Is my doctor crazy?

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  • rm7161
    rm7161 Posts: 505
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    I lost easily at 1800 a day when I was at the height of my weight.

    But I was weighing my food pretty religiously, counting every morsel that passed by my lips as well as possible, and I exercise vigorously. (getting heart rate consistently up over 70 percent capacity is pretty important, and I usually get it over 80.
  • neanderthin
    neanderthin Posts: 10,020 Member
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    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.
    The low carb diet is made for people with PCOS.....I'm surprised your Dr. hasn't recommended that, considering the results of that diet for PCOS.
  • jessicae1aine
    jessicae1aine Posts: 885
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    I am /not/ on a doctor-prescribed weight loss plan (they said, "oh, make sure you be active and don't eat more than 2000 calories a day" like everything is that simple), and I'm definitely not a doctor, but I can tell you what's working for me!

    I started off at 300.1 pounds, and was hovering between 285-292 for months. I have PCOS, and you clearly know that makes this a heckuva lot harder. I was floundering, pretty much, until my awesome friend posted this: http://www.myfitnesspal.com/topics/show/943139-weight-loss-cheat-sheet-ipoarm

    I put in my numbers. I did the math. It was quick and mostly painless (other than those measurements... ouch!). Day 1, I was at 285. Three weeks in, I'm weighing in at 272.6. In the middle of this I even went out of town and had a pretty excessive day, calorie-wise, and I'm still doing awesome and losing weight. There aren't any diet restrictions, so I can eat real food that I know I love. You're not required to exercise - but if you do, you get your calories.

    Honestly, I'd never suggest anything as strongly as I suggest this. It's free, and it's working for me, and the people who've put it all together are amazing at answering questions, double-checking things for you, and giving general support - and there is a Facebook page, and a group on here, as well as tons of us around that are using it. What's to lose, other than some pounds?
  • jzammetti
    jzammetti Posts: 1,956 Member
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    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.

    The weight training will help with PCOS, I think (I am NOT a doctor). But improving muscle mass improves the hormonal functioning in your body:

    "When it comes to PCOS muscle mass really matters. Strength and resistance training is a very efficient way to bring down insulin levels and help with weight loss and should be part of an exercise routine for all women with PCOS. A study published in the September 2009 issue of Diabetes (1) suggests that exercise stimulates muscles to increase glycogen breakdown. By mobilizing fuel stores in muscle, the researchers propose that exercise may help to restore energy balance (i.e. insulin and glucose)." http://divapcos.wordpress.com/2010/04/01/muscle-matters-with-pcos/

    http://www.pcos.insulitelabs.com/blog/3608/is-lifting-weights-as-good-as-running-for-better-pcos-health/

    There are articles all over the internet about women who have success with weight training and high intensity cardio (HIIT).

    I do think your calories will be too low and result in the opposite effect the doctor wants - eventually, the weight you lose will be a large percentage of lean body mass, screwing up insulin delivery even more (negatively affecting your hormonal processes). I would go to 1450 or so at the least (and that is probably too little, also).

    Also, do you limit carbs? If not, you should - to less than 50grams a day (maybe less).

    Whatever you decide, I wish you luck!
  • jessicae1aine
    jessicae1aine Posts: 885
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    I do think your calories will be too low and result in the opposite effect the doctor wants - eventually, the weight you lose will be a large percentage of lean body mass, screwing up insulin delivery even more (negatively affecting your hormonal processes). I would go to 1450 or so at the least (and that is probably too little, also).

    This is also quite true! I hope you find and decide on something that will work well for you. :)
  • RunFarLiveHappy
    RunFarLiveHappy Posts: 805 Member
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    I am definitely NOT a nutritionist nor am I a medical professional... However when you are obese it is often recommended to start at a much higher deficit than when you only need to lose 10 or 20 pounds. I was not under medical guidance during my journey, but I was 127 pounds overweight when I began and I did start with a 1200 calorie goal. I ate back exercise calories as needed when I was hungry. I started at 46% body fat and 300 pounds. I am now 26% body fat and 189 pounds. I have increased my calorie goal as I've gotten closer to my goal weight and now have it set at TDEE -20% which is 1590 calories. Again I eat my exercise calories as needed because I'm hungry.

    I wish you sincere luck in your journey. The trick with calorie restriction is to eat as many whole foods as you can so you don't sacrifice your calories on foods that won't fill you up. Also use 10-20% of your calories for treats so you don't feel too restricted, which will help prevent binging and general resentment and bitterness.

    Again just my opinions on what has worked for me, there's no "perfect" plan that works for everyone.
  • LiftAllThePizzas
    LiftAllThePizzas Posts: 17,857 Member
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    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....
    If you gained 10 lbs over the course of 8 months, it would mean you ate an average of about 150 calories over maintenance. Meaning, your maintenance for that weight would be 1450 a day. Going down to 800-900 to lose a whole 10 pounds is ridiculous and you should slap your doctor upside the head.
  • LeahT84
    LeahT84 Posts: 202 Member
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    I started out at 278, and for the last 10 weeks I have only gone over 1300 once or twice, usually sticking to 1200 but no more than 1400. I can still eat a lot in a day, it's just a lot more veggies and low calorie foods and I don't ever feel starved and I am losing consistently.

    Give it a try...see how it works for you, how you feel after a week of sticking to it, and what your results are from it. I would believe a doctor long before I would believe the "experts" of MFP. It's all about what works for you. You have a lot of weight to lose, therefore it's okay to lose it by restricting calories. I have talked to doctors about my weight in the past and they all said the same thing your doc is saying. Lowering calories. It is not unsafe for someone with a lot to lose.
  • _Zardoz_
    _Zardoz_ Posts: 3,987 Member
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    The doctor is a specialist (bariatician) and has referred you to a dietician. Listen to them. If you had any other medical condition and wee speaking to a specialist doctor would you be taking notice of those on the internet off a medical specialist? I very much doubt it.
  • jessicae1aine
    jessicae1aine Posts: 885
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    The doctor is a specialist (bariatician) and has referred you to a dietician. Listen to them. If you had any other medical condition and wee speaking to a specialist doctor would you be taking notice of those on the internet off a medical specialist? I very much doubt it.

    FWIW, if I was unsure of/uncomfortable with the recommendations of a doctor for whatever reason, I would definitely ask the opinions of other people. Sometimes specialists don't have all the answers. As a matter of fact, when I was put on Metformin I started having serious issues when I was eating too many carbs - which was something my doctor had no idea about the correlation of, but people on the internet had also mentioned. When I lowered my carb intake, it was nothing but smooth sailing.
  • CrazyTrackLady
    CrazyTrackLady Posts: 1,337 Member
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    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. :-)

    I'm curious to know if that book was recommended by the same folks who do the show "The Food Hospital"? I started watching a show all about how choosing the right foods to eat can seriously and drastically reduce certain health symptoms, PCOS being one of them. The folks there are all the tops in their fields of diet, nutrition and obesity.

    I would suggest you google "The Food Hospital" and watch the episode they have of the woman with severe PCOS and how they drastically reduce her symptoms, and she drops a lot of weight, because of the changes she made to her diet. VERY impressive.
  • neandermagnon
    neandermagnon Posts: 7,436 Member
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    If you have a lot of fat to lose, you can get away with a bigger deficit. However unless you're on the brink of becoming very ill from obesity, or you're already at that point, losing the weight in a slow, steady and sustainable way is better, as you won't feel like you're torturing yourself in the process, and maintenance is easier.

    Very low calorie diets can be used in the short term when there's a medical need to it, i.e. morbid obesity that's severe enough that the health risks of staying obese outweigh the health risks of a very low calorie diet. Additionally, someone who's carrying a huge amount of body fat will be able to get away with a much bigger calorie deficit before health problems due to a very low calorie diet kick in. So in these circumstances, the VLCD may be the best option.

    If you're not in that category, then the best advice would be to follow a diet that's sustainable, that you'll be able to stick to in the long term. The aim is to reach the goal weight and stay there for the rest of your life, the goal is not to lose the weight as quickly as possible (unless you're on the brink of becoming seriously ill due to obesity, then there is a time factor in getting rid of the fat). If you're losing steadily on 1500 cals and not feeling excessively hungry, and you're doing a healthy amount of exercise, then I'd stick with that. Ask your doctor what the risks are if you stay at 1500 cals/day, i.e. will it harm your health if you lose the fat more slowly but still lose it and keep it off for life... if the answer is no, then stick with 1500 cals/day.

    And nothing wrong with getting a 2nd opinion. very low calorie diets have risks, and should only be prescribed when the benefits outweigh the risks.

    Also, I saw from other posts that you have PCOS... a lower carb (not zero carb, but being careful about how any and what kind of carbs you eat) can help with PCOS, so don't just watch calories, watch carbs too.
  • cindyhoney2
    cindyhoney2 Posts: 603 Member
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    Goodness, I exercised at 265 lbs. You should be at least walking each day if you can't do something more physical that is. I too agree that slow and steady wins the race. It has taken me 2 yrs to lose 90 lbs and you'll have to deal w/your lose skin too (it sucks) so you'll help yourself out in that area if you lose slowly. Good luck!
  • paulahutton1
    paulahutton1 Posts: 4
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    Not knowing your doctor, and what his credentials are, I would never tell you to go against his recommendations. What I would say, however, is, if you don't trust and have faith in what your doctor recommends, then you need to find a new doctor that you can trust. I have absolute faith in my doctor, and would do what he recommends knowing he has my health and best interests at heart. Anybody who can't say that, needs to find a new doctor.
  • icimani
    icimani Posts: 1,454 Member
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    I'm also at 270 pounds right now. I'm eating about 1800 cals a day and I don't eat back my exercise calories.

    If I'm consistent I do lose about 1 pound a week.

    Feel free to friend me.
  • cwolfman13
    cwolfman13 Posts: 41,867 Member
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    Being obese and on a very low calorie diet under a doctors supervision is much different than a very low calorie diet done on your own or a very low calorie diet when you only need to lose a handful of cosmetic pounds. If you really question your bariatrician, get a second opinion...otherwise, listen to your doctor.
  • Jagkat
    Jagkat Posts: 37 Member
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  • DavidC1857
    DavidC1857 Posts: 149 Member
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    I know it's an "evil fad diet", but I did Medifast. I was in the weight loss phase for about 9 months, started at 328 and went to 200. I am 6'4", 46 years old. I was eating a little higher than their recommendation of 800-1000 calories. I was usually hitting 1000-1100.

    I didn't die. I didn't starve, or really even feel hungry. I was not cranky (more than usual), nor did I feel sick. My metabolism appears to be fine. I lost 3 to 3.5 pounds per week, approximately. As far as I know I did not lose significant muscle mass.

    I did 8 weeks of transition, during which I lost down to 193 at one point. I've been in maintenance for 12 weeks and have not gained, beyond returning back up to my goal weight of around 200. I am maintaining at around 2100-2300 calories per day, which is technically lower than my TDEE. But I am not that concerned.

    Take it for what it's worth. TDEE-20% isn't the only safe, reliable way to lose weight.
  • Jagkat
    Jagkat Posts: 37 Member
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    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.

    We must have had the same dr..LOL I was told the same and took all the pills. I hated the way they made me feel so I stopped. And I was starving on 1200 calories and cranky so I stopped dieting. Now I am just trying to do it on my own..
  • dakitten2
    dakitten2 Posts: 888 Member
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    Try seeing a dietician. I have seen one monthly since I started in October 2011. I don't use any of the defaults set by mfp. My dietician reviews my food logs and adjusts my calorie intake and other percentages when needed.

    I've NOT had any weight loss surgery either. Are you planning on having WLS and having to lose a certain amount of weight before the surgery?

    I agree with other posters that doctors aren't the best source for losing weight. My dietician is with the diabetes unit of a major hospital and after my initial consultation, my visits only cost $13 a month. I don't have diabetes and am not pre-diabetic, but I wanted to see someone who was really knowledgeable and she has been a lifesaver. I only see my doctor for regular blood work and the discontinuation of so many meds.

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