach.

I was now in my mid-50s, and it seemed like losing all the weight would be even harder than ever. But I was wrong.

I started eating higher protein in the summer of 2019. I lost more weight and I lost it much faster than I did before. I finally achieved my goals of reversing obesity and obtaining a normal A1c below 5! And I could easily enjoy my eating plan, even during vacations and holidays.

While Dr. Naiman can’t be everyone’s doctor, he has laid it all out in his book The P:E Diet. You can also find him on Twitter, Instagram, and of course on Diet Doctor.

Editor’s note: You can also look for low carb friendly doctors, dietitians, coaches and other health providers near you on our “Find a Provider” map.

Did you have any health or weight struggles before going low carb or keto?
I’ve struggled with my weight my entire life. A doctor said I needed to lose 20 pounds when I was in first grade. I was pushing 200 pounds when I was only 13.

My high blood sugar problem started in my late teens, and I was diagnosed with diabetes and morbid obesity in my mid-30s.

I joined commercial weight loss programs many times to lose some weight, only to gain it all back plus more. I tried liquid diets and diet pills.

I even had gastric sleeve surgery at one point. The surgery did nothing to reduce my appetite. In fact, it made my problems with food even worse, and I ended up even heavier than I was before. I have never felt worse about my weight than I did at that point.

After these failures, I kept reverting back to the standard American diet because I felt nothing worked anyway.

What does a typical day of eating and/or fasting look like for you now?
I love intermittent fasting (IF). I like to mix up the schedule around my work or social life. I rarely eat breakfast and often push lunch to the afternoon.

I occasionally use a 23-hour fast (OMAD) but, there are many weeks where I don’t do this at all. I target an eight-hour eating window and fast for 16 hours most days (16/8).

Here is a typical day:

• Breakfast
  Coffee (always!), either iced or with sugar-free almond milk.
• Lunch
  Chaffles (eggs and low-fat mozzarella cheese cooked in mini waffle makers) topped with a generous portion of Greek yogurt and slightly defrosted frozen strawberries plus sugar-free syrup.
• Dinner
  Generous portion of grilled leaner meat (flank steak, skinless chicken thighs, salmon, pot roast, lean burger, etc.), sliced tomatoes and salsa, and grilled asparagus.
• Dessert or snack
  Frozen low-fat Greek yogurt “bark” that I make myself, drizzled with dark chocolate, or low-fat Greek yogurt with berries, or a Fairlife protein shake.

In what ways has your health improved?
People are most impressed with my weight loss — I have now lost over 130 pounds (60 kilos).

After a lifetime of high blood sugar and diabetes, there’s no sign that I have any diabetes damage to my eyes. I’ve been worried about this all my life – my mother and grandmother both lost their vision to diabetes.

I’m in a better mood on a daily basis. I’m not as anxious when life’s challenges arise. It is hard to pinpoint how much of this is due to the diet vs. being more active, but it doesn’t really matter — I feel that these things just naturally go together.

I love pictures of my face-to-face comparisons. I actually made them because some people thought my before-and-after photos were fake.

Have you learned from any mistakes?
Yes. While I lost weight on the first leg of my low carb journey, eventually I was eating too much fat and too little nutrition.

For example, I followed recipes that mixed sweeteners, cream cheese, chocolate, and other ingredients to create desserts. I dipped spicy pork rinds into sour cream.

Some people can eat these kinds of tasty treats, but I cannot. I ate too much of these, gained weight, but failed to recognize the problem. I believed the myth that protein “turns to sugar in the body” and causes weight gain. I thought targeting fat was what I was supposed to do. That was my biggest mistake.

When Dr. Naiman brought up higher protein to me, I felt he was all wrong, but I could see he was starting a protein movement in the low carb community and became curious about it.

I looked at his infographics (on Twitter and Instagram) and listened to interviews (Diet Doctor on YouTube is really great) explaining concepts like “protein is a building block” and not something the body utilizes to build fat stores. I learned how beneficial protein is for health and the reduction in appetite. I calculated that I was only eating half the protein he recommends.

So, I doubled my protein intake. I stopped picking up the Costco-sized butter and half-and-half cream. Combining higher protein with intermittent fasting worked like gangbusters.

Do you think exercise is necessary for success on low carb?
To lose weight? No. Weight loss is 95% diet. But exercise ramps up the little fat-burning factories in your cells called mitochondria and primes you for weight loss (a tip from Dr. Naiman). Exercise also makes you feel great both mentally and physically.

As a larger person, I started with exercise walking hills and using a rowing machine (another tip from Dr. Naiman). I use the rower to do high-intensity interval training (aka HIIT), which is a way to get a beneficial workout in just a few minutes. I do short HIIT “sprints” on my rower.

I also do Dr. Naiman’s “no gym” strength training exercises. Diet Doctor has a great video (the cruise ship video) of Dr. Naiman demonstrating how to get started if you are a beginner. I used the kitchen counter to do standing push-ups. I started squats by sitting and standing from a chair. I started pull-ups on the ground under a dip bar (aka bodyweight rows).

In all, I spend less than 10 to 15 minutes a day exercising.

What are your top three tips for people starting low carb?

1. Reduce the carbs slowly over a few weeks. I had tried to do “Atkins induction” twice and fell flat both times.
2. Try eating bacon and eggs as your first meal of the day. This will help you get off of the snacking train because you won’t have that blood sugar crash/post-meal hunger situation.
3. Definitely get support in the way that works for you. Those first few weeks can be especially hard, so don’t give up! You’ll get over that hump, and then you will be on your way to greater health!

If you are still reading this far, thank you for reading my story. I truly hope this helps someone. I wish you the best of luck and the best of health. And if anyone wants to follow me, they will find me on Twitter. I am KeyTones@apowersurfer.

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Kathy, your success with a higher protein, lower carb diet will inspire others who are wondering about this approach. Congratulations on your tremendous achievements.

~Anne Mullens

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