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Mar 20

Long-term weight loss on keto: Maintaining a ‘no excuses …

Name: Tami MarinoAge: 51Height: 54 (163 cm)Highest weight: 305 lbs (139 kg)Current weight: 144 lbs (65 kg)Lowest weight: 133 lbs (61 kg)

How do you maintain a weight loss long-term on a keto low-carb diet? Tami Marino has a no excuses approach, which clearly works extremely well for her.

Indeed, this attitude helped her lose 170 pounds (77 kg) during perimenopause a period of hormonal fluctuation that often involves weight gain.

However, for decades her life was consumed by yo-yo dieting, food addiction, and bingeing.

I first became overweight during puberty and got up to 250 pounds (114 kg) in my teens. It was a really tough time, Tami remembers. My mom was always overweight and really concerned about my weight. Shed buy certain foods for my sister, who never had a weight problem, but they were off limits for me. I definitely felt a lot of pressure to lose weight. My grandparents would always say, If you would just lose weight, Ill take you shopping or Ill get you whatever you want if you just lose weight. And that made things very uncomfortable, and its probably what led me to start eating in secret.

She struggled with her weight throughout her teens and into adulthood. Although shed lose weight by following Weight Watchers or starvation diets, she always gained it back.

Although she didnt develop gestational diabetes with any of her three pregnancies, when she was 40, Tami was diagnosed with type 2 diabetes. At the time her HbA1c was 9.4%, which reflects an estimated average blood sugar level of 223 mg/dL (12.4 mmol/L).

Her A1c continued to climb over the next several years, despite doing everything she was told to do, which included taking larger dosages of diabetes medications and following low-fat dietary recommendations. In addition, she developed fatty liver, high blood pressure, and severe depression.

Then in May of 2014, everything changed following a visit to her doctors office.

Id been on metformin and glipizide for a while, and Id also started taking Victoza injections a couple of times within the past month. I was really scared about taking that last medication because of some things Id read about it. I remember my doctor telling me not to test my blood sugar at home, but I would test anyway. And even with all those meds, my blood sugar was still in the 300s mg/dl (16.7 mmol/L) and even in the 400s mg/dl (22.2 mmol/L) sometimes, she recalls.

Then I heard the doctor say, Along with the meds youre already taking, youre going to need to take insulin. And that absolutely petrified me, remembers Tami.

Unwilling to accept that she was destined to take multiple medications and insulin for the rest of her life, she began doing her own research online. She found a Facebook group called Type 2 Rebels and began to realize there might be a way to improve her blood sugar control and potentially even reverse her disease. It was in this group that she learned about the work of Dr. Richard K. Bernstein, a doctor with type 1 diabetes who follows and recommends a very low-carb diet for all types of diabetes.

I read his book Diabetes Solution, and although it made a lot of sense, I didnt start following it immediately, Tami admits. It was just completely different than what Id heard from my doctor and what Id been told for years about nutrition, which was to eat low fat, lots of whole grains, and things like that.

Although it took her about a month to fully embrace the concept of a very low-carb lifestyle, once she did, the results were dramatic and life changing.

I felt so much better, was less hungry, less depressed. It was amazing.

Whats more, she achieved her lowest weight of 133 pounds (61 kg) in May of 2016 and has maintained that loss within 11 pounds for the past 17 months.

Although exercise has become an integral part of her life in maintenance, Tami didnt do much physical activity during her weight loss journey.

I really didnt exercise while I was losing weight, but I became more mobile. I had more energy and could move around a lot more easily, she says.

The powerful changes in her blood sugar, weight and overall health help motivate her to remain low carb at all times. However, she has had several challenges over the past several months.

Im now in menopause, which has been more of a struggle than I ever expected, says Tami. The hormone changes often lead to hunger and trigger binge-eating behaviors. I still eat only low-carb foods, but I sometimes eat too much. Im not perfect, but I do the best I can.

Additionally, a few financial setbacks have led to more limited food choices.

I try to focus on less expensive low-carb options like eggs, canned fish, and chicken. I really cant afford to have some of the foods I love very often, like steak and bacon. Those are like treats for me. But I wont ever eat high-carb foods like rice or pasta, no matter how cheap they are. Staying low carb is my priority,she states, confidently.

No matter what is going on in her life, Tami maintains her characteristic no excuses attitude. In fact, its a hashtag she uses on social media on a regular basis.

Years ago, I would have given up and gone back to where I started. But now I just wont do that. No excuses allowed.

Although she rarely tracks her food intake, Tami believes she stays below 20 grams of net carb per day as a rule. Except when I eat almond butter, she laughs. Thats a tough food for me to consume in moderation, so I try to stay away from it most of the time.

Breakfast (8:00 am):Black coffee

Lunch (2:00-3:00 pm):Hard-boiled eggs, avocado, flaxseed, pickles, salad

Dinner (6:00 pm):Chicken or bunless burgers, vegetables or salad with olive oil or bleu cheese dressing

Snack (8:00-9:00 pm):Sardines, salad, nuts

I actually dont add much fat to my meals, she says. I cook veggies in a little olive oil or coconut oil, and I like bleu cheese dressing on a bacon cheeseburger sometimes.

Treats are few and far between. Ill sometimes have almond butter or other nut butters when theyre on sale. I also like Quest bars because they dont spike my blood sugar and theyre portion controlled, which really helps, says Tami. And once in a great while Ill make a low-carb treat to bring to a holiday party. But overall, I try to keep things as simple as possible and really not focus on food too much because of my food addiction, she says.

In addition, she maintains the same no excuses attitude about exercise, which she finds extremely beneficial for mental, physical and emotional health.

I work out 5-6 times a week, aiming for 6 whenever possible, she says. I prefer to do it first thing in the morning after having coffee. I walk on the treadmill for about an hour on the highest incline. Sometimes Ill do a core class that has some cardio. Ive tried yoga and Zumba, but I dont like classes too much. Ive figured out that I really like doing things at my own pace.

And her favorite form of exercise?

Oh, I absolutely love resistance training, Tami says, enthusiastically. I do at least an hour and lately often closer to two hours because I recently increased my reps. I cant do free weights because I have a hernia, but I do leg presses, incline presses. I also have a good support system at the gym as far as the people who work there and friends I see there. On days I cant get to the gym, Ill do planks on the floor at home or get out and walk as much as I can. No matter what, I get some kind of physical activity in every day.

Here are Tamis tips for maintaining a no excuses attitude:

You can follow Tami on her Instagram account, @tamislowcarblife.

Franziska Spritzler, RD

For more tips on losing weight long term, have a look at one of these guides:

Top 10 tips to lose weight on low carb for women 40+

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Long-term weight loss on keto: Maintaining a 'no excuses ...

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