Broken Bones and Calorie Deficit

Annie_01

I broke my wrist on Friday and it has limited my activity. My first thought was to lower my activity level to sedentary in order to remain at a 1lb deficit. I planned on upping calcium and protein to assist in healing. I have been really tired but I related that to a lack of appetite...activity...pain medication...sore ribs.

I did some research this morning to see how being in a calorie deficit affected healing.

It seems as if the healing of broken bones can raise your BMR up 6000 calories a day if you suffer from multiple breaks. I expected it to be higher but not by that much.

http://www.betterbones.com/bonefracture/speedhealing.pdf

Provide the body with adequate energy. Fracture healing requires more energy than you might expect. Thus, it’s appropriate to increase your caloric intake to promote healing. In traumatic fractures of the long bones, for example, there is an immediate increase in metabolic demands that can translate into a caloric demand three times that of normal. While a normally active adult may require 2,500 calories a day, a bedridden, injured patient with multiple fractures may need 6,000 calories per day!2 If this demand is not met, the healing process is compromised.

I doubt if I would burn anywhere near that amount so I decided to start out at maintenance/sedentary until I see the orthopedic surgeon next week.

I was curious what others have done about calorie deficit after experiencing a severe injury.

StaciMarie1974

I believe it, though I don't know the exact #s.

Once upon a time, I started my first ever attempt at weight loss. 3 weeks later I was in a car accident and broke both my legs. I had a horrible time eating while in the hospital, as anything dry brought on a gag reflex after 1-2 bites. (I assume it was an odd side effect of medication - I got over when I was out of the hospital.) So I had soup, milk, shakes, and similar. I was not logging so don't know how much I consumed daily, but when I left the hospital after 3 weeks: I had lost 30 pounds. Part of that time including physical therapy but with broken legs I was NOT active. And there is no way that I had a calorie defict - based on the normal BMR of a 27 year old 180+ pound woman - of 35,000 per week.

*Note I can't be certain the before and after weights were on the same scale calibration, but I imagine at most the difference would be 5-10 pounds and losing 20-25 pounds in 3 weeks with little movement is pretty extreme.

Kalikel

You know how people say, "Feed a cold, starve a fever"? People are dumb. Feed both. And feed your broken bone.

Anything that makes your body have to heal itself or fight off infection means you're going to need more calories. It makes sense if you think about how they work will require more energy and calories are really just energy.

That broken wrist does not sound fun! Ouch. Feel better!

Annie_01

StaciMarie1974 wrote: »

I believe it, though I don't know the exact #s.

Once upon a time, I started my first ever attempt at weight loss. 3 weeks later I was in a car accident and broke both my legs. I had a horrible time eating while in the hospital, as anything dry brought on a gag reflex after 1-2 bites. (I assume it was an odd side effect of medication - I got over when I was out of the hospital.) So I had soup, milk, shakes, and similar. I was not logging so don't know how much I consumed daily, but when I left the hospital after 3 weeks: I had lost 30 pounds. Part of that time including physical therapy but with broken legs I was NOT active. And there is no way that I had a calorie defict - based on the normal BMR of a 27 year old 180+ pound woman - of 35,000 per week.

*Note I can't be certain the before and after weights were on the same scale calibration, but I imagine at most the difference would be 5-10 pounds and losing 20-25 pounds in 3 weeks with little movement is pretty extreme.

I calculated your calorie burn based on 20lbs...that would have been over a 3300 daily deficit not including any calories that you might have consumed!

I am glad that i did my research. As much as I would like to get this last 30lbs off I have no desire to do it quite that fast.

Thanks for verifying my concerns.

Annie_01

Kalikel wrote: »

You know how people say, "Feed a cold, starve a fever"? People are dumb. Feed both. And feed your broken bone.

Anything that makes your body have to heal itself or fight off infection means you're going to need more calories. It makes sense if you think about how they work will require more energy and calories are really just energy.

That broken wrist does not sound fun! Ouch. Feel better!

Worst part about it...I am right handed and of course...that is the one that I broke. I am now doing everything one-handed and believe me...it just doesn't want to cooperate...it has a mind of its own.

Cantstopmyshine1993

I just had surgery on my foot a week ago bc I broke it. I just changed my activity level to sedentary bc I was worried if I didn't I'd gain eat the calories I was bc I was exercising a lot. It's working for me have lost 3 lbs since surgery.

Liftng4Lis

Hope it heals up quickly.

Jackson2348

I fell and broke my wrist just before Labor Day, and had surgery 2 days later. I mostly slept for 3 days bc EXCELLENT painkillers. I expected a loss when I got up and on the scale, but instead I was up 8 pounds!!! I guessed it was all the swelling. I lost 13 pounds over the next 2 weeks. It was AWESOME. I changed from active/very active to sedentary, then after a couple of weeks when I could walk Outside some I upped it to lightly active. I've been losing as expected for my deficit. Mine is my right too, it's very frustrating. You have my sympathy!!!

Annie_01

Thanks guys for all the encouragement and the info. I think that for this week I will just eat at maintenance and see what happens over the next couple of weeks. If I can keep my loss to about 1lb a week then I will feel okay with my weight loss.

jgnatca

I think I'd allow myself a 72 hour pity party, with chocolate.

lemurcat12

Annie_01 wrote: »

Thanks guys for all the encouragement and the info. I think that for this week I will just eat at maintenance and see what happens over the next couple of weeks. If I can keep my loss to about 1lb a week then I will feel okay with my weight loss.

This sounds sensible.

I'm really sorry about the wrist, that's a bummer.

HippySkoppy

@Annie_01 sorry to read about your break I hope you heal quickly.

When I broke my back last year I found that I had to up the calories to stop losing.....till reading this I had never considered that extra calories would be required (Duh....feel so stupid) but of course it makes total sense. Your body has to work hard to heal itself....

I think eating at maintenance sounds like a good idea and make sure to get in lots of calcium rich foods to help with the fracture.

All the best.

kiela64

I understand why it would work with bones - your body has to fix the break - but I wonder with muscles? I dislocated my knee cap and have been working with a physiotherapist to recover. But my weight loss has slowed down during this time, likely because my activity levels have decreased. There is probably not enough damage to warrant using too many more calories, but sitting on my butt has made burning them off less likely.

Mouse_Potato

I am so glad I saw this post! I, too, have a broken right wrist and was wondering if I need to up my calories. I lost 2.2 pounds in the last 9 days and my deficit is set for half a pound a week. All my doctor said was "more calcium and vitamin D."

Sued0nim

Hope you heal quick and I think maintenance or above is a good idea with a focus on protein and vitamin and mineral intake

tomatoey

Sorry that happened to you, Annie_01. Your plan sounds solid. Hope you heal fast.

Annie_01

kae612 wrote: »

I understand why it would work with bones - your body has to fix the break - but I wonder with muscles? I dislocated my knee cap and have been working with a physiotherapist to recover. But my weight loss has slowed down during this time, likely because my activity levels have decreased. There is probably not enough damage to warrant using too many more calories, but sitting on my butt has made burning them off less likely.

I read somewhere on pubmed that there are different stress levels associated with different types of injuries thus putting various energy requirements on your body.

There was a formula that was used...

bmr x injury stress level x activity level

They didn't give a complete guide to the stress levels but burn victims was one of the highest.

Annie_01

jgnatca wrote: »

I think I'd allow myself a 72 hour pity party, with chocolate.

lol

I finally get to a point that I can eat more and I am struggling...I can't get anything opened! By the time I do...I am too tired to eat it.

I tried making a peanut butter sandwich...got it out of the jar on to the bread...couldn't spread it out. I ended up with 2 slices of bread with this blob in the middle.

I have been painfully reminded of the hardships that many people live with on a daily basis. Mine will heal in time...for some people...it is their life. So I am trying not to pity myself too much.

Annie_01

Mouse_Potato wrote: »

I am so glad I saw this post! I, too, have a broken right wrist and was wondering if I need to up my calories. I lost 2.2 pounds in the last 9 days and my deficit is set for half a pound a week. All my doctor said was "more calcium and vitamin D."

Glad it helped. They don't tell you these things at the doctor's office. All mine said was no weight training but I could continue with aerobics...which just burns even more calories!

My weight has been basically stable so far but I know that I am retaining a lot of fluid right now and it is not showing up on the scale yet. So I think I have lost at least a few pounds.

Annie_01

rabbitjb wrote: »

Hope you heal quick and I think maintenance or above is a good idea with a focus on protein and vitamin and mineral intake

tomatoey wrote: »

Sorry that happened to you, Annie_01. Your plan sounds solid. Hope you heal fast.

Thank you.

I have stocked my frig with greek yogurt and picked up a multi-vitamin.

It has certainly made me more aware of eating at too large of a deficit for our bodies to heal itself even with just those minor every day injuries.

Annie_01

lemurcat12 wrote: »

Annie_01 wrote: »

Thanks guys for all the encouragement and the info. I think that for this week I will just eat at maintenance and see what happens over the next couple of weeks. If I can keep my loss to about 1lb a week then I will feel okay with my weight loss.

This sounds sensible.

I'm really sorry about the wrist, that's a bummer.

Thanks LC.

It is a bummer but it has also been a learning experience...like learning to put on a bra with one very uncoordinated arm!

HippySkoppy wrote: »

@Annie_01 sorry to read about your break I hope you heal quickly.

When I broke my back last year I found that I had to up the calories to stop losing.....till reading this I had never considered that extra calories would be required (Duh....feel so stupid) but of course it makes total sense. Your body has to work hard to heal itself....

I think eating at maintenance sounds like a good idea and make sure to get in lots of calcium rich foods to help with the fracture.

All the best.

Don't feel stupid...it makes sense but who would have thought. Usually being inactive requires less energy. I don't know what made me decide to research it...maybe it was because I was so bored because I couldn't do anything else. IDK

thereshegoesagain

3 years ago i had a spinal fusion, my weight was 248. During the early stages of healing, I didn't eat as much as normal, but did use my walker around our house, working up to 1 mile walks around the furniture, through the kitchen, back to the bedrooms, etc. I very quickly lost 20 lbs and it was the beginning of my life changes. Today, I'm at 174 and while I'm still working at it, I'm much more active and healthy.

Mouse_Potato

I've been fastening my bra around my waist and then wriggling it in to place. Just a tip. Also the sling can be used to carry stuff. I have a lot of meetings and need my left hand for my coffee cup.

Any suggestions for cleaning the exposed fingers on your right hand? I tried straight alcohol, but didn't care for it. Baby wipes?

Unknown

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minties82

I definitely would eat more when healing. I had surgery during the earlier part of my weight loss and it took a long time to heal until I decided to eat more, then it suddenly healed up quite nicely. I had a weeping wound for almost 11 weeks.

Brokenankle2016

Annie_01 wrote: »

rabbitjb wrote: »

Hope you heal quick and I think maintenance or above is a good idea with a focus on protein and vitamin and mineral intake

tomatoey wrote: »

Sorry that happened to you, Annie_01. Your plan sounds solid. Hope you heal fast.

Thank you.

I have stocked my frig with greek yogurt and picked up a multi-vitamin.

It has certainly made me more aware of eating at too large of a deficit for our bodies to heal itself even with just those minor every day injuries.

Hi Annie,
a few months later was wondering how you did? I hope your wrist is better and how did your weight loss/maintenance plan work out? Am asking because broke my ankle almost 2 weeks ago and am in a cast for a little more than 4 weeks more. I have also just lost a good amount of weight and don't want to put it on. Any words of encouragement or advice would be great. I appreciated everyone's posts!!!

pinggolfer96

I highly doubt it's 6000. The body does need extra calls when repairing, but not 6000. Also, the term "use it, or you lose it" definitely applies in terms of muscle loss. You may lose weight, but it's gonna be a mix of fat, muscle, and water depending on how much the injury affects you.

Annie_01

Brokenankle2016 wrote: »

Annie_01 wrote: »

rabbitjb wrote: »

Hope you heal quick and I think maintenance or above is a good idea with a focus on protein and vitamin and mineral intake

tomatoey wrote: »

Sorry that happened to you, Annie_01. Your plan sounds solid. Hope you heal fast.

Thank you.

I have stocked my frig with greek yogurt and picked up a multi-vitamin.

It has certainly made me more aware of eating at too large of a deficit for our bodies to heal itself even with just those minor every day injuries.

Hi Annie,
a few months later was wondering how you did? I hope your wrist is better and how did your weight loss/maintenance plan work out? Am asking because broke my ankle almost 2 weeks ago and am in a cast for a little more than 4 weeks more. I have also just lost a good amount of weight and don't want to put it on. Any words of encouragement or advice would be great. I appreciated everyone's posts!!!

Thank you for asking.

I lost about 10lbs in two weeks. Honestly it took it's toll on me. While it looked good on the scale it didn't feel so good on my body. I am old...63...so that probably had a role in my recovery.

My plan went out the window. In my case at the same time that I broke my arm/required surgery the doctor put me on a low sodium diet which required basically cooking everything that I eat. Since I couldn't use my hand it put a LOT of restrictions on my cooking. It was hard to eat enough.

About the time my arm healed enough to start using it again I came down with the flu/some type of crud. Since I was so rundown from my arm it has taken most of the winter to recover. During this time my main goal has just been to maintain.

That would be my advice...just try to maintain your current loss.

vivrevotrevie

In July I blew out my knee in July, and had a similar situation. Something I found challenging was really monitoring my weight loss at all. I ended up having to have reconstructive surgery and as a result, lost a significant amount of muscle because I was forced to be pretty immobile for quite some time. I agree with those who say you should eat to help refuel the healing process. It has been about 6 months since my injury and a little over 3 since my surgery and for me, my goal was to avoid gaining weight. Now that I am able to get back into working out a little more (still quite limited in some aspects), I am focusing more on the weight loss.

MelaniaTrump

Ask your doctor for a DEXA bone density scan for osteoporosis. Just to make sure. At 63, you need to know.

yirara

It's an old zombie thread, but I thought I'd dig it out. My normal maintenance calories are around 1750kcal without exercise. Since a complex proximal humerus fracture about 4 weeks ago I eat about 500 calories extra per day, and still lose weight slowly. That's about 1/3 extra. Never thought it'd be that massive.

I also sleep an awful lot. Every time the painkillers stop working (most don't work, and the ones that do only last just above 3hrs) I get terribly tired and fall asleep.