My BMI was 59.5 in February last year. I've been morbidly obese since 1989 and have a load of comorbidities, including diabetes and several other auto-immune illnesses. Last week I had lost 56kg or 8 st 11.5 lb without dieting.
My rheumatism had flared up again and by February last I was unable to walk, hobbling painfully on two sticks. when I came across a pod cast about the gut microbiome, and how eating 6 small portions of fermented foods had changed the populations of gut bacteria and reduced inflammation markers in the blood by up to 18%.
I was desperate and decided I had nothing to loose by giving it a go.
I ordered kombucha (which I hadn't even heard of before) and kefir with my grocery deliveries, and set up a subscription with a firm that sends me 8 jars of assorted sauerkraut and kimchi every 6 weeks. The kimchi took some getting used to, I'm not a big fan of spicy food, but I've gradually come to quite like it. I love sauerkraut and can eat it with a fork straight from the jar, though it’s even better mixed with 10g of pecan nuts and 15g of chopped dried apricots or some grated apple.
Next I learnt that it takes between ten and twelve hours from the last time you consume any calories at all, before your body switches from the metabolic processes of digestion and fat storage, into the processes of repair and fat burning. Failure to reach that state causes a build up of free radicals that lead to chronic inflammation, and triggers autoimmune reactions.
I’m pretty sure my body hadn’t taken a 14 hour break between meals for several decades, and was a tiny bit peeved that nobody had thought to tell me how important it was, especially when I was first diagnosed with diabetes and referred to a dietician. Perhaps it wasn’t known back in the 1990s?
I was in so much pain that it seemed a good idea to start fasting for 14 hours every day. The first few nights were difficult, my guts were rumbling and it felt like my stomach was trying to eat me. After a while I realised that when I woke up the next day my stomach was at peace, and didn't start grumbling until I started thinking about it. That made it easier to ignore the night time growling, it rarely happens now but when it does I just think that it’ll stop as soon as I fall asleep, and that helps not to get hung up on it.
I didn't try to limit what I was eating at all, because I wasn't thinking about loosing weight, I just wanted to be able to walk normally again. After a while I grew curious about how many calories I was getting through in a normal day, and reanimated an old account with Myfitnesspal.
Since the 1st March last year I’ve logged every single thing I’ve eaten. My daily totals were between 3,500kcals and 4,200kcals that first month. Each time I completed the daily log the algorithm told me how much weight I was going to have gained in five weeks time, if I continued to eat the same number of calories. After a few weeks I got curious, dusted off my old scales and climbed on board to see how much I had gained, expecting it to be several kilos.
Instead the scales said I'd lost 10.5kgs which seemed so unlikely that I assumed the batteries had started loosing their charge, and ordered replacement batteries with my next grocery delivery. By the time they arrived and I got back on the scales I'd lost a total of 12 kgs, despite not having eaten less than 3000kcals on any of the days since I started the dietary changes.
When I logged that weight loss into myfitnesspal it wanted to recalculate my calorie needs to adjust for the new lower weight. I ignored it and kept on eating whatever I wanted, so long as it was within the 10 hour "eating window" and included at least one glass of kombucha, one glass of kefir, and between one and three servings of fermented vegetables. I kept on eating an average of around 3,600kgs/day, each day the algorithm predicted weight gain, but when I weighed myself again 4 weeks later I'd lost another 9.1kgs.
The weight loss has gradually slowed to around 3kg/month. Last autumn I made an effort to try and stay within a 2500kcal allowance, it took me a few months but I managed to do it. This spring after only loosing 1.7kg in March I decided to try and lower the daily limit to 2000kcals, I’m still having trouble with this, some days I manage 1900 but most days it’s closer to 2250, but the weight loss has continued at just over or under 3kg/month.
I've come to the conclusion that when you are morbidly obese your body burns a lot of calories, and when that calorie intake is drastically restricted the metabolism goes into starvation mode and does everything possible to resist weight loss and refill the depleted fat cells. Somehow the changes I made in an attempt to improve my gut microbiome were resetting my metabolism in a good way, so weight was being dropped without triggering the starvation response.
My BMI is currently 38.7, but because I have diabetes anything over BMI 35 is still classed as morbidly obese. When I realised that I’d have to loose 65.5kgs before I even dropped from morbidly obese to merely obese it was discouraging. That’s an entire person I’d have to loose before hitting that first milestone.
So I decided to work out hoe much was 10% of my current body weight, and celebrate after loosing that amount. Then recalculate based on the new body weight, calculate 10% of that and have another celebration. I just celebrated loosing 10% of my body weight for the fourth time, or 34% of my starting weight. That’s as good as the results after bariatric surgery (which has dreadful complication rates and wrecks your healthy guts) and better than the average weight loss using Wegovy.
I expect that as my body mass decreases the number of calories I can get away with consuming will decrease and eventually I will have to either decide to keep trying to reduce my calorie intake until it is down to the "average calorie requirement of a 66yr old woman" (which google tells me is a mere 1600), find someway of being able to become less sedentary despite the pain, or accept that I’ll never be “normal” weight and do what I can to be healthy by eating well and (hopefully) being less sedentary if the pain issue can be ameliorated.
Fasting became easier and easier, my body thrives on it, so I've gradually reduced my eating window to 6 hours, leaving 18 hours for the digestive system to rest and recuperate. Sometimes I’ll get a hankering in the evening for biscuits, crisps or salted peanuts, but I just tell myself I can have them after breakfast tomorrow, and so far I’ve never actually fancied them at that time of day.
Eating to nurture the gut microbiome has gradually changed what I eat too. My favourite ultra processed foods don’t make it onto the grocery list. No more accidentally inhaling an entire box of Mr Kiplings French Fancies as a mid morning snack.
These days it's more likely to be a weighed portion of fresh or dried fruit, 10 grams of nuts and a square of Lindt's 90% dark chocolate. I'd still scarf down a big slice of gateaux if someone offered, and wouldn't feel bad about it afterwards.
I haven't wasted any energy thinking about what I’m not “allowed” to eat. I’m too busy thinking of all the things that are good for the gut microbiome, and how to fit as many as possible into each day.
I listen to the Zoe podcasts where they interview different scientists who work in nutrition and gut science and keep tweaking what I eat using ideas gleaned from the podcasts. I started eating a teaspoon of NKD inulin powder (available quite cheaply in 1kg bags from Amazon) each day after hearing that some really beneficial gut bacteria reproduce much faster in the presence of oligosaccharides, and have gradually increased it so that I can eat 2 tablespoons without any negative side effects. That’s 10g of water soluble fibre per tablespoon which is also good.
I’d been vegetarian since the early 1980s, but started eating fish again to boost healthy fats and protein levels without adding loads of extra calories. I also get through 4 tubs of ASDA’s quark each week, another low calorie source of protein that hasn’t been ultra processed.
I’ve made a bit of a game of trying to eat as many different plant foods as possible each week. The Zoe people consider anything that comes from a plant as a plant, so every kind of grain, vegetable, fruit, seed, bean, (including all the different varieties of tea, as well as cocoa and coffee), each pinch of herb and spice counts, you don’t need to eat a “portion” a pinch might be enough to spark life into a different variety of healthy gut microbe. Variety encourages different bacteria species to thrive, the more variety, the better.
I sprinkle cardemom and cinnamon in my porridge (along with hemp, poppy, chia, sunflower, pumpkin and linseeds), and dust fish dishes with dried seaweed sprinkles. I weigh out between 15-25g of nuts and seeds to eat every day. Alongside all the usual fruit and vegetables I have less usual things like dried sea buckthorn powder, goji or black mulberries, and frozen okra (I’m not quite ready to try the bitter gourd yet). I alternate between pearl barley, rice, quinoa, couscous, millet and buckwheat as well as pasta and potatoes, usually mixed with different herbs, spices, vegetables, seeds or nuts and sometimes fruit. Most weeks I manage to consume between 60 and 70 different plants, and I still enjoy finding some new plant to add to the repertoire. The powdered sea buckthorn was a treat, I had friends who harvested the berries on islands in the Baltic, wearing motorbike leathers and gauntlets to protect themselves from the evil spikes, and convert them into a mouth puckeringly sour cordial that was supposed to be full of vitamin C and antioxidants. Finding a freeze dried powdered version was a source of joy!
I used to avoid oil, nuts and avocados because of their high calorie content, but now I don’t bother about fat so long as it is unprocessed and arrives in fish, nut, seed, avocado or olive form (I don’t like rape seed oil), and doesn’t tip me too far outside the daily calorie allowance. If it’s a choice between staying within the calorie limit or having extra vegetables I tend to go for the extra vegetables. My fibre intake is usually between 50 and 60g/day. I'm a bit naff at eating fresh green leaves, but quite like fresh watercress, and then go over to adding chopped frozen spinach to things once the fresh stuff has been used up. I can't walk the couple of hundred metres to the local Lidl, and have become reliant on weekly grocery deliveries from Sainsbury's or ASDA instead. Which means that the last couple of days before the next delivery is heavy on frozen or dried fruit and vegetables. Though at this time of year the raised beds in the garden are full of more French beans, bush beans, courgettes, beetroot and winter squash than I can eat.
I’ve been making my own kefir (using the instant pot to convert a 1L packet of long life milk and two tablespoons of Yeo Valley kefir into a litre of home made plain kefir to go in a jug in the fridge door) from the start. Those kefir yogurts with “fruit” are a rip off, they can’t use fresh fruit because it would go mouldy, so they use a kind of jam instead. It’s much nicer and healthier to add fresh berries to home made kefir, and if you need it a bit sweeter to start off with you can always drizzle a bit of honey across the top, and sprinkle a few seeds or nuts.
Recently I got sick of paying extortionate amounts of money for shop bought kombucha and invested in two 4 litre brewing jars, 6 1L bottles with flip caps, and a kombucha scoby on Amazon, and have been making my own. If anyone else is tempted to have a go, I strongly recommend ignoring the advice to steep the tea for 30 minutes, it will make your kombucha taste like stewed builder’s tea that wants to strip the enamel off you teeth.
The last batch I made was only steeped for 10 minutes and is perfect. All organic too, made with organic black tea and organic cane sugar. It’s so alive that when I pour it into the bottles and leave them on the counter for a couple of days for the second fermentation to use up the last of the sugar, a little scoby forms at the top of the liquid inside the bottle. The expensive shop bought stuff is more like overpriced fizzy pop than proper live kombucha.
Anyhow, if anyone has managed to read this far, I just wanted to say that I’ve lost just short of 9 stone in 18 months, 34% of my starting weight, without feeling as if I’ve made any real efforts to limit what I allow myself to eat. I’ve drastically reduced my consumption of ultra processed foods, and now when I check out the special offers on the online supermarket I discard most of them because the ingredients contain things that are bad for the gut microbiome.
I’ve also had to stop alternating ibuprofen with paracetamol on days when my rheumatism is being evil, after finding out that ibuprofen has the same effect on gut microbes as antibiotics. They kept that quiet!
So if you can start fasting for 14 hours a day, concentrate on eating as many different plants as possible, and do what you can to repair your gut microbiome, you might find it a lot easier to loose weight than you expected. I have previously lost large amounts of weight at different times, but never without any effort, or without becoming obsessed with what I wasn’t allowed to eat, and how much I really wanted to eat it!
When I saw the diabetes consultant for my annual check up earlier this month he was very impressed at my weight loss, my now no-longer-diabetic blood results, and my much-healthier-than average for my age blood pressure, especially compared to how it was when he last saw me in January last year.
He kept asking me questions about how long I fasted, what time did I start eating? What time do I stop? What fermented foods was I eating (he asked for a link to Loving Foods who deliver my subscription), and how to make kefir using long life milk and a starter from shop bought kefir. He said he was going to start fasting for 14 hours, and playing the “how many different plants can you eat in a week?” game. He also told me that if my weight loss slowed down as I neared a more normal weight and I started to feel discouraged then I could rely on him to start me on Liraglutide at my appointment next year, to improve control of my diabetes. I really hope when I see him next year that his little beer gut will have vanished and he is still feeling beneficent.