Completely lost in this maze of weight loss
clh1228
Posts: 2 Member
I am not sure that anyone can help, but if you can, I'd really appreciate it! I am 38 years old, weigh 248 lbs and am 5ft 5.5 inches. I have been trying to lose weight the majority of my lifetime with my weight ballooning abruptly around age 8 after having been normal weight and underweight in the years prior. I have tried every diet imaginable, I have been prescribed several weight loss medications over the years (most recently Contrave in the past month, but could not tolerate the extreme side effects I had on it). I have been to two bariatric specialists in the past 4 years. One was quite helpful with a realistic diet plan and visits every 3-4 weeks, but closed her practice 3 months after I started going there. The other just put me on meal replacement protein bars and wanted me to come back every 3 months without much other guidance--not so helpful. I have a family history of hypothyroidism in which my paternal grandmother and father both have it. My thyroid labs have been increasingly rising, but are still considered within the "normal" of the lab ranges. TSH in 2014 was 2.4, '15 was 2.99, and in '16 was 3.51. My free T4 ranges from 0.64 to 1.00 within those years. I have many symptoms of hypothyroidism yet my doctor says my thyroid numbers "look beautiful" and refuses to talk about possible thyroid problems preventing me from losing weight. I saw my doctor again today and again expressed concern that despite being on 1000-1200 calories per day plus regular exercising, I am not dropping any weight. The only time I dropped weight in the past 4 weeks was while I was on Contrave and so sick I could only get in about 500 calories per day before nearly vomiting. She said this was acceptable and that 500 calories is sufficient for obese people as they are losing weight. She told me that I should have continued the Contrave and remained on 500 calories only per day to lose the weight. When I said that I felt this was unhealthy, she disagreed and told me I was closed minded. She then recommended I go to one of the Quick Weight Loss type centers for guidance and to look into the hcg injections. Not to offend anyone here, but I am unconvinced that hcg injections are effective long term. I don't really know what I'm asking for here, but does anyone have any input or ideas for me? I am back to working on this on my own with just MyFitPal for now since I would not go along with her "plan". What would you do?
Thank you.
Thank you.
2
Replies
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Do you weigh your foods (food scale for solids, cups/spoons for liquid)? 9.9 times out of 10 when we see these questions it's because someone is eating way more than they think.
ETA: Less calories in than out should net you weight loss in most cases.6 -
Count your calories, using a food scale. Log everything you eat into this website. Eat the number of calories this website assigned to you. That's all. It's really that simple. Not necessarily easy, but definitely simple.
You don't need special food, pills, shakes, shots, teas, equipment (other than the food scale), surgeries, etc, to lose weight.
I entered the stats you gave into a calorie calculator, assuming you are female and pretty sedentary (my apologies if my assumptions were wrong). Here is what I got:
Your BMR is the amount of calories you need just to survive, if you were completely bedridden - no movement or exercise.
To maintain your current weight you need approximately 2226 calories per day.
To lose approximately 2 pounds per week, you should shoot for 1781 calories per day.
To make sure you are actually eating that amount of calories, you need to use a food scale because most of us SUCK at guessing what two tablespoons of peanut butter, or a half-cup of ice cream, really looks like. At least, I did!
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Check out the Success boards, lots of inspiration to read. You can do this!!0
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quiksylver296 wrote: »Count your calories, using a food scale. Log everything you eat into this website. Eat the number of calories this website assigned to you. That's all. It's really that simple. Not necessarily easy, but definitely simple.
To maintain your current weight you need approximately 2226 calories per day.
To lose approximately 2 pounds per week, you should shoot for 1781 calories per day.
1781 would be a deficit of 500 calories, so about 1 pound a week. To lose two, you'd need to cut your calories to 1225 or so. I agree with the rest.
Do you do any exercise? That may help, both in burning more calories, and helping to build muscle which will make you burn more calories overall. MFP allows you to eat back the exercise calories, but many people just eat half, because the program can overestimate how many calories get burned while exercising.2 -
spiriteagle99 wrote: »quiksylver296 wrote: »Count your calories, using a food scale. Log everything you eat into this website. Eat the number of calories this website assigned to you. That's all. It's really that simple. Not necessarily easy, but definitely simple.
To maintain your current weight you need approximately 2226 calories per day.
To lose approximately 2 pounds per week, you should shoot for 1781 calories per day.
1781 would be a deficit of 500 calories, so about 1 pound a week. To lose two, you'd need to cut your calories to 1225 or so. I agree with the rest.
I didn't do the math myself, just chose the 20% deficit option. Stupid website.
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Try using MFP as designed as quiksylver advised. I would weigh and measure everything and try to stay within my calorie goal everyday. Do this for a month or 2 and see if you can get results without medication. You can evaluate from there. Try to move a little more. Walking is fine to start. Good luck.0
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Also, I can personally attest that the HCG shots are NOT effective long-term. Man, I wasted a lot on money on that bunch of woo!5
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I would suggest ensuring that there is not a under-estimation of calories. Are you using a food scale and logging everything correctly?0
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Speaking as someone with hypothyroidism this only impacts your BMR by ~5%, so that isn't stopping you from losing. Bottom line is you are not in a caloric deficit.
Pay close attention to the data @quiksylver296 posted. You won't lose weight any faster maintaining a greater deficit in the long run. Make sure you are logging correctly, weighing food with a scale. Even trained professionals underestimate by hundreds of calories, so look at this first.
Don't make too many changes at once and think marathon, not sprint. Write down 4 changes you are going to make to lose weight - scratch off 3 and tackle one. Replace a bad habit with a good habit. Hit that goal, celebrate, then move on to another goal.8 -
I have similar stats. 37, 5'5, started at 240 in January and am down to 227. I log everything and weigh most foods. Drink LOTS of water. I have been drinking at least 80oz day and sometimes double that. The first two weeks I did not eat any bread or pasta. Most days are oatmeal with fruit or hard boiled eggs and coffee for breakfast, fruit for mid-morning snack, salad (usually spinach) with a few slices of turkey, fruit or low cal Greek yogurt in the afternoon, and chicken with spinach salad for dinner. I found that I was staying between 1000-1200 cal/day. I have been measuring most of my food. Hope this helps somewhat.1
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Any doctor recommending a 500 calorie a day diet should be "fired."13
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I'm 37, a little heavier than you, and I'm definitely hypothyroid (it was removed). You don't need fancy/trendy diets, it's all about your calorie deficit. As much as it seems like you need some detox to quick start, eat cabbage soup for a month, give up all your carbs...no. Just have a good calorie deficit you can maintain.
Grab a food scale, weigh what you eat (meal planning helps so you aren't doing it for every meal every day). Eat what you want, but within your calorie deficit (I commonly have 2 cookies or a serving of ice cream so I don't kill people get crazy cravings). Make changes that are sustainable for you! If you like pasta, eat pasta, just know how many calories you're going to have to make sure it fits.
A lot of issues that you see with hypothyroid can also leak over to just being overweight (ie being tired all the time) that you may see go away, but since you already have a family history you definitely want to keep up on it. If you have a doctor that doesn't listen to you, get another doctor (if possible). My endocrinologist was horrible about listening, would just brush off issues like he didn't care (he talked more into his tape recorder than to me). I stopped going to him. On the plus side, you've already been tested for T3/T4 which is not uncommon of us to mention.
The hardest part is just doing it, and continuing when you don't see a loss (I know that s.o.b. scale is going to move eventually). Read all the pinned posts at the top of the different sections, they're full of good information.6 -
quiksylver296 wrote: »Count your calories, using a food scale. Log everything you eat into this website. Eat the number of calories this website assigned to you. That's all. It's really that simple. Not necessarily easy, but definitely simple.
You don't need special food, pills, shakes, shots, teas, equipment (other than the food scale), surgeries, etc, to lose weight.
I entered the stats you gave into a calorie calculator, assuming you are female and pretty sedentary (my apologies if my assumptions were wrong). Here is what I got:
Your BMR is the amount of calories you need just to survive, if you were completely bedridden - no movement or exercise.
To maintain your current weight you need approximately 2226 calories per day.
To lose approximately 2 pounds per week, you should shoot for 1781 calories per day.
To make sure you are actually eating that amount of calories, you need to use a food scale because most of us SUCK at guessing what two tablespoons of peanut butter, or a half-cup of ice cream, really looks like. At least, I did!
This is spot on.
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Stella3838 wrote: »ETA: Less calories in than out should net you weight loss in most cases.
It will result in weight loss in all cases. Thermodynamics always works. What gets messed up in that equation, if someone has a metabolic or hormonal condition that genuinely gets in the way, is the "out" side. The tools we have for estimating normal calorie burn assume a normal metabolism. If something's wrong, the tools can be misleading, and give too high a number.
@clh1228 , if I were you I'd see an endocrinologist, not my family practitioner. If something's going on that your regular doctor isn't seeing, a specialist is more likely to spot it.2 -
I suggest first of all, find a different doctor. This one is pushing you in the wrong direction and doesn't sound particularly helpful.7
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Oh, and all of the above and stay in touch for support!
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Great info in this thread1
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1) Yes, I weigh my food with an accurate, digital food scale.
2) Yes, I exercise. I walk 3-4 times per week and do weight training about twice per week. I hiked this past Saturday up and down a mountain a total of 7.5 miles.
3) I have seen an endocrinologist against my doctor's wishes. He said my thyroid was trending toward an issue and that he would like to try me on medication once it hits the magical TSH of 4.0. Wasn't a great fan of him, but at least he sort of listened a little.
4) I am definitely looking for another PCP/doctor. I am a science educator and can't abide by someone telling me to do things like follow a 500 calorie diet, get hcg shots at a quick weight loss facility, don't count calories because it is too stressful (I did anyway because I was afraid of not knowing how "far off" I might be), and to pray about my weight loss. Yes, she did all of that.
5) I gave up 80% of my carbs this past month with little to no results. My breakfast is typically 2 eggs and an apple or with spinach (no cheese) omelette.
Thank you for all of the help. I am going to try some of the things you mentioned. It's just hard to know where to start when I've pretty much never been successful. I was 200 lbs by age 14, so I've never been thin since age 8.2 -
4) I am definitely looking for another PCP/doctor. I am a science educator and can't abide by someone telling me to do things like follow a 500 calorie diet, get hcg shots at a quick weight loss facility, don't count calories because it is too stressful (I did anyway because I was afraid of not knowing how "far off" I might be), and to pray about my weight loss. Yes, she did all of that.
WHAT.
Is there is some kind of medical standards board she can be reported to because a doctor actually telling patients to pray about it is ridiculously bad.
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4) I am definitely looking for another PCP/doctor. I am a science educator and can't abide by someone telling me to do things like follow a 500 calorie diet, get hcg shots at a quick weight loss facility, don't count calories because it is too stressful (I did anyway because I was afraid of not knowing how "far off" I might be), and to pray about my weight loss. Yes, she did all of that.
WHAT. Is there is some kind of medical standards board she can be reported to because a doctor actually telling patients to pray about it is ridiculously bad.
That ain't all. It's very hard to get adequate nutrition on only 500 calories no matter how obese you are. You can probably do it, but unless the doctor is following the case closely it's incredibly irresponsible to recommend such a thing offhand. Even the medically supervised fast weight loss programs put a patient on around 800 calories, and then load them with supplements to make sure they have what they need to, like, live.2 -
Are you logging here? Open your diary.0
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...I am definitely looking for another PCP/doctor. I am a science educator and can't abide by someone telling me to do things like follow a 500 calorie diet, get hcg shots at a quick weight loss facility, don't count calories because it is too stressful (I did anyway because I was afraid of not knowing how "far off" I might be), and to pray about my weight loss. Yes, she did all of that...
What the...?
Time for a new doctor.
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Even with a thyroid issue at your height weight and activity level it should be impossible not to be losing weight when you eat between 1000 and 1200 calories... is that your total for the day or do you also eat exercise calories?
If you eat exercise calories back maybe you are drastically over estimating how much you burn?
Or maybe you USUALLY eat between 1000 and 1200 but then occasionally go out to eat and have a large indulgent meal and don't track? Or sometimes have binge days? Or sleep eat??
There has to be more calories going in than you've stated for you not to be losing weight.
Also are you sure you're not losing weight over all? You said you dropped weight when you were on 500 cals a day- so you're capable of losing. Do you gain it back when you go back to eating 1000? Maybe you are losing weight but you're just expecting faster weight loss than the rate you're actually losing at?? It's going to be slower than you expect, but any weight loss is still progress.0 -
Also 4 weeks is not really long enough to judge wether weight loss is happening. Day to day fluctuations will be greater than your actual loss rate so you can't really tell how much you've lost until you're a few months in and tracked your weight and the general trend is going down. 1 month is too short a time frame. I'd say keep counting calories, stay consistent, and be prepared for the fact that getting to a normal weight is going to take a WHILE. Like maybe a year or more. It's not going to happen in 4 weeks.1
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She said this was acceptable and that 500 calories is sufficient for obese people as they are losing weight. She told me that I should have continued the Contrave and remained on 500 calories only per day to lose the weight. When I said that I felt this was unhealthy, she disagreed and told me I was closed minded. She then recommended I go to one of the Quick Weight Loss type centers for guidance and to look into the hcg injections. Not to offend anyone here, but I am unconvinced that hcg injections are effective
"FDA advises consumers who are using “homeopathic” HCG for weight loss to stop using the product, to stop following any labeled dieting instructions, and to discard the product.
HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity. There is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or ‘normal’ distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.”
Assuming you're in the US, the above message was brought to you by your tax dollars at work:
https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/MedicationHealthFraud/ucm281834.htm
I can see one situation where your doctor "justifiably" advised "500 Cal":
If in your doctor's educated opinion you are counting your calories so incorrectly that you're eating 2400 Calories while thinking that you eat 1000, then their advice to eat "500", i.e. by analogy 1200 real Calories, would be "appropriate". Assuming they think you're an idiot who cannot be trusted with full information about your own care.
Fire their sorry kitten to the curb and consider complaining to your local doctor police/ethics board/whatever the crap body regulates your local sawbones for unprofessional conduct, or bad advice, or both.
And, since they don't seem to know which side of their body they use to pass gas and which one to talk with, ask them to refer you to a registered dietitian who might be aware as to which bodily orifice is customarily used for what.6 -
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1) Yes, I weigh my food with an accurate, digital food scale.
2) Yes, I exercise. I walk 3-4 times per week and do weight training about twice per week. I hiked this past Saturday up and down a mountain a total of 7.5 miles.
3) I have seen an endocrinologist against my doctor's wishes. He said my thyroid was trending toward an issue and that he would like to try me on medication once it hits the magical TSH of 4.0. Wasn't a great fan of him, but at least he sort of listened a little.
4) I am definitely looking for another PCP/doctor. I am a science educator and can't abide by someone telling me to do things like follow a 500 calorie diet, get hcg shots at a quick weight loss facility, don't count calories because it is too stressful (I did anyway because I was afraid of not knowing how "far off" I might be), and to pray about my weight loss. Yes, she did all of that.
5) I gave up 80% of my carbs this past month with little to no results. My breakfast is typically 2 eggs and an apple or with spinach (no cheese) omelette.
Thank you for all of the help. I am going to try some of the things you mentioned. It's just hard to know where to start when I've pretty much never been successful. I was 200 lbs by age 14, so I've never been thin since age 8.
Good! Stick around and take note of the "stickied" threads in the new user forums. These are goldmines of great simple information. Open up your diary and have someone with experience review this. Mine is open by the way if you care to review.
Definitely go with an endocrinologist. This is far too specific for a general practitioner to tackle. The good news is with hormonal issues is that these will often improve with weight loss.0 -
You mentioned one doc gave you a realistic diet plan that you liked but she left after 3 months. Why are you not following the plan that doc gave you? Why don't you post the plan here so we can see it.0
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@clh1228 , You seem to be fixated on blaming your thyroid for your obesity. As has already been pointed out, your thyroid is not the responsible party, you are. Get your thyroid issues treated, by all medical means, but your obesity is a separate problem with separate solutions.2
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A quick fix won't do you any good in the long run. First of all reset your mindset - you can lose weight with a healthy lifestyle. Eat healthy clean foods - how about giving up all processed foods for lent (even if you aren't Catholic)? Move as much as possible. Stop the excuses. Set your calorie goals to what MFP says for a 1-1.5 lb loss per week. See where you are in a month - and then adjust. A couple of things I've learned on this journey (lost just over 150 lbs), if you have an oops - get right back on track. Don't wait until Monday or even tomorrow. Get back on track now! I set my weight loss goals at 25 per quarter - 2 lbs. per week. I come close to that. It's just too daunting to think "I have 100 lbs to lose". Good luck!
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