Asking for help is not my thing... But I need it now

(Chris Kreifels) #1

Ok Dudes and Followers, I need some help. First and foremost, I want to apologize in advance for the long post, but I’m desperately hopeful that somebody is in the same boat that I am and can provide some insight.

First, a little about myself, then some history:
I am a 35 year-old father of four, college senior, little-league football coach, and an IT professional by trade. I live in a small town of about 7500 people in south-central Kansas.

I’ve always been a big dude. I’ve been known as “Big C” or “Bigguns” or “Big Guy” since grade school. The first time I remember paying attention to my weight was in 7th grade, when I wrestled in the 180 weight class. I was big, and I was terrible. Not terrible in the sense of Andre’ the Giant, destroying everything in his path, but terrible as in 1-18 all season, but I digress. Next, I remember weighing 318lbs when I graduated high school because I had to have a physical for my summer job that year. We did not own a scale at home. My parents were big, but not huge. As a senior in high school, I outweighed my dad, who was no small man at 6’2" and 285lbs. I would go on to have a child right out of high school, and go straight to work. My weight, combined with a terrible set of genetics from both sides of my family, led me to develop sleep apnaea and spend 3 years without being able to sleep in a bed or achieve any real semblance of sleep. My blood oxygen level was dropping to 30% at night. I’m sure most of you know that this is deadly, and destroyed much of my memory and cognitive functions which I used to be quite proud of, in addition to what it did to the rest of my health. In 2006, at the age of 22, I got my first real job which provided me health insurance, and I set about a path to get some sleep. The sleep hospital was the first place I had found which had a scale large enough to weigh me, and the day of my consultation, I weighed in at a whopping 579lbs. After being officially diagnosed with sleep apnaea and treated with my CPAP, I lost 120lbs in one year from nothing more than sleep alone. I was very happy with this.
Then came the tough years. From age 23 to age 33, I was dealt blow after blow to my health and well-being. High blood pressure, Type 2 Diabetes, Adult ADD, Cholesterol, multiple bouts with cellulitis, depression, anxiety, and frequent scares in which I’d get a random bloody nose that would last for over an hour at a constant flow. In this period of time, as they say, I lost the same 50-60 lbs, 10-12 times. I was scared. In 2017, my doctor diagnosed me with binge eating disorder and tried drug after drug after drug, but to no avail. Finally, in February of 2018, and against her better judgement, my doctor placed me on phentermine. I lost 130lbs from February to June to reach 330lbs at my lowest. I was walking 3 miles per day, eating 1600 calories, and feeling GREAT. But then, the drugs stopped working. It was like the phentermine rushed in, took the weight, and destroyed my metabolism in the process. I had two months left of the drug, but the weight stopped coming off and I lost my drive, as all calorie restrictive diets do. I searched frantically for something to replace the drug when I could no longer take it, and in August, found Keto, and began researching. I bought books, listened to podcasts, socked in as much info as I could, and started my Keto journey in September. Since September, I’ve stayed right about 340-350. I lose, and touch the 330s. I gain, and enter the 360s, then lose, then gain, but cannot break that 340 lb line.

Now, about My Keto
Initially, I felt great, the brain fog was gone, my inflammation dropped, and I felt good. I went from three diabetic meds, and a weekly injection, to zero (My a1c went from 10 to 4.1) ; from three blood pressure meds, to one. I now only take one anxiety/depresion med, and one blood pressure med daily.

Then, in about November, I stopped reaping the rewards of Keto. I got groggy, tired, I hurt all the time, I cannot get my energy back that I had initially, and the weight is creeping back on, to 362 lbs this morning. I keep hearing about people eating satiety and not being hungry. I don’t get that. If I eat to satiety, I gain weight. If I do not eat to satiety, I’m hungry constantly and buckle under to temptation. I am a food addict and cannot seem to kick it. This was one of the reasons Keto seemed so amazing to me. My blood glucose is staying around 80-100, and I keep my total carbs under 40g and my net carbs definitely under 20g. I’ve read about IF, and typically I skip breakfast, but overeat at lunch and dinner. I know it has to be a calories game, but satiety isn’t coming to me, and that’s probably the most frustrating part.

Those who know me, know I don’t ask for help until I’m sinking. I’m sinking, and I do NOT want to go back to my old life. I won’t be that person again. I owe it to myself and my family to do this and continue getting healthier, but I can’t seem to get past this.

My weight is creeping up, my inflammation is coming back (to the point I can barely walk one mile, every other day for the soreness), and my energy is gone. I do great for a week or so, then get frustrated and eat stupid. Does anybody else struggle with binge eating disorder/depression/anxiety? This has to be a mental game. I KNOW my body doesn’t need 3,000-3,500 calories per day. I KNOW I lived on half of that. My doctor is frustrated with me, I’m frustrated beyond belief with myself, and I’m just hoping somebody has experience in these areas that can help me out.

Thanks for listening to my ramblings. I’ve thought about posting this for a few months now, but finally talked myself into it today.

(David Brown) #2

Can you post an “honest” breakdown of the food you are eating.

Can you swim? Do you have access to a pool?

(hottie turned hag) #3

@Chris_Kreifels ok if I understand correctly, you started keto Sept 2018, by Nov 2018 you started displaying the symptoms above cited?
What changed in Nov, i.e. did you up intake? Decrease activity? Change type of foods though not upping intake?

Tagging @OgreZed as he started at a very high, 579lb I believe, weight. His input may be more germane to your case than mine.
Also tagging @240lbfatloss and @Rgbigun

(CharleyD) #4

I don’t see a reason to do a CICO style calorie restriction yet. Remember weight loss isn’t linear and you need to heal your metabolism before you start seeing lasting bodyfat losses.

That may mean you need to eat in such a way that makes you gain a little in the short term in order to ramp up the metabolism and get your body comfortable with pulling from fat stores. (which makes OMAD and longer fasting much more comfortable)

(Marianne) #5

I think it’s great that you reached out, despite being hesitant. I, too, am sorry for the long post, but I seem to have a hard time keeping it short.

I saw a post on this forum sometime that basically said that the science indicates that if you stay under 20g carbs a day, you will be successful. I find that very hopeful.

Your story is a mystery at this point, and it would be helpful if you provided more info. about what you are eating, how often, etc. I know there are so many people here who will be able to provide you good information and hope.

Before keto and like many here, I suffered terribly from carb addiction. I really didn’t think there was any viable solution that I could maintain long term. When I started keto, I ate three meals a day, no snacks, no alcohol, only drank strictly plain water and a cup of coffee a day, no fruit. I kept my carbs between 8-15g/day, (but that isn’t hard for me as was never one for veggies too much - my carbs usually came from dairy [cream and cheese mainly]), and made sure to eat enough fat. Almost immediately after beginning to eat like this, my cravings for pasta, pizza, bread, ice cream, sweets, and everything else we consider bad carbs was almost completely lifted, to the point where those foods were no longer difficult to resist. I totally enjoyed my meals (and still do), and looked forward to my meals but didn’t obsess about food or when/what I would eat. Within 2-3 weeks of three meals/day, I no longer felt a desire to eat that much or as often in a day because I felt physically satisfied, and the monkey that had always been on my back driving me to binge, was gone. All throughout I have continued to lose weight.

I hope you stay here and keep us posted as you continue your journey. Good luck.

#6

I think there are a lot of things at play here and it’s important for us to get an understanding of what you’re eating and how much.

In the meantime, here’s a couple things to consider re: ADHD and food binging. One of the hallmarks of ADHD is impulsive behavior and binge eating is a common problem in people with ADHD (often without purging, unlike other causes of binge eating disorders). While very low carb diets like keto can be a first line of defense to help manage ADHD symptoms, it still doesn’t cure it. You may still need a good solid drug like Adderall.

Another (or additional) option is Wellbutrin, especially for impulse control. I never felt so in control of what I ate as when I was on Wellbutrin. It was amazing. I switched ADHD drugs to something that worked better overall for me, but it’s still something to consider. I believe you can take them in combination. Wellbutrin does have some side effects and can raise blood pressure (though not always). On the other hand, losing more weight and staying on keto could help you lower your blood pressure, potentially to a no-meds-needed level. So it’s something to discuss in detail with your doctor.

“Satiety” as a line doesn’t work for everyone. It doesn’t work for me. It’s not that I’m super hungry, per se, just constantly craving more food. If you’re starving-hungry and gaining weight that’s a perplexing issue. But if you’re just craving more food, this is more likely tied to the impulse control stuff. It also sounds like you might have some metabolism issues from eating 1600 calories/day for a long time.

(George) #7

Hi Chris,

I was always heavier too, I look back at pictures of myself from kindergarten and think “why the hell did my parents/grandparents let me get that big at that age?!” but oh well

Anyway, I had my son right out of high-school, and right after that it seemed like the weight just slowly added on over the years. That, and a crappy failed 1st marriage seemed to make the weight gain even worse.

To top it off, I met my now wife in my late 20’s, and that blissful new relationship phase we’ve all experienced caused even more of a weight gain.

I too was a binge eater (especially behind closed doors). All I can really say to that is that yes, its’definitely a mental thing. For me, there had to be something significant to spark this last weight loss attempt, no BS, no excuses.

In my case, it was a picture that was taken of me in December, a few days after my 29th birthday, and that was it. That picture made me feel so horrible about myself that I knew there was no way in hell I was going to enter my 30’s in the morbidly obese category. By that point, I had already listened to a few keto podcasts and had a basic understanding of it and I’ve stuck with it.

So anyway, I guess for me personally it just came down to a “how badly do I really want this” kind of thing. I do OMAD, and meal prep all my food on sundays, and they go right in the freezer. I do not buy snacks or other things that I can easily binge, and since I keep my meal’s frozen up until the day I eat them, there’s no way I can binge on those either. That method, coupled with quite a few extended fasts I have done have allowed me to get a handle on excess eating, since I can now differentiate what true hunger feels like, and can rationalize if I really NEED to put food in my mouth or not. Looking back now, every single time I binged it wasn’t because I was hungry, it was because I was bored and food was available, so by removing that option, I do something productive when feeling bored now.

(Alec) #8

Chris, I can see lots of flags in your story.

Focus on this… this is critical. I know you want and need weight loss, but removing your diabetes is a critical first step. You are doing this with that great a1c. Well done!!

Meds will promote insulin, and may block you burning bodyfat. Not sure you can do much, but be aware.

This sounds to me like you are somehow blocked from using your bodyfat. I think this is possibly high insulin. Have you had any insulin tests done? Insulin does move up and down, but if you get a high reading it may be the cause of your hunger issues.

I recommend that right now you don’t IF. I think you need to avoid the hunger that this brings.

Personal opinion… been there myself losing the same many lbs over and over… this is a root cause of the issue here and you have a low metabolism. And you need to give it time to repair… may take a LONG time if previous dieting was chronic as it seems to be.

Please do let us know what you are eating as others have asked. But also see if you can get an insulin test. Continue to keep carbs low… the best point in here for your health is your current a1c. Hold on to that and keep working at it. This shows you are doing keto well, the issue is I think you are highly insulin resistant and your insulin remains high. But to be proven.

Most important. Don’t get down about this. Keep going, keto is the best place for you given you background and history. It just may take a long time.

Keep posting here, don’t give up. We are here for you.

(Carl Keller) #9

Hi Chris.

You’ve had some wonderful advice and encouragement so far and I won’t try to overload you with comments from a person who has never had the problems you have and who is certainly not a doctor or nutritionist. I just want to point out the importance of one thing:

This is remarkable and has nothing to do with what and how much you are eating. One hormone, cortisol, is capable of wreaking havoc on our humblest weight loss plans. I’m curious if somehow cortisol isn’t creeping back into your life and causing your gains of late… or even if some new medication is involved.

Like @Alecmcq suggests, your metabolism could be in need of further repair, which might explain your downgrade of energy. But I’m also inclined to wonder if you are experiencing some type of mineral deficiency or anemia since you did experience better energy for a time before it tanked. A blood test and a thorough checkup might shed some light on the problem.

(Full Metal KETO AF) #10

I would assume this because he’s on an anti anxiety drug to deal with stress.

Chris I’m sorry the road has been so rough for you. I have lots of health issues that I have dealt with, many had to do with being overweight and eating poor food choices. We all want to know what you are eating and also what your food binge episodes are like as far as food and how often they occur. Is it junk food or overeating keto food?

I would think a heavy protein diet or even trying a carnivore diet for a couple of months if you’re a meat lover, would keep you satisfied between meals. Don’t eat lots of fat, use it like a lever. Add some if you’re feeling you’re really hungry, eat less sometimes to burn your own fat instead. But I would just keep your food basic until you figure it out. No keto pizzas or keto treats. Avoid artificial sweeteners if you’re using them, ween off. Your taste will adjust. Meat and fat in equal gram weight as a center point. Moderate vegetables. Giant salads require lots of salad dressing often. Do steamed or blanched broccoli cabbage whatever with some butter or olive oil now and then. I eat sauerkraut that I make. If you’re eating lots of cheese and nuts this can be very much a problem. I would limit cheese to a 30g per day and the same with nuts if you’re eating them. If you’re eating berries stop.

Get Cronometer and start tracing and weighing your low carb foods accurately.

I have mostly been eating twice a day now. Meat and eggs for breakfast and a late afternoon meal of meat and vegetables typically. Sometimes that’s just 3/4 cup of sauerkraut raw, that’s less than 1 carb and it helps with keeping salt up besides helping with weight loss with regular probiotics in your diet. All you need is salt and cabbage and a little internet reading. I noticed a jump in weight loss when I started making and eating it often. You don’t need to obsess over the daily food, you should look at your protein and fat macros as goals and carbs as limits. If you’re carb binging when have those bad moments it could keep you from staying in a good state of ketosis if they’re frequent enough.

I heard someone say a long time before I ever started keto that the reason people overeat at meals is because they eat too fast and don’t chew enough. The thing about overeating is that the pleasure of eating is 98% in your mouth. When people eat quickly and don’t chew food enough the eating experience ends before we’re satisfied with the meal and we want the experience to go on. Seconds, thirds…dessert. In the end you never gave your self the chance to experience satiety, which is at about 80% full. You’re not stuffed where you feel like you need to stretch out on the sofa, and your not hungry anymore either. The way I achieve this is by either talking with a companion if someone is eating with me, or I’m watching television and leasurely enjoying and savoring the eating experience. Smaller bites chewed longer goes a long way towards recognizing that elusive thing people call satiety here.

Also it’s good to drink some water a half hour before your going to eat. I think this aids digestion and preloads your stomach not so you’ll eat less, but that you won’t have some urge to eat quickly if you were very hungry. :cowboy_hat_face:

(Bunny) #11

Hi Chris, Welcome:

After carefully reading your position about your dietary life, and getting some insight, I do enjoy reading and hearing people’s dietary autobiographies when it comes to human physiology and health, which I do deeply enjoy reading and helping out if I can, so I thought the link below might be helpful and very specific to your needs, by Dr. Jason Fung

Controlling Hunger-Part 1

What is fat fasting and when should you do it?

(PSackmann) #12

Chris, I haven’t gone through what you have, but I can tell you, at half your size my body loses on 1,500 calories most days, when I track. Your body very well could need 3,000 daily. So, remove the CICO from your mindset for the time being.

In your research, did you read The Obesity Code by Dr. Jason Fung? If not, I would suggest reading it, and watching some of his videos. He has had amazing results with his patients through fasting, to help break through severe insulin resistance. He also has a web-based program, search idm Jason Fung to find it (not sure about posting links). Also, check out the fasting threads here, you’ll find some great inspiration.

(Jill F.) #13

Hi there @Chris_Kreifels welcome and stay a while, this is the place to be when you have questions or need support! I, like many others on here, only had about 40 to 50 pounds to lose not 100’s, so I can only imagine how daunting that must be! But like a familiar recovery program states, one day at a time is the way to go.

I agree with others and would not do IF, especially if you tend to overeat at lunch and dinner. I think you need to eat when hungry and just focus on keeping carbs under 20. Honestly, I think even if you kept your carbs under 30 to 40 a day it would still be a huge improvement over your past eating habits!

I am a 5 ft 4 female and I tend to eat 1100 to 1600 calories a day so I can only imagine you eating only 1600 is not nearly enough and sets you up for failure hunger wise. I think drinking a lot of fluids during the day (like so much you have to pee hourly) helps me a lot with hunger. I drink an entire bottle of water between meals and eat a few pickles or a couple of Slim Jim’s and it helps me to not overeat at meal time. (I know snacking is counterproductive for insulin spiking reasons, but so is grossly overeating!)

I am a therapist and I also suffer from anxiety. I think staying on your anxiety meds is crucial, and maybe consider seeing a therapist to get to root of the binge eating/impulse control issues. I found out after I started keto that i was a huge emotional eater and when I no longer could drown my worries in a family size bag of chips or a king size Snickers I had terrible anxiety. I have had to go to therapy myself to work through my emotions.

I am not a dr or a keto expert by any means, those are just things I have observed that work for me. We are glad to have you here and hope that some of our love and advice is helpful for you!

#14

That’s an unusually low A1C. Jusy wondering if there’s something going with how your red blood cells are performing, since an increased turnover rate will skew the A1C result in a downward direction.

Like others have mentioned, this is likely a result of elevaled insulin, for which there are many root causes. Until this issue is addressed either through dietary changes, like eliminating specific trigger foods, or reducing cortisol from stress etc. the hunger and satiety signals will not have a chance to be normal. That said, insulin regulation is only the first step. There are lots of people who have severely disturbed incretin systems and/or psychological eating habits that puts them at a whole different level of difficulty.

Also, have you had thyroid hormones checked?

(Chris Kreifels) #15

Thank you all for the responses. I do feel like my sleep hygiene needs improvement, and that it is affecting my weightloss. In my over-analytical mind, I look back and wonder what (besides the drugs) was the difference last year to now. I’m thinking it was that I made my walks very close to bed time, then fell right asleep. I was avoiding going back to the Dr for the shame of showing up 30 lbs heavier than my last visit. The thing is, It’s nothing for me to fluctuate 10-12 lbs overnight sometimes. I’ve put that aside and made an appointment for later this week to discuss a different treatment plan. In an honest look at myself, while and after reading your comments, I realize that my anxiety is not as in control as it once was and that most of my binge eating has come from anxiety moments due to stress.

Here’s an honest look at my food intake yesterday, which was a pretty bad anxiety day for me:

Breakfast:
Coffee with 2 TBS heavy cream

Lunch:
3 Pieces of Bacon - fried
2 cups frozen spinach
4 broccoli florets
2 jalapenos
16 oz of corned beef brisket I smoked over the weekend.
(all cooked in said bacon fat)
Finished with 2 TBS sour cream and 1/4 cup heavy cream

Dinner:
8 oz ground beef
2 jalapenos
3 pieces of bacon
1/2 of a leek
2 oz cream cheese
2 TBS sour cream
1/4 cup heavy cream

Late night - 9:00pmish
2 eggs
4 oz brisket

A few things i noticed are too much protein and maybe too much dairy? That 1600 calorie lunch was stupid, and I felt miserable afterwards - all afternoon. Dinner was probably about normal for me. The late night snack came because I decided to prep my breakfast (4 scrambled eggs) and lunch (4 boiled eggs and 2 cans of tuna) for today. I realize that meal prep may be my best bet, but i can’t seem to find the time. I’m just going to have to. That, and I’m a taster. I do the cooking in my house, and when I make a meal, I taste it the whole way through to the point that sometimes I have a full meal before I sit down to have my meal. Part of that is hunger, most is just not being in control of myself. That said, past attempts of meal prepping led to overeating at prep time to the point of being miserable. Also, I’m the only person eating Keto in my household. My seemingly unblock-able mental position is to make extra to save for lunch tomorrow, then when I sit down to eat, if there is more in the pan… It’s not making it to tomorrow. Then comes the frustration/guilt cylce, etc.

According to MyFitnessPal, I ended the day with 3000 calories, 21g carbs (3%), 173 grams protein (25%), and 222 grams of fat (72%).

When I binge, it is exclusively on KETO friendly food, no sugars, etc. Cheese and meat are generally my goto’s. The scale went up another 2lbs, from yesterday, but I’m attributing that to having been a bit dehydrated over Monday-Tuesday. I do weigh evey day as a check-point, but only record once per week and use those readings in my analyses.

#16

Do you have any blood ketone or glucose readings? That might help you figure out if you are sensitive to higher protein levels lowering ketones and therefore screwing with satiety and mental clarity.

(Chris Kreifels) #17

When I first switched to keto, I checked BG and ketone levels often, but then, in an effort to pigeon-hole a little cash (which failed miserably with 4 kids, haha) I didn’t order more of the expensive strips. I’ve ordered more and they’ll be here later this week. I got a sense of false security when my Dr said I no longer fell into the Type II category, and stopped checking my BG. I’m firing that back up this week as well. My fasting BG was 105 this morning.

#18

I think going back to testing for a while is a great starting point. Personally I can feel a mental difference between being above 1.0 and being borderline ketosis. It would be good to see if you can narrow down a range that works for you.

(Full Metal KETO AF) #19

That’s a better number than I get as I near my 9 month mark, and I am no longer overweight. I’m on prednisone and may never achieve that below 100 average BG level on my HbA1c but keto is still working. I am very insulin resistant. I have never tested myself.

#20

Here’s an article about about the really low A1C compared to fasting glucose tests.

Is anemia one of your problems? That would give you increased fatigue etc. too.

Another condition that affects hemoglobin A1c levels is anemia. People who are anemic have short-lived red blood cells, so like diabetics, they will test with falsely low A1c levels. In my practice, about 30-40% of my patients have some degree of anemia, so this is not an uncommon problem.

https://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker/