Doctor said 1000 calories
Replies
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michelle172415 wrote: »LorettaB1967 wrote: »I have to take in 900-1000 calories a day to lose .5 - 1 pound a week. Been walking 3-4 miles a day and trying to balance 1000 calories and end up losing 1 pound a month. I am 5'2" 173. Everybody's body is metabolism, I know mine sure is. Good luck! Just try it for a few weeks and see if what the doctor says is right. But don't make yourself sick.
I'm sorry, but this is not good advice. It's extremely difficult to get in all the nutrients you need consuming 1,200 calories per day, virtually impossible eating less than 1,000 calories per day. Yes, ultimately weight loss is about calories in calories out, but there is something to be said for the quality of the calories that you are consuming.
I agree- 900 cals is awfully low - especially if you are walking 3 miles daily.Hard to judge the doctor's intent w/out more info. However if he is running a "weight loss clinic", I suspect his outlook is geared more towards low-calorie diets rather than a more multifaceted approach.
Your situation has some challenges in that you are (or feel you are) overweight, yet you're not that overweight. With your size it is also more of a challenge to maintain a calorie deficit because your TDEE is smaller. In theory, given your size, a 1000 cal/day diet is not outlandish. However, as you known, it's not much fun either which makes it hard to sustain.
Personally I would also recommend increasing your cal intake into the 1200-1400 range and work more on increasing your total activity, both exercise and casual. TBH, you need to be on that treadmill at least 5 days a week; some strength training would help as well.
Why is 3 days not good enough if thats all she can do right now?
Some people lose a lot of weight with no exercise.2 -
Go to http://scoobysworkshop.com/calorie-calculator/ enter your info as lightly active and see what it tells you to eat... and eat that.However, you don't seem to be weighing your food, so you're probably eating more than you think anyway. I'm guessing that's why a lot of doctors put patients on low calorie diets... they know that they'll underestimate their food anyway.0
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Assuming you don't spend 18 hours a day in bed, your TDEE will be at least 115-120% of your BMR. So about 1500 for sedentary, meaning you take perhaps 2500-5000 steps thru the course of your waking hours. Sitting at a desk job mostly, but you still move some thru the day. You can help your TDEE by making an effort to move more.
You're on the petite side, so going under 1200 with doctor's supervision may be right for you. I'm not really qualified to say. I would inquire as to your doctor's experience/credentials with nutrition & weight loss.
You CAN lose weight eating more than 1000, but with having a somewhat low TDEE you'll need to be meticulous in your logging accuracy. And finding a way to move more would be good also.Hello all, so I went for my checkup at the doctor and we discussed my weight. He also runs a weight loss clinic along with his family practice. He suggested I cut to 1000 calories a day and no more than 25 mg of fat a day.
Isn't that too low calorie? I've been logging consisently for 2 weeks (open diary take a look). I average from 900 to 1100 day. Fat grams avg 24-30.
My BMR is 1294
TDEE is not much more than that maybe 1350.
5' 2"
CW: 143.2
I've lost around 2 pounds since 02/22.
% of body fat is 34%
Need your expertise and advice.
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LorettaB1967 wrote: »I have to take in 900-1000 calories a day to lose .5 - 1 pound a week. Been walking 3-4 miles a day and trying to balance 1000 calories and end up losing 1 pound a month. I am 5'2" 173. Everybody's body is metabolism, I know mine sure is. Good luck! Just try it for a few weeks and see if what the doctor says is right. But don't make yourself sick.
OP, don't try this, not even for a week. Undereating always leads to overeating. A neverending cycle of deprivation and binge. Finding the balance takes time and effort, but it's so worth it.0 -
I'm 5'1" and both my doctor and nutritionist put me on 1,000 calories a day. My mother who is 5'3" was put on 1,200 by her doctor a few years ago. Yours doesn't sound TOO far fetched. I would grab a second opinion though if you're concerned.2
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I would take the advice of anyone running a weight loss clinic for profit with a grain of salt. Sure s/he has described ONE way to lose a little weight, but there are others. You could go for a less aggressive deficit and shift the weight over a longer spell of time. I don't know if you have other health concerns. I've lost weight being pretty much fat & carb agnostic. I set a goal for my protein macro, then let the fats & carbs just fight it out among themselves within my day's caloric budget. I don't sweat daily deficits either; I prefer to track my weekly deficit for a little more wriggle room. There are hundreds of people here on MFP figuring out what works for themselves in different ways. If you don't have a pre existing medical condition, I would encourage you to put something together for yourself that makes you comfortable. You might find it more pleasurable!1
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ToughHippieChick wrote: »I'm a nurse and work with lots and lots of doctors. They don't always know what they're talking about, especially if they're one of those doctors of osteopathy (DO),
Generalizations aren't helpful.
There are different types of people in all career paths. Some are competent, some are not.
How one chooses which type of physician is best for them is a very personal choice and often rooted in philosophical belief about the body and health.
D.O.s are osteopathic and M.D.s are allopathic.
D.O.s specialize in a whole-body, holistic, preventative, and macro-lifestyle approach to medicine.
M.D.s specialize in a medicative, medical procedural, pharmaceutical, and micro-structural approach to medicine.
Their medical training is nearly identical. It is their philosophy about the human being as a whole person that is different. Both are fully licensed physicians who have attended and graduated from accredited medical schools and put in their hard work, study, and performed accredited medical residency. Both are required to pass a state licensing examination to practice medicine. They both should be knowledgeable in their field, offer sound medical advice, and have their patient's well-being at the core of their oath. Failure to be/do any of those things is a lack in their character or competency, not their chosen career.
Yeah, when I see a DO refer a patient to a chiropractor to get treatment for their asthma, I tend to be a bit skeptical of their degree.
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im the same height as you and lose consistently eating between 14-1500.0
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Without knowing how long you are to be on this amount of calories and full health history, etc it is hard for anyone to offer you sound advice other than to pursue a second opinion. The simple fact that you are posting the question to a forum says you have conflicting feelings or thoughts so, definitely reach out to another professional.
Everyone is going to offer you advice on here that conflicts and adds to your confusion. Most of it will be out of personal experience (restraining myself from adding my own two cents about my experience). I would be leery of anyone telling you on a forum to not listen to a health care professional but, I know from personal experience that there are a huge amount of incompetent nurses, doctors, dietitians and nutritionists (I'm sure no one will personalize that) out there.
Again, when in doubt about any professional opinion in the real world seek out a second, third or how many opinions you need to feel secure in your decision.1 -
ToughHippieChick wrote: »I'm a nurse and work with lots and lots of doctors. They don't always know what they're talking about, especially if they're one of those doctors of osteopathy (DO),
Generalizations aren't helpful.
There are different types of people in all career paths. Some are competent, some are not.
How one chooses which type of physician is best for them is a very personal choice and often rooted in philosophical belief about the body and health.
D.O.s are osteopathic and M.D.s are allopathic.
D.O.s specialize in a whole-body, holistic, preventative, and macro-lifestyle approach to medicine.
M.D.s specialize in a medicative, medical procedural, pharmaceutical, and micro-structural approach to medicine.
Their medical training is nearly identical. It is their philosophy about the human being as a whole person that is different. Both are fully licensed physicians who have attended and graduated from accredited medical schools and put in their hard work, study, and performed accredited medical residency. Both are required to pass a state licensing examination to practice medicine. They both should be knowledgeable in their field, offer sound medical advice, and have their patient's well-being at the core of their oath. Failure to be/do any of those things is a lack in their character or competency, not their chosen career.
Yeah, when I see a DO refer a patient to a chiropractor to get treatment for their asthma, I tend to be a bit skeptical of their degree.
There are actually many studies out there that speak to the benefits of chiropractic care for a multitude of ailments, including asthma. Yes, there are crackpot chiros out there who are only in it for the money and will prescribe every patient a full course of treatment 3x/week for 6 weeks, and then there are chiros who spend time developing treatment plans that are specific to the individual and their ailments. It makes me sad that DOs and Chiros get such a bad reputation because of a few quacks. There is something to be said for homeopathic treatments and I for one am a believer.
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I would take the advice of anyone running a weight loss clinic for profit with a grain of salt.
This is kind of the key to me. Are you having any health concerns that are associated with your weight? If not, there is no need to "struggle" to lose some weight. Use one of the TDEE calculators that have already been linked and aim for a minimal weekly weight loss goal, like half a pound per week.
Just as a reference, I am 43 yrs old, 5'4" and lightly active and workout 4 times a week. I started at 145 and lost @ half-pound per week eating 1500-1600 cals. I'm currently maintaining at 130 lbs eating 1,800 cals.
Personally, unless there are medical issues involved, I wouldn't go below 1200, and I wouldn't aim for more than half-pound per week, but since you are on the small side that is a decision you have to make. Get a food scale if you don't have one and start using it to make sure you are really eating at the right level. Good luck!0 -
It sounds like he wants you to fail in order to drum up business for the weight loss clinic.
You are barely overweight, unless there is a medical condition you didn't mention, there is no reason at all to go to extremes like this.0 -
Another take: It is a fairly general pattern that many people overestimate the amount of calories that they eat. The doctor may have recommended 1000 thinking that you will probably wind up eating somewhat more than that.0
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From your diary, I see you become easily frustrated by the calories in the foods you eat. Breaded fish, breaded and fried chicken, less than lean ground beef, and cold cuts like bologna are highly processed and contain huge amounts of fat and sodium. Also, just because a food is Weight Watchers or Nutri System doesn’t mean it’s satisfying. It still has calories.
I suspect your doctor wants you to cut your fat and calories due to an underlying health problem like high blood pressure or high cholesterol. If it’s high blood pressure, the sodium in processed foods like bologna and hot dogs is bad for your system. Going from canned to frozen vegetables was a good choice for lowering your sodium. If it’s high cholesterol, the amount of fat in cheese and fried foods make managing it difficult. This includes things like breaded fish. Your choice of Healthy Choice Steamers and baked Tilapia looks great in terms of calories and sodium compared with some of your previous foods.
I don’t do protein shakes so I won’t put them down. They do, however, take up a lot of the calories that you could eat in solid foods and are fairly high in sodium. I only mention this because you say you’re always hungry and I don’t know if these shakes are actually filling.
Since the 1st of March, I think you’ve made excellent choices. The addition of the oat bread should help you stay fuller and who doesn’t need their take out coffee.
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I figure if a doctor is going to give that sort of advice they better be prepared to support you 24/7. Because that advice is not sustainable.
What you are doing is working, so I suggest tweaking your plan so you are not as hungry.0 -
Another take: It is a fairly general pattern that many people overestimate the amount of calories that they eat. The doctor may have recommended 1000 thinking that you will probably wind up eating somewhat more than that.
This is exactly what I was about to post. I really do think that some doctors quote low calorie intakes because people tend to overeat/underestimate their portions. That doesn't make it okay to do, but even on the boards we see people claim they eat "about" 1200 calories and don't lose weight, so I can't even imagine how many times doctors encounter this fallacy.
OP, if I were you I'd buy a food scale and weigh all of your food to the gram. Start with an intake of 1300 or so to be safe. Don't eat low fat. It will take a while to figure out the best ratios for your satiety, but 40% carbs, 30% fats, and 30% protein is a good place to start for most people. Give it a few weeks and see how much weight you lose. If you don't lose weight or lose less than you wanted to, you can reassess your calorie goals.0 -
This seems wayy to low. I am also 5'2, but 128 (only 15 lbs less than you!!) and I could not eat only 1000.
The anti fat statement (25g a day??) makes me think your doctor is old school (fat is bad, eggs are probably bad, don't bother lifting). Fat gives many a satiated feeling, much like protein. I am for double what you're instructed to eat.
Anywho- I would get a second opinion. I would not cut calories that low, and not eat that little fat.
Have you considered strength training as an aid?0 -
ToughHippieChick wrote: »I'm a nurse and work with lots and lots of doctors. They don't always know what they're talking about, especially if they're one of those doctors of osteopathy (DO),
Generalizations aren't helpful.
There are different types of people in all career paths. Some are competent, some are not.
How one chooses which type of physician is best for them is a very personal choice and often rooted in philosophical belief about the body and health.
D.O.s are osteopathic and M.D.s are allopathic.
D.O.s specialize in a whole-body, holistic, preventative, and macro-lifestyle approach to medicine.
M.D.s specialize in a medicative, medical procedural, pharmaceutical, and micro-structural approach to medicine.
Their medical training is nearly identical. It is their philosophy about the human being as a whole person that is different. Both are fully licensed physicians who have attended and graduated from accredited medical schools and put in their hard work, study, and performed accredited medical residency. Both are required to pass a state licensing examination to practice medicine. They both should be knowledgeable in their field, offer sound medical advice, and have their patient's well-being at the core of their oath. Failure to be/do any of those things is a lack in their character or competency, not their chosen career.
OP - If you are seeing one that instructed you to do something you are not comfortable with, it can't hurt to seek out advice from the other and then compare the opinions. (Or even seek a third opinion.) There is also, as many others have mentioned, the alternatives of seeking out advice from a nutritionist, dietitian or even a kinesiologist; or seek out professional, yet non-biomedical, advice.
I sympathize with your feeling of hunger. I almost always feel hungry which often leads to over-eating and lands me in a vicious cycle of weight-gain.
A last tidbit... do you have time to fit some walking in your day? I know when the weather is nice and I take a daily walk with my neighbor, I find my weight slightly easier to manage.
Good luck
My daughter is a DO (board-certified psychiatrist), so I just dismiss those negative generalizations as coming from ignorant boobs.
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Hello all, so I went for my checkup at the doctor and we discussed my weight. He also runs a weight loss clinic along with his family practice. He suggested I cut to 1000 calories a day and no more than 25 mg of fat a day.
Isn't that too low calorie? I've been logging consisently for 2 weeks (open diary take a look). I average from 900 to 1100 day. Fat grams avg 24-30.
My BMR is 1294
TDEE is not much more than that maybe 1350.
5' 2"
CW: 143.2
I've lost around 2 pounds since 02/22.
% of body fat is 34%
Need your expertise and advice.
Wouldn't you think your doctor is the expert???... I don't think anyone on here is really an expert ... just in their own minds. I'm sure there are a couple of people that will give you a bunch of certificates that they have, but only your doctor knows your medical situation, has reviewed your blood work... you know ... all the important stuff.0 -
MFP lowest recommendation is 1200 cals a day. However, there are things you can eat that will help you feel fuller longer. I drink protein shakes. Big Train Fit Frappe is one of my favs. They have a mocha and vanilla flavor that rock. I either mix them with Water or Coffee and if I want a cold one, I blend them with ice. On shorter bodies, the weight shows more. My daughter is 5ft and on a 1,000cal limit for loss, once she is done she will go back to 1,600 for maintenance. If you are feeling hungry, don't forget your water. Also try higher fiber foods that help you feel fuller longer.0
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ToughHippieChick wrote: »I'm a nurse and work with lots and lots of doctors. They don't always know what they're talking about, especially if they're one of those doctors of osteopathy (DO),
Generalizations aren't helpful.
There are different types of people in all career paths. Some are competent, some are not.
How one chooses which type of physician is best for them is a very personal choice and often rooted in philosophical belief about the body and health.
D.O.s are osteopathic and M.D.s are allopathic.
D.O.s specialize in a whole-body, holistic, preventative, and macro-lifestyle approach to medicine.
M.D.s specialize in a medicative, medical procedural, pharmaceutical, and micro-structural approach to medicine.
Their medical training is nearly identical. It is their philosophy about the human being as a whole person that is different. Both are fully licensed physicians who have attended and graduated from accredited medical schools and put in their hard work, study, and performed accredited medical residency. Both are required to pass a state licensing examination to practice medicine. They both should be knowledgeable in their field, offer sound medical advice, and have their patient's well-being at the core of their oath. Failure to be/do any of those things is a lack in their character or competency, not their chosen career.
OP - If you are seeing one that instructed you to do something you are not comfortable with, it can't hurt to seek out advice from the other and then compare the opinions. (Or even seek a third opinion.) There is also, as many others have mentioned, the alternatives of seeking out advice from a nutritionist, dietitian or even a kinesiologist; or seek out professional, yet non-biomedical, advice.
I sympathize with your feeling of hunger. I almost always feel hungry which often leads to over-eating and lands me in a vicious cycle of weight-gain.
A last tidbit... do you have time to fit some walking in your day? I know when the weather is nice and I take a daily walk with my neighbor, I find my weight slightly easier to manage.
Good luck
My daughter is a DO (board-certified psychiatrist), so I just dismiss those negative generalizations as coming from ignorant boobs.
There's a DO here that is an oncologist who prescribes chemotherapy daily. I'm not sure where he fits in on this supposed list...0 -
Tedebearduff wrote: »Hello all, so I went for my checkup at the doctor and we discussed my weight. He also runs a weight loss clinic along with his family practice. He suggested I cut to 1000 calories a day and no more than 25 mg of fat a day.
Isn't that too low calorie? I've been logging consisently for 2 weeks (open diary take a look). I average from 900 to 1100 day. Fat grams avg 24-30.
My BMR is 1294
TDEE is not much more than that maybe 1350.
5' 2"
CW: 143.2
I've lost around 2 pounds since 02/22.
% of body fat is 34%
Need your expertise and advice.
Wouldn't you think your doctor is the expert???... I don't think anyone on here is really an expert ... just in their own minds. I'm sure there are a couple of people that will give you a bunch of certificates that they have, but only your doctor knows your medical situation, has reviewed your blood work... you know ... all the important stuff.
Yes and no. There certainly are people here who think that because they lost 10 pounds or read fitness magazines that they somehow have more insight and expertise than a medical professional.
On the other hand......
A lot of general docs who run "weight loss clinics" on the side can have a narrow view of the situation and tend to use a "template" approach for everyone; and they don't always keep up with current trends and research.
So I think your response is reasonable, but I would not automatically assume that a doctor is a weight loss "expert".
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OP - I second what a lot of people have said. Get a second opinion from a nutritionist/dietician before reducing your calorie intake to 1000 calories a day. Your TDEE might be more in line with "lightly active" - so I would also recalculate your TDEE to figure out how much of a deficit you should be doing.
Good luck!0 -
Another take: It is a fairly general pattern that many people overestimate the amount of calories that they eat. The doctor may have recommended 1000 thinking that you will probably wind up eating somewhat more than that.This is exactly what I was about to post. I really do think that some doctors quote low calorie intakes because people tend to overeat/underestimate their portions. That doesn't make it okay to do, but even on the boards we see people claim they eat "about" 1200 calories and don't lose weight, so I can't even imagine how many times doctors encounter this fallacy.
OP, if I were you I'd buy a food scale and weigh all of your food to the gram. Start with an intake of 1300 or so to be safe. Don't eat low fat. It will take a while to figure out the best ratios for your satiety, but 40% carbs, 30% fats, and 30% protein is a good place to start for most people. Give it a few weeks and see how much weight you lose. If you don't lose weight or lose less than you wanted to, you can reassess your calorie goals.
Agree with both of you. The doctor tells you to eat 1000 because he figures that's easier than telling you to eat 1500 and buy a food scale and log everything accurately, and then actually follow up if you aren't logging everything accurately.
I am 20 lbs into the obese category, with another 20 lbs after that to the high end of a healthy weight. My doctor suggested I lose the first 20 lbs in a year, and then the next year the next 20 lbs to get to a healthy weight. Obviously she wants it to be a long term sustainable process for me. She referred me to some classes my HMO offers on nutrition and weight loss as well, rather than giving me specific off the cuff advice herself.0 -
I am also on a 1000 calorie intake and eat small meals every 3 -4 hours and exercise 2 -3 times a week. I drink a minimum of 8 glasses of water which keep me full. I do not feel hungry at all during the day. Hi protein diet keeps me full. I have been on this regime for 3 weeks and I am losing 2 lbs per week. I am very happy with my the results. Good Luck.0
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Tedebearduff wrote: »Hello all, so I went for my checkup at the doctor and we discussed my weight. He also runs a weight loss clinic along with his family practice. He suggested I cut to 1000 calories a day and no more than 25 mg of fat a day.
Isn't that too low calorie? I've been logging consisently for 2 weeks (open diary take a look). I average from 900 to 1100 day. Fat grams avg 24-30.
My BMR is 1294
TDEE is not much more than that maybe 1350.
5' 2"
CW: 143.2
I've lost around 2 pounds since 02/22.
% of body fat is 34%
Need your expertise and advice.
Wouldn't you think your doctor is the expert???... I don't think anyone on here is really an expert ... just in their own minds. I'm sure there are a couple of people that will give you a bunch of certificates that they have, but only your doctor knows your medical situation, has reviewed your blood work... you know ... all the important stuff.
Yes and no. There certainly are people here who think that because they lost 10 pounds or read fitness magazines that they somehow have more insight and expertise than a medical professional.
On the other hand......
A lot of general docs who run "weight loss clinics" on the side can have a narrow view of the situation and tend to use a "template" approach for everyone; and they don't always keep up with current trends and research.
So I think your response is reasonable, but I would not automatically assume that a doctor is a weight loss "expert".
Good point..... so which doctor are you supposed to trust exactly? whichever ones direction lines up with what you want to do?
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Tedebearduff wrote: »Tedebearduff wrote: »Hello all, so I went for my checkup at the doctor and we discussed my weight. He also runs a weight loss clinic along with his family practice. He suggested I cut to 1000 calories a day and no more than 25 mg of fat a day.
Isn't that too low calorie? I've been logging consisently for 2 weeks (open diary take a look). I average from 900 to 1100 day. Fat grams avg 24-30.
My BMR is 1294
TDEE is not much more than that maybe 1350.
5' 2"
CW: 143.2
I've lost around 2 pounds since 02/22.
% of body fat is 34%
Need your expertise and advice.
Wouldn't you think your doctor is the expert???... I don't think anyone on here is really an expert ... just in their own minds. I'm sure there are a couple of people that will give you a bunch of certificates that they have, but only your doctor knows your medical situation, has reviewed your blood work... you know ... all the important stuff.
Yes and no. There certainly are people here who think that because they lost 10 pounds or read fitness magazines that they somehow have more insight and expertise than a medical professional.
On the other hand......
A lot of general docs who run "weight loss clinics" on the side can have a narrow view of the situation and tend to use a "template" approach for everyone; and they don't always keep up with current trends and research.
So I think your response is reasonable, but I would not automatically assume that a doctor is a weight loss "expert".
Good point..... so which doctor are you supposed to trust exactly? whichever ones direction lines up with what you want to do?
That's the crucial question. I would be more trusting of the Doctor who either a) had some extra training/proficiency in these areas (which you would still have to verify) or b) knew his/her limitations and referred you to a registered/licensed dietitian.
We all have to be active partners in our own health care--look at credentials, do research, ask good questions. You do the best you can.
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I'm a nurse and work with lots and lots of doctors. They don't always know what they're talking about, especially if they're one of those doctors of osteopathy (DO), and there are a lot of them who do family medicine.
That is a REALLY ridiculous and inaccurate stereotype to be throwing around on the internet. My sister is a DO, and is an extremely qualified doctor who literally saves the lives of babies every day in a nationally renowned neonatal intensive care unit. So, let's just stop right there with the bogus generalizations about an entire profession.
On the OP's question...I'd consider getting a second opinion, but I am also short (5'1") and have been told by doctors in the past that the 1200 calorie number is somewhat arbitrary, and that caloric intakes lower than 1200/day could make sense for some people in some circumstances, provided they are under supervision by a doctor or qualified nutritionist. If I were you, I'd ask the doctor to defend his/her recommendation a bit more, and make sure the potential risks are part of the discussion.3 -
_lyndseybrooke_ wrote: »I really hope you mean 25g of fat, not 25mg. Actually, I take that back. 25g is just as ridiculous.
My advice is to find a doctor that's not a complete moron. 1200 calories per day is the bare minimum of what you should be eating.
You're in your 40s, you're relatively short, and I assume you're pretty inactive (?), so yes, your goal will be on the low side. However, 1000 calories per day is absolute nonsense. Please eat more than that. If you're exercising at all, you definitely need more than that.
You've lost 2 lbs in 2 weeks. Averaging a pound per week is fine, but not if you have to essentially starve yourself. Eat more and try to get your rate of loss to half a pound a week. You didn't say how much you want to lose, but since you're in the 140s, I wouldn't imagine it's all that much. Why rush it if it means eating less than a toddler needs?
How can you tell? You examined OP or something?
I second those who advise her to get a second opinion, especially if she is hungry very day, all day. It's not sustainable anyway.
A person's size makes a big difference. One or two inches even.
I cannot lose if I eat more than 1200, and in fact, I often stall at 1200. 1100 will make me lose .05 per week, if I am extremely strict. I am 45 years-old, 5'3", and I don't workout.
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OP: I hope you hear the advice you're getting. Chronic hunger is a pretty strong sign we're doing something wrong (not eating enough , most likely, or in some cases on medications or have a metabolic condition). Since you are losing weight, I'd take the advice to increase your calories. Someone gave you Scooby link, and MFP should also up your calories if you do the guided weight loss and set for 0.5 lbs/week loss which is really the max you want to be at your weight.
I too am concerned your doctor is setting you up to fail, so he can sell you his weight loss services, which he no doubt believes in. That is, he has a conflict of interest.
Also a shout-out to Doctors of Osteopathy. My PCP is a D.O. and he is absolutely amazing. Intelligent, perceptive, knowledgable about medicine... and only the second doctor I've ever had to actually LISTEN to me. Thanks to him my lupus, which nearly killed me, is under control now.1
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