NHS very low calorie diet help
Replies
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Thank you. I totally agree.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!"
OP- We all mis-estimate our intake. It's just a matter of how much. In studies where they trained people on how to log accurately and then tested them, people missed 25% of their calorie intake, on average. But most of us think we're accurate, or else why would we bother? But it's like asking people if they're a better driver than average. Everyone believes they are.0 -
I just want to clear something up from some of the comments in here
This is not America - no professional, and certainly not any dietician working for the NHS earns any commission, or indeed anyone within the NHS based on "sales" or any product enforcement, and that is seriously disgusting to insinuate. Also a RD is not a 'nutritionist'. A RD has dedicated their entire career, and many years of their life studying nutrition, and it's effect on individuals especially relating to different conditions. While I agree that 12 weeks seems a long time for a VLCD, it is the advice of a professional who knows far more about the subject matter than most of us, and certainly knows more about their client than we do.
tl;dr - stop slagging off the RA, read the rest of the comments, and maybe try to answer OP's actual question about making sticking to the VLCD easier.0 -
Im putting this out there,my grandma in the mid/late 1980s was literally hospitalized so they could feed her a vlcd to see what would happen bc she was gaining weight uncontrollably.
She gained a pound.
Onky bariatric surgery and a very very strict lifetime diet made her lose any weight.
Also I gained weight eating around 1400kcal while breastfeeding a newborn-100lbs in 4mos.
Only recently being on near the max dose of thyroid hormone am I able to drop weight. It was work just to maintain. Maintain 326lbs on about 1400kcal. Breastfeeding.
And yes I know what a food scale is.
I have severe hypothyroidism and thyroid tumors.
Sometimes sick bodies act illogically.0 -
I've lost 3.8 kg is less than 1 week according to the scales, I should be happy but this isn't a healthy loss is it?0
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It wouldn't be if that was happening very often, but it's very normal after a change in diet/intake to see a large loss like that. Well done !0
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I've lost 3.8 kg is less than 1 week according to the scales, I should be happy but this isn't a healthy loss is it?
Well not really but you are in week 1 so most of that will be 'water weight' anyway.
If I were you I would use this tool, it's helped a lot of people with their goals: http://scoobysworkshop.com/accurate-calorie-calculator/
It tells you how much you should eat a day based on your height, weight and activity level.
Also you can still eat the things you enjoy but you just need to eat less of it.
The NHS still consider BMI to be the epitome of health. I wouldn't rely on them too much - slow and steady wins the race.
If you start a VLC diet now it will only make things harder in the long run.0 -
Is this pre bariatric surgery? That is the only ONLY reason for something like this-coming from an RD...I cannot see any reason to go this low on calories unless you are pre op...and even then 12 weeks seems WAY too long for something like this.
No it isn't, my doctor has told me despite my referral from another GP that I will not receive bariatric surgery as my BMI isn't high enough at 43.
OK, three things jumping out at me here. The NHS requirement to be considered for bariatric surgery is a BMI over 40. See here: http://www.nhs.uk/Conditions/weight-loss-surgery/Pages/who-can-use-it.aspx . Think it's time to find a new doctor, as this one clearly doesn't believe you, and it would seem, doesn't know his stuff about NHS guidelines.*
Secondly, unless your meal replacements are high-protein, and pretty high in essential fats, this diet is not going to cut the mustard in keeping you healthy for 12 weeks. I'd also be concerned about going so low-carb if you have a history of depression.
Thirdly, you're seeing this nutritionist about once a month??? A VLCD like this should be very closely monitored - at least twice a week, especially with your medical history as described here. Sounds to me like you need to be asking some questions about the people you're seeing. Are they really NHS Registered? Are there other options in the local area? It sounds very fishy to me... Start asking questions, and investigating the people who are treating you, as far as possible. It's relatively rare, but people do occasionally manage to scam the system and pass themselves off as doctors/nutritionists/etc when their training is nonexistent, or massively under par.
One other thing - so four things - 3.8kg in under a week? Yeah, not a healthy loss. Probably water, for the most part.
Sorry you're experiencing this, and good luck.
*Though it is possible your local PCT has different requirements, but I'd look into that closely if I were you, rather than just taking the doctor's word.0 -
OK, three things jumping out at me here. The NHS requirement to be considered for bariatric surgery is a BMI over 40. See here: http://www.nhs.uk/Conditions/weight-loss-surgery/Pages/who-can-use-it.aspx . Think it's time to find a new doctor, as this one clearly doesn't believe you, and it would seem, doesn't know his stuff about NHS guidelines.*
Secondly, unless your meal replacements are high-protein, and pretty high in essential fats, this diet is not going to cut the mustard in keeping you healthy for 12 weeks. I'd also be concerned about going so low-carb if you have a history of depression.
Thirdly, you're seeing this nutritionist about once a month??? A VLCD like this should be very closely monitored - at least twice a week, especially with your medical history as described here. Sounds to me like you need to be asking some questions about the people you're seeing. Are they really NHS Registered? Are there other options in the local area? It sounds very fishy to me... Start asking questions, and investigating the people who are treating you, as far as possible. It's relatively rare, but people do occasionally manage to scam the system and pass themselves off as doctors/nutritionists/etc when their training is nonexistent, or massively under par.
One other thing - so four things - 3.8kg in under a week? Yeah, not a healthy loss. Probably water, for the most part.
Sorry you're experiencing this, and good luck.
*Though it is possible your local PCT has different requirements, but I'd look into that closely if I were you, rather than just taking the doctor's word.
I'm going to request a different GP next time I go in as I'm going to ask for some blood test work, I've had a string of bad experiences with this one, including her telling me she'd refer me for surgery then never sending the form off for over a year making it so an embarrassed receptionist had to call me up to tell me it had never been sent, then telling me I must stuff my face because I have depression despite seeing my written diet diary, then referring me to this dietitian who I knew as he was giving me this plan that it contradicted everything I'd learnt over the years about a healthy diet including from other NHS professionals.0 -
I've lost 3.8 kg is less than 1 week according to the scales, I should be happy but this isn't a healthy loss is it?
The director at work lost about the same, no idea what he's doing but he has plenty to go at (he's raising money for charity by dieting).
Seems to me the point of the doctor was to demonstrate that you can lose weight if you go on an appropriate regime, and that has been demonstrated. Rather than trying to sabotage the process on here I feel you would be better taking your medicine as prescribed and going back to discuss progress when you reach a goal or start to find it hard to stick to.0 -
tl;dr - stop slagging off the RA, read the rest of the comments, and maybe try to answer OP's actual question about making sticking to the VLCD easier.
+10 -
The director at work lost about the same, no idea what he's doing but he has plenty to go at (he's raising money for charity by dieting).
Seems to me the point of the doctor was to demonstrate that you can lose weight if you go on an appropriate regime, and that has been demonstrated. Rather than trying to sabotage the process on here I feel you would be better taking your medicine as prescribed and going back to discuss progress when you reach a goal or start to find it hard to stick to.
I'm not trying to sabotage it! As you can see in the original post i'm asking for recipes which work within the diets limitations!0 -
OK, three things jumping out at me here. The NHS requirement to be considered for bariatric surgery is a BMI over 40. See here: http://www.nhs.uk/Conditions/weight-loss-surgery/Pages/who-can-use-it.aspx . Think it's time to find a new doctor, as this one clearly doesn't believe you, and it would seem, doesn't know his stuff about NHS guidelines.*
Secondly, unless your meal replacements are high-protein, and pretty high in essential fats, this diet is not going to cut the mustard in keeping you healthy for 12 weeks. I'd also be concerned about going so low-carb if you have a history of depression.
Thirdly, you're seeing this nutritionist about once a month??? A VLCD like this should be very closely monitored - at least twice a week, especially with your medical history as described here. Sounds to me like you need to be asking some questions about the people you're seeing. Are they really NHS Registered? Are there other options in the local area? It sounds very fishy to me... Start asking questions, and investigating the people who are treating you, as far as possible. It's relatively rare, but people do occasionally manage to scam the system and pass themselves off as doctors/nutritionists/etc when their training is nonexistent, or massively under par.
One other thing - so four things - 3.8kg in under a week? Yeah, not a healthy loss. Probably water, for the most part.
Sorry you're experiencing this, and good luck.
*Though it is possible your local PCT has different requirements, but I'd look into that closely if I were you, rather than just taking the doctor's word.
I'm going to request a different GP next time I go in as I'm going to ask for some blood test work, I've had a string of bad experiences with this one, including her telling me she'd refer me for surgery then never sending the form off for over a year making it so an embarrassed receptionist had to call me up to tell me it had never been sent, then telling me I must stuff my face because I have depression despite seeing my written diet diary, then referring me to this dietitian who I knew as he was giving me this plan that it contradicted everything I'd learnt over the years about a healthy diet including from other NHS professionals.
Yeah... I know going through NHS is different than the American (privatized) health system, but I'd have dropped her like a ton of bricks if she told me I was "just stuffing my face" and lying in my diaries. In fact, I did pretty much that, because I did have a doctor that treated me somewhat the same way. It was one of the best decisions I made for my health/weight loss efforts.
From what I hear, it can be harder to get a new doctor under NHS, but I think it's probably worth the hassle, especially in your situation. It sounds like you probably even have grounds for a formal complaint to whatever entity oversees the doctors there.0 -
I've lost 3.8 kg is less than 1 week according to the scales, I should be happy but this isn't a healthy loss is it?
The director at work lost about the same, no idea what he's doing but he has plenty to go at (he's raising money for charity by dieting).
Seems to me the point of the doctor was to demonstrate that you can lose weight if you go on an appropriate regime, and that has been demonstrated. Rather than trying to sabotage the process on here I feel you would be better taking your medicine as prescribed and going back to discuss progress when you reach a goal or start to find it hard to stick to.
Agreed. You've seen you can lose weight and your loss on that first week is almost certainly water weight. Where people should be concerned is if you're losing 3.8 kg on average over a period of multiple weeks, but 1 week that could easily just be a fluctuation, glycogen depletion, and so on. Worrying about an unsafe rate of loss during the first week of a new diet is just needless worrying.
I'd give their diet a try for a few more weeks and see how it goes, then meet back with them. This doesn't have to be what you do forever and I'd encourage you not to follow their exact plan in the long term - but it does make a nice experiment and a way to prove to yourself that you can lose weight following a super strict program, something which you say you've struggled with in the past. And the risks associated with following a diet like they've prescribed are pretty minimal, with your biggest risk probably being feeling like crap or feeling hungry a lot of the time. I'd give this a try, see what you like and what you dislike about it, see what elements you'd like to keep and what you'd like to change, and then workout a new plan in a few months with your physician/dietician so that you can keep working towards your long-term goals.0 -
I don't know how anyone could suggest recipes with this info but maybe try the Food forum. I don't even understand it. How do you get to 1000 calories with a limit of 75 calories of veg, 100 calories of fruit, a half pint of milk and "no other foods allowed"? Are you supposed to add in 750 calories of supplements/'meal replacements'? There's not much there to make a recipe out of.I've been given a diet by my dietitian for twelve weeks, I was hoping people could help me find ways to makes this diet less of a strain, e.g. vegetable recipes i.e. soups/stews/roasted etc.
-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.
The diet:
Breakfast: 1 meal replacement + Tea/coffee with skimmed milk allowance
Mid-Morning: Tea/Coffee or low calorie drink
Lunch: Serving of salad/vegetables + 1 portion of fruit.
Mid-Afternoon: 1 meal replacement
Evening Meal: Serving of vegetables/ Salad
Bed-Time: 1 meal replacement.0 -
I'm going to keep on this, but i'm changing to a higher protein lower sugar powder as suggested so I don't have to worry about my body eating it's muscles. The program I have has a side effects box to fill out next to weight each week so I can monitor my health and write down my worries my next dietitians appointment is on the 28th so at the very least it's staying till then.0
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I don't know how anyone could suggest recipes with this info but maybe try the Food forum. I don't even understand it. How do you get to 1000 calories with a limit of 75 calories of veg, 100 calories of fruit, a half pint of milk and "no other foods allowed"? Are you supposed to add in 750 calories of supplements/'meal replacements'? There's not much there to make a recipe out of.I've been given a diet by my dietitian for twelve weeks, I was hoping people could help me find ways to makes this diet less of a strain, e.g. vegetable recipes i.e. soups/stews/roasted etc.
-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.
The diet:
Breakfast: 1 meal replacement + Tea/coffee with skimmed milk allowance
Mid-Morning: Tea/Coffee or low calorie drink
Lunch: Serving of salad/vegetables + 1 portion of fruit.
Mid-Afternoon: 1 meal replacement
Evening Meal: Serving of vegetables/ Salad
Bed-Time: 1 meal replacement.
You are meant to reach the other calories on the meal replacements.0 -
I don't know how anyone could suggest recipes with this info but maybe try the Food forum. I don't even understand it. How do you get to 1000 calories with a limit of 75 calories of veg, 100 calories of fruit, a half pint of milk and "no other foods allowed"? Are you supposed to add in 750 calories of supplements/'meal replacements'? There's not much there to make a recipe out of.I've been given a diet by my dietitian for twelve weeks, I was hoping people could help me find ways to makes this diet less of a strain, e.g. vegetable recipes i.e. soups/stews/roasted etc.
-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.
The diet:
Breakfast: 1 meal replacement + Tea/coffee with skimmed milk allowance
Mid-Morning: Tea/Coffee or low calorie drink
Lunch: Serving of salad/vegetables + 1 portion of fruit.
Mid-Afternoon: 1 meal replacement
Evening Meal: Serving of vegetables/ Salad
Bed-Time: 1 meal replacement.
Yeah, if you look at the meal plan, there's a meal replacement at breakfast, mid-afternoon, and before bed. I agree, though, there's only so much you can do with that little.0 -
No it isn't, my doctor has told me despite my referral from another GP that I will not receive bariatric surgery as my BMI isn't high enough at 43.
We recommend surgery for people with a BMI of 40 or higher, that have exhausted other methods of weightloss actually. So I'm not sure wth is going on with your local service.
I know what you mean and I've asked them about it but they never give me an answer and i'm sure it ignores NHS guidelines on BMI.
Yes I think you are correct. This is from the NICE guideline:
NICE clinical guideline CG43 on obesity recommends that bariatric surgery is
a treatment option for adults and children if all of the following criteria are
fulfilled:
the person has a BMI of 40 kg/m2 or more, or between 35 kg/m2
and 40 kg/m2
and other significant disease (for example, type 2
diabetes or high blood pressure) that could be improved if they
lost weight
all appropriate non-surgical measures have been tried but have
failed to achieve or maintain adequate, clinically beneficial
weight loss for at least 6 months
the person has been receiving or will receive intensive
management in a specialist obesity service
the person is generally fit for anaesthesia and surgery
the person commits to the need for long-term follow-up.
Best of luck to you :flowerforyou:0 -
To your original question re recipes- You can do a lot with veggies to keep things from getting tiresome.
My recent fave is zucchini. I either slice it, place on cookie sheet, spritz lightly with Olive oil spray and sprinkle with garlic and other spices, then broil til starts to turn brown around edges. If I don't want to heat up the kitchen, I just put it in the microwave til just getting soft.
I also bought a veggetti spiral cutter which makes zucchini noodles quick and easily. Put in a micro safe bowl with cover. Add garlic, dried onion, salt, pepper, whatever spices you want, then microwave for 2 minutes. Great lowcal snack.
For a sweet treat- slice up an apple, place in a bowl with a pkt of Stevia and cinnamon, and microwave covered for a minute or 2 until apples are soft. It's like the inside of an apple pie- almost!
It sounds like your dr's experiment is working, since you have lost weight this week on the low cal diet. The trick is keeping it up longer term, and not getting tired of feeling hungry and binging. This is the reason that people claim to gain weight on VLCD. They don't actually GAIN weight long-term on a deficit, but rather they lose a bit at first, then they stall for a few days or a week, then they get frustrated and give up.
Most of us in that cycle do not realize-
1. How many calories we are actually eating on average in a month.
2. How many calories we actually need to maintain our current weight.
3. What a serving actually is, and how many calories are in the food and drink we intake.
To learn the answers to these questions, we have to be 100% accurate in our weighing, measuring, and logging. Every thing, every day. Then after a month or so, we can see our progress compared to our intake, and get a better idea of what cal level we should be eating at to lose at a moderate level.
Weight loss isn't linear. You will lose a lot the first week or 2, then you may stall or even gain back a little one week. Don't panic when this happens. It is normal. Just stick with the plan to make it thru that week, and you will settle into a fairly steady weightloss.
For women, time of the month will cause a temporary stall or gain. again don't panic.
If you start a new exercise regimen, you may gain a little in waterweight, as your muscles swell from the new exercise. Again, do not panic. It will level out in a week or so.
I mention panicking a lot, because that is what kept me from losing weight for a long time. I wanted the weight gone immediately. I would start off strong, losing every day, then when the scale stalled or went up, I would panic, declare that diets don't work for me, and go back to normal eating and gain the weight back.
Learning the answers to the 3 points above, has helped me lose and maintain my loss in the past 2 yrs. I am not at goal yet, but am much closer than I was 2 yrs ago. I also feel confident that I willl keep the weight off.0 -
OK, three things jumping out at me here. The NHS requirement to be considered for bariatric surgery is a BMI over 40. See here: http://www.nhs.uk/Conditions/weight-loss-surgery/Pages/who-can-use-it.aspx . Think it's time to find a new doctor, as this one clearly doesn't believe you, and it would seem, doesn't know his stuff about NHS guidelines.*
Secondly, unless your meal replacements are high-protein, and pretty high in essential fats, this diet is not going to cut the mustard in keeping you healthy for 12 weeks. I'd also be concerned about going so low-carb if you have a history of depression.
Thirdly, you're seeing this nutritionist about once a month??? A VLCD like this should be very closely monitored - at least twice a week, especially with your medical history as described here. Sounds to me like you need to be asking some questions about the people you're seeing. Are they really NHS Registered? Are there other options in the local area? It sounds very fishy to me... Start asking questions, and investigating the people who are treating you, as far as possible. It's relatively rare, but people do occasionally manage to scam the system and pass themselves off as doctors/nutritionists/etc when their training is nonexistent, or massively under par.
One other thing - so four things - 3.8kg in under a week? Yeah, not a healthy loss. Probably water, for the most part.
Sorry you're experiencing this, and good luck.
*Though it is possible your local PCT has different requirements, but I'd look into that closely if I were you, rather than just taking the doctor's word.
I'm going to request a different GP next time I go in as I'm going to ask for some blood test work, I've had a string of bad experiences with this one, including her telling me she'd refer me for surgery then never sending the form off for over a year making it so an embarrassed receptionist had to call me up to tell me it had never been sent, then telling me I must stuff my face because I have depression despite seeing my written diet diary, then referring me to this dietitian who I knew as he was giving me this plan that it contradicted everything I'd learnt over the years about a healthy diet including from other NHS professionals.
Yeah... I know going through NHS is different than the American (privatized) health system, but I'd have dropped her like a ton of bricks if she told me I was "just stuffing my face" and lying in my diaries. In fact, I did pretty much that, because I did have a doctor that treated me somewhat the same way. It was one of the best decisions I made for my health/weight loss efforts.
From what I hear, it can be harder to get a new doctor under NHS, but I think it's probably worth the hassle, especially in your situation. It sounds like you probably even have grounds for a formal complaint to whatever entity oversees the doctors there.
Have to agree. Definitely time to switch surgeries - or is there someone else at your surgery you could try? I suspect there are more local surgeries in London than Yorkshire, so it may be more difficult to switch surgery completely, but worth a go. I'd also seriously consider lodging a complaint, especially if you have evidence that the referral was unsent, or other concrete examples of mismanagement. I'm afraid you do sometimes have to stand up for yourself and not be terribly British about it all, if you want to get appropriate treatment. Many NHS docs are great. Others, not so much. Whatever they may try to tell you, you do have the right to request a different doctor.0 -
Ah. I would make a vegetable soup. Studies find water rich foods are more filling than 'dry foods' plus water to drink. 75 calories isn't a lot but you could load it with cabbage and onions and other low-cal veg, and at least have plenty of broth.You are meant to reach the other calories on the meal replacements.
12 weeks is a long time to live on meal replacements. I imagine I would rotate through all the types and brands, just for variety.0 -
DebbieLyn63 - Thanks for the advice and the recipes, I have bought a blender to make this diet easier to stick to [quick soups, shakes, shake smoothie things] and me and my mother who has volunteered to join me on the diet for support are doing current weight photos tonight, is a Zucchini the same as a courgette or is it a different veg?0
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Ah. I would make a vegetable soup. Studies find water rich foods are more filling than 'dry foods' plus water to drink. 75 calories isn't a lot but you could load it with cabbage and onions and other low-cal veg, and at least have plenty of broth.
12 weeks is a long time to live on meal replacements. I imagine I would rotate through all the types and brands, just for variety.
We have a few different flavours and brands of powders including a big tub of whey protein from when my younger sister was trying to lose weight, she lost nearly 8 stone in a year [very proud]. And i'll get some different flavour bars when my next pay cheque comes in
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Have to agree. Definitely time to switch surgeries - or is there someone else at your surgery you could try? I suspect there are more local surgeries in London than Yorkshire, so it may be more difficult to switch surgery completely, but worth a go. I'd also seriously consider lodging a complaint, especially if you have evidence that the referral was unsent, or other concrete examples of mismanagement. I'm afraid you do sometimes have to stand up for yourself and not be terribly British about it all, if you want to get appropriate treatment. Many NHS docs are great. Others, not so much. Whatever they may try to tell you, you do have the right to request a different doctor.
I'm giving them one last chance but with a different doctor in the practice next time, as I want to get some blood tests in relation to my thyroid because of my family history, but if it seems same old same old I've found a closer practice which has a five star rating. They seem to be good at other medical conditions except weight, but it may just be this particular doctor.0
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