NHS very low calorie diet help

parkscs

Find a new dietician.
With 65lbs to lose, there is no reason to eat that little.

THis^^ x1000

Responses like this always amaze me. Did you read the thread? If the OP swears she's not losing at 1200 calories per day over a sufficiently lengthy period of time such that fat loss could not be masked by water retention, why would eating more ever produce better results in terms of weight loss? That's just illogical. What's more likely is that due to inaccuracy in logging, the OP's 1200 calories is not truly 1200 calories. Just because I log 1200 calories doesn't mean that I didn't eat 1600 or 1800 calories, and telling me to start eating more just exacerbates this problem (e.g., I log 1600 and eat 2200). What's also a very real possibility is that all of these diets the OP has tried haven't lasted long enough for the OP to see results. Yoyo'ing between various diets with breaks of uncontrolled eating in between and not sticking with any of them long enough to see results is a great recipe for getting bigger over time. But if that's the case, eating more during the diet phase of the yoyo will just make things worse. And there's always the possibility that the OP is 100% accurate and is dealing with an undiagnosed medical issue or a side-effect of a drug she's taking, but if that's the case, telling her to eat more is again just going to exacerbate the problem. In short, there's almost never a situation where eating more will break a long-term plateau or will stop long-term weight gain as we're seeing here.

This is a bit of a rant on my part at this point, but weight loss goes beyond just plugging numbers into a calculator and getting a calorie target. That simply gives you a rough estimate for your starting point and going forward you should be adjusting your targets around the results you're seeing. If you're not losing at the rate you should be over a lengthy period of time, drop the calories ~10%. If you're losing too fast over a lengthy period of time, up the calories. But it needs to be based on results, not just ballpark estimates based on someone's stats.

Just my $0.02, but the OP's doctor is probably putting her on "meal replacement" products because it's a controlled environment. I can log 1200 calories but that doesn't mean I actually ate 1200 calories, and if I'm not weighing my foods and/or preparing my own foods, it can be difficult to get a very accurate estimate. On the other hand, "meal replacement" products are fairly well controlled. A shake is always going to be around X calories, a prepackaged meal will always be around Y calories, and so on. I suspect they're recommending that sort of diet plan to see whether the OP truly can't lose at 1000 calories or if perhaps the reason for the lack of loss was inaccurate tracking. But in any event, I just can't understand all the posts saying "your doctor is a quack, eat more!"

sweetsarahj

Has your doctor considered / tested you for metabolic syndrome? I've read that can stop people from losing weight even when they are exercising and eating right.

sweetsarahj

Also- have you considered having your TDEE (Total Daily Energy Expenditure) measured? That would tell you how many calories you're burning every day, and give you a better handle on how much of a deficit you should have in your diet.

sympha01

-Can add spices/herbs/stock
-1000 Calories max per day.
- 2 Fruit portions 50 calories max each
-Skimmed milk allowance = 1/2 pint
-2 Portions of veg [no potatoes] = 75 calories max
-No other foods allowed.

Can I just say, I don't even think this adds up right?

50 calorie fruit X 2 = 100 calories
1/2 pint skim milk = 100 calories
75 calorie veg X 2 = 150 calories
Total = 350 calories max

I think you have mis-interpreted something in the advice given. That is not even approaching "1000 calories max."

Generally I am sympathetic when people have a hard time sticking to a VLCD, but the diet plan you outlined is NOT actually something that a nutritionist or dietician would recommend for anyone for 12 weeks. So either:

1) you're leaving some crucial piece of information about the diet out, or
2) you have massively misunderstood the advice you were given
3) your "dietician" should be prosecuted for fraud and/or malpractice.

I know you want us all to go with door number 3 here. But given the history with your medical providers you've provided I'm suspecting something a little willful going on around door number 1.

davidbernstein148

I'm currently doing a 1200 calorie a day diet myself. My wife did 900 calories a day.

It looks like your carbs are way too high and your protein is way too low, at least the way your dietician set you up, which is going to set you up to fail. Protein and fat makes you feel full, feeling full helps keep you on the diet.

Here's my plan with my wife's in parantheses if you're interested in trying it instead. You'll need to convert weights as I'm American.
Breakfast
6 oz (4 oz) chicken breast boneless skinless
2 - 60 (1 -60) calorie thin slice bread with butter
Lunch
6 oz (4 oz) chicken breast boneless skinless
1-2 serving broccoli (or other vegetables)
Dinner
6 oz (4 oz) chicken breast boneless skinless
8 oz (6 oz) greek yogurt with cut up fuji apple and cinnamon

We also took multi vitamins and drank piles of water. Those are pretty important steps because your body will need those minerals to aid the weight loss. Also if your BMI is over 40, at least state side, you don't need any comorbities for bariatric surgery, so I find it odd that they'd refuse to give it to you since you likely have high blood pressure or bad cholesterol at that BMI. If all your health indicator are fine however and you're not suffering health problems as a result of your weight, I'd lay off the dieting and tell them to stuff it, since you're basically healthy.

lfetter61

Do not have weight loss surgery. I had a realize band put in over 5years ago, a total waste. The only thing I found out is that I don't eat a lot. My problem is not consuming enough protein and too many carbs. I find that no matter what my calorie intake is, if I don't have a lot of protein and very low carbs, my body will not give up the weight. For the past month I have been watching what I'm eating and working out 1 - 2 hours 5 days a week. Lost maybe 3 pounds. So I'm tweeking my plan. I increased my calorie intake from 1200 to 1500 calories and going to add protein shakes since I am so low on protein. Hopefully, adding the protein will help the weight come off. I have to say, all the exercise is tightening the body up, its just my body doesn't like to give up the pounds.

As with your meds (fluoxetine) it can make you hold onto weight as it also has helped people lose weight. I do think your calorie intake is very low, I would either talk to your doctor about raising your calorie intake, and increasing exercise to a minimum of 60 minutes 5 times a week - or get another doctor.. 30 mins just warms up your body. Also, the endorphins released during exercise will help depression.

One other thing I found helps, drink lots, lots of water and don't eat after 7pm.

Meikakiri

Has your doctor considered / tested you for metabolic syndrome? I've read that can stop people from losing weight even when they are exercising and eating right.

Depends is that the same as hypothyroidism?

Meikakiri

I'm currently doing a 1200 calorie a day diet myself. My wife did 900 calories a day.

It looks like your carbs are way too high and your protein is way too low, at least the way your dietician set you up, which is going to set you up to fail. Protein and fat makes you feel full, feeling full helps keep you on the diet.

Here's my plan with my wife's in parantheses if you're interested in trying it instead. You'll need to convert weights as I'm American.
Breakfast
6 oz (4 oz) chicken breast boneless skinless
2 - 60 (1 -60) calorie thin slice bread with butter
Lunch
6 oz (4 oz) chicken breast boneless skinless
1-2 serving broccoli (or other vegetables)
Dinner
6 oz (4 oz) chicken breast boneless skinless
8 oz (6 oz) greek yogurt with cut up fuji apple and cinnamon

We also took multi vitamins and drank piles of water. Those are pretty important steps because your body will need those minerals to aid the weight loss. Also if your BMI is over 40, at least state side, you don't need any comorbities for bariatric surgery, so I find it odd that they'd refuse to give it to you since you likely have high blood pressure or bad cholesterol at that BMI. If all your health indicator are fine however and you're not suffering health problems as a result of your weight, I'd lay off the dieting and tell them to stuff it, since you're basically healthy.

Thanks for the info adding it to the suggestions log i'm creating ^_^ , it's causing problems in my day to day, I don't like how I look, I can't find clothes that fit, It's giving me back problems as well.

Meikakiri

-Can add spices/herbs/stock
-1000 Calories max per day.
- 2 Fruit portions 50 calories max each
-Skimmed milk allowance = 1/2 pint
-2 Portions of veg [no potatoes] = 75 calories max
-No other foods allowed.

Can I just say, I don't even think this adds up right?

50 calorie fruit X 2 = 100 calories
1/2 pint skim milk = 100 calories
75 calorie veg X 2 = 150 calories
Total = 350 calories max

I think you have mis-interpreted something in the advice given. That is not even approaching "1000 calories max."

Generally I am sympathetic when people have a hard time sticking to a VLCD, but the diet plan you outlined is NOT actually something that a nutritionist or dietician would recommend for anyone for 12 weeks. So either:

1) you're leaving some crucial piece of information about the diet out, or
2) you have massively misunderstood the advice you were given
3) your "dietician" should be prosecuted for fraud and/or malpractice.

I know you want us all to go with door number 3 here. But given the history with your medical providers you've provided I'm suspecting something a little willful going on around door number 1.

Actually I stated in the original post that it included 3 meal replacements as shown in the diet plan. Also I stated I think my dietitian is doing the best he can with the data available hence why I started a topic asking for recipes that work within the limitations of the diet so i'm not munching carrot sticks every day.

Meikakiri

Also- have you considered having your TDEE (Total Daily Energy Expenditure) measured? That would tell you how many calories you're burning every day, and give you a better handle on how much of a deficit you should have in your diet.

Dietitian said there was no absolutely accurate way of measuring it.

Dragonwolf

Has your doctor considered / tested you for metabolic syndrome? I've read that can stop people from losing weight even when they are exercising and eating right.

Depends is that the same as hypothyroidism?

Egads, your doctors have you stuck on the thyroid thing, don't they?

No, it's not.

http://www.nhlbi.nih.gov/health/health-topics/topics/ms/

Dietitian said there was no absolutely accurate way of measuring it.

She's right in a sense -- you can't get a perfectly exact number, because it changes based on circumstances, so there will probably still be some tweaking in practice, but that's also thanks to inaccuracies in nutrition fact labeling, too.

However, you can get your resting metabolic rate tested, and it's considered to be fairly accurate.

http://www.sparkpeople.com/blog/blog.asp?post=the_most_accurate_way_to_measure_your_metabolism

Combine that with other tools, such as a FitBit, and you can get a fairly accurate measurement of your TDEE. Quite a bit more accurate than the online calculators, generally.

Meikakiri

She's right in a sense -- you can't get a perfectly exact number, because it changes based on circumstances, so there will probably still be some tweaking in practice, but that's also thanks to inaccuracies in nutrition fact labeling, too.

However, you can get your resting metabolic rate tested, and it's considered to be fairly accurate.

http://www.sparkpeople.com/blog/blog.asp?post=the_most_accurate_way_to_measure_your_metabolism

Combine that with other tools, such as a FitBit, and you can get a fairly accurate measurement of your TDEE. Quite a bit more accurate than the online calculators, generally.

Thanks for the info and I'm going to get myself a fitbit as soon as I get my next wage in had a good look at them and think one would be very useful

CloudyMao

Has your doctor considered / tested you for metabolic syndrome? I've read that can stop people from losing weight even when they are exercising and eating right.

Depends is that the same as hypothyroidism?

ETA: You don't 'test' for metabolic syndrome - you fit into a criteria, it is usually used to describe a person's hightened risk of complications like CVD. Mostly it's a combination of diabetes, high blood pressure, and obesity. So rather than an actual thing in itself it's a term to describe a cluster of conditions in one individual. - Metabolic syndrome is not a "thing" that would effect your weight, as it's not an individual condition, however along the same lines - insulin resistance /// pre-diabetes is something that can make it very difficult for someone to lose weight, it's very hard to diagnose as it basically has little/un-noticable symptoms if any are present at all.

sympha01

-Can add spices/herbs/stock
-1000 Calories max per day.
- 2 Fruit portions 50 calories max each
-Skimmed milk allowance = 1/2 pint
-2 Portions of veg [no potatoes] = 75 calories max
-No other foods allowed.

Can I just say, I don't even think this adds up right?

50 calorie fruit X 2 = 100 calories
1/2 pint skim milk = 100 calories
75 calorie veg X 2 = 150 calories
Total = 350 calories max

I think you have mis-interpreted something in the advice given. That is not even approaching "1000 calories max."

Generally I am sympathetic when people have a hard time sticking to a VLCD, but the diet plan you outlined is NOT actually something that a nutritionist or dietician would recommend for anyone for 12 weeks. So either:

1) you're leaving some crucial piece of information about the diet out, or
2) you have massively misunderstood the advice you were given
3) your "dietician" should be prosecuted for fraud and/or malpractice.

I know you want us all to go with door number 3 here. But given the history with your medical providers you've provided I'm suspecting something a little willful going on around door number 1.

Actually I stated in the original post that it included 3 meal replacements as shown in the diet plan. Also I stated I think my dietitian is doing the best he can with the data available hence why I started a topic asking for recipes that work within the limitations of the diet so i'm not munching carrot sticks every day.

To be specific, you didn't STATE this, you just included the meal replacements in the daily meal plan without comment. But in the meal plan you've included 3 meal replacement shakes. Based on the 1000 calorie limit I'm assuming that each one is about 200 calories, and you're getting about 2/3 of your daily calories from them. But how many grams of protein does each have? How much fat?

I still feel it's at best misleading and at worst a little disingenuous for you to have not included the three 200-calorie meal replacement shakes in the upfront list of foods you eat, because that upfront list suggests to the the casual reader here that your only sustenance is fruit and veg with a little bit of milk, and there is only like 10 g of protein and zero fat in the list.

VLCD diets including meal replacement shakes are NOT FOR EVERYONE, certainly not for people who are not under direct medical supervision (indeed they are a terrible idea for most people), but a medical professional will sometimes suggest them for limited periods in extreme cases like yours, partly as a way of identifying other potential problems (e.g. a food intolerance, or an eating disorder).

You say you've tried everything, but you're also suggesting you're simply not willing to give this particular plan a chance. That's entirely your choice. But then you can't say you've tried everything. And if you give up your doctor is I think at least partially justified in dismissing you as having made a valid attempt to work with him or her. If you've legitimately tried / exhausted reasonable diet plans and they didn't work, and you don't want to follow a VLCD diet, you've been tested for metabolic issues, what exactly do you EXPECT your doctor (or us) to advise you to do?

Again, I say all this from a position of someone who DOES NOT RECOMMEND VLCD diets for casual or self-directed dieters and is horrified by the idea of "meal replacements" in any form. I think they're absolutely terrible. But I believe when a doctor prescribes such a diet in concert with a nutritionist for a limited period of time there's usually a reason, and I think that giving the advice a shot for 12 weeks is not unreasonable and is something you should consider. You'll be unhappy, but it won't kill you. It's a 12 week investment in peace of mind knowing that you're actually following medical advice and giving something an honest shot. Asking a bunch of diet and fitness enthusiasts on the internet -- who incidentally know you and your habits and history a lot less well than your doctor -- for validation in rejecting medical advice is not likely to end in results for you. If you don't like this doctor's advice, fine, get other PROFESSIONAL guidance. And yes, you may have to pay for it.

For whatever it's worth, having looked at some older entries in your diary, the one red flag I see is that it looks like you're not weighing your food. Not everyone needs to weigh their food, but if you've been tracking a calorie deficit for a long time (> 2 months) with no results, this is an important thing to consider. When I was your age I used to think I was good at eyeballing portions, or that the portions served to me in restaurants were standard. I was NOT good at it, and restaurant portions vary A LOT (especially takeaway). I am not even exaggerating here: if you don't weigh portions (and when you're using database entries for generic takeaway food, making sure you're using database entries that allow you to enter things by the gram or ounce instead "per portion"), then you could EASILY be eating 2X what you think you are, or even worse. SERIOUSLY. Like, a typical takeaway container for curry may hold 16 oz of food, and the database entry for "1 portion" might be assuming about 4-6 oz per portion. A person eats half the food in the container and feels virtuous for not eating the whole thing, but you'd need to log it as 1.5 -2 portions to be accurate. Just for example. Try weighing food for 1 month and wow, it's a real eye-opener.

yarwell

And you promoting that people should net 1000 calories or less is irresponsible and reckless. I think you should educate yourself a little better when it comes to nutrition.

In the OP's jurisdiction 1000 calories is perfectly acceptable to professionals for Obese patients.

The current Obesity Guideline consultation says "Consider low-calorie diets (800–1600 kcal/day), but be aware these are less likely to be nutritionally complete. "

DebTavares

I was referred to them because my doctor was convinced I was stuffing my face because of my depression despite no evidence for and a lot against.
I've had multiple blood tests to check thyroxine levels over the years all coming back normal.
My new dietitian put me on this because he's found no issues with my diet at all to see if an even lower calorie rate will yield results [previous 1200 calories] and as documented evidence to my doctor that I'm not stuffing my face.

Are you on meds for the depression?

yarwell

Dietitian said there was no absolutely accurate way of measuring it.

You can have your resting metabolic rate measured, which puts a pin on the map.

http://www.intelligentnutrition.eu/ may do it, or know somewhere that does. Some gyms or University departments offer the service where your breathing volume and composition is used to assess your calorie burn.

It's only fair to say that it is very rare for the test to turn out a number less than 1000 cals/day so I wouldn't want to give the impression that you have a very low metabolic rate based on what you've said.

FatFreeFrolicking

Has your doctor considered / tested you for metabolic syndrome? I've read that can stop people from losing weight even when they are exercising and eating right.

Depends is that the same as hypothyroidism?

ETA: You don't 'test' for metabolic syndrome - you fit into a criteria, it is usually used to describe a person's hightened risk of complications like CVD. Mostly it's a combination of diabetes, high blood pressure, and obesity. So rather than an actual thing in itself it's a term to describe a cluster of conditions in one individual. - Metabolic syndrome is not a "thing" that would effect your weight, as it's not an individual condition, however along the same lines - insulin resistance /// pre-diabetes is something that can make it very difficult for someone to lose weight, it's very hard to diagnose as it basically has little/un-noticable symptoms if any are present at all.

Insulin resistance and pre-diabetes are not hard to diagnose.

You can be diagnosed through a simple blood test or mixed meals test.

FatFreeFrolicking

Also- have you considered having your TDEE (Total Daily Energy Expenditure) measured? That would tell you how many calories you're burning every day, and give you a better handle on how much of a deficit you should have in your diet.

Dietitian said there was no absolutely accurate way of measuring it.

Yes, there is. Through an oxygen consumption test.

FatFreeFrolicking

Has your doctor considered / tested you for metabolic syndrome? I've read that can stop people from losing weight even when they are exercising and eating right.

Depends is that the same as hypothyroidism?

Metabolic syndrome is not the same as hypothyroidism. Metabolic syndrome is a cluster of conditions. Individuals who have metabolic syndrome have: a large waistline (abdominal obesity), high blood pressure, high blood sugar, high triglycerides, a low HDL cholesterol.

There are many endocrine disorders… hypo/hyperthyroidism, insulin resistance, pre-diabetes, diabetes, PCOS, insulinoma, hyperglycemia, hypoglycemia, carcinoid disease, Cushing's syndrome, goiter's, Grave's disease, Addison's disease, pituitary tumors, adrenal cancer.