Shannon – Patient Profile

By Jason Fung, MD

I wanted to share an email I received from Shannon, a reader. He writes:

As Hans and Franz used to say, “Hear me now and believe me later.” Never let yourself get out of shape.  I included a picture from last November at an ICON 39 book signing–as you can see, I barely fit in the chair. At that point, I weighed 390 pounds–by January, I would at 395.

So, not long after that picture was taken, January 2015, I decided that I needed to make a change in my life. I was 40 years old, severely overweight, and diabetic. The problem was, I didn’t know how to change in a way that would work for me.

First a little history: I think I went on my first diet when I was 12 years old. My mother could tell I was too big and enjoyed food. She tried to get me to eat less, got me hooked on diet soda, and even had me try low carb for a while. I shaped up a little in my teens, between farm work and marching in Drum and Bugle Corps, and by the time I got to college, I wasn’t in bad shape, just a little heavyset, but I let my weight slide and I was up to 280 by my senior year. I managed to take off a few pounds that year and graduated at 250.

During the next two decades, my weight was slowly climbing. I’d try dieting here and there, and I’d fail. I managed to take off a few pounds here and there, but after the holidays, I always weighed more. A few pounds a year doesn’t seem like much but it adds up.

By 2013, with my weight sitting at 380, I was diagnosed diabetic. I think my fasting blood sugar was around 250 when they did that metabolic panel on me. Before that diagnosis, I hadn’t learned a whole lot about diabetes. I knew I’d had a cousin who’d lost a leg to it, and my mother had been diagnosed a few years earlier and was controlling hers with a low carb diet.

During 2014, I tried the product Soylent, a mostly tasteless food substitute as a way of trying to give up food. I thought that, like any addict, I could try to quit “cold turkey.” I found I couldn’t sustain it for more than a week at a time. Worse than that, it seemed to have a negative effect on my blood sugars.

By January of 2015, I topped the scale at 395 first thing in the morning, which meant that by the end of the day, I weighed 400 pounds. That’s just a lot of weight to carry around–doing anything physical makes you miserable. When I was younger, I could say, “I’m big, but I’m in good shape,” but at this point, I knew I wasn’t in good shape. I could tell going up a flight of stairs was harder than it should be, and my blood sugar was out of control, requiring my medication to be changed.

I felt helpless. I’d read all the studies, and I knew the basics of nutrition, but whenever I tried to eat right, I’d just start craving my old favorites. I’d spent vast portions of my life doing diets, which made me feel awful. I’d struggle just to take off a few pounds, and when I stopped, I would gain the weight back.

Being diabetic, I wanted to learn as much about the disease as I could. I went to diabetic education classes. I watched medical lectures and Ted Talks. I read forums and blogs. I found much of the information contradictory, but one thing was certain. No one really understood what was causing metabolic syndrome (a variety to diseases of which obesity and diabetes are grouped) so no one had a clear view of the solution.

I was reading comments on an internet post in a diabetic forum when someone recommended this video: The Two Big Lies of Type 2 Diabetes by Dr. Jason Fung. For the first time in my life, I felt like someone really understood what was going on with my body.

Because Dr. Fung’s clinic was in Canada, I decided to take the ideas from his lectures (I watched everything he had online) and treat myself as a test subject. I designed a regimen for myself–a cyclical fast, 4 1/2 days of not eating followed by a weekend of eating. I even went as far as telling my doctor that I was discontinuing Glucotrol, because it raised insulin levels, Glucotrol’s main effect.

When I told my doctor I was doing this, he was less than thrilled, but he said as long as I was careful, monitored my blood sugar, and came back to him if it seemed things weren’t working, he wasn’t going to try to talk me out of it.

My first week of fasting was scary. I didn’t know what to expect. On the first day, I didn’t feel too bad, but on the second day, I started feeling hungry, really hungry. I did my best to ignore it and went to bed early–something I still have to do on the 2nd day of a fast.

The third day was the most worrying. I had a 2-hour drive followed by an important meeting. Because I had heard so many horrible things about fasting, I was worried I was going to pass out from the combined stress from fasting and the meeting, especially while I was driving alone on the highway. I was able to make the drive and have the meeting without issue.
By the fifth day, the only thing that made me want to go back to eating was a psychological need. I’d made it. I’d fasted a week. It wasn’t as hard for me as other diets, and I lost weight. Even better, my blood sugar had dropped to a normal range.  Then, I just repeated.

Over the months, I didn’t always make all 4 1/2 days. Sometimes I ate breakfast or lunch with coworkers on Friday if it was someone’s birthday. Occasionally, I’d go out with family. But the entire time, I was monitoring my weight. I could plainly see the effects of eating or not eating, and every Friday morning, when I stepped on the scale and I was a couple pounds down from the week before, I knew I was doing something good.

Four months into my fasting, I had my first Hemoglobin A1C test. The normal range for these tests is between 4 and 5.6. Anything above this is considered at least pre-diabetic. My previous score–taken about the same time as the photo above–had been an 8.3, and I was thrilled to find out my new number: 5.3! My doctor’s comment was, “That’s better than mine, and I’m not diabetic.”

When I started fasting and saw how quickly the weight was coming off, I made a goal to lose 100 pounds in 2015. I met that goal in September, but October was a difficult month–it was time for the local Science Fiction convention, and hanging out with authors involves a lot of eating and drinking. Then, at the end of the month is Halloween, which puts candy easily within reach. Add in a couple cheat days, and some irresistible fall treats, and I didn’t manage more than a three day stretch in the whole month.

This is the confession paragraph: Even when I do fast, I do several things which are contraindicated by Dr. Fung, diet soda, sweetener in my coffee, and sugar free jello, essentially things that make me feel full and satisfy my sweet tooth. I also allow myself a light snack in the evening. I stick pretty well to my plan, most days trying to stay around 100-200 calories, but sometimes I binge on the weekends. My weaknesses are pizza, sweets, and red wine. Before I started fasting, eating like this would push my blood sugar levels over 300. October was so bad, I stopped checking my sugar on the weekends, not wanting to know. And I was afraid that I would never be writing this testimonial because I would have screwed up my A1C so badly.

Shannon – After

I thought it was important to add those last two paragraphs to illustrate that this is not an easy process. Every diet treats every person differently–I know, I’ve tried them all. To me, fasting was the easier choice, but it still wasn’t easy. There are many days I’ve considered giving up. There are times family and social obligations made it impossible to stick to the plan. There are times I had to give up a meal in my favorite restaurant. But from the beginning, I decided not to treat this as a brief attempt to lose weight, but to see it as a lifestyle change. I’ve chosen to see any setbacks as learning experiences or inconveniences rather than defeats.

So, last Wednesday, when I had my blood taken for the second time since I started fasting, I was a little nervous. I told myself that I would take any A1C under a 6 as a victory, but I was honestly worried. I had to wait for 2 days to get the results, but they finally came in. I, again, was at a 5.3! Once again, my blood sugar was in the normal range.

Another great effect that this journey has had is my liver health. Let’s just say numbers that were way outside normal levels are now well within the normal range.

So, there it is: my story of how, with some good advice, I brought myself back from the brink of self-destruction. I still have a ways to go–I don’t want to keep flirting with weighing 300 pounds–but I’m healthier than I’ve been in years, and I have hope that I can continue on the path I am on and continue to have success.

Dr. Jason Fung: Terrific job, Shannon. If adding diet soda works for you, then by all means, go ahead. The most important thing is to stick to the plan and get results. If you are using sweeteners, but getting good results, then continue. However, if you do not see the results you want, then consider changing. In our clinic, we often allow a little cream in coffee, which is also technically not a fast. However, the difference is small enough that most people do well. Some will tolerate diet soda fine, but many will not.

The other point I would emphasize is that fasting is not always easy. But it has the ability to make you healthier. My clinic is the Intensive Dietary Management Program, not the Easy Dietary Management program. Day 2 is usually the hardest day of fasting for most people. That is when the body begins switching to burning fat. Once you know that, you can prepare yourself.

Congratulations again, Shannon. Merry Christmas and Happy New Year to all. I’ll write again in the New Year.

By The Fasting Method

For many health reasons, losing weight is important. It can improve your blood sugars, blood pressure and metabolic health, lowering your risk of heart disease, stroke and cancer. But it’s not easy. That’s where we can help.

Jason Fung, MD

By Jason Fung, MD

Jason Fung, M.D., is a Toronto-based nephrologist (kidney specialist) and a world leading expert in intermittent fasting and low-carb diets.

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