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DECLARE74's Photo DECLARE74 Posts: 1,222
9/27/13 4:41 A

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Think I did a lot better today - so will abandon this post now and hope I continue to stay focussed - Thanks again Becky and Kris, and my early respomses from Anarie and Lady which got me thinking :-)

Edited by: DECLARE74 at: 9/27/2013 (04:42)
DEBORAH CLARE
TAURANGA, NEW ZEALAND



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DECLARE74's Photo DECLARE74 Posts: 1,222
9/26/13 9:03 P

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Great idea Kris I'm allergic to nuts but do like dried fruit and seeds - I also like nibbling on carrot sticks and cherry tomatoes - which will help get extra veges in :-)

DEBORAH CLARE
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9/26/13 8:33 P



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Have you thought about nibbling on some nuts or a couple dried dates or figs? They help up the calories, increase the fibre and provide other nutrients without over-filling you. Peas are a great way to increase fibre, increase protein and are higher calories than a lot of other veges.

Below is a link for some other tips you may find useful:
www.sparkpeople.com/resource/nutrition_art
icles.asp?id=593


Given the lack of fibre in your diet, it might be partly to blame for your being enema dependent. Increasing fruit/veges increases the fibre, and so too does lentils, baked beans, kidney beans, Cannelloni beans and peas.

Kris

Edited by: SLIMMERKIWI at: 9/26/2013 (21:13)
Co-Moderator Dealing with Depression
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DECLARE74's Photo DECLARE74 Posts: 1,222
9/26/13 8:21 P

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Thanks for that Becky, that makes sense.

I was originally going to go back on the optifast intensive that worked for me last year but I am surrounded by a lot of negativity as I failed to keep it off last time and then I get disheartened and head for bread - my comfort food - the pizza was a mistake at a birthday that made me feel horrible as I haven't eaten that kind of food in a long time :-(

- I thought about stopping the optifast shakes completely but realised I had no idea how to get even close to the number of calories SP and others keep telling me I need :-( so now I'm doing this weird mix - and although I'm losing weight which is good it doesn't seem right

In NZ we don't have optifast centres, you just buy it at the chemist or online, you join the online support group (based in Australia) and get regular blood tests from your doctor (some don't even seem to have doctors or tell their doctors) I understand this is very different than the Northern Hemisphere - they do say the shakes give you everything your body needs but I take supplements as well

I will aim for the 1200 calories wiith more protein, and of course i know I should eat more fruit and veges its just they are so filling - this however does seem a much more achievable plan thanks

Deb

DEBORAH CLARE
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DIETITIANBECKY's Photo DIETITIANBECKY Posts: 26,573
9/26/13 8:03 P

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1. To answer your initial question about your BMR. Often the BMR calculations give a too high calorie amount for people who have a greater amount of weight to lose. And this has probably happened to you. Your extra weight is fat not muscle tissue. Fat does not burn as many calories as muscle. So the "basic formula" overestimates need. As a dietitian, I use an "adjusted weight" when calculating BMR for people who have a BMI of greater than 30.

2. I did look at your nutrition tracker and I am concerned about your food intake which is showing about 900 calories taken in daily using optifast shakes. I have no problem with meal replacement shakes and low calorie diets--"when" the low calorie diet is medically supervised. The doctor/nurse/dietitian at the optifast center would be managing your weight loss and health care needs; running tests to assure safety on a weekly basis. From your records, I don't think you are doing this.

3. Our SP site is for general weight loss. We have a lower calorie range set at 1200 calories. While it is fine to use meal replacement shakes, you would want to include other foods to supplement your diet to assure that protein, fat, carbs, vitamins, minerals, fiber are met daily. I am concerned with your 900 calories (and only 40-50 grams of protein) and also seeing 300 calories of pumpkin bread, 1000 calories in pizza, and very few fruits and veggies, little lean protein foods, etc.

4. I would encourage 1200 calories and 60 grams of protein as a daily minimum. At least 5 servings of fruits and veggies daily.

Becky
Your SP Registered Dietitian Nutritionist

SLIMMERKIWI's Photo SLIMMERKIWI SparkPoints: (128,141)
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9/26/13 6:29 A



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There are a lot of similarities between you and me - LOL! I don't have fibromyelgia but I do suffer from fatigue - as the result of a head injury after a bad car accident a few years ago. I can't stand too long - I have always been like that - have been known to black out because of it, but having arthritis of the spine and scoliosis certainly doesn't help. I have had significant input from a Psychologist as a result of severe depression, basically caused by that car accident and very poor treatment I received while in hospital. I have had a lot of input from an Osteopath, and it was good re the pain etc. but when I had to go to a Physiotherapist long-term for rehab, I stopped going to the Osteopath because I had to pay for him, but the Physio was free as part of my rehab, AND she was doing a lot of what the Osteopath was. I went to a Dr (who practices mainly by Acupuncture) for the treatment of Benign Essential Tremors because I couldn't have the normal treatment for it (medication) because of Asthma - the drug could have had fatal consequences.

My Dietitian had talked to me about possibly using Optifast or similar, but they all had milk and I am dairy intolerant. I can take small amounts occasionally, but not regularly. There was also an option for weight loss tablets, but my Dr dismissed that because of some medication I take. That was why the Dietitian had me on 1400 cal's, no range, and also why the slow loss, but at least the slow one meant that I didn't end up with tons of flapping skin left hanging.

I had a real bad experience with a Dietitian years ago too. When I went to have surgery for a breast lump removal, the Drs in the hospital did bloods - turned out my cholesterol was horrid - all very high except the HDL was very low. Because of a very strong family history of heart disease I was sent to the Hospital's Dietitian clinic. She was extremely rude and wouldn't look at the list of foods I had been eating, etc. because "I don't have the time" and sent me in to another room with a lot of people, and THEN proceeded to discuss ME and MY weight with everyone!! I was NOT impressed. I wasn't impressed either when I got a copy of a letter she sent to my Dr telling him she was discharging me because I had NO INTEREST in helping myself!!!! My current Dietitian knew her and said she had quite a reputation and it wasn't a good one. My point is, you can't judge them all by one bad apple. MOST of them are really good and helpful!! That "B" one didn't help me one iota, but the one I see has been truly a God-send!

Where it comes to Optifast and other similar plans, you must remember - they might be good at helping you to lose weight, but then what happens when you have lost the weight and need to start eating real food in real quantities. You and your body haven't learned what is best for it. I'm not knocking those shakes, tho'! They can be good for a meal replacement in emergencies, altho' I would imagine that ones like Fortisip and Ensure or even Complan would be tons cheaper in those circumstances.

I read your post a couple times, and I certainly don't take it as you being negative! I actually think you are being positive. You are working through things and trying to find answers - there is nothing wrong with that. Hopefully you will find what you are looking for, but I really REALLY think that a Dietitian would be best - especially considering your health issues, including the Iron.

BIG hugs,
Kris

Co-Moderator Dealing with Depression
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I am not a Dr - please check with your qualified Health Professional for a diagnosis and treatment plan


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DECLARE74's Photo DECLARE74 Posts: 1,222
9/26/13 6:04 A

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Hi Kris, no problem at all discussing this as its no point asking for help or advice and then not being honest

I have a few health issues - so I have a rheumatologist and a neurologist, on top of my GP. I have also had others join in to try and help with certain issues like a chiropractor, psychologist, physio, acupuncturist, naturopath etc ... after all sorts of weird and wacky stuff going on throughout my life medically and then getting even weirder as an adult - I can honestly say my health though a long list of issues is actually in a more stable user friendly state than it has been in years ... sounds weird but it is true

I have Chronic Fatigue Syndrome, Fibromyalgia, was born with a cruddy liver and bad lungs - mainly due to being 3mths prem, pneumonia and bronchitis are constantly an issue, I do not store vitamin B and my iron levels are terrible, I am listed by the doctor as enema dependent - meaning my bowel doesn't work at all without one, my thyroid is underactive but the treatment caused other issues so I now use a natural product and take iodine drops (ast tests had me .2 above the treatable level - not good but a sign the natural stuff helps) I have an issue where I can't stand still long without falling over or passing out, and my hormonal issues since puberty resulted in me lactating for four years, miscarrying twice, and now bleeding every month to the point I have to take medication for haemophilia at that time.

the amazing thing is all of these things although probably not helped by my weight are not caused by my weight, all the big scary things that come from me being obese loom ahead of me if I don't do something now

at the moment my cholesterol is good, my blood sugars etc are fine and I am not in danger immediately

I need to do this, and I don't know but maybe I should just go back on the optifast totally as at least I know that worked but I wanted to do this in a way that I felt educated and in control and didn't feel like everyone was looking at me going " another fat chick on a shake diet - she'll gain it back"

I gained weight on WW, on Jenny Craig, and on every other diet I have tried, except the cabbage soup diet which just made me ill ... Optifast I found out about from a friend who had had gastric sleeve and brought it to the attention of my GP I did it for 14 weeks on the intensive level - that is 3 shakes, 2 cups of approved vegetables, 1tblsp oil and 3 litres of water a day (that reminds me every day on my planner here I have not put in my oil - I will fix that shortly) I lost 29 kgs and was delighted however like most it wasn't something I could maintain long term and instead of doing the transition program and adjusting back to real food I just went off the wagon ... then four months later I had a major health upset and over the next few months all my hard work came undone - and even though I saw it happening I couldn't get the drive to stop it even when my health first improved (embarrassing to admit)

I have been to a dietician years ago before I was diagnosed with half my issues and I guess she put me off all dieticians lol but in saying that I know that is unfair so will try to get my head out of my bum if I can't make any progress here


The naturopath was a disaster I was starving all the time, basically it was salad veges, rice, rice cakes, rice crackers, and meat - thank God she didn't say I had to go vegetarian too - although I kind of got the feeling it was just a matter of time lol
Her theory was I had "systemic candida" "gluten and wheat intolerance" and a "leaky gut" apparently these are very unlikely conditions but many supposed naturopaths bandy them around like common ailments


Reading back over my post it sounds so negative - please don't take it that way - I just really need as much advice as I can get so all cards are on the table

DEBORAH CLARE
TAURANGA, NEW ZEALAND



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9/26/13 5:19 A



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BTW - That naturopath with "no gluten, no wheat, no sugar, no fruits, no dairy, and only half the vegetables i like" sound like it was almost 'no food' :-(

What DID he/she allow you to eat?

Co-Moderator Dealing with Depression
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ndividual.asp?gid=17464


I am not a Dr - please check with your qualified Health Professional for a diagnosis and treatment plan


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9/26/13 5:17 A



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It sounds like your medical team are good in one regard, but not helpful where it comes to the weight issue. If the weight in your weight-ticker is correct, then I can't believe that they don't seem to think that it is important for you to lose weight! I would REALLY be inclined to push for a referral to a Registered Dietitian.

VLCD should NOT be undertaken without qualified input, and that is where a Registered Dietitian comes in. Most Doctors don't have the qualifications to advise in this area. With the calories you are on, it can be extremely difficult to ensure that you are giving your body the nutrients that it requires, and when you are heavier, you need more nutrients than the average Joe Blog.

My starting weight was much lower than yours, but when my Dietitian put me on 1400 calories (no range) she told me that in NZ they very seldom recommend less than that UNLESS supervised by a Dietitian. When ever I see mine, I take my spreadsheet which shows the daily calorie intake, fat, fibre and exercise, and also general comments re pain, fatigue, out all day etc. Because I am one who practices occasionally having a day for eating whatever I fancy and my calories might go up to 2000 or a bit over, she told me that she is pleased to see that the following days I am back around the 1500-1600 calories, and that she does NOT want me going down to 1200 AT ALL, even tho' I have overeaten that previous day.

I had been overweight for about 30 years, and all that time I had eaten mostly around the 1650 - 1850 calories. MOST of that time I was also very active with exercise (walks mainly) and hard, physical work - at times up to 60-80 hrs in a week. I was still gaining weight, steadily. It was only when I was referred to a Dietitian, mainly because of pain issues caused by arthritis of the spine and scoliosis, and the Dr feeling that weight reduction would reduce the pain, that my problem was turned around. I took her some printouts from the SP Nutrition Tracker to show exactly what and how much I was eating. She had the problem sorted within about 5 minutes because of those printouts, and was then able to get me on the right road. I haven't looked back since. It took 16 months to lose the first 50lb, then I happily sat there for a year before deciding to move on down again. I have since reached my goal, and have been there for nearly 3 years. I still weigh and record all of my food to ensure that I stay there.

Do you mind my asking what area of expertise your Specialists are?

Kris

Co-Moderator Dealing with Depression
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I am not a Dr - please check with your qualified Health Professional for a diagnosis and treatment plan


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DECLARE74's Photo DECLARE74 Posts: 1,222
9/26/13 3:35 A

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Yeah I am logging everything, missed that the chocolate bar didn't have the calories must have picked the wrong one as there was one with calories listed ...

I am under two specialists and a GP and unfortunately none of them seem to interested in me trying to lose weight, in fact told me he thought i had very little chance, then again 2/3 didn't think I'd be able to hold up a job, one thought a wheelchair was my future and well this is the best team I've had ... In the last 8 years i have gone thru 13 doctors - these ones at least care, they agreed on diagnosis and treatment ...

Just means on this journey i know they will monitor my condition etc but none of them have given any constructive advice, offered any help or in fact even told me I'm extremely overweight ... I did discuss weight watchers - they told me it couldn't hurt, i did discuss Optifast a VLCD program i went on for a while last year - they told me to be careful but give it a go - i lost 29kgs but you can't do that forever

I spent thousands at a naturopath who put me on a ridiculous and unrealistic plan of no gluten, no wheat, no sugar, no fruits, no dairy, and only half the vegetables i like - i didn't lose any weight or see any imorovement in health but i felt suicidal

So now I'm here doing it on my own - well with any help I can find :-)

Thanks all of you for your input

Edited by: DECLARE74 at: 9/26/2013 (03:39)
DEBORAH CLARE
TAURANGA, NEW ZEALAND



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9/26/13 3:18 A



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I had a quick peek at your nutrition tracker, and am wondering if you are entering everything you eat??? The reason I ask is that MOST days the calorie consumption is under 1000 - often in the 700's. I also noted that on 21st Sept. you ate an Optifast Choc Bar but it doesn't record any calories etc. at all, and the total calories for the day is 350.

I think that you might benefit from asking your Dr for a referral to a Registered Dietitian, taking your Nutrition Tracker print-outs with you. He/she will be able to help you devise a safe plan, based on your needs - any medical conditions and exercise.

Good luck,
Kris



Co-Moderator Dealing with Depression
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I am not a Dr - please check with your qualified Health Professional for a diagnosis and treatment plan


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ANARIE's Photo ANARIE Posts: 12,406
9/26/13 2:07 A



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"can someone just not need what the formula says they do?"

Absolutely.

The formulas are linear. They were created based on healthy people-- athletes, in many cases. They use your body weight as one of the terms in the equation, but they assume that every pound of your body uses as many calories as every pound of their healthy young experimental subjects' bodies. That's only true if you are also a healthy young subject. If you're obese, most of your pounds, the extra ones, use fewer calories. And since your weight is multiplied in that equation, the more extra (low-burning) pounds you have, the bigger the error. According to your ticker, you've got more than 100 extra pounds, so the formula is just totally messed up for you.

A safe alternative is to calculate what your maintenance calorie range would be at your healthy weight, and use that as your weight loss range until you get within about 50 pounds of your goal. (The reason you have a minimum calorie target is to make sure you get enough nutrients. Your nutrient needs don't change much with your body weight. The calorie/nutrient level that will be healthy for you when you're healthy is healthy for you now.)

Your healthy maintenance calories should be low enough to let you lose weight at a reasonable rate for now. At some point you'll have to go lower, but not for quite a while yet.





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LADYSTARWIND's Photo LADYSTARWIND SparkPoints: (21,817)
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9/26/13 1:39 A

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Health conditions (such as Hypothyroid for example) can most certainly affect weight gain/loss....so can many medications. If you have not done so recently, I would certainly consider consulting your Doctor....

You might also want to rethink What you are "eating". I took a peek at your Tracker...and note you are doing a lot of the Optifast shakes, etc. at least lately. If you have been doing so for quite a while now, your body's metabolism might need some "real food" to shake it up a bit. I'm NOT claiming there's supporting science for that...just a personal opinion that our bodies do much better when there's actual food moving through and supporting our digestive track.....

Perhaps if you see your Doctor, you might really consider asking for a referral to a Registered Dietician who could help you get to the bottom of this. I've found they are so supportive, and willing to work for solutions!!

Best Wishes, (and I will look forward to reading others information on this topic....! Spark has so many great educated folks here!!)
patti

"Its not the Mountain ahead that wears you out, but the grain of sand in your shoe..."


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DECLARE74's Photo DECLARE74 Posts: 1,222
9/26/13 12:44 A

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Can anyone explain to me if there are any reasons why BMR seems to be totally wrong when working out my calories ... I have followed the rule of BMR then worked out how many calories I am allowed to consume and feel I need to burn off, SP clearly use the same formula and so do Weight watchers which I did in 2011 - its just everytime I have stuck to eating that huge amount of calories even if I workout an hour a day - I don't lose any weight in fact nine times out of ten I gain - can someone just not need what the formula says they do? Can someones health conditions effect what they need ??

I really want longterm health and hopefully a nice body too .. at the moment my weight is going down at around 1/2kg to a kg a week but I'm having quite a bit less than my calculated calories - I am eating more now than I did in all the years I was getting this size and certainly healthier - but am I doing some sort of damage I dont know about by eating only 2/3 of my daily calories - am I at risk of this starvation mode thing I keep reading and hearing about ???

Please help

DEBORAH CLARE
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