Doc & Nutritionist confused me

ishtar13

This is sort of more of a rant than asking for advice.

First stats:

42 years old
Female
5'3"
~188 lbs
Military measurement body fat 46-47%
Scale body fat 42-44%

I have several risk factors for diabetes and am showing insulin resistance.
I am "apple" shaped.
My mom has just been diagnosed with diabetes (and there's other family history).
I take a medication that has weight gain and increased risk of diabetes. For various reasons, I'm not ready to change that med.
I had my gallbladder taken out in November.

I'm doing SL 5x5 3x/week.
On 3 non-lift days, I either walk (30-60 mins) or swim (20-30 mins).
This give me one complete rest day per week.

I'm seeing a doctor and nutritionist through the VA's MOVE clinic (http://www.move.va.gov/)

It's been about 5 or 6 weeks since I started tracking food and started to exercise at all and about; about 4 weeks since starting SL. Before that, I was very sedentary for several months.

While I think my doctor may like to see me at around 120 lbs, if I'm muscular and fit, I'd be happy around 145 (and she knows that and is going for it at the moment.)

The most fit I've ever been was right out of bootcamp (Navy) when I was 18 and at 127 lbs. At that time, people all around me were dropping weight like crazy and I only lost 2 lbs in the whole 8 weeks, but I went from a size 11/12 to a size 7. So, I know I tend to hold onto weight when I lose fat/get stronger. This means I'm not terribly worried about what the scale says. (I've lost about 8 lbs since beginning, half of it in the first week, but I'm not obsessing).

This is the first time, however, that I'm really paying attention to my diet. In the past, I've always just increased my activity and not worried about food. I mean, I tried to eat a little cleaner, but never counted calories or macronutrients before. So, I want to do it right.

And the doc and nutritionist confused me after I thought I had it figured out.

Nutritionist stressed 55%-60% carbs, about 20% protein, 20-25% fat. I reminded her that I was lifting, and she changed it to 50/25/25. She said I could probably lose at 1400-1500 Calories.

Doc stresses fiber. To the point where she wants me take a fiber supplement before every meal. (Holy crap, I think I'll live in the bathroom!) She wants at least 26 g of fiber daily. Her initial protein recommendation was 60 g/day, when reminded I'm lifting, upped it to 80-90 g/day (using 1g protein per kg of bodyweight). Then she said that maintenance would be 1600 Cal/day and if I wanted to lose, I needed to do 500 less. Putting me at 1100/day.

HOWEVER, I watched her, and I'm pretty sure the formula she's using is (wt in kg)*25. Which means she used my GOAL weight to figure the maintenance level. Using that formula, my CURRENT maintenance level would be a little over 2100. So, it seems to me that 1600 would be 500 less than current maintenance and I should continue to lose at that level until I get closer to goal.

Also, using the Fat2FitRadio calculator, I get that maintenance at goal would be 1661 (for sedentary) and suggest that I eat that amount to lose. That's pretty close to what she's got for maintenance at the new weight.

When I mentioned that I thought 1100 was too low, she said my weight loss would be slower if I went over that. Frankly, I'm ok with that as long as the trend continues.

I did ask about accounting for exercise, and she said that for weight loss, they don't recommend accounting for calories burned. Exercise is for overall health, not weight loss. This sort of blew my mind a little. Then she gave me a chart on how many calories certain activities burn on average.

It's no wonder people give up when all the info is completely contradictory.

wftiger

There is so much information that it is hard to keep it straight. I always defer to the Doctor over the rest. They treat many people that need to lose weight and contrary to what some on here post they do know what they are doing.

And about the 26 grams of fiber, that is correct. Women are supposed to get at least 25 grams per day according to the governmental powers that be agencies that direct that.