Help with changing the body's set point (T2 diabetic)

[Deridan]

Hi everyone,

I’ve had some good initial success with EF and have kept the weight off despite stuffing myself on several occasions (my weight barely goes up). Further fasts however have been tough and food cravings/hunger are a ongoing feature although as the days tick by, this lessens (1st 2-3 days are the hardest).

I want to lose more weight to get to about 165-170lbs. I’m 5’7" (170cm) and currently weight 180lbs and I still have belly fat & loose skin around it. (I’m on day 6 of a fast currently).
I have only recently become aware of the body’s set point and I am interested to see how I can change mine.

I recently watched Dr Fung’s video Leptin & Insulin Resistance Balancing Tips, which was very interesting, but when he talked about the body’s set point, I didn’t quite hear him say how the body’s set point can be lowered.

I think lowering my BSP would be helpful so I can maintain my weight at the level I believe I should be, without needing to go on EF, or watching what I eat too much, which is one of the reasons I fast. I also am using EF to try to reverse my T2 diabetes, which has plagued my life for many years.
My blood glucose readings remain high when I fast and only drop slowly (& they go up too). Today my BG was 154 and strangely, it went up to 200 yesterday when I tested at 8pm. At 7am yesterday it was 157. No food. Just black coffee and water.
Even when I did a 4 week fast, the lowest BG I achieved was 125, before I caved and started my re-feeding procedure.

Also, I do not know what my insulin levels are and have no idea how to measure this. I cannot afford to see a doctor and i do not qualify for free/low cost healthcare. I do not take any meds (I cannot afford them nor do I qualify for free/low cost, even if I did chose to take them).

Any help on the set point, how to test my insulin levels, why my BG readings might be remaining high would be appreciated.

[240lbfatloss]

Set points are nonsense. What occurs is Lipostasis, a function of lifestyle, food intake, and metabolic health. Manipulation of one or more of those aspects is how you resume fat loss.

[Chris1]

Are these high blood sugars possibly a result of the reduction in liver stored sugars or glucose that is stored in the muscles? Perhaps the sugar that is stored in viscera or gluconeogenesis? I think that the lowering of the set point occurs the longer that one does regular, consistent fasting, but I would struggle to cite the reasons for this at the present time.

[Fruno]

Set points are nonsense. What occurs is Lipostasis, a function of lifestyle, food intake, and metabolic health. Manipulation of one or more of those aspects is how you resume fat loss.

IDK. I went from 245 to 210 in a year of low carb, but have been stuck there for the last 8 months. Doesn’t matter what I do, whether I eat carnivor or salad, OMAD or 20:4 (my default), fast 2 days a week or eat 2 meals a day. If I eat less I’ll be very cold and lethargic. Even lapses into eating carbs won’t change my weight.

The set point theory sounds reasonable to me. Especially since I’ve been around 210 for most of my adult life (though it was around 230 for the last 10 years or so). I’m trying a 7-day fast now to see if it changes anything, as I’d like to another 45 pounds…

My blood glucose readings remain high when I fast and only drop slowly (& they go up too). Today my BG was 154 and strangely, it went up to 200 yesterday when I tested at 8pm.

For many diabetics, gluconeogenesis runs in overdrive. One of the main functions of metformin is to slow this down.

Give it time. You might want to make sure your protein content is lower than normal on keto, maybe >75% of calories from fat and <25% from protein. We can hope that your liver eventually learns that it doesn’t have to create so much glucose. It’s similar with the dawn effect (high bg in the morning), bg can take years to come down if people were severely insulin resistant.

Are these high blood sugars possibly a result of the reduction in liver stored sugars or glucose that is stored in the muscles?

Not after a 4-week fast. Has to be glucose created from protein. Now remember that we have a lot of excess protein if we lose weight, all the connective tissue, cell membranes and whatever that is no longer required if we lose fat.

[Vladaar_Malane]

Yeah I agree, with Dr. Fung’s setpoint theory in that your body seems to get used to a weight. Once that happens if you deprive it, it thinks your starving and does whatever to try to get it back.

Now, as to how to overcome it, that is something that may differ from person to person. I have tried extended fasting quite a bit, but seem to always get the weight nearly back when I finish the fast. So I deprive myself for 3 or more days, then eat and seem to almost regain the same weight in one or two days. Even staying keto.

So I can’t say I know the answer here. Maybe a longer fast, and or as some people do the ADF alternate day fasts. I guess you got to find what works for you. I am thinking I might try the 7 day fast, because I always do intermittent fasting, have tried OMAD now and then and really don’t get much more results. Set point seems to keep me coming back to weight.

Good Luck, but yeah set point is not nonsense.

[Shinita]

Stalling may mean the comfortably smallest possible calorie intake causes no deficit anymore. I have that. I lost fat easily then that’s it because my TDEE reached the minimum amount I was able to eat.
OMAD? Keto? Extra efforts? I can eat my usual calories (and more) the same. It’s hard with a smaller energy need and little activity helps little.

I don’t say there is no such thing as our body clings to some fixed weight but a stall often can be explained with something else like in my case. I am very sure that I would lose fat easily (and super slowly) again if I was more active, too bad I couldn’t test it this far. My body is simple, it doesn’t even matter what I eat (regarding fat-loss, I mean), just the calories (the two are very correlated though if I can use free will). But as we know, not everyone is like this. There are so many possible factors, we probably don’t even know about them all.

[atomicspacebunny]

Are these high blood sugars possibly a result of the reduction in liver stored sugars or glucose that is stored in the muscles? Perhaps the sugar that is stored in viscera or gluconeogenesis? I think that the lowering of the set point occurs the longer that one does regular, consistent fasting, but I would struggle to cite the reasons for this at the present time.

What I’m writing below is highly theoretical and is my personal hypothesis on this:

What your looking at below is what I think the epicenter of the metabolism is or the ‘set point,’ or ‘settling point’ is and to reach a zero energy balance you need to eradicate intramyocellular lipid build up in skeletal muscle tissue, if you did not have any fat in your muscle (inc. visceral fat around the liver and pancreas) you could eat what ever you wanted with no high blood sugars and a tiny spikes in insulin.

image link

The reason your blood sugars are so high is you have the blood sugars of a person who has high need to expend energy or what would be required by an athlete. The energy you are accumulating in your body has no where to go?

The different types of fat or lipids in the the human body communicate with each other (believe it or not?) and accumulate according to percentage you eat from sugar (saturated fat) or actual dietary fat in different tissue causing you to diminish your capacity to oxidize carbohydrates which means glucose gets stored as lipids (saturated fat) in panniculus subcutaneous adipose tissue and visceral fat, and expand when skeletal muscle are full (insulin resistance) of stored lipids also. Each bodily organ has it’s own cellular metabolism that respond to lipid ratios.

The copyright to this is no longer valid:

1. “…A lipid blend designed to decrease the accumulation of intramyocellular lipid in an individual, characterized in that it contains:

• medium-chain fatty acids in an amount of from
40-65%;

• glycerides with long-chain Saturated fatty acids of from 20-50%, and;

• monounsaturated or polyunsaturated fatty acids in an amount of from 0-30%. …More

References:

[1] Example: “…a. Multiply the grams of saturated fat by 9 = (xx) the number of saturated fat calories in the food item. b. Divide (xx) the number of saturated fat calories in the food item by the total number of calories in the food item = % of saturated fat. 1) Fat – 3 x 9 = 27 fat calories; 27/90 = 30% total fat. …More

[2] Is there evidence for a set point that regulates human body weight?

[RightNOW]

I have a loose theory based on my own experience, which has zero official support that I know of, so, you get what you pay for here with my advice.

I think that most of us, due to lifetime diet, have serious issues with our livers. Past a certain point, it doesn’t easily or quickly heal without help. I don’t know that there is any proof that everyone’s liver automatically is able to make enough ketones. Sure they can make some. Maybe enough that they have no energy but survive. Or maybe they feel ok but they just don’t lose a damn pound.

Well we can avoid carbohydrates, drop insulin, eat only meat even!, and sometimes people still do not lose fat. Sure there’s a million possibilities. But I think one is that their liver is simply not converting anything more than the bare minimum for their survival and function into energy.

So how to fix this? Well:
Liposomal Vitamin C
Phospholipid European Milk Thistle
Phosphatidyl Choline Complex
MSM (OptiMSM) (sulfur)
Activated Quercetin
SerraEnzyme Serrapeptase

(And for godssakes no traditional diet soda, which likely keeps the liver busy working on detoxing that.)

I don’t know if it will help – but pubmed suggests that silymarin (search: silymarin hepatic) is incredible for the liver. And Serra is great for every damn thing, from getting rid of excess proteins on the brain to helping clear up problems all over. It dissolves “dead proteins.” Take it at least 2 hours before/after a meal, on its own. I take it before bed.

I have searched to see if I could find any research suggesting whether a person’s liver was able to make the tons of ketones necessary to not only power the body but to give one energy – and lose bodyfat as a result. People of different ages and physical conditions. I can’t find anything. Might be searching poorly I guess.

But it is possible if we’re not getting enough energy incoming, and the liver cannot make more than a certain amount of energy to give us, that the body automatically downregulates metabolism to spare us.

[PaulL]

Lustig et al. showed that merely reducing the fructose content of the diet for ten days was sufficient to reduce hepatic adiposity and bring liver enzymes back into their normal ranges. Granted, the number of subjects was small, but the data are intriguing.

Researchers are more and more coming to believe that inflammation is at the root of every form of metabolic dysfunction. I am still trying to get my head around this, but I have seen some persuasive material lately. One phenomenon definitely linked to systemic inflammation is mitochondrial damage, and a major source of damage to the mitochondria is excessive bombardment with glucose needing to be metabolised (glycolysis produces an abundance of reactive oxygen species, which cause all sorts of damage to not only mitochondria, but also in other areas of the cell).

The profile of the fats we consume is another source of inflammation. Ω-6 fatty acids, though essential to the human diet, cause inflammation when ingested above a certain minimal level, and the vegetable oils (actually they are all seed oils) touted as being rich in polyunsaturated fats all contain stunningly high percentages of ω-6 fatty acids. One researcher recommends limiting our intake of polyunsaturated fatty acids to no more than one percent of our total fat intake.

[atomicspacebunny]

Lustig et al. showed that merely reducing the fructose content of the diet for ten days was sufficient to reduce hepatic adiposity and bring liver enzymes back into their normal ranges.

”…Fructose: is sweeter than glucose, so it’s most often used as an added sugar in processed foods, whether in the form of high-fructose corn syrup or just plain old sugar. Scientists call plain old sugar sucrose, and it’s a 50-50 mix of fructose and glucose. …” …More

Now that’s extremely scary? So much for the countries that banned HFCS?

Even with the HFCS ban diabetes and obesity is still skyrocketing?

The sugar industry people are some really sneaky folks?

I’ve seen how these folks live at the expense of our little tiny pancreas and liver? They shuttle around in their own private limousines, private helicopters, airplanes, collection of sports cars, and cultivate this sugar all over the world as well as giant mansions, beach houses world wide…crazy easy money!

Reminds me of that song “the smugglers blues“ fructose the new cocaine…lol

[SporkyDonkey]

You used two different omegas, and it’s bothering me.

[Fruno]

Lustig et al. showed that merely reducing the fructose content of the diet for ten days was sufficient to reduce hepatic adiposity and bring liver enzymes back into their normal ranges. Granted, the number of subjects was small, but the data are intriguing.

Crucially, they were children. What we see in the population is consistent with damage that accumulates over decades. I know my daughter makes ketones in the morning even if she ate carbs the evening before. Children are apparently much more metabolically flexible, and they will heal faster. For adults, it might take a very long time to heal, or maybe it never happens.

Agree with your other points.

One researcher recommends limiting our intake of polyunsaturated fatty acids to no more than one percent of our total fat intake.

That’s obsessive. The omega-6 content in grass fed beef is around 5 percent, so that should be a good target. Granted, if you ate too much omega-6 in the past it will accumulate in your lipid cells, it makes sense to aim for less. But that’s hard to achieve without eating butter and drinking olive oil, as n-6 content in commercial meat is higher than in “natural” meat.

I am very sure that I would lose fat easily (and super slowly) again if I was more active, too bad I couldn’t test it this far. My body is simple, it doesn’t even matter what I eat (regarding fat-loss, I mean), just the calories (the two are very correlated though if I can use free will).

No. The CICO (calories in = calories out) point of view is complete bogus from a scientific point of view. There are many threads here talking about this. More activity leads to more hunger, so unless you’re starving yourself (not eating to satiety) more activity doesn’t lead to weight loss. Sports are great for many other things, and it’s one of the best investments of personal health, but it doesn’t do jack for weight loss.

[OldDoug]

The CICO (calories in = calories out) point of view is complete bogus from a scientific point of view.

I have to disagree with this. The problem is that it is people who are not being scientific - they are not keeping track of the “calories out.” They are failing to take that part into consideration or don’t know what it is for them.

[PaulL]

LOL! One is a capital omega, the other is lower case. If you want to get really freaky, the Greek alphabet also has three sigmas, a capital, and two lower-case, one for the beginnings and middles of words, the other for the ends. How’s your sigma tolerance these days?

[PaulL]

That’s obsessive. The omega-6 content in grass fed beef is around 5 percent, so that should be a good target.

Possible confusion here, which I should have worked harder to avoid. I was saying 1% of fat intake, not 1% of total calories. My guess is that when you say the ω-6 content of beef is 5%, that’s 5% of calories, not 5% of weight. If I’m right, that means that keeping total ω-6 consumption to around 1% of total fat content (and I believe the presenter I got this from was speaking in terms of weight, not calorie content) should not be too difficult. The lecture I got all this from was part of an all-day conference with several speakers, so it may take me a while to re-watch the video and find the references. In any case, the précis of the executive summary of the synopsis of my point is simply to keep your intake of ω-6 fatty acids as low as possible.

Cooking with butter and/or other animal fats, which are something like 51% monounsaturated fats and 48% saturated fats, should keep polyunsaturated fat consumption low enough to avoid any ill effects, no matter how much comes along with the meat.

[Fruno]

That’s obsessive. The omega-6 content in grass fed beef is around 5 percent, so that should be a good target.

Possible confusion here, which I should have worked harder to avoid. I was saying 1% of fat intake, not 1% of total calories. My guess is that when you say the ω-6 content of beef is 5%, that’s 5% of calories, not 5% of weight.

Nope: 5% of total fatty acids
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846864/

I have to disagree with this. The problem is that it is people who are not being scientific - they are not keeping track of the “calories out.” They are failing to take that part into consideration or don’t know what it is for them.

Well, it’s complicated. The first law of thermodynamics holds, that is, if you want to lose weight then you need to have a negative energy balance. But consider this: If you ask “why is this restaurant full”, would you consider an answer “because more customers came in than left” correct? Mathematically, yes. But it doesn’t answer the question.

The big thing is that output depends on input. If you eat more, you’ll burn more. If you eat less, you’ll burn less. People will actually gain weight if they eat less calories on a high-carb diet, there are plenty of studies to this effect. Cut calories by 20%, people lose weight for 3 month and then start gaining it back. After a year they’re back at baseline. CICO is bs. Look for Gary Taubes talks on youtube for thorough coverage on this.

The body behaves very different on a high-carb diet than on a low-carb diet. If insulin is high, the body will do everything to protect its fat reserves, lower expenditure if necessary. OTOH if insulin is low, the body will use its fat reserves freely.

[PaulL]

Nope: 5% of total fatty acids

Gotcha!

The first law of thermodynamics holds, that is, if you want to lose weight then you need to have a negative energy balance.

And while this is true, Gary Taubes points out that the arrow of causality can run in both directions. The hormonal hypothesis of weight maintenance is that the hormonal effects of the foods we eat determine whatever energy balance we may experience. In other words, we put on fat because we are in fat-storing mode and must therefore eat more than we expend, in order to have fat mass to add. We lose fat because we are in fat-loss mode, and must therefore eat less, so that some of our stored fat can be metabolised.

My favourite example is children in the middle of their pubertal growth spurt. We all know that they put on weight because their hormones are telling them to, not because they are eating their parents out of house and home. The huge food intake is an effect of the growth spurt, the growth is not the effect of the increased food intake. Only an idiot would maintain otherwise.

Why we don’t apply the same logic to adults who put on fat, I don’t understand. Like a bear preparing for hibernation, we signal our bodies to store fat by eating lots of carbohydrate. When we stop eating carbohydrate, our insulin drops again, and those stored fatty acids are free to leave the adipose tissue to be metabolised.

[OldDoug]

The first law of thermodynamics holds, that is, if you want to lose weight then you need to have a negative energy balance.

Good, thank you - well said. The alternative to acknowledging this reality is to engage in ‘magical thinking.’

But consider this: If you ask “why is this restaurant full”, would you consider an answer “because more customers came in than left” correct? Mathematically, yes. But it doesn’t answer the question.

Well, there could be an enormous multitude of answers. If we are talking about the quantity of customers inside, then I would say it depends on enough more going in than leaving, or just having enough in there, period, i.e. being at capacity - which was given as a premise. So…

The big thing is that output depends on input. If you eat more, you’ll burn more. If you eat less, you’ll burn less. People will actually gain weight if they eat less calories on a high-carb diet, there are plenty of studies to this effect. Cut calories by 20%, people lose weight for 3 month and then start gaining it back. After a year they’re back at baseline. CICO is bs.

That’s an illogical conclusion, because CICO is right there all along, operating away. Yes - eating more may mean some increased burning, but the math is still going to work out, and one’s weight will reflect that. Person by person, this may mean gaining weight, because often the increase in metabolism will not fully offset the increased intake. It’s rarely if ever going to be an exactly linear, equal thing.

I agree with you 100% about the hormonal effects and the difference that high-carb and low-carb can make. Yet it seems this argument never ends, and all the while the critics of CICO are choosing to ignore the “calories out” part.

Simply “eating less” is not guaranteed to be a successful way for people to lose weight (especially, as you note, over the long term) - here too I agree 100%. But there we’re only looking at the “in” part. Meanwhile, CICO is saying that by definition you will lose weight if you keep the “out” bigger than the “in.”

[amwassil]

We’re having a discussion in another topic, which is likely relevant to what’s being discussed in this topic.

https://www.ketogenicforums.com/t/gaining-fat-in-a-healthy-way/102326

@Tim_Cee wants to store more fat but remain in ketosis doing so. Thus, ‘carbing up’ is not an option. No one denies the laws of thermodynamics, which incidentally apply to closed systems which humans are not. Nonetheless, humans evolved eating to excess when food was available to store enough of it as fat for the days, weeks or even potentially months to the next meal. I don’t know the exact relationship between energy balance and hormonal response, but it makes sense to me that in ketosis you could use weight/fat loss/gain as a rough approximation of both.

[Fruno]

That’s an illogical conclusion, because CICO is right there all along, operating away. Yes - eating more may mean some increased burning, but the math is still going to work out, and one’s weight will reflect that. Person by person, this may mean gaining weight, because often the increase in metabolism will not fully offset the increased intake. It’s rarely if ever going to be an exactly linear, equal thing.

Sorry, but that’s not true. At least without adding restrictions. It may be true short term, but not long term. Most people look only short term, they eat less and are happy if the scales show they lost 4 pounds in a month. But they all start regaining weight. The body reduces base metabolic rate to compensate, in fact it overcompensates in the long term.

There are plenty of studies where people ate less and didn’t lose weight at the end of the study, if they checked for a year or more. Look at this study: https://drc.bmj.com/content/8/1/e001012 One group was on a starvation diet (800 calories) for 3 months, and then 600 calories below their baseline for 9 more months. The other group was 600 calories below baseline for a whole year. And they all gained weight in the last half year of the study, significantly, eating 600 calories less than they ate before. IIRC the “starvation” group gained 10 pounds on average. So high carb messes CICO up, the body overcompensates by lowering the baseline metabolism. If they had continued the study for another year, there is little doubt that they would have reached their previous weight or more.

You may be right in a low carb/ketogenic setting. But in my personal experience, weight gain is very moderate even if I eat a LOT. There was this case of a n=1 experiment where one guy switched to keto and ate twice the calories that he usually did, something like 5500 calories a day. After 4 weeks or so he had gained very little weight (3 pounds IIRC, all numbers from memory and might be slightly off) but lost waistline circumference, so the weight gain could have been due to muscle growth. The usual CICO arithmetic predicted that he would gain 18 pounds. Which happened almost perfectly when he repeated the experiment with a high carb diet.