Long-term weight loss on keto: Maintaining a ‘no excuses’ attitude


Before and after

Name: Tami Marino
Age: 51
Height: 5’4” (163 cm)
Highest weight: 305 lbs (139 kg)
Current weight: 144 lbs (65 kg)
Lowest weight: 133 lbs (61 kg)

How do you maintain a weight loss long-term on a keto low-carb diet? Tami Marino has a “no excuses” approach, which clearly works extremely well for her.

Indeed, this attitude helped her lose 170 pounds (77 kg) during perimenopause – a period of hormonal fluctuation that often involves weight gain.

However, for decades her life was consumed by yo-yo dieting, food addiction, and bingeing.

“I first became overweight during puberty and got up to 250 pounds (114 kg) in my teens. It was a really tough time,” Tami remembers. “My mom was always overweight and really concerned about my weight. She’d buy certain foods for my sister, who never had a weight problem, but they were off limits for me. I definitely felt a lot of pressure to lose weight. My grandparents would always say, ‘If you would just lose weight, I’ll take you shopping’ or ‘I’ll get you whatever you want if you just lose weight.’ And that made things very uncomfortable, and it’s probably what led me to start eating in secret.”

She struggled with her weight throughout her teens and into adulthood. Although she’d lose weight by following Weight Watchers or starvation diets, she always gained it back.

Although she didn’t develop gestational diabetes with any of her three pregnancies, when she was 40, Tami was diagnosed with type 2 diabetes. At the time her HbA1c was 9.4%, which reflects an estimated average blood sugar level of 223 mg/dL (12.4 mmol/L).

Her A1c continued to climb over the next several years, despite doing everything she was told to do, which included taking larger dosages of diabetes medications and following low-fat dietary recommendations. In addition, she developed fatty liver, high blood pressure, and severe depression.

The change

Then in May of 2014, everything changed following a visit to her doctor’s office.

“I’d been on metformin and glipizide for a while, and I’d also started taking Victoza injections a couple of times within the past month. I was really scared about taking that last medication because of some things I’d read about it. I remember my doctor telling me not to test my blood sugar at home, but I would test anyway. And even with all those meds, my blood sugar was still in the 300s mg/dl (16.7 mmol/L) and even in the 400s mg/dl (22.2 mmol/L) sometimes,” she recalls.

“Then I heard the doctor say, ‘Along with the meds you’re already taking, you’re going to need to take insulin.’ And that absolutely petrified me,” remembers Tami.

Unwilling to accept that she was destined to take multiple medications and insulin for the rest of her life, she began doing her own research online. She found a Facebook group called Type 2 Rebels and began to realize there might be a way to improve her blood sugar control and potentially even reverse her disease. It was in this group that she learned about the work of Dr. Richard K. Bernstein, a doctor with type 1 diabetes who follows and recommends a very low-carb diet for all types of diabetes.

“I read his book ‘Diabetes Solution,’ and although it made a lot of sense, I didn’t start following it immediately,” Tami admits. “It was just completely different than what I’d heard from my doctor and what I’d been told for years about nutrition, which was to eat low fat, lots of whole grains, and things like that.”

Although it took her about a month to fully embrace the concept of a very low-carb lifestyle, once she did, the results were dramatic and life changing.

“I couldn’t believe how much more stable my blood sugar was, as opposed to going up and down all day long like when I was on medication. I felt so much better, was less hungry, less depressed. It was amazing,” she remembers. “It took me about one year to get off all the meds, and by that time, my A1c had gone all the way down to 4.6%, where it’s stayed ever since. My fatty liver and sleep apnea went away as well.”

What’s more, she achieved her lowest weight of 133 pounds (61 kg) in May of 2016 and has maintained that loss within 11 pounds for the past 17 months.

Although exercise has become an integral part of her life in maintenance, Tami didn’t do much physical activity during her weight loss journey.

“I really didn’t exercise while I was losing weight, but I became more mobile. I had more energy and could move around a lot more easily,” she says.

The powerful changes in her blood sugar, weight and overall health help motivate her to remain low carb at all times. However, she has had several challenges over the past several months.

The challenges

“I’m now in menopause, which has been more of a struggle than I ever expected,” says Tami. “The hormone changes often lead to hunger and trigger binge-eating behaviors. I still eat only low-carb foods, but I sometimes eat too much. I’m not perfect, but I do the best I can.”

Additionally, a few financial setbacks have led to more limited food choices.

“I try to focus on less expensive low-carb options like eggs, canned fish, and chicken. I really can’t afford to have some of the foods I love very often, like steak and bacon. Those are like treats for me. But I won’t ever eat high-carb foods like rice or pasta, no matter how cheap they are. Staying low carb is my priority,”she states, confidently.

No matter what is going on in her life, Tami maintains her characteristic “no excuses” attitude. In fact, it’s a hashtag she uses on social media on a regular basis.

“It keeps me motivated and accountable,” she says. “Weight maintenance is a day-to-day thing. When things get especially stressful, jotting it down on Facebook or Instagram really helps me stay focused on what I need to do. There are days that I end up eating more food than I want to, because I’m human and it’s tough to ignore hunger, especially in menopause. But there’s no excuse to go crazy by eating high-carb stuff or not exercising. Years ago, I would have given up and gone back to where I started. But now I just won’t do that. No excuses allowed.”

Although she rarely tracks her food intake, Tami believes she stays below 20 grams of net carb per day as a rule. “Except when I eat almond butter,” she laughs. “That’s a tough food for me to consume in moderation, so I try to stay away from it most of the time.”

A typical day of eating for Tami

Breakfast (8:00 am):
Black coffee

Lunch (2:00-3:00 pm):
Hard-boiled eggs, avocado, flaxseed, pickles, salad

Dinner (6:00 pm):
Chicken or bunless burgers, vegetables or salad with olive oil or bleu cheese dressing

Snack (8:00-9:00 pm):
Sardines, salad, nuts

“I actually don’t add much fat to my meals,” she says. “ I cook veggies in a little olive oil or coconut oil, and I like bleu cheese dressing on a bacon cheeseburger sometimes.”

Treats are few and far between. “I’ll sometimes have almond butter or other nut butters when they’re on sale. I also like Quest bars because they don’t spike my blood sugar and they’re portion controlled, which really helps,” says Tami. “And once in a great while I’ll make a low-carb treat to bring to a holiday party. But overall, I try to keep things as simple as possible and really not focus on food too much because of my food addiction,” she says.


In addition, she maintains the same “no excuses” attitude about exercise, which she finds extremely beneficial for mental, physical and emotional health.

“I work out 5-6 times a week, aiming for 6 whenever possible,” she says. “I prefer to do it first thing in the morning after having coffee. I walk on the treadmill for about an hour on the highest incline. Sometimes I’ll do a core class that has some cardio. I’ve tried yoga and Zumba, but I don’t like classes too much. I’ve figured out that I really like doing things at my own pace.”

And her favorite form of exercise?

“Oh, I absolutely love resistance training,” Tami says, enthusiastically. “I do at least an hour and lately often closer to two hours because I recently increased my reps. I can’t do free weights because I have a hernia, but I do leg presses, incline presses. I also have a good support system at the gym as far as the people who work there and friends I see there. On days I can’t get to the gym, I’ll do planks on the floor at home or get out and walk as much as I can. No matter what, I get some kind of physical activity in every day.”

Her best tips

Here are Tami’s tips for maintaining a “no excuses” attitude:

  1. Don’t feel that your food has to be grass-fed or organic if you can’t afford it. “Yes, those are healthy and ideal, but you really just need to eat the right foods,” says Tami. “Don’t use the excuse that it’s too expensive to eat low carb, because it’s not.”
  2. Jot down what you’re going to do and follow through. “This can really help keep you motivated more than anything, no matter what is going on,” she says.
  3. Take it day by day and meal by meal. “Stuff happens with all of us” Tami admits. “One meal isn’t going to ruin you, so don’t make it a bigger deal than it is and go off plan altogether. Start right back at the next meal.”
  4. No judging or comparing yourself to others. “Remember that the other person you’re looking at may have never struggled with weight or eating issues. It’s not a fair comparison,” Tami points out. “Do the best that you can do, and be proud of your own progress.”

You can follow Tami on her Instagram account, @tamis_fitlife.

Franziska Spritzler, RD

Losing weight

For more tips on losing weight long term, have a look at one of these guides:

Top 10 tips to lose weight on low carb for women 40+

How to lose weight

Try a keto diet yourself

Sign up for the free 2-week keto low-carb challenge!



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  1. Maha
    Congratulations! So glad you're staying on plan and able to work around various challenges thrown at you. I think that is the real key, to not get down on one's self when everything isn't perfect, because it rarely is. Nice work!
  2. PJ
    Love your advice about not letting expensive alternatives like grass fed options and organic eating stop you. Just stay in your budget. Congrats ?
  3. Debra
    Thank you for motivating me to do more for my health
  4. Tami
    Thank you guys for this it means so much to me. I think so many look so much more into it than need be making excuses. A lot of that comes from listening to others that may have easier options and may be able to make it more interesting at times but believe me when you want it you can still often find those ways or little things that help you personally make it happen.
    One day at a time keeping it simple and real just never giving up . We all have bad days it's the good we put into the bad that makes even the next moment better.
    Thank you again and good luck on your journey.
    If I can help in any way I'm just like you so. I judgement feel free to ask..
  5. Tami
    Sorry no judgement I meant ( autocorrect
  6. Karen Parrott
    Tami, I loved your story. Thanks for sharing with us. Great points and reminders. And yes, eating within a budget is totally do-able on LCHF. Bravo for all the work, I know how hard it is as we have similar stories (FS featured me a few weeks ago- lol)

    I started following you on IG, so I'll keep up the great work and thinking good thoughts for yard situation... Karen P

  7. Tami
    Karen thank you I will too look for your IG. It's amazing meeting others that have gone through so much so similar and knowing that we aren't alone in our struggle and our successes. Congrats to you as well and it's a pleasure to be able to hear these kind words coming from you. Here's to us both and everyone else out there just trying and taking the intiative being pro active even though the days may not always be the easiest! We got this and biggest hugs your way.. thank you again !
  8. 1 comment removed
  9. Helena
    Hi Tami, you're looking absolutely beautiful, congratulations. I am feeling so relieved since reading your comments of of making right choices of food, and not necessarily expensive organic foods, as I am also on a tight budget. Sometimes I think it's forced on us to use organic everything, with the result people give up eating healthy, so thank you for covering that, and putting it to bed.
    I would love to follow you and your progress as you've given me hope. Love Helena.
  10. Dwayne
    I remember watching you grow as you learned how a LCHF life can absolutely give you power over your disease.

    We were very happy that you allowed us to be part of your journey and success.

    Keep rocking Tami!!!!!

    Rebels cofounder.

  11. 1 comment removed
  12. Toni Q
    Thank you Tami for sharing your story.Your advice and suggestions have blessed me and helped me to have a new outlook on how to adapt to a LCHF lifestyle.
    lt isn't easy but nothing worth while ever is.
    You aquire to inspire and there are many of us who need inspiration to give us motivation.
    May you continue to do well and continue to bless others by sharing your journey as you reach your goals.
    Your story has surely encouraged me to keep on keepin'on✊
  13. Barbara G.
    Down 25 pounds since New Year's 2017 and it is now October, 2017. THRILLED! It hasn't been difficult, I love eggs and avocados and mayonnaise and meat protein and above ground vegetables and occasionally I have a small bowl of potato chips, but no root vegetables for the most part. I find I can go to a restaurant and ask for a burger without the bun or similar, have a lettuce wrap, taco salad or any number of other menu offerings. I have gone from a size 16 or even 18, down to a 10 and now I am even contemplating an 8, OMG, never in my years since I was 25 (now 65) would I have thought it possible! I love LCHF!!

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