Chelle 42 yr old Pagan Witch, mom of 4, living in the MidWest
willowraven's Journal
The AppointmentsApr 18 2007 07:40
I am so tired. Have only had about 2 hours of sleep, so I'm writing this, then crawling back into bed.
I went to the nutritionist appointment on April 12th. Overall I would say it was a good appointment, though there were some things I wasn't too happy with. First off, she said that she felt my 1700-2100 calorie allowance for the day was too high and said that was probably why I wasn't able to either lose weight or maintain the loss I've had. She originally had suggested I go down to 1200 calories, but we agreed (compromised?) on a 1700-1800 calories/day diet. I told her I was using the USDA Food Pyramid:
as my guide for the diet (that it wasn't a set diet like Atkins or Weight Watchers) and she felt that was fine - she didn't have any problems with it. I told her that after a while the food got boring, that I needed some variety (keeping in mind that my budget is limited and had to keep within what we could afford) and she gave me some booklets with various recipes. Some look really good too - told Wes we gotta try them. :) I had printed out my weight log, activity log and food log from here from the day I started to about a month ago because I wanted to show my regular doctor. I had also shown them to the nutritionist, who made copies of them for my files. She felt that my exercise routine was excellent and to continue doing it and that my combination of cardio and weight resistance was the correct thing to do. We discussed starvation mode as well as the whole 'thrifty gene' belief, and the fact that, growing up, I did a lot of yo-yo dieting and she had a theory that maybe now that my body has gotten sort of used to the less amount of calories (vs what I used to have before dieting), that it is seeing my new calorie span of 1700-2100 as the new 'set point' for yo-yoing, and that when I have 1700 calories, it sees me as 'starving' (even though I'm not) so when I have the higher calories, it is holding on to it like a body would do when going below and above 1200 calories over an extended period of time - which is how we came upon trying to keep around 1700-1800 calories. I admit though, the way she explained it, it made sense. Overall, I came out of the appointment feeling a bit hopeful. She wants me to continue keeping a food log/journal - which I have started back doing. I go back May 5th.
My appointment with the endocrinologist was yesterday. And he made me a total wreck. Wes went with me in to the appointment - my request as he lives with me and I want him aware of what is going on and being discussed (he also was there during the nutritionist appointment). I told the Dr. about all the symptoms I have, about the blood tests my regular doctor took for my thyroid, my past medical history, etc. I showed him the logs I had printed out as well as my gym routine (what I do and how much, including the weight amounts on the resistance machines) - he seemed quite unimpressed. Took a look at a few of the food log pages - without looking at the activity logs - and told me that my calories were too high, that the only way I would lose weight is going to 1200 calories OR LESS. He pretty much had looked at me as someone who was just 'fat' with no control and needed to "just eat less". He had NOTHING to say about the fact I've been going to the gym, or doing 8-12 glasses of water a day or the fact that, despite dieting and water and exercise, I had GAINED 11 lbs in the matter of a week! He pretty much appeased me by ordering the bloodwork for my thyroid and other metabolic tests, but kept stressing that he really felt that the answer was a 1200 calorie diet and that most nutritionists are 'afraid of being honest with their patients' about restricting diets to 1200 calories. What really drew up a red flag was him saying "or less". When I told him about the BMR calculator and what it had determined my BMR is/was and what I should be taking in for calories to both maintain my current weight and what I needed to take in to lose 1-2 lbs safely per week, he told me that either the calculator was wrong, or the calculations (math) was wrong, but either way I needed to go to 1200 calories or I would not lose the weight. By the time I walked out of the office (they drew 7 vials of blood at the lab thats on-site ... the doctor said they would call me with the results and he wants me to keep a food log as well), I felt defeated, depressed, hopeless...like everything I'm doing is for NOTHING. Talk about futility. I felt like I used to feel - like food and my body are the enemy, and that being thinner and 'normal weighted' is some sort of goal I'll never be able to achieve. I feel like, somehow or for whatever reason, this fat is some sort of punishment for some wrong-doing in my life (or lives). By the time we got home, I was holding it in, trying not to cry. I went to the bathroom and couldn't hold it in anymore and started crying. Since then I have been fluctuating between mad at the doctor for being so uninformed and suggesting something so drastic, to being depressed and upset and defeated and feeling hopeless, to being ready to call it quits with everything... I did my food journal for yesterday and despite only having 3 meals and small, low-fat snacks I went over 2500 calories. Go flippin' figure.
So, just now, I calculated my BMR based on my current weight (here). According to the calculations, my BMR is 2878 and my RMR is 2818 for a sedentary lifestyle. So, if I was to do a deficit of 500 calories/day for a 1 lb/week weight loss, I would want to take in approximately 2300 calories/day, net --- right? Am I still on track with the understanding of how it's *suppose* to work? And that you shouldn't have more than a 750 deficit per day? However even if I did a 1000 calorie/day deficit, I'd still be around 1800 calories/day -- correct? That would give me about a 2 lbs/week loss, if my math is still right on all of this. Wouldn't dropping to 1200 calories be too much of a deficit? Or am I just totally wrong and the nutritionist and endocrinologist are right to drop me right to 1200? And if I'm right, then how do I get *them* to understand it, and take me and my concerns, seriously? One thing I'm concerned about is, when I get to goal (which is a long way off), how am I going to get my body to accept whatever the 'normal' calorie amount is for that weight, and do it without gaining the weight back? How is my body going to know that I am doing losing - 1200 seems to be that 'cut off' point, and such a precarious line to be near. If I cut my calories to 1200 and on the days I go to the gym and burn 300 calories, I'm going to be dropping my net calories for the day to about 900. However both doctors aren't comparing the food logs with the activity logs and noting that days I had higher calories were also days (usually) I had the gym and/or other activities burning off those 'excess' calories. So I'm screwed either way. ::sigh::
Last night (actually early this AM) as Wes and I were getting in to bed, I was feeling the whole depressed-defeated-hopeless again and I swear, I'm trying not to dwell on it but it's hard when you feel like everything you've done for the last several months is for naught .... and I told him that all I've ever wanted was to be normal, normal-weighted. That I have been enemies with my body and with food my whole life, and I hate it, and that I would pretty much give my soul for the next few lifetimes to be normal-weighted. And I'm not even talking rail thin. I'm just talking what is considered normal weight for someone my age, height and body build (which is about 135ish lbs). Hell, at this point, I'd even be happy to get to my pre-pregnancy weight of 160ish lbs (which was a size 14 on me). I'm tired of feeling like a prisoner in my body. He's like "what do you want me to say?" I said "nothing - I'm not expecting or asking you to say or do anything"... and then I apologized and said I was done, not gonna mention it anymore. Before he fell asleep, he gave me a hug and said "let's just wait and see what the tests show" because even he feels that something has to be wrong because 95% of the time I'm doing everything right and I shouldn't be struggling *this* much.
OK... rambled long enough. It is 8:52 AM and I'm crawling back in to bed.
I hope you all have a wonderful day. ::hugs:: to you all.
I went to the nutritionist appointment on April 12th. Overall I would say it was a good appointment, though there were some things I wasn't too happy with. First off, she said that she felt my 1700-2100 calorie allowance for the day was too high and said that was probably why I wasn't able to either lose weight or maintain the loss I've had. She originally had suggested I go down to 1200 calories, but we agreed (compromised?) on a 1700-1800 calories/day diet. I told her I was using the USDA Food Pyramid:
as my guide for the diet (that it wasn't a set diet like Atkins or Weight Watchers) and she felt that was fine - she didn't have any problems with it. I told her that after a while the food got boring, that I needed some variety (keeping in mind that my budget is limited and had to keep within what we could afford) and she gave me some booklets with various recipes. Some look really good too - told Wes we gotta try them. :) I had printed out my weight log, activity log and food log from here from the day I started to about a month ago because I wanted to show my regular doctor. I had also shown them to the nutritionist, who made copies of them for my files. She felt that my exercise routine was excellent and to continue doing it and that my combination of cardio and weight resistance was the correct thing to do. We discussed starvation mode as well as the whole 'thrifty gene' belief, and the fact that, growing up, I did a lot of yo-yo dieting and she had a theory that maybe now that my body has gotten sort of used to the less amount of calories (vs what I used to have before dieting), that it is seeing my new calorie span of 1700-2100 as the new 'set point' for yo-yoing, and that when I have 1700 calories, it sees me as 'starving' (even though I'm not) so when I have the higher calories, it is holding on to it like a body would do when going below and above 1200 calories over an extended period of time - which is how we came upon trying to keep around 1700-1800 calories. I admit though, the way she explained it, it made sense. Overall, I came out of the appointment feeling a bit hopeful. She wants me to continue keeping a food log/journal - which I have started back doing. I go back May 5th.
My appointment with the endocrinologist was yesterday. And he made me a total wreck. Wes went with me in to the appointment - my request as he lives with me and I want him aware of what is going on and being discussed (he also was there during the nutritionist appointment). I told the Dr. about all the symptoms I have, about the blood tests my regular doctor took for my thyroid, my past medical history, etc. I showed him the logs I had printed out as well as my gym routine (what I do and how much, including the weight amounts on the resistance machines) - he seemed quite unimpressed. Took a look at a few of the food log pages - without looking at the activity logs - and told me that my calories were too high, that the only way I would lose weight is going to 1200 calories OR LESS. He pretty much had looked at me as someone who was just 'fat' with no control and needed to "just eat less". He had NOTHING to say about the fact I've been going to the gym, or doing 8-12 glasses of water a day or the fact that, despite dieting and water and exercise, I had GAINED 11 lbs in the matter of a week! He pretty much appeased me by ordering the bloodwork for my thyroid and other metabolic tests, but kept stressing that he really felt that the answer was a 1200 calorie diet and that most nutritionists are 'afraid of being honest with their patients' about restricting diets to 1200 calories. What really drew up a red flag was him saying "or less". When I told him about the BMR calculator and what it had determined my BMR is/was and what I should be taking in for calories to both maintain my current weight and what I needed to take in to lose 1-2 lbs safely per week, he told me that either the calculator was wrong, or the calculations (math) was wrong, but either way I needed to go to 1200 calories or I would not lose the weight. By the time I walked out of the office (they drew 7 vials of blood at the lab thats on-site ... the doctor said they would call me with the results and he wants me to keep a food log as well), I felt defeated, depressed, hopeless...like everything I'm doing is for NOTHING. Talk about futility. I felt like I used to feel - like food and my body are the enemy, and that being thinner and 'normal weighted' is some sort of goal I'll never be able to achieve. I feel like, somehow or for whatever reason, this fat is some sort of punishment for some wrong-doing in my life (or lives). By the time we got home, I was holding it in, trying not to cry. I went to the bathroom and couldn't hold it in anymore and started crying. Since then I have been fluctuating between mad at the doctor for being so uninformed and suggesting something so drastic, to being depressed and upset and defeated and feeling hopeless, to being ready to call it quits with everything... I did my food journal for yesterday and despite only having 3 meals and small, low-fat snacks I went over 2500 calories. Go flippin' figure.
So, just now, I calculated my BMR based on my current weight (here). According to the calculations, my BMR is 2878 and my RMR is 2818 for a sedentary lifestyle. So, if I was to do a deficit of 500 calories/day for a 1 lb/week weight loss, I would want to take in approximately 2300 calories/day, net --- right? Am I still on track with the understanding of how it's *suppose* to work? And that you shouldn't have more than a 750 deficit per day? However even if I did a 1000 calorie/day deficit, I'd still be around 1800 calories/day -- correct? That would give me about a 2 lbs/week loss, if my math is still right on all of this. Wouldn't dropping to 1200 calories be too much of a deficit? Or am I just totally wrong and the nutritionist and endocrinologist are right to drop me right to 1200? And if I'm right, then how do I get *them* to understand it, and take me and my concerns, seriously? One thing I'm concerned about is, when I get to goal (which is a long way off), how am I going to get my body to accept whatever the 'normal' calorie amount is for that weight, and do it without gaining the weight back? How is my body going to know that I am doing losing - 1200 seems to be that 'cut off' point, and such a precarious line to be near. If I cut my calories to 1200 and on the days I go to the gym and burn 300 calories, I'm going to be dropping my net calories for the day to about 900. However both doctors aren't comparing the food logs with the activity logs and noting that days I had higher calories were also days (usually) I had the gym and/or other activities burning off those 'excess' calories. So I'm screwed either way. ::sigh::
Last night (actually early this AM) as Wes and I were getting in to bed, I was feeling the whole depressed-defeated-hopeless again and I swear, I'm trying not to dwell on it but it's hard when you feel like everything you've done for the last several months is for naught .... and I told him that all I've ever wanted was to be normal, normal-weighted. That I have been enemies with my body and with food my whole life, and I hate it, and that I would pretty much give my soul for the next few lifetimes to be normal-weighted. And I'm not even talking rail thin. I'm just talking what is considered normal weight for someone my age, height and body build (which is about 135ish lbs). Hell, at this point, I'd even be happy to get to my pre-pregnancy weight of 160ish lbs (which was a size 14 on me). I'm tired of feeling like a prisoner in my body. He's like "what do you want me to say?" I said "nothing - I'm not expecting or asking you to say or do anything"... and then I apologized and said I was done, not gonna mention it anymore. Before he fell asleep, he gave me a hug and said "let's just wait and see what the tests show" because even he feels that something has to be wrong because 95% of the time I'm doing everything right and I shouldn't be struggling *this* much.
OK... rambled long enough. It is 8:52 AM and I'm crawling back in to bed.
I hope you all have a wonderful day. ::hugs:: to you all.
I understand where you are at and how you are feeling. First: This is not a character issue. It is merely a tricky metabolic issue. I think we, as obese people, are not subject to the same math as people who are merely overweight. The medical community, as a whole, seems to support your doctor's way of thinking. I know its hard, but I think the 1200-1500 calorie a day thing is probably accurate. I think we store calories differently because of years of accumulation and fluctuation. Its not that your body is the enemy, honey, it's that evolution has created a metabolic machine that prevents us from perishing. Its just science, not morality. Think of it as a pendulum. You have to sort of overcompensate for your body's metabolism. Kickstart it into burning. It will be stubborn, but then it will start working. I know of one person who posts here who has lost over 100 pounds. Her doctor recommended a 1300-1500 calorie per day diet in addtion to exercise. The doctor also prescribed thyroid meds. It has taken her about a year. Username Lady Obsydian, very inspiring. So.. I believe you are on the right track. I have started having success with 1500 cals per day. I take vitamin supplements, as well, about every other day. No thyroid meds, but I have started using an herbal thyroid support supplement. I only take it once or twice a week. I think once we get into an 'overweight' range the calculators will start to apply. Peace. |
(((HUGGS))) Seems like you had a rough day. No wonder that you did not sleep. Did you know that most doctors do not even take a nutrution course in med school? Have you been sitting down and planning what you are going to eat for the day? This helps me a lot, because if I plan my day I eat 1700 and if I don't plan I eat 2300. Have a good day! |
i am perplexed by doctors as of late. i swear you could go to 4 different doctor's and get 4 different answers... Sometimes it just isn't as simple as calories in vs calories out, now is it? sigh. i hope you feel better soon girlie. keep up the good work. you're doing great, and eff that endocrinologist. sometimes people just don't understand. |
I am so sorry to hear about your experience at the doctor yesterday. Sometimes I think that doctor's have lost sight of really caring for their patients as people and we have all just become numbers. Please try and be positive. As to what the site says for cals etc., there are many of us who have successfully been losing weight using the site and hopefully it will work for you as well. One trick I've found is making sure you get at least 100 ounces of water every day and keep the sodium to less than 2900 grams. That way you are not be frustrated by water weight. Keep your head up and just remember that we are all behind you and are here for you!! :) ::hugs:: |
How discouraging and disappointing it seems to have been. You need your rest to stay strong and be able to lose this weight. We all know you can do it and support you every step of the way. Don't you dare give up!! Sometimes we still hope these doctors and professionals have that magic cure but reality is, it is through perseverence and determination that we win this battle, and we all are here in it together. Reach our for what you need. ((((hug)))) |
Well that sounds like a big ol' pile of horse dung to me! I'm obviously no expert on the right allotment of calories, but the fact that the doc just skimmed your food logs and barely glanced at your activity logs tells me that he wasn't looking at YOU as a UNIQUE, INDIVIDUAL patient, but just as "another obese person." I don't know how either of them can presume to know what your caloric intake should be, or accuse the math or calculator of being incorrect, when NEITHER of them took to the time to do the calculations themselves. This IS science. We CAN figure it out. It may not be 100% perfect, and what works for person A may not work for person B, but there is a reason all these indexes and standards have been set. So to just arbitrarily tell you that you need to drop to 1200 cals/day is horseshit, in my not so humble opinion! Keep up the dieting, keep up the exercise, keep up the water, and keep up the Dr's ass if you aren't happy with results you're seeing after taking his advice!! |
Hi Chelle, There's a couple of good things in your story: 1) The nutritionist seems reasonable (as opposed to the endocrinologist with the trollish bedside manner). 2) Wes seems like a really supportive guy. Don't give up, hon. You can do this. It may be hard from time to time, but just lean on your friends and keep going. *hugs* |
reading quickly, kids are waking up here you are in my thoughts and sending hugs to you hunny xoxoxoxoxo |
(((((HUGS)))) I know I haven't posted much lately here, but I have been "following" your progress. Yes PROGRESS!!!!!!! You hang in there. Sorry your "Endio" doc was not very nice. I hope he is testing your insulin levels too. High insulin levels (insulin resistance) can cause our metabolism to slown down as well. http://en.wikipedia.org/wiki/Insulin_resistance It has been a problem for me as well as the thyroid. I always find it is better to be informed and ask "TONS" of questions of the doc and make them explain it so you understand everything. And if they seem like they don't have the time for you, find another doc. They work for YOU!!!! Good luck!!! |
Sorry you had such a rough time with the endocrinologist. My step son wants to be one. He is a type 1 diabetic. This was his reason for picking this field. I don't count calories----I measure my food. All my meat, chicken, fish is only 3 1/2 ounces. Vegetables, are unlimited at each meal. I steam all veggies. Pita wraps are good. I had 1/2 one for lunch ---fill it will lots of veggies and even lean ground beef. I lost 20 lbs in November by watching how much I ate and exercise. I have only gained one pound of that back after my operation. I agree with what kathygator says. Find what your test results are. You want to do this and you will. Don't get discouraged----we are all here for you!!! Happy Weight Loss!! You can do it. |
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