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from a really average woman who lost 100 lbs.
and works every day to keep it off.

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Wednesday, March 19, 2003  

Insulin Insulation

I remember so well meeting with an endocrinologist several years back and her response to my tears. I had been steadily gaining weight despite great efforts to lose it, actually gaining weight while diligently following Weight Watchers guidelines. I was in a state of panic, despair. I couldn't believe my size, or the rate of weight gain when I was eating as little as I was. I thought I was crazy. It was a nightmare.

She didn't think I was crazy. She'd seen this before. She was sorry for me, but wanted me to move on. In effect, she said, 'Yeah, some people's metabolisms are really that bad, and it's too bad for you. You lose. Sorry about that. So, listen, you're bound to be fat, you unlucky woman."

Her goal was to help me not gain any MORE, but she felt the likelihood of my losing a significant amount of weight was slim to none. Pardon the expression.

That was the first time I'd heard this expression. Her diagnosis: Syndrome X.

Syndrome X, insulin resistance, Metabolic Syndrome, Metabolic Syndrome X… These terms describe a collection of symptoms, at the center of which seems to be the body's increasing inability to respond to insulin, which leads, eventually to adult onset, or Type II Diabetes. My symptoms? Polycystic ovaries, rapid weight gain around my middle, increased testosterone (and hair growing in even more places where girls don't like to grow hair), rapid callus growth and cracking on my feet, edema, rising blood pressure, etc., etc. I was in my late 30s, and too young to be losing my health so quickly.

No one would be more thrilled than this doctor that I was able to do more than hold my weight, but lose it, lose the symptoms, and maintain my health for more than a year now through steady low-carb, adequate protein dieting and loads of exercise.

Why this diet is right for people in my situation has to do with the way our bodies can become resistant to insulin's efforts over time. I can't explain it as well as the links at the bottom of this post can. It's highly recommended reading if my symptoms and yours have anything in common.

The site editor of has been diagnosed with PCOS (Polycystic Ovarian Syndrome), and that diagnosis and the treatment, has made all the difference for her. I asked her to share her story, in case it jibes with yours:


"I do not claim that my experience with fatness is just like everyone else's, but I do believe that it's closer to the truth for many than the "I eat like a whale" experience that fits the theory most people have about obesity. Of course, it is my belief that with time, scientists will find that the great majority of obese individuals are obese for reasons beyond their inability to push their face from the table.

"I gained weight in the 6th grade (this is something you do not forget) and although I had a brief stint as "skinny" in college, my adult life has been as a heavy women. I didn't overeat. I didn't eat the right kinds of foods, that much is fact, nor did I spend a lot of time moving my body. At 34, I was widowed and the lack of desire to eat anything at all for nearly a year forced a weight loss on me (far less than one would imagine, however).

"Miraculously (okay, I consider it a miracle....), at the ripe age of 41, a very astute gynecologist referred me to a very knowledgeable endocrinologist, and I was diagnosed with PCOS (Polycystic Ovarian Syndrome). That diagnosis provided an explanation for a number of life's "huh's?"

"It explained why I was shaped as I was (like an apple, with a large middle and smaller, almost thin, extremeties); it explained why I had a very long history of menstrual irregularitites (not fixed with pills nor procedures); it explained why my energy had for so long been lower than it should have been and why I continued to maintain, or gain, weight despite eating no more than my thin and average sized counterparts. It made me happy, to finally understand, and it made me angry to have been saddled with a disorder that had caused me to spend too much of my life feeling like an outsider as a large woman in a thin-loving world.

"Polycystic Ovarian Syndrome was originally believed to be caused by the very small, pearl like, cysts in the ovaries (thus the name). However, with more study it was discovered that these cysts were not the cause, but rather another symptom of the real culprit, faulty insulin. The short and sweet version is this: Women with PCOS have too much insulin (and testosterone as well), as a result the energy they take in (as food) goes to storage rather than supplying their energy needs -- because their bodies believe they have sufficient stores of energy because of the presence of excess insulin. The result is not only obesity along with disproportional abdominal heaviness, but also symptoms that include acne, hirsutism (excess hair), menstrual irregularities, and infertility. There are also symptoms that are less cosmetic and more dire in terms of health - a great possibility of developing diabetes and cardiovascular disease.

"The good news is that physicians now have medication to assist women with PCOS to live healthier lives. The primary medication used is Metformin which is a medication also used to treat Type II Diabetes. For most the side effects of Metformin are very low and disappear within a few weeks. For me, Metformin has been a mini-miracle -- my menstrual cycles are now as regular as clockwork, my energy is as high as I remember it being since I was 18, and my ability to lose weight given my average eating habits has zoomed. Of course, Metformin is not a true miracle. I must do what I can to assist my body to return to a healthy state. I do that by weight lifting (slow cadence) and eating low-carb, as is recommended by most who frequently treat PCOS.

"There are a number of good resources on the Net where you can learn more about PCOS - of course, having a good gynecologist with whom you can discuss the possibilities of endocrine abnormalities is truly invaluable. As for me, I'm changing daily and only my body will know when they change will stop. I am not aiming at thinness, I am aiming at being the healthiest and hottest 42 year old that I can be -- want to leg wrestle!?"

There are things you can do to manage insulin resistance if that's what your body is facing, if that's the legacy of your genetic history. You don't have to take "You're stuck with it, it's your genes. Sorry," as an answer. You don't have to live with the many debilitating symptoms of insulin resistance or develop diabetes just because your momma did.

Medication is one route. Diet is another. Exercise of course. But the most important thing to do is to arm yourself with information. Feed your brain. Try a new diet. Listen to your body, experiment, see how you feel. I do believe your body will give you a clear and obvious response when you've found the right diet for you.

Good luck, dears,


PCOS FAQ at The Low Carb Life
WebMD on Insulin resistance
Dr. Ron Rosedale's 1999 BoulderFest lecture. Really interesting.
Doc Weil explains hyperinsulimia
American Academy of Family Physicians describe Insulin Resistance

posted by Julie |
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