Notes to a Friend

It's invaluable to have a doc you can trust and yet, doctors have been saying cholesterol and fat intake is the problem in our diet, and that is factually incorrect. The medical profession lost their authority when they abandoned science, which never confirmed that cholesterol CAUSED heart disease.  Cholesterol is a weak predictor of disease, there is almost no benefit to mortality reduction from fat restriction.  The benefits of carb restriction are no longer disputable. I don't know how to help you except to say doctors are as human as any of us, and they no longer have access to more info than you and I do. I know you want to trust your doctor. I would to.

There are two things that may affect the "want a cookie" experience.  One is falling blood sugar - that probably triggers a habitual need for something to stop that from proceeding to blood sugar crash.  That's part of the sugar addiction cycle.  The other part is just an association to pleasure.  The unconscious mind (UCM) always wants to feel pleasure, avoid pain, that is what it does for you.  If cookies distract from pain (and think of the whole cookie eating experience is loaded with guilt, pleasure, surprise, taste, disappointment if its a bad one, etc - these are all great distractions), anytime the UCM can get away from pain by having you eat a cookie.  Obviously that's a short term win, long term loss for "net pain."  

In either case, the way to attenuate the impulse is to have something you can eat that does not derail your blood sugar, but that you like.  This can take a while to find since it's so different for each person.  I use coconut/macadamia nut in a spoon, or coconut and sunflower seeds.  When I'm as lean as I am now, I use coconut on dark chocolate (70% or more).  Sometimes, an egg or avocado will do it (avocado, with salt and champagne vinegar).  Bacon is good too!  Anything that is high in fat and tastes good to you will work.  Over time, this does two things.  One, you don't pit yourself against your hunger or your UCM - that's a losing formula.  Two, you dilute the association between pleasure and cookies.  Three, by not eating cookies it gives your liver time to heal and start processing carbs like it is supposed to

Q: Why would blood sugar be an issue when I'm eating good food?
A:  Hard to know.  Possibly - body expects a sugar bomb every time you eat, prepares by pumping insulin.  That's just a body habit like pavlov's dog, it will stop after eating "right" for long enough

There's a whole part of physiology that goes wrong for folks who eat carbs and especially sugar habitually.  Fat burning enzymes are a use it or lose it prospect, just like everything else in the body.  Your muscles and other tissues run well on fat except for the brain and a few other tissues.  When you don't use fat burning enzymes, the stores of these enzymes decrease.  Then, when you don't eat for a while, you can't convert to fat burning for very long.  The trick to get these stores back up to normal is to deprive your body of exogenous sugar for long enough that the body has to run on fat and rebuild the stores of enzymes in the process.  This can take 1-3 weeks.  It can also feel bad - plus, as you reduce your carb intake, your chronic insulin levels go down, and that allows your tissues to flush excess fluids.  That cycle means you can get low on electrolytes like potassium, sodium and magnesium.  Even moderate dehydration can make a person hungry.  As you eat for health, initially, you have to deliberately drink more water with electrolytes (Smart Water is a good commercial product that does this).  

This is why the "extreme" low carb diets work especially well for reversing metabolic syndrome/diabetes - they keep blood sugar levels so low for so long that the body regains insulin sensitivity, and the liver can get rid of excess liver fat.  This allows the liver to regain insulin sensitivity too.  However, the dehydration/electrolytes issue can be very uncomfortable.  I wouldn't necessarily recommend this for you - your body needs the break from carbs so it can heal, but the heart rhythm issues could be worse in the short term due to electrolyte fluctuations.  You'd need to sip smart water all day long.  Once you get through the 3 week fat burning adaptation period, the appetite regulation, blood sugar regulation, better sleep, rapid weight loss (and all while eating a high fat snack anytime you feel hungry or just feel an impulse to eat) is amazing.  But it's super hard to do by yourself or if you have other demands (work, for example).  Much easier if you are doing this with others.  This is why CF can work so well for lifestyle change - community.

Part of the reason this is important to know is it explains why the idea of no bread no beans no corn tortillas seems so hard - you probably cannot burn fat so you have a true metabolic need for exogenous carbs.  That doesn't always have to be that way, getting fat adapted changes that.

Eat meat, vegetables, nuts/seeds, little fruit/starch, no sugar/wheat, and all the fat you can shove down your pie hole.