Belly roll, but doctor said to stop losing weight? Help!

ghartleroad1 wrote: »

Thanks for the quick reply @DavPul! Why still in deficit? Two things:
1. As I stated I'm still striving for a temporary achievement of 18.4 BMI.
2. I'm mentally freaked out about gaining weight.

A few weeks ago when I reduced my cardio to add weightlifting I gained a pound over two weeks (& I highly doubt it was muscle since I'd just started). Then last week I was on vacation during which I pretty much ate whatever I wanted (including piles of ice cream), didn't workout, but somehow maintained my weight exactly. I'm very confused about what's going on! Thoughts?

Azdak wrote: »

RockstarWilson wrote: »

ghartleroad1 wrote: »

Thanks for the quick reply @DavPul! Why still in deficit? Two things:
1. As I stated I'm still striving for a temporary achievement of 18.4 BMI.
2. I'm mentally freaked out about gaining weight.

A few weeks ago when I reduced my cardio to add weightlifting I gained a pound over two weeks (& I highly doubt it was muscle since I'd just started). Then last week I was on vacation during which I pretty much ate whatever I wanted (including piles of ice cream), didn't workout, but somehow maintained my weight exactly. I'm very confused about what's going on! Thoughts?

If you are freaked out about gaining a pound or two now...what will you feel when you are at a lower bmi? I would bet you would feel the same, not be where you want to be with your gut, and still want to lose.

Your doc told you to stop losing weight because you are at the bottom end of your ideal range, and you will be in a knock out-drag out fight with your body over losing any more.

No, you do not have to lose weight to lose fat. If you do not eat enough protein, for instance, for protein synthesis (the process of restoring and building muscle), you will lose muscle.

If you start losing weight below your ideal range, you WILL lose muscle. Do some research at this point. Find out how to use protein and fats and carbs to build muscle and allow the muscle to burn the fat. At your weight, it will be difficult because it is a precise balance, and it will take time to tone, but it can be done. Losing more weight, however, is not going to get you what you want.
http://www.calculator.net/ideal-weight-calculator.html?ctype=standard&cage=42&csex=f&cheightfeet=5&cheightinch=7&cheightmeter=180&printit=0&x=69&y=8

You are still ignoring the key fact that OP is 27% body fat. So there wouldn't be any "knockdown drag out fight".

If people don't know the difference between BMI and body fat %, or the implications of having a low LBM vs normal, they should be more cautious on this subject. While the advice is the same --emphasize resistance training over calorie restriction/fat loss--a lot of the associated comments can be superfluous or misleading IMO.

Since you advocate "doing research" I would direct you to this study:

Are under- and overweight female elite athletes thin and fat? A controlled study.
Medicine and Science in Sports and Exercise 2012 May 44(5): 949-957

The researchers compared BMI to body fat % in athletic females vs a control group.
Of all athletes in the "normal" BMI range, 6.7% were "obese" according to body fat (>33%).
In the control group, the number was closer to 50%.

Conclusion: "Our data show that BMI is not a valid measure for assessing or monitoring body composition in female elite athletes, and it should be used carefully in female nonathletes."

Bottom line: you cannot make judgments about the appropriateness of someone's weight loss goals based on BMI alone.

tomatoey wrote: »

Azdak wrote: »

RockstarWilson wrote: »

ghartleroad1 wrote: »

Thanks for the quick reply @DavPul! Why still in deficit? Two things:
1. As I stated I'm still striving for a temporary achievement of 18.4 BMI.
2. I'm mentally freaked out about gaining weight.

A few weeks ago when I reduced my cardio to add weightlifting I gained a pound over two weeks (& I highly doubt it was muscle since I'd just started). Then last week I was on vacation during which I pretty much ate whatever I wanted (including piles of ice cream), didn't workout, but somehow maintained my weight exactly. I'm very confused about what's going on! Thoughts?

If you are freaked out about gaining a pound or two now...what will you feel when you are at a lower bmi? I would bet you would feel the same, not be where you want to be with your gut, and still want to lose.

Your doc told you to stop losing weight because you are at the bottom end of your ideal range, and you will be in a knock out-drag out fight with your body over losing any more.

No, you do not have to lose weight to lose fat. If you do not eat enough protein, for instance, for protein synthesis (the process of restoring and building muscle), you will lose muscle.

If you start losing weight below your ideal range, you WILL lose muscle. Do some research at this point. Find out how to use protein and fats and carbs to build muscle and allow the muscle to burn the fat. At your weight, it will be difficult because it is a precise balance, and it will take time to tone, but it can be done. Losing more weight, however, is not going to get you what you want.
http://www.calculator.net/ideal-weight-calculator.html?ctype=standard&cage=42&csex=f&cheightfeet=5&cheightinch=7&cheightmeter=180&printit=0&x=69&y=8

You are still ignoring the key fact that OP is 27% body fat. So there wouldn't be any "knockdown drag out fight".

If people don't know the difference between BMI and body fat %, or the implications of having a low LBM vs normal, they should be more cautious on this subject. While the advice is the same --emphasize resistance training over calorie restriction/fat loss--a lot of the associated comments can be superfluous or misleading IMO.

Since you advocate "doing research" I would direct you to this study:

Are under- and overweight female elite athletes thin and fat? A controlled study.
Medicine and Science in Sports and Exercise 2012 May 44(5): 949-957

The researchers compared BMI to body fat % in athletic females vs a control group.
Of all athletes in the "normal" BMI range, 6.7% were "obese" according to body fat (>33%).
In the control group, the number was closer to 50%.

Conclusion: "Our data show that BMI is not a valid measure for assessing or monitoring body composition in female elite athletes, and it should be used carefully in female nonathletes."

Bottom line: you cannot make judgments about the appropriateness of someone's weight loss goals based on BMI alone.

All that says is that BMI doesn't speak to body composition. Which is fair enough. In order to make a judgement about what an "appropriate" body composition is, you now need to show what the health implications of various body composition ranges are.

tomatoey wrote: »

I don't see how health implications can be set aside even theoretically, and in this case surely shouldn't, given OP's PCP is interested in that side of things.

It's different for men bc men 's *weight* isn't as consequential for their overall & reproductive health. All those conditions have been linked to low BMI, with fat % effectively unimportant (given typical samples, with a normal distribution) - ie it's accounted for by variance. BMI is exactly what matters for risk.

I am sure that studies of normal weight obesity will show other things. But OP isn't in that category.

ghartleroad1 wrote: »

Thanks for the quick reply @DavPul! Why still in deficit? Two things:
1. As I stated I'm still striving for a temporary achievement of 18.4 BMI.
2. I'm mentally freaked out about gaining weight.

A few weeks ago when I reduced my cardio to add weightlifting I gained a pound over two weeks (& I highly doubt it was muscle since I'd just started). Then last week I was on vacation during which I pretty much ate whatever I wanted (including piles of ice cream), didn't workout, but somehow maintained my weight exactly. I'm very confused about what's going on! Thoughts?

Azdak wrote: »

tomatoey wrote: »

I don't see how health implications can be set aside even theoretically, and in this case surely shouldn't, given OP's PCP is interested in that side of things.

It's different for men bc men 's *weight* isn't as consequential for their overall & reproductive health. All those conditions have been linked to low BMI, with fat % effectively unimportant (given typical samples, with a normal distribution) - ie it's accounted for by variance. BMI is exactly what matters for risk.

I am sure that studies of normal weight obesity will show other things. But OP isn't in that category.

I (briefly--working a 12-hour day today) looked over the studies you linked to and I think you are drawing more definite conclusions than are supported by the evidence. The only real longitudinal study specifically stated that:

"In conclusion, there is little evidence that BMI influences age at menopause in a way that is clinically relevant for later disease risk. Low BMI at all ages and underweight trajectory (20–36 years) were related to earlier age at start of HT, which may be a proxy measure for age at menopause. In order to understand the postmenopausal health implications for underweight women, further studies need to assess whether the association is due to an earlier menopause among underweight women or due to behavioural characteristics which mean that they start HT early, independent of menopausal status. "

And that is the challenge of all research--determining what is actually influencing the numbers. I am still staying with the idea that BMI is of extremely limited value when used to assess an individual, and one BMI number does not justify the alarmist response that is so often applied to women. FWIW, here is a link that describes the BMI's shortcomings in more detail, although the focus is on overweight rather than underweight individuals.

http://www.todaysdietitian.com/newarchives/010614p30.shtml

Again, I'll repeat for I believe the third time, I am not recommending that the OP use calorie restriction to lose fat or scale weight. (Although, hypothetically, we are talking about a loss of 6 pounds and a reduction of body fat % from 27 to 24---numbers that are not unhealthy by any definition).

I am trying to put this in perspective, however, in a real-life context. I see 10-12 women every year who fall into this category--normal BMI, but unexpectedly high levels of body fat. I have never advised any of them to "lose fat". I have always told them that they don't have a fat problem, they have a (lack of) muscle "problem". For their long-term health, I always emphasize the importance of resistance training first. But I also help them to understand the makeup of their bodies, so they don't draw the same conclusion as OP. Most of these women feel "fatter" than they look (and not because of body image issues). But they don't feel like they can verbalize their feelings because of the lecturing and negative comments they receive from their peers. I also explain the idea of inherited fat storage distribution patterns, so they have realistic expectations about what they can achieve.

DavPul wrote: »

tomatoey wrote: »

Azdak wrote: »

tomatoey wrote: »

I don't see how health implications can be set aside even theoretically, and in this case surely shouldn't, given OP's PCP is interested in that side of things.

It's different for men bc men 's *weight* isn't as consequential for their overall & reproductive health. All those conditions have been linked to low BMI, with fat % effectively unimportant (given typical samples, with a normal distribution) - ie it's accounted for by variance. BMI is exactly what matters for risk.

I am sure that studies of normal weight obesity will show other things. But OP isn't in that category.

I (briefly--working a 12-hour day today) looked over the studies you linked to and I think you are drawing more definite conclusions than are supported by the evidence. The only real longitudinal study specifically stated that:

"In conclusion, there is little evidence that BMI influences age at menopause in a way that is clinically relevant for later disease risk. Low BMI at all ages and underweight trajectory (20–36 years) were related to earlier age at start of HT, which may be a proxy measure for age at menopause. In order to understand the postmenopausal health implications for underweight women, further studies need to assess whether the association is due to an earlier menopause among underweight women or due to behavioural characteristics which mean that they start HT early, independent of menopausal status. "

And that is the challenge of all research--determining what is actually influencing the numbers. I am still staying with the idea that BMI is of extremely limited value when used to assess an individual, and one BMI number does not justify the alarmist response that is so often applied to women. FWIW, here is a link that describes the BMI's shortcomings in more detail, although the focus is on overweight rather than underweight individuals.

http://www.todaysdietitian.com/newarchives/010614p30.shtml

Again, I'll repeat for I believe the third time, I am not recommending that the OP use calorie restriction to lose fat or scale weight. (Although, hypothetically, we are talking about a loss of 6 pounds and a reduction of body fat % from 27 to 24---numbers that are not unhealthy by any definition).

I am trying to put this in perspective, however, in a real-life context. I see 10-12 women every year who fall into this category--normal BMI, but unexpectedly high levels of body fat. I have never advised any of them to "lose fat". I have always told them that they don't have a fat problem, they have a (lack of) muscle "problem". For their long-term health, I always emphasize the importance of resistance training first. But I also help them to understand the makeup of their bodies, so they don't draw the same conclusion as OP. Most of these women feel "fatter" than they look (and not because of body image issues). But they don't feel like they can verbalize their feelings because of the lecturing and negative comments they receive from their peers. I also explain the idea of inherited fat storage distribution patterns, so they have realistic expectations about what they can achieve.

The BMI isn't the be all / end all, of course not. Yes, it is a population measure. Yes, it doesn't account for body fat. However, with regard to the health risks I described above - which are well known to medical people, it's not just those studies I plucked out of a Google search - those are associated with low BMI. (18.5 and below is regarded as "extreme" low BMI in at least one of those studies). That's the association that has been found over multiple studies. (See also "female athlete triad".)

So BMI, even though it's imperfect, is a perfectly appropriate tool for a physician to use to evaluate those risks in a given individual, after examining that individual. Which is what happened with the OP.

Another thing with women is that because our society basically sets us up for body dysmorphia almost no matter what we look like, and because we have heard thousands of times over most of our lives that the way to handle body dissatisfaction is to lose weight, I am really not supportive of any message that even suggests that as a solution in a situation like the OP's.

Is she allowed to express body dissatisfaction? Sure. I completely (and directly) understand her complaints. There's nothing wrong with wanting to look a certain way, as long as it doesn't risk a person's health. There is just a lot of room for slippage between those old messages to "lose weight" and "be thin" and the new messages to "cut and bulk". Her MO until now has been to cardio her way down, so I feel like it's valuable for her to hear unambiguously that strength training while maintaining her current weight is the solution to her (valid) complaints. Which it unquestionably is.

*fist bump*