Doctor advice is always more important than internet forum strangers

MargaretYakoda

Disability makes weight loss and exercise tricky.
No two people are alike.
No two disabilities are alike.

ALWAYS CONSULT YOUR DOCTOR BEFORE BEGINNING AN EXERCISE OR WEIGHT LOSS REGIMEN

ALWAYS CONSULT YOUR REGISTERED DIETITIAN BEFORE DOING ANY SUDDEN OR EXTREME DIET CHANGES

klt052194

Excellent advice. Doing just that next week at the Miller Cardiology and Cardiovascular Institute at the Cleveland Clinic.
THANK YOU!

NerdyScienceGrl

MargaretYakoda wrote: »

Disability makes weight loss and exercise tricky.
No two people are alike.
No two disabilities are alike.

This is so true! Finding the balance that works for each individual is a journey of it’s own. I’ve done the drastic elimination diets to find out what food work and don’t for me. The food that not only fill me with joy but also physically satisfy my body’s needs. I had to learn how to prepare food differently, how to substitute for those things that I wanted but made me feel bad, and generally improve my outlook on health by forgiving myself for being human.

NerdyScienceGrl

I wasn't sure where to post this, but it seems to fit here with the Margaret's original post description about tricky weight loss. Originally posted in the Larger Loser group.

A lesson in patience and self-compassion

Learning to be compassionate with myself was extremely difficult and the thought of talking to myself as I would a friend felt foreign. During the last few months, it’s been a struggle but my body has been under a lot of stress and the last thing I needed to do is beat myself up. So with a little patience and some positive affirmations, "this too shall pass".

As the screen name suggests, I'm a scientist, statistician, and all around data nerd, so I have a big ugly spreadsheet of data that I update regularly. Given the stress I've been under and the non-linear scale movements, I thought I'd sit down, look at the spreadsheet and reflect some -- and ramble at ya'll in the process (or those willing to read this long winded space-taker-upper).

A little about me —
About 10-yrs ago (in my mid-30s), I learned I won the genetic lottery ; probably shouldn’t have tested my mortality so many times when younger; and that a highly physical, outdoor career had led to some pretty serious lower back issues — osteoarthritis and associated things like bone spurs; loss of curvature in the spine; and, degenerative disc disease. As a consolation prize, I have arthritis in both hips. For my 40th birthday, I gifted my neurosurgeon with a nice down payment for his new BMW and in return, he put an artificial disc in my lower back.

To say this changed my life would be an understatement. I went from week long horseback camping trips, long hikes with a pack (work and enjoyment), fly fishing (lost the ability to balance in-stream), and much more, to being much more sedentary. Combating pain meant almost a 180 in lifestyle (or so I felt at the time), introducing a range of medications to deal with inflammation, pain, depression, and ultimately weight gain. I was never thin, but I also was never held back by my weight.

Fast forward to 2018, and I’d had enough, and made massive lifestyle changes — diet, exercise, mindfulness, compassion, patience, and a 65lbs weight loss in the process.

Although I “fell of the wagon” of healthy habits when COVID hit my community hard, I woke up at the beginning of the year, made my mental health a priority, returned to the healthy habits and lost the weight I gained during COVID and was doing great!

The here and now —
So, recently my self-compassion and patience have been tested by inflammation and pain. I’ve generally been able to keep these things under control with diet and exercise. Once or twice a year, I’ll need a steroid pack to get on track, but a recent attempt didn’t work, so I have a doctors appointment tomorrow to start what will likely be a long drawn out process of tracking down and treating the issue.

Because of the arthritis, I work very closely with my PCP (I've probably bought her a BMW or two). Although I saw her in early June, and again in early August, in preparation for my appointment tomorrow I wanted to take a good look at weight. Here is the graphic I came up with -- I'll explain more below it.



What's in the graphic
Each of the horizontal black axis represent 5 lbs to give you an idea of scale.

Red w/ blue dots (the "actual") are weekly average weight for the past 14 weeks. I'm self conscious so I removed the lbs from the axis.

The red dotted line is the actual weight trend for that period -- or the 'uphill battle".

The black and orange dots are the average weight I’d be at, based on calorie deficit, in a perfect world (for descriptive purposes, the “projected”).

Next the colored boxes over the graph represent "stress" —
Blue - in mid-May my emotional well-being went to *kitten* as I dealt with some personal issues. I chose a cut-off date based on when eating habits went back to "normal" although that stress didn't magically disappear on a given date.

Yellow - I sustained an injury that was the true kick off of uncontrolled inflammation and pain (ongoing)

There is a period where the yellow and blue boxes overlap, I dropped weight, and fast, due to some very unhealthy life choices.

Green - The period I took the prednisone to try and combat inflammation.

_____
Statistics and other info that goes with the graphic
Total days included: 100 (14 weeks)

Consistently logged calories:
-June 6 - June 30
-Aug 9 - Sept 13.
-The between period was logged but has 17 days missing.
-Based on actual, not averaged data, I’d have had to consume calories far in excess (on the very low end 1500+) of my TDEE (around 2000 +/- 100ish) each of those unlogged days to explain weight increases between weigh-ins.

Of the days logged, I was over my TDEE 6 times that totaled 2,625 calories or 0.75 lbs. These overages were minimal and infrequent, so they didn’t compromise my “projected” weekly averages

On days I wasn’t over, my deficits were inconsistent and ranged from 1 to 3551 calories (let's not talk about those high calorie deficit days.. )

My average weekly “projected” loss was 1.3lbs but ranged from 0.4 - 3.6lbs. In no week did the average equate to gaining
-The difference between the “actual” and “projected” weights in mid-Sept is 19.4 lbs. (Shocking, eh?)

My weigh-ins were sporadic throughout and don’t always include 2 or more weights but that wouldn’t change the trend (I graphed actual too).

The two highest “actual” points are likely inflated weights from taking the prednisone and represent increased overall inflammation from eating things like donuts (damn donut commercials! ) and cheese which my body HATES. I had zero willpower the last few days on the steroid and on one of those days likely exceeded TDEE by 1500 calories -- not logged, too ashamed to even look at it, but know what I ate... eesh! I also tend to carry a lot of excess water after taking prednisone. The decreasing average actual weight after is likely the loss of water.

With the exception of the prednisone days, overall, I ate my standard diet of "anti-inflammatory foods". For those interested that might have been curious, sorry, my MFP diary is private. Instead of seeing it as an accountability tool, I’d likely end up with some seriously disordered eating habits (with notes that read like an apology for committing some sort of atrocity against humanity when over/under eating) and couldn’t handle feedback. Not a compassionate move for me.

Until the last few weeks, I had difficulties mentally (lack of motivation) and physically exercising. If this were going to show up, it'd been in the last dot on the actual averages, and I ate back the vast majority of those calories - so theoretically is a wash.

Sleep has been all over the place for majority of the period. Generally between 4 and 6 hrs. Even when sleeping for 6+ hrs the quality has been poor and my fitness tracker shows very little recovery happening (high stress and low body battery numbers in the AM).

_____
So what does it mean (for me, and my interpretation) —
First for clarity, this is a snippet of data that felt pertinent to my current situation. Also, because these are averages over 7-days, the first dots show nothing of actual importance but a starting point -- but, you’ll see my “actual” loss was above the “projected”. Yay me!

Using the widely circulated graphic I see on the forum (below), “safe” loss for me is somewhere between 1 and 1.5 lbs (I’m unclear how “Total Loss” is determine - BMI?) based on the 1% of total body weight. Given an average “projected” loss of 1.3/wk, it feels like my calorie deficit is in the okay range.



There is the potential that I'm under eating given my current situation -- however, there is a fair amount of information that suggests that calorie restriction, can be effective at lowering inflammation. Seems like a double-edged sword to me.

Looking at this from a purely CICO take -- 100 days, all weeks averaged out to a loss (even if minimal) although the actual weight trend suggests otherwise. If I removed highest weight as an "outlier" from the prednisone, the dip from bad life choices (another outlier), that would flatten the line, but there is always going to be outliers in weight loss (no cherry picking data here!), and even a flat-line doesn't have a downward trajectory.

Okay, so what could it be?
How are my clothes fitting? ...fat pants baby! all the way -- no mm, cm, inches lost only gained.
Am I under-eating? ...highly unlikely since, I "honor thy hunger" and eat to fuel myself on the days that I feel significantly more hungry, more worn down, or pain levels are higher. I have no issue moving to maintenance and eating at my TDEE (or over) if my body is telling me I need it.
Not eating enough protein? ...well, protein is something I do struggle with, but the appetite suppression isn't a problem - I'm generally not overeating (barring prednisone induced donut binging). Metabolic slowdown? Seems unlikely.
Too many carbs? ...I don't buy that carbs make me, personally, fat so -- nope.
Too much sugar? ...nope, natural sugars only in limited quantities and artificial sweeteners are the devil and create some pretty horrific inflammation for me.
Not enough water? ...100+ oz a day isn't enough?
Too much alcohol? ...meet the dip in "actual weight" early on.. hello bourbon diet! ...a full-time bourbon diet would probably be a bad idea. Outside of that period, no alcohol.
Processed/junk good? ...don't we all eat some? Overall though, I eat fruits, veggies, animal proteins (unprocessed but I do love me some salami from time to time), whole grains... I cook at home most of the time. I did an elimination diet to tell me what my body doesn't like -- a number of ingredients you find in highly processed foods make the list.

...I don't eat perfect, I definitely consume things that create inflammation, but I'm also human and can't always deny the need for something yummy that I haven't had in awhile.

So, is it a logging issue?
While I missed logging days during the period, those that I did log, are based on the theory, "if the food/drink goes in my mouth, I log it" ..if I log it, it's been weighed. I check entries in MFP that seem off and unreasonable. MY TDEE is based on my Garmin Connect, which automatically syncs with my scale app, so it updates with each weigh in. My MFP is set to sedentary because I have an office job, and well, it's appropriate for the time series in question. It is my understanding that's based on 3,000 steps, well, I'm sure there are days that I didn't get there. During the early part of the data set, I did not have "negative calorie adjustment" set on my MFP, so if I didn't get the 3,000 steps, there may have been some calories subtracted from my deficit, but even those calories wouldn't have had a large enough impact to change my weekly averages. With any shift in weight (generally +/- 5 lbs), I updated my MFP calorie targets. Doesn't seem like a logging issue. So what is it?

Stress (ding, ding, ding.. it seems we have a winner..?)
Between the stressors, particularly the chronic inflammation, it appears my body is fighting me to actually realize any significant loss. Total actual loss over the 100 days is - drum roll please -- 0.7 lbs. I'll take it, it wasn't a gain! As I’ve read/heard many times weight loss isn’t linear.

In the "perfect world" (projected) scenario, based on CICO, I'd have seen about a 19lbs weight loss. I know from the past, I can carry around a significant amount of inflammation weight, but not 19lbs. Add in additional water weight from any number of things (stress, carbs), and I'm still not sure that equals 19lbs.

Yep, stress and it's constant companion lack of or quality sleep. No good sleep - no repairing.

Seems stress is a *kitten*. So is gravity! ...Karma's long lost sisters, maybe?

What did I miss?
_____
BUT, this all gets back to patience and compassion.

I didn't start my "journey" to drop as fast as possible, to serve a petty means.. instead to improve my health, try and outwit my genetics, and prolong life. So, in that vein... am I frustrated? With the pain, yes. With the inflammation, yes. But not with the scale. Sure, I'd love to see that 19lbs translate into real loss and they will eventually, but until, I will be patient. I will continue to do what I do because.. well, if I hadn't, what tale would the scale tell? I won't allow the numbers on the scale to dictate how I feel about myself. I will continue to cater to my mental and physical health. I'll honor my body and treat it with compassion. It's all about the journey, but damn the destination seems far off sometimes!

“Patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish.” -John Quincy Adams

If you made it this far.. WOW! Thank you. Constructive feedback is absolutely welcome and invited.

MargaretYakoda

Wow! @NerdyScienceGrl that is amazing!

MargaretYakoda

There’s some people on the forums who love love love to give out unsolicited medical advice.

I am about to lose my patience with people who insist that diabetes only has one root cause.
Or that keto is the only way for everyone else on the planet.
Grump grump grump