Is my doctor crazy?

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. :-)

gr8xpectationz

Seek out a second opinion from a state registered dietitian.

This particular program has several on-staff. The bariatrician prescribes the goal (and medication to those who need it), and a dietician supervises food logs and helps with suggestions about how to meet the goals. It's kind of a smart system for them to work as a team.

As an aside (not directly related to your post), people always confuse "bariatrician" with "bariatric surgeon". I'm not having surgery. A "bariatrician" is just a doctor who specializes in weight loss.

ngressman

I think that is about right for what a doctor would say. Both my sister and I do a 1200 calorie diet, but I do eat my exercise calories back. Only you will know whether or not your doctor's advice works for you. Protein shake or meal replacement shakes can help too. If you want to try something else find a doctor/nutritionist who agrees with your ideas. For me the 1200 calorie diet works good. (I know it's not the popular way on mfp, but it works for me).

servilia

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:

This

gr8xpectationz

Wow, Sarah! That's great! I'm already low-glycemic. But once I get through the initial month or so of this doctor-prescribed thing, I'll look into the book and see what other tips and strategies I can glean.

PikaKnight

Seek out a second opinion from a state registered dietitian.

This particular program has several on-staff. The bariatrician prescribes the goal (and medication to those who need it), and a dietician supervises food logs and helps with suggestions about how to meet the goals. It's kind of a smart system for them to work as a team.

As an aside (not directly related to your post), people always confuse "bariatrician" with "bariatric surgeon". I'm not having surgery. A "bariatrician" is just a doctor who specializes in weight loss.

Well, try maybe asking Tony. http://www.myfitnesspal.com/forums/show/13105-ask-the-dietitian

He's a Texas state registered dietitian. If you are having second thoughts about what your dietitian and doctor are telling you, maybe asking another dietitian might help put some of your concerns to rest or at least help you understand more about what is being prescribed.

Tereless

Im working with my doctor to break the cycle of yo yo weight gain and loss. At this point they have dropped the carbs to 30 a day and I have been loosing weight by about 2-3 lbs a week. Tons of veggies and meat. Try lowering the carbs from fruit (sugar) to veggies and see if that helps. I eat about 1800 calories daily and am now losing weight and I was faithful to 1500 calories with higher carbs for over 1 year and did not lose weight. Switched to the lower carbs and lowered the fruits in my diet and the weight is falling off in a healthy fashion.

Hope this helps.

SarahDavs

Wow, Sarah! That's great! I'm already low-glycemic. But once I get through the initial month or so of this doctor-prescribed thing, I'll look into the book and see what other tips and strategies I can glean.

I have to admit, I lost the bulk of that 20 pounds before I joined MFP and started calorie counting. I did start here at 1200, but after reading a lot of threads about TDEE and eating more to lose more I went up to 1400. I'm trying the 1400 for a few weeks to see if anything changes. If it doesn't I might go up a bit or back down. I'm still trying to figure all of this out. But I hope you figure it out too. Best of luck.

gr8xpectationz

Joy, I'm loving that "ask the dietician" suggestion. My appointment with my doctor's program-affiliated dietician isn't until next week, so this would be a good way to check in on the advice before that appointment.

SteelySunshine

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?

Sounds crazy to me. But, later you mention PCOS and I understand that messes with your metabolism a great deal. I would say it is definitely bad otherwise, because I can't see how your TDEE could be any lower than 2500 calories unless you are much older than you look and are very very short. In any case 1500 would be about 1000 calories less than TDEE for most people your weight so in most cases that would have you losing weight at a pretty good clip. If I went that low I would lose weight very rapidly. Anyway, I don't see how even for someone that didn't have PCOS how dropping 200 more calories would be helpful at all, it would just make me hungrier and crankier and more prone to bingeing and I am not usually a binger. So anyway, it looks like you have been losing weight, so I don't understand what your doctor's issue is.

smantha32

That seems too low to me. I'd bet that at 270 pounds you can still lose easily on 1500 calories.