Paraplegic need help!!!!

hellsintown

Okay Im lost. I need to figure out my proper BMR for a 39 year old male, 6'2 height, and 266 lbs with paraplegia (sedimentary during winter).

Second issue. The app has told me my BMR is 2740 calories a day. I set up for 2 lbs a week, which is 1000 calories off that. So my daily caloric intake should be 1740 calories a day. The problem is, every day I get to 1500 calories and hit total to check and Im just under and losing weight in progress. 1 more apple and the progress tracker says I will gain 1 lb in 5 weeks? Why is it say this if Im within the 1740 limit? I thought maybe starvation mode? So I started adding foods till it tallied up to 1740 calories. The tracker then told me I would be 2 lbs heavier in 5 weeks? Im sooo lost, is my app broken? 1000 under BMR should lose in the 5 weeks?

If someone can tell me the proper BMR for a sedimentary paraplegic...somewhat not true, but I'll go with that number in winter. I will stick to that caloric deduction and tally calories, but right now Im terrified that the app is misbehaving.

janesmith1

I think eating an apple when you have 1740 is fine. I just googled, an apple is just 95 cals. For males, 1800 is supposedly the bare MINIMUM of cals since your bodies burn differently than us females. For instance, for women the bare MINIMUM is 1200 cals and I know that being under 1500 a day usually gives me a daily weight loss amount.

Also that thing at the end that says "you will be x amt in 5 weeks" is just a model, not necessarily accurate. Hope this helps.

hellsintown

The problem Im seeing though, is the model is showing I will gain weight every time even if Im under my targeted calorie intake? So the app says I can have 1740 calories. If I have 1560 calories the model says "You will be 1lb heavier in 5 weeks"? The apple is nothing, just an example.

hellsintown

The other issue Im having is with 1800 being my bare calorie intake. I'm a paraplegic, so my body isn't burning calories the same as non para's. That number actually should be lower. I've heard so many numbers now that I don't know where to begin. Some say a paraplegic BMR is 20% lower than individuals without paraplegia. Some say I'm to knock off 500 more calories off the basic calorie needs of 1800 to 1300, that seems way to drastic. This is why weight loss is so hard for paraplegics. I need a solid answer to this number and cant find anything online. No point in spending 5 months dieting if my calorie intake is really 1500 and Im way above that every day.

booksgiver

Wow, you're asking a tough question here and I don't have an answer except to tell you of my own experience. I'm very sedentary due to severe rheumatoid arthritis in most of my joints. I can't walk or stand more a few minutes and I was 339 when I started here. I'm only 5'2" so my BMI was dreadful, 61 I think. When I entered my information I entered my wish to lose 2 pounds a week. Anyway, MFP started me out at a shocking 1580 calories a day...and I lost weight! Always before when I'd dieted I'd reduced my calories so dramatically that it made it so much harder to stick too. I was amazed as I thought I'd have to starve at eating below 1000 per day. As I lost weight my suggested calories deceased and has been at 1200 for several months now. It's not easy, but it is doable, and I'm not starving. I'm still losing between 6 to 8 pounds each month. What I'd suggest is not to worry about the apparent contradiction right now. Begin to reduce your caloric intake to the MFP initial suggestion and see what happens. Keep us updated and don't worry about an apple. I should eat them more often.

hellsintown

Yes it is tough, but your doing very well.

Ive lost 6 lbs in 2 weeks so far. But like I said if I do the numbers correctly BMR says 2740 calories, then I deduct 2 lbs a week off(1000 calories), making that number making it 1740. Now I think I could be losing tonnes more if I deducted the deficit for me being a paraplegic, but Im not sure what that correct amount is? That would be rough for me seeing it would put me, a 266 lb man eating only 1240 calories to lose 2 lbs a week.

janesmith1

The other issue Im having is with 1800 being my bare calorie intake. I'm a paraplegic, so my body isn't burning calories the same as non para's. That number actually should be lower. I've heard so many numbers now that I don't know where to begin. Some say a paraplegic BMR is 20% lower than individuals without paraplegia. Some say I'm to knock off 500 more calories off the basic calorie needs of 1800 to 1300, that seems way to drastic. This is why weight loss is so hard for paraplegics. I need a solid answer to this number and cant find anything online. No point in spending 5 months dieting if my calorie intake is really 1500 and Im way above that every day.

I found this online

"If you are already overweight, the calculation should be based on your desirable weight, not your current weight. For example, a person with tetraplegia (quadriplegia) whose desirable weight is 165 pounds, or 75 kg, needs 1703 (75 x 22.7) calories per day. A 165-pound person with paraplegia would need 2093 calories per day. Unfortunately, "this formula doesn't take into account your gender, age or activity level," Barton said. "You probably need 200-300 fewer calories per day if you're 50 rather than 20 years old. And you use more calories with activity." Even the amount of air in wheelchair tires can affect energy expenditure (less air makes it harder to push) and calorie needs. "

"
"People with SCI often ask me how many calories they need," Barton said. A formula to calculate calorie needs in SCI was developed in a 1985 study (2) that is still quoted widely today:

Persons with paraplegia: 27.9 calories times body weight in kg. (1 kg. = 2.2 lbs)
Persons with tetraplegia (quadriplegia): 22.7 calories times body weight in kg."

http://www.apparelyzed.com/forums/topic/19568-paraplegic-and-quadriplegic-weight-loss-tips/

JTick

I wouldn't worry about the whole "you'll weigh this much in 5 weeks"...I don't think that's been accurate for pretty much anyone. There are just too many variables in life.

Pick a calorie goal, and stick with it for at least 4 weeks. Then compare your actual results with expected. If you don't lose anything, lower it a little. If you lose too much, raise it a bit. If you stay the same, congratulations you found your TDEE.

rockmama72

The best example is going to be YOU. Log faithfully and see what happens after 4 or 6 weeks and then adjust.

AmykinsCatfood

I understand your issue but unfortunately don't have much to offer by way of numbers tweaking.

I do however have some advice regarding wanting to lose so much so quickly. Especially for someone who already has some muscle atrophy due to being paraplegic, I wouldn't aim to lose more than 1.5 lbs a week. You're going to lose a lot at first, it always happens that way but once that initial whoosh of water weight is gone, you're going to be sacrificing even more lean muscle by losing so much so quickly. It's a lot healthier to lose slowly, both on your muscles and your skin.

MargaretWalks

I am wondering if YOU are subtracting the 1000 calories in order to lose 2 lbs. a week?? The calorie level that MFP gives you has already taken into account the amount needed to lose the weight. I would say...trust the calorie amount that MFP has given you.

blazergrad

The best example is going to be YOU. Log faithfully and see what happens after 4 or 6 weeks and then adjust.

I wouldn't worry about the whole "you'll weigh this much in 5 weeks"...I don't think that's been accurate for pretty much anyone. There are just too many variables in life.

I have to agree with both of these statements. I've been a paraplegic for 23 years now and I've been diligently working out for about the past 3½ years. Even with exercising, though, I have to be very mindful of my diet because, as someone in a wheelchair, it is indeed very easy for me to start gaining unwanted weight with a relatively minor fluctuation in my overall average calorie intake.

I've been on MFP for somewhere around 4-5 years now and I've had plenty of time to adjust my calories up and down over the years to find what works for me. Unfortunately, there is no cut and dry formula... there are plenty of guidelines to go by and use as starting points, but what works for one person will not necessarily work for the next person. We're all different, and being in a wheelchair does throw an extra wrench into the equation as well.

For me, I found that when I average anywhere around 2,000-2,200 calories a day (or more, obviously), I started to gain a bit. The range where I seem to be able to maintain my weight is just below that.... maybe in the 1,700-1,800 range.... and if I average less than 1,500, then I start to lose. Again, this is with me exercising 4 days/week. Since I can't weigh myself, I either measure my waist or I just notice how my clothes are fitting.

My best advice is what Rockmama and JTick said .... log your calories faithfully for a few weeks, trying to stay within the same range, and see what happens and then adjust accordingly. Yeah, it's pretty much trial and error to start with, but after a while you'll start to get a handle on what does and doesn't work for you. And also note that if you can start to do some form of exercising, then obviously that'll help speed up any weight loss.

Greytfish

If you lost 6 lbs in 2 weeks, you're in a calorie deficit.

lcfairbairn74

You shouldn't be taking 1000 calories off your BMR, it should be 1000 calories off your TDEE. What amount of calories does MFP give you to eat?

Although you may need less than a sedentary person who is not paraplegic, you may not. If you're in a manual chair, you could be burning just as much as someone who isn't. I was in a wheelchair when I joined MFP and lost 40 pounds using the target set for me by the app.

mumblemagic

In terms of the predictions, I think that's an technical problem. I have a few suggestions:
1. In my app, I have current weight, starting weight and goal weight, activity level, net calorie goal and weightloss goal. From the activity level and current weight it calculates your BMR and TDEE. Do you have your activity level set up correctly? Mine is set to sedentary, and I add exercise calories from my workouts as extra.

2. Secondly, if it's specifically related to one apple, check the weight you have put in. I had a massive apple once that came to 200 cal, because it was huge! If it's a regular thing with any random foods, then you may want to submit a ticket to the app people.


Also

Although you may need less than a sedentary person who is not paraplegic, you may not. If you're in a manual chair, you could be burning just as much as someone who isn't. I was in a wheelchair when I joined MFP and lost 40 pounds using the target set for me by the app

This. A manual chair looks exhausting!

auddii

I wouldn't worry about the whole "you'll weigh this much in 5 weeks"...I don't think that's been accurate for pretty much anyone. There are just too many variables in life.

Pick a calorie goal, and stick with it for at least 4 weeks. Then compare your actual results with expected. If you don't lose anything, lower it a little. If you lose too much, raise it a bit. If you stay the same, congratulations you found your TDEE.

This. My "in 5 weeks" is never accurate.

mumblemagic

Just found this article:
http://ajcn.nutrition.org/content/77/2/371.full

It's a study on the metabolisms of paraplegic people vs non-paraplegic people. They found no significant difference between resting metabolic rate (RMR, similar to BMR) between the groups. This means all you have to adjust for is your activity level. Could you get a fitbit or HRM to monitor this?

As a physicist, I would guess that the primarly energy from activity levels for daily tasks goes to moving your body around, which takes as much physical energy for someone using their legs as manually propelling a wheelchair, even though the two functions use different muscle groups. So, from a physics perspective I would suggest going through MFP's guided goal setting thing on the website and try that.

blazergrad

Could you get a fitbit or HRM to monitor this?

Unfortunately, none of the current activity monitoring devices (Fitbit, UP, FuelBand, etc.) are accurate when it comes to wheelchair users. There are several published studies on PubMed that speak to the fact that the devices on the market today are not all that good at estimating energy expenditure during wheelchair propulsion and arm-ergometry.

However, there was a very recent study done at the University of Pittsburgh where they developed their own "PAMS" (Physical Activity Monitor System), as they called it, for use by manual wheelchair users. The results of the study indicated that the device could reliably track wheelchair-based activities, but I do not know exactly what metrics they looked at. Whether or not there are plans to actually develop and market the device, though, is unknown.

I know that I would love to have some type of device that could give me a relatively accurate measurement of my daily energy expenditure and with all the research taking place, hopefully something will come out.... but I also know that it would be a limited market, so it may not be something that's actually financially feasible.

mumblemagic

Could you get a fitbit or HRM to monitor this?

Unfortunately, none of the current activity monitoring devices (Fitbit, UP, FuelBand, etc.) are accurate when it comes to wheelchair users. There are several published studies on PubMed that speak to the fact that the devices on the market today are not all that good at estimating energy expenditure during wheelchair propulsion and arm-ergometry.

However, there was a very recent study done at the University of Pittsburgh where they developed their own "PAMS" (Physical Activity Monitor System), as they called it, for use by manual wheelchair users. The results of the study indicated that the device could reliably track wheelchair-based activities, but I do not know exactly what metrics they looked at. Whether or not there are plans to actually develop and market the device, though, is unknown.

I know that I would love to have some type of device that could give me a relatively accurate measurement of my daily energy expenditure and with all the research taking place, hopefully something will come out.... but I also know that it would be a limited market, so it may not be something that's actually financially feasible.

Interesting! My inner geek and gadget lover are cheering

OP:
In that case, I would suggest you measure your TDEE. There's a guide to doing this here http://www.myfitnesspal.com/topics/show/1111515-for-the-nerds-in-you-tdee-estimation-with-graphs?hl=TDEE+measurement+with+graphs&page=2#posts-17453890

I set up a spreadsheet myself to do it (for nerdy giggles) but there are a few pre-mades out there. You basically log religiously over a couple of months, measuring your weight on a regular basis and your total intake of calories on a daily basis. You can then export your data to csv using a google crome add-on, and load it into excel / openoffice / whatever spreasheet you like. Then from your weight measurements, you can calculate how many calories you have been in deficit/ over eaten in that time period, add those to your total calorie intake (or subtract if you have gained weight), then average them out and voila, you have measured your TDEE (or made a good estimate anyway).

You can either use this as a raw number, or you can use a BMR calculator and work out which activity level you best fit in by doing TDEE / BMR, and plug that into MFP. I found these numbers on a body-building forum:
1.2 – Sedentary: Little or no physical activity.
1.375 – Lightly Active: Light exercise or activity 1-3 days per week.
1.55 – Moderately Active: Moderate exercise or activity 3-5 days per week.
1.725 – Very Active: Hard exercise or activity 6-7 days per week.
1.9 – Extremely Active: Hard daily exercise or activity and physical work

Pick which ever one you are closest to and then stick that into MFP.

I'll load my spreadsheet onto google drive and PM you a link if you'd like, or you could send me the csv, I'll plug the numbers in and send you back a spreadsheet with your data instead of mine I love doing this kind of thing!

Sounds like a lot of work, and it may take you a couple of months of logging as you'll need to log every day to make sure you get an accurate estimation of your calorie intake, but I found it fun , and it would be really good for other paraplegic people on MFP to know if you feel able to do it.

mumblemagic

Actually, pretty pretty please would someone do this. I really wanna know the answer now..... such a nerd.

blazergrad

Actually, pretty pretty please would someone do this. I really wanna know the answer now..... such a nerd.

I would love to do it, but unfortunately I can't weigh myself. "Wheelchair" type roll-on scales literally cost thousands of $$... I think I once stumbled across some there were in the $700 range. While I would like to be able to weigh myself, there are a ton of other things ahead of a scale in the queue that I could spend that kind of money on.

Now, along those lines, I did find a platform scale on Amazon rated at 400 lbs. It's 38" x 20" in dimension, so while it's not big enough to wheel up on in a chair (and I do have a relatively compact manual chair), I could transfer out of my chair and sit on the scale. It's only about $260.... much more affordable. This one may be an actual possibility.