How do I get past my bitterness with previous doctors, trainers, dieticians unable to help?

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  • moonangel12
    moonangel12 Posts: 971 Member
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    Read around on here and you will see a trend to the threads asking for advice - the seasoned veteran posters will ask for specifics, double check information, because they do want to help! And in order to do so there is a basic amount of information needed. The questions asking about weighing food are common because people will throw a calorie count out there, but weren’t accurately weighing their food (either eyeballing, going by packaging, roughly measuring). You even mention in your OP that you TRIED to be honest. That makes a huge difference on MFP - every bite needs to be logged accurately. Believe it or not, people ctruly are trying to help.

    And counseling is another recommendation because this is a weight loss forum, and with that comes some people who are not mentally or emotionally ready to do what they want or need to do (and alternately some people have a skewed perception of reality making weight loss a dangerous venture). People do want to listen, it’s hard when everything they say gets shot down though. I had a “friend” IRL that was like that in nearly every conversation and it.was.exhausting (and honestly, I had a few years of deep depression and was likely that friend for a while as well).
  • norman_cates
    norman_cates Posts: 95 Member
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    Yeah, so in order to get anyone to talk, I have to not ask questions? Not say where it hasn't worked for me before? Not describe my problems and why I distrust?

    All that's going to do is make me lie to everyone.
  • GummiMundi
    GummiMundi Posts: 396 Member
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    norman_cates wrote: »
    Yeah, so in order to get anyone to talk, I have to not ask questions? Not say where it hasn't worked for me before? Not describe my problems and why I distrust?

    All that's going to do is make me lie to everyone.

    It doesn't matter if you lie to everyone or not. In the end of the day, the only "victim" of those hypothetical lies will be yourself.

    I truly hope you can find some help that suits your needs, here or anywhere else.
  • norman_cates
    norman_cates Posts: 95 Member
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    moonangel12 wrote: »
    Believe it or not, people ctruly are trying to help.

    And counseling is another recommendation because this is a weight loss forum, and with that comes some people who are not mentally or emotionally ready to do what they want or need to do (and alternately some people have a skewed perception of reality making weight loss a dangerous venture). People do want to listen, it’s hard when everything they say gets shot down though. I had a “friend” IRL that was like that in nearly every conversation and it.was.exhausting (and honestly, I had a few years of deep depression and was likely that friend for a while as well).

    I do think people are trying to help. The last three or four days have been awful for various reasons and it all became way too much. And yes I am thrashing around.

    I'm feeling a LOT better now, a combination of yes, talking to a counsellor about a lot of stuff (not just this) and finding my old SSRI meds which I haven't needed in ages, but now... I think they are being helpful.

    I am FULLY aware that I am being "that guy" that has been negative and exhausting to talk to.

    I am feeling better, but it still doesn't stop my needing to ask why no one has any consistent information. At least, it seems that way. I am also in the process of using this lockdown for the next month to log EVERYTHING accurately. My exercise (as best I can with a Fitbit), my food since we can't get fast food for that time so everything is made by me or packets.

    In some ways, this is actually a golden situation to test what the heck is going on with me...
  • norman_cates
    norman_cates Posts: 95 Member
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    AnnPT77 wrote: »

    So, I believe Rhedd (among others) is suggesting you log ultra-meticulously and ultra-honestly for a few weeks, and compare yourself to estimates from MFP (recognizing it expects you to add exercise calories separately), TDEE calculator formulas, and/or your fitness tracker's estimate . . . and see how close these are. Some methods may be closer than others, for you personally, but it's also conceivable that no method will be close at all.

    If it's the latter, your own data is sufficient to guide what you need to do, going forward. (I admit, in saying this, I'm expecting you to take seriously the idea that calories are body energy in the same way that gasoline is most cars' energy, and that there'll be a relationship between energy input and energy output. But I'm saying you could be right, and that you burn gas like a Prius, super thrifty at 50-some mpg, not like a 1970 Ford Impala's 15mpg . . .er, calories, not gas ;) .)

    After a few weeks of careful, honest logging, you will have actionable data you can use. If you choose to, and only if you can buy into that basic idea that energy isn't magically created or destroyed, i.e., 1st law of thermodynamics.

    First, thank you for your INCREDIBLY long and kind post.

    Although I am aware that calorie burn (and for that matter the calories stated in food) is an estimate, explaining the underlying reason why they may be inaccurate AND WHY the companies cannot account for it is very helpful.

    One comment / question I would have was that I wear my fit bit all the time, so it does gather my resting heart rate at night. I assume that it plugged into these calculations to give a more accurate calorie burn?
    I also believe in Thermodynamics. Which was why I was searching for other reasons for my failure to lose weight than assuming that I was a physics freak and should be immediately studied... for SCIENCE!

    The thing is that the calories in, calories out equation ASSUMES that our bodies use food in exactly the same ways. But we know that's not the case. People with hypoglycemia have a reaction to sugar that excretes too much insulin and that shuttles the sugars etc into fat storage. People with diabetes have too little insulin and so can lose weiught because the insulin isn't shuttling sugars, and proteins into the right places. Like muscles, glycogen, and indeed fat storage.

    I see almost no one acknowledge that. The closest is the fad diets (or lifestyle eating) like Paleo, keto, meat only diets. Many of which have no expectation to stay on.

    Why remove an entire macronutrient group (carbs) if your body DOESN'T treat the parts of food differently.

    If my body is incredibly efficient and can break down food into energy at a better rate than others, then I will have to eat less. None of the calories plans account for that, or seem to allow for that possibility.

    Surely if you were able to guarantee that you were logging as accurately as you could, and using the standards fitness models for calorie burn, and you keep doing that. And see how your weight goes. (But also presumably take many other measurements to establish if it's muscle or fat going....)

    Then you see the predicted slope of weightloss, vs the actual slope of weightloss. And it should be ridiculously easy at that point to make one change (say change how much you eat) for a few weeks, probably a month, and compare again. Your estimated energy expenditure would keep using all the same equations so even if your exercise changed, it SHOULDN'T (touch wood) count as a second variable.

    I don't recall seeing ANYTHING like that ANYWHERE...

    Note that I am not advocating counting calories for all our lives. That's no way to live.

    But in order to discover how OUR bodies are reacting to calories etc, we need to do the experiment...

    I have never seen anyone suggest it. Until now really. I don't know if that was your intent, but that's pretty much exactly what you are saying you did...

  • MaltedTea
    MaltedTea Posts: 6,286 Member
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    First off, glad you're feeling better, Norman!

    Some of the experiments you're talking about aren't ones that can be done independently, at home. You'd need a kinesiologist, access to a Dexa scanning machine (and the expert to interpret), regular blood tests, etc.

    Like, nobody's got time for all that. Unless you're a celebrity or, like, Tim Ferris and full of biohacking curiosity. (I can only imagine what he's up to in quarantine right now. I'm sure we'll get a book about it.)

    Instead, as I mentioned somewhere before: we make do with what we have.

    And then we expect to see a general trend towards our desired result based on reliably tracking our efforts.

    For some, that's weight loss, pure and simple. For others, it's body composition (which may mean you gain, you lose, or you stay relatively the same). For others, they just want to ensure their bloodwork or other diagnostic testing results come back less sucky. And still, others have some combo of these.

    Lastly, if you check the maintenance thread: there are people who are counting calories for the long-term. They may be weighing themselves regularly too. That's what works for them.

    You'll need to find what, ultimately, works for you (within the parameters of generally accepted science, of course, as patiently explained in large part by @AnnPT77)
  • norman_cates
    norman_cates Posts: 95 Member
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    Again, thank you for an incredible amount of words, and I appreciate the time this took you.

    To address your last comment, no it's totally fine. I demanded (totally the right word) ideas and some level of evidence and new thoughts. You have kindly taken the time.
    AnnPT77 wrote: »
    I also believe in Thermodynamics. Which was why I was searching for other reasons for my failure to lose weight than assuming that I was a physics freak and should be immediately studied... for SCIENCE!

    The thing is that the calories in, calories out equation ASSUMES that our bodies use food in exactly the same ways. But we know that's not the case. People with hypoglycemia have a reaction to sugar that excretes too much insulin and that shuttles the sugars etc into fat storage. People with diabetes have too little insulin and so can lose weiught because the insulin isn't shuttling sugars, and proteins into the right places. Like muscles, glycogen, and indeed fat storage.

    I see almost no one acknowledge that. The closest is the fad diets (or lifestyle eating) like Paleo, keto, meat only diets. Many of which have no expectation to stay on.

    I think you're looking at the CICO balance differently than I do. Please understand that I'm making a distinction between CICO (the balance, or equation, which is basically just a restatement of the laws of thermodynamics taken to the special case of weight management), vs. calorie counting, the set of processes some people use for weight management or to "diet". There are different methodologies for calorie counting as a weight management tool; the CICO balance is a more basic idea.

    To a certain extent, calorie counting methodologies do assume that all humans have similar bodies. Statistically, all humans do. ;) So, it's a valid statistical assumption. But there can be outliers.
    There are outliers, but calling them outliers is diengenous because they are pretty common.

    I have two friends who roomed together and ate the same meals. One ate more than the other and was thin and maintained or lost weight, the other was a bit chubby and gained weight.

    This is 100% anecdotal in that there were no controls, no proper observations.

    What isn't anecdotal is that the thin friend was diagnosed later with a condition that meant he didn't digest all his food properly.

    Now that's a medical condition and so you may be right in dismissing it out of the box. But there are many people, even within the same family, who have significant differences in their weight, with the same environment. We all know the hard gainer, or the hard loser (as it were.)

    You go on to discuss of course some ideas that are pretty much exactly what my concern is.

    The calorie values in food are NOT the values that our bodies use. They are the values from an ash test. The food is literally burned and the carbon dioxide given off is measured. (IIRC). That's 100% caloric use.

    Say the average person uses 60% of the caloric value of food. This would be the effective number that all these equations use. If my body happens to be able to utilise 75% of the caloric value of food, then I would need to eat, I think, 20% less calories for the same result.

    As you say in other parts, it then comes down to the testing and experimental stage. Absolutely.

    BUT, no one provides the tools to show the theoretical graph line, compared to your actual graph line. We can see our weight in MFP, and the track over time.

    But there is NOT (unless I missed it) a graph showing the theoretical weight loss given what we have entered in.

    That would be an extremely simple and graphic way of demonstrating how you are doing in reality, against the theoretical. And would allow adjustment pretty easily.

    But i have never seen that suggested. I know that people say weigh yourself and see how you are doing. But there is nothing to compare that current, real number to.

    Having a theoretical weightloss would be a doddle for any of these programs that we enter in food and exercise.


    AnnPT77 wrote: »
    <SNIP>

    When not in a deficit, the body (IMU) prefers to burn calorie intake first, and in a calorie surplus (in a person on a balanced diet, because I don't want to veer off into keto) will generally burn carb intake preferentially, and store fat intake preferentially, because that's the efficient thing that natural selection has helped us to do through millennia of food scarcity (unlike our current abundance).

    Burnable energy is essentially carb-y/sugar-y stuff (glycogen and friends). Stored fat is essentially fat. The model you're suggesting is that eating carbs, even in a deficit, will encourage the body to jump through biochemical hoops to convert the carbs into fat it can store, while . . . I guess? . . . simultaneously biochemically jumping through other hoops to convert the fat into the kind of stuff the body can actually directly utilize? That doesn't make sense to me.
    Buuuut, it does often do exactly that. Or at least, remove glucose from our bodies at a rate that drops our blood sugar below the level our brains like and so we feel hungry again.

    It's the classic high carb energy dip.

    And our brain is the most demanding organ in our body and will protect itself like billy oh from lack of glucose. If the brain can't stop that dip from happening in healthy people, and even less so in hypoglycemics then why isn't this a scenario that absolutely happens.

    I used cagey language above because the glucose could be shuttled to glycogen storage in muscles or liver and probably is before it goes to fat storage.

    But my point about hypoglycaemia or indeed diabetes wasn't to say that this is is a reasonable mechanism to explain much, but that it was simply an example where it does have a different effect, and the parts of food are not treated the same by the body.
    Surely if you were able to guarantee that you were logging as accurately as you could, and using the standards fitness models for calorie burn, and you keep doing that. And see how your weight goes. (But also presumably take many other measurements to establish if it's muscle or fat going....)

    Then you see the predicted slope of weightloss, vs the actual slope of weightloss. And it should be ridiculously easy at that point to make one change (say change how much you eat) for a few weeks, probably a month, and compare again. Your estimated energy expenditure would keep using all the same equations so even if your exercise changed, it SHOULDN'T (touch wood) count as a second variable.

    I don't recall seeing ANYTHING like that ANYWHERE...

    <snip>

    But in order to discover how OUR bodies are reacting to calories etc, we need to do the experiment...

    I have never seen anyone suggest it. Until now really. I don't know if that was your intent, but that's pretty much exactly what you are saying you did...
    AnnPT77 wrote: »
    That's EXACTLY what I'm trying to say, if I understand you correctly. And I think it's what various other people in this thread have been trying to say, too.

    Maybe? But like everyone else it's all been couched in fuzzy vague language. "Count everything, then see how your weight is doing". Without a comparison point, that's actually a useless statement. I mean, I made that statement to make a point, so it's very much a straw man. But I don't see anything more helpful being suggested.

    We KNOW MFP can do these calculations instantly because when you complete a day of meals it says "If you kept on this path, you would be XXXkg By April 30th" or similar.

    But it just does that ONCE. It doesn't graph it for you. It doesn't do a running average or a best fit line for your theoretical weight loss based on your last two weeks of measurments. Unless I've missed it...

    This now seems very obvious to me to have...


  • rheddmobile
    rheddmobile Posts: 6,840 Member
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    Re: insulin and diabetes. I’m a type 2 diabetic and I can give you some insights into this. You aren’t wrong that in type 1, and in extreme cases type 2, it’s possible to ingest food which your body can’t metabolize because of lack of insulin. That actually happened to me before I was diagnosed - I had an unrelated medical situation (ovarian tumor), and my cortisol levels, which block the action of insulin, shot way up, so for about a month until they figured out what was going on with me I was operating without enough insulin.

    Trust me, if you had anything similar going on, you would notice. During this month I continually felt like I was starving, my extremities hurt, and I could barely get out of bed. I ate entire bags of peppermint candy trying to stop from feeling hungry. And I lost 25 lbs in a month.

    This level of metabolic disorder also tends to show up on blood tests. When I presented at the ER at the end of the month my blood glucose was 272 and my a1c was 11. Normal is under 100 and about 5. The only reason the diabetes wasn’t caught earlier is that at the beginning of my symptoms when routine bloodwork was run, the doctor didn’t bother mentioning the results!

    Anyway, for healthy people, there is some relationship between insulin levels and appetite, but it’s fairly minor. A healthy body does a good job of keeping things level.

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