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Weight Loss Forum / General Topics / May 2004Advice for my wife... Morbid obesity...
Hi, I'm Mike. I've posted a few times now about my recent diet and I've gotten some great advice to this point so I thought I'd come here again. My wife has been trying to diet along with me since I started at the beginning of April, and so far she's been doing alright. She's 26 and has been morbidly obese since the beginning of high school, and right now she's at 361 pounds. She's lost about twenty pounds over the last couple of months just from reducing her daily caloric intake to around 1500, but she's starting to get frustrated about the amount of time her diet is taking. Her first big goal is 285 pounds, which is a weight that I've never even seen her at. Her eventual goal is 165 pounds, which seems about right to me as she's 5'5" and larger framed to begin with. I wouldn't want her to go too much below. She hasn't worked in over a year and a half due to her ongoing knee/high blood pressure/hypoglycemia/thyroid battles, and thus is not getting the kind of exercise that I get running around six nights a week at the convenience store. So here are some questions, as she's asked me to find out what I can for her... Is a 1200-1500 calorie diet dangerous for someone at her weight? Should she be trying to eat 100+ grams of protein a day as the end result is thermogenic? Is daily housework and the occasional shopping trip a good substitute for exercise at this point? Basically any tips or pointers from anyone who has ever been near her weight would really help us out. She has been sort of set on stomach stapling until now but I think that if she can stick with this diet, eventually she'll be able to take walks and lose more and more of the weight on her own. Considering her low self esteem, it could be a really empowering and important thing for her to lose it on her own. Mike 196/167.8/165 (for now) What does her doctor say? With somebody morbidly obese, you need a doctor involved for hospital admissions as needed -- other than the emergency room and while you don't want to go there, it may be inevitable. > Hi, I'm Mike. I've posted a few times now about my recent diet and I've > gotten some great advice to this point so I thought I'd come here again. My [quoted text clipped - 27 lines] > Mike > 196/167.8/165 (for now) > starting to get frustrated about the amount of time her diet is taking. People who lose no more then 1 pound a week have the best chance of keeping it off. Patience. > She has been sort of set on stomach stapling until now but I think that if > she can stick with this diet, eventually she'll be able to take walks and > lose more and more of the weight on her own There was recently a thread here about bariatric surgery. Go to google and search on that term in this newsgroup. The upshot of that thread was that it is not a permanent solution and it comes with serious medical side effects. I would recommend you get you and your wife sign up for Weight Watchers. Aside from knowing what they are doing they give a lot of support that can help someone in your wifes position. Going there with your wife will fortify that support. Steve A Tue, 25 May 2004 19:36:04 -0400, Steve <nospam@please.reply.to.group.thanks.com> escribió: > > starting to get frustrated about the amount of time her diet is taking. > People who lose no more then 1 pound a week have the best chance of > keeping it off. While that's true for the average person, research indicates the exact opposite is true for morbidly obese patients. -- bicker® "It is far better to grasp the Universe as it really is than to persist in delusion, however satisfying and reassuring." - Carl Sagan http://humanist.net http://www.csicop.org http://www.skeptic.com > Hi, I'm Mike. I've posted a few times now about my recent diet and I've > gotten some great advice to this point so I thought I'd come here again. My [quoted text clipped - 4 lines] > just from reducing her daily caloric intake to around 1500, but she's > starting to get frustrated about the amount of time her diet is taking. Uhoh. This is a warning sign right here. Please understand that I have never been morbidly obese: I was about 90 pounds overweight, though, and have learned many many lessons in the journey. One of them is that you ought not to diet. What you need to do is change your life-style for the rest of your life. If she were at goal she'd weigh around 165 and be able to eat about 12 times her weight in calories. That means she needs to learn how to eat at 2000 calories a day. She has from today until the day she dies to figure this out. My advice to her is to learn what 2000 calories feels like, get used to working with that calorie budget, play around a bit with macronutrient ratios until she can feel sated at that level, and develop some recipes that you all like that works with that calorie budget. This is a big project. She will fail more often than she succeeds at first, but she can keep trying and eventually she'll succeed more often than she fails. This is not about dieting or making a goal or whatever, this is about learning how to feed her body. That's step one: Eat less. > Her > first big goal is 285 pounds, which is a weight that I've never even seen > her at. Her eventual goal is 165 pounds, which seems about right to me as > she's 5'5" and larger framed to begin with. I wouldn't want her to go too > much below. My second piece of advice is to get a cloth tape measure and take measurements rather than use a scale. Weight-based goals are lethal to large women: it tells insidious lies like "weight-lifting made me bulk up" (when she is retaining water in the muscles) or "I tried and failed to lose weight" (when she's retaining water because of her TOM.) No good can come of a scale - seriously. She can use clothing sizes, tape measures, regular polaroid pictures... but throw out the scale. I'm really serious here. If she's morbidly obese her goals need to be behaviorly based, IMO, not weight based. A good goal might be to drink enough water all week or to get enough sleep all week (both are very important to fat loss.) > She hasn't worked in over a year and a half due to her ongoing > knee/high blood pressure/hypoglycemia/thyroid battles, and thus is not [quoted text clipped - 3 lines] > So here are some questions, as she's asked me to find out what I can for > her... Is a 1200-1500 calorie diet dangerous for someone at her weight? The woman has life-threatening illnesses due to her obesity. Isn't this something the doctors have discussed with her? She needs some nutritionist visits, some behavioral modification visits, etc. There is just no way that we can know hwer blood sugar issues here. Having said that, many people who have PCOS (does she?) seem to do well with low-carb diets. It just seems to manage blood sugar swings better. I'd recommend she read up on glycemic index diets and the Zone diet. > Should she be trying to eat 100+ grams of protein a day as the end result is > thermogenic? I don't know what you mean by that. The protein consumption does two things: it's more likely to leave her sated on a lower calorie load than a high-carb diet, and there's some thought that it might be more muscle-sparing, since the muscle is more metabolically active she'd like to hold onto it as best she can. > Is daily housework and the occasional shopping trip a good > substitute for exercise at this point? Basically any tips or pointers from > anyone who has ever been near her weight would really help us out. There was a great book out two years ago called '8 Minutes in the Morning' that I'd recommend to someone who is chair-bound or morbidly obese: it was essentially doing some very basic resistance exercises with cans of soup and squatting against a wall. My experience is that resistance training, i.e., weight-lifting, is a better first step than cardio workouts. Cardio workouts tend to be too hard. Building up some muscle makes you feel stronger, more energetic and is more protective of joints. Also, if you're a 350 pound woman the one thing you've got going for you is a whole LOT of muscle mass. Use it to your advantage - that muscle knows how to burn calories when you use it! > She has been sort of set on stomach stapling until now but I think that if > she can stick with this diet, eventually she'll be able to take walks and > lose more and more of the weight on her own. Considering her low self > esteem, it could be a really empowering and important thing for her to lose > it on her own. I not only agree with that statement, but I've grown really resistant to people wanting to have bariatric surgery. Look at the thread on this subject from last week. The gist of it is, you STILL have to learn how to live like a thin person. Why not just skip the surgery step? What's her name, Mike? Please tell her to keep at it. It's a life-long journey, not just something she does in 2004. The skills come bit by bit. Dally 244/177.5/169 > Hi, I'm Mike. I've posted a few times now about my recent diet and I've > gotten some great advice to this point so I thought I'd come here again. My [quoted text clipped - 11 lines] > getting the kind of exercise that I get running around six nights a week at > the convenience store. You sound like a loving husband. Congratulations on your own progress. With all the health complications of obesity that she is having, weight loss is a health imperative. If she is frustrated with the amount of time her dieting takes, it is like being frustrated with the sun setting every evening. There is no way around it. > So here are some questions, as she's asked me to find out what I can for > her... Is a 1200-1500 calorie diet dangerous for someone at her weight? I would think that it is close to dangerous. How quickly is she losing? Is she cheating on her diet secretly? What is she eating? > Should she be trying to eat 100+ grams of protein a day as the end result is > thermogenic? 100 grams of protein is pretty much the RDA for her weight. > Is daily housework and the occasional shopping trip a good > substitute for exercise at this point? No, but it is possible to lose weight without exercise, not to say it is desirable, but possible. After losing 70 or so lbs, it will be easier for her. Have her thyroid issues been resolved? > Basically any tips or > pointers from anyone who has ever been near her weight would really [quoted text clipped - 5 lines] > esteem, it could be a really empowering and important thing for her to lose > it on her own. It is a very uphill battle... especially if she is mot sufficiently motivated. i A Tue, 25 May 2004 18:46:33 -0400, "Michael Plumridge" <mplumridge@charter.net> escribió: > Is a 1200-1500 calorie diet dangerous for someone at her weight? Not specifically. Many folks maintain a 1200 calorie per day diet, with only positive impact. By the same token, eating the wrong things you can mess yourself up with a 1800 calorie per day diet. > Should she be trying to eat 100+ grams of protein a day Not a bad idea. I didn't always get up to 100 gm of protein a day while I was eating 1200 calories per day, but that was my goal. > Is daily housework and the occasional shopping trip a good > substitute for exercise at this point? Those things are great supplements to more formal exercise. It is probably best to aim to add on exercise, rather than substitute for exercise. > She has been sort of set on stomach stapling until now but I think that if > she can stick with this diet, eventually she'll be able to take walks and > lose more and more of the weight on her own. Surely, medically-supervised weight-loss is a much less risky approach than surgery, no? That is unless her immediate risk from the obesity itself is so high... -- bicker® "It is far better to grasp the Universe as it really is than to persist in delusion, however satisfying and reassuring." - Carl Sagan http://humanist.net http://www.csicop.org http://www.skeptic.com > Hi, I'm Mike. I've posted a few times now about my recent diet and > I've gotten some great advice to this point so I thought I'd come here > again. My wife has been trying to diet along with me since I started > at the beginning of April, and so far she's been doing alright. <snip - reposted elsewhere> Kudos for being such a caring hubby! And you've come to a group that really cares. That being said though, at your wife's weight, the two of you should be getting advice from a qualified doctor, nurse, nutritionist, etc. My MD recommended an internist, who discovered that I'm Type 2 diabetic -- he's helping me handle that along with weight loss. Who knows what health issues your wife may need to deal with? Best to find out now, and get diet/exercise advice that suits her physical sitation. Best of luck to both of you!!  SignatureJ.J. in WA State (Change COLD to HOT for e-mail) Start of diet : 251 Current Weight : 234 Original Weight: 275 Goal Weight : 150 > She's lost about twenty pounds over the last couple of months > just from reducing her daily caloric intake to around 1500, but she's > starting to get frustrated about the amount of time her diet is taking. I agree with what Dally said. Lifestyle first, body changes 2nd, weight not important. Other than the 4 feet of bypassed small intestine, surgery doesn't solve anything that a healthy diet can't also. Put the out-of-pocket money surgery would cost in a pot and spend it on something worthwhile (like a vacation) at the halfway point. Before I changed my WOE, I thought dieting would be a horrible experience, due to my misappreciation of what dieting had to be (low-fat cottage cheese, salads with low-fat dressing, celery sticks, etc). But by just cutting out the unneeded crap -- keeping the mostly good / not bad stuff I was eating before -- I've managed to lose 2lbs/week consistently over the past 14 weeks (this rate of loss has undoubtedly been helped by an increasingly aggressive exercise regimen). I've found the first stages of the diet to be less than encouraging. But after 3 months I feel a lot lighter and clothes that used to be too tight are (nearly) comfortable again. ... > So here are some questions, as she's asked me to find out what I can for > her... Is a 1200-1500 calorie diet dangerous for someone at her weight? As Dally said, it's important to treat the regimen as a new way-of-life not just a new WOE. I think an extreme diet of 1200 kcal is just too low to live enjoyably. My 1500-2000 kcal/day diet has a lot of room for just about anything, other than really crappy treats like soft drinks, ice cream, packaged snack foods, chocolate bars (and the other bad habits that made me fat in the first place), which I exclude out of general principle. > Should she be trying to eat 100+ grams of protein a day as the end result is > thermogenic? I wouldn't worry about dieting buzzwords at this point. More basic needs should be addressed. > She has been sort of set on stomach stapling until now but I think that if > she can stick with this diet, eventually she'll be able to take walks and > lose more and more of the weight on her own. Considering her low self > esteem, it could be a really empowering and important thing for her to lose > it on her own. Well, for starters, I would suggest she post here herself. It's anonymous, and while I haven't done WW seems like a good substitute for the money. Your wife may benefit from group support. However, if you research "morbid obesity" on the web you'll come up with discouraging stats. My suggestion - have her eat only healthy foods to help preserve her health - it's possible that within three years new meds may be available for the morbidly obese. The surgery option has many side effects and should be a last resort. For healthy eating see http://www.hsph.harvard.edu/nutritionsource/pyramids.html For a truthful look at the odds for the morbidly obese see http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/index.htm > Hi, I'm Mike. I've posted a few times now about my recent diet and I've > gotten some great advice to this point so I thought I'd come here again. My [quoted text clipped - 27 lines] > Mike > 196/167.8/165 (for now) Like Heywood I will use Dally's response as the benchmark and attempt to build on it. > She's lost about twenty pounds over the last couple of months Has she faced the reality of this success? Have a face to face with her and compare start to now. Put the reality of her success in front of her. > but she's starting to get frustrated about the amount of time her > diet is taking. This is an *enormous* pair of red flags. 1) She thinks she's on a diet. Diets end. Going off is a simple matter of cause and effect that causes it all to come back. To keep it off the process isn't a diet. It's a permanent lifestyle. 2) When it really comes down to it, frustration is the first step towards quitting. Frustration is the first bad feeling that is harnessed as justification for exitting the process. Quitting has exactly one outcome. > Her first big goal is 285 pounds No. Her first goal has to be simpler than that. ONE - Stay on the plan today. Intend to stay on the plan tomorrow. In her situation (heck, in everyone's situation) staying on-plan is more important than any goal of a scale reading, any goal of a tape measure reading. *Behavior* can always be controlled, so *behavior* has to be the goal. > Is a 1200-1500 calorie diet dangerous for someone at her weight? Common guidelines run as low as 8 calories per pound of goal to 12 calories per pound of current weight. > Should she be trying to eat 100+ grams of protein a day as the > end result is thermogenic? Yes. Protein Power by Drs Eades gives a good formula to give an exact minimum protein amount. > Considering her low self esteem, it could be a really empowering > and important thing for her to lose it on her own. This goes back to seeing the reality of her success already. She HAS lost and it HAS been by her own effort. Do NOT let her go into denial about that. Of course it's slower than she wants. That's true for *everyone*. >>Basically any tips or pointers from anyone who has ever been near her weight would really help us out. << I started at 365 pounds. >>She hasn't worked in over a year and a half due to her ongoing knee/high blood pressure/hypoglycemia/thyroid battles, and thus is not getting the kind of exercise that I get running around six nights a week at the convenience store. << Let me add my voice to others who have said she absolutely must have ongoing medical care. I am under a doctor's care, and had been seeing a nutritionist. I'm seeking a new nutritionist, as the former one left the clinic. >>Is daily housework and the occasional shopping trip a good substitute for exercise at this point?<< Given her weight and health problems, I'd aim for trying to walk a little more. Perhaps park at the far end of the lot when going shopping, for example. When I was at my heaviest, I couldn't walk more than two city blocks without getting short of breath and developing severe back spasms. I now walk 2.25 miles daily and walked as much as four miles a day during my vacation in New York City last week. >>if she can stick with this diet<< As others have said, your wife needs to adjust her attitude. This is a way of living, not something temporary. And I agree that you wife should post here herself. If she wants encouragement from someone who knows what it's like to be supermorbidly obese, have her e-mail me privately. As always, YMMV. Kasey 365/262/??? |
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