Another thought: recognize that people with insulin resistance (and therefore generally high insulin levels) are hungry frequently, and tend to crave sweets.
When I see a new patient, I put them on a no sweet/no starch diet. Think protein and veg's. No fruit (temporarily-we compensate with a dynamite good vitamin). The reason for that is people who are craving sweets will substitute tons of fruit ie. sweets. If you eat 6 bananas, you might have been ahead to have just had the snickers bar, as far as weight loss is concerned.
Exercise boosts the insulin lowering effect.
Later we add back carbs, one at a time to see how they're tolerated.
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