Medical Conditions Which Affect Weight: Separating Fact From Fiction

tincanonastring wrote: »

midwesterner85 wrote: »

tincanonastring wrote: »

midwesterner85 wrote: »

tincanonastring wrote: »

midwesterner85 wrote: »

mccindy72 wrote: »

midwesterner85 wrote: »

mccindy72 wrote: »

midwesterner85 wrote: »

PeachyCarol wrote: »

midwesterner85 wrote: »

janejellyroll wrote: »

midwesterner85 wrote: »

tincanonastring 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&q=DKA+fat+loss&as_sdt=1,23&as_sdtp=

Which one of those supports your statement?

*Sorry to continue the derailment.

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

PeachyCarol wrote: »

cafeaulait7 wrote: »

I'd have to agree, because if we don't have to care about all the variables that come into play to make up the I and the O, then of course CICO is what 99% boils down to.

I don't think it's wise to state conclusively that no special diets are required, though, other than that 'required' is such a strong term. No special diet is warranted with PCOS? That's a bit like saying no special diet is warranted with diabetes, except that not everyone with PCOS has IR yet.

For an example that is hopefully illustrative, we do suggest folks eat protein. Imagine someone eating a no-protein diet for years. Are the results still just CICO? I'm seriously asking.



I had some kind of muscle wasting when I got a malabsorption disease that went undiagnosed. Along with the malabsorption, I eventually lost my appetite so badly that my calorie intake was also quite low (and it was harder to swallow than usual). I got down to 85 lbs before diagnosis. I really don't understand the muscle wasting (my doctor does), but fortunately for me all it took was intermuscular treatment with the vitamin I couldn't absorb through my stomach. Bam, everything changed, starting that same week It was kind of crazy! The only thing that remained was some of the nerve damage that had gone on too long to be reversed.

I figure somewhere in there might be an example of simple CICO not working, but like I say, I don't understand the mechanism behind the muscle wasting while I was still at a nice weight.

IR does not necessarily require a low carbohydrate diet. It's a myth among some people who have IR who have chosen that path that one must low carb to address it. It's simply not true. There are three people on my friend's list with IR or who previously had it (it resolved with weight loss), and not one of them low carbs.

There is nothing wrong with choosing to low carb if you have IR. There is plenty wrong with implying that it's the only way a person can eat if they have it.

PeachyCarol wrote: »

cafeaulait7 wrote: »

I'd have to agree, because if we don't have to care about all the variables that come into play to make up the I and the O, then of course CICO is what 99% boils down to.

I don't think it's wise to state conclusively that no special diets are required, though, other than that 'required' is such a strong term. No special diet is warranted with PCOS? That's a bit like saying no special diet is warranted with diabetes, except that not everyone with PCOS has IR yet.

For an example that is hopefully illustrative, we do suggest folks eat protein. Imagine someone eating a no-protein diet for years. Are the results still just CICO? I'm seriously asking.



I had some kind of muscle wasting when I got a malabsorption disease that went undiagnosed. Along with the malabsorption, I eventually lost my appetite so badly that my calorie intake was also quite low (and it was harder to swallow than usual). I got down to 85 lbs before diagnosis. I really don't understand the muscle wasting (my doctor does), but fortunately for me all it took was intermuscular treatment with the vitamin I couldn't absorb through my stomach. Bam, everything changed, starting that same week It was kind of crazy! The only thing that remained was some of the nerve damage that had gone on too long to be reversed.

I figure somewhere in there might be an example of simple CICO not working, but like I say, I don't understand the mechanism behind the muscle wasting while I was still at a nice weight.

IR does not necessarily require a low carbohydrate diet. It's a myth among some people who have IR who have chosen that path that one must low carb to address it. It's simply not true. There are three people on my friend's list with IR or who previously had it (it resolved with weight loss), and not one of them low carbs.

There is nothing wrong with choosing to low carb if you have IR. There is plenty wrong with implying that it's the only way a person can eat if they have it.

PeachyCarol wrote: »

I'd actually like to show midwesterner where he's going off the rails, because he derails every CICO thread with his DKA episode.

He's even saying now -- to the point he left a question unanswered -- that his current medical condition renders CICO to not work absolutely.

The last statement goes to the heart of exactly what I'm trying to get to in this thread, and that is the mechanics whereby certain medical conditions effect CICO.

The understanding on the boards should be clear: CICO is always valid. The confounding factors can usually be explained, and in more complex, elegant accountings of CICO, they are indeed accounted for. Saying you have a medical condition doesn't negate CICO, add to it, or detract from it. It's just a part of the equation.

So let's explore those medical conditions and bring to light how they effect energy balance so people can understand why weight loss/gain might not work as expected.

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.

janejellyroll wrote: »

RuNaRoUnDaFiEld wrote: »

My friends son has an awful condition called Prader willi syndrome. It is soul destroying to witness.

EDIT- What a great thread topic OP!

I read a really intense article about this syndrome last year (wish I could remember where). It really stuck with me, how difficult it is for families to deal with.