NHS very low calorie diet help

Meikakiri

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!

Dragonwolf

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.

parkscs

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.

WalkingAlong

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.

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.

Meikakiri

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.

Meikakiri

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.

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.

You are meant to reach the other calories on the meal replacements.

Dragonwolf

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.

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.

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.

pinkyslippers

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:

DebbieLyn63

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.

castadiva

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.

WalkingAlong

You are meant to reach the other calories on the meal replacements.

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.

Meikakiri

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?

Meikakiri

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

Meikakiri

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.