concerned about a friend

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laropmet
laropmet Posts: 52 Member
in Health and Weight Loss
I have a friend at work that has been trying to lose weight for as long as i've known her. About 2 months ago her doctor put her on orlistat and she began eating a low fat diet. About a month after that she was diagnosed with diabetes and the diabetic clinic put her on a low carb diet. Her doctor now knows about the diabetes but hasn't stopped prescribing the orlistat. In my head eating a low carb diet while taking a fat blocker doesn't make any sense and I can't figure out where she will be getting nutrients from, besides the protein. So far she hasn't been losing any weight. She always seems to be on the verge of tears from hunger and is suffering from shakiness and dizzy spells presumable because of low blood sugar. I've advised her to go back to her doctor but does anyone have any realistic advice beside this I could use to encourage her. I know I shouldn't get so wrapped up in other people's struggles but I can't stop being worried.
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  • Sued0nim
    Sued0nim Posts: 17,456 Member
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    She hasn't lost weight in 2 months?

    She's not doing it right

    Tell her to go back to doctor
  • laropmet
    laropmet Posts: 52 Member
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    I think the problem is she is always hungry and there is no way anyone can fight hunger forever. Ive already told her to go back but the doctor is pretty much saying stick to the diet and you aren't working hard enough. I've been saying that she needs to eat some fat but obviously with the orlistat that's not an option. I don't claim to know more than the doctor but i can't help but feel that he's wrong by prescribing that.
  • Mistraal1981
    Mistraal1981 Posts: 453 Member
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    She could have hypothyroidism. Maybe also see if she is weighing her food, introduce her to mfp. For some ppl being on a diet means no "cheat" food, and don't realise that eating too much chicken and broccoli will make you gain weight too.
  • yarwell
    yarwell Posts: 10,477 Member
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    The UK has Orlistat as a treatment of last resort in Obesity, see section 8 in http://pathways.nice.org.uk/pathways/obesity/overweight-and-obese-adults.pdf

    "Orlistat
    Only prescribe orlistat as part of an overall plan for managing obesity in adults who meet one of
    the following criteria:
    a BMI of 28 kg/m2
    or more with associated risk factors
    a BMI of 30 kg/m2
    or more.
    Continue orlistat therapy beyond 3 months only if the person has lost at least 5% of their initial
    body weight since starting drug treatment. Also see below for advice on targets for people with
    type 2 diabetes.
    Make the decision to use drug treatment for longer than 12 months (usually for weight
    maintenance) after discussing potential benefits and limitations with the person."

    If she can't hack a low fat diet with Orlistat and doesn't lose weight then changing to a restricted carbohydrate increased fat diet without orlistat would be an option to discuss with the doctor.
  • yarwell
    yarwell Posts: 10,477 Member
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    PS to add that I don't see how a low carb (for the diabetes) low fat (for the Orlistat) regime is going to work without it being excessive protein / rabbit starvation.
  • melonaulait
    melonaulait Posts: 769 Member
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    To me it doesn't sound like your friend really benefits from the low fat or low carb diets. Do you think it's possible your friend could try a balanced, more plant-based diet?
  • bellabonbons
    bellabonbons Posts: 705 Member
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    I would tell her to see a new doctor asap.
  • LKArgh
    LKArgh Posts: 5,179 Member
    edited February 2016
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    laropmet wrote: »
    I think the problem is she is always hungry and there is no way anyone can fight hunger forever. Ive already told her to go back but the doctor is pretty much saying stick to the diet and you aren't working hard enough. I've been saying that she needs to eat some fat but obviously with the orlistat that's not an option. I don't claim to know more than the doctor but i can't help but feel that he's wrong by prescribing that.

    It sounds like the dr is telling her the truth: no weight loss in 2 months, means she is actually not following the diet. Maybe she is trying to follow the diet, then ends up eating everything because she is hungry. If she has a diet from the diabetic clininc, orlistat or not, she should be losing. She is not following her diet. No matter what meds she takes or does not take, unless she actually follows the eatign plan, nothing will change
  • chandanista
    chandanista Posts: 986 Member
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    She should get a second opinion from another doctor.
  • smotheredincheese
    smotheredincheese Posts: 559 Member
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    What is she eating at the moment then? does she end up binging because the diet is too restrictive?
  • ilex70
    ilex70 Posts: 727 Member
    edited February 2016
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    Agree on seeing another doctor or maybe a certified dietitian.

    As far as low carb/low fat it is hard to say without more detail since we don't know from your post exactly what is being prescribed as far as "low carb".
    Carb-friendly: less than or equal to 30 g/serving

    Low-carb: less than or equal to 15 g/serving

    Very low-carb: less than or equal to 3 g/serving

    Lots of diabetes in my family. If her plan is something like "3 meals/2 snacks, no more than 30 grams of carbs each" then being low fat too isn't that scary. Especially if "low fat" means something like 30% of calories from fat. The 30 grams of carbs limit is something my relatives have had prescribed. Eating 5 times that could be up to 150 grams of carbs a day, so not at risk of "rabbit starvation".
  • kommodevaran
    kommodevaran Posts: 17,890 Member
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    You can't go low fat AND low carb at the same time. No wonder she hasn't lost weight, while still hungry, and shaky, she must be terrified as well as confused. Tell her to get a new doctor, pronto.
  • sallygroundhog
    sallygroundhog Posts: 133 Member
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    ilex70 wrote: »
    Agree on seeing another doctor or maybe a certified dietitian.

    +1 Maybe a dietician could figure out a workable plan from the 2 diets suggested. Or give a definitive opinion on following one or the other.
  • WalkingAlong
    WalkingAlong Posts: 4,926 Member
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    If she's not losing weight I wouldn't worry about her not getting nutrients. I also would take another dieter's claims with a grain of salt and let the doctors do the diagnosing. In my opinion, usually when someone says they're doing it right but not losing, they're not doing it right at all, or they're doing it right 80% of the time and blowing their diet out of the water the other 20%.
  • kshama2001
    kshama2001 Posts: 27,897 Member
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    kommodevaran wrote: »
    You can't go low fat AND low carb at the same time. No wonder she hasn't lost weight, while still hungry, and shaky, she must be terrified as well as confused. Tell her to get a new doctor, pronto.

    Cosigned.
  • nadler64
    nadler64 Posts: 124 Member
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    kshama2001 wrote: »
    kommodevaran wrote: »
    You can't go low fat AND low carb at the same time. No wonder she hasn't lost weight, while still hungry, and shaky, she must be terrified as well as confused. Tell her to get a new doctor, pronto.

    Cosigned.

    +1
  • CassidyScaglione
    CassidyScaglione Posts: 673 Member
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    I would advise her to switch doctors, and to go to the new one with a detailed list of her symptoms as a result of what the old one advised.
  • laropmet
    laropmet Posts: 52 Member
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    I totally agree with everything, everyone has said in this post. Even the ones that are saying she's not sticking to it. I don't believe she is sticking to it because she keeps telling me things like "I got shaky on the way home so had a coke to help", or "It got to dinner time and I had a whole packet of biscuits". The impression I'm getting is that she is so hungry that she grabs whatever is handy rather than cooking and part of me can't blame her for that because who among us can tolerate low fat and low carb at the same time. I don't know her ratio's. She's in her 50's, probably around 225lbs although she has never actually told me her weight. Definitely at risk and probably an ideal candidate for Orlistat. I just don't feel this is too healthy.
  • LKArgh
    LKArgh Posts: 5,179 Member
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    laropmet wrote: »
    I totally agree with everything, everyone has said in this post. Even the ones that are saying she's not sticking to it. I don't believe she is sticking to it because she keeps telling me things like "I got shaky on the way home so had a coke to help", or "It got to dinner time and I had a whole packet of biscuits". The impression I'm getting is that she is so hungry that she grabs whatever is handy rather than cooking and part of me can't blame her for that because who among us can tolerate low fat and low carb at the same time. I don't know her ratio's. She's in her 50's, probably around 225lbs although she has never actually told me her weight. Definitely at risk and probably an ideal candidate for Orlistat. I just don't feel this is too healthy.

    Sorry, but if this is what she is doing, this is suicide by eating and no dr can help her. Nothing is stopping her from grabbing an apple, or a yoghurt if she needs to eat something immediately. Usually a diabetic clinic will give an eating plan and this eating plan will be low-ish carb and also low-ish fat, until there is improvement. Which means mostly high protein at first, which also means lots of cooking options. Meat, fish, chicken, grilled, sauteed, in tomato based sauces, in lemon etc based sauces, lots of salads, a couple of fruit per day, yoghurt, low fat cheese, milk, nuts, legumes, eggs. Lots of things that are easy to prepare, and will not leave her starving.
  • kommodevaran
    kommodevaran Posts: 17,890 Member
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    aggelikik wrote: »
    laropmet wrote: »
    I totally agree with everything, everyone has said in this post. Even the ones that are saying she's not sticking to it. I don't believe she is sticking to it because she keeps telling me things like "I got shaky on the way home so had a coke to help", or "It got to dinner time and I had a whole packet of biscuits". The impression I'm getting is that she is so hungry that she grabs whatever is handy rather than cooking and part of me can't blame her for that because who among us can tolerate low fat and low carb at the same time. I don't know her ratio's. She's in her 50's, probably around 225lbs although she has never actually told me her weight. Definitely at risk and probably an ideal candidate for Orlistat. I just don't feel this is too healthy.

    Sorry, but if this is what she is doing, this is suicide by eating and no dr can help her. Nothing is stopping her from grabbing an apple, or a yoghurt if she needs to eat something immediately. Usually a diabetic clinic will give an eating plan and this eating plan will be low-ish carb and also low-ish fat, until there is improvement. Which means mostly high protein at first, which also means lots of cooking options. Meat, fish, chicken, grilled, sauteed, in tomato based sauces, in lemon etc based sauces, lots of salads, a couple of fruit per day, yoghurt, low fat cheese, milk, nuts, legumes, eggs. Lots of things that are easy to prepare, and will not leave her starving.

    But she didn't get an eating plan, and wasn't told to eat moderate fat, moderate carbs, plenty of protein, and get cooking - she has been told to, practically, "not eat". She's panicking.
    I recognize this pattern of behavior from my own experience. I took the nutritional guidelines so seriously and literarily that I tried to avoid fat as much as possible, which of course wasn't possible, and instead of allowing more fat from real, nutritious food, I caved and bought lots of junk. Looking back, I understand that I was too scared by the health warnings, of cancer, heart failure and even diabetes, to think straight and investigate alternatives. I regard myself as both sensible and literate, and this makes me feel more sad and angry than stupid. I love to talk about myself, sorry, but I hope this is useful to understand this seemingly irrational behavior.

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