I’ll add that even when I would go hard-core (say, a keto diet and leading 6 Zumba classes a week for months), I wouldn’t lose weight, my A1c stayed the same, and I built no muscle mass. My docs would just laugh and shake their heads in bemusement. I could walk across Spain with a backpack and gain weight.
When a dietician opined that I could omit the 1 T of half and half I put in my coffee, I asked if she really thought that would make a difference. She said no, but there was nothing else she could see in my food diary to suggest.
Ozempic stopped working very quickly, but Mounjaro, which isn’t pleasant for me, has fostered some weight loss, not a lot, and A1c improvement, though I’m still taking the max recommended dose of metformin.
I’ve been in awe of your exercise & walking regime for years. That you can do all that with the BMI you have is a testament to your great stamina and fortitude.
It’s a shame you’ve had very bad luck on the genetics of how your body maintains weight.
Thanks. My body is super efficient at the wrong thing. It quite fries me to hear people say weight is about lifestyle. Sometimes yes, sometimes no. Similarly, that “a calorie is a calorie,” which has nothing to do with actual individual metabolism.
A bit off topic here but i’m curious. Lots of folk go “keto” when trying to lose weight. All my training as a biologist says what you eat doesn’t matter when it comes to weight loss (ignoring nutritional requirements for the moment). It’s (calories in < calories out) that matters.
From my own experience, I suspect that the reason keto probably works is that for a given amount of calories eaten, high protein satisfies hunger for longer compared to carbs. I can eat 300 calories of protein and i’m full for hours. But if I eat 300 calories of bread, in a half hour I just want more bread.
It’s also why, at least for me, weight loss happens in the kitchen, not the gym. It’s quite easy to say “no” to that 350 calorie cookie. To burn 350 calories at the gym takes at least an hour on the treadmill. I actually think this way when looking at a nice dessert etc… is this worth busting my ass on the treadmill for an hour? Usually it isn’t.
Do you have diabetes? My metabolism isn’t your metabolism. I wasn’t overweight until the diabetic process started. Without the right medication, nothing works. Let me emphasize this: for me, nothing works without medication.
Sorry, I wasn’t referring to you - I was asking in a more general sense (keto fad diets etc…). Metabolic issues such as diabetes of course throw this stuff out the window.
Well put. As you said, catching it early is key. Unfortunately, your insulin can be going up while your blood sugar/blood glucose remains low, until it doesn’t, and by that time, it may be too late to reverse it. That’s why it’s an excellent idea to check your insulin levels annually, not just your blood sugar. It increases the chance of catching a problem earlier rather than later.
… Subject of course to the effect that resting metabolic rate has on calories out.
Made up example numbers …
A 180# couch potato burns 500 calories a day just being alive. A 180# amateur athlete on a full rest day might burn 1500 calories just being alive while being equally sedentary.
It’s one heck of a lot easier for that athlete to have calories in < calories out. Even before we consider the calorie consumptive effect of their actual exercise.
And ref @susan vs my example, how much of what you eat is just excreted versus brought into your metabolism. The only thing that makes sense for adult 130# me to live on 4K calories a day for decades without weight gain is that one hell of a lot of those calories just ended up in my poop, not in my body. Come the Famine, I’m screwed. Less now than at age 30, but I’m still screwed.
I started weighing myself daily back in April, but I’m not concerned about my daily weight so much as I’m looking for a weekly average. My weight can fluctuate by as much as five pounds on occasion though one or two pounds is the norm.
When COVID his back in 2020, we were all sent to work from home in March. By May, I started hearing about the COVID 15, people gaining weight because they were eating and doing nothing. Just for funsies, I decided I’d try to lose 15 pounds. I started by exercising and making incremental changes to my diet. I ended up going from 290+ to about 225 by 2023.
I gained some weight back, got up to 255, but since April I started to exercise again and watch what I eat. I’ve lost about 30 pounds this year and I’m down to under 225. So far the lowest I’ve weighed is 220.
I didn’t believe a radical, sudden change in my diet would be successful. Instead I changed things a bit slowly. Mostly what I did was start controlling my food portions. I used to be able to eat a large pizza by myself, but these days I limit myself to 2-3 pieces. When I went to my local Japanese buffet I’d eat a minimum of two, full plates and at least 2-3 sodas. These days I eat two sparsely filled plates and a single soda.
Yep you have to measure your RMR to have this work (and it will change as you lose fat and gain muscle). There are online calculators to estimate this (although how well they work if you have diabetes or other metabolic disorder I do not know).
I had an exercise physiology colleague empirically measure mine . It’s probably time to do that again.
This is funny to me. I lost 25 pounds during my work from home stint in 2020 because I didn’t have access to my snack drawer at work and at home my spouse doesn’t keep junk food around (we also had a new dog that I was walking twice a day).
I quickly gained back the 25 when I started going back into the office but this was the kernel that started me thinking that I should lose weight more systematically.
interesting … I have/had similar thoughts … (the younger ME could eat what I wanted in absurd quantities and not gain weight) … so I always joked that I am blessed with the Cadillac of bodies (huge gas/cal. consumption no power to speak of) …
You are just unlucky to live in 2025 and not in 1625 … b/c in that scenario, I would have probaby died of malnutrition or “consumption” wheras you would have thrived in a scarcity environment.
Another example of how lowering your calorie intake while maintaining or increasing your calorie output will help you shed weight over time. I used to think it was all about keeping your insulin low, but I now know that’s only a minor part of the story. To lose weight, you have to be energy-negative for long enough for your body to switch to burning more fat and less glucose than it used to. Cutting carbs will definitely help, but it’s not the total answer to healthy weight management.
My immediate thought is any diet that requires me to give up bread simply isn’t sustainable in the long term. It isn’t healthy to look at any food, even refined sugar, as bad. Eat a little of everything and don’t overdo it.
My wife’s in the same boat. Until age and cumulative injuries caught up with her, we was a lifelong extremely competitive tennis player with a national title under her belt. Post-cancer, she’s been working out with a personal trainer 2x a week and monitoring calories with a grim intensity.
Ozempic did not help. Zepbound is working, but at the same highest dose and side effects issues. She’s got her eyes on Lilly’s triple agonist, Retatrutide, coming late in 2026. The studies are looking very good on that, especially with slow responders.
I’d wager you have better executive function than 95% of the general population. It’s dangerous to assume everyone has the same capacity to develop different habits. The fact that you don’t seem to feel like you’re out of control of your eating says a lot. If you’ve never felt that way, you’re doing it on easy mode.
I’ve talked to many people who don’t understand, for example, my problems with social media. They don’t have my neurology therefore it’s not a struggle for them. I had to quit social media completely (unless the Straight Dope counts, I guess - but I still struggle with excessive use of this place, too. It’s just less toxic than other social media.) Unfortunately I can’t quit eating completely.
I was also talking to my husband about an executive function thing, that came to mind when talking about categorical changes upthread. I have a difficult time making decisions based on real world immediate context. Which is why I can stand in a kitchen full of food and feel absolute paralysis about what to eat. I do usually have a meal plan for dinners but there are a host of obstacles that make it difficult to get over the finish line. One is my struggle with task initiation, another is the overwhelm I feel standing in a cluttered kitchen.
I have commented recently in another thread that for some people, there are literally not enough hours to do what needs to be done. This is also a major challenge I’m facing.
Now, that doesn’t mean positive changes are not possible for me. There are techniques that people like me can use to get through life and make changes for the better, but it’s slow going, with more setbacks. I’m always on the lookout for things that could help. I’m very experimental about my life. I’ve always felt that no matter how bad things are, there’s always something that can be changed for the better.
Generally whenever I can create a categorical rule, I do better, because it removes the necessity to make decisions in the moment.
Oh, another thing I learned is that poor sleep really impacts executive function. Things have been easier since I started using a CPAP for sleep apnea three weeks ago. It’s probably not a surprise that obesity and sleep apnea are linked, but I can’t help but wonder if part of the relationship is that poor sleep makes it harder to make the wiser choice.
My understanding is its both. Its really visceral fat that does the health damage, not subcutaneous fat. Subcutaneous fat is the fat under your skin that most people think of as ‘fat’. However visceral fat is the fat that accumulates inside and around your internal organs. That is the fat that causes type II diabetes, cancer, heart disease, etc.
There have been studies where people are put on a near starvation diet, and as a result a good portion of their visceral fat disappears. I think visceral fat in the liver and pancreas is a major factor in type II diabetes, and when people lose visceral fat in these organs, the type II diabetes goes into remission.
The problem is people can’t keep the weight off. After 5 years, many of these people had gained enough weight back that their diabetes came back.
Our ancestors spent the last 4 billion years evolving not to starve to death. Its really only in the last few decades, and only in wealthy parts of the world, that starvation stopped being a major health risk. Our bodies can’t tell the difference between a temporary diet to improve our metabolic health and starving to death due to lack of food.
As much as people want to, they can’t shut off 4 billion years of biological programming to match a social fad. The vast majority of people who lose weight end up regaining it because when you lose weight you trigger a cascade of a dozen endocrine changes that are designed to make you regain the weight. You have to be dedicated and motivated the rest of your life to stay on top of those dozen endocrine changes that are pushing you to regain the weight.
Also the thing that sucks is people don’t need that much visceral fat to cause serious damage. A few ounces of visceral fat in the liver and pancreas can be the difference between normal blood sugars and type II diabetes. Most people only have a few pounds of visceral fat in their bodies.
FWIW, this is why waist to height measurement is a better metric of metabolic health than BMI. Waist to height measures your visceral fat better. If you are 70" tall, then an ideal waist is around half that, so around 35". Health risks start to go up as your waist is higher than 50% the size of your height, and start to really accelerate when waist size is 60% the size of height or more.
Having said that, medicine is constantly advancing. In ~30 years, losing a large amount of bodyfat (visceral and subcutaneous) and keeping it off permanently will be far easier. But right now we don’t have the technology for this to be realistic for most people under real world settings.
Obesity is bad for you, and poor diet is bad for you. If you are obese but it is all subcutaneous fat with very little visceral fat, and you eat a healthy diet and exercise, then I assume that you won’t face too much health risk (other than sleep apnea or joint pain). Someone who eats a poor diet and is sedentary but who isn’t obese will face health risks from that.
Also some people can be skinny-fat, where they don’t appear fat, but they have several pounds of visceral fat in and around their organs causing health problems.
But having said all that, obesity is just one of many risk factors in life. The health BMI is 25, and a BMI of 30-35 will take 2-4 years off your life, and a BMI of 50-55 (being about 350-400 lbs) will take about ~10 years off your life. Of course at really high BMI you have other risks like lymphedema, etc.
But 10 years is about the life expectancy gap between smokers and non-smokers, or between high school graduates and college graduates. The life expectancy gap between black men and latina women is 13 years.
Chris Farley’s father weighed 600 lbs and he lived to his 60s.
. It’s probably time to do that again.