I'm sorry your blood work did not yield any useful answers to your questions.
Kudos to you for all the dietary changes you have made over the past year! I know it is frustrating that you are still gaining weight in spite of all the work you have already done. But I would urge you to consider the fact that you gained a lot less weight over the past 6 months than over the previous 6. This is evidence that you have made positive changes! You're not there yet. But you are taking steps in the right direction.
shakes make me want to go throw up and it is not worth it to feel that way twice a day every day.
Is it possible that you are lactose intolerant? I'm not advocating for the use of meal replacement drinks. Those things are for people who don't like eating, or who have a medical condition that makes eating sufficient food physically difficult for them. For the rest of us, I agree with you: real food is better. But those drinks do tend to be milk-based. So a lactose issue could be what was going on there. (Lactose intolerance isn't like severe food allergies where one has to avoid a product entirely. Lots of people can tolerate milk products in small quantities with other food, but not when taken in excess or exclusively, on an empty stomach, which is pretty much what you're doing with a meal replacement drink.)
Over the past year, when I decided things needed to change, I started by decreasing my high protein intake and substituting in more vegetables. I also realized that I haven't been drinking enough water, so that has been a struggle. Over the last couple of months, I was able to rediscover the Modern Hero Meal plan, which looked coincidentally a lot like a handout I got from a nutritionist back around the start of COVID as well. Since then, I have been working towards that.
I know everybody is different, and what works for one person won't necessarily work for the next. But following Modern Hero definitely helped me when I was trying to lose weight a few years back. For me the key factors were:
1. No snacking. This could be tough if you have issues with hypoglycemia. But if you can do it, three meals a day, with nothing in between, goes a long way towards curbing excess calorie consumption.
2. Eating 50% fruit and vegetables, with most of this being vegetables, and choosing lower-sugar options when I did eat fruit. (For example: raspberries and rhubarb, both of which contain more fibre by weight than sugar, as opposed to grapes, which contain over 16 times more sugar than fibre.)
3. Eating raw veggies as much as possible, including eating a massive salad for lunch every day containing a huge pile of dark leafy greens. It's really hard to overconsume raw vegetables, because they contain so much water. They will go a long way towards your quest to consume more water too! Cooked veggies have a lot of their water boiled/baked/pressed out of them. But raw veggies are very hydrating. Yet it takes a while for your body to break down the fibre surrounding all that water--so you don't need to immediately pee it all back out. (When I go out on my paddleboard I try to always take raw veggies like carrots and/or tomatoes with me for this reason.)
4. Eating homemade food as much as possible. The typical North American diet is stupidly high in sugar and salt. It's high in these things because processed food manufacturers add a tonne of them to their products, because they know sugar and salt are like cocaine to our brains, which evolved to help our species survive in a time when food was scarce. They put that shit in their products
deliberately to make us eat more! We are all habituated to eating food that is far sweeter and far saltier than is good for us, and it's extremely hard to get away from this unless we prepare our own food from basic ingredients. (Which is also hard to do because it's so time-consuming. But it does help.)
My breakfasts have improved, though I don't always finish eating my fruit in that sitting because I'm hurrying to get to work. My lunches are back to looking like things I want to eat and I have moved my afternoon veggie tray snack (usually a mix of cucumbers, baby carrots, and bell peppers) into being a part of that meal. Dinner is a work in progress, but overall, my eating is way better than it has ever been in my entire life. (See dinners of my teenage years where we had meat and maybe some rice.) I rarely eat junk, but when I do, I make sure that I have to make the effort to go get it and 90% of the time, I don't come home with it anyway.
You are doing so many good things already! I wish for you strength to stay the course, and wisdom to figure out the missing ingredient(s) that will get you the rest of the way to where you want to be!
I have a hard time just enjoying an adult beverage on the weekend because I'm so paranoid about eating healthy. Which is a great shame because I have some really nice mead that I would like to enjoy.