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Frustrated/Confused over Doctor's Recommendations

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  • PsychgrrlPsychgrrl Member Posts: 3,151 Member Member Posts: 3,151 Member

    When do you follow up with the doctor again? Did you go over what you were doing with him before and what did he have to say about it?

    Not sure where you are, but it's very common here to be able to call the office for quick questions and clarifications from someone on staff, or to make a phone appointment with the doctor. That would be my first step if it's still a while until your next appointment.

    We did go over what I have been eating and he had a few critiques and information on a few of the items I had been eating. Like discouraging eating bananas instead of other options etc. Then quickly went to providing the plan I am on now.

    My follow-up appointment is mid June. I will take your advice and check into if I can contact him with questions. Thank you.

    All too often, it seems like Keto (low carb, high fat) seems to be the default doctors recommendation without much consultation with the patient.

    Keto can definitely work for weight loss, but it is a very specific way of eating that is not for everyone. 🙋🏻‍♀️ I’d ask why your doctor put you on this particular diet. If there is no health-related basis beside weight-loss, I’d point out your success in losing weight prior to being out on the new restrictive diet.

    You had terrific results and they can begin for you again. Please don’t let this temporary set back discourage you, you’ll be back on track in no time! 💖
  • age_is_just_a_numberage_is_just_a_number Member, Premium Posts: 486 Member Member, Premium Posts: 486 Member
    Congratulations on embracing a lifestyle change and losing 30 pounds.
    Weight loss happens when at a caloric deficit. The composition of those calories really doesn’t matter for weight loss.
    Higher protein and lower carbs are often suggested for weight loss to:
    A) maintain muscle mass
    B) feel more satisfying — feel full longer.

    I find 45 grams of protein difficult to get at each meal.
  • Speakeasy76Speakeasy76 Member Posts: 806 Member Member Posts: 806 Member
    It seems like when a weight loss doctor prescribes a weight loss plan, he or she just recommends the one he prefers or is most familiar with, or the weight loss clinic promotes. It doesn't seem he or she gives any real thought as to whether or not the patient can actually LIVE with the plan. It also seems he or she doesn't give any real thought to the behavioral changes necessary for permanent weight loss, and ideally small changes are more sustainable than big ones all at once.

    Like others said, if you think you can live with the things the doctor told you, then by all means do it. However, if you don't think you'll be able to keep it up long-term, take what you think you can do and combine it with what you've already doing.
    Also, I'd ask the doctor what his specific reasoning is for his suggestions, and what evidence he has to back it up. That'll probably throw him for a loop.
  • bubus05bubus05 Member Posts: 121 Member Member Posts: 121 Member
    Interesting thread. The plan given by the good doctor sounds like hard core keto. i have done something similar, a pretty tough keto regime for a year until April this year. it can be effective but strict keto is clearly not for everyone. These 'rules' and numbers of keto, what you can or can't eat or how many grams of carbs or proteins are allowed I always considered merely 'suggestions going in the right direction'. For me there was never really a daily limit on macros, it is frustrating and I found it impossible to follow. Instead I tried to be as close as possible to the suggested limits, if I went over no big deal i tried to calculate a weekly average that allowed me some room to maneuver. Not all keto diets are the same, it is not an absolute. Ultimately one wants to lose weight, do what works, make adjustions if needed or re-arrange macros completely to make them sustainable.
  • Cinder333Cinder333 Member Posts: 29 Member Member Posts: 29 Member
    I am baffled that the doctor gave you a new plan to follow when you are clearly having great success with what you are already doing. I would continue to do what you have been since you find it sustainable. And I agree with the person above who advised you don't need to follow up with that clinic if it wasn't helpful.
  • PAV8888PAV8888 Member Posts: 8,816 Member Member Posts: 8,816 Member
    Have you visited the Larger Losers group? There is a bunch of people there who have either faced or are facing challenges similar to your own: https://community.myfitnesspal.com/en/group/133315-larger-losers

    There are some very good posts there by @NovusDies

    @AnnPT77 (a tad bit shy she is; but she hides it well! and if, you ask her nicely, she) will link you to her "sticky posted" thread on how to develop your own diet plan.

    Am I seeing right that you've dropped almost 40 lbs in just over two months and that you dropped another 7 lbs in two weeks? So close to double the maximum rate recommended on MFP? OR operating on a 1750 to 2000 Cal deficit a day?

    There may also exist an expectations issue here. You're at or exceeding a 1% of body weight per week loss rate both during the past two months and during the past 14 days.

    I've heard of very few people who find such a large deficit long term sustainable.

    And you may want to keep in mind that (UNLESS THERE ARE UNDISCLOSED MEDICAL REASONS NECESSITATING IMMEDIATE RAPID WEIGHT LOSS to say engage in life saving surgery) that faster loss is not always better... especially if you push things to the point where you start to experience some negative side effects.

    The goal is to lose the weight AND MAINTAIN THE WEIGHT LOSS for YEARS... not months. You need to figure out how you will be eating and moving now and in the future... not just and only how you can consume the least amount of calories for a few months to drop a tonne of weight... and then what?
    edited May 13
  • AnnPT77AnnPT77 Member, Premium Posts: 21,559 Member Member, Premium Posts: 21,559 Member
    PAV8888 wrote: »
    Have you visited the Larger Losers group? There is a bunch of people there who have either faced or are facing challenges similar to your own: https://community.myfitnesspal.com/en/group/133315-larger-losers

    There are some very good posts there by @NovusDies

    @AnnPT77 (a tad bit shy she is; but she hides it well! and if, you ask her nicely, she) will link you to her "sticky posted" thread on how to develop your own diet plan.

    Am I seeing right that you've dropped almost 40 lbs in just over two months and that you dropped another 7 lbs in two weeks? So close to double the maximum rate recommended on MFP? OR operating on a 1750 to 2000 Cal deficit a day?

    There may also exist an expectations issue here. You're at or exceeding a 1% of body weight per week loss rate both during the past two months and during the past 14 days.

    I've heard of very few people who find such a large deficit long term sustainable.

    And you may want to keep in mind that (UNLESS THERE ARE UNDISCLOSED MEDICAL REASONS NECESSITATING IMMEDIATE RAPID WEIGHT LOSS to say engage in life saving surgery) that faster loss is not always better... especially if you push things to the point where you start to experience some negative side effects.

    The goal is to lose the weight AND MAINTAIN THE WEIGHT LOSS for YEARS... not months. You need to figure out how you will be eating and moving now and in the future... not just and only how you can consume the least amount of calories for a few months to drop a tonne of weight... and then what?

    I think the OP already has some kind of plan from the doctor? If it's just macro goals from the doctor, yes, this process could be used:

    http://community.myfitnesspal.com/en/discussion/10636388/free-customized-personal-weight-loss-eating-plan-not-spam-or-mlm/p1

    It doesn't talk about balancing macros meal-by-meal as the OP seems to describe, but it's reasonably obvious how the same process could be applied at the meal level.

    FWIW, the thread is in the "Getting Started" stickies (a.k.a. "Most Helpful Posts" section.)

    I'm a shameless self-promoter of my own threads, because I'm lazy and don't like retyping the same thing over and over into individual threads. 😉
  • PAV8888PAV8888 Member Posts: 8,816 Member Member Posts: 8,816 Member
    AnnPT77 wrote: »
    I think the OP already has some kind of plan from the doctor? If it's just macro goals from the doctor, yes, this process could be used:

    Not sure. The OP, in my opinion, has to take charge and filter through everything and make this process his own.

    Is there a medical exigency for some of the things he is told to do? Or are these general recommendations and suggestions as to how he should lose weight? If he is unsure about the answer to that he has access to the medical staff to ask and confirm why he is receiving certain recommendations.

    If there is medical necessity for the recommendations then obviously he should follow them and the issue is out of anyone's pay grade to discuss other than between the OP and their medical provider!

    If this is a more general "you need to lose weight and here is THE ONE way you can do it" discussion... well that's a more open discussion. And since the doctor won't be living the OP's life over the next several years, the OP will have to balance things out so that they can actually work out for them.
    edited May 13
  • Maverick6714Maverick6714 Member Posts: 9 Member Member Posts: 9 Member
    PAV8888 wrote: »
    Have you visited the Larger Losers group? There is a bunch of people there who have either faced or are facing challenges similar to your own: https://community.myfitnesspal.com/en/group/133315-larger-losers


    Am I seeing right that you've dropped almost 40 lbs in just over two months and that you dropped another 7 lbs in two weeks? So close to double the maximum rate recommended on MFP? OR operating on a 1750 to 2000 Cal deficit a day?

    There may also exist an expectations issue here. You're at or exceeding a 1% of body weight per week loss rate both during the past two months and during the past 14 days.

    Yes, thank you for the Larger Losers Group suggestion. I joined that last week.

    It is 40 pounds total since March 8th. I was simply saying 7 of those pounds were since the meeting at the clinic. I really don't have any specific expectations, except want to continue to make progress and I understand there will be some fluctuation. I am eating around 1800 calories a day and back to doing well eating/mind wise now that I stopped trying to beat myself up if I was at 38 carbs instead of under 30 (as the doctor prescribed) for a given meal. I have found some protein shakes that have helped for breakfast on the go and were on the recommended list from the clinic.
  • Maverick6714Maverick6714 Member Posts: 9 Member Member Posts: 9 Member
    AnnPT77 wrote: »

    I think the OP already has some kind of plan from the doctor? If it's just macro goals from the doctor, yes, this process could be used:

    http://community.myfitnesspal.com/en/discussion/10636388/free-customized-personal-weight-loss-eating-plan-not-spam-or-mlm/p1

    It doesn't talk about balancing macros meal-by-meal as the OP seems to describe, but it's reasonably obvious how the same process could be applied at the meal level.

    FWIW, the thread is in the "Getting Started" stickies (a.k.a. "Most Helpful Posts" section.)

    I'm a shameless self-promoter of my own threads, because I'm lazy and don't like retyping the same thing over and over into individual threads. 😉

    Thank you for the link. I will check that out tonight!
  • corinasue1143corinasue1143 Member Posts: 5,795 Member Member Posts: 5,795 Member
    About the bananas. Not fact, just a thought. Some people consider a banana 2 servings of fruit. It seems to have something to do with diabetes and how the sugar in a whole banana affects blood sugar. I think some people hear that and get “avoid bananas” rather than, “if bananas cause a problem, go easy on them.” According to what you said you were eating just before your appointment, it doesn’t seem like that would be a problem for you.
  • PAV8888PAV8888 Member Posts: 8,816 Member Member Posts: 8,816 Member
    It is 40 pounds total since March 8th. I was simply saying 7 of those pounds were since the meeting at the clinic. I really don't have any specific expectations, except want to continue to make progress

    Your body is happy to lose weight. But your body is also stressed by you losing weight. And stress generates reactions and side effects at the physical level. Some short term and some longer term. Some of these side effects have the potential to derail. Faster is not always better. Sustainability is important.

    A back of the napkin calculation is 3500 Calories of deficit = 1lb of fat loss. 40lbs = 140,000 Cal, 7lbs = 24,500.

    Divide by the number of days and you find your ACTUAL daily deficit as calculated by your body (as opposed to your logging) :smile:

    You said you're eating around 1800. My back of the napkin says you're creating deficits in the 1600 Cal to the more than 2000 Cal range DAILY.

    MFP maxes out at 1000 Cal daily. There is a reason for that!

    Because of your initial weigh things are not actually dire yet... but as you're losing weight you're moving further and further from what's sustainable

    So, I am highlighting for you that you're creating a deficit that on average is equal to 50% of your TDEE. You're taking in about half the energy you would have needed to take in to maintain your weight.

    But, deficits that exceed 25% of TDEE when people cary obese levels of energy reserves (or 20% when the energy reserves they are carrying are such where they would have been correctly characterized as overweight or normal weight)... are aggressive!

    And as you can probably surmise, if 25% is an aggressive deficit, 50% is a heck of a lot more aggressive!

    You can cross reference the above with the fact that most people find deficits that generate a loss of 0.5% of body weight a week to be easier to sustain that deficits that generate a loss of 1% of body weight a week. And that generally speaking most people would consider losing more than 1% of body weight a week to be a very aggressive attempt at weight loss increasing the potential for unwanted side effects.

    I've heard of very few aggressive weight loss attempts going past the six month mark. And fewer still where the aggressive dieter was able to retain that weight loss once they reached the I give up stage.

    Nothing stops you from making an adjustment before things become too hard!

    You will still lose weight when you lose 2lbs a week and 1.5lbs a week and even 1lb a week. I still lost weight when I lost less than 1lb a month and I still haven't regained those last 11 lbs almost five years later. But had I continued to try and lose 3+ lbs a week like I was doing when I first found MFP... I would have given up while I was still in the 240lb range (and regained) instead of continuing on to 155 (and maintain).

    You can sustain a higher loss rate when you are obese than when you have less energy reserves, but in neither case can you sustain an unlimited loss rate.

    In the general theme started above when discussing macros... don't make things too hard on you.

    Your big money is on finding something you can sustain long term...
    edited May 13
  • g2renewg2renew Member Posts: 146 Member Member Posts: 146 Member
    Just something to consider: maybe add protein drink to help meet your minimum requirement. Protein is pretty close to equally important as CICO while dieting, IMHO.

    I have days where I have difficulty getting enough protein in. I aim for 130g per day at 5'-5" ~170lb 60yo female sedentary. It doesn't seem to matter if my protein is evenly divided among meals or heavy at breakfast-just the total grams per day.

    FYI: I prefer to go heavy at breakfast. It helps keep me satiated and if I fall short of my goals during the day, I already have a good amount to start. Looking at past 90 days, I average about 80g per day. When I drop to 50g or lower, I do not do well on my plan.

    Some days it helps me to drink a protein shake in addition to my meal (s) to make sure I get close to my goal. There are several powders/pre-mixed drinks out there with 30g protein per serving with around 150 cal and 1g sugar. It makes a good 'snack' or meal, mixed with berries and yogurt.

    Protein and good quality fats (walnuts and flaxseed oil have omega 3s in them!) help me stay satiated. Whole foods help too.

    Re; carbs: Glad you are not being to tough on yourself when going over a bit:-). I have found it helpful to try to keep most of my carbs complex, rather than simple. I am always over my carb macro it seems. But since it is not high glycemic carbs, I don't sweat it. This may be where your doctor's head is when suggesting cutting back on bananas-especially if they are yellow, not green.

    Best guess (and it is a 'guess'-only your doctor knows for sure) is that he has chosen to provide you with a diet plan that he is comfortable with for his standard patient. None of us are truly 'standard':-). Discuss your concerns with him. It may be that he is unaware of how close your previous food plan is to what he has suggested.

    I second everyone who has stated that 'sustainable' is a high priority. Being healthy is a long term/forever plan, and not a 'quickie fix'. Best wishes!

    edited May 14
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