Melissa Mangraviti had tried every diet and weight-loss program around when she finally went to see her GP five years ago.
The then 28-year accountant from Sydney knew that the diet and binge-eating cycle she found herself in was doing her health no favours yet no matter what she tried, nothing seemed to keep the kilos at bay.
But after a series of tests, her GP — who specialises in women's health — diagnosed her with PCOS and insulin resistance.
These are clinical conditions that can make weight-loss very difficult — in fact, if you have these conditions, some diets you try might actually make things worse.
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"After running a series of tests, my GP told me that the low-fat diet that I had been trying to follow was actually doing more harm than good, and explained why I would generally regain any weight I successfully lost.
"I needed a higher protein approach supervised by a dietitian to not only support weight loss, but to help manage and improve my insulin resistance and PCOS," she said.
Insulin resistance and PCOS are closely related and mean that the body is producing excessive amounts of the hormone insulin whenever carbohydrates are consumed. The issue with this is that the more insulin that is produced, the less likely fat is to be metabolised, as insulin blocks fat loss. For this reason a high carbohydrate diet which has been traditionally prescribed for weight loss can actually make insulin resistance worse.
For Melissa, the first step in taking control of her weight for good was finding the right professionals — a dietitian and trainer who specialised and understood the diet and exercise balance required to successfully manage insulin resistance.
"My diet is simple — fewer carbohydrates, especially at night and plenty of vegetables and protein to help keep me full" she told news.com.au.
"During the week I try and finish eating each day by 5 or 6pm to give myself at least 12-14 hours overnight without food to gain an added benefit of regular fasting which has helped to shift my weight when it has plateaued at various times throughout this process.
"One of the most important things for me was having someone to be accountable to and touch base with regularly to help keep me on track, so I see my dietitian at least once a month and more frequently when things have slipped off track at various times.
"Equally as important as been my PT who again works out the right balance of cardio and weight training to continually see drops on the scales.
"Since beginning my journey more than five years ago I have lost almost 40kg, but best of all am keeping it off which is the most important thing for me."
While 40kg is an enormous amount of weight to lose, the loss was slow and steady, which allows her to maintain her very social lifestyle.
"I love good food, and I love eating out, and what my dietitian was able to do was help me get the balance of keeping my diet relatively strict during the week so I could enjoy the weekends.
"I also got into the habit of allowing myself a treat regularly whether it is buying some new clothes, or having a wine and cheese night.
"This makes the program sustainable for me. I also know that for me planning is everything, and something I will need to do for the rest of my life. I still have some weight to lose so planning my meals and food in advance is really important.
So what advice does Melissa have for anyone else struggling to lose the kilos but not sure why things do not seem to be working?
"Deep down I knew something was wrong because I could not eat anything without gaining weight. I was constantly craving carbs and feeling tired, and low-fat eating was doing nothing to shift the kilos even though I was eating healthy.
"So if you are not feeling 100 per cent see a doctor and get your hormones tested. Insulin resistance is very common, especially when we have jobs that see us sit for most of the day. Like me, you could need medication and a specialised diet and exercise program to get results."