Your body really doesn't want to be in some states (because you'll die) so certain markers/metabolic disease states like NAFLD and pre-T2D MetS will lower dramatically soon after the insult (chronic overfeeding) is stopped. RCTs have shown dramatic improvements in as little as a week or two. In my case, both my elevated AST and TG numbers halved a month into making significant lifestyle changes and almost all my bloodwork continued to improve dramatically into my next labs at 9mo and 1y.

That isn't to say there isn't accrued/long term damage, I think most people going through this sort of change will tell you that they are still dealing w/ health issues long term. I've notice that years after my initial interventions, my body still seems much more predisposed to weight gain for example - but trust me though, not feeling like crap is it's own reward. You can basically get used to anything and you don't really realize just how bad you were feeling (slowly getting worse over the course of a decade or so for me) until you turn it around.

Hey I'm really worried about sending out the wrong signal here, so let me tell you it was not a picnic. NOT a picnic! But it was a walk on the park, so to speak.

And I definitely wouldn't let myself go out of shape like that again thinking it would be an easy ride home. Basically I stomped my A1C almost in half, from 50 (knocking on the door of diabetic) down to 30 (complete remission to decent health) - so totally mullahed it. Doc says that's at the limits of medical science, so I was pretty chuffed. Need to maintain now with IF and regular workout.

What it cost me was:

IF, 12 or 18 hour sessions once (occasionally twice) per week.

Diet change to 80% plant based, more raw veg, nuts, fish

Setting a reminder to drink water

Walking 20 miles twice a week with a full pack (that's where most people will wobble a bit).

Cold water sea swimming (you get used to it)

I added two tricks. One is to walk on sand. Other is replace lost weight by stuffing a modular armour jacket with little sand bags in the plate pockets. When I dropped from 95kg to 90kg I just added 5 kilos of sand and so on. This happens gradually. When you carry around the weight you lost it keeps the calorie burn the same per mile and really motivates you because you can literally feel how much lighter you are when you take the vest off. Also you can just drop weight if you get exhausted on a long yomp.

Yes I am lucky too. I live in a place with opportunity for outdoor activity. Probably good metabolic genetics. Made time to do the health work by dropping some contracts (I consider it an investment in myself like college etc) Also I took the diagnosis seriously and researched an action plan.

Oh yea for sure. I understand that you put in a lot of effort for the results that you mentioned.

> The doc basically said my latest bloods are outstanding

But I am not clear if you've had any lasting damage from the past or is everything is simply reversed. Is there anything that cannot be reversed with any amount of effort?

It's a mixed bag as I understand it. Some things recover quick and some take much longer, many years of changed lifestyle.

It's got me more interested in health and biology for sure. The human body is remarkably hackable.

Things like bone density and tendon health definitely change slowly. Superficial organ fat, the most dangerous type, is apparently the first thing to go, and you can get so it won't go on quickly again. That's what the cold swimming is for, something to do with types of fat metabolics. I think being overweight for a considerable time (a few years) may have given me joint damage, knees maybe, but TBH I've not pushed myself into injuries and I think it's all strengthening well. I may move to some light strength training soon, but I prefer bodyweight only. Getting to the state where you can even do bodyweight, like 20 press-ups, is a great target.

If you're thinking about doing this... DO IT. I wish I could be beside you on some long walks. Maybe talk to the doc first and set a reasonable plan. But the fasting is not as hard as you think. After the first couple times it gets old and you start to make friends with hunger.

And what ever you improve, whether it's lasting or not, that's gotta be good right?

>Then what would be the point of living a healthy lifestyle everyday if you can simply 'get healthy' in a matter of months when you need it.

Because the labs are just indicators of whether or not damage is being done.

If you have high LDL for example, disease state is correlated to how long, and how high LDL levels have been. (The evidence for that is robust.) So for example, while you can improve those levels in 6 months, that doesn't mean you weren't racking up damage for the previous 10 years.

This is a common thing with most health indicators actually: blood pressure, LDL, blood sugar, etc. End organ damage, and risk of adverse events are correlated to how high and how long levels were maintained.

> that doesn't mean you weren't racking up damage for the previous 10 years.

> and risk of adverse events are correlated to how high and how long levels were maintained.

Is there a way to measure this though. How can I tell what my current level of damage is.

GP got the usual indicators into shape. Is all the 'racking up damage' reversed in OPs case ?

>Is there a way to measure this though. How can I tell what my current level of damage is.

It's a cumulative thing. There are ways to ascertain the damage, but not through routine tests.

>GP got the usual indicators into shape. Is all the 'racking up damage' reversed in OPs case ?

Particularly in the case of cardiovascular damage like atherosclerosis and resulting kidney damage, narrowing arteries, etc, no it's not reversed.

> There are ways to ascertain the damage

Well, what are these ways.

This would get very specific to the organ systems involved, and starts to get above my understanding, but it'd be things like:

Coronary calcium scan to check for the progress of atherosclerosis in the coronary arteries, ultrasound of the kidneys, maybe the heart to check for left ventricular hypertrophy (or do you need an echocardiogram for that?), ultrasound for the carotid arteries, etc.

Like sex, do you want to have the benefits along the way or wait until the last days of life?

Yes but my question is doesn't poor diet and lifestyle have lasting damage or can it be simply reversed in few months like OP.