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Need advice as to why I’m not losing

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  • corinasue1143corinasue1143 Member Posts: 3,578 Member Member Posts: 3,578 Member
    So down 9 pounds in 3 weeks? Pretty fast weight loss.
  • RowdibRowdib Member Posts: 11 Member Member Posts: 11 Member
    Is three pounds a week really too much? I know much more probably wouldn’t be good.
  • PAV8888PAV8888 Member Posts: 7,113 Member Member Posts: 7,113 Member
    The generally safe levels are 20% of TDEE, maybe 25% while obese. 0.5% to 1% of body weight per week. Usually the higher the initial weight the larger the loss per week that can be tolerated. Tolerable and tolerated does not mean optimal and best and healthiest rate for the individual.

    First or second week losses are often different than the longer term trend. Weight trend over long enough time periods is what matters in the end. Not any subsets of one or two weeks.
    edited February 10
  • PAV8888PAV8888 Member Posts: 7,113 Member Member Posts: 7,113 Member
    PAV8888 wrote: »
    The generally safe levels are 20% of TDEE, maybe 25% while obese. 0.5% to 1% of body weight per week. Usually the higher the initial weight the larger the loss per week that can be tolerated. Tolerable and tolerated does not mean optimal and best and healthiest rate for the individual.

    First or second week losses are often different than the longer term trend. Weight trend over long enough time periods is what matters in the end. Not any subsets of one or two weeks.

    In the interest of "correctness" and even though I don't believe that fast a rate of loss to be a good idea for reasons other than body composition, an obese individual would probably tolerate 1.5% per week just as well from a favourable body composition results perspective as 1% per week.

    Again, tolerate well (i.e. that you're not going to lose excess lean mass) does not mean optimal for a particular individual. In the end if 1.5% per week is hard and you end up derailed after a couple of months, you will lose way less than the person who only loses 0.5% a week... but keeps doing so for a year.
  • covevendorcovevendor Member, Premium Posts: 5 Member Member, Premium Posts: 5 Member
    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.
    edited February 10
  • oceangirl99oceangirl99 Member Posts: 159 Member Member Posts: 159 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.
  • lemurcat2lemurcat2 Member Posts: 5,268 Member Member Posts: 5,268 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.

    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.
  • RowdibRowdib Member Posts: 11 Member Member 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!
  • snowflake954snowflake954 Member Posts: 4,951 Member Member Posts: 4,951 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.
  • PAV8888PAV8888 Member Posts: 7,113 Member Member Posts: 7,113 Member
    Good job @cheryldumais
    Was wondering how the vape campaign was going! Really glad to hear you managed to conquer it!!!
    edited February 11
  • cheryldumaischeryldumais Member Posts: 1,928 Member Member Posts: 1,928 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.
  • PAV8888PAV8888 Member Posts: 7,113 Member Member Posts: 7,113 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.

    Dang. You will get it on your next try once you have more time!!!
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