Doctor Said 600 Calories a Day Was Okay?
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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
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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
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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
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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
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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 -
As a side note, I used to weigh 272 pounds - I'm 155 now. Even though my HR, BP, glucose, cholesterol, and every other stat imaginable were not only normal, but optimal, I was still treated differently by many medical professionals because of my weight. And I'm not talking about being concerned about my weight and making suggestions to lose it. That part was entirely appropriate. I am talking about the WAY they did it - the WAY they treated me.
The one thing that I found most frustrating/infuriating was how completely dismissive people in general, and medical professionals in particular were to me, and still are to people who are obese.
Don't let anyone "explain" to you that being morbid obesity is unhealthy ... as if you didn't know, or didn't have a brain in your head. Your doctor dismissed your concerns without taking them or you seriously. He literally said "you're fat so it doesn't matter". Trust your instincts. It IS a bias.
It is good that you spoke with more than one doctor, and that you are doing additional research to find out about options. You are going to need to speak up louder than the average patient.0 -
You can, and I do, get all my macro nutrients in 900-1000 calories. 85-105 grams protein, 20-25 grams of fiber, 100-130 grams of carbs (fruits, veggies, whole grains), and 25 grams of fat (only a few grams are saturated). If you eat right, you get way more bang for your buck. I love to eat, so the trade off is, if I want to eat a big portion, I choose to eat veggies and healthy food.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 -
Get a new doctor! I am 5ft 5in and used to weight 206lbs. My blood pressure, cholesterol, blood sugar and all other lab tests were within normal range even though,, according to my BMI, I was obese. My doctor never said a word to me about losing weight and really doesn't make any mention of my weight lose now.0
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Get a new doctor! I am 5ft 5in and used to weight 206lbs. My blood pressure, cholesterol, blood sugar and all other lab tests were within normal range even though,, according to my BMI, I was obese. My doctor never said a word to me about losing weight and really doesn't make any mention of my weight lose now.
I'd be more likely to question your doctor than the OP's, if they are not commenting on your weight when you're in the obese range. A lot of it comes down to minimizing risk and just because your blood numbers are fine today doesn't mean you aren't at a higher risk of health complications tomorrow.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.
This.
And for those who say that the doctor should be focused only on weight loss and might not be trusting her perception of the calories, since she's obese, remember she's lost 130 lbs. There's no need for such skepticism about her ability to lose weight without such an extreme calorie limit.0 -
Get a new doctor because this one does not care about your health and I've heard that's kind of important and stuff.0
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I had my gallbladder removed when I had a liver resection. I have no problems with fats, but I tend to not eat stuff with a whole lot of fat in it. My father had his gallbladder out and he eats terribly, but doesn't have a problem (other than being overweight). I think the whole no/low fat thing for gallbladder problems depends on the individual. Eating healthy is a good thing though (obviously).0
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This would not only ruin your health, but also your metabolism!
Medical doctors are not trained in nutrition issues. I would suggest you see a Nutritionist, preferably a naturopathic one that would help you with proper supplements and how to reach goals without completely wrecking your health! Congratulations on the weight loss you've achieved! Check out website of Dr. Josh Axe and also Dr. Mercola for a lot of healthy and common-sense information, recipes, weight-loss plan, etc.0 -
Most doctors know very little about nutrition, I'm not even kidding, it is a very small portion of the required curriculum, if it is even there. A good doctor would realize this and refer you to a registered dietitian, because they will have the nutrition background.0
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I'm a close friend of someone who recently had bariatric surgery, and while true, they aren't able to eat a lot of calories at first, they're also consuming a lot of supplements in order to give them the nutrients they need to survive!!!0
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I too have gallstones - or rather one MASSIVE one - it's huge and won't pass on its own so I am now waiting for surgery. In the interim I am trying to lose weight and sticking to a relatively low fat diet, high in protein, low in carbs (following the South Beach diet for the most part). I hadn't realised that my low-fat diet (during which I lost over 150lbs - though I have gained some back and am now losing it again) followed by a few months of bingeing on junk food and everything that is bad for me (hence the weight regain) actually caused the blinking thing in the first place. I am in a lot of pain a large amount of the time, my appetite has actually decreased and some days I struggle to eat, but apparently this is normal. I have seen a surgeon, two doctors and a nutritionist, been referred onto various diet plans and since done it mostly alone.
I had a doctor previously (moved and got referred to a new one) who constantly said nothing but "Calories in vs energy expended" and nothing more when I asked for help to get down from 368lbs...I ended up going it alone for the most part and though I am still not quite there I am doing it...I would recommend that you follow your 'gut' (no pun intended) and ignore the doctor when it comes to the calories, get a referral to a nutritionist if you can, they will help you to ensure that you eat a balanced and healthy diet and continue to lose weight.0 -
This is most likely going to get some hate response but here goes.
From working with doctors for many years, I’ve learned they might not be verbalizing their entire thought process, only the conclusion they come to. So his conclusion was most likely whatever you are eating is sustaining you. You have not lost weight too rapidly and you have not wasted away to nothing. The truth is most people do eat way more than they think they do and burn way fewer calories than they think. The fact that you report you are not hungry says a lot. He probably should have gone into more detail with you about your habits.
I would ask for a referral to a dietician. Since your doctor is blaming your health problems on your weight (correctly or incorrectly) you should be able to get that covered. If not ask if they have a nurse, PA, or NP who can work with you. You are your own best advocate. Bring this up at every follow up appointment. If you don’t get the support you need then switch. There is a bias when you “jump ship” among doctors, who talk to each other. Show him you are not lazy and that you are working this weight loss plan and need support.0 -
I've no idea how you can consistently function on so little and still manage to work out. I'm close to your weight and some days struggle to stay within the calories MFP sets me unless I exercise for more.0
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I have been there too. The doctor basically telling you your fat so if you don't need to eat that much it's fine. They don't understand because one, they have been bean pole thin all their lives. And two, they have seen so many obese people not follow their advise they are jaded.
I started at 307 pounds and at 5'6" that is morbidly obese. My doctor said it is not healthy to eat less than 1200 calories. The reason for this is that your body goes into starvation mode and will mass produce fat to store up for the starvation. If you do loose it is not fat but muscle, which is never good. I eat 1300-1600 calories a day and loose weight. If you loose too fast you have a better chance of putting it back on. My doctor gave me 3 months to loose 32 pounds and I am at the 20 pound mark now. It seems slow but I know it is healthy. Maybe you should look for a doctor that is not so jaded or "has been there". You want to feel comfortable talking about your weight issue. I know from experience that having a doctor like the one you described does not help your challenge or your self esteem! You deserve better! Keep up the fight! You ARE worth it!0 -
Doctors aren't here to be your friends or provide a shoulder for you to cry on.
Sometimes the cold, hard truth hurts, and can be a kick in the *kitten* for people to get their act right and get to where their body needs them to be.
Nothing wrong with what the Dr. said IMO0 -
Doctors aren't here to be your friends or provide a shoulder for you to cry on.
Sometimes the cold, hard truth hurts, and can be a kick in the *kitten* for people to get their act right and get to where their body needs them to be.
Nothing wrong with what the Dr. said IMO
:noway:0 -
I agree with many others who have responded to your questions. I would, without a doubt and as quickly as I could find a new doctor. The cold hard truth can be delivered with compassion and caring. This guy just sounds like an *kitten*.
Also I think if I were you and questioning my daily caloric intake, I would first assess exactly what is is I'm eating and then move on to a more healthy diet from there. From everything I have read and learned your intake of 600-800 is far too low. I worked with a registered dietician for a year and she always coached me to never go below 1200.
At this moment I am trying to increase my protein intake and I am finding that some of the high protein foods I love are a bit higher in calories than others. Since protein is such an important building block of a healthy diet, you may want to start there first.
Good luck with everything and congrats on your weigh loss to this point. I wish you success and joy as you continue your journey to a healthy lifestyle.0 -
Well, morbidly obese people will have more fat to derive energy at around 30/cals/lb/adipose but it's still very low calorie consumption......I suspect that you'll binge frequently, which will kinda negate the low calories.......try upping the calories to around 1500 or so.....trust me you'll still lose weight. The biggest drawback for you will be daily required nutrients, which you don't want to mess with going forward.......
Agree on all points. Physically you'd probably be fine at 600 calories, at least for a while, assuming you follow a strict diet and supplement as needed to ensure proper nutrition. But what's physically possible is only half the battle. You also need to find a diet and exercise routine that is sustainable and that helps you make progress towards your goals. If you're trying to stay active, a VLCD is probably not the best way to achieve those goals, as you'll probably lack energy on such a diet. Not to mention, that lack of energy and overall feeling of crappyness needs to be considered when it comes to how sustainable the diet is. It might be perfectly sustainable depending on the person, but it's just something to consider.
So while his advice was probably fine in theory, in practice I'm not sure how helpful that advice actually is.0 -
Get a new Doctor.
My doctor said not to go under 1000 calories, then you are going into starvation mode.
I battle with Diverticulitis and Irritable Bowel Syndrome, when I have to go on a low residue diet for a couple of days.
Doctor said try to keep it at 1000 calories at least.
When I was on a low fat diet, I kept getting cold no matter how many layers of clothing I had on
I just kept chilling, when I added more fat to my diet my metabolism came back on track
Good Luck in finding a new doctor, one that is not so judgmental and will take the time to talk to you
I have an excellent doctor who I really like and has helped me on my weight journey.
I am now on Maintainence mode now0 -
Personally I would be more worried about a doctor that believes in starvation mode than a doctor who thinks a VLCD may be appropriate for an obese patient.0
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