TL;DR: Sounds like you’re doing reasonably well. So besides suggesting you take a clear-eyed, no-foolin’ look at your menu to ensure you’re not perhaps eating more in the way of carbs than you’ve recognized, I’ve got no meaningfully constructive ideas. Although your profile said keto since 2017, you’ve also said above that you’ve been doing keto since Sept '24? If so, then after just 7 mos in, you’re making clear progress. Stay the course.
Here’s the long version…
Heavier folks hit various plateaus as their bodies change inside - all kinds of things self-adjust at different rates. Give yourself time. My guess is you spent many decades getting to roughly 300 lbs. So you deserve to be patient with yourself as you stay on your new healthy path. Kudos.
I’m not finding much in what you’ve shared to suggest there’s a significant issue holding you back. If you started at 320 lbs - now at 295 lbs - you’re heading in the right direction. These things take time and you’re making genuine progress.
You haven’t shared your height or BMI, but I’ll assume you’re still considerably well over your healthy best weight, so you’ve got a journey ahead. This is especially the case given where you’ve started from, which again, likely took decades to reach.
Blood pressure often comes down naturally in conjunction with a “trimmer” waistline/chest. Have you lost much in the way of waist inches with those 25lbs? Or did it come off from elsewhere thus far?
And if your BP is genuinely elevated only at the Dr’s office, you’re in good company with many folks. (Yeah, it’s a stressful moment to get measured.)
Regarding insulin resistance, do you have specific bloodwork on that front? E.g., Insulin readings allow you to also calculate a HOMA-IR metric? NMR Lipid profile allows you to get another glimpse at particle sizes, pattern A vs B, which also provides measures of IR?
And while your fasting glucose at 125 is still somewhat higher than a keto WOE usually produces, the avg of 95 isn’t bad at all. It’s the excursions that are always the most important (I’d read somewhere that meaningful tissue glycation doesn’t occur until you’re above 145, though not quite sure about this).
Look, 125 mg/dl glucose as a dawn effect level is not ideal. You’ve likely done years of inflammation-related damage to mitochondria while putting on the weight. But if you’re testing yourself at postprandial glucose levels (1-2hrs after meals) and not tipping beyond 140 - from a 125’ish morning baseline - this suggests to me that you’re heading in a good direction to address the metabolic syndrome you’ve accumulated and reversing the accumulated insulin resistance issues from the past.
HbA1c of 5.8 is certainly not excessive given your history prior to your recent eating changes. Pretty darn good. Yeah, trigs are a bit higher than expected given keto but not off the charts. For context, how’s your HDL in comparison to those trigs?
Again, the best I can offer is to ensure that you’re not eating more in the way of carbs than you might be leading yourself to assume? I’m not accusing you! Just encouraging you to be sure you’re treating yourself the best way you deserve to promote long term progress and healing.
I’d also be asking about alcohol intake, but you said you gave that up (very helpful!) so let’s pass on that possibility. Well done.
I don’t know just how much coffee you’re drinking and yes, some purists will encourage you to give that up, too. Not me. Unless caffeine makes your heart race, produces AFIB, etc., then a single mugful of black coffee (or even with heavy cream!) each morning is simply not going to make a massive difference in where you go from here.
So that’s my personal $0.02 on coffee. Sure, if you’re drinking 3-4 cups, okay then that’s another matter. But a single cup of dark roast? No problem for the vast majority of us.
Okay, I could mix anything with more water but it’s still not the way normal people drink ready made drinks (except some optional ice cubes).