Medical Conditions Which Affect Weight: Separating Fact From Fiction

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  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    kkenseth wrote: »
    kkenseth wrote: »
    lyttlewon wrote: »
    Where I take issue is when users argue that it isn't possible to lose weight unless one is burning more calories with RMR + exercise than what they consume (often referred to as CICO). I've seen users argue that medical conditions don't change that, but can only affect RMR. My point is that there are, in fact, medical conditions that fall outside of the CICO equation. Is it a good idea to try DKA? No, absolutely not. Does it still provide an example of where CICO is wrong? Yes, definitely.

    I'm pretty sure most people understand there are medical conditions that cause massive amounts of water retention, and massive amounts of water loss. Those things are exceptions to the day in, day out issues people deal with in regards to management of chronic disease. My type 1 diabetic uncle had issues with water retention to the point where he would get water in his lungs. This did contribute to his weight. The reason he was obese was still primarily CICO.

    When I gave birth to my 11lb 4oz son I lost 25 lbs due to water retention from being pregnant baby, and having HBP. That has nothing to do with the fact that I was also obese, and had to lose weight.

    It isn't just water, there is fat loss with DKA. As I explained earlier, your body breaks down fat to convert it into glucose and then removes that glucose through urine. Again... this is not healthy, but it is what happens to cause fat loss without exercise.

    It's clear that this episode of hypovolemic shock was very impactful on your life. You lost a lot of weight.

    Can you point to an instance when bringing this up has made a meaningful change in someone's health journey? It's an unlikely scenario for most people and the fact of the matter is, MFP is built around a caloric deficit and that should be the focus because barring a tiny percentage of medical conditions that may change the way someone implements CICO, it still works.

    How is it impacting your journey NOW? What are you doing differently NOW because of it? Do you count calories? Are you in a deficit? Because if you're not tracking with MFP and believe in deficit, why are you here? It's an honest question.

    Hyperglycemic, not hypoglycemic.

    I don't have enough detailed information about what everyone does on the MFP boards to say whether it has caused a meaningful change in someone else's journey. There are things like DKA that cause variations in the almighty CICO formula. The specific medical phenomena may be different for different users, but it still remains that CICO is not absolute. I'm hoping other users will understand that. I don't know whether it has helped or not (I get the sense that it has not because those users are unwilling to accept that CICO is not absolute).

    I do count calories, and I am eating in a deficit. That alone is not enough for me, as I am doing other things to manage my health beyond calorie counting. I'm losing weight at a safe rate, not just due to CICO, but because of a combination of all factors. Counting calories is an important piece of the puzzle, but it isn't the only piece.

    Where did you get hyper/hypoglycemic from? I was referring to the shock syndrome that you would have incurred from losing that much fluid in your body that rapidly, or hypovolemia.

    I'm glad it's working for you because I can't imagine the lasting damage that left on your body. That aside, CICO still works. If you don't believe that, you should find a forum that specializes in medical conditions, rather than CICO.

    Sorry, I thought you were trying to write hypoglycemia and misspelled it.

    I've not experienced any long-term negative effects from that particular issue, which happened almost 16 years ago. CICO does work for me, but not as absolutely as many users believe (maybe it works perfectly for them, maybe not... they seem to imply it does).

    You are still employing CICO whatever you are doing, midwesterner. Perhaps you could elaborate on what you feel makes it not work absolutely? Is it because the numbers don't work as expected?

    I have made this point before, and I will continue to make it -- CICO is a complicated equation, and energy balance is something that functions outside of our personal ability to track and account for every factor involved in its functioning. Simply because you can't get a grasp from the outside and calculate and predict precisely the CO portion does not mean CICO is flawed. It means your ability to calculate the factors involved in that side of the equation are limited.

    I see this kind of thinking a lot on the forums, and I don't understand why it's so hard for some people to accept that TDEE calculators, exercise burn calculators and other similar things are all averages. I also don't understand how people can hope to get exact numbers when they know they have confounding factors influencing how their body burns energy.

    I really don't understand the disconnect.
  • Sued0nim
    Sued0nim Posts: 17,456 Member
    edited November 2015
    lyttlewon wrote: »
    rabbitjb wrote: »
    lyttlewon wrote: »
    jgnatca wrote: »
    How about maturity? A whole bunch of systems start working differently. For instance, bone growth and remodelling slows down. My friends in their thirties notice that weight does not drop as fast as when they were younger when they switch to a fasted diet.

    CICO still rules, IMO, but at a slower rate.

    What does that mean, does not drop as fast as when they are younger? I'm 37 and I haven't had any special problems losing weight compared to my 20's.

    Your TDEE drops about 100 cals per decade, but how much of that is due to lifestyle changes and reduced muscle mass is open to debate...my personal opinion is that it's all of it so can be compensated for by building muscle

    The algorithms adjust for age though, so if I'm calculating my TDEE on a regular basis the added noise from my age would be compensated for. I might have to eat 1800 cals to lose weight vs. 2000 cals (just using for conversation), but the act of losing at a deficit is the same, no?

    Absolutely

    Interestingly I'm currently having to eat 100-200 calories more than the MFP calculations plus my activity and exercise adjustments (on fitbit and HRM) mean I keep losing in maintenance. I put that down to lifting

    And to make this relevant to the thread, I believe it speaks to ageing and perimenopause
  • 100df
    100df Posts: 668 Member
    edited November 2015
    I had to take a few different drugs via mouth and IV drip that have weight gain as a side effect. The drugs were to treat cancer.

    I believe it's CICO. It can be very difficult to cut calories enough to get to point where you either maintain or lose with the combination of the side effects of the medication(s).

    It took me 18 months to feel normal after treatment ended. Not having the drugs in my system has made it easier to eat at a deficit and lose. Very happy that I only take a multivitamin and Biotin now.

    On the other hand, I participated in a drug trial towards the end of treatment. One of the side effects is weight loss. During that time I stopped gaining and maintained.

    While it's CICO, medication can definitely change your calorie allowance. If you are on multiple drugs that cause your metabolism to slow, it's very easy to gain weight.

    The "sick" part of all this is that one of my first thoughts after being diagnosed is that I would lose the 20 lbs I had been carrying. Really bothers me that I had that thought. Especially when I felt that way because of the mirror over health.

    Edited to clarify - The drugs I was on did not add fat to my body. The side effects of increased appetite and slowed metabolism did.

    The drug I took that had a side effect of weight loss didn't make fat disappear, it's just that everything I ate went right thru me - sorry to be gross.
  • Liftng4Lis
    Liftng4Lis Posts: 15,151 Member
    jgnatca wrote: »
    How about maturity? A whole bunch of systems start working differently. For instance, bone growth and remodelling slows down. My friends in their thirties notice that weight does not drop as fast as when they were younger when they switch to a fasted diet.

    CICO still rules, IMO, but at a slower rate.

    I think a lot of this has to do with us just not moving as much as we use to. Sure our BMR drops, thus less calories, but as you said still CICO. No one said it doesn't suck, because hell, I want that extra damn oreo.
  • mccindy72
    mccindy72 Posts: 7,001 Member
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.
  • SezxyStef
    SezxyStef Posts: 15,267 Member
    thorsmom01 wrote: »
    Great thread carol !

    I have nothing to add as far as medical conditions but would like to mention prescription medicine .

    When I was first starting out, I went to the doctor and said " my depo birth control shot is causing me not to lose weight !"

    He said, that's actually a myth. Google the words" birth control and weight gain" , you'll see thousands saying the same thing but its only because that's how misunderstood people are. He explained that it can cause an increased appetite , thus causing people to eat at a surplus and gain weight. But people like to leave out the surplus part and go straight to the weight gain part . if you ask 100 girls did they gain weight on depo, 75 will say yes and zero will admit to overeating. So that's how the " weight gain from depo " thing goes.

    It came down to calories. Not the shot . once I truly was ready to give up the excuses, I was able to lose weight.

    There Will always be people who enjoy having an excuse. They really don't want it. I was once one of those people so I know all about it.


    Its often very hard for people to let go off the myths and excuses. Weight loss will always come down to calories . some will have to work a little harder then others but it still comes down to calories .

    x2 for me as well..depo for 5 years then Mirena now Depo again.

    I did my research and found out it's "increase in appetite" that causes the weight gain.

    Even my new doctor mentioned the "weight gain" yesterday when I got my refill by saying it doesn't have to happen just watch intake.

    For me I go from one extreme to another with Iron levels...lethargic when it's low (CO part is screwy) and B12 issues...

    all can be treated and I am still 60lbs lighter. Using Depo/Mirena and having issues.
  • jgnatca
    jgnatca Posts: 14,464 Member
    rabbitjb wrote: »
    lyttlewon wrote: »
    jgnatca wrote: »
    How about maturity? A whole bunch of systems start working differently. For instance, bone growth and remodelling slows down. My friends in their thirties notice that weight does not drop as fast as when they were younger when they switch to a fasted diet.

    CICO still rules, IMO, but at a slower rate.

    What does that mean, does not drop as fast as when they are younger? I'm 37 and I haven't had any special problems losing weight compared to my 20's.

    Your TDEE drops about 100 cals per decade, but how much of that is due to lifestyle changes and reduced muscle mass is open to debate...my personal opinion is that it's all of it so can be compensated for by building muscle

    My dad, who is in his eighties and is in end stage COPD, noted a marked slow down of healing recovery. It could be from a progessive lack of oxygen but there's a reason that many elective surgeries are not recommended for people over sixty-five.

    I am in my fifties and I've noted I do not need as many calories as when I was younger. Now, my needs went up when my activity went up, but the general trend is that I need less. If I had not adjusted my eating habits as I got older, I'd get fat on less.
  • mccindy72
    mccindy72 Posts: 7,001 Member
    brendak76 wrote: »
    My cortisol issues were not due to daily stress from life. They were due to 2 separate trauma situations. Fight or flight. After the 2nd episode about 6 weeks after the first it took my 3 days to stop shaking. Longer for my breathing to return to normal. I've read it can take months to recover from these kind of episodes. I also found out this week in severely vitamin D deficient which can also cause problems. (Side note I also have celiac and hashimotos but those are very well regulated and have not hindered weight loss.) In my case I can see the insulin resistance more than a non diabetic. My insulin needs more than doubled with both traumas and it's taking about 3 weeks each time to come back down to normal. Crazy stuff.

    (Not sure why he dka discussion is happening here. Yes you quickly lose weight and either die or take insulin.)

    that's not cortisol - that's adrenaline. It surges through your body in emergent situations to give you the energy to either fight or flee.
  • PeachyCarol
    PeachyCarol Posts: 8,029 Member
    edited November 2015
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    Thank you, as a medical professional, for explaining the condition in terms I can understand. I hope this puts paid to the idea that there are things which cause fat loss that aren't explained by CICO, which is the argument midwesterner uses to undermine the validity of CICO.

    The purpose of this thread was to discuss how medical conditions might effect weight loss or gain for people, you have explained the mechanism by which DKA effects weight loss very well here. Thank you. It's clear that it's not applicable to the general user as I believe most of the diabetics on the forum manage their conditions well.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.
  • maidentl
    maidentl Posts: 3,203 Member
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    I don't understand DKA so I am not going to pretend to. I do understand that someone telling you that you were having hallucinations during a crisis that is known to cause hallucinations is not even remotely on the same plane as calling you a liar.
  • SezxyStef
    SezxyStef Posts: 15,267 Member
    Perhaps what you are trying to do is reduce the short cuts people make?

    I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.

    What 'fiction' do you think needs to be addressed?


    I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.

    As far as DKA that I brought up in a prior thread (2 prior threads, actually), you claim that my experience is impossible. That's not correct. Before I go any further, I'm going to stress that DKA should never be intentionally caused to occur. It is potentially fatal. Those who have diabulimia should consult appropriate professional help.

    Here's how diabetic ketoacidosis (DKA) works:

    Insulin breaks down glucose in blod and delivers it as fuel to cells... usually. When someone has very little or no insulin (type 1 diabetics fit this criteria), blood glucose (BG) rises and cells starve.

    When BG rises: When BG rises above 225 mg/dl (average based on current research, but can be more or less), osmotic diuresis ocurs to remove BG through urine.

    When cells starve: Gluconeogenesis occurs. Cells are calling for energy, but getting none. So you start breaking down fat for energy. The fat gets broken down and deposited into the blood as glucose. Then the cells should be able to get to that BG, but without insulin, the process of breaking down fat continues. Some of the BG is removed (see explanation abov of osmotic diuresis), but not all of it and certainly not as quickly as one is creating more glucose from fat. A by-product of this process are ketones.

    Some on these forums will understand ketones because they are experiencing gluconeogenesis in a non-diabetic context. In DKA, ketone levels are significantly higher than in ketosis. High levels of ketones are toxic.

    In addition to extreme thirst and frequent urination (because of osmotic diuresis), DKA also causes vomiting and very strong "ketone breath." Because cells are starving (most pathways for cells to get energy require insulin, which isn't present in this scenario), they start weakening and eventually organs will stop functioning altogether. Often this leads to a coma before death.

    Here's what happened in my situation:

    I was a teenager, and pretty much just gave up and decided I didn't want to deal with diabetes any more. I figured if I didn't eat anything, I would just run a little bit high and not have any immediate issues.

    I was on multiple daily injections (MDI) of insulin, and last took insulin on Friday. On a Sat., I ate nothing and took no insulin, except late morning, I was super thirsty and drank 3 cans of regular soda (which propelled my BG even higher). I was feeling lethargic by Sat. evening and was urinating frequently.

    On Sun., I ate nothing. Early in the day, I started vomiting and continued to urinate frequently. I was also still extremely thirsty and was drinking lots of water. I remember a particular point where I drank a glass of water, and ran to the bathroom (in this house, the kitchen and bathroom were connected - an unusual design today, but this was an old rural house and these rooms were added together when plumbing was installed). So the bathroom was about 10-12 feet away from where I was standing as I drank water, and I vomited all of that water within seconds of drinking it (except it was yellow when it came back up - obviously because it included other substances). There was another point where I thought I had vomited everything in my stomach, but was still heaving. What came out was a thick dark red - black substance. I was very sick at this point with DKA.

    On Monday, I skipped school and was still sick after spending all night drinking lots of water and then vomiting and urinating (I was urinating about every 7-10 minutes at this point). My parents called the endocrinologist, who said to take some insulin and wanted me to be taken by ambulance to the nearest hospital (around 15 miles away) and then by helicopter to the nearest major city, where her hospital was located (around 80 miles by car). At this point, I had lost 47 lbs. from the last time I weighed (a week prior). I couldn't see clearly and had so little energy I could barely walk.

    My parents decided (my dad decided, as my mom wanted to go with the endo's suggestion), for whatever reason (probably cost), to drive me himself for the whole 90-100 mile trip to the hospital. I took an ice cream bucket, which I continued to vomit and urinate in throughout the trip... I'm sure I lost at least another 3 lbs. on the way, but I usually say "about 50 lbs." because that is a rounded number and the specific amount beyond 47 is unknown. On the way down, I started going in and out of consciousness.

    When we arrived at the emergency room, I was unable to even stand on my own power. My dad held me up as we walked in. The first stop was a water fountain, as I was still extremely thirsty. After I sat down, I noticed the tips of my fingers were starting to turn an indigo color.

    When they were starting to take vital signs, I vomited on the nurse. They didn't finish, as it became clear how serious of shape I was in. Right away, they started taking me to the ICU (I was in a wheelchair at this point). I remember being pushed into an elevator on the wheelchair, and then losing consciousness again. The next time I awoke, for a brief moment, was in a bed in the ICU with lots of medical personnel surrounding me working very quickly. My dad was standing behind them at the foot of the bed with a very worried look on his face. The next time I awoke, there were just a couple of medical personnel on the other side of the room (it was a large room with several beds and just curtains), but nobody around me. I had an IV in the major blood vessel that runs through my groin.

    On Tues., they transferred me out of the ICU to an intermediate area, and on Wed., sent me to the general section of the hospital. The endocrinologist visited, as did the CDE (because they thought I didn't have enough training, when it was just that I didn't care enough). So they sent a psychologist to talk to me, and I was released from the hospital on Fri. When I got home, the scale said I had only lost 24 lbs. compared to 2 weeks prior. They had been pumping plenty of fluids in me, but I'm leaving open the chance that I was still slightly dehydrated. The 50 lbs. is approximate because of what I described earlier. I'm guessing around 60% of that was water weight because of how much was re-gained in the hospital.

    You can tell me that what happened to me didn't really happen to me, but I assure you it did. Just because you don't understand it doesn't mean it isn't possible.

    My brother is a type 1 diabetic..

    He has gone into DKA and not lost a pound....why because he didn't let it get too far.

    DKA does not counter CICO at all ever.

    And I may not be a type 1 diabetic but have spent the last 40 years around one who has on more than one time had issues...he doesn't lose weight (except fluid weight).
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    maidentl wrote: »
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    I don't understand DKA so I am not going to pretend to. I do understand that someone telling you that you were having hallucinations during a crisis that is known to cause hallucinations is not even remotely on the same plane as calling you a liar.

    She is saying I was having hallucinations a week before the crisis and several days afterwards, not during.
  • mccindy72
    mccindy72 Posts: 7,001 Member
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    1. I certainly am not calling you a liar. People who are in medically emergent states don't have good recall after the event - that doesn't mean they are lying when they give their imperfect recall of the event, it just means they are wrong.
    2. You wouldn't have had a heart attack from the high acid levels, you would have stopped breathing after going into respiratory distress, if they hadn't intubated you or given you a sodium bicarb drip in time to compensate for the acidity.
    3. As I've explained, you coudn't have possibly lost more than a couple of pounds of fat in that week. You could have lost as much as 10-15 pounds of water weight in a week, but that's about it.

    As a medical professional who has treated and cared for numerous people in DKA, some who have not survived, I'm sorry to say that you are incorrect in much of your information. I hope that others reading along are able to understand that I am not calling you a liar, but that I am only saying that a) your memories are distorted and incomplete, and b) any information you've been given or researched since then has been misinterpreted.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    SezxyStef wrote: »
    Perhaps what you are trying to do is reduce the short cuts people make?

    I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.

    What 'fiction' do you think needs to be addressed?


    I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.

    As far as DKA that I brought up in a prior thread (2 prior threads, actually), you claim that my experience is impossible. That's not correct. Before I go any further, I'm going to stress that DKA should never be intentionally caused to occur. It is potentially fatal. Those who have diabulimia should consult appropriate professional help.

    Here's how diabetic ketoacidosis (DKA) works:

    Insulin breaks down glucose in blod and delivers it as fuel to cells... usually. When someone has very little or no insulin (type 1 diabetics fit this criteria), blood glucose (BG) rises and cells starve.

    When BG rises: When BG rises above 225 mg/dl (average based on current research, but can be more or less), osmotic diuresis ocurs to remove BG through urine.

    When cells starve: Gluconeogenesis occurs. Cells are calling for energy, but getting none. So you start breaking down fat for energy. The fat gets broken down and deposited into the blood as glucose. Then the cells should be able to get to that BG, but without insulin, the process of breaking down fat continues. Some of the BG is removed (see explanation abov of osmotic diuresis), but not all of it and certainly not as quickly as one is creating more glucose from fat. A by-product of this process are ketones.

    Some on these forums will understand ketones because they are experiencing gluconeogenesis in a non-diabetic context. In DKA, ketone levels are significantly higher than in ketosis. High levels of ketones are toxic.

    In addition to extreme thirst and frequent urination (because of osmotic diuresis), DKA also causes vomiting and very strong "ketone breath." Because cells are starving (most pathways for cells to get energy require insulin, which isn't present in this scenario), they start weakening and eventually organs will stop functioning altogether. Often this leads to a coma before death.

    Here's what happened in my situation:

    I was a teenager, and pretty much just gave up and decided I didn't want to deal with diabetes any more. I figured if I didn't eat anything, I would just run a little bit high and not have any immediate issues.

    I was on multiple daily injections (MDI) of insulin, and last took insulin on Friday. On a Sat., I ate nothing and took no insulin, except late morning, I was super thirsty and drank 3 cans of regular soda (which propelled my BG even higher). I was feeling lethargic by Sat. evening and was urinating frequently.

    On Sun., I ate nothing. Early in the day, I started vomiting and continued to urinate frequently. I was also still extremely thirsty and was drinking lots of water. I remember a particular point where I drank a glass of water, and ran to the bathroom (in this house, the kitchen and bathroom were connected - an unusual design today, but this was an old rural house and these rooms were added together when plumbing was installed). So the bathroom was about 10-12 feet away from where I was standing as I drank water, and I vomited all of that water within seconds of drinking it (except it was yellow when it came back up - obviously because it included other substances). There was another point where I thought I had vomited everything in my stomach, but was still heaving. What came out was a thick dark red - black substance. I was very sick at this point with DKA.

    On Monday, I skipped school and was still sick after spending all night drinking lots of water and then vomiting and urinating (I was urinating about every 7-10 minutes at this point). My parents called the endocrinologist, who said to take some insulin and wanted me to be taken by ambulance to the nearest hospital (around 15 miles away) and then by helicopter to the nearest major city, where her hospital was located (around 80 miles by car). At this point, I had lost 47 lbs. from the last time I weighed (a week prior). I couldn't see clearly and had so little energy I could barely walk.

    My parents decided (my dad decided, as my mom wanted to go with the endo's suggestion), for whatever reason (probably cost), to drive me himself for the whole 90-100 mile trip to the hospital. I took an ice cream bucket, which I continued to vomit and urinate in throughout the trip... I'm sure I lost at least another 3 lbs. on the way, but I usually say "about 50 lbs." because that is a rounded number and the specific amount beyond 47 is unknown. On the way down, I started going in and out of consciousness.

    When we arrived at the emergency room, I was unable to even stand on my own power. My dad held me up as we walked in. The first stop was a water fountain, as I was still extremely thirsty. After I sat down, I noticed the tips of my fingers were starting to turn an indigo color.

    When they were starting to take vital signs, I vomited on the nurse. They didn't finish, as it became clear how serious of shape I was in. Right away, they started taking me to the ICU (I was in a wheelchair at this point). I remember being pushed into an elevator on the wheelchair, and then losing consciousness again. The next time I awoke, for a brief moment, was in a bed in the ICU with lots of medical personnel surrounding me working very quickly. My dad was standing behind them at the foot of the bed with a very worried look on his face. The next time I awoke, there were just a couple of medical personnel on the other side of the room (it was a large room with several beds and just curtains), but nobody around me. I had an IV in the major blood vessel that runs through my groin.

    On Tues., they transferred me out of the ICU to an intermediate area, and on Wed., sent me to the general section of the hospital. The endocrinologist visited, as did the CDE (because they thought I didn't have enough training, when it was just that I didn't care enough). So they sent a psychologist to talk to me, and I was released from the hospital on Fri. When I got home, the scale said I had only lost 24 lbs. compared to 2 weeks prior. They had been pumping plenty of fluids in me, but I'm leaving open the chance that I was still slightly dehydrated. The 50 lbs. is approximate because of what I described earlier. I'm guessing around 60% of that was water weight because of how much was re-gained in the hospital.

    You can tell me that what happened to me didn't really happen to me, but I assure you it did. Just because you don't understand it doesn't mean it isn't possible.

    My brother is a type 1 diabetic..

    He has gone into DKA and not lost a pound....why because he didn't let it get too far.

    DKA does not counter CICO at all ever.

    And I may not be a type 1 diabetic but have spent the last 40 years around one who has on more than one time had issues...he doesn't lose weight (except fluid weight).

    Right, mild cases of hyperglycemia with ketones don't cause losses for me either... it requires things to really get bad for those losses to happen. When they come, they are big.
  • snickerscharlie
    snickerscharlie Posts: 8,578 Member
    Wonderfully informative thread, Carol! Thank you for starting it and I hope it manages to stick around and help a lot of people in spite of some rather blatant derails.

    I have hashimoto's thyroid disease. I am a post-menopausal, +60 year old female with a medical condition (ankylosing sponditilis) for which I take medication in order to function. This medication along with the other factors mentioned result in the fact the weight loss is more challenging for me than it would be for someone without these 'handicaps.' An added bonus is that I have some physical limitations to exercise as well.

    I have lost over 70 lbs in 9 months, though, by not allowing myself to fall into a victim mentality.

    I started out by simply eating less and moving more. I know that's really, really simplistic, but honestly, that's the basic premise it comes down to! You don't even have to utilize the 'move more' part of the equation as long as the 'eat less' side is working for you. I chose to also incorporate a bunch of move more elements because that, in turn, allowed me to eat a bit more than I would have been able to otherwise. And this - for me - has been really key in helping me stay the course without feeling deprived.

    I am about 10 lbs away from my goal, although my weight loss has continued to slow the closer to goal I get, I have no reason to think that I won't be able to accomplish losing 80 lbs within a year. And every single one of them will have been shed without anything more complicated that CICO, a food scale and a fitbit. :)
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    mccindy72 wrote: »
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    1. I certainly am not calling you a liar. People who are in medically emergent states don't have good recall after the event - that doesn't mean they are lying when they give their imperfect recall of the event, it just means they are wrong.
    2. You wouldn't have had a heart attack from the high acid levels, you would have stopped breathing after going into respiratory distress, if they hadn't intubated you or given you a sodium bicarb drip in time to compensate for the acidity.
    3. As I've explained, you coudn't have possibly lost more than a couple of pounds of fat in that week. You could have lost as much as 10-15 pounds of water weight in a week, but that's about it.

    As a medical professional who has treated and cared for numerous people in DKA, some who have not survived, I'm sorry to say that you are incorrect in much of your information. I hope that others reading along are able to understand that I am not calling you a liar, but that I am only saying that a) your memories are distorted and incomplete, and b) any information you've been given or researched since then has been misinterpreted.

    I kept the remaining (after returning from hospital) weight off for several months (almost a year), so I can't believe it was water weight. There are several academic journal articles that can be readily found that explain how fat loss occurs with DKA. My memories are supported by others who were there at the time, including an endocrinologist and other medical staff.
  • brendak76
    brendak76 Posts: 241 Member
    mccindy72 wrote: »
    brendak76 wrote: »
    My cortisol issues were not due to daily stress from life. They were due to 2 separate trauma situations. Fight or flight. After the 2nd episode about 6 weeks after the first it took my 3 days to stop shaking. Longer for my breathing to return to normal. I've read it can take months to recover from these kind of episodes. I also found out this week in severely vitamin D deficient which can also cause problems. (Side note I also have celiac and hashimotos but those are very well regulated and have not hindered weight loss.) In my case I can see the insulin resistance more than a non diabetic. My insulin needs more than doubled with both traumas and it's taking about 3 weeks each time to come back down to normal. Crazy stuff.

    (Not sure why he dka discussion is happening here. Yes you quickly lose weight and either die or take insulin.)

    that's not cortisol - that's adrenaline. It surges through your body in emergent situations to give you the energy to either fight or flee.

    Yes, adreneline is the immediate surge in flight or flight. Cortisol is also released by the adrenal glands in large amounts in these situations and can stick around for a while. Cortisol is what is causing my elevated blood sugars/ insulin resistance for several weeks. The adreneline rush doesn't hang around that long.

  • SezxyStef
    SezxyStef Posts: 15,267 Member
    SezxyStef wrote: »
    Perhaps what you are trying to do is reduce the short cuts people make?

    I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.

    What 'fiction' do you think needs to be addressed?


    I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.

    As far as DKA that I brought up in a prior thread (2 prior threads, actually), you claim that my experience is impossible. That's not correct. Before I go any further, I'm going to stress that DKA should never be intentionally caused to occur. It is potentially fatal. Those who have diabulimia should consult appropriate professional help.

    Here's how diabetic ketoacidosis (DKA) works:

    Insulin breaks down glucose in blod and delivers it as fuel to cells... usually. When someone has very little or no insulin (type 1 diabetics fit this criteria), blood glucose (BG) rises and cells starve.

    When BG rises: When BG rises above 225 mg/dl (average based on current research, but can be more or less), osmotic diuresis ocurs to remove BG through urine.

    When cells starve: Gluconeogenesis occurs. Cells are calling for energy, but getting none. So you start breaking down fat for energy. The fat gets broken down and deposited into the blood as glucose. Then the cells should be able to get to that BG, but without insulin, the process of breaking down fat continues. Some of the BG is removed (see explanation abov of osmotic diuresis), but not all of it and certainly not as quickly as one is creating more glucose from fat. A by-product of this process are ketones.

    Some on these forums will understand ketones because they are experiencing gluconeogenesis in a non-diabetic context. In DKA, ketone levels are significantly higher than in ketosis. High levels of ketones are toxic.

    In addition to extreme thirst and frequent urination (because of osmotic diuresis), DKA also causes vomiting and very strong "ketone breath." Because cells are starving (most pathways for cells to get energy require insulin, which isn't present in this scenario), they start weakening and eventually organs will stop functioning altogether. Often this leads to a coma before death.

    Here's what happened in my situation:

    I was a teenager, and pretty much just gave up and decided I didn't want to deal with diabetes any more. I figured if I didn't eat anything, I would just run a little bit high and not have any immediate issues.

    I was on multiple daily injections (MDI) of insulin, and last took insulin on Friday. On a Sat., I ate nothing and took no insulin, except late morning, I was super thirsty and drank 3 cans of regular soda (which propelled my BG even higher). I was feeling lethargic by Sat. evening and was urinating frequently.

    On Sun., I ate nothing. Early in the day, I started vomiting and continued to urinate frequently. I was also still extremely thirsty and was drinking lots of water. I remember a particular point where I drank a glass of water, and ran to the bathroom (in this house, the kitchen and bathroom were connected - an unusual design today, but this was an old rural house and these rooms were added together when plumbing was installed). So the bathroom was about 10-12 feet away from where I was standing as I drank water, and I vomited all of that water within seconds of drinking it (except it was yellow when it came back up - obviously because it included other substances). There was another point where I thought I had vomited everything in my stomach, but was still heaving. What came out was a thick dark red - black substance. I was very sick at this point with DKA.

    On Monday, I skipped school and was still sick after spending all night drinking lots of water and then vomiting and urinating (I was urinating about every 7-10 minutes at this point). My parents called the endocrinologist, who said to take some insulin and wanted me to be taken by ambulance to the nearest hospital (around 15 miles away) and then by helicopter to the nearest major city, where her hospital was located (around 80 miles by car). At this point, I had lost 47 lbs. from the last time I weighed (a week prior). I couldn't see clearly and had so little energy I could barely walk.

    My parents decided (my dad decided, as my mom wanted to go with the endo's suggestion), for whatever reason (probably cost), to drive me himself for the whole 90-100 mile trip to the hospital. I took an ice cream bucket, which I continued to vomit and urinate in throughout the trip... I'm sure I lost at least another 3 lbs. on the way, but I usually say "about 50 lbs." because that is a rounded number and the specific amount beyond 47 is unknown. On the way down, I started going in and out of consciousness.

    When we arrived at the emergency room, I was unable to even stand on my own power. My dad held me up as we walked in. The first stop was a water fountain, as I was still extremely thirsty. After I sat down, I noticed the tips of my fingers were starting to turn an indigo color.

    When they were starting to take vital signs, I vomited on the nurse. They didn't finish, as it became clear how serious of shape I was in. Right away, they started taking me to the ICU (I was in a wheelchair at this point). I remember being pushed into an elevator on the wheelchair, and then losing consciousness again. The next time I awoke, for a brief moment, was in a bed in the ICU with lots of medical personnel surrounding me working very quickly. My dad was standing behind them at the foot of the bed with a very worried look on his face. The next time I awoke, there were just a couple of medical personnel on the other side of the room (it was a large room with several beds and just curtains), but nobody around me. I had an IV in the major blood vessel that runs through my groin.

    On Tues., they transferred me out of the ICU to an intermediate area, and on Wed., sent me to the general section of the hospital. The endocrinologist visited, as did the CDE (because they thought I didn't have enough training, when it was just that I didn't care enough). So they sent a psychologist to talk to me, and I was released from the hospital on Fri. When I got home, the scale said I had only lost 24 lbs. compared to 2 weeks prior. They had been pumping plenty of fluids in me, but I'm leaving open the chance that I was still slightly dehydrated. The 50 lbs. is approximate because of what I described earlier. I'm guessing around 60% of that was water weight because of how much was re-gained in the hospital.

    You can tell me that what happened to me didn't really happen to me, but I assure you it did. Just because you don't understand it doesn't mean it isn't possible.

    My brother is a type 1 diabetic..

    He has gone into DKA and not lost a pound....why because he didn't let it get too far.

    DKA does not counter CICO at all ever.

    And I may not be a type 1 diabetic but have spent the last 40 years around one who has on more than one time had issues...he doesn't lose weight (except fluid weight).

    Right, mild cases of hyperglycemia with ketones don't cause losses for me either... it requires things to really get bad for those losses to happen. When they come, they are big.

    What makes you think it was "mild hyperglycemia" he was sick...very sick...hospital sick. Don't assume his experience was any less scary than yours...the difference is he didn't do it to himself.

    mind you it didn't happen often as my parents were diligent but it does happen....even now as an adult if things don't go right he is at the hospital due to his age now (almost 50)...

    Fluid loss <>fat loss.



  • tincanonastring
    tincanonastring Posts: 3,944 Member
    mccindy72 wrote: »
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    1. I certainly am not calling you a liar. People who are in medically emergent states don't have good recall after the event - that doesn't mean they are lying when they give their imperfect recall of the event, it just means they are wrong.
    2. You wouldn't have had a heart attack from the high acid levels, you would have stopped breathing after going into respiratory distress, if they hadn't intubated you or given you a sodium bicarb drip in time to compensate for the acidity.
    3. As I've explained, you coudn't have possibly lost more than a couple of pounds of fat in that week. You could have lost as much as 10-15 pounds of water weight in a week, but that's about it.

    As a medical professional who has treated and cared for numerous people in DKA, some who have not survived, I'm sorry to say that you are incorrect in much of your information. I hope that others reading along are able to understand that I am not calling you a liar, but that I am only saying that a) your memories are distorted and incomplete, and b) any information you've been given or researched since then has been misinterpreted.

    I kept the remaining (after returning from hospital) weight off for several months (almost a year), so I can't believe it was water weight. There are several academic journal articles that can be readily found that explain how fat loss occurs with DKA. My memories are supported by others who were there at the time, including an endocrinologist and other medical staff.

    So, could you provide those sources?
  • Azexas
    Azexas Posts: 4,334 Member
    brendak76 wrote: »
    mccindy72 wrote: »
    brendak76 wrote: »
    My cortisol issues were not due to daily stress from life. They were due to 2 separate trauma situations. Fight or flight. After the 2nd episode about 6 weeks after the first it took my 3 days to stop shaking. Longer for my breathing to return to normal. I've read it can take months to recover from these kind of episodes. I also found out this week in severely vitamin D deficient which can also cause problems. (Side note I also have celiac and hashimotos but those are very well regulated and have not hindered weight loss.) In my case I can see the insulin resistance more than a non diabetic. My insulin needs more than doubled with both traumas and it's taking about 3 weeks each time to come back down to normal. Crazy stuff.

    (Not sure why he dka discussion is happening here. Yes you quickly lose weight and either die or take insulin.)

    that's not cortisol - that's adrenaline. It surges through your body in emergent situations to give you the energy to either fight or flee.

    Yes, adreneline is the immediate surge in flight or flight. Cortisol is also released by the adrenal glands in large amounts in these situations and can stick around for a while. Cortisol is what is causing my elevated blood sugars/ insulin resistance for several weeks. The adreneline rush doesn't hang around that long.

    Gotta love that "stress Hormone".

    When I was in nursing school, I was under so much stress that my cortisol level was pretty much off the chart. Blood sugar was elevated, I was constantly getting sick, I could barely sleep, and my brain was so foggy during that time. When I graduated and my stress levels returned to my baseline, everything went back to within normal limits. My endocrinologist said it was all related to my cortisol level being so high.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    mccindy72 wrote: »
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    1. I certainly am not calling you a liar. People who are in medically emergent states don't have good recall after the event - that doesn't mean they are lying when they give their imperfect recall of the event, it just means they are wrong.
    2. You wouldn't have had a heart attack from the high acid levels, you would have stopped breathing after going into respiratory distress, if they hadn't intubated you or given you a sodium bicarb drip in time to compensate for the acidity.
    3. As I've explained, you coudn't have possibly lost more than a couple of pounds of fat in that week. You could have lost as much as 10-15 pounds of water weight in a week, but that's about it.

    As a medical professional who has treated and cared for numerous people in DKA, some who have not survived, I'm sorry to say that you are incorrect in much of your information. I hope that others reading along are able to understand that I am not calling you a liar, but that I am only saying that a) your memories are distorted and incomplete, and b) any information you've been given or researched since then has been misinterpreted.

    I kept the remaining (after returning from hospital) weight off for several months (almost a year), so I can't believe it was water weight. There are several academic journal articles that can be readily found that explain how fat loss occurs with DKA. My memories are supported by others who were there at the time, including an endocrinologist and other medical staff.

    So, could you provide those sources?

    My dad died in June (though we talked about it on occasion in the years since it happened), I'm not going to give my mom's or sibling's contact information, and the medical facility would not tell you anything anyway because of HIPPAA.
  • tincanonastring
    tincanonastring Posts: 3,944 Member
    edited November 2015
    mccindy72 wrote: »
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    1. I certainly am not calling you a liar. People who are in medically emergent states don't have good recall after the event - that doesn't mean they are lying when they give their imperfect recall of the event, it just means they are wrong.
    2. You wouldn't have had a heart attack from the high acid levels, you would have stopped breathing after going into respiratory distress, if they hadn't intubated you or given you a sodium bicarb drip in time to compensate for the acidity.
    3. As I've explained, you coudn't have possibly lost more than a couple of pounds of fat in that week. You could have lost as much as 10-15 pounds of water weight in a week, but that's about it.

    As a medical professional who has treated and cared for numerous people in DKA, some who have not survived, I'm sorry to say that you are incorrect in much of your information. I hope that others reading along are able to understand that I am not calling you a liar, but that I am only saying that a) your memories are distorted and incomplete, and b) any information you've been given or researched since then has been misinterpreted.

    I kept the remaining (after returning from hospital) weight off for several months (almost a year), so I can't believe it was water weight. There are several academic journal articles that can be readily found that explain how fat loss occurs with DKA. My memories are supported by others who were there at the time, including an endocrinologist and other medical staff.

    So, could you provide those sources?

    My dad died in June (though we talked about it on occasion in the years since it happened), I'm not going to give my mom's or sibling's contact information, and the medical facility would not tell you anything anyway because of HIPPAA.

    What the hell does that have to do with the several academic journal articles that are readily available?

    ETA: Sorry for your loss, man.
  • SezxyStef
    SezxyStef Posts: 15,267 Member
    Chatted with my brother and he sent me to a couple sites.

    "Diabetic ketoacidosis occurs when a person with diabetes becomes dehydrated. As the body produces a stress response, hormones (unopposed by insulin due to the insulin deficiency) begin to break down muscle, fat, and liver cells into glucose (sugar) and fatty acids for use as fuel. These hormones include glucagon, growth hormone, and adrenaline. These fatty acids are converted to ketones by a process called oxidation. The body consumes its own muscle, fat, and liver cells for fuel.

    In diabetic ketoacidosis, the body shifts from its normal fed metabolism (using carbohydrates for fuel) to a fasting state (using fat for fuel). The resulting increase in blood sugar occurs, because insulin is unavailable to transport sugar into cells for future use. As blood sugar levels rise, the kidneys cannot retain the extra sugar, which is dumped into the urine, thereby increasing urination and causing dehydration. Commonly, about 10% of total body fluids are lost as the patient slips into diabetic ketoacidosis. Significant loss of potassium and other salts in the excessive urination is also common."

    So basically you are saying your body broke down enough muscle, existing fat and liver cells for you to lose appx 20lbs....

    You weren't eating any food for 4 days, not taking in calories that stayed in your body for use as fuel, only drank water and it was the DKA that caused fat loss....no.

    Based on what I could find in the sites I was sent to you lost muscle tissue just like someone on a VLCD does...why no food at all...no calories in to fuel your body and DKA ate muscle tissue and existing fat but your body would have done it even without DKA as it needs fuel to run and you weren't giving it any. DKA may have sped up the process but it wasn't "fat loss"
  • Sued0nim
    Sued0nim Posts: 17,456 Member
    Can this thread stop being about Midwesterner and his special life event and start being about the OP?
  • snickerscharlie
    snickerscharlie Posts: 8,578 Member
    rabbitjb wrote: »
    Can this thread stop being about Midwesterner and his special life event and start being about the OP?

    +1000
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    mccindy72 wrote: »
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    1. I certainly am not calling you a liar. People who are in medically emergent states don't have good recall after the event - that doesn't mean they are lying when they give their imperfect recall of the event, it just means they are wrong.
    2. You wouldn't have had a heart attack from the high acid levels, you would have stopped breathing after going into respiratory distress, if they hadn't intubated you or given you a sodium bicarb drip in time to compensate for the acidity.
    3. As I've explained, you coudn't have possibly lost more than a couple of pounds of fat in that week. You could have lost as much as 10-15 pounds of water weight in a week, but that's about it.

    As a medical professional who has treated and cared for numerous people in DKA, some who have not survived, I'm sorry to say that you are incorrect in much of your information. I hope that others reading along are able to understand that I am not calling you a liar, but that I am only saying that a) your memories are distorted and incomplete, and b) any information you've been given or researched since then has been misinterpreted.

    I kept the remaining (after returning from hospital) weight off for several months (almost a year), so I can't believe it was water weight. There are several academic journal articles that can be readily found that explain how fat loss occurs with DKA. My memories are supported by others who were there at the time, including an endocrinologist and other medical staff.

    So, could you provide those sources?

    My dad died in June (though we talked about it on occasion in the years since it happened), I'm not going to give my mom's or sibling's contact information, and the medical facility would not tell you anything anyway because of HIPPAA.

    What the hell does that have to do with the several academic journal articles that are readily available?

    ETA: Sorry for your loss, man.

    I thought you meant the ones who were there at the time.

    Here is a good place to start:

    http://scholar.google.com/scholar?hl=en&amp;q=DKA+fat+loss&amp;as_sdt=1,23&amp;as_sdtp=
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,502 Member
    rabbitjb wrote: »
    Can this thread stop being about Midwesterner and his special life event and start being about the OP?

    Sounds fine to me. The OP mentioned my posts from a prior thread, and I was responding to that comment and others who didn't understand (whether they thought they did or not). If other users stop making incorrect responses, I'll stop correcting them.
  • tincanonastring
    tincanonastring Posts: 3,944 Member
    mccindy72 wrote: »
    mccindy72 wrote: »
    @midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?

    http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=

    Most of those other threads were either specifically about diabetes (where DKA is relevant), and I didn't really go into detail. In some of those threads, it was in response to others who had already mentioned DKA (as in this thread). DKA is related to weight loss, and is relevant to individual conditions experienced by users in the threads where I've either brought it up or responded to it.

    This thread is specifically about medical conditions / anomalies that affect weight. It directly is linked to the topic of this thread. In addition, another user brought up the topic and provided bad information. What I'm providing is accurate information about the topic, and I'm not encouraging anyone to do it. In fact, I'm explicitly encouraging people NOT to inentionally go into DKA.

    I'm not going to stop mentioning it any more than other users on this site will stop mentioning CICO (which is not as exact as most users purport).

    But this is a forum for an app dedicated to using CICO to meet weight goals. This isn't a DKA site.

    It's a fitness site, and DKA is relevant everywhere I've brought it up or responded to a mention about it. Otherwise, the same logic could be used when mentioning PCOS or any number of other things related to weight.

    DKA, which results in a loss of fluid is not relevant to a site where people are looking for meaningful, lasting fat loss.

    You continually bringing up an emergency medical condition to "prove" CICO is wrong is spurious. It just proves that there are medical conditions that can impact the fluid levels in the body and that the human body carries a lot of fluid in it.

    It is not meaningful to constantly interject "CICO doesn't always apply" into discussions based on your experience with fluid loss and dehydration, just as it's not meaningful for me to bring up my experience with celiac disease.

    Again, it isn't just fluid. There is fat loss as well.

    Ah, no. I see you didn't really read my post last night addressing your misinformed posting addressing this issue.

    1) you are discussing something that happened back when you were a teenager, and you were in DKA. People in DKA experience hallucinations, disorientation, and periods of unconsciousness, so it's highly unlikely that you are remembering any of what happened clearly in any way, shape or form.

    2) While people in DKA do experience high volumes of urine output, unless you continued to intake something (water, soda, something) eventually after you ran out of vomit and then bile (the dark stuff) you would only dry heave. It's not physically possible for your body to give you anything else to vomit out unless your stomach or esophagus ruputured and you were vomiting blood, and if that had happened, you most likely would have had surgery.

    3) While it is true that the adipose cells do release fatty acids in a desperate attempt to provide an energy source for gluconeogenosis, it's only the fatty acids that are released. There isn't time for a complete breakdown of adipose tissue and fat loss. When this happens, the blood becomes incredibly acidic. Disrupting the acid/base balance of the blood causes the body to try to compensate by forcing the respiratory drive into high gear (hyperventilation) to blow off as much carbon dioxide as possible. (carbon dioxide is an acid in the blood) the respiratory muscles can't work that hard, tire out, and unless the person is in a hospital where a sodium bicarb drip can be given to compensate the acidity of the blood, the person will stop breathing and die.

    4) As I said last night, if the body actually dumped that much fat into the blood in just a couple of days, the additional volume would be so great, the blood pressure would rise too high, and the risk of either stroke or aneurysm would be incredible.

    5) Considering that the majority of the body is comprised of water, and that it doesn't take much loss to create dehydration at a dangerous level, if you lost that much weight in a few days and it was all water weight, you would have died of dehydration despite the best efforts of hospital staff to save you.

    I did read your point last night and responded. In regards to these points:

    1. I explained what happened, and have before and after weights from a week prior to entering DKA and several days after returning to a normal state. You are basically saying that I hallucinated before and after being in DKA... in other words, you are just calling me a liar.
    2. I was drinking water, as explained earlier. I vomited some water as well as other substances in my stomach (bile).
    3. As I explained in my response last night, acid levels were extremely high during that event. In fact, the dr. was surprised I didn't have a heart attack because of high acid levels.
    4. Again, I addressed that last night.
    5. I'm not saying I lost 50 lbs. of water weight in that time. I explained this last night and again today. Some of that weight was water, some was fat. Others who don't understand this are claiming that it was all water weight. Those people are wrong.

    1. I certainly am not calling you a liar. People who are in medically emergent states don't have good recall after the event - that doesn't mean they are lying when they give their imperfect recall of the event, it just means they are wrong.
    2. You wouldn't have had a heart attack from the high acid levels, you would have stopped breathing after going into respiratory distress, if they hadn't intubated you or given you a sodium bicarb drip in time to compensate for the acidity.
    3. As I've explained, you coudn't have possibly lost more than a couple of pounds of fat in that week. You could have lost as much as 10-15 pounds of water weight in a week, but that's about it.

    As a medical professional who has treated and cared for numerous people in DKA, some who have not survived, I'm sorry to say that you are incorrect in much of your information. I hope that others reading along are able to understand that I am not calling you a liar, but that I am only saying that a) your memories are distorted and incomplete, and b) any information you've been given or researched since then has been misinterpreted.

    I kept the remaining (after returning from hospital) weight off for several months (almost a year), so I can't believe it was water weight. There are several academic journal articles that can be readily found that explain how fat loss occurs with DKA. My memories are supported by others who were there at the time, including an endocrinologist and other medical staff.

    So, could you provide those sources?

    My dad died in June (though we talked about it on occasion in the years since it happened), I'm not going to give my mom's or sibling's contact information, and the medical facility would not tell you anything anyway because of HIPPAA.

    What the hell does that have to do with the several academic journal articles that are readily available?

    ETA: Sorry for your loss, man.

    I thought you meant the ones who were there at the time.

    Here is a good place to start:

    http://scholar.google.com/scholar?hl=en&amp;q=DKA+fat+loss&amp;as_sdt=1,23&amp;as_sdtp=

    Which one of those supports your statement?

    *Sorry to continue the derailment.
  • SezxyStef
    SezxyStef Posts: 15,267 Member
    rabbitjb wrote: »
    Can this thread stop being about Midwesterner and his special life event and start being about the OP?

    sorry but yes for sure.