Help really Needed, PCOS & Visceral fat

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NiftyPineapple914
NiftyPineapple914 Posts: 16 Member
edited November 2014 in Health and Weight Loss
Dx at age 18 with PCOS. Was always very skinny but extremely hirsute with double max level of testosterone. Was put on glucophage/metformin 500mgx 3 daily. Weight remained stable but periods returned after 5+ years absence. I always avoided grains and a lot of dairy but ate a lot of fruit and beans, so my diet was not at all low carb.

Cue March of this year. Was hospitalised due to reaction to antibiotics. Rhabdo for ten days meant i lost HUGE amounts of muscle. Periods disappeared immediately. 9 months have passed, still no periods and I have gained an enormous amount of body fat. IDXA/DEXA scan revealed I am low-middle/ healthy BMI but with 33% body fat (!) and Vast majority is visceral (stomach). It is rock hard with the fat around my organs.

Stats: 5ft 2 53kg, Tiny (think asian) frame. Maintained with ease around 103-106 for years with normal cycle and managed pcos symptoms. Calculators say my BMR is around 1100, when calculator includes my high BF %.

I am looking, desperately, for advice on:

1) Ideal weight loss protocol. At the moment I am intending to continue my new plan of weight training 3x a week with 1-2 days of intense cardio between 20 and 60mins.
2) How many calories to eat.
3) For someone so insulin resistant and androgen-dominant, should I stick to below 50g carbs net? This is what I have been shooting for.

Aiming to lose 10lbs by Feb '15.

Anyone with knowledge of shedding viseral fat and increasing insulin sensitivity, please chime in, and commentary on total calories would be hugely appreciated.

Replies

  • ana3067
    ana3067 Posts: 5,623 Member
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    1) caloric deficit.
    2) calculate your TDEE and subtract 20% from it and set as goal; or calculate net energy needs withou including exercise and subtract 20% from that and set as your goal while eating back at least 50% of your exercise calories that you log. Exrx.net is a good website for most people, they have a calculator.
    3) Stick to whatever works for you. If for health purposes your doctor says to eat this few carbs, then go ahead.

    I\d assume losing visceral fat is the same as losing any fat: caloric deficit, enough protein to minimize muscle loss, weight training for the same purpose, small to moderate deficit (10-20%), very accurate logging every day (weigh food).
  • warriorguy
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    Can't give advice. Testimony of my daughter-in-law, age 57....weighed 152....went on 8 weeks 800 cal. diet....3 to 4 mile brisk walk daily....lost to 125 where she is maintaining, and said she never felt better or had so much energy the whole time. She was Type II diabetes, and is now non-diabetic and takes no Metformin or Glucophage like my wife does. I would highly recommend doctor overseeing your program but don't believe the lie that you can't nutritionally get diabetic free....some do. Good luck. Act wisely.
  • NiftyPineapple914
    NiftyPineapple914 Posts: 16 Member
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    Okay so when I select 'exercise 3x a week' my tdee - 20% is 1250 calories net. But when I select sedentary, my tdee-20% is less than my BMR! Pasted: ''Your BMR is:
    1137 . . .Your TDEE is: 1364 ( so this is before subtraction of 20%)''. . .

    So do I eat 1250 on workout days and less than 1000 net calories on non-workout rest days? I work long hours at a desk. I want this to work but don't want to do anything unsafe. Eating so little wouldn't be impossible as i typically shoot for over 140g protein a day and lots of fats but want to make sure that even as a tiny person people have been successful and not caused further metabolic damage.
  • lolly715
    lolly715 Posts: 106
    edited November 2014
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    I am roughly your height with PCOS. I find I don't need to limit to 50g carbs. I have my goal set to 40% (roughly 100g) and it is low enough for me to see results. I do try to limit the higher GI carbs though. Both of these limits were recommended by my doctor.

    Your calories are going to be tricky. Because you're short and already at a low weight, your TDEE calculation even with the exercise is only about 1650. So you may not be able to healthily create a large enough deficit to lose 10lbs in only a few months. I'd suggest doing TDEE-20% (roughly 1350 calories) and see how that goes.
  • Liftng4Lis
    Liftng4Lis Posts: 15,151 Member
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    Caloric deficit = weight loss. With only 9 pounds to lose, its more difficult, as that logging belt needs to be tighter.
  • ana3067
    ana3067 Posts: 5,623 Member
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    Based on your stats, 1750 would potentially be a good starting intake to lose ~0.5lbs/week or less. I have no idea where you got 1250 calories from.

    I got 1750 by averaging out numbers for 1-3x a week and 3-5x a week, because you say you are doing weights 3x a week and cardio a few x a week.

    scoobysworkshop.com/calorie-calculator/
  • ana3067
    ana3067 Posts: 5,623 Member
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    lolly715 wrote: »
    I am roughly your height with PCOS. I find I don't need to limit to 50g carbs. I have my goal set to 40% (roughly 100g) and it is low enough for me to see results. I do try to limit the higher GI carbs though. Both of these limits were recommended by my doctor.

    Your calories are going to be tricky. Because you're short and already at a low weight, your TDEE calculation even with the exercise is only about 1650. So you may not be able to healthily create a large enough deficit to lose 10lbs in only a few months. I'd suggest doing TDEE-20% (roughly 1350 calories) and see how that goes.

    Where are you getting her TDEE as 1650 based on her working out at least 3x a week? Even with working out 3x a week I'm getting her TDEE 200 cals higher.

    TDEE-20% is definitely too much for her as well right now. -10% is more htan enough with such a small goal.
  • 09NewMe12
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    Hello;
    My name is (Nat)alie, and I am 38.
    I was just diagnosed with Type 2 Diabetes, and am very over-whelmed by the daunting life-style changes around me. I have a lot of family, friends, and people I know with Type 1 or 2 diabetes, however unfortunately none of them are good examples of how to look after yourself.
    They all don't take the diagnoses seriously and still eat what they want, and don't look after themselves, and for me this is a wake up call. Almost like I was waiting for something this extreme to kick me ***** to get healthy, be a better me, and really take this seriously....but WOW no idea where to start, how to feel and still feeling worried that I wont figure it out or navigate through how to start...
    Anyways looking for friends that can be supportive, motivating, share info (diaries to look at), and just share in this journey together. Thank you so much for reading!
    cheers~ Nat :)
  • rainbowblu
    rainbowblu Posts: 119 Member
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    Liftng4Lis wrote: »
    Caloric deficit = weight loss. With only 9 pounds to lose, its more difficult, as that logging belt needs to be tighter.

    Not always that simple when you have PCOS.
  • ana3067
    ana3067 Posts: 5,623 Member
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    rainbowblu wrote: »
    Liftng4Lis wrote: »
    Caloric deficit = weight loss. With only 9 pounds to lose, its more difficult, as that logging belt needs to be tighter.

    Not always that simple when you have PCOS.

    But it is, because it will still be about eating at a deficit. So if OP weighs food to ensure as much accuracy as possible and eats at a 10% deficit from her estimated maintenance needs, then monitors for a month or two... she can lower the calorie intake if she's not losing ~2lbs/month. It's the exact same process as everyone else. Do it until you find the number that works.
  • NiftyPineapple914
    NiftyPineapple914 Posts: 16 Member
    edited November 2014
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    It is definitely harder to lose on a small deficit with PCOS.

    Exercising 3x a week = 30mins weight training. So I don't think this will account for a significant calorie burn? My heart rate goes up for sure but I don't see a way of tracking so I'd rather err on the side of caution intake-wise on those 3 days but ensure sufficient protein. Does this sound sensible? I've ordered a Polar ft4 so that I can clock calories burnt on the two other cardio work out days, probably one day cycling at speed of above 80km/h 30 mins, and one day of an hr long zumba class.

    Still would love any more input on tdee etc and thanks for replies so far. I'm really desperate for my cycle to come back, gyne just recommended progesterone tablets but I know from experience these cause serious retention and weight gain and I can't wear anything but loose tracksuit pants as it is.
  • lolly715
    lolly715 Posts: 106
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    ana3067 wrote: »
    lolly715 wrote: »
    I am roughly your height with PCOS. I find I don't need to limit to 50g carbs. I have my goal set to 40% (roughly 100g) and it is low enough for me to see results. I do try to limit the higher GI carbs though. Both of these limits were recommended by my doctor.

    Your calories are going to be tricky. Because you're short and already at a low weight, your TDEE calculation even with the exercise is only about 1650. So you may not be able to healthily create a large enough deficit to lose 10lbs in only a few months. I'd suggest doing TDEE-20% (roughly 1350 calories) and see how that goes.

    Where are you getting her TDEE as 1650 based on her working out at least 3x a week? Even with working out 3x a week I'm getting her TDEE 200 cals higher.

    TDEE-20% is definitely too much for her as well right now. -10% is more htan enough with such a small goal.

    That came from IIFYM, using the BF method since that was a known figure. I normally wouldn't recommend -20% for a small goal, however PCOS definitely skews the figures. So I personally would start with the higher deficit and increase up if required.
  • psuLemon
    psuLemon Posts: 38,411 MFP Moderator
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    Honestly, there are tons of calculators and all are a bit different. What I would suggest is starting around 1600 with 25% carbs, 30% protein and 45% fats and fiber around 30g+. Honestly, LCHF is the way to go with PCOS but you still need to achieve a deficit. Having said that, make sure you log every day and use a food scale. It's possible once you get to a lower weight, you might have to add some muscle back through a bulk to get the figure you want.
  • NiftyPineapple914
    NiftyPineapple914 Posts: 16 Member
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    yes including the high bf% makes a difference. I think 1600 seems a bit too high. I doubt i could even maintain on that consistently without doing intense cardio every day given my small frame.. .
  • psuLemon
    psuLemon Posts: 38,411 MFP Moderator
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    yes including the high bf% makes a difference. I think 1600 seems a bit too high. I doubt i could even maintain on that consistently without doing intense cardio every day given my small frame.. .

    Considering you are fairly active (since you workout 5 days a week), I don't see 1600 is far fetched. I know plenty of women your size, that are older losing at that calorie range. And based on your stats, workout plan, I would have you at 1600 to start. I suspect you would maintain around 2000 calories.

    But if you don't feel comfortable, start at 1400 calories with similar macros. In the end, these are all estimates and they only weigh to really understand is track your food every day, use a food scale to measure all solids and use measuring cups/spoons for liquids and assess at 4-8 weeks.


  • NiftyPineapple914
    NiftyPineapple914 Posts: 16 Member
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    I would understand 1600 if it was 5 days of cardio. But its 2x out of the 5 days. And my cardio fitness is quite poor; I'll know the cals for that when the polar arrives. Its the days I'm resting and weight training (mix of free and body weights) that I'm eager to eat the right amount for. I Don't doubt there are women that can maintain on 1600-2000 but I sure ain't one of them. This is down to the high bf % (2% away from obese) and lowish lean mass %.
  • psuLemon
    psuLemon Posts: 38,411 MFP Moderator
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    Like I said, these are all estimates. Even with a higher BF %, we don't know exactly unless you got get your RMR tested and even then, we still dont' fully know your TDEE. What we would know is if your starting point is higher or lower than the average. So ideally, pick a number, log your calories and assess after 4-6 weeks to understand your true TDEE. But to do this, you have to log every day and use a food scale to be consistent. It's also why I suggest eating 1400 to start.
  • girlviernes
    girlviernes Posts: 2,402 Member
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    Can you increase your cardio...? even 30 minutes of a walk a day should help if you have insulin resistance. Make sure as well that you are getting enough sleep (7-9 hr range and feeling rested during the day). Can't comment on the macros, as I'm not sure for your specific situation, but I'll tell you want I am trying for insulin resistance based on the research I've done. Basically, I am careful about starches and sugars. So starchy foods being potatoes, rice, corn and other grains (anything with a high glycemic load) and limiting those to 1-2x per day and 30g at any one meal, and always balancing with protein and fat. I also use cinnamon regularly since it can help with blood sugar.
  • ana3067
    ana3067 Posts: 5,623 Member
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    lolly715 wrote: »
    ana3067 wrote: »
    lolly715 wrote: »
    I am roughly your height with PCOS. I find I don't need to limit to 50g carbs. I have my goal set to 40% (roughly 100g) and it is low enough for me to see results. I do try to limit the higher GI carbs though. Both of these limits were recommended by my doctor.

    Your calories are going to be tricky. Because you're short and already at a low weight, your TDEE calculation even with the exercise is only about 1650. So you may not be able to healthily create a large enough deficit to lose 10lbs in only a few months. I'd suggest doing TDEE-20% (roughly 1350 calories) and see how that goes.

    Where are you getting her TDEE as 1650 based on her working out at least 3x a week? Even with working out 3x a week I'm getting her TDEE 200 cals higher.

    TDEE-20% is definitely too much for her as well right now. -10% is more htan enough with such a small goal.

    That came from IIFYM, using the BF method since that was a known figure. I normally wouldn't recommend -20% for a small goal, however PCOS definitely skews the figures. So I personally would start with the higher deficit and increase up if required.

    IIFYM estimates low for pretty much everyone. She would be better off using a more well-respected calculator or something like exrx.net which allows custom energy entries (i.e. I do moderate intensity activity x hours, I do light acivity x hours, I sit x hours, etc).

    OP will have a muhc easier time, regardless of her medical conditions, if she starts at a 10% deficit. It's very easy to lower the calories, for most it's hard to increase them for psychological reasons but also because it generally causes water weight gain, so then people go back to lowering their calories.
  • ana3067
    ana3067 Posts: 5,623 Member
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    Using KM formula lowers the caloric intake recommendation by like 20 calories on scoobys calculator. If assuming only 1-3hrs of exercise per week, which includes your strength training, then 1450 calories would be a good place to start for a 10% deficit. Weigh food, log everything meticulously, be consistent with exercise, and if you are not losing 2lbs in a month then lower to 1400. Another month, no 2lbs, lower to 1350. Etc.

    I also get 1450 (actually 1460) when using exrx.net and inputting 8hrs sleep, 1hr walking (which almost everyone will accomplish), about 150 mins/week (or 5 30min sessions a week) or 21 mins/day of moderate exercise, and the rest of the hours spend sitting. Then deduct 10%. So if again you're not losing a few lbs per month then just lower the intake.