NHS very low calorie diet help

Hi,

According to the NHS requirements you have to have a BMI of 45 to 49,9 with at least one co-morbidity (diabetes or high blood pressure) or a BMI of over 50 in order to be considered for bariatric surgery, so the doctor is correct on that, but the diet is ridiculous....

If you are depressed, eating at that level is not going to help you, it will probably make you feel worse - I know it would me and I'm not depressed....

Where in the country do you live, I went onto one of the NHS weight management schemes called Waist Wise (Tier 2) and it was pretty good, I'm currently on Tier 3 (lifestyle) but I was on Tier 4 (pre surgery, but I declined the surgery after losing over 3 stone in 3 months). Personally I'd go back to your G.P and say you're unhappy with the dietitian and asked to be referred to another one, maybe at a different hospital.

1000 calories a day is not going to help you lose weight, if 1200 wasn't doing the trick; serious sweetheart, go back to your G.P, demand more tests - I have PCOS but every test known to man has come up negative for it, only an ultrasound scan proved what my G.P had already suspected to be the case.

I really hope you get this sorted out soon and hope you get a proper dietitian, as the one you currently have seems a bit of a *kitten* in my personal opinion.

xXx

I'd go and speak to your Doctor again or go see another one in your practice.

1/ One of two things are happening either your eating more than you think or log (no I'm not saying your lying) sometimes people just don't realise what they eat unconsciously or how big there portions really are (just watch secret eaters for proof of that). Frequently people think they're logging honestly but they really aren't

2/ The other option is you have a serious medical problem which really needs to be dealt with via a specialist so your Doctor should refer you to the appropriate specialist for the most appropriate tests/treatment.

Either way go and see your doctor as IMO the dietitians advice is poor as with any other profession you'll get good and bad ones. (An NHS Dietitian once recommended my wife drink milk even though she's allergic to milk and eggs and no matter how many times we said this or pointed to the diagnosis on her medical records this dietitian was convinced milk was the answer)

This seems crazy - so low calorie and almost no protein? It seems very extreme. Go see another dietician, perhaps also an endocrinologist?

However, about the previous few months:

Have you been weighing everything you eat and drink with a digital scale, and logging it BEFORE you ate it? (so not using eyeball estimations, no measuring spoons/cups etc, and no remembering what you ate after the fact)?

I'm asking because looking at your diary in the past few months, the answer seems no, and is full of "cups", "scoops" and thing like "1 small banana" if it is filled in at all. In sum, your diary seems very very inaccurate. Maybe your written diary is different (everything written down, and all of it weighed out in grams?). If not, try actually measuring and logging what you eat.

Also: Have you tracked any exercise, and if so, how did you measure your exercise calories?

Have you tried some of the recipe books for the likes of the 5:2 fasting diet. They have lots of low calorie but filling recipes in them.
Although it doesn't look like you are allowed much protein apart from that provided by the meal replacement drinks.

I hope you find a solution to the problem 1000 calories is tough to bear especially if you are trying your best to lose weight.

At least its only 12 weeks that they have you on this for, unless of course they find another reason in the mean time

I personally use the garmin vivofit to track activity as it has a HRM facility I can use with it as well. Also I have other garmin items so it all ties together for me

I peeked at your diary and I have a comment. Please don't take it as harsh criticism, this was something I learned not too long ago: Western "Chinese" food is crap. It's crap and it has way more calories than you might think.
You should get to indulge every once in a while-- especially on such a restrictive diet!-- but if you could just adjust your palete so that a splurge was, say, a handful of pistachios or turkey jerky or even a homemade ham sandwhich, I think you'd feel much better overall.

^^ Totally agree!.

Also, get off the Slim Fast. Not good for you. A lot of sugar. Add protein to your diet. It is not all about eating a certain # of calories. You need to balance out where those calories are coming from. Get on something like 40/30/30 (40% carbs/30% protein/30% fats) Balance everything out. Be choosy about where your calories are coming from.

Is the 1000 a day net calories, or total calories consumed?
So are you allowed to eat back the calories burned? Cause if not, then my first tought about this is that you are eating too low! And that's the reason you gain weight. I actually have had something similair in the past, eating at a 700 a day for 10 weeks and i gained 5 kg.
This was before MFP but i did weight everything i ate.

Last year i actually started to do it better by eating 1600 calories a day and eat back my exercises.
Lost about 5 kg in the first month

I'm sorry, but that is just scientifically impossible to gain over 10 lbs if you were truly only eating 700cals a day, EVERY day, for 10 weeks with no cheat meals. It takes 500 cals a day OVER maintenance to gain 1 lb a week, so that would mean your maintenance cals were only 200 cals a day?? Just would not happen.

I peeked at your diary and I have a comment. Please don't take it as harsh criticism, this was something I learned not too long ago: Western "Chinese" food is crap. It's crap and it has way more calories than you might think.
You should get to indulge every once in a while-- especially on such a restrictive diet!-- but if you could just adjust your palete so that a splurge was, say, a handful of pistachios or turkey jerky or even a homemade ham sandwhich, I think you'd feel much better overall.

^^ Totally agree!.

Also, get off the Slim Fast. Not good for you. A lot of sugar. Add protein to your diet. It is not all about eating a certain # of calories. You need to balance out where those calories are coming from. Get on something like 40/30/30 (40% carbs/30% protein/30% fats) Balance everything out. Be choosy about where your calories are coming from.

Losing weight IS about eating a certain count of calories- calories in/calories out. Nutrition is about meeting your macros. I agree with 40/30/30, but not for weight loss purposes. You can have any combination of macros and still lose weight as long as you eat at a calorie deficit.

Couldn't agree more. People haven't read the thread or diary - OP has an answer for everything and not many sound plausible.

This may sound harsh. But it 100% (still) sounds like you aren't logging accurately and consistently. And as above poster has said, probably jumped from diet to diet with periods of overeating in between. I hadn't heard of NHS dieticians recommending slimfast but it could be for the reasons above I suppose.

OP try giving this diet your best effort for more than a few weeks and if you are tempted to binge (I'd find it very hard to believe that you didn't occasionally especially if you have been depressed about your appearance and you are using such restrictive diets) then log every single thing - at least then you can look back and say, 'okay I had 3 days were I blew my calories by 1000, that explains that 1lb gain' - surely that would be better than logging 600-800 calories and saying you don't understand why you have 65 or 80 lb (depending on which was accurate) to lose and it's not happening.

If you did that, I think you would get a better take on how this works and could then probably deal with a more sensible deficit. I hope you get a handle on it and it works for you this time.

The log is accurate and I find it really disrespectful to assume that I'm cheating on this diet, my original question has nothing to do with my previous weight loss attempts, I am asking for nothing more than recipes that fit within my diet. You should not make assumptions that because I have depression which is exasperated by my weight that I over eat, depression is mental health issue and it doesn't always produce behaviours that link to the problem.

It seems like you just want people to tell you your doctor is wrong and that you should eat more food. You're free to do what you want, but eating more food is not going to cause you to lose fat. And you might be asking for recipes but you've also given way more information than that about your situation in this thread, and so it's no surprise people are trying to give you helpful advice.

And saying your log is almost certainly inaccurate is not some personal attack on you or people trying to disrespect you. It could be as simple as you not using a food scale. Food entries like "1 cup of chicken" and "200g of potato" are pretty solid indicators that you're estimating what you eat, and while the log may be accurate in terms of the foods you ate, the portions could very well be completely off because you're just estimating. Estimating is fine if you're still losing weight, but for someone who claims to be unable to lose weight and is potentially even gaining weight, estimating should be about as common as Halley's comet. People are trying to bring that to your attention so that you can correct it, not to try and pick on you.

All that said, I do agree with the people saying to try and get more protein. Perhaps see if you can substitute a low calorie protein shake for at least one of the meal replacement items, if you're sticking with the original plan.