Is my doctor crazy?

gr8xpectationz

Is anybody here on a medical weight loss plan that does NOT involve surgery?

I saw my bariatrician yesterday, and she wants me to drop from 1500 to 1300 calories a day, with between 80 and 100 grams each of carbs and protein. And no adding exercise calories. I weigh 270 pounds, and that seems extremely low... waaaay below my TDEE.

I'm not sure whether to be excited by the challenge, or horrified at such seemingly tight restrictions. Does this seem crazy? Or is it reasonable? Is it similar to what you're hearing from your doctor?

shadow2soul

To me that seems low. I'm not on any medical assisted weight loss plan. Personally I would seek a second opinion. Unless there are health concerns where you can't exercise, I don't see any reason for telling you not to. The advice, just seems really weird to me. I don't blame you for questioning it.

buildingdreams

im in hte same boat. Was eating 1600 per day , eating back my calories burned since feb...Doc told me I gained 10 lb since Aug and req I go back to 1200 and not eat back my exercise calories. Hubby agrees with her. . Im doing it but not crazy about the whole idea. ehen I exercise my net calories are between 800-900 per day....

willdob3

Why does she want you to lower your calories?

I would never discuss nutrition with my doctor. He does not know anything about nutrition. Most PCPs do not.

SarahDavs

I would probably just try it for a few weeks and see what happens. If you don't lose anything get a second opinion.

ETA: My doctor (who I talk to about my weight issues) has always recommended 1400 a day. I believe that's pretty far under my TDEE. Someone suggested that I go to 1500 but I am just trying out the 1400 for a few weeks to see what happens and will change it if I don't see the results I'm looking for.

ThriftyChica12

remember that docs, even bariatric ones, are painfully ignorant about nutrition most times. can u see a nutritionist instead?

Mads1997

You have a lot of weight to lose going by your ticker. Eating at TDEE -20% would take you forever. I assume your doctor is trying to speed the process up and since you have large fat reserves your body will use these whilst eating low calories.

I would trust what your doctor suggest.

willdob3

remember that docs, even bariatric ones, are painfully ignorant about nutrition most times. can u see a nutritionist instead?

Sadly, most nutritionists don't know much either.

willdob3

You have a lot of weight to lose going by your ticker. Eating at TDEE -20% would take you forever. I assume your doctor is trying to speed the process up and since you have large fat reserves your body will use these whilst eating low calories.

I would trust what your doctor suggest.

She could probably cut off an arm & a leg & get the weight loss quicker still. Unless there is a medical reason I can see no reason to do this.

gr8xpectationz

Why does she want you to lower your calories?

I would never discuss nutrition with my doctor. He does not know anything about nutrition. Most PCPs do not.

I wouldn't either, with my regular doctor. But she's a bariatrician...meaning she specializes in weight loss.

Incidentally, she also referred me to a dietician within her office to discuss my current food logs and how to work toward these goals.

RunningOnPurple

Well, I weigh 263 and I eat 1400-1600 calories per day on average and have lost 89 pounds in the last 9 months so I don't know what would work for you, but it works for me.

Mads1997

remember that docs, even bariatric ones, are painfully ignorant about nutrition most times. can u see a nutritionist instead?

Sadly, most nutritionists don't know much either.

That is true, you don't need a degree to become a nutritionist, anyone on this site could call themselves a nutritionist. See a registered dietician if you can afford it.

willdob3

Why does she want you to lower your calories?

I would never discuss nutrition with my doctor. He does not know anything about nutrition. Most PCPs do not.

I wouldn't either, with my regular doctor. But she's a bariatrician...meaning she specializes in weight loss.

Incidentally, she also referred me to a dietician within her office to discuss my current food logs and how to work toward these goals.

Is there a reason you are discussing weight loss & nutrition with them rather than just doing it? I get the impression you don't really need them to advise you.

gr8xpectationz

remember that docs, even bariatric ones, are painfully ignorant about nutrition most times. can u see a nutritionist instead?

Sadly, most nutritionists don't know much either.

That is so very true. I used to work at Whole Foods in the supplements and body care aisle. It was absolutely astonishing how many medical conditions have a specific nutritional imbalance or deficiency at their core. I'm not at all opposed to modern medicine, but there's something to be said for a touch of skepticism when it comes to the pharmaceutical industry and the advice of doctors. Doctors are great. But it's your body and your health, so it's a good idea to do your own research too.

tmauck4472

Oh yeah because the people on MFP are way more knowledgable than your doc. I'd say listen to your doctor and see what happens. But remember if you can do it on your own long enough to have the surgery you can do it on your own without it.

Willowana

My highest weight was 282 lbs. I weighed 266. lbs. at the beginning of the year when I started on my doctor's diet.

....Which was 1200 calories and Phentermine pills.

I dropped 15-ish lbs. and plateau'd. I put myself on 1600 calories, stopped the pills, and did it MY way. I'm down to 44 lbs. gone since mid-January, and still losing strong. I weigh 222 lbs. right now, down from 266.

My doctor used to work for the bariatric department in a large hospital around here. At my last check up, he nearly fell out of his chair when he saw how much I had lost since he had last seen me. He couldn't believe it. He had put me on thyroid pills, which I stopped cold turkey when my hair started falling out. I'm on a lot of medication for Fibromyalgia that make weight loss nearly impossible. He's never seen anything like it.

I told him everything I was doing. My calories now fluctuate from 1300 - 1500 most days. He told me I'm doing everything right, and that he was proud of me. He told me I'm doing all the right things for my metabolism by exercising and eating enough for my body. In short, my doctor ate crow that day.

My advice: You don't need a bariatric diet. I've dropped two pants sizes, and I'm about to drop another one very soon. Everyone at work looks at me in disbelief.

<---- and ignore my pics. I don't have any new ones posted.

Mads1997

You have a lot of weight to lose going by your ticker. Eating at TDEE -20% would take you forever. I assume your doctor is trying to speed the process up and since you have large fat reserves your body will use these whilst eating low calories.

I would trust what your doctor suggest.

She could probably cut off an arm & a leg & get the weight loss quicker still. Unless there is a medical reason I can see no reason to do this.

Well perhaps there is a time frame to lose the weight before an operation..........

jenilla1

I saw my bariatrician yesterday, and she wants me to drop from 1500 to 1300 calories a day, with between 80 and 100 grams each of carbs and protein. And no adding exercise calories. I weigh 270 pounds, and that seems extremely low... waaaay below my TDEE.

You should be eating way below your TDEE. TDEE is maintenance level - it's what you eat to stay the way you are. Unless you don't trust your bariatrician (an expert in weight loss for people with extreme levels of weight to lose) and plan to fire her, you might want to follow orders at least for awhile to see if it works. Typically, extremely overweight people can handle huge deficits. The rules for bariatric patients are not necessarily the same as those for average people looking to cut weight. Don't get sucked in too much by the advice of MFPers. Good luck! :flowerforyou:

gr8xpectationz

Why does she want you to lower your calories?

I would never discuss nutrition with my doctor. He does not know anything about nutrition. Most PCPs do not.

I wouldn't either, with my regular doctor. But she's a bariatrician...meaning she specializes in weight loss.

Incidentally, she also referred me to a dietician within her office to discuss my current food logs and how to work toward these goals.

Is there a reason you are discussing weight loss & nutrition with them rather than just doing it? I get the impression you don't really need them to advise you.

I have Polycystic Ovarian Syndrome, a hormonal imbalance that impacts insulin sensitivity and metabolism. It makes weight loss very very hard. It's hard for people without this issue too, of course. But with PCOS, the common wisdom is that you have to work twice as hard for half the progress.

jjhanlon

remember that docs, even bariatric ones, are painfully ignorant about nutrition most times. can u see a nutritionist instead?

Sadly, most nutritionists don't know much either.

Talk to a Registered Dietitian, these issues are what they are trained for! :bigsmile:

NanaWubbie

I would say your bariatrition knows his stuff. It is ok to lose weight rapidly if you are being supervised medically. Some people to better steady and slow, others just want to knock it off quickly and get to the next phase of their lives. You paid good money for his/her advice, why not try it for a month and see what happens?

metacognition

You could probably lose at least 50 pounds on a reasonable restriction to 2000 calories per day, if you don't have a tight schedule for weight loss.

Fast weight loss is painful, and will lead to cravings as well as lean muscle loss.

I eat more than you and I'm 102 pounds!

Be sure to add in light, low impact exercise when you reach a plateau. Don't forget to do body resistance exercises, it is absolutely crucial to hold onto lean muscle mass as you will be in a deficit for a long time. Your body weight should be enough to make resistance activities effective - you could probably do them at home, too.

fresh_start59

The sad truth is that those of us with a lot of weight to lose can live on fewer calories. We have plenty of fat stores for our body to draw energy from.

Personally, I don't see a problem with those of us with LOTS of weight to lose (not 15-20 pounds) eating below our BMR for a few weeks at a time.

However, my fear is that doing it long term (months) could lead to an unexpected change in our metabolism. Or, just as bad, it could cause us to fall off the wagon and into a great big binge.

I've still got about 80 more pounds to lose. I'm not very active, so it's all I can do to eat at a 500-calorie per day deficit, which amounts to a loss of about 1 pound a week. Yes, that's slow. But I hope that after losing a bit of weight I'll be able to exercise more and create a bigger deficit.

My estimated BMR is 1,497. I try to eat about 1,500 calories, but don't fret if I occasionally go 50 under or 100 over. For me, the key to continuously lose weight is to eat lots of protein and to fit little treats into my day. Some days it's dark chocolate. Other days it's tacos or ice-cream. I figure the less I feel deprived, the less chance I'll have of giving into a major binge.

gr8xpectationz

Thanks to everyone for your input. I'm going to try it for a month or so and see how it goes. My doctor's hope is that with 1300 calories a day, plus at least 5 hours of cardio per week, plus resistance training, I can lost up to two pounds a month. This seems like a LOT of effort for such a small slow weight loss, but with PCOS that's how it goes. The good news is that as my weight gets lower, the hormonal imbalance also steadies which will hopefully make weight loss a little faster as I go along.

sarathrasher12

remember that docs, even bariatric ones, are painfully ignorant about nutrition most times. can u see a nutritionist instead?

Agreed! Perhaps you need to see someone who specializes in the field. I did go to a weight loss clinic when I was in high school, though. All liquid diet and exercise. It wasn't for me, but there are different programs out there.

Willowana

Thanks to everyone for your input. I'm going to try it for a month or so and see how it goes.

Good luck with it. Only you will know if it works for you. If you take nothing from my story--- just keep in mind that if it doesn't work for you...don't give up! There are other ways, and you CAN lose the weight.

....and the person that mentioned the binge eating is spot on. On 1200 calories a day AND diet pills....I binged and ate an entire large pizza in one day plus other food. Since upping my calories, I haven't binged like that.

Do what works for you, but just don't get frustrated and give up.

FATJAKE5

Is anybody here on a medical weight loss plan that does NOT involve surgery?

I saw my bariatrician yesterday, and she wants me to drop from 1500 to 1300 calories a day, with between 80 and 100 grams each of carbs and protein. And no adding exercise calories. I weigh 270 pounds, and that seems extremely low... waaaay below my TDEE.

I'm not sure whether to be excited by the challenge, or horrified at such seemingly tight restrictions. Does this seem crazy? Or is it reasonable? Is it similar to what you're hearing from your doctor?

You and I are in the same boat! I discussed this with my family doctor and cardiologist. They both agree. I have been doing it for 54 days losing 3 lbs/week. I average out my stats nightly. cal=1206, chol=114, fat=45, protein=63, sodium=1032. I stopped tracking carbs because they were always low. The only problem I seem to have is not making it to 1200 calories each day. I eat a lot of fresh raw, steamed and boiled veggies and they are very filling. Today I didn't make it to 1,000 cal and normally I force myself to eat more to get there with almonds and some my grandson's gold fish crackers. They also want me to balance my sodium intake to calories and that's why the crackers. Right now, I cannot eat another bite!

gr8xpectationz

Thanks to everyone for your input. I'm going to try it for a month or so and see how it goes.

Good luck with it. Only you will know if it works for you. If you take nothing from my story--- just keep in mind that if it doesn't work for you...don't give up! There are other ways, and you CAN lose the weight.

....and the person that mentioned the binge eating is spot on. On 1200 calories a day AND diet pills....I binged and ate an entire large pizza in one day plus other food. Since upping my calories, I haven't binged like that.

Do what works for you, but just don't get frustrated and give up.

Thanks, Willowana. What I liked about your story is the recognition that there's not just one magic formula for everybody. Sometimes you gotta put in some effort to figure out what's best for your body and your metabolism. That's one of the reasons I decided I'll try this for a month and see how it goes. If it works, great! If it doesn't, it's one more piece of the puzzle that can still get me closer to figuring out what will work best for me.

PikaKnight

Seek out a second opinion from a state registered dietitian.

gr8xpectationz

Is anybody here on a medical weight loss plan that does NOT involve surgery?

I saw my bariatrician yesterday, and she wants me to drop from 1500 to 1300 calories a day, with between 80 and 100 grams each of carbs and protein. And no adding exercise calories. I weigh 270 pounds, and that seems extremely low... waaaay below my TDEE.

I'm not sure whether to be excited by the challenge, or horrified at such seemingly tight restrictions. Does this seem crazy? Or is it reasonable? Is it similar to what you're hearing from your doctor?

You and I are in the same boat! I discussed this with my family doctor and cardiologist. They both agree. I have been doing it for 54 days losing 3 lbs/week. I average out my stats nightly. cal=1206, chol=114, fat=45, protein=63, sodium=1032. I stopped tracking carbs because they were always low. The only problem I seem to have is not making it to 1200 calories each day. I eat a lot of fresh raw, steamed and boiled veggies and they are very filling. Today I didn't make it to 1,000 cal and normally I force myself to eat more to get there with almonds and some my grandson's gold fish crackers. They also want me to balance my sodium intake to calories and that's why the crackers. Right now, I cannot eat another bite!

So maybe it is do-able! I had a problem occasionally coming in too low at 1500 calories, and used the same almond trick to get it filled out. But with 1200 I don't think coming in too low will be a problem, at least initially...

SarahDavs

Why does she want you to lower your calories?

I would never discuss nutrition with my doctor. He does not know anything about nutrition. Most PCPs do not.

I wouldn't either, with my regular doctor. But she's a bariatrician...meaning she specializes in weight loss.

Incidentally, she also referred me to a dietician within her office to discuss my current food logs and how to work toward these goals.

Is there a reason you are discussing weight loss & nutrition with them rather than just doing it? I get the impression you don't really need them to advise you.

I have Polycystic Ovarian Syndrome, a hormonal imbalance that impacts insulin sensitivity and metabolism. It makes weight loss very very hard. It's hard for people without this issue too, of course. But with PCOS, the common wisdom is that you have to work twice as hard for half the progress.

I have PCOS too. I have worked very hard in the past to lose and saw little to no results. Now I'm reading and going by the book 'The G.I. Diet: Glycemic Index' by Rick Gallop. And have been exercising about 20 minutes a day and have lost 20 pounds in 2 1/2 months! It's really exciting for me because I've worked twice as hard in the past and saw very poor results from it, which caused me to go into a depression and I ended up giving up. Now I'm eating about 1400 calories a day, but I also eat 6 times a day. I don't feel in want of anything, I'm not hungry all the time and my sweet tooth is almost completely gone. If you like, check out the book, it's changing my life. :-)