Need advice as to why I’m not losing

2

Replies

  • covevendor
    covevendor Posts: 6 Member
    edited February 2020
    The weight loss procedure was done years ago and the removal of likely an adjustable gastric band is a very minor procedure and would not need increased protein to allow for healing from the surgery as some people have stated. I agree that half of 1350 kcal per day would be way too little, but our experience is that most people are very bad about estimating calories without help or very carefully logging things. It is not uncommon in the first week or two to be consume little and this calorie estimate may be right. Agree with the comments above regarding "starvation mode"...what you are referring to are changes in the non-exercise activity thermogenesis (NEAT) which is not likely to be a factor here (a long technical side discussion if people are interested).

    Some suggestions:
    1. Continue to follow a diet. The one you mention sounds reasonable. Multiple studies have shown that following a diet is useful especially in the long term. It does not seem to matter so much which diet you do since trials comparing different diets have usually found weight loss to be similar but better than people who were just counseled regarding weight loss but not given a specific plan.
    2. It is important to set realistic goals and think of this as a long term process. I find it really frustrating that I can only lose 1.5 to 2 pounds per week but I have to remind myself that the weight came on slowly and your body will only allow you to remove it safely at limited rate. Trying to push weight loss beyond about 2 pounds per week is just not sustainable in my experience, and we worry about the long-term health effects.
    3. Consider cutting out highly processed foods (sodas [including diet], fast food, chips, etc). This was a study out of Stanford University last year where people did that and either followed a low carb or low fat diet, and they achieved good weight loss without counting calories (I think it was on the order of 12 pounds over the study).
    4. I personally think it is best to weigh yourself frequently - every day or at least once per week and put the result in one of may programs online that will show you a trend line (or you can do it in Excel). There is considerable daily variation in weight based on fluid retention alone and this is especially true in your case where you have some leg swelling. This can result in several pounds of weight swing up or down and can be very discouraging if you are retaining more fluid than usual or lead to unrealistic expectations of weight loss achieved if you are on the lower end. I find it useful to keep a careful track of calories consumed and activity (easy with a Fitbit or Apple Watch). Taking this along with my basal metabolic rate (estimated through a number online calculators) I graph out in Excel what my weight actually is predicted to be. What I have noticed is and my weight will swing up and down around the true weight. This difference can be several pounds. It is quite common for people to it have a very dramatic weight loss in the first week or 2 and unfortunately this is primarily due to changes in fluid retention (due to a number factors including the decrease in glycogen in muscle which is only temporary). However, real weight loss is occurring so hang in there.
    5. Keep a log of what you eat. I find keeping a log of what I eat easy to do with phone apps or online programs, and I think it is helpful. For me it helps me make better food choices.
    6. Medically supervised weight loss is not all the same. In this case it sounds like your physician has given you a diet, but he or a dietician is not meeting with you frequently, tracking your progress carefully, and adjusting your diet as can be done. I think this later approach is more effective, but insurance does not pay for this usually and few people can afford it out of pocket.
    7. The procedure I suspect you had is years ago was a laparoscopic adjustable band or less likely a vertical banded gastroplasty or other similar procedure. These just reduce the stomach size, and weight loss has been very disappointing from such procedures especially long term. There are multiple reasons for this, but the biggest is that they do not impact the hormones that signal hunger and feeling full. If your obesity is bad enough (class II or III) then a Roux-en-Y gastric bypass (the most common procedure) may be something to think about especially if you have health problems related to obesity. This surgery makes a smaller stomach that is connected to the esophagus (swallowing tube) and intestines. It also rearranges the intestines so you can absorb less of the calories from the food you eat. The gastric pouch can stretch out over time (as it likely did with your gastric band), but with a Roux-en-Y the intestinal bypass is still there (the "malabsorptive component") that will help lose weight.
    8. There are a number of medications that can assist in weight loss such as Contrave or topiramate. Talk with your doctor about these if you have not lost weight after a couple more months. They are not miracle drugs, but they will help cut your appetite.
    9. Your edema is a bit concerning. I'm assuming that you have been checked for obstructive sleep apnea or are already on treatment with CPAP.
  • oceangirl99
    oceangirl99 Posts: 161 Member
    I wonder if "Lean Green Protein" is another way of saying Keto or very low carb diet? I tried keto for a while and lost weight without counting calories because I ate less since I wasn't hungry AT ALL. Food actually started to gross me out and I knew it wasn't something I could stick to for the long term. I really needed fruit and other veggies. I found that when I started eating more "normal" foods again and counting calories, my appetite came back.
    You should follow your doctor's advice though but you might want to consider a 2nd opinion.
  • lemurcat2
    lemurcat2 Posts: 7,885 Member
    oceangirl99 wrote: »
    I wonder if "Lean Green Protein" is another way of saying Keto or very low carb diet? I tried keto for a while and lost weight without counting calories because I ate less since I wasn't hungry AT ALL. Food actually started to gross me out and I knew it wasn't something I could stick to for the long term. I really needed fruit and other veggies. I found that when I started eating more "normal" foods again and counting calories, my appetite came back.
    You should follow your doctor's advice though but you might want to consider a 2nd opinion.

    Googling suggests that it may be an Optavia thing, and sounds a lot like a healthy version of a keto diet.

    I am another who thinks that OP should talk to her medical team about what is going on in that the signs of water retention make the actual rate of loss unclear and if she is eating only half of her 1320 (and doesn't know what she should be aiming for anyway), that's a worrisome sign. And yes, eating keto can kill appetite and make hunger untrustworthy, as can eating in a way that cuts out all favorite foods and which isn't all that appealing (I think the Optavia thing sounds tasty enough but not everyone would).

    Also, OP mentioned a medication which could be an appetite suppressant and also is an added reason why the issues with being able to eat and possible water retention need to be brought to the doctor.
  • Rowdib
    Rowdib Posts: 11 Member
    My bariatric doctor wanted to convert me to a sleeve or bypass but my insurance refuses to cover it. That’s when he suggested a medical weight loss program. I’m on topiramate and phentermine. I was put on the topiramate months ago for migraines and never saw any weight loss. And I have no sleep apnea, thank God. I’m just fat and really out of shape. I want to get back to riding horses again like I used to. But right now I couldn’t mount if my life depended on it. Part of my having no appetite too is stress. I’m going through a break up with my boyfriend and having to find a new place to live. I’m trying to focus on taking care of me and doing what I need to do for me and not get mired down that a part of my life is ending. And trust me everyone, I’m logging every single calorie that goes in my mouth. I do see my doctor once a month so I will see him again on the 20th. The only thing besides cereal that I’d like to have, is a big ole whopper with cheese! Lol. Commercials on tv are so bad. But they are 860 calories and 51 grams of fat. So that’s a no go. I try to limit my fat to 30 grams per day. Anyway thank you for the great feedback!
  • snowflake954
    snowflake954 Posts: 8,399 Member
    Rowdib wrote: »
    My bariatric doctor wanted to convert me to a sleeve or bypass but my insurance refuses to cover it. That’s when he suggested a medical weight loss program. I’m on topiramate and phentermine. I was put on the topiramate months ago for migraines and never saw any weight loss. And I have no sleep apnea, thank God. I’m just fat and really out of shape. I want to get back to riding horses again like I used to. But right now I couldn’t mount if my life depended on it. Part of my having no appetite too is stress. I’m going through a break up with my boyfriend and having to find a new place to live. I’m trying to focus on taking care of me and doing what I need to do for me and not get mired down that a part of my life is ending. And trust me everyone, I’m logging every single calorie that goes in my mouth. I do see my doctor once a month so I will see him again on the 20th. The only thing besides cereal that I’d like to have, is a big ole whopper with cheese! Lol. Commercials on tv are so bad. But they are 860 calories and 51 grams of fat. So that’s a no go. I try to limit my fat to 30 grams per day. Anyway thank you for the great feedback!

    As you go along you might want to consider that whopper as a treat and cut it in half. Then it might be doable. Put the other half in the frig for a couple of days. Another option is to make your own at home, substituting some ingredients for others and using very lean beef, less bread,...... If you do this for awhile you learn how to enjoy without going overboard. If you're going through a difficult time, just hang in there and maybe use it as a trampoline to start a new life for yourself focusing on your health. Wishing you the best of luck.
  • PAV8888
    PAV8888 Posts: 14,242 Member
    edited February 2020
    Good job @cheryldumais
    Was wondering how the vape campaign was going! Really glad to hear you managed to conquer it!!!
  • cheryldumais
    cheryldumais Posts: 1,907 Member
    PAV8888 wrote: »
    Good job @cheryldumais
    Was wondering how the vape campaign was going! Really glad to hear you managed to conquer it!!!

    Oh @PAV8888 I'm sorry to say I went back to vaping as I was gaining with no end in sight. I'm retiring this year however and hope to try again once I get settled.
  • PAV8888
    PAV8888 Posts: 14,242 Member
    cheryldumais wrote: »
    PAV8888 wrote: »
    Good job @cheryldumais
    Was wondering how the vape campaign was going! Really glad to hear you managed to conquer it!!!

    Oh @PAV8888 I'm sorry to say I went back to vaping as I was gaining with no end in sight. I'm retiring this year however and hope to try again once I get settled.

    Dang. You will get it on your next try once you have more time!!!
  • Jossy_star
    Jossy_star Posts: 7 Member
    I am not 100% sure but swelling indicates water retention try lowering your salt intake and drink more water and remember weight loss is not a quick fix it’s a lifestyle
  • covevendor
    covevendor Posts: 6 Member
    edited February 2020
    "OP was bed ridden from complications for a month and had a poor diet prior to the removal. It is not uncommon for the edema she is describing to be related to low protein/low albumin. Additionally, many post-op complications are a result of poor protein intake needed for proper healing. Of course, her doctor is the most appropriate person for her to be discussing this with.[/quote]"

    I really doubt from her description that she has hypoalbuminemia. In addition, I have not noticed waxing and waning edema to be commonly due to low protein since it more typically causes persistent swelling. This is a minor laparoscopic procedure to remove it and it would be uncommon to be bed ridden from complications from the removal.
  • covevendor
    covevendor Posts: 6 Member
    "Did you actually read the OP?? It's clearly stated that this person is under eating by quite a bit. They don't need medication to curb their appetite.

    This is the second time I've seen you suggest completely unwarranted weight loss medication."

    Thanks. Yes I read their post. Did you look at my reply? Did you read what the poster said? I think not. We actually do not know how much she is consuming based on her not keeping a careful log. I doubt that we are truly at 1/2 that goal, and I think it would be useful to keep a careful log. I mentioned medication (which it turns out she is on...read her post) since it is an option depending on her degree of obesity. I have made 2 posts by the way so thanks for reading them. I think in both cases medication to assist in weight loss is an option especially if we are going to the point of surgical intervention, but as I mentioned it should be discussed with her physician.
  • Rowdib
    Rowdib Posts: 11 Member
    Wow. I’m an educated woman, and in my way of thinking, if I’m cooking my own food at home, at least I know what is going into it and how it is cooked. And so from what I’m gathering here, if I open a can of black beans to use in a recipe, the nutritional information in the side of the can is not to be trusted?? That just doesn’t seem right to me. And if you can’t trust the nutritional information on the packages, then where do you get it? The nutrition fairy?? If I go to a restaurant I have no reassurance of exactly what is in my food, how much exactly is there, or how it was cooked. Or am I supposed to trust their handy nutritional guides? Come on. And btw, by not eating nachos, I know damn well I haven’t consumed a days worth of empty calories in one setting. And that my friend, is all the accuracy I need when it comes to nachos. I think these boards could use a little more positivity and a little less criticism. I know I asked for advice, but good grief, I never thought people would be this negative. It’s hard enough to do what we’re doing, a little encouragement goes a long way.
  • salvador231
    salvador231 Posts: 7 Member
    Make sure you get enough sleep and avoid overthinking and stressing on your weight. It fluctuates on daily basis. If you want to reduce the swelling of your leg, try to eat food that has diuretic property like parsley and cucumber. Eating broccoli also helps since it removes excessive estrogen in your body which is link to fluid retention.

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