First of all - credit where it's due - well done. Losing 150 pounds is outstanding. Seriously - well done.

As to your problem, I think if you fast for long periods then feel miserable and stuff yourself, perhaps you're taking it too far. You don't say in your question, but I wonder if you have gone from not fasting to fasting a lot too quickly? It took my body a long time (about four months) to get used to the 40 hour fast I do once a week (dinner Sunday to lunch Tuesday), but now it's fine. It was a real struggle initially. And what's wrong with stuffing your face, as long as it's paleo? That's natural - your body is recognising it has gone a long time without food. If you really don't want to do that, you could do what some people do and eat multiple meals in the window - may stop you eating a lot if you know you can eat again in 90 minutes.

I stressed in another question how the last bit of weight always comes off slowly. The last 20 pounds could take years I would guess. So you may just need to give it a bit more time, and perhaps if and when you can exercise again, that will help a bit.

Congrats on your huge weight loss!

Your story is very familiar to me based on what I've seen on low-carb forums. Low-carber loses a huge quantity of weight, but can't get last bit off (depending on the size of the person and where they started, this can be from 15-40 lbs.). They buckle down harder - drop dairy and nuts and eventually start to restrict calories too. Their weight moves sideways. They add more exercise...nothing works. Eventually they cut artificial sweeteners, and they are less hungry...but their weight still won't budge. A few try Eat-Stop-Eat or Alternate Day Dieting too.

Seriously - go look at lowcarbfriends.com or forum.lowcarber.org and read the "challenge" threads on zero carb or Atkins '72. You'll see the same story unfolding over weeks or months. The vast majority of these people are female, but I don't know if this happens to men or not.

Last year, I had been reading a lot of the Rosedale/Bernstein/Gedgaudas/Optimal Diet stuff recommending "adequate" protein and lots of fat. That just FLAT OUT does not work for me. I found the same problems with satiety and hunger when I buckled down and went lower carb, lower protein (.8 per kg of bodyweight) and higher fat.

After years of low-carbing, I got to the point where I could eat fat endlessly, and my hunger would not shut off until I'd eaten way too much. I tried adding more fat (to keep protein and carbs low), and I wound up eating more calories - I got up to 185g of fat a day, easy. This causes me to gain prodigious amounts of weight.

I re-read The Paleo Diet recently, and believe me, there's fruit in his meal plans and a lot more protein than I remembered (25-30% of dietary calories)

What I do not have and maybe never have had is metabolic syndrome. I started adding the carbs back in with a BG meter to test my a.m. fasting numbers and one and two hour post-prandials.

http://heartscanblog.blogspot.com/2010/07/to-lose-weight-prick-your-finger.html has some guidelines for what post prandial sugars should be - he's very conservative. Some people feel that 125 an hour after eating is fine. I get numbers around 95-100 one hour after eating a meal that includes 30g of fruit or yams. Non-paleo carbs do not work the same way for me. Corn in particular gives me very high sugars (140 ish) with the same gram amount of carbs, so you won't react to all foods the same way either.

But maybe consider not pushing it harder - take a bit of a diet break and maintain for a while.

Kudos to you for getting rid of 150 pounds naturally! You must be so proud of your new self! IME, a lot of people have trouble with the last few pounds. I sometimes wonder if that is from long term damage from an unbalanced system. I have also had people tell me it is very hard to get rid of the last bit without good exercise. Anyway, it sounds like to me that you are fasting too long. Fasting does not yield weight loss in everyone. It may not be the way to lose more weight for you, although it may long term help you regain insulin sensitivity.

I totally understand that you are probably super eager to lose that last bit of weight. We all want to be able to show off what we have accomplished! Just keep in mind, it may not be a simple or fast process. My advice would be to dial back on the fasting to levels that are more comfortable for you and do not illicit binging. This is a diet for life, so you have plenty of time to work on the last few pounds. DOn't let those last few pounds discourage you! Often, the body needs time to get used to the new regime and the last few pounds come off very very slowly. See if you can do some light exercise with your uppper body. Exercise helps with mental state as well as hormonal balance. I don' t know your exact diet, but maybe elimination of diary or nut intake or cheese might help. I have heard many say that cheese, nuts, and diary are stallers for many.

Also, you have some other serious issues with torn muscles and whatnot so healthwise, those may be your biggest issues right now anyway and may deserve more of your attention. Now may be a good time for you to get used to your new eating style and learn to listen to what your body needs. Looks into the food you are eating and think of ways to make them more balanced nutritionally. I have to work on that a lot myself because I long ago lost most of my natural instincts about when to eat and when to stop. I thank carbs for that. Large amounts of extra weight are a major health problem but now sounds like you have lost most of that and are fine tuning. Now is a time to look at your overall physical and mental health and work on the whole package. THere is no race to the finish line on this one because the process never ends. -Eva

You need to shorten your fasting period back down to 14 hours. This is what Martin from Leangains suggests for women because, for some reason, women do not fare as well on longer fasts.

I'm doing a shorter fast 16-18 hrs and it took me 3 weeks for my body to adjust to the hunger. What helped me initially is drinking lots of water and tea. The tea sweetened with stevia tricks your body into thinking it's got some incoming calorie and the hunger pang goes away (no scientific proof here, just me rationalizing why my hunger pang goes away as quickly as it comes).

You didn't say how much you're eating within the feeding window. There's nothing magical about IF, your total calorie still matter.

You could benefit from going on a diet break(1 wk to 2 wks) eating at maintenance calorie, upping your carb a bit to restore hormone levels to baseline then resume with IF.

Many people struggle to lose those last few pounds that they want to lose until they take out dairy products, that might help. Also, Robb Wolf has said that there really isn't any benefit gained by going past 16 hours in fasts, because that's about the time when liver glycogen runs out and your body starts using body protein(muscle) to make glucose.

Big ups to you for all you've accomplished with paleo! In my opinion there is nothing magical about IF. It is just a tool. It works for some, not so much for others. If a tool isn't working put it back in the toolbox. First things first, go back to eating the way you did that helped you lose the 150 lbs. If you stall again try going uber-strict paleo. Maybe even do a 30 day challenge (try whole 9 life they are a great resource for this). As far as exercise, don't try anything new until your eating is back in a happy place. Then just move. Ramp it up slowly until you begin to feel stronger. Then maybe try some more challenging exercise.

On the question of being really hungry during the eating window and eating more than you would ordinarily, it could be the same problem described by Spencer in another question. There I suggest that it might simply be taking longer than the duration of a meal for his body to respond and feel sated by the calories. This could be especially extreme after a long fast where you build up 1600 calories of hunger, eat 1600 calories, but then eat again within a couple of hours because all of this food hasn't been digested/registered by the body. " The same thing, theoretically, wouldn't occur where you're eating regular meals and so only ever getting slightly hungry and intaking small numbers of calories constantly. This seems to tally with what you say:

I think what bugs me is that I'll suddenly realise that I've eaten not till I'm satiated, not till I'm full, but till I'm almost sick - it's like there's a switch in my brain that fails to turn on.

Presumably not eating for many hours makes you especially hungry (even if it's only hungry for the right amount of calories), there's just more scope to move from 'satiated' to 'more than full' if you're trying to eat a day's calories within a few meals. It's possible that if you ate your day's meal (of as much food as you think is acceptable) as soon as you broke your fast, then waited 3+ hours that you would feel satiated and with no further desire to eat. Alternatively you might feel genuinely hungry and you'd only find out through trial and error whether this was a genuine need for nutrition. Either way, it wouldn't be "mindless" eating if you fasted, ate and waited to see.

In any case, as has been suggested, cutting back to a level of fasting you're comfortable with and then working your way upwards might be best, since your body might slowly adapt to longer fasts once it gets used to the idea that it's not starving.

Hi! I was just looking through this site and found your question. It was posted awhile ago, so I don't know if you are still receiving the answers. I am an obesity specialist who uses primal diet for permanent weight maintenance in my patients. Here's what I would say to you about the last 20 pounds.

In my practice, it is rare that someone achieves exactly the loss they envisioned. This leads to unhappiness at the end of the diet phase. But truly, there is no reason to be unhappy. I believe that people who have been overweight and then lose are "denser" after weight loss and therefore weigh more on the scale. This could easily be because they made millions of new fat cells during weight gain. These cells likely empty during loss, but they do not disintegrate. Think of them as collapsed down. The tissue that supports these cells is still there as well. When you get on the scale, you weigh more or have stubborn areas that remain. On the positive side, you may be in the size of clothes you desire or have good measurements.

If you try to force weight loss at this point, it is likely going to come out of muscle. You will wind up with the Bill Clinton look: he's a dedicated vegan and looks to me like he has cachexia (muscle wasting).

You've done a remarkable thing, but no bodily results are perfect. If you learn to be happy with comfortably maintaining, you may trend downward over time. Or you may not. Such is life! Congratulations on your most amazing and worthwhile achievement.

Dr. Barbara Berkeley www.refusetoregain.com

I'm not sure if this would be worse for you or better, but you might try alternate day fasting. The total fast is longer, so this might be worse, but the the reprieve is longer, so maybe you would do fine if you were having a full day of eating ad libitum with no rush in between your fasts.

I concur with Drew's comment. Be very careful with fasting. I'm dealing with fairly serious adrenal fatigue, and I'm well nigh convinced that my long attempt at IF'ing contributed to this.

Fasting is not for everyone. I think there are probably a lot of other ways to try to tighten things up. I would try a "Whole30" a la the Whole 9 website. You don't want to smoke your adrenals. It makes weight loss really impossible.

hi blue. i'm 45 as well, 5'3". i went from 143 in august of 09 to 129 in 3 months and have been stuck there ever since, so maybe i'm not one to give advice, except that our issues might be similar. i've been intermittent fasting all along, but i look at it as maintenance- it hasn't helped me lose more weight. arthur de vany thinks we should take a calcium supplement since he has found research by dr. robert lustig linking calcium intake with fat loss. i'm going to try to take calcium supplements since i don't feel i get enough calcium with the occasional yogurt and bone soup. my other issue is low ferritn (5) and having some nights where i can't get a good night's sleep because of feeling hot and cold. it maybe related to perimenopause. it doesn't happen every night, so i've recently started to keep a food/supplement/exercise journal. i mention this because you are also at that age. you might benefit from this kind of journal as well. i've only been at the journaling 4 days, so nothing conclusive yet. good luck to you and report back if you find something that works.

Hi! I was just looking through this site and found your question. It was posted awhile ago, so I don't know if you are still receiving the answers. I am an obesity specialist who uses primal diet for permanent weight maintenance in my patients. Here's what I would say to you about the last 20 pounds.

In my practice, it is rare that someone achieves exactly the loss they envisioned. This leads to unhappiness at the end of the diet phase. But truly, there is no reason to be unhappy. I believe that people who have been overweight and then lose are "denser" after weight loss and therefore weigh more on the scale. This could easily be because they made millions of new fat cells during weight gain. These cells likely empty during loss, but they do not disintegrate. Think of them as collapsed down. The tissue that supports these cells is still there as well. When you get on the scale, you weigh more or have stubborn areas that remain. On the positive side, you may be in the size of clothes you desire or have good measurements.

If you try to force weight loss at this point, it is likely going to come out of muscle. You will wind up with the Bill Clinton look: he's a dedicated vegan and looks to me like he has cachexia (muscle wasting).

You've done a remarkable thing, but no bodily results are perfect. If you learn to be happy with comfortably maintaining, you may trend downward over time. Or you may not. Such is life! Congratulations on your most amazing and worthwhile achievement.

Dr. Barbara Berkeley www.refusetoregain.com