Doctor Said 600 Calories a Day Was Okay?
Options
Replies
-
I think you need to ask what you need and want in a primary care physican and if you can find it. Will another professional be able to help more?
Yes this MD sounds like a tool but I don't know if you are going to find much better.
I have been going to a lot of doctor appointments with a parent lately and am generally horrified at what gets ignored or glossed over. Recently we wanted to change one of the doctors and the Primary strongly counseled against it ...not because the docotr was good but because it could be seen as doctor shopping and then no one will see you. I am not happy that the issue isn't the quality of care but if the original doctor gets his feelings hurt.
I am always puzzled when people suggest talking to your doctor as if he or she knows everything. I have been overweight most of my life and doctors have said 2 things to me: "you might want to lose some weight" and "soy is good for you".
Maybe search locally for an RD attached to a hospital that isn't pushing weight loss surgery.0 -
If it's a financial burden to change doctors and his care has been adequate in other ways, disregard his diet advice.
I agree that your doctor was less than compassionate but it isn't prejudice to say your diet caused the gallstone or can cause T2 diabetes. Maybe that was his inelegant way of trying to warn you that you are setting yourself up for more than just gallbladder surgery if you were to continue to eat excessive fat, sugar, calories.0 -
Your doctor is not crazy, and you should not "report him" as other posters are suggesting. There are different approaches to weight loss for obese patients, and one of those is the Very Low Calorie Diet (VLCD). http://www.win.niddk.nih.gov/publications/low_calorie.htm
If it's working for you, you don't feel deprived, and you've got the go-ahead from your doc, there's nothing inherently wrong with your diet.0 -
Is the doctor who recommended 600 calories a day the same one who recommended surgery?
I would get a second opinion on both.
The operation may be necessary. Most people who have trouble with stones have actually had them for years, but the stones were small enough to pass without much difficulty, or they did cause symptoms, but they were mild enough that the people didn't worry about them or even know what they meant. You may have damage to your gall bladder that has been going on for a while. However, given his other comments, I would still ask another doctor. This is surgery, and all surgery is major.
The calorie intake is another matter.
#1, It really is an unhealthy range. Telling you basically that "doing whatever it takes to lose weight is fine because you are so fat" is not only inappropriate, it is medically irresponsible. Eating zero calories would also cause you to lose weight, but your fat is not going to protect you from the dangers of that behavior.
#2, rapid weight loss can actually CAUSE gallstones and gallbladder distress.
Yo-yo dieting in general puts stress n the gallbladder, and that's really what you would be doing, because eating 600 calories a day is simply not sustainable. you would end up binging, or going off the diet and then trying to go back on.
If he is worried about putting the gallbladder under additional stress before the surgery, and wants you to avoid fat because of it, fine. But he should also be concerned about stressing it with dramatic calorie reduction.
Get a second opinion before you go under the knife.
You may very well need the surgery, but even if you do, get another doctor to help guide you with a reasonable, healthy and SUSTAINABLE weight loss plan.0 -
It's okay. The tinfoil-hat-wearing people love to trot out the old "starvation mode" myth that was disproved over 60 years ago, but like a zombie, just won't die. How much do you think people that have had *successful* weight loss surgery are eating? Certainly nowhere near 1000 calories, much less over that. As long as your calories aren't made up by empty fluff like starchy carbs (potatoes, rice, breads, grains, cereals, etc.), and are eating dairy in moderation (although a good source of protein, is still high in carbs due to lactose), and you're filling up on proteins and veggies, you can be perfectly healthy and lose weight on that few calories. After all, veggies hardly contain any calories, so the bulk of your calories would be coming from proteins and fats. It's very hard to eat anywhere near 1000 calories worth of veggies in a day...unless you're a wood chipper.
If you can get all of your daily micro nutrients (including fiber, iron, calcium, vitamins, potassium, etc.) on 600-1000 calories (no cheating, vitamin supplements don't count, we're talking food, and you say "perfectly healthy"), I'll eat a tinfoil hat. Bonus: I'll eat an entire tinfoil suit if such a diet doesn't result in anemia, severe muscle loss, fatigue, significant hair loss and reduced bone density.0 -
Two separate doctors recommended surgery. It's a single stone (I had to get my records released from the hospital for unrelated reasons, etc.), and that's the first time it's ever bothered me. I only even went to the hospital/ER because I thought I had appendicitis. Of course, the ER doctor saw I was obese and ran a panel for blood sugar as well, so at the least, I know I'm in no danger for diabetes. I'm in the lower range of normal, actually. (yay!) I believe it might be needed for some, but not a single doctor has talked to me about alternatives that I've now learned from the internet. Such as them passing or medications. It's frustrating.
I know the weight loss can cause gallstones. I imagine that's probably what caused the first one.
I'm working on trying to increase my calories against his advice, but I want to do it in a good way. i'm trying to find good low/no-fat options with high-ish protein, but I'm a bit tired of chicken and skim milk.
And I can only have so much tuna before I'm concerned about mercury. 0 -
I would say that you need a new Doctor because you don't feel respected by him or trust his judgment. Trust and respect need to be at the core of your relationship with your primary care physician.
The 600 calories per day depends. I am one of those people who had weight loss surgery (gastric sleeve). I started at 367 lbs, and am currently at 222. I eat about 900 calories per day. (The whole point is to maintain a significant calorie deficit so that my body will use my stored fat resources for energy.) However, I am under close physician supervision, including routine blood work to test my vitamin levels and organ functions. I meet minimum daily protein goals (at least 75 grams) so that my body will not cannibalize my muscles for needed protein. (There are zero carb low calorie protein shakes! - I drink syntrax nectar.) Also I take vitamins and minerals every day, because 900 calories of food does not give me 100% of my RDA of most nutrients. So I don't think 600 calories in and of itself is a problem, but that low of a calorie diet should be closely monitored and supervised by a professional.
Best of luck to you.0 -
I don't think it's a bias at all. You're obese, which puts you at risk for certain diseases which can be easily tested for to rule out the risks. Also, as this is a new doc for you, it's wise for him to get a full range of tests done to see how your overall health is doing if previous results are outdated, missing from your file or if tests have never been done. After my cousin passed away from a sudden heart attack several years ago, I now get a comprehensive blood test done at my annual to rule out any hidden issues. Better to be safe than sorry.
It's my understanding that general practitioners don't get a whole lot of nutrtional education in school. Also, the science behind nutrition changes almost constantly. Just think of how eggs were evil in the not too distant past and now are considered completely fine to eat. Hell, I remember even hearing at one point that oatmeal was bad for us. So much info out there and hard to keep up.
Anyway, my point is, you won't necessarily get better advice from a different GP. How about going to a Nutritionist for a more specilized guidance?
600 is definitely too low. As williams696 pointed out, there's no way you're getting proper nutrition on that little calories. At least with 1200, while it still may be quite low for you, you're more likely to cover all the bases.
ETA: Additional thought. If you don't trust your doc or don't like his bedside manner, you should definitely find someone else. There's nothing more stressful IMHO, than having to go get serious advice about your health from someone that doesn't seem to know what they're talking about. I've had good luck thankfully but my husband has had some of the worst doctors...wish I could find someone local for him (my doc is located by my work, not home).0 -
i'm trying to find good low/no-fat options with high-ish protein, but I'm a bit tired of chicken and skim milk. And I can only have so much tuna before I'm concerned about mercury.
Lean beef
Lean pork
Wild game
Beans0 -
To be honest, his advice probably isn't as wrong as people are making it out to be. Your doctor is coming from the perspective of knowing the health consequences of being obese, which are dire. I can't speak for him, but I suspect he hears that you're losing weight and you're not going hungry, and thus concluded you should keep doing what you're doing to get the weight off as soon as possible for the benefit of your health. Your biggest risk eating such a deficit is probably going to be malnutrition and perhaps a bit more LBM loss, and I suspect your doctor believes those pale in comparison to the risks of continued obesity in your current state.
That sort of advice goes against the typical weight loss forum advice because it's way more aggressive than it typically recommended in fitness circles, but that doesn't mean it's wrong. Honestly, I think a lot of people take the "slow and steady" mentality way too far around here - I've seen recommendations for people that have over 100 pounds to lose to just aim for 1 pound a week, when in reality they can and almost certainly should aim to be more aggressive with their weight loss.
Not saying he's right or that you should go out and eat 600 calories, and certainly it's not a bad idea to get a second opinion, but just that the kneejerk reaction people are having to "OMG it's under 1200 calories!" is probably not warranted. We have tons of examples of obese people losing substantial amounts of weight with VLED's, with many of them keeping that weight off in the long-term. I think a lot of the posts here are well-intentioned but are overlooking the risks of continued obesity.0 -
Dude !!
I am sure you didn't like what your doctor had to say and especially how he said it to you. However if you are morbidly obese then you are playing with your life. Are you going to take the advise of some random Internet experts or seek sound medical advice ?
considering the stakes perhaps you should get a second medical opinion if you don't agree with your doctor.
Otherwise I would take my doctors advise over what Internet experts are regurgitated from something they heard or read but clearly have no medical background in.0 -
he's probably operating under the assumption that your eating more than you think. he is right even if his comments came off rude, you need to lose weight and eating less is the way to do it. maybe ask hin a few more questions before looking for a new doctor0
-
I'm working on trying to increase my calories against his advice, but I want to do it in a good way. i'm trying to find good low/no-fat options with high-ish protein, but I'm a bit tired of chicken and skim milk. And I can only have so much tuna before I'm concerned about mercury.
If you're really concerned about his advice, I'd talk to another doctor. Don't make important decisions based on internet forums.0 -
You need another doctor! Yes, doctors should inform/warn us about the issues of being over weight. However, there is a way to say it. We already know we are over weight. One thing I have learned from the years of gaining and losing weight is that it is better if you reduce gradually. This is confirmed by how Weight Watcher does it and MFP. My calorie limit is less know then it was when I started at 245 pounds. The slow process allows your body to adjust to eating less and helps with keeping the weight off.0
-
Interesting post- as I just had a similar convo with my doctor (mine was much more compassionate). My doctor advised me to keep my calories at 1000. I said that goes against everything I read and hear about the body needing at least 1200 calories for BMR. I know all BMR's are different, but I thought all the talk meant that NOBODY should go below 1200.
He explained to me that he has many patients with BMR's less then 1200 and have several at 600. Yes- they only need 600 calories to keep their body functioning. He said that some people just have very low BMR's and I am one of them (I do have thryoid issues, which was why I had the appointment, because I was having symptoms- but he said my levels are perfect). My doctor is well respected by other health care workers (they rave about him everywhere I go).
So that is probably one of the reasons why your doctor wasn't concerned about eating 600 calories if you felt fine on it. Now, this doctor's bedside manner wasn't the best-that alone would be the first reason I would be looking for a new doctor.
Thank you. I was at my heaviest at 327 lbs. Always lost 30, gained 60, lost 30, gained 60. I don't usually respond to these threads because I know the backlash people get from so many people with that same narrow mindset. You'd be amazed how uneducated many really are. The body can survive just fine on less than 1200 cal/day, when there is excess weight like the OP mentions. According to my doctor, it is not until your body reached 5% bf or less that it starts to realize this "starvation mode" everyone talks about.
Unfortunately for those of us who have been obese, our bodies will never function the same as a normal/slightly overweight person. That's what obesity does, it changes everything. My permanent solution, I had surgery. Call it what you will (I'm looking at you, you judgemental, narrow-minded people), but after losing all my excess weight and getting down to a healthy 140 lbs at 5'6", I am the healthiest my doc has ever seen! Do you know what program my surgeon put me on? Seeing as I could only handle about 4oz food as a meal ever, I had a hard time getting to the 400-600 cal/day requirement initially. My maximum allowed in the losing phase further out was 800 cal. Now at goal, healthier than ever, I am to maintain at ~1200, or as the doc says, whatever level my body finds balance at with a bit of experimentation. I exercise regularly as well.
As long as it's doctor-monitored, and your bloodwork/checkups are done regularly to make sure everything is fine, I say don't knock it. Only recommendation is don't forget your vitamins
0 -
Why would you stay with a doctor that didn't have your health as their main concern?
First - congrats on your weight loss so far - that is amazing!
Second - you are correct, 600 calories a day - especially with exercise is not healthy. Any doctor worth their medical license knows this.
As I understand it, a low fat diet is the best for gallbladder issues. But from what I've seen in friends and family members is that it's fried foods, way to much butter or olive oil that can cause issues. Try some healthy fats - avocados, nuts, etc. to help with the calories.
I had my gallbladder out 9 yrs ago. It's all fat, even healthy fat. But if you stay at 30g or less daily and spread it out over the day (no binging on eggs and bacon, sadly), you should be fine.0 -
I'm working on trying to increase my calories against his advice, but I want to do it in a good way. i'm trying to find good low/no-fat options with high-ish protein, but I'm a bit tired of chicken and skim milk. And I can only have so much tuna before I'm concerned about mercury.
If you're really concerned about his advice, I'd talk to another doctor. Don't make important decisions based on internet forums.
^^^Exactly what I was about to post.0 -
So you're going vegan for the time being. Check. Dry seasonings may not be as much fun as sauces, but cayenne pepper doesn't have any fat. Cheers to the internet for having all of the recipes, ever.
Also, your doctor can take a long walk off a short pier. Drink your calories and take your vitamins, but if you're old enough to be on this site, you're too old to live off half of a McD's salad. Unless you have severe medical issues (other than your gallbladder), you burn 600 calories during a restless night's sleep.0 -
The reason they want you on a low-fat diet could be to shrink your liver so they have easier access to your gallbladder. Just a thought.0
-
To be honest, his advice probably isn't as wrong as people are making it out to be. Your doctor is coming from the perspective of knowing the health consequences of being obese, which are dire. I can't speak for him, but I suspect he hears that you're losing weight and you're not going hungry, and thus concluded you should keep doing what you're doing to get the weight off as soon as possible for the benefit of your health. Your biggest risk eating such a deficit is probably going to be malnutrition and perhaps a bit more LBM loss, and I suspect your doctor believes those pale in comparison to the risks of continued obesity in your current state.
That sort of advice goes against the typical weight loss forum advice because it's way more aggressive than it typically recommended in fitness circles, but that doesn't mean it's wrong. Honestly, I think a lot of people take the "slow and steady" mentality way too far around here - I've seen recommendations for people that have over 100 pounds to lose to just aim for 1 pound a week, when in reality they can and almost certainly should aim to be more aggressive with their weight loss.
Not saying he's right or that you should go out and eat 600 calories, and certainly it's not a bad idea to get a second opinion, but just that the kneejerk reaction people are having to "OMG it's under 1200 calories!" is probably not warranted. We have tons of examples of obese people losing substantial amounts of weight with VLED's, with many of them keeping that weight off in the long-term. I think a lot of the posts here are well-intentioned but are overlooking the risks of continued obesity.
agreed. sounds like your doctors primary concern is getting your weight down, which is fair, imo. being morbidly obese ups your chances of nearly every health issue that you could think of.0
Categories
- All Categories
- 1.4M Health, Wellness and Goals
- 391.6K Introduce Yourself
- 43.5K Getting Started
- 259.7K Health and Weight Loss
- 175.6K Food and Nutrition
- 47.3K Recipes
- 232.3K Fitness and Exercise
- 393 Sleep, Mindfulness and Overall Wellness
- 6.4K Goal: Maintaining Weight
- 8.5K Goal: Gaining Weight and Body Building
- 152.7K Motivation and Support
- 7.8K Challenges
- 1.3K Debate Club
- 96.3K Chit-Chat
- 2.5K Fun and Games
- 3.3K MyFitnessPal Information
- 23 News and Announcements
- 938 Feature Suggestions and Ideas
- 2.3K MyFitnessPal Tech Support Questions