Medical Conditions Which Affect Weight: Separating Fact From Fiction

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  • tomteboda
    tomteboda Posts: 2,171 Member
    I'm going to give a case example in weight gain where morbid obesity is due to factors largely beyond the person's control. My mom is morbidly obese because of a confluence of factors. She pretty much "won" the jackpot on medical problems. You see, her mother took a particular drug, during pregnancy that turned out to cause some very serious health problems in unborn children.
    1. Cushing's Syndrome

      Her form is endogenous, meaning its not caused by a tumor (and is therefore nonoperable). Her cortisol levels are sky-high all the time, which has messed up a number of metabolic pathways and signaling cascades in her body. Most significantly, the cortisol imbalance causes both enormous hunger and the ability of the body to create fat out of next to nothing. With Cushing's, your body will actually prioritize storing fat over pretty much anything else. Plus it makes you hungry. Living with hunger is no easy thing. It's the primary reason that most diets are unsustainable.

      When she developed the Cushing's Syndrome, she gained over 100 lbs in the space of six months. I remember going to the doctor with her as a child, and the doctor told her, to her face, that there was nothing wrong with her, and that she was a "fat pig" and "hypochondriac" (yes, he called her that) who "stuffed her face." He told her to go home, quit eating so much and stop making things up. It was almost 20 years later before a physician actually looked at her and said "How long have you had Cushing's?" and then set up the referrals to the Mayo Clinic, who confirmed the diagnosis but unfortunately were unable to find a treatment plan for her.

      This undiagnosed condition led to a host of other issues, including the next major cause of her morbid obesity.

    2. Kidney failure and Heart failure

      Kidney failure causes a retention of water. In my mom's case, this is exceptionally severe. She has trouble breathing because water does not clear from her lungs due to poor circulation, and her legs ooze fluid because her kidneys aren't filtering it out. Her skin is tight and shiny and easily broken or infected as a result.

      Her doctor estimates that she's carrying around 100 lbs of retained water. I believe this, because when they have put her on aggressive diuretic regimens in the past she's lost as much as 70 lbs within 2 weeks. Unfortunately, as soon as the diuretics are discontinued it pretty much all comes back, and its unsustainable as they also degrade what little remaining kidney function she has.

      Technically those aren't the only organs she has failing (she has liver failure as well), but her organs are the victims of three different diseases:
      • Systemic Scleroderma
      • Systemic Lupus Erythematosus
      • Type I Diabetes Mellitus
        It is especially notable that my mother's diabetes was diagnosed as a child, but because her parents were farmers who would lose their health insurance for the whole family, they did not treat her for the condition. Instead, my grandmother would test her urine sugar daily, and if she was spilling high levels, she'd only be allowed to eat two hard-boiled eggs for the day. All in all, it was pretty awful diabetes management that continued until she was in her mid-thirties (when we took her to the ER because she was nearly comatose. Her blood sugar was over 400. Not one physician had tested her blood sugar as an adult to that point!).

    3. Giant abdominal fibromas

      My mother's physician estimated last May that she was carrying around more than 150 lbs of gigantic fibromas. These are benign (noncancerous) tumors, but they are exceptionally aggressive. Unfortunately, removing them only triggers more growth, and with her very poor wound healing as well as general ill health she's been told she just has to live with them. These tumors are growing throughout her abdomen as well as two external tumors, one of which is larger than a cantaloupe.
    4. Loss of mobility.

      Being sedentary is a distinct problem for the calories-in/calories-out balance. Until she lost her mobility, while a large woman, my mom was of a manageable weight such that she could enjoy limited exercise, maintaining the house and garden, and getting out. Now she's entirely housebound and dependent upon assistance for everything. There were multiple causes of her loss of mobility, each one playing a significant and painful role.
      • Multiple Sclerosis

        While not a "cause" of weight gain, I suggest someone try to actually walk or move for exercise when suffering from uncontrollable spasms. When this condition interfered with her balance enough to require a walker, her weight really started going up.
      • Osteoarthritis

        This has always been a challenge for my mom. Her arthritis, present since early childhood, made moving around quite painful.
      • Osteopetrosis of the spine.

        This is a congenital problem (at birth) where her bones are super-dense, and very brittle. Excessive remodeling of her spine, causing pinching of the nerves, has occurred where she sustained a few injuries as a teen and young woman. This led to limited ability to bend or twist, or bear weight.
      • Congenital hip dysplasia.
        No, this isn't only a condition your purebred dog suffers from.. humans have this problem too. As a result of the misaligned hip joint, her hips tend to "fall out of joint", that is, her femur can dislocate very easily from the hip socket. It's about as pleasant as you might expect.
      • Strokes
        Mom's had at least 4 of them now over the past 2.5 years. They've partially paralyzed half her body. She's really not getting around much at all; getting her onto her toilet which is right next to her chair is almost impossible some days when she's really weak.

    I have witnessed countless hostile actions and things people have said to, around, and about my mother over the years regarding her weight. From the doctor who sighed and asked my father "You're a skinny man, how did you let this happen to your wife?" (That she got so fat) to the woman who pointed at my mom while telling her daughter "Look at that disgusting woman. That's what happens when you eat like a pig!", to people who harassed her for using a mobility cart in the stores when she could still get out of the house. Every one of the people thought they were justified in their rudeness. Some thought that their hostility would help her, would motivate her to lose weight. Really, it was none of their business and their presumption showed how ignorant they were.

    Being overweight, even obese, was no major problem for Ma as long as she was able to be active. However, when her other health conditions made her sedentary, the weight just started piling on. And then she became nearly completely immobilized, and her weight makes accomplishing little daily things, like going to the bathroom, or getting into a car (with assistance!), really, really hard.

    My mom weighs about 475 lbs. Of that, about 250 are directly due to water retention and tumors. Before her significant height loss (due to spine degeneration) her height was 5'11". She would be around 225 lbs ... "obese", but barely, without them. "Calories-in/calories-out" rules the day. But sometimes life just really makes winning on that equation pretty much impossible.
  • HippySkoppy
    HippySkoppy Posts: 725 Member
    @tomteboda Reading your Mum's story is heartbreaking, just heartbreaking. I am so sorry for what she must be going through. She would feel very blessed to have your unconditional love, support and understanding. <3

  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    rankinsect wrote: »
    In any event, it would be like asking everyone to acknowledge that CICO is not absolute even after it's been proven to be flawed. As much as I can try, it isn't going to happen even when some argue that it is absolute because the flaw occurs in a minority of cases (which acknowledges the flaw while simultaneously denying it).

    CICO isn't flawed. Medical conditions can either change CI or CO, but they can't change physics; the total amount of energy is remaining constant in the absence of any nuclear fission or fusion occurring in your body.

    Ultimately, calories lost because of epithelial malabsorption, calories lost from glycosuria, proteinuria, or lipiduria, etc. are all "calories out", as it's energy-containing substances that leave the body.

    "Calories out" is not exactly the same as "calories burned", although in most people it's quite close.

    It depends on definition. Most posts I've seen mentioning CICO were based on the definition of CO being RMR + exercise. That seems to be the consensus on the MFP forums.

    No, it's not. That's your assumption. I have repeated and keep repeating and many other posters will keep telling yo that all these other things that rankinsect mentioned are included in it.

    I wish I could click a like button, rankinsenct was spot on.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    rankinsect wrote: »
    In any event, it would be like asking everyone to acknowledge that CICO is not absolute even after it's been proven to be flawed. As much as I can try, it isn't going to happen even when some argue that it is absolute because the flaw occurs in a minority of cases (which acknowledges the flaw while simultaneously denying it).

    CICO isn't flawed. Medical conditions can either change CI or CO, but they can't change physics; the total amount of energy is remaining constant in the absence of any nuclear fission or fusion occurring in your body.

    Ultimately, calories lost because of epithelial malabsorption, calories lost from glycosuria, proteinuria, or lipiduria, etc. are all "calories out", as it's energy-containing substances that leave the body.

    "Calories out" is not exactly the same as "calories burned", although in most people it's quite close.

    I want to embroider and frame this post.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    edited November 2015
    rankinsect wrote: »
    In any event, it would be like asking everyone to acknowledge that CICO is not absolute even after it's been proven to be flawed. As much as I can try, it isn't going to happen even when some argue that it is absolute because the flaw occurs in a minority of cases (which acknowledges the flaw while simultaneously denying it).

    CICO isn't flawed. Medical conditions can either change CI or CO, but they can't change physics; the total amount of energy is remaining constant in the absence of any nuclear fission or fusion occurring in your body.

    Ultimately, calories lost because of epithelial malabsorption, calories lost from glycosuria, proteinuria, or lipiduria, etc. are all "calories out", as it's energy-containing substances that leave the body.

    "Calories out" is not exactly the same as "calories burned", although in most people it's quite close.

    It depends on definition. Most posts I've seen mentioning CICO were based on the definition of CO being RMR + exercise. That seems to be the consensus on the MFP forums.

    But isn't it really TDEE - deficit(weekly loss goal dependent) + exercise? Hence the choice you have to make when you pick activity level? Otherwise, most everyone would be set at the same # wouldn't they? I can't imagine we're all at 1200 calorie limits... (yes, I'm really asking the question, not an attempt to disagree)

    Well, to function on MFP? Almost. Exercise is already included in TDEE. How your body functions? Close enough for most healthy people.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    Cortisol can have an impact on weight for sure. One reason I think a lot of people don't gain as much weight as they might expect on a vacation is because they lowered their cortisol levels by being relaxed.

    One of the reasons it's suggested to take breaks from eating at a deficit is that long term dieting is itself a stressor. I think I might be coming to this point myself.

    In addition to cortisol, they might have also increased their activity level, by spending a day at the beach (several hours), swimming, walking, etc., instead of just their typical (1 hour) of daily exercise; of swimming at the gym or walking around their neighborhood or even was busy enjoying something sedentary, to not become bored enough to eat; like they might have otherwise.

    I have definitely hit a road block with my weight loss, even though my (known) stress causes haven't increased; in fact they've decreased but I hadn't considered the potential of a deficit stress but it makes sense, since we are subsisting on less; than what's usually optimal. @PeachyCarol so how long do you suppose a break from a deficit, should be? I believe 2 weeks would be sufficient, for me. When returning to one's deficit level, do you think that'd be considered as starting over? Even though one would be technically starting, where they left off; as in no weight gain within that break period & because there'd be no weight gain, do you believe that it's likely that when they restart, that it'd be like a typical 1st week when most initially began? Such as losing pounds of water weight or do you think that it'd just revert to being within the average fat loss, that was taking place; before the deficit break?

    I've been looking into diet breaks lately, and the usual recommendations to allow time for the hormones to get back up to appropriate levels is 10 days to 2 weeks. I'm not sure if there'd be weight gain, there might be some glycogen replenishment depending on carbohydrate intake.

    I'm not really sure of the fat loss rate once you return to dieting either. I think it would be better since your hormones are in a happier place. At least I hope so.

    For me, I'm looking into it because I've been eating at deficit a long time, and I'm having a hard time keeping my head in the game right now due to life stress. (We're moving)
  • tiptoethruthetulips
    tiptoethruthetulips Posts: 3,371 Member
    @tomteboda Thank you for taking the time to write and share your post. Your mother's situation is truly heartbreaking.

  • Working2BLean
    Working2BLean Posts: 386 Member
    This thread has a the feel of a low carb diet argument. Maybe over many redirects, or attempts?

    Physical conditions impacting CICO

    MY EXPERIENCE:

    I weigh almost half what I used to. When I was taking acto plus metformin, it did change the CICO equation efficiency point.

    As I lost weight and got in shape I burned calories more efficiently and lowered my resting heart rate. Another change in my personal CICO burn rate.

    Now I am on no medication, have a heart rate in the 40's. My doctor has advised I need fewer calories because I am not on the medication, and that we adapt over time in the "efficiency factor".

    So that factor is in place in every person. I experienced the medicine effect on that calorie burn efficiency rate and it was pre warned to me by my doctor.

    CICO is a function that has a few variables.

    It isn't ever voided.

    Lots of this thread seems to be arguing ketogenic diet claims.

    I like lower carb as my way of eating but not keto. I never had success with any diet not counting calories to apply a basic CICO. There is something about a high protein day once a week that works for me. I can't explain it. I often drop a pound or two after a meat only day. I'm sure there is a good reason. A reason that is not magic or invalidates the premise of calorie expenditure.

    Medicines factor in. They don't invalidate the equation

    Those with depression have a double whammy. Getting hungry and Eating to try and feel an energy bump and then not wanting to exercise is a tough road.

    It can be done. I'm not here to argue minutiae. I have lost my 100+ pounds. Went from desk mushroom to triathlon guy.

    Good luck and best wishes to all on reaching their goals.



  • yarwell
    yarwell Posts: 10,477 Member
    umayster wrote: »
    In the real world people do not trot off to the doc with a list of symptoms and get an accurate diagnosis, appropriate treatment and timely resolution - especially for endocrine problems.

    Darn, so House isn't a documentary ?
  • MondayJune22nd2015
    MondayJune22nd2015 Posts: 876 Member
    edited November 2015
    Cortisol can have an impact on weight for sure. One reason I think a lot of people don't gain as much weight as they might expect on a vacation is because they lowered their cortisol levels by being relaxed.

    One of the reasons it's suggested to take breaks from eating at a deficit is that long term dieting is itself a stressor. I think I might be coming to this point myself.

    In addition to cortisol, they might have also increased their activity level, by spending a day at the beach (several hours), swimming, walking, etc., instead of just their typical (1 hour) of daily exercise; of swimming at the gym or walking around their neighborhood or even was busy enjoying something sedentary, to not become bored enough to eat; like they might have otherwise.

    I have definitely hit a road block with my weight loss, even though my (known) stress causes haven't increased; in fact they've decreased but I hadn't considered the potential of a deficit stress but it makes sense, since we are subsisting on less; than what's usually optimal. @PeachyCarol so how long do you suppose a break from a deficit, should be? I believe 2 weeks would be sufficient, for me. When returning to one's deficit level, do you think that'd be considered as starting over? Even though one would be technically starting, where they left off; as in no weight gain within that break period & because there'd be no weight gain, do you believe that it's likely that when they restart, that it'd be like a typical 1st week when most initially began? Such as losing pounds of water weight or do you think that it'd just revert to being within the average fat loss, that was taking place; before the deficit break?

    I've been looking into diet breaks lately, and the usual recommendations to allow time for the hormones to get back up to appropriate levels is 10 days to 2 weeks. I'm not sure if there'd be weight gain, there might be some glycogen replenishment depending on carbohydrate intake.

    I'm not really sure of the fat loss rate once you return to dieting either. I think it would be better since your hormones are in a happier place. At least I hope so.

    For me, I'm looking into it because I've been eating at deficit a long time, and I'm having a hard time keeping my head in the game right now due to life stress. (We're moving)

    I'll definitely take a deficit break, once I am no longer overweight (I am only 11 pounds shy of that) & I've only been eating at a deficit since June 22nd (hence my user name), so it seems to soon; to implement a break currently but since I'm small frame, I'll have to be at the lowest healthy weight range for my height; in order to not still look overweight (which is approximately another 35 pounds). For me any longer than 2 weeks, of not losing weight; would be extremely discouraging (even if it's my choice not to, since I haven't reached; my goal weight yet) & I'll also document it, since there're so many important "unknowns"; that I'm curious to learn about.

    Since relocating isn't something we do often, like traditional housework; it isn't apart of our daily activity level. Therefore that's exercise in of itself. So you'd possibly still lose weight if you ate at maintenance & didn't do any of your regular exercising.
  • yarwell
    yarwell Posts: 10,477 Member
    TDEE is an acronym for Total Daily Energy Expenditure. Simply explained, it is resting metabolic rate (RMR) + exercise. Your TDEE will vary from day to day. MFP uses your inputs (gender, height, weight, and activity level) to estimate your TDEE. That doesn't mean it is your actual TDEE; it is but an estimate.

    This depends somewhat on how you define "exercise". MFP in general works with TDEE = RMR + daily activity + exercise so the exercise part can be zero on some days and TDEE will be greater than RMR (by ~20% if "sedentary").
  • yarwell
    yarwell Posts: 10,477 Member
    rabbitjb wrote: »
    TEF is clearly redundant and included in BMR

    Nope, BMR is unfed and hence has no TEF component.
  • yarwell
    yarwell Posts: 10,477 Member
    rabbitjb wrote: »
    Hang on

    Doesn't NEAT include BMR?

    Eg BMR+ activity level = NEAT

    NEAT+ purposeful exercise = TDEE

    That's how I have always used it

    indeed, and you haven't been correct. Non Exercise Activity Thermogenesis is not part of BMR nor does it include BMR, it is energy used on activity (eg fidgetting) that isn't "exercise".

    The root of your confusion might be the people who talk of the "NEAT method" vs the "TDEE method" where in the former case (as used by MFP's algorithm) you take a deficit of the BMR + NEAT (possibly + TEF) and cancel out exercise by eating back, in the latter case you take a deficit from the true TDEE.
  • Sued0nim
    Sued0nim Posts: 17,456 Member
    yarwell wrote: »
    rabbitjb wrote: »
    Hang on

    Doesn't NEAT include BMR?

    Eg BMR+ activity level = NEAT

    NEAT+ purposeful exercise = TDEE

    That's how I have always used it

    indeed, and you haven't been correct. Non Exercise Activity Thermogenesis is not part of BMR nor does it include BMR, it is energy used on activity (eg fidgetting) that isn't "exercise".

    The root of your confusion might be the people who talk of the "NEAT method" vs the "TDEE method" where in the former case (as used by MFP's algorithm) you take a deficit of the BMR + NEAT (possibly + TEF) and cancel out exercise by eating back, in the latter case you take a deficit from the true TDEE.

    What do you mean I haven't been correct @yarwell

    I said NEAT = BMR+ activity

    You said NEAT is not included in BMR

    Same thing

    I am not confused by NEAT vs TDEE as I understand how to differentiate purposeful exercise from activity level
  • auddii
    auddii Posts: 15,357 Member
    Holy thread to catch up on.

    A few notes. Not understanding what goes into the CO portion of CICO does not invalidate it.

    Ugh, I had like 4 other things I wanted to comment on, but they were like 4 pages back and now I don't remember.

    Anyways, just wanted to share my story, although it's been on the boards a few places.

    I'm reactive hypoglycemic which apparently runs in my dad's family (he has it and just found out last weekend my aunt does too). So, I found out early that I shouldn't eat cereal for breakfast (especially since I like it dry, so no milk). This stems from me testing at a blood sugar of 30 two hours after eating cereal back in middle school (my mom is diabetic and had the equipment to test).

    Occasionally, I'd eat stuff that I wasn't supposed to and suffer the consequences, but really as long as you eat protein and fats with your carbs, you're fine, and eating more often can help as well. This was all naturally regulated as a child because I ate a ton of food and preferred fatty foods in general (seriously, graham crackers with butter is amazing). So, I became very overweight with relatively few symptoms of low blood sugar.

    Fast forward to me attempting to lose weight, and being relatively successful at it (I'd lost 25lbs since starting mfp, and about 60 total). Then suddenly I'd start getting shaky, sweating, be unable to focus every few hours. Every day. My typical fixes didn't work, and so obviously I'd eat more. However, that almost never seemed to work to actually make me feel better overall; it would head off acute symptoms, but I never actually felt "good".

    I went to my doctor (my gynecologist because that's the only one I see with any regularity), and she ran some blood work. I'd also bought my own testing supplies and had about two weeks worth of data, testing before I ate and two hours after meals. My BS was consistently in the low 50s. My A1c cam back at 4.5, which my doctor said she'd never seen one that low (no clue if it's actually that rare, but it freaked me out at the time.

    She referred me to an endo, who started treating me as she would a diabetic. She put me on a medication to help prevent BS spikes after carbs (I didn't understand that on because my BS never spiked high), and had me test my BS every time before I drove. If it wasn't above 90, I needed to eat a snack. I ended up eating more than 3000 calories a day. I'd run to the grocery store for two items, need to snack before I drove there, and before the return drive, I'd need another snack because I'd be low again.

    And again, I spent all day being miserable. I don't think I laughed for 3 months. I have no clue why my boyfriend stayed with me because I was a *completely not nice person to the extent that I can't describe it on these boards without violating TOS*. But, I also started using it as an excuse to partake in binges (I have a binging history). My BS was 84? Ooh yay! I can have peanut butter crackers before my drive? Symptoms of hypo? I'm going to eat nonstop until they go away! I made a lot of bad choices because I had an excuse. I can see that looking back now, but I felt very justified at the time.

    So, the endo wasn't helping, so I decided to go for a third opinion to just a family practice doctor. She told me to stop everything the endo had told me. While it is very common for a diabetic who has low BS to drop much lower quickly and pass out, it's pretty rare for non diabetics (although not unheard of). And she felt what I was doing was creating a huge roller coaster for my bs. She suggested I go low carb.

    I took her advice, but felt the low carb was odd. Hell, I'd been doing relatively low carb for a few months before all this started. Oh hey. That got me thinking, I'd been messing with low carb (was giving paleontology a go) and that kind of seemed like it kicked all this off.

    So, I ignored everyone and added more carbs in, but mostly at night because that's when I seem to tolerate them best. I skip breakfast, but eat lots of small snacks an meals saving the majority of my calories for night. And I'm back to losing. I'm not perfect, and there are times I still get low blood sugar. At those times, I know I can eat a spoonful of peanut butter and wait out the symptoms and they will go away, but I still have the urge to eat continously until they do. Right now I win that battle about 50% of the time, which I'll take. I also have anxiety, which mimics the same symptoms, and it can be difficult to decipher if it's low blood sugar or a panic attack.

    But, I also realize I have a choice about what goes into my mouth, and what does will impact my weight. And I've continued to lose another 35lbs, although I still have another 25 at least to go.
  • umayster
    umayster Posts: 651 Member
    yarwell wrote: »
    umayster wrote: »
    In the real world people do not trot off to the doc with a list of symptoms and get an accurate diagnosis, appropriate treatment and timely resolution - especially for endocrine problems.

    Darn, so House isn't a documentary ?

    Just a delicious fantasy. :'(
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    LOL
  • LastingChanges
    LastingChanges Posts: 390 Member
    auddii wrote: »
    Holy thread to catch up on.

    A few notes. Not understanding what goes into the CO portion of CICO does not invalidate it.

    Ugh, I had like 4 other things I wanted to comment on, but they were like 4 pages back and now I don't remember.

    Anyways, just wanted to share my story, although it's been on the boards a few places.

    I'm reactive hypoglycemic which apparently runs in my dad's family (he has it and just found out last weekend my aunt does too). So, I found out early that I shouldn't eat cereal for breakfast (especially since I like it dry, so no milk). This stems from me testing at a blood sugar of 30 two hours after eating cereal back in middle school (my mom is diabetic and had the equipment to test).

    Occasionally, I'd eat stuff that I wasn't supposed to and suffer the consequences, but really as long as you eat protein and fats with your carbs, you're fine, and eating more often can help as well. This was all naturally regulated as a child because I ate a ton of food and preferred fatty foods in general (seriously, graham crackers with butter is amazing). So, I became very overweight with relatively few symptoms of low blood sugar.

    Fast forward to me attempting to lose weight, and being relatively successful at it (I'd lost 25lbs since starting mfp, and about 60 total). Then suddenly I'd start getting shaky, sweating, be unable to focus every few hours. Every day. My typical fixes didn't work, and so obviously I'd eat more. However, that almost never seemed to work to actually make me feel better overall; it would head off acute symptoms, but I never actually felt "good".

    I went to my doctor (my gynecologist because that's the only one I see with any regularity), and she ran some blood work. I'd also bought my own testing supplies and had about two weeks worth of data, testing before I ate and two hours after meals. My BS was consistently in the low 50s. My A1c cam back at 4.5, which my doctor said she'd never seen one that low (no clue if it's actually that rare, but it freaked me out at the time.

    She referred me to an endo, who started treating me as she would a diabetic. She put me on a medication to help prevent BS spikes after carbs (I didn't understand that on because my BS never spiked high), and had me test my BS every time before I drove. If it wasn't above 90, I needed to eat a snack. I ended up eating more than 3000 calories a day. I'd run to the grocery store for two items, need to snack before I drove there, and before the return drive, I'd need another snack because I'd be low again.

    And again, I spent all day being miserable. I don't think I laughed for 3 months. I have no clue why my boyfriend stayed with me because I was a *completely not nice person to the extent that I can't describe it on these boards without violating TOS*. But, I also started using it as an excuse to partake in binges (I have a binging history). My BS was 84? Ooh yay! I can have peanut butter crackers before my drive? Symptoms of hypo? I'm going to eat nonstop until they go away! I made a lot of bad choices because I had an excuse. I can see that looking back now, but I felt very justified at the time.

    So, the endo wasn't helping, so I decided to go for a third opinion to just a family practice doctor. She told me to stop everything the endo had told me. While it is very common for a diabetic who has low BS to drop much lower quickly and pass out, it's pretty rare for non diabetics (although not unheard of). And she felt what I was doing was creating a huge roller coaster for my bs. She suggested I go low carb.

    I took her advice, but felt the low carb was odd. Hell, I'd been doing relatively low carb for a few months before all this started. Oh hey. That got me thinking, I'd been messing with low carb (was giving paleontology a go) and that kind of seemed like it kicked all this off.

    So, I ignored everyone and added more carbs in, but mostly at night because that's when I seem to tolerate them best. I skip breakfast, but eat lots of small snacks an meals saving the majority of my calories for night. And I'm back to losing. I'm not perfect, and there are times I still get low blood sugar. At those times, I know I can eat a spoonful of peanut butter and wait out the symptoms and they will go away, but I still have the urge to eat continously until they do. Right now I win that battle about 50% of the time, which I'll take. I also have anxiety, which mimics the same symptoms, and it can be difficult to decipher if it's low blood sugar or a panic attack.

    But, I also realize I have a choice about what goes into my mouth, and what does will impact my weight. And I've continued to lose another 35lbs, although I still have another 25 at least to go.

    I really relate to you. I suspect I have reactive hypoglycemia. I had hypo as a child so I guess it now came back. I feel like I was going through a roller coaster as well with my sugar.
    I gained about 30 pounds from always trying to remedy the symptoms with more food. Smaller meals, no processed sugar, small portion of carbs or not eating carbs on its own helps a lot, but that took a while to figure out. So yes it is CICO but for a while no matter how much I wanted to be in control of CICO, if I wasnt feeling well I needed to eat more. Hypoglycemia didnt directly cause weight gain, but I really couldnt take countrol of my 'calories in' until I figured out how I should be eating.
  • auddii
    auddii Posts: 15,357 Member
    auddii wrote: »
    Holy thread to catch up on.

    A few notes. Not understanding what goes into the CO portion of CICO does not invalidate it.

    Ugh, I had like 4 other things I wanted to comment on, but they were like 4 pages back and now I don't remember.

    Anyways, just wanted to share my story, although it's been on the boards a few places.

    I'm reactive hypoglycemic which apparently runs in my dad's family (he has it and just found out last weekend my aunt does too). So, I found out early that I shouldn't eat cereal for breakfast (especially since I like it dry, so no milk). This stems from me testing at a blood sugar of 30 two hours after eating cereal back in middle school (my mom is diabetic and had the equipment to test).

    Occasionally, I'd eat stuff that I wasn't supposed to and suffer the consequences, but really as long as you eat protein and fats with your carbs, you're fine, and eating more often can help as well. This was all naturally regulated as a child because I ate a ton of food and preferred fatty foods in general (seriously, graham crackers with butter is amazing). So, I became very overweight with relatively few symptoms of low blood sugar.

    Fast forward to me attempting to lose weight, and being relatively successful at it (I'd lost 25lbs since starting mfp, and about 60 total). Then suddenly I'd start getting shaky, sweating, be unable to focus every few hours. Every day. My typical fixes didn't work, and so obviously I'd eat more. However, that almost never seemed to work to actually make me feel better overall; it would head off acute symptoms, but I never actually felt "good".

    I went to my doctor (my gynecologist because that's the only one I see with any regularity), and she ran some blood work. I'd also bought my own testing supplies and had about two weeks worth of data, testing before I ate and two hours after meals. My BS was consistently in the low 50s. My A1c cam back at 4.5, which my doctor said she'd never seen one that low (no clue if it's actually that rare, but it freaked me out at the time.

    She referred me to an endo, who started treating me as she would a diabetic. She put me on a medication to help prevent BS spikes after carbs (I didn't understand that on because my BS never spiked high), and had me test my BS every time before I drove. If it wasn't above 90, I needed to eat a snack. I ended up eating more than 3000 calories a day. I'd run to the grocery store for two items, need to snack before I drove there, and before the return drive, I'd need another snack because I'd be low again.

    And again, I spent all day being miserable. I don't think I laughed for 3 months. I have no clue why my boyfriend stayed with me because I was a *completely not nice person to the extent that I can't describe it on these boards without violating TOS*. But, I also started using it as an excuse to partake in binges (I have a binging history). My BS was 84? Ooh yay! I can have peanut butter crackers before my drive? Symptoms of hypo? I'm going to eat nonstop until they go away! I made a lot of bad choices because I had an excuse. I can see that looking back now, but I felt very justified at the time.

    So, the endo wasn't helping, so I decided to go for a third opinion to just a family practice doctor. She told me to stop everything the endo had told me. While it is very common for a diabetic who has low BS to drop much lower quickly and pass out, it's pretty rare for non diabetics (although not unheard of). And she felt what I was doing was creating a huge roller coaster for my bs. She suggested I go low carb.

    I took her advice, but felt the low carb was odd. Hell, I'd been doing relatively low carb for a few months before all this started. Oh hey. That got me thinking, I'd been messing with low carb (was giving paleontology a go) and that kind of seemed like it kicked all this off.

    So, I ignored everyone and added more carbs in, but mostly at night because that's when I seem to tolerate them best. I skip breakfast, but eat lots of small snacks an meals saving the majority of my calories for night. And I'm back to losing. I'm not perfect, and there are times I still get low blood sugar. At those times, I know I can eat a spoonful of peanut butter and wait out the symptoms and they will go away, but I still have the urge to eat continously until they do. Right now I win that battle about 50% of the time, which I'll take. I also have anxiety, which mimics the same symptoms, and it can be difficult to decipher if it's low blood sugar or a panic attack.

    But, I also realize I have a choice about what goes into my mouth, and what does will impact my weight. And I've continued to lose another 35lbs, although I still have another 25 at least to go.

    I really relate to you. I suspect I have reactive hypoglycemia. I had hypo as a child so I guess it now came back. I feel like I was going through a roller coaster as well with my sugar.
    I gained about 30 pounds from always trying to remedy the symptoms with more food. Smaller meals, no processed sugar, small portion of carbs or not eating carbs on its own helps a lot, but that took a while to figure out. So yes it is CICO but for a while no matter how much I wanted to be in control of CICO, if I wasnt feeling well I needed to eat more. Hypoglycemia didnt directly cause weight gain, but I really couldnt take countrol of my 'calories in' until I figured out how I should be eating.

    Yup, controlling the medical issues is very important, and once people can get that control, then applying CICO and maintaining a deficit becomes much easier.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    @auddii, thanks for sharing your story and for explaining it all so thoroughly. That really sounds like a tough situation to get a handle on. Congratulations on all the progress you've made so far.
  • jgnatca
    jgnatca Posts: 14,464 Member
    @tomteboda thank you for taking the time to share your mother's story.

    A takeaway from this is that while CI-CO is not invalidated from your mother's example, diet alone can't resolve her weight issues.
  • daniwilford
    daniwilford Posts: 1,030 Member
    I wish this gigantic thread could be split in three, one for the discussions of what comprises CICO and the acronyms that are included in the CO; one for, the rare medically dangerous, thing that shall not be named; and the one Carol actually titled.
  • SLLRunner
    SLLRunner Posts: 12,942 Member
    @tomteboda Reading your Mum's story is heartbreaking, just heartbreaking. I am so sorry for what she must be going through. She would feel very blessed to have your unconditional love, support and understanding. <3

    This. Makes me very sad.
  • Unknown
    edited November 2015
    This content has been removed.
  • daniwilford
    daniwilford Posts: 1,030 Member
    I had a heart valve fail. Latent birth defect, actually, my aortic valve was half normal size and refused to open much. I was never especially athletic even as a kid. I never knew; it was Ohio in the 60's and if you were the un-athletic kid you just studied a lot instead and got teased a lot. But, being deformed, the valve's function began to diminish when I was in my 40s. I stopped jogging. Seemed to hurt too much. I lost interest. Increasingly, I passed on visiting the gym. My top speed on the treadmill declined. After awhile I stopped going - getting up the stairs was painful. Slowly over a 5 year period I became sedentary. Work went well and I spent more time at my desk. I became a manager. Longer hours and more time sitting at my desk. I just thought I was getting old. (I've never grown old before, so I didn't think much of it). Not watching calories, I didn't reign in my food intake. So I became obese, the natural result of CICO.

    Anyway, a job change led to a decision to get back to exercising, which led to chest pain, which led to examination, then to discovery, and finally to surgical repair. After surgery, I entered cardiac re-hab. I was amazed at the difference adequate blood flow made to my exercise tolerance. I even started to enjoy exercise!! The cold creepy ache that I always experienced when active was gone. In its place this warm glow-ey feeling! Startling! I began to push the nursing staff and ultimately my doctors for an increase in maximum allowed heart rate. One day, noticing the nurse appeared busy - they're always understaffed in that profession! - I set the treadmill for jog and let loose. You never saw a staff member run to take a blood pressure that fast!

    Anyway, she forgave me. I continued to push and to improve markedly. She also recommended a calorie counting using a food journal. Being a geek, I found MFP and set about using that. That was three years and about 60+ lbs. ago. Two years ago I transitioned back to my old gym and hired a personal trainer. Found one familiar with heart patients but was still willing to push. I always pushed myself a little harder than he asked. A few more repetitions, a little more weight, always take the optional exercise.

    After 6 months I joined a boot camp style class with TRX and other torture implements. Really kicked my rear end. The look of shock when I returned for the next class. I would learn later that the class was popular with trainers and as a way to get their exercise - I had walked blindly into the "top gun" set of fitness at the gym. Doh! But I kept at it and the months passed. I grew smaller, lumpier and harder. Still counting calories. Down an additional 20 lbs. But best of all for me, I grew stronger.

    I took up lifting too. Started with Stronglifts 5x5. Moved to Madcow 5x5 when the weights became too heavy for me to add additional weight each workout. Two weeks ago, I squat-lifted my body weight. I can deadlift 1.25x my bodyweight. Not bad for the kid who was always teased in school for being weak, slow and overweight.

    I petitioned the FAA to renew my aeromedical certificate. I submitted a bunch of test results showing every last detail of my body's function measured out to a couple digits past the decimal point. Last January, I was restored to full flying status, subject to undergoing the same bunch of tests every year, of course.

    So if there's a moral to my story, other than control your exercise and your intake, I guess "Never Give up" would be a good moral.

    Amazing, inspiring story! Thanks for sharing. I am just starting with the TRX, I played around with it earlier, but it is part of my routine now.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    I had a heart valve fail. Latent birth defect, actually, my aortic valve was half normal size and refused to open much. I was never especially athletic even as a kid. I never knew; it was Ohio in the 60's and if you were the un-athletic kid you just studied a lot instead and got teased a lot. But, being deformed, the valve's function began to diminish when I was in my 40s. I stopped jogging. Seemed to hurt too much. I lost interest. Increasingly, I passed on visiting the gym. My top speed on the treadmill declined. After awhile I stopped going - getting up the stairs was painful. Slowly over a 5 year period I became sedentary. Work went well and I spent more time at my desk. I became a manager. Longer hours and more time sitting at my desk. I just thought I was getting old. (I've never grown old before, so I didn't think much of it). Not watching calories, I didn't reign in my food intake. So I became obese, the natural result of CICO.

    Anyway, a job change led to a decision to get back to exercising, which led to chest pain, which led to examination, then to discovery, and finally to surgical repair. After surgery, I entered cardiac re-hab. I was amazed at the difference adequate blood flow made to my exercise tolerance. I even started to enjoy exercise!! The cold creepy ache that I always experienced when active was gone. In its place this warm glow-ey feeling! Startling! I began to push the nursing staff and ultimately my doctors for an increase in maximum allowed heart rate. One day, noticing the nurse appeared busy - they're always understaffed in that profession! - I set the treadmill for jog and let loose. You never saw a staff member run to take a blood pressure that fast!

    Anyway, she forgave me. I continued to push and to improve markedly. She also recommended a calorie counting using a food journal. Being a geek, I found MFP and set about using that. That was three years and about 60+ lbs. ago. Two years ago I transitioned back to my old gym and hired a personal trainer. Found one familiar with heart patients but was still willing to push. I always pushed myself a little harder than he asked. A few more repetitions, a little more weight, always take the optional exercise.

    After 6 months I joined a boot camp style class with TRX and other torture implements. Really kicked my rear end. The look of shock when I returned for the next class. I would learn later that the class was popular with trainers and as a way to get their exercise - I had walked blindly into the "top gun" set of fitness at the gym. Doh! But I kept at it and the months passed. I grew smaller, lumpier and harder. Still counting calories. Down an additional 20 lbs. But best of all for me, I grew stronger.

    I took up lifting too. Started with Stronglifts 5x5. Moved to Madcow 5x5 when the weights became too heavy for me to add additional weight each workout. Two weeks ago, I squat-lifted my body weight. I can deadlift 1.25x my bodyweight. Not bad for the kid who was always teased in school for being weak, slow and overweight.

    I petitioned the FAA to renew my aeromedical certificate. I submitted a bunch of test results showing every last detail of my body's function measured out to a couple digits past the decimal point. Last January, I was restored to full flying status, subject to undergoing the same bunch of tests every year, of course.

    So if there's a moral to my story, other than control your exercise and your intake, I guess "Never Give up" would be a good moral.

    Amazing, inspiring story! Thanks for sharing. I am just starting with the TRX, I played around with it earlier, but it is part of my routine now.

    I concur, amazing story of perseverance. My trainer is a big fan of TRX, we've introduced one-legged moves into my routines lately. They are killer for working stabilizing muscles, and very hard for a klutz like me.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    rankinsect wrote: »
    In any event, it would be like asking everyone to acknowledge that CICO is not absolute even after it's been proven to be flawed. As much as I can try, it isn't going to happen even when some argue that it is absolute because the flaw occurs in a minority of cases (which acknowledges the flaw while simultaneously denying it).

    CICO isn't flawed. Medical conditions can either change CI or CO, but they can't change physics; the total amount of energy is remaining constant in the absence of any nuclear fission or fusion occurring in your body.

    Ultimately, calories lost because of epithelial malabsorption, calories lost from glycosuria, proteinuria, or lipiduria, etc. are all "calories out", as it's energy-containing substances that leave the body.

    "Calories out" is not exactly the same as "calories burned", although in most people it's quite close.

    It depends on definition. Most posts I've seen mentioning CICO were based on the definition of CO being RMR + exercise. That seems to be the consensus on the MFP forums.

    No, it's not. That's your assumption. I have repeated and keep repeating and many other posters will keep telling yo that all these other things that rankinsect mentioned are included in it.

    I wish I could click a like button, rankinsenct was spot on.

    I hardly think you are better than me to say what is in "most posts I've seen." Nonetheless, excretion is in addition to what most others in this thread have mentioned. So there is still that flaw.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    rankinsect wrote: »
    In any event, it would be like asking everyone to acknowledge that CICO is not absolute even after it's been proven to be flawed. As much as I can try, it isn't going to happen even when some argue that it is absolute because the flaw occurs in a minority of cases (which acknowledges the flaw while simultaneously denying it).

    CICO isn't flawed. Medical conditions can either change CI or CO, but they can't change physics; the total amount of energy is remaining constant in the absence of any nuclear fission or fusion occurring in your body.

    Ultimately, calories lost because of epithelial malabsorption, calories lost from glycosuria, proteinuria, or lipiduria, etc. are all "calories out", as it's energy-containing substances that leave the body.

    "Calories out" is not exactly the same as "calories burned", although in most people it's quite close.

    It depends on definition. Most posts I've seen mentioning CICO were based on the definition of CO being RMR + exercise. That seems to be the consensus on the MFP forums.

    No, it's not. That's your assumption. I have repeated and keep repeating and many other posters will keep telling yo that all these other things that rankinsect mentioned are included in it.

    I wish I could click a like button, rankinsenct was spot on.

    I hardly think you are better than me to say what is in "most posts I've seen." Nonetheless, excretion is in addition to what most others in this thread have mentioned. So there is still that flaw.

    The flaw is in your perception, not what CICO actually is in a scientific sense. You keep wanting to parse the phrase to make yourself right, and in so doing are derailing this thread.

    With all due respect? Please stop.

    It has been explained to you time and time again that the real science of CICO is absolute.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    yarwell wrote: »
    TDEE is an acronym for Total Daily Energy Expenditure. Simply explained, it is resting metabolic rate (RMR) + exercise. Your TDEE will vary from day to day. MFP uses your inputs (gender, height, weight, and activity level) to estimate your TDEE. That doesn't mean it is your actual TDEE; it is but an estimate.

    This depends somewhat on how you define "exercise". MFP in general works with TDEE = RMR + daily activity + exercise so the exercise part can be zero on some days and TDEE will be greater than RMR (by ~20% if "sedentary").

    Yes, I know my explanation was simplified (hence the "simply put" part) But to clarify, I'm counting all exercise, including wgetting up an going to the toilet and other small things that is not necessarily extra recreational activity.

    I think it is possible for MFP users who participate in recreation most days to enter a high level of activity and then log their exercise as well. This is a more clear method to look at demonstrate the difference between normal activity and extra exercise. Some people's activity is another person's exercise. It is a way that users can accidentally miscalculate their allotted calories.