I do not count carbs. I follow Sugarbusters, and eat only whole grains. I do tend to keep my starchy carbs to two or three servings a day, but I am not really strict about it. (maybe I would lose faster if I were...
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Is your friend a diabetic? With insulin resistance, weight loss is often VERY difficult. Raised insulin levels promote fat storage, making it hard to let go of the fat. Before I started on the injections I am on now called Byetta, I could eat perfectly, exercise regularly and see NO weight loss, or inches lost either. This went on for years for me. Some people are just metabolically resistant to weight loss. It is very frustrating. If your friend is a diabetic, there are some meds that help with weight loss, like glucophage and Byetta. Others hinder it.
I hope that helps.