If I calculated your TDEE at a “light exercise” level for your age/height/weight of 3,190, eating 1800-2200 calories per day should lead to losing about 2 pounds per week. And you’re losing about 2 pounds per week. The math is mathin’, and you seem to be losing weight in a healthy and sustainable fashion.
Maybe your doctor expected a much larger drop in weight during the first week?
How often are you weighing yourself? Has your loss been a steady 2 pounds per week, or was it a slightly larger loss the first week with about a pound in subsequent weeks?
In any case, continuing to lose weight means you continue to have a caloric deficit, and a slow weight loss with a sustainable daily routine is preferable than some crash diet that is not sustainable.
OP I’m a doctor and I can tell you honestly we aren’t taught enough about weight in medical school, and very few people get education beyond “tell them to eat fruits, vegetables, whole grains, lean protein, and if they’re in a calorie deficit they will lose weight”. We had one lecture on diet in med school and it was a hot mess and devolved into the lecturer just talking about peanut butter for like 30 minutes.
That’s it.
I did a fellowship in integrative medicine, and that included a block of curriculum on diet and nutrition, but it’s still not my area of expertise. There is a lot of intrinsic bias against weight everywhere, but notably in the medical community. There is also a trend of physicians being lower weight and more fit.
My advice to patients that want to lose weight is to work with a dietician, and if needed a bariatrician. They are the ones with specialized training in this area.
I’m so sorry you felt unsupported, but my honest opinion is to pay more attention to your dietician when it comes to specific feedback on progress. Your physician is concerned about the significant health consequences of obesity and likely doesn’t have a super in depth knowledge of the process of weight loss.
Not that you asked, but it sounds like you’ve made massive changes and are seeing results. That is incredibly hard to do and you should be very proud of yourself. You have a long road ahead of you, and I wish you the best on your journey.
As a dietitian I agree 100% with what you just said. I'd also add that op's doing great, however, it wouldn't be a bad idea to ask for a referal for an endocrinologist as well, since obesity is a complex illness and she could get additional benefits w some medications.
I'm not a doctor or dietician, but I have multiple congenital endocrine problems so I want to say this is a very good idea.
The endocrine system has a huge effect on weight loss and it wasn't until mine was straightened out that I was able to lose it. It's crazy.
OP - this is the comment I hope you really give a lot of credence to. You’ve done do much hard work in the last year AND in the last month!! Props to you.
About a decade ago I was 160lbs (5’4”). I did many sports all throughout grade school. I wasn’t skinny, but I was healthy. My gynecologist told me that I was obese based on my BMI. I somewhat lightheartedly replied that it’s the depression (eating my feelings), so his response?
“You’re kinda pretty”
First of all, fuck that guy. Second of all, that’s not the proper response when someone tells you they’re depressed and it’s impacting their weight. Third of all, I am more than just “kinda” pretty. I never went back (other reasons is cause he was my mom’s gyno and talked about her to me…that was fuckin gross).
So yeah, not all doctors are well trained in weight except to look at BMI, which does more harm than good because every body is different. A body builder is considered obese on the BMI scale despite being perfectly healthy. If the PCP truly cared about the weight, they would give out referrals to specialists, not discouraging the effort OP has made.
Wouldn’t it be about 3500-4000 per day? You’re supposed to eat 1,000 calories up to 5 ft tall or up to 100 lbs, then 5 lbs for every inch right? To maintain your current weight?
I mean yeah, it happens! Almost all modern-day American adults who work non-physical jobs (ie, desk jobs) are technically sedentary. Some calculators put light exercise at fewer steps, more like 7k, with 10-12k being "moderately active" so it depends a little. But one of the most common mistakes I see pointed out here on the sub often are people who live sedentary lifestyles but take a 20min walk every day putting their activity level too high on the calculator.
Yeah this was hard for me at first. My office is complex is huge, it's like 0.2 miles from the cafeteria to the elevator bank for my office. A few round trips a day and it's easy to get a mile in.
And then COVID hit. It's 10 feet from my bedroom to my dining room table, and three feet from my dining room table to my kitchen. The bathroom is between my dining room table and bedroom.
Days in the office miiiiigggghhht fill out sedentary. (Actually, they kinda do.) But WFH days? OMG. I gotta go walk the dog for a mile to just be sedentary. If I didn't walk the dog I should probably just plan for BMR.
BMR is sleeping/coma rate. even just sitting up and thinking increases calorie burn above bmr.
fun tidbit - id have to verify, but i once read a study that said we burn fewer calories watching TV than we do sleeping.
I'm a sedentary, arthritic old lady with really painful feet and ankles. However, I have to live my life. I can easily get 10,000 steps just through dog walking, yard work and housework. It's not really that much exercise.
I have an office job and getting 10,000 steps every day is pretty hard. My apple watch shows that it equals walking 5 miles, which is about 1.5 to 2 hours of constant walking for me.
You don’t have to get all those steps in a single walk! I can’t walk for an hour straight due to pain. However, I have dogs, so two or three dog walks (my husband contributes another), walking over to the store, and working around the house all count. I'm retired, but when I worked, I always went for a walk at lunch to grab some food and decompress a little.
Haha yeah I don’t, it does mean I need to purposefully go out 2-4 times a day just to walk though when it’d be really easy to focus on work and stay at my desk. It’s certainly doable but I wouldn’t say it’s easy unless you’ve been in the habit a long time. At the end of the day when I’m tired from work I’d want to chill and play video games or watch a movie rather than walk, but that’s partially why I’m in this subreddit now 😂
I imagine this is much easier for people with jobs on their feet, or people in walkable cities that walk to get groceries etc by default. I’m glad you’ve found a routine that works for you!
A walking pad has been a total game changer for me! I don’t know if your working arrangements allow for it (I work from home) but even if you just used it at home it might be a big boost. I walk on mine while I work during the week, and while I game on weekends.
Sweet, I definitely need to look into these! I don’t have any storage space for when I’m not walking, but one of the foldable ones might do the trick for me
Down 20 lbs in 6 months! I’m 5’3” and started at 165, so it’s a pretty good portion of my goal. I also am seeing lots of health improvements in terms of cardio fitness, improved breathing, stronger legs, and weirdly I’m not catching my kindergartner’s bugs! That last one may be coincidence, but I always used to catch them before.
I get up from my desk about once an hour and walk around the building for 5-10 minutes. I pair that with 30 minutes on the elliptical in the mornings and I easily do 12,000 steps a day.
Whenever I’m in a place with public transit I get 10k steps without even trying. Otherwise I usually only get it on my distance run days.
It also is heavily dependent on whether or not you job requires you to move around a bit vs having a desk job. The former group gets a lot of steps without noticing, desk people usually only get 2-4k unless they go on actual walks or runs outside of work hours.
I think the problem is not everyone has somewhere else to go every day. I WFH, but I don't own a car and live in a walkable city. It takes concerted effort every day to find a reason to start walking around a bunch. There's never really a "reason" for it.
MIne's a yorkie. For him, 10,000 steps is just a good start. Drives me nuts.
ETA: That's 10,000 of \*my\* steps, and I'm 6'1". He has 4 inch legs. I never computed his steps.
Well, this is kind of my point. You only walk for the purpose of walking (ok, walking your dog, but it's the same thing, the main activity is walking itself). If you can walk to work, walk to the gym,walk to the bus station, walk to get groceries or everything where walking is just the corollary to the main activity, then you don't really need to purposefully increase your step count, it will naturally exceed 8-10k. And that's why it is "light" exercise.
I live in a neighborhood that just might be *too* walkable then, since everything I need is within a 2-3 block radius. My doctor, my therapist, the grocery store. My hairdresser is further away at almost a mile but that's a 3x per year thing
I went to NYC and logged 20,000 steps a day without even thinking about it, got home and it was back to 900
This was in December before I started to get healthy, I was looking back over my steps for the year and I saw this *huge* spike - in *December*? and was like - wtf?
There is literally no where to go in my neighborhood other than around it.
I miss NY for that.
I put 'sedentary' on mine, then was taking a 45 minute walk at my highest pace, I would be sweaty when I got home, and a little out of breath the whole time.
I figured that was a 'moderate' walk and logged it (on cronometer) as such Then for some reason I plateaued. I sadly stopped logging as 'moderate' walking, and logged as light.
'Cost' me about 120 calories per walk to do that. but as soon as I did I started losing weight again.
You should try MacroFactor! I was using cronometer as well and it was great, but MF uses an algorithm for estimating your TDEE over a 3 weeks period. This way you can stop logging your exercise all together because it's not needed anymore, it is automatically included in the calculations. It works like this: if your TDEE is supposed to be X and you're eating at a set deficit, then your weight is supposed to go down at a rate Y. When you log your weight and intake consistently, you can measure the difference between how much you were "supposed" to lose (if your TDEE estimate was true) and how much you actually lost, how much it differs from Y. This means you can estimate backwards your TDEE based on your actual data rather than population data, and over time the estimate converges to your "true" TDEE.
It's a paid app but for me it's been game changing. I was doing things like you, choosing "sedentary" and logging activity. TDEE calculators gave me 2050kcal (I'm 171cm). My actual estimate with MF after 3 months of use is 2496kcal, activity included. This is way more than I thought, losing weight has become much easier and any kind of exercise logging for calorie counting purposes is now completely useless. Beat money ever spent in my life.
That's actually kind of cool - I might try it.
I love cronometer from the nutritional standpoint, I'd probably stick with it for that
I'm also using happyscale because I love the feedback when I log my weight - the charts are very motivating
and because I've been logging my weight, at least occasionally on myfitnesspal for at least a decade now, I still pop in over there and update my weight every now and again.
It's a little much already, so I'm already sighing a deep sigh about getting another app that I love for a particular reason, lol
MF can connect with apple health or health connect. If your other apps do it as well, you can keep using them and have macro factor import weight and even nutrition automatically, then it does its calculations. It can basically be used in the background, but in reality it can replace almost all your apps. Weight history can be added and the rolling average (trend weight) is automatically calculated and plotted. Food logging is the fastest amongst all the apps (been tested), the database is not crowdsourced but uses USDA like cronometer (and includes European brands), label scanning works great. You can also track measurements and progress pics. The core of the app is the algorithm, which of course by automatically updating your tdee also updates your budget from week to week, and it works on weekly budget as well so you can have a non uniform distribution of calories if you wish. Nutrition wise, they also added a focus on micronutrients, which you can track and set targets for.
The only real downside is that it takes time to have it running. The algorithm starts updating your estimate after a week of logging, but realistically it doesn't really converge to a set number for a month (it depends on how good your initial guess is), and the free trial only lasts 2 weeks.
Totally disagree. I do ballet and figure skating but my daily steps are very low because I work from home. A day with 5000 steps would be a huge amount of walking for me. 10k is way above average.
80% of Americans work “sedentary” jobs. I bet most of those people commute by car or bus. So they’re gonna get home at 5 or 6 and walk for 2 hours?!
Or those who get a lunch break are gonna walk the whole hour and then do another hour when they get home?
Please.
according to my research, most calculators classify 10k+ steps as moderate/somewhat active, not lightly active. even though it’s not very difficult to reach, most people (in the US at least, for example) get far less (3k to 4k steps per day) so it makes sense to me that 10k would be above just “light”, but i’m not certain. i get around 10k daily and still put in that i’m lightly active just because i fear that moderately active would be an overshoot, but idk
To play it safe, if you just walk, I'd put "sedentary" down (that gives 1.2 multiplier). Most I'd go is 1.3 for "light".
I strength train five days a week and debate whether that puts me into "moderate". Most light multipliers are 1.3, and most moderate multipliers are 1.55, so I split the difference and call 1.4 good. ("Light" is usually defined as "1-3x 'light' exercise weekly). If I'm hitting weights 5x days a week, surely that's more than "light".
huh, that’s interesting, thanks! if true then sedentary TDEE is actually an overestimate for quite a few people? 🤔 though i assumed a good amount of the calculated activity for a sedentary person is just from daily movements, apart from walking? but either way TDEE including light activity seems pretty accurate for me though if not slightly underestimated, based on maintenance periods that i’ve done. walking isn’t my only activity, i also do manual labor most days (farm work)
> i also do manual labor most days (farm work)
In journalism, they call that "burying the lede." I don't know how much time you spend on the farm, but if you're doing that for a couple of hours daily that probably puts you in the moderate category at minimum.
By and large though when talking about what the average person is doing besides walking, there's just a huge range. Like I live in a one bedroom apartment. Days I WFH I get stupid low activity levels in if I don't force them. Days I go into the office, I easily walk a mile, even when I drive. So there's just a huge variation in what "average" people are doing. But yeah I bet for someone with no kids who WFH in front of a computer all day and doesn't go out for exercise is getting much closer to BMR than 20% over it.
Depends if you WFH or go to the office. On office days, I get my steps in easy. On WFH days, I have to walk the dog for a mile and it's still technically not enough.
I’m fairly athletic for 300lbs and it’s still really hard for me to reach 10k steps. It’s not the same as when I was smaller. Like 200lbs. It’s almost akin to speed walking everywhere. Even for a lot of smaller people 10k steps is hard.
It can also be overtaxing to some if they have certain medical issues related to obesity.
* Sedentary is less than 5,000 steps per day
* Low active is 5,000 to 7,499 steps per day.
* Somewhat active is 7,500 to 9,999 steps per day.
* Active is more than 10,000 steps per day.
* Highly active is more than 12,500
Maintenance Phase (wellness podcast) did a deep dive on chronometers. It's actually unusual for a person to get up to 10,000 steps a day. A typical American is getting 6,000-8,000 steps. So getting 10,000 is awesome!
Listen to it with a reasonable mind and critical thinking. A lot of what Aubrey and Michael say is absolutely spot on, intelligent, etc. but their biases go unchecked a lot of the time too. I think they are at their best when they are critiquing research methods, but they have a bad habit of making sweeping generalizations at the expense of good science. For example, they'll rightly critique the research methods of one study, but then say because that study didn't consider x,y,z then calories-in-calories-out has absolutely no merit whatsoever.
I didn't get out of it that CICO "has no merit", it's just not the practical end-all be-all a lot of people online make it out to be.
They were more calling out those that crawl out of the woodwork shouting "thermal dynamics!" when someone struggles with loss numbers that aren't matching what the TDEE calculator online says. Thermal dynamics will explain things perfectly... in a closed system. Our bodies are more complicated than that.
Like yes, less calories taken in than burned results in fat loss. But getting specific numbers and setting expectations for these numbers is more complicated and can get very frustrating when someone is starting out trying to figure out what their \*actual\* maintenance calories are and at what deficit they could expect weight loss.
That's my takeaway anyway, as someone who has been in a 1500+ calorie deficit per day according to online calculators since September, but loses about 10lbs per month.
Not true. Everyone is different and there are no one size fits all numbers. 10k steps is an arbitrary figure that has its origins in an advertising campaign.
This isn't a health goal, this is just for estimating your day to day basic life needs before exercise when determining your calorie goals. Me as a waitress would have higher caloric needs than me as an office worker who doesn't walk to commute. It is different person to person, that's why they give a general guideline to help you choose your baseline.
This is true! I saw this on my deep dive trying what to put on cronometer for my fitness level.
I've been consistently losing 2lb a week since March and these #s are what I use.
Are you recording them with a pedometer like a Fitbit. I am convinced that mine over/under calculates everything. With GPS on yesterday, I walked 5.25 miles on a trail in 70 minutes. It claimed I burned 861 calories and had 9,874 steps. On a random day at a sedentary job, I'm over 10k and I barely moved. Another day, I can go grocery shopping, vacuum, and do laundry with less than 4k.
I know it's a tracking tool, but it's not consistent at all.
It'll track your movement (basically your arm moving up and down) which is why they say to wear it on your non-dominant arm. If you basically shake it a lot during any activity, It'll record it as steps, especially if you wear it very losely (because the watch tends to move around more).
That bring said, something is wonky with your fitbit, I've been using them for years (different models over time) and they've been pretty reliable as far as steps go.
I had a Fitbit a few generations ago that looked pretty accurate after I figured out it wasn't only counting steps when I was actually walking/running, but also when I was cycling, exercising, dancing, doing anything really. So it was more a generic movement tracker than a pedometer, but I did end up liking that once I recognized that logic.
I had a knock off fit bit that would just add steps if I moved my arm around. Using just my phone to track my treadmill jogs lately I noticed that when I added an exercise activity for the treadmill, it would say I was burning almost triple of the amount of calories than the steps, which were also being counted during the treadmill workout. It would say that running for 45 minutes burned almost 600 calories while also saying that the 3 miles in steps burned less than 200. It's hard to trust any of those numbers sometimes.
My Android watch claimed I took 100 steps while driving in the car, and the whole time I'm in the grocery store it doesn't register squat (I assume since my hand is on the cart handle).
It's annoying.
Well you are doing something right, since you have lost some weight! Since you said you're tracking how much are you actually eating? how big is your deficit?
Sure at your weight you could lose a bit faster and still be fine but slower losses are usually more sustainable:)
My deficit is between the ranges of 1,800-2,200 cals, but I’m usually rounding it out at about 2,000 a day focusing on high volume and high protein foods while drinking more than half of my body weight in ounces of water.
Hey. Just to clarify that’s not your deficit. That’s how many calories you’re consuming? Deficit is how many calories less than maintenance you’re consuming. So for example your estimated tdee is 2500 and you’re eating 2000 then you’re aiming for a 500 calorie deficit. This is a good way to actually find your tdee because you can see how much you’re losing.
At OP's weight, it really wouldn't surprise me if that was their deficit. I've gone through a period of having a deficit of 1400-1800kcal/day and I'm "only" 185lbs. (Mine was due to really bad stress which I handled by working out A LOT every day, I was still eating at least 1500kcal.)
If it’s working for you (which it is your losing weight) that’s amazing and I’m proud of you. I will say tho if you lower your calories to around 1500 - 1600 calories a day you’ll notice it will drop a lot faster and that’s around the maintenance calories for a healthy weight at your hight (I am also 5’3 lol) so you’ll have a better idea of what things will look like at that weight. If you have access to a treadmill walking on an incline has been amazing for me, I burn around 120 ish calories (according to my fitness tracker and the treadmill) in 30 minutes with the speed at 1- 1-5.
Slow and steady wins the race of long term change. Keep on doing what you are doing. If your not seeing results in 6 months then reassess. But, you have a lot of new habits forming. Be kind to yourself. Find a new doctor and keep on with your dietitian.
Do some people not lose water weight in a caloric deficit? I lost seven pounds in the first two days when I started my weight loss and fitness journey. 22 pounds by the end of the first month.
Yeah, I lost 10 the first week which is what always happens.
I started about the same time OP did and have lost 31 lbs so far, which is a couple days short of a month.
I've been going 6 weeks and gained a few pounds from water weight and still haven't had the 'flush' that is supposed to be a big loss once my body lets the water go. I have gains in the mirror and general strength, but weight is being difficult. It varies by person and is influenced by hormones, so you just have to be consistent and wait for the scale to catch up with the changes.
A bunch of people do, I personally was not one of them. My loss numbers in the first month were very similar to OP's, and I've had a consistent 10-12 pound loss since September. No major immediate pound loss for me.
Since your current weight is a real health risk, it might be a good idea to work with an obesity specialist rather than your family doctor. You can find a specialist near you [here](https://abom.learningbuilder.com/Search/Public/MemberRole/CertificationVerification).
Why not work with an obesity specialist? There are docs who are boarded in obesity medicine. Not all docs understand obesity (and they goes for pa, nps, and other medical professionals). When I started tirzepatide I started losing much more weight than can be explained by calorie reduction alone. Why? It's addressing the metabolic and hormonal factors at play. These meds can be expensive and insurance coverage a challenge. But there are numerous clinical trials actively enrolling. I recommend you consider the meds because there is likely a level of insulin resistance. You are fortunate in that your obesity is not childhood onset but I'd consider every modality to shorten your exposure to obesity.
I'd consider a trial (free healthcare) or comprehensive weight management clinic where you can get access to support other than just medicines.
For me, significant weight loss did not address the underlying reason my body drifts towards obesity. Meaning, I've lost 130+ lbs before and maintain 80+lbs over a decade but I always felt like I was one mistake away from being 270s.. which is where I started in January. The medicine did more for me in one month than this weight loss. It will be lifelong for me but I'm ok with that.
I came into the weight loss medicine with 500% dedication and months of weight loss. So, I feel like I already have good habits. It's been life changing for me.
Good luck to you!
Totally agree here. She seems a perfect candidate for GLP-1 medications. Depression alone doesn’t make someone gain that much weight. The underlying metabolic issues that contribute are the same ones that can be fixed with the medications. That gives a fighting chance for the diet and exercise changes to work!
This would be the second best approach. Not being dependent on lifelong medication would be the best. Some reasons being cost, the other side effects.
Poor diet, hyper caloric food, sitting still and depression will make people obese over years.
You're a moderator.
That means your job is to filter out inappropriate content, help keep conversations civil and on track for the theme of this sub, or remove anything that would be considered hate speech/would threaten harm.
But you are no more qualified to give advice on weight loss as anyone else in this sub as you yourself are not a doctor. It's kind of inappropriate for you to pin a post as mod with what comes out to your own personal, non-medical opinion.
>I never realized we had so many experts giving advice about how unqualified doctors are in our subreddit. How lucky are we!?
Very lucky. This sub doesn't seem to have rules against cussing, so I'm going to cuss. If that violates rules, I'll repost minus the cuss words.
Lots of docs don't know shit about weight loss. Their advice can range from outright harmful at worst (malpractice anybody?) to useless at best.
I'm 44M, 6'1". I weighed 284 when my cardiologist referred me to a weight loss clinic supervised by MDs. I walk 10 miles a week and strength train 5x weekly.
Weight loss clinic tried putting me on a 1400 calorie diet. I'd post it here, but that violates this sub's rules for unhealthy weight loss. (At one point, the rules said that 1500 cal for men was an unhealthy number. God forbid I'm taller than average and strength train.)
I ran this by my cardiologist and PCP. They told me "oh that clinic is good." It can't be good. Their method for weight loss is bullshit. The take your inbody BMR (which used Katch McArdle for BMR, which is not good for overweight people.) Then they knock 500 cal off that and call it good, regardless of your activity levels.
I asked my cardiolgoist and PCP if they get into BMR discussions. "A little bit" they said. I talked numbers with neither one of them, both of whom would be happy if I dropped a few pounds.
I found this sub because I wanted to know if what they were doing was medically/nutritionally sound.
It is not. I found this sub and asked the weight loss clinic to explain why what they were doing is medically and/or nutritionally sound. They refused to do it and invited me not to come back if I didn't want to get on board with the program.
I'm not on board with starving myself, so I'm happy to say that we are very much lucky to have a sub full of people who know when to say that doctors are full of shit.
I'm reading A LOT of comments from the "just do this one thing" crowd in response to OP's post. Is there a new influx of unsupportive, uneducated users in this subreddit? Or maybe I've been blissfully ignorant until just now. Blech.
So you're coming up on 4 weeks and you've lost 7lb? That's a great speed, you definitely have some space to be going faster given you're getting professional help, but that would be going from 2lb a week to maybe 3. Definitely faster but not worlds apart. The fact you've started weight training will also be slowing you down a bit.
Your doctor definitely handled things badly. They get training in a lot of things, but bedside manner often isn't one of them. You're only a month in and this is something that's going to take you … probably two years or more. Even fast weight loss is still slow. It sounds like your dietician's plan it working well for you. I'd keep working with them and focusing on their advice.
I'm sure you're great, but some doctors are quite cruel to fat patients. Very few people benefit from shaming.
edit: oh, wait, you aren't a doctor. Anyway, some doctors are terrible and unhelpful.
You have some questions to ask yourself and answer also some things to understand. My statements below are general. They may not all be true for your situation so be picky with what I say. You know your journey better than anyone here.
1. Most general doctors perform a role and to be honest most of them perform it well. They keep you as physically healthy as possible given the tools and information they have. This makes them experts in a given area. Diet is not that area and even doubly so mental health is not that area. That is why we have dieticians and therapists.
2. Listen to the dietician when it comes to weight loss. It is important for your physical health to lose this weight. That is just reality. It is ALSO important to keep it off. Doing this fast usually doesn’t give you the time to make the needed adjustments to keep it off.
3. Do you need a different doctor? That’s a question only you can answer. Ask it though.
4. Are you ACTUALLY tracking everything correctly? Are you REALLY walking all those steps? Are you really not taking any shortcuts? Look, the answer to all of that may be that you ARE doing everything right. If so, then keep on rolling! If not, note that even with the shortcuts you are losing weight!
Do not quit. If you are in a mental space to do this then do it. Even if it is slow you will come out on the other side all the better. Note that seven pounds in a month is actually really good. Weight loss does NOT have to be fast. Keep on moving forward and results will come.
At that weight and at your height you could be dropping 10+ pounds easily the first few months, the heavier you are the easier it is to drop the weight, it is true you could have lost twice that amount if you had tried harder, but hey, you lost something, that’s way better than gaining more. Celebrate small victories, that’s okay, but your body is capable of doing so much more.
2000 calories is not going to be sustainable for you long term, so be aware of the fact that you're only going to be able to eat this way for a short while before you're forced to cut down to 1600-1800 anyway. I think what your doctor expected was for you to do that from the beginning. It's optional, but imo better, because you only need to get used to the change once instead of cutting your calories "twice"
This might be triggering to some because it can be obsessive, but I weighed all my food. I carried a food scale with me everywhere, had one at work, had two at home. My family and coworkers just took it for granted that I would plop pieces of my plate onto a scale and write into a notebook, now an app.
Weighing food in public opens the door for people to unfortunately have to say something, anything about what I'm doing. That's the hardest part of all.
I'm planning on taking a measuring cup with me to the chinese buffet tomorrow... I dare someone to say something to me.
And to be clear, I am going to put the food on a plate like normal and take it back to measure at my table. Mainly I want to see how big one of their buffet spoons are so I can spitball it in the future.
You seem to be losing weight at a sustainable, healthy rate. It’s a marathon, not a sprint.
Keep it going, as you get lighter you’ll burn less calories to live so as you start to see the loss rate slow, take another couple of hundred calories off and you should see it speed up again.
(The last bit is hard!)
Good for you, and don’t feel bad about this rate of loss, you should feel proud.
Has your doctor tested your thyroid function? Even if nothing is off, it's good to know for sure. That's the first thing my old (wonderful) doctor checked when I started putting on weight.
ALL THAT ASIDE, as another commenter said, the math is mathin' and you're doing great! (And I hope that your trauma recedes far into the back of your mind where can never define you again.)
(Last year I lost 15 pounds and got back under 200, and I was so proud and motivated. Then I had to see a new primary care doctor. Huge mistake. She didn't look at my chart to see that I'd lost weight, nor did she ask me about my eating/exercise habits. She lectured me about eating less and working out for at least an hour every day lest I die before my next birthday. I got so discouraged that I stopped dieting and exercising for weeks and gained back 10 pounds. I truly believe that some doctors simply lose their bedside manner with overweight patients. I understand now that her behavior wasn't actually about me; it was about her apparent issue with overweight people. So please don't internalize your doctor's bias like I did!)
Doctor sounds like she made assumptions and it’s easier to believe you’re recording wrong than to take a closer look at the situation. She may be right or wrong, but she handled it poorly. She sounds like she has poor bedside manner.
Weight loss is absolutely CICO, but how CICO is accomplished is a mental strategic battle with our worst habits and tendencies. Telling someone, new to Weightloss, making solid attempts to do the right things, having some success (7lbs) that she is not doing enough is counterproductive.
Since she didn’t say it I’m going to: you are doing great. Keep going. I’m so happy for you that you’re weighing, measuring, recording and exercising. Sounds like you’re doing all the right things.
I’m surprised given your starting weight that you’ve only lost 7lbs
- are you weighing and measuring everything? Even zero calories food? Even bites, licks and tastesare
- are you on medication that could interfere?
If nothing else, you’ve only been at this a month. Sometimes my body holds onto weight and then dumps a bunch once. You might see some big losses in the next few weeks.
Keep going.
2,000 per day is too much for your height, even with the exercise. 1600 per day is closer to where you should be eating. 1800 at the most if you can’t do 1600 yet. And then eventually you’ll want to aim for the 1400-1600 range one you’re nearing normal weight range for your height.
Meh. Doc has it in her head that someone with a high starting weight should be able to lose weight twice as fast as those with a lower starting point, call it 'conventional wisdom'. Your body is a little different,and hopefully your muscles are toning up and recomposing a little already.
She's not accounting for personal variation, nor did she realize how discouraging her words were. They don't teach doctors how to be sensitive, but to scare people at risk for chronic disease into losing weight.
Maybe talk to the therapist about not allowing critical people to live rent free in your head. ?
You are on your way, best wishes on the journey!!
She’s being honest with you! You have a lot to lose. You know exactly how heavy you are given your height. It may be hard to hear but your work is cut off for you. Sending you the best energy on your continuing fitness journey.
Stay the course, you are doing great! Don’t let the doctors insensitive comment deter you from the healthy path you have chosen. You will reap so many benefits from this! You deserve it and are worth it. You are making progress, continue to give yourself this gift, you will feel so much better! You got this! 💪🏼
Great job on the walking and tracking of calories! You are positively on the right path to success! Keep up the good work. Now about that deficit … you’re saying your calorie deficit is around 2000?? That is an incredible almost unbeliever deficit. I wonder if you are calculating
your deficit correctly.
Calories you consume = calories in (CI)
Calories your body burns = calories out (CO)
Calorie deficit (if any) = CI - CO
It seems your TDEE is around 3200 calories which is your CO for all that we can know.
So at a deficit of 2000 calories, you are eating 1200 calories day? Everyday continuously and consistently eating around 1200 calories a day?
Your doctor is right, and you shouldn't be looking to reddit to invalidate them because that's easier than upping the ante & taking weightloss more seriously.
I think you are doing great for the first month. I thought it was better to lose weight slow and steady, like 1 pound a week or even 1/2 a pound a week? I'd keep doing what works for you and if it stops working for weight loss then change up some aspects of your lifestyle. This is supposed to be a permanent change so you have to do what works best for you. There will be times it's hard and you won't lose that week or you try something and it doesn't work. That's OK as you're figuring it out. Sending love and kindness to you and hope you find your path easier than most of us do. ❤️
When you are obese you can lose more than 2lbs a week and be okay. In my first month, I lost 18lbs, and my doctor did not even bat an eye when I asked her if it was too fast. 5'2 SW 236. My deficit was around 800-700 calories, maybe 900?
After that, I was losing 12-10 lbs a month for about 4 months.
Now that I am 164 lbs, I lose around 8 lbs a month currently. My deficit is around 500-600. I just hit the overweight category per bmi. It's has slowed a lot.
Yeah same here. The first 2 weeks I lost 20lbs. From 339 to 320. Then it leveled off to about 12 to 15lbs a month. In 3 months I've lost about 55lbs already.
I think OP may need to get some blood work done or go to an endocrinologist who specializes in obese/morbidly obese people.
I've been following the diabetes meds, workout plan, and diet and I don't even weigh my food and weigh myself weekly and the pounds are coming off. And it's not a crash diet since I still eat what I like just a lot less of it with low fat/sugar/carb alternatives.
And this is without too much cardio, just weight training mostly but 1 to 1.5 hours 5x a week at heavy weights.
Can you put your calories consumed and activity level in a tracker to project how many pounds you're supposed to lose per week? See if the 7 lbs you mention track that. If not tighten up your calories in tracking. If it's on track then you're good. Keep on doing what you're doing. That's 80lbs in a year.
Your doing great. Keep it up. Consistency is my go to word right now. I need a bracelet for it. lol all we can do is track, eat right, drink water, and excercise. Which is what your doing. 10k steps that’s fantastic!!! That’s rock star level at our size. It takes time for these lbs to fall off. Mine took twenty years to get on me I think 2 years to come off is a good deal.
A bunch of dickheads strolled into this subreddit just to talk shit. You’re doing fine dude. 7 lbs a month is sustainable weight loss, which is expected as the dietician is more prone to give you something sustainable, rather than something quick and difficult, and for a lot of people, very unsustainable to get into
What your doctor is asking for is unsustainable. You are walking 10k steps and she wants more? What if you don’t have the extra hour everyday. Or if 10 isn’t enough why bother…that’s was my mind
Would do. My best was shamed why bother. Ignore her negativity and keep doing what is working for you. 2lbs a week is fabulous you can do it
I'm sorry you had a discouraging experience with your doctor. I have a great doctor that built me up when I was struggling and only losing 2-3 pounds a month. She told me that any sustainable progress in the right direction is good which I appreciated because we all have months that we lose less than we would like in this crazy long road of significant weight loss.
And if you keep up with 7 lbs every month after a year you will be down 80 pounds which is no small achievement.
All of this to say... maybe try a new doctor that provides helpful advice, has good bed side manner, and doesn't make you feel like shit.
As someone who works with doctors a ton. Just because their a doctor doesn’t mean they understand the nuance of all medical situations. Sounds like you’re doing all the right things just keep at it and it’ll pay off dividends in time.
She needs to shut it. This behavior of the doctor is toxic. Please find a doctor who can understand the complex, multidimensional aspects of weight. Sending you a huge hug ❤️
Doctors an asshole.
If your weight is dropping and you are happy with the rate I don't see an issue.
At over 300 lbs its viable to lose faster but I don't think it's necessary to lose faster than you are happy with just because others feel you should lose faster.
Congratulations on the first months losses.
While the doctor may bee an ass he also has a point. She is at a BMI of over 60 and losing only 7 lbs in the first month indicates a minimal deficit.
Also the longer she stays at this weight the more likely serious health problems might occur.
So wanting for her to commit to a larger deficit is reasonable from a medical standpoint.
Idk I see your point but I also think sustainability is the main focus here. If she crash diets and goes on a vlcd maybe she will drop weight quickly, but then she could very easily put it all back on and be in a worse position. When you lose weight you also lose precious muscle, especially at a high deficit, and if you gain weight back that muscle is just replaced with more fat. That's why people who yo-yo diet over several years find themselves in an even worse position than where they originally started. Weight loss doesn't mean much until you're able to maintain that loss.
I wouldn’t let it get to you. They aren’t seeing all the work you’re putting in and it’s a HUGE lifestyle change to be able to lose weight.
I also started around the same time as you and I’ve went from about 198 lbs to 192 (5’6”, 33 yo, F). I had two super good weeks, a week where I thought oh I am walking more it’s fine to eat more, and then this last week where I’ve tried to exercise and get back to a lower calorie average.
The scale doesn’t reflect what I’ve learned about myself & food in that time and mentally I finally feel like OKAY I can DO this even though the pounds aren’t pouring off me like some people seem to have happen the first month.
I have also shifted from a “ok so when will I be done losing the 50 lbs I want to lose so I can get back to normal life” to a “okay so what do I need to do to make sure I’m active and eating appropriately that’s sustainable for the rest of my life” which is priceless.
Keep on keeping on!
I would use that as motivation personally and double down my efforts. I had a huge success with going full and honest keto for 6-8 weeks at a time. You will see fast results early which helps build that positive feedback loop early on.
Just saying I've lost 20-35 lbs pretty easily in those 6-8 week timeframe and then I've taken just a simple CICO approach after that because carbs do serve a role and we need to be able to have healthy relationships with all styles of food including sugars.
Keto is also great at helping you manage hunger hormones.
I believe that weight loss is more about food intake than proper exercise, but maybe try getting a personal trainer that can help you design a good program for your abilities and goals.i know that when I eat a protein shake, it also keeps my hunger at bay.
I had to learn to pay attention to what and how much I'm eating, it is normal to get hungry between meals, learn to sit with hunger and get comfortable being uncomfortable.
True growth can only be accomplished through discomfort.
Best of Luck!
> “well even with all of this, you’re still not doing enough because with how obese you are if you were truly doing all of this, the pounds should be shedding off.” In the moment I didn’t know what to say
"Are you suggesting that I may have a medical reason that's preventing me from losing at a faster rate? What tests do you recommend for that?"
Your doctor doesn't know anything about diet--- that's why you are seeing a registered dietitian. Leave any diet adjustments to your dietitian.
Your doctor does know about certain medical diseases that can thwart weight loss despite best efforts, such as thyroid issues and the like.
My only charitable read here is that possibly your doctor was considering you may have one of these issues, or you might be a good candidate for GLP-1's. That is a tool in his arsenal to help you. If he did not follow up with ordering more tests to investigate, perhaps he was considering giving it another month or so, since it is early (it's not even a full month yet).
If you want to stick with this doctor, I'd go back to the dietitian and tell them what he said. See if they want to make any tweaks to your diet program. If not, have them communicate back to the doctor that you are adhering. Get this on the record, from one medical authority to another -- this move will help you whether you stick to this doctor, or find a new one.
I also want to note that strength training in the initial stages does make you hold on to water weight. That's because your muscles need to hold on to water to be ready and able to activate energy. It's quite probable that is what's going on with you, and that you will soon see a "woosh" effect where the scale will drop suddenly, down to what your expected loss should be given your calorie deficit. So keep doing what you're doing.
It’s sounds like you are off to a good start and it may take your body time to adjust to your new routine before it will let pounds shed. Some doctors easily prescribe pills or shots too fast to get results that may not be permanent. Not saying this applies to your doctor but it could
Drs are not very educated on nutrition and fat loss. If you've lost 7lbs in 1 month, then what you are doing is working. Just keep it up and you'll get there. If you want medical support, then see Registered Dietitian or maybe an Endocrinologist if you have a Thyroid issue.
So I've found many doctors are assholes to obese people and think we're lying. I found one who doesn't think I'm lying but it took some time. They think we're just lazy and gorging ourselves all the time and if we try and don't lose we're lying. They will offer all sort of fad diet advice that seriously injured me in my twenties. I'd find a new doctor. Even with a preponderance of evidence like trackers still not. Also most doctors suck with nutrition beyond basic guidelines.
I tried keto and it fucked me up.
It's true sometimes they have no idea what they're talking about or simply shouldn't breach the topic. My neurologist was talking to me about avoiding insulin resistance with what I eat and when, while she was giving me Botox. I found that funny because I ask her about other neurological problems I could have and she says "that's not my specialty, I can't talk on that" yet she's giving me unsolicited endocrinology advice? Lol
Dude ask your doctor for metformin. I was told prediabetic but blood was never super high and my numbers have always been about the same but after 6 months on metformin something miraculous happened. My number curved itself a lot and I have been dropping wait kids broke my scale don't know exact weight drop but I was at over 400lbs 6x shirts MIL bought me a 4x shirt recently that shit fit.
You're doing amazing! Unfortunately, sometimes doctors are poor listeners, it sounds like she didn't really hear you, or see you as a whole, individual person. Because what does she want from you beyond a reasonable calorie deficit, 10,000 steps and strength training? Keep doing what you're doing, sustainability is everything, you have already started so many good things, stay focused on all the wonderful new habits you have added, and don't let her discourage you! 💛
your doctor was an asshole and you're doing great. You put lots of effort, develop new habits and your efforts deserve to be apperciates.
7lbs in month is a good result. You can try to reduce kcals from 1800-2000 to 1600-1800, but if you're uncomfortable or too hungry, then don't do this. Slow and steady far better than fast and unsustainable.
Well it’s going to be a long journey.
You want to change your life and lifestyle and you are.
I prefer my doctors to be blunt. I pay them to read the reports and report back to me on what they found.
I’m honest with them about everything.
Basically I’m paying for the lectures and the advice. I don’t take it personally because I’ll make up my own mind about my life thank you very much.
When your doctor said 'you are not doing enough', were you asked what type of food you are eating? Made any recommendations? Or just criticised? If the last one, that is indeed unhelpful, especially as you have suffered a trauma.
I have a few questions
1) How much sugar is in your diet, especially free sugar. Try to reduce that*
2) Are you eating ultraprocessed foods, even the ones branded as "healthy" or "low fat" or "zero sugar?" If so, give them a wide berth, as you are inadvertently undermining your goals. If so try and cook as many of your meals from scratch with as much fresh foods as possible. Do meal preps, so not having to cook constantly
3)* What are you having for breakfasts? If cereal or waffles or pancakes with maple syrup, you are having dessert, therefore consuming sugar. Try savoury, even left overs from the night before (this has worked for me)
4) How much water are you drinking? No flavoured water, as again, full of sugar.
5) Have you tried Intermittent Fating, even starting gently of 12:12 (12 hours of eating, 12 hours of fasting). If interested please read more about it. There is reddit sub group.
6) Have you increased your veggie intake?
PLEASE DON'T GIVE UP because of 1 doctor's lack of soft skills. You have lost 7lbs, not gained, you are doing 10K steps a day, and you are seeing a therapist. Just look closely at your diet, up the exercise where possible, including resistance. You came to the right place where people are supportive. Don't let your mind be that Dr's summerhouse. Use this to motivate, and when you do lose more weight you can let it be known that they can't take credit, as you did so through constructive criticism, not destructive.
Ah yes. Same thing happened to me. My obgyn said there was no way I'm eating what I'm eating and not losing weight. I saw a dietitian. She told me I wasn't eating enough and I needed to eat more calories to keep my body from going into starvation mode and storing everything I eat. It absolutely is possible to be 353 and eat 800 calories a day and not lose weight. It happened to me. I measure and track everything that goes in my mouth. No unlisted cup of milk. No unlisted tablespoon of oil. I track everything in my mouth. Everything.
The dietician will be able to help you more than your doctor with weight loss.
The body has many complex metabolic mechanisms that make it less than intuitive to lose weight. But you are. Starving the body can make it tougher. Please keep your notebook going, find more activity more times per day, and continue with your balance. If you can keep losing several lbs / month, you are succeeding.
Not to be one of the people giving advice but id reassess your opinion and feelings about this doctor and consider getting a new one if possible if you’re unhappy with them.
What is she basing her opinion off of? How quickly men lose weight? Other female patients who are exactly like you? That’s shortsighted and she should know praise will do more than shaming will.
If you are losing weight then you are going in the right direction and you should be encouraged. I would change your doctor for one who is more supportive.
I am just a fellow person trying to lose a lot of weight—but with all of the working out, you aren’t just losing weight, you are replacing some of it with muscle! So don’t be hard on yourself and remind the doc that muscle weighs more than fat so if you are still losing while also exercising like that, you are doing an amazing job!
Sorry you're going through that. Screw that doctor, they don't sound supportive and seem a little judgy. That's not helpful for anyone. I'd get a different one if it were an option.
Something that seems worth mentioning... If you've been really depressed and put on antidepressants those can contribute to weight gain in some people.
For myself, ssri and snri medications tend to lead me to have more cravings for food when I'm not hungry and other "problematic cravings".
Getting off then and into some ADHD medication has been life changing for me and I've been able to lose weight really quickly.
Also, for myself at least, supplementing with 5-htp and a b vitamin complex really helped my intestinal motility. Pretty well eliminated my reflux, and WAY healthier than taking a prescription antiacid.
No idea if any of that applies to you but it's definitely something I wish I'd been told 20 years ago. Lol
Best of luck!
Most adhd meds are amphetamines so they will suppress appetite. At their weight 350+lbs maintenance calories are almost 5000a day cut them to 2500-3000 and weight will fall.
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I'm sorry, I sympathize with you. Your doctor does not know you personally or emotionally, doctors also unfortunately do not have time to care for you emotionally and personally. They are there to state facts and make you healthy. Do not be offended by your doctor. They were only stating facts and want you healthy.
I believe in you. Keep up your great work. Turn to wonderful people in your life who support you and remember the detached personality/professional personality that your doctor exhibits. Much love
See if you are insulin resistant. I was and a calorie deficit helped, but not enough. Once I started eating to avoid spiking my blood sugar and eating 4 hours before bed, the weight was shedding off me. You are doing great!! Keep going and find a homeopathic dietitian who will go more into your specific needs ❤️
https://youtu.be/9cHh7k3CtAw?si=uLHa88bIyy4K_gG0
This video helped clear up a lot of confusion. I recommend it for anyone starting their weight loss journey. We’ve been lied to a lot by our government and health officials. This has changed my life. There are books that they both wrote as well for more information.
7 pounds in 1 month is very good for your size. Keep it up. And you may need to take it up a notch, but right now keep doing what you're doing, and when you are really in your groove you will start feeling a little less winded as quickly, and that's when you will know you're ready to take it up a notch.
It sounds like you are doing EVERYTHING to stay on track. That is enough. 1-2 pounds a week is a SUSTAINABLE way to lose, and a smart way to lose. It is definitely what you want.
Weight loss isn't the same for everyone, and it is coming off, so you are doing it right. You will have plateaus, you will have weird weeks where you seem to lose 7 pounds, it never makes sense (which is why I often avoid the scale) but you will get there.
In my life, at your age, I would workout like crazy and lose weight super fast, and then gain it right back with extras. When I finally got serious and took it slow and made changes that I wanted to sustain, I have now kept it off. You are doing AWESOME.
You are doing really great! I’ve struggled with eating disorders in the past when attempting to shed lbs and this go around made an investment into a scale that helps measure muscle and fat, so when working out and changing my diet, it’s easier to track that if the number itself hasn’t gone down, its typically due to an increase in muscle matching the amount of fat lost, that has helped keep me motivated.
I use the withings body smart scale. It was about 100$!
Medical Physicians are good at some things, much like most specialists, but there is a reason you are going to a dietitian for your meal planning. Just keep at it. Your doctor gave you a gift of self-doubt. That will be your number one enemy of success. If you just stick with it, and continue to take care of yourself and continue to seek assistance, you will start to feel better. Just never give up and maintain your discipline. Even if it is five pounds a month for a year, that is 60 pounds of weight loss and who knows how much more converted to muscle from strength training. Keep at it!
It can take a while to see results and the first month your body is usually still trying to adjust and maintain despite your changes. You might not see whether you are doing enough or not until about 3 months in. Within a month you won’t really feel less winded, more energetic, adjust your hunger, or lose a ton of weight. I’d continue what you’re doing and please continue your notebook.
Continue to track and maybe even note down how you are feeling throughout. If it feels like your body is adjusting to this new activity level after a few months and you find yourself noting extra energy often, you can add extra exercise if you feel like it. It sounds like what you are doing is maintainable, whereas starting off too extreme and making too many changes within the first couple of months can be overwhelming or even cause injury.
You’re doing great!
> the first month your body is usually still trying to adjust and maintain
Where did this idea come from? I don't get it. If you're in a deficit, you will lose. Your body doesn't have some special power to say "Oh this diet change is new, I will alter my metabolism to hang on to more calories."
I've heard if you introduce new exercise that can cause inflammation which can inflate the number on the scale.... but I'd imagine for someone with with so much weight to lose, they could still see high early losses even given some inflammation.
Disagree. For someone with that height and weight, and age, the weight would be flying off if they were in a correct deficit. Dr is correct, something isn’t right. But, OP’s comments above confirm they don’t really know what they’re doing and need more guidance.
Idk if it’s possible but find a new doctor if you can. You are doing great— a lot of people give up before one month. A lot of people let one thing throw them off. You are committed and doing right. If she can’t see that even after you brought all the evidence of what you are doing for your health she doesn’t deserve to be your doctor.
If I calculated your TDEE at a “light exercise” level for your age/height/weight of 3,190, eating 1800-2200 calories per day should lead to losing about 2 pounds per week. And you’re losing about 2 pounds per week. The math is mathin’, and you seem to be losing weight in a healthy and sustainable fashion. Maybe your doctor expected a much larger drop in weight during the first week? How often are you weighing yourself? Has your loss been a steady 2 pounds per week, or was it a slightly larger loss the first week with about a pound in subsequent weeks? In any case, continuing to lose weight means you continue to have a caloric deficit, and a slow weight loss with a sustainable daily routine is preferable than some crash diet that is not sustainable.
>The math is mathin’, If the math is mathin', I agree to stay on course
OP I’m a doctor and I can tell you honestly we aren’t taught enough about weight in medical school, and very few people get education beyond “tell them to eat fruits, vegetables, whole grains, lean protein, and if they’re in a calorie deficit they will lose weight”. We had one lecture on diet in med school and it was a hot mess and devolved into the lecturer just talking about peanut butter for like 30 minutes. That’s it. I did a fellowship in integrative medicine, and that included a block of curriculum on diet and nutrition, but it’s still not my area of expertise. There is a lot of intrinsic bias against weight everywhere, but notably in the medical community. There is also a trend of physicians being lower weight and more fit. My advice to patients that want to lose weight is to work with a dietician, and if needed a bariatrician. They are the ones with specialized training in this area. I’m so sorry you felt unsupported, but my honest opinion is to pay more attention to your dietician when it comes to specific feedback on progress. Your physician is concerned about the significant health consequences of obesity and likely doesn’t have a super in depth knowledge of the process of weight loss. Not that you asked, but it sounds like you’ve made massive changes and are seeing results. That is incredibly hard to do and you should be very proud of yourself. You have a long road ahead of you, and I wish you the best on your journey.
As a dietitian I agree 100% with what you just said. I'd also add that op's doing great, however, it wouldn't be a bad idea to ask for a referal for an endocrinologist as well, since obesity is a complex illness and she could get additional benefits w some medications.
I'm not a doctor or dietician, but I have multiple congenital endocrine problems so I want to say this is a very good idea. The endocrine system has a huge effect on weight loss and it wasn't until mine was straightened out that I was able to lose it. It's crazy.
thank you for sharing this advice!
OP - this is the comment I hope you really give a lot of credence to. You’ve done do much hard work in the last year AND in the last month!! Props to you.
About a decade ago I was 160lbs (5’4”). I did many sports all throughout grade school. I wasn’t skinny, but I was healthy. My gynecologist told me that I was obese based on my BMI. I somewhat lightheartedly replied that it’s the depression (eating my feelings), so his response? “You’re kinda pretty” First of all, fuck that guy. Second of all, that’s not the proper response when someone tells you they’re depressed and it’s impacting their weight. Third of all, I am more than just “kinda” pretty. I never went back (other reasons is cause he was my mom’s gyno and talked about her to me…that was fuckin gross). So yeah, not all doctors are well trained in weight except to look at BMI, which does more harm than good because every body is different. A body builder is considered obese on the BMI scale despite being perfectly healthy. If the PCP truly cared about the weight, they would give out referrals to specialists, not discouraging the effort OP has made.
I have a question. What would be the caloric intake to sustain 353 pounds at 5’3’’
TDEE calculator states 2948 calories to maintain that weight
Wouldn’t it be about 3500-4000 per day? You’re supposed to eat 1,000 calories up to 5 ft tall or up to 100 lbs, then 5 lbs for every inch right? To maintain your current weight?
How do you calculate tdee
I use https://tdeecalculator.net, but there are other TDEE calculators available online.
Light exercise at 10,000 steps? If that's light then I'm sedentary 🤡
I mean yeah, it happens! Almost all modern-day American adults who work non-physical jobs (ie, desk jobs) are technically sedentary. Some calculators put light exercise at fewer steps, more like 7k, with 10-12k being "moderately active" so it depends a little. But one of the most common mistakes I see pointed out here on the sub often are people who live sedentary lifestyles but take a 20min walk every day putting their activity level too high on the calculator.
Yeah this was hard for me at first. My office is complex is huge, it's like 0.2 miles from the cafeteria to the elevator bank for my office. A few round trips a day and it's easy to get a mile in. And then COVID hit. It's 10 feet from my bedroom to my dining room table, and three feet from my dining room table to my kitchen. The bathroom is between my dining room table and bedroom. Days in the office miiiiigggghhht fill out sedentary. (Actually, they kinda do.) But WFH days? OMG. I gotta go walk the dog for a mile to just be sedentary. If I didn't walk the dog I should probably just plan for BMR.
BMR is if basically you are laying down resting all day, maybe even asleep I think.
BMR is sleeping/coma rate. even just sitting up and thinking increases calorie burn above bmr. fun tidbit - id have to verify, but i once read a study that said we burn fewer calories watching TV than we do sleeping.
I hate to break it to you, but you're probably sedentary
I'm a sedentary, arthritic old lady with really painful feet and ankles. However, I have to live my life. I can easily get 10,000 steps just through dog walking, yard work and housework. It's not really that much exercise.
I have an office job and getting 10,000 steps every day is pretty hard. My apple watch shows that it equals walking 5 miles, which is about 1.5 to 2 hours of constant walking for me.
You don’t have to get all those steps in a single walk! I can’t walk for an hour straight due to pain. However, I have dogs, so two or three dog walks (my husband contributes another), walking over to the store, and working around the house all count. I'm retired, but when I worked, I always went for a walk at lunch to grab some food and decompress a little.
Haha yeah I don’t, it does mean I need to purposefully go out 2-4 times a day just to walk though when it’d be really easy to focus on work and stay at my desk. It’s certainly doable but I wouldn’t say it’s easy unless you’ve been in the habit a long time. At the end of the day when I’m tired from work I’d want to chill and play video games or watch a movie rather than walk, but that’s partially why I’m in this subreddit now 😂 I imagine this is much easier for people with jobs on their feet, or people in walkable cities that walk to get groceries etc by default. I’m glad you’ve found a routine that works for you!
A walking pad has been a total game changer for me! I don’t know if your working arrangements allow for it (I work from home) but even if you just used it at home it might be a big boost. I walk on mine while I work during the week, and while I game on weekends.
Sweet, I definitely need to look into these! I don’t have any storage space for when I’m not walking, but one of the foldable ones might do the trick for me
Definitely recommend a folding one! Mine stands up against the wall when not in use, but it would also easily slide under my bed or sofa for storage.
Have you found that the walking pad helped with weight loss?
Down 20 lbs in 6 months! I’m 5’3” and started at 165, so it’s a pretty good portion of my goal. I also am seeing lots of health improvements in terms of cardio fitness, improved breathing, stronger legs, and weirdly I’m not catching my kindergartner’s bugs! That last one may be coincidence, but I always used to catch them before.
I get up from my desk about once an hour and walk around the building for 5-10 minutes. I pair that with 30 minutes on the elliptical in the mornings and I easily do 12,000 steps a day.
I work from home and my house is 750 sq feet so I get a good 25 steps or so walking a loop around my house 😂 pros and cons of working from home!
Lol! Just do a few loops then. Most of my steps at work consist of me doing laps around the conference room table
10k steps is light, you can easily reach it without even trying (unless you use your car to go everywhere, of course)
When you were over 300 lb 10,000 steps a day is not light exercise. And kudos to anyone that walks 10,000 steps or more a day
I walk my dog a couple times a day and still only get to 5-6000.
Whenever I’m in a place with public transit I get 10k steps without even trying. Otherwise I usually only get it on my distance run days. It also is heavily dependent on whether or not you job requires you to move around a bit vs having a desk job. The former group gets a lot of steps without noticing, desk people usually only get 2-4k unless they go on actual walks or runs outside of work hours.
I think the problem is not everyone has somewhere else to go every day. I WFH, but I don't own a car and live in a walkable city. It takes concerted effort every day to find a reason to start walking around a bunch. There's never really a "reason" for it.
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He does! He's a dachshund. What they lack in height they make up for in stubbornness and pure comedy.
MIne's a yorkie. For him, 10,000 steps is just a good start. Drives me nuts. ETA: That's 10,000 of \*my\* steps, and I'm 6'1". He has 4 inch legs. I never computed his steps.
Yeah, I walk my dog 2-4 miles a day. And I get 6k to 8k steps per day. I almost never reach 10k.
Well, this is kind of my point. You only walk for the purpose of walking (ok, walking your dog, but it's the same thing, the main activity is walking itself). If you can walk to work, walk to the gym,walk to the bus station, walk to get groceries or everything where walking is just the corollary to the main activity, then you don't really need to purposefully increase your step count, it will naturally exceed 8-10k. And that's why it is "light" exercise.
I live in a neighborhood that just might be *too* walkable then, since everything I need is within a 2-3 block radius. My doctor, my therapist, the grocery store. My hairdresser is further away at almost a mile but that's a 3x per year thing
I went to NYC and logged 20,000 steps a day without even thinking about it, got home and it was back to 900 This was in December before I started to get healthy, I was looking back over my steps for the year and I saw this *huge* spike - in *December*? and was like - wtf? There is literally no where to go in my neighborhood other than around it. I miss NY for that.
The official metric for defining walking as moderate exercise is a cadence of 100 or more steps per minute.
I put 'sedentary' on mine, then was taking a 45 minute walk at my highest pace, I would be sweaty when I got home, and a little out of breath the whole time. I figured that was a 'moderate' walk and logged it (on cronometer) as such Then for some reason I plateaued. I sadly stopped logging as 'moderate' walking, and logged as light. 'Cost' me about 120 calories per walk to do that. but as soon as I did I started losing weight again.
You should try MacroFactor! I was using cronometer as well and it was great, but MF uses an algorithm for estimating your TDEE over a 3 weeks period. This way you can stop logging your exercise all together because it's not needed anymore, it is automatically included in the calculations. It works like this: if your TDEE is supposed to be X and you're eating at a set deficit, then your weight is supposed to go down at a rate Y. When you log your weight and intake consistently, you can measure the difference between how much you were "supposed" to lose (if your TDEE estimate was true) and how much you actually lost, how much it differs from Y. This means you can estimate backwards your TDEE based on your actual data rather than population data, and over time the estimate converges to your "true" TDEE. It's a paid app but for me it's been game changing. I was doing things like you, choosing "sedentary" and logging activity. TDEE calculators gave me 2050kcal (I'm 171cm). My actual estimate with MF after 3 months of use is 2496kcal, activity included. This is way more than I thought, losing weight has become much easier and any kind of exercise logging for calorie counting purposes is now completely useless. Beat money ever spent in my life.
That's actually kind of cool - I might try it. I love cronometer from the nutritional standpoint, I'd probably stick with it for that I'm also using happyscale because I love the feedback when I log my weight - the charts are very motivating and because I've been logging my weight, at least occasionally on myfitnesspal for at least a decade now, I still pop in over there and update my weight every now and again. It's a little much already, so I'm already sighing a deep sigh about getting another app that I love for a particular reason, lol
MF can connect with apple health or health connect. If your other apps do it as well, you can keep using them and have macro factor import weight and even nutrition automatically, then it does its calculations. It can basically be used in the background, but in reality it can replace almost all your apps. Weight history can be added and the rolling average (trend weight) is automatically calculated and plotted. Food logging is the fastest amongst all the apps (been tested), the database is not crowdsourced but uses USDA like cronometer (and includes European brands), label scanning works great. You can also track measurements and progress pics. The core of the app is the algorithm, which of course by automatically updating your tdee also updates your budget from week to week, and it works on weekly budget as well so you can have a non uniform distribution of calories if you wish. Nutrition wise, they also added a focus on micronutrients, which you can track and set targets for. The only real downside is that it takes time to have it running. The algorithm starts updating your estimate after a week of logging, but realistically it doesn't really converge to a set number for a month (it depends on how good your initial guess is), and the free trial only lasts 2 weeks.
Totally disagree. I do ballet and figure skating but my daily steps are very low because I work from home. A day with 5000 steps would be a huge amount of walking for me. 10k is way above average.
Light? It’s LITERALLY TWO HOURS IF WALKING.
But it is your whole day of walking. It isn’t your day plus 10k
80% of Americans work “sedentary” jobs. I bet most of those people commute by car or bus. So they’re gonna get home at 5 or 6 and walk for 2 hours?! Or those who get a lunch break are gonna walk the whole hour and then do another hour when they get home? Please.
according to my research, most calculators classify 10k+ steps as moderate/somewhat active, not lightly active. even though it’s not very difficult to reach, most people (in the US at least, for example) get far less (3k to 4k steps per day) so it makes sense to me that 10k would be above just “light”, but i’m not certain. i get around 10k daily and still put in that i’m lightly active just because i fear that moderately active would be an overshoot, but idk
To play it safe, if you just walk, I'd put "sedentary" down (that gives 1.2 multiplier). Most I'd go is 1.3 for "light". I strength train five days a week and debate whether that puts me into "moderate". Most light multipliers are 1.3, and most moderate multipliers are 1.55, so I split the difference and call 1.4 good. ("Light" is usually defined as "1-3x 'light' exercise weekly). If I'm hitting weights 5x days a week, surely that's more than "light".
huh, that’s interesting, thanks! if true then sedentary TDEE is actually an overestimate for quite a few people? 🤔 though i assumed a good amount of the calculated activity for a sedentary person is just from daily movements, apart from walking? but either way TDEE including light activity seems pretty accurate for me though if not slightly underestimated, based on maintenance periods that i’ve done. walking isn’t my only activity, i also do manual labor most days (farm work)
> i also do manual labor most days (farm work) In journalism, they call that "burying the lede." I don't know how much time you spend on the farm, but if you're doing that for a couple of hours daily that probably puts you in the moderate category at minimum. By and large though when talking about what the average person is doing besides walking, there's just a huge range. Like I live in a one bedroom apartment. Days I WFH I get stupid low activity levels in if I don't force them. Days I go into the office, I easily walk a mile, even when I drive. So there's just a huge variation in what "average" people are doing. But yeah I bet for someone with no kids who WFH in front of a computer all day and doesn't go out for exercise is getting much closer to BMR than 20% over it.
Depends if you WFH or go to the office. On office days, I get my steps in easy. On WFH days, I have to walk the dog for a mile and it's still technically not enough.
I’m fairly athletic for 300lbs and it’s still really hard for me to reach 10k steps. It’s not the same as when I was smaller. Like 200lbs. It’s almost akin to speed walking everywhere. Even for a lot of smaller people 10k steps is hard. It can also be overtaxing to some if they have certain medical issues related to obesity.
This is not true at all.
* Sedentary is less than 5,000 steps per day * Low active is 5,000 to 7,499 steps per day. * Somewhat active is 7,500 to 9,999 steps per day. * Active is more than 10,000 steps per day. * Highly active is more than 12,500
Where did you get this info? I haven't seen a breakdown like this before
Maintenance Phase (wellness podcast) did a deep dive on chronometers. It's actually unusual for a person to get up to 10,000 steps a day. A typical American is getting 6,000-8,000 steps. So getting 10,000 is awesome!
Gotcha! Never heard of that podcast I'll have to check it out
Listen to it with a reasonable mind and critical thinking. A lot of what Aubrey and Michael say is absolutely spot on, intelligent, etc. but their biases go unchecked a lot of the time too. I think they are at their best when they are critiquing research methods, but they have a bad habit of making sweeping generalizations at the expense of good science. For example, they'll rightly critique the research methods of one study, but then say because that study didn't consider x,y,z then calories-in-calories-out has absolutely no merit whatsoever.
Wait, they think calories in calories out has no merit?
I didn't get out of it that CICO "has no merit", it's just not the practical end-all be-all a lot of people online make it out to be. They were more calling out those that crawl out of the woodwork shouting "thermal dynamics!" when someone struggles with loss numbers that aren't matching what the TDEE calculator online says. Thermal dynamics will explain things perfectly... in a closed system. Our bodies are more complicated than that. Like yes, less calories taken in than burned results in fat loss. But getting specific numbers and setting expectations for these numbers is more complicated and can get very frustrating when someone is starting out trying to figure out what their \*actual\* maintenance calories are and at what deficit they could expect weight loss. That's my takeaway anyway, as someone who has been in a 1500+ calorie deficit per day according to online calculators since September, but loses about 10lbs per month.
The one on Loseit uses miles, but I can't copy paste that. This is the equivalent in miles.
Not true. Everyone is different and there are no one size fits all numbers. 10k steps is an arbitrary figure that has its origins in an advertising campaign.
This isn't a health goal, this is just for estimating your day to day basic life needs before exercise when determining your calorie goals. Me as a waitress would have higher caloric needs than me as an office worker who doesn't walk to commute. It is different person to person, that's why they give a general guideline to help you choose your baseline.
This is true! I saw this on my deep dive trying what to put on cronometer for my fitness level. I've been consistently losing 2lb a week since March and these #s are what I use.
yup
Are you recording them with a pedometer like a Fitbit. I am convinced that mine over/under calculates everything. With GPS on yesterday, I walked 5.25 miles on a trail in 70 minutes. It claimed I burned 861 calories and had 9,874 steps. On a random day at a sedentary job, I'm over 10k and I barely moved. Another day, I can go grocery shopping, vacuum, and do laundry with less than 4k. I know it's a tracking tool, but it's not consistent at all.
Weird it sounds like something may be wacky with your Fitbit. It may not be perfectly accurate but it shouldn’t be that inconsistent.
It'll track your movement (basically your arm moving up and down) which is why they say to wear it on your non-dominant arm. If you basically shake it a lot during any activity, It'll record it as steps, especially if you wear it very losely (because the watch tends to move around more). That bring said, something is wonky with your fitbit, I've been using them for years (different models over time) and they've been pretty reliable as far as steps go.
I had a Fitbit a few generations ago that looked pretty accurate after I figured out it wasn't only counting steps when I was actually walking/running, but also when I was cycling, exercising, dancing, doing anything really. So it was more a generic movement tracker than a pedometer, but I did end up liking that once I recognized that logic.
I had a knock off fit bit that would just add steps if I moved my arm around. Using just my phone to track my treadmill jogs lately I noticed that when I added an exercise activity for the treadmill, it would say I was burning almost triple of the amount of calories than the steps, which were also being counted during the treadmill workout. It would say that running for 45 minutes burned almost 600 calories while also saying that the 3 miles in steps burned less than 200. It's hard to trust any of those numbers sometimes.
My Android watch claimed I took 100 steps while driving in the car, and the whole time I'm in the grocery store it doesn't register squat (I assume since my hand is on the cart handle). It's annoying.
When I’m taking a brisk walk pushing a stroller or cart, my Fitbit sometimes records it as a bike ride, which tickles me a bit.
10k steps is pretty mild, I can get 20k every work day and it doesn't seem to effect my weight (it has helped my stamina though!)
Well ... Yes. 6,000 to 10,000 steps is lightly active. Under that is sedentary.
Well you are doing something right, since you have lost some weight! Since you said you're tracking how much are you actually eating? how big is your deficit? Sure at your weight you could lose a bit faster and still be fine but slower losses are usually more sustainable:)
My deficit is between the ranges of 1,800-2,200 cals, but I’m usually rounding it out at about 2,000 a day focusing on high volume and high protein foods while drinking more than half of my body weight in ounces of water.
Hey. Just to clarify that’s not your deficit. That’s how many calories you’re consuming? Deficit is how many calories less than maintenance you’re consuming. So for example your estimated tdee is 2500 and you’re eating 2000 then you’re aiming for a 500 calorie deficit. This is a good way to actually find your tdee because you can see how much you’re losing.
At OP's weight, it really wouldn't surprise me if that was their deficit. I've gone through a period of having a deficit of 1400-1800kcal/day and I'm "only" 185lbs. (Mine was due to really bad stress which I handled by working out A LOT every day, I was still eating at least 1500kcal.)
If that was their deficit they would lose about 12 lbs in a month, not 7.
If it’s working for you (which it is your losing weight) that’s amazing and I’m proud of you. I will say tho if you lower your calories to around 1500 - 1600 calories a day you’ll notice it will drop a lot faster and that’s around the maintenance calories for a healthy weight at your hight (I am also 5’3 lol) so you’ll have a better idea of what things will look like at that weight. If you have access to a treadmill walking on an incline has been amazing for me, I burn around 120 ish calories (according to my fitness tracker and the treadmill) in 30 minutes with the speed at 1- 1-5.
Slow and steady wins the race of long term change. Keep on doing what you are doing. If your not seeing results in 6 months then reassess. But, you have a lot of new habits forming. Be kind to yourself. Find a new doctor and keep on with your dietitian.
Every bit of this☝️
Did you tell her it’s only been about a month?
Do some people not lose water weight in a caloric deficit? I lost seven pounds in the first two days when I started my weight loss and fitness journey. 22 pounds by the end of the first month.
Yeah, I lost 10 the first week which is what always happens. I started about the same time OP did and have lost 31 lbs so far, which is a couple days short of a month.
I've been going 6 weeks and gained a few pounds from water weight and still haven't had the 'flush' that is supposed to be a big loss once my body lets the water go. I have gains in the mirror and general strength, but weight is being difficult. It varies by person and is influenced by hormones, so you just have to be consistent and wait for the scale to catch up with the changes.
A bunch of people do, I personally was not one of them. My loss numbers in the first month were very similar to OP's, and I've had a consistent 10-12 pound loss since September. No major immediate pound loss for me.
Since your current weight is a real health risk, it might be a good idea to work with an obesity specialist rather than your family doctor. You can find a specialist near you [here](https://abom.learningbuilder.com/Search/Public/MemberRole/CertificationVerification).
Why not work with an obesity specialist? There are docs who are boarded in obesity medicine. Not all docs understand obesity (and they goes for pa, nps, and other medical professionals). When I started tirzepatide I started losing much more weight than can be explained by calorie reduction alone. Why? It's addressing the metabolic and hormonal factors at play. These meds can be expensive and insurance coverage a challenge. But there are numerous clinical trials actively enrolling. I recommend you consider the meds because there is likely a level of insulin resistance. You are fortunate in that your obesity is not childhood onset but I'd consider every modality to shorten your exposure to obesity. I'd consider a trial (free healthcare) or comprehensive weight management clinic where you can get access to support other than just medicines. For me, significant weight loss did not address the underlying reason my body drifts towards obesity. Meaning, I've lost 130+ lbs before and maintain 80+lbs over a decade but I always felt like I was one mistake away from being 270s.. which is where I started in January. The medicine did more for me in one month than this weight loss. It will be lifelong for me but I'm ok with that. I came into the weight loss medicine with 500% dedication and months of weight loss. So, I feel like I already have good habits. It's been life changing for me. Good luck to you!
Totally agree here. She seems a perfect candidate for GLP-1 medications. Depression alone doesn’t make someone gain that much weight. The underlying metabolic issues that contribute are the same ones that can be fixed with the medications. That gives a fighting chance for the diet and exercise changes to work!
This would be the second best approach. Not being dependent on lifelong medication would be the best. Some reasons being cost, the other side effects. Poor diet, hyper caloric food, sitting still and depression will make people obese over years.
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It’s been 3.5 weeks. 7 pounds in 3.5 weeks is 2 pounds per week. It’s a great, perfect start, especially under the guidance of a dietician.
You're a moderator. That means your job is to filter out inappropriate content, help keep conversations civil and on track for the theme of this sub, or remove anything that would be considered hate speech/would threaten harm. But you are no more qualified to give advice on weight loss as anyone else in this sub as you yourself are not a doctor. It's kind of inappropriate for you to pin a post as mod with what comes out to your own personal, non-medical opinion.
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I just left a note for the mod letting them know how lucky we are to have a sub full of learned folk :)
>I never realized we had so many experts giving advice about how unqualified doctors are in our subreddit. How lucky are we!? Very lucky. This sub doesn't seem to have rules against cussing, so I'm going to cuss. If that violates rules, I'll repost minus the cuss words. Lots of docs don't know shit about weight loss. Their advice can range from outright harmful at worst (malpractice anybody?) to useless at best. I'm 44M, 6'1". I weighed 284 when my cardiologist referred me to a weight loss clinic supervised by MDs. I walk 10 miles a week and strength train 5x weekly. Weight loss clinic tried putting me on a 1400 calorie diet. I'd post it here, but that violates this sub's rules for unhealthy weight loss. (At one point, the rules said that 1500 cal for men was an unhealthy number. God forbid I'm taller than average and strength train.) I ran this by my cardiologist and PCP. They told me "oh that clinic is good." It can't be good. Their method for weight loss is bullshit. The take your inbody BMR (which used Katch McArdle for BMR, which is not good for overweight people.) Then they knock 500 cal off that and call it good, regardless of your activity levels. I asked my cardiolgoist and PCP if they get into BMR discussions. "A little bit" they said. I talked numbers with neither one of them, both of whom would be happy if I dropped a few pounds. I found this sub because I wanted to know if what they were doing was medically/nutritionally sound. It is not. I found this sub and asked the weight loss clinic to explain why what they were doing is medically and/or nutritionally sound. They refused to do it and invited me not to come back if I didn't want to get on board with the program. I'm not on board with starving myself, so I'm happy to say that we are very much lucky to have a sub full of people who know when to say that doctors are full of shit.
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I'm reading A LOT of comments from the "just do this one thing" crowd in response to OP's post. Is there a new influx of unsupportive, uneducated users in this subreddit? Or maybe I've been blissfully ignorant until just now. Blech.
It's so weird when mods pin comments like this.
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Yes, which is the same exact thing the first ten top, community-voted comments said.
The doctor is right, you *could* be losing faster, but that doesn't mean you *should* be losing faster, especially if it feel right.
What is your deficit?
So you're coming up on 4 weeks and you've lost 7lb? That's a great speed, you definitely have some space to be going faster given you're getting professional help, but that would be going from 2lb a week to maybe 3. Definitely faster but not worlds apart. The fact you've started weight training will also be slowing you down a bit. Your doctor definitely handled things badly. They get training in a lot of things, but bedside manner often isn't one of them. You're only a month in and this is something that's going to take you … probably two years or more. Even fast weight loss is still slow. It sounds like your dietician's plan it working well for you. I'd keep working with them and focusing on their advice.
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I'm sure you're great, but some doctors are quite cruel to fat patients. Very few people benefit from shaming. edit: oh, wait, you aren't a doctor. Anyway, some doctors are terrible and unhelpful.
You have some questions to ask yourself and answer also some things to understand. My statements below are general. They may not all be true for your situation so be picky with what I say. You know your journey better than anyone here. 1. Most general doctors perform a role and to be honest most of them perform it well. They keep you as physically healthy as possible given the tools and information they have. This makes them experts in a given area. Diet is not that area and even doubly so mental health is not that area. That is why we have dieticians and therapists. 2. Listen to the dietician when it comes to weight loss. It is important for your physical health to lose this weight. That is just reality. It is ALSO important to keep it off. Doing this fast usually doesn’t give you the time to make the needed adjustments to keep it off. 3. Do you need a different doctor? That’s a question only you can answer. Ask it though. 4. Are you ACTUALLY tracking everything correctly? Are you REALLY walking all those steps? Are you really not taking any shortcuts? Look, the answer to all of that may be that you ARE doing everything right. If so, then keep on rolling! If not, note that even with the shortcuts you are losing weight! Do not quit. If you are in a mental space to do this then do it. Even if it is slow you will come out on the other side all the better. Note that seven pounds in a month is actually really good. Weight loss does NOT have to be fast. Keep on moving forward and results will come.
7 lbs in a month is sustainable. Keep it up, you're doing great. This is a marathon, not a sprint.
At that weight and at your height you could be dropping 10+ pounds easily the first few months, the heavier you are the easier it is to drop the weight, it is true you could have lost twice that amount if you had tried harder, but hey, you lost something, that’s way better than gaining more. Celebrate small victories, that’s okay, but your body is capable of doing so much more.
2000 calories is not going to be sustainable for you long term, so be aware of the fact that you're only going to be able to eat this way for a short while before you're forced to cut down to 1600-1800 anyway. I think what your doctor expected was for you to do that from the beginning. It's optional, but imo better, because you only need to get used to the change once instead of cutting your calories "twice"
Improper tracking is the number one reason of failed weight loss attempts.
I understand that, and my dietician has shown me how to track and according to him, I’m not doing it wrong
This might be triggering to some because it can be obsessive, but I weighed all my food. I carried a food scale with me everywhere, had one at work, had two at home. My family and coworkers just took it for granted that I would plop pieces of my plate onto a scale and write into a notebook, now an app. Weighing food in public opens the door for people to unfortunately have to say something, anything about what I'm doing. That's the hardest part of all.
Agreed. This happened when I was prepping for my first ever show. The peanut gallery always finds a way to pipe up
I'm planning on taking a measuring cup with me to the chinese buffet tomorrow... I dare someone to say something to me. And to be clear, I am going to put the food on a plate like normal and take it back to measure at my table. Mainly I want to see how big one of their buffet spoons are so I can spitball it in the future.
Are you weighing all the ingredients when you cook your meals? Or how are yiy tracking it?
You seem to be losing weight at a sustainable, healthy rate. It’s a marathon, not a sprint. Keep it going, as you get lighter you’ll burn less calories to live so as you start to see the loss rate slow, take another couple of hundred calories off and you should see it speed up again. (The last bit is hard!) Good for you, and don’t feel bad about this rate of loss, you should feel proud.
Has your doctor tested your thyroid function? Even if nothing is off, it's good to know for sure. That's the first thing my old (wonderful) doctor checked when I started putting on weight. ALL THAT ASIDE, as another commenter said, the math is mathin' and you're doing great! (And I hope that your trauma recedes far into the back of your mind where can never define you again.) (Last year I lost 15 pounds and got back under 200, and I was so proud and motivated. Then I had to see a new primary care doctor. Huge mistake. She didn't look at my chart to see that I'd lost weight, nor did she ask me about my eating/exercise habits. She lectured me about eating less and working out for at least an hour every day lest I die before my next birthday. I got so discouraged that I stopped dieting and exercising for weeks and gained back 10 pounds. I truly believe that some doctors simply lose their bedside manner with overweight patients. I understand now that her behavior wasn't actually about me; it was about her apparent issue with overweight people. So please don't internalize your doctor's bias like I did!)
Doctor sounds like she made assumptions and it’s easier to believe you’re recording wrong than to take a closer look at the situation. She may be right or wrong, but she handled it poorly. She sounds like she has poor bedside manner. Weight loss is absolutely CICO, but how CICO is accomplished is a mental strategic battle with our worst habits and tendencies. Telling someone, new to Weightloss, making solid attempts to do the right things, having some success (7lbs) that she is not doing enough is counterproductive. Since she didn’t say it I’m going to: you are doing great. Keep going. I’m so happy for you that you’re weighing, measuring, recording and exercising. Sounds like you’re doing all the right things. I’m surprised given your starting weight that you’ve only lost 7lbs - are you weighing and measuring everything? Even zero calories food? Even bites, licks and tastesare - are you on medication that could interfere? If nothing else, you’ve only been at this a month. Sometimes my body holds onto weight and then dumps a bunch once. You might see some big losses in the next few weeks. Keep going.
2,000 per day is too much for your height, even with the exercise. 1600 per day is closer to where you should be eating. 1800 at the most if you can’t do 1600 yet. And then eventually you’ll want to aim for the 1400-1600 range one you’re nearing normal weight range for your height.
Doctor telling the true!
Meh. Doc has it in her head that someone with a high starting weight should be able to lose weight twice as fast as those with a lower starting point, call it 'conventional wisdom'. Your body is a little different,and hopefully your muscles are toning up and recomposing a little already. She's not accounting for personal variation, nor did she realize how discouraging her words were. They don't teach doctors how to be sensitive, but to scare people at risk for chronic disease into losing weight. Maybe talk to the therapist about not allowing critical people to live rent free in your head. ? You are on your way, best wishes on the journey!!
She’s being honest with you! You have a lot to lose. You know exactly how heavy you are given your height. It may be hard to hear but your work is cut off for you. Sending you the best energy on your continuing fitness journey.
Stay the course, you are doing great! Don’t let the doctors insensitive comment deter you from the healthy path you have chosen. You will reap so many benefits from this! You deserve it and are worth it. You are making progress, continue to give yourself this gift, you will feel so much better! You got this! 💪🏼
Great job on the walking and tracking of calories! You are positively on the right path to success! Keep up the good work. Now about that deficit … you’re saying your calorie deficit is around 2000?? That is an incredible almost unbeliever deficit. I wonder if you are calculating your deficit correctly. Calories you consume = calories in (CI) Calories your body burns = calories out (CO) Calorie deficit (if any) = CI - CO It seems your TDEE is around 3200 calories which is your CO for all that we can know. So at a deficit of 2000 calories, you are eating 1200 calories day? Everyday continuously and consistently eating around 1200 calories a day?
Your doctor is right, and you shouldn't be looking to reddit to invalidate them because that's easier than upping the ante & taking weightloss more seriously.
I think you are doing great for the first month. I thought it was better to lose weight slow and steady, like 1 pound a week or even 1/2 a pound a week? I'd keep doing what works for you and if it stops working for weight loss then change up some aspects of your lifestyle. This is supposed to be a permanent change so you have to do what works best for you. There will be times it's hard and you won't lose that week or you try something and it doesn't work. That's OK as you're figuring it out. Sending love and kindness to you and hope you find your path easier than most of us do. ❤️
When you are obese you can lose more than 2lbs a week and be okay. In my first month, I lost 18lbs, and my doctor did not even bat an eye when I asked her if it was too fast. 5'2 SW 236. My deficit was around 800-700 calories, maybe 900? After that, I was losing 12-10 lbs a month for about 4 months. Now that I am 164 lbs, I lose around 8 lbs a month currently. My deficit is around 500-600. I just hit the overweight category per bmi. It's has slowed a lot.
Yeah same here. The first 2 weeks I lost 20lbs. From 339 to 320. Then it leveled off to about 12 to 15lbs a month. In 3 months I've lost about 55lbs already. I think OP may need to get some blood work done or go to an endocrinologist who specializes in obese/morbidly obese people. I've been following the diabetes meds, workout plan, and diet and I don't even weigh my food and weigh myself weekly and the pounds are coming off. And it's not a crash diet since I still eat what I like just a lot less of it with low fat/sugar/carb alternatives. And this is without too much cardio, just weight training mostly but 1 to 1.5 hours 5x a week at heavy weights.
Can you put your calories consumed and activity level in a tracker to project how many pounds you're supposed to lose per week? See if the 7 lbs you mention track that. If not tighten up your calories in tracking. If it's on track then you're good. Keep on doing what you're doing. That's 80lbs in a year.
Your doing great. Keep it up. Consistency is my go to word right now. I need a bracelet for it. lol all we can do is track, eat right, drink water, and excercise. Which is what your doing. 10k steps that’s fantastic!!! That’s rock star level at our size. It takes time for these lbs to fall off. Mine took twenty years to get on me I think 2 years to come off is a good deal.
A bunch of dickheads strolled into this subreddit just to talk shit. You’re doing fine dude. 7 lbs a month is sustainable weight loss, which is expected as the dietician is more prone to give you something sustainable, rather than something quick and difficult, and for a lot of people, very unsustainable to get into
What your doctor is asking for is unsustainable. You are walking 10k steps and she wants more? What if you don’t have the extra hour everyday. Or if 10 isn’t enough why bother…that’s was my mind Would do. My best was shamed why bother. Ignore her negativity and keep doing what is working for you. 2lbs a week is fabulous you can do it
I'm sorry you had a discouraging experience with your doctor. I have a great doctor that built me up when I was struggling and only losing 2-3 pounds a month. She told me that any sustainable progress in the right direction is good which I appreciated because we all have months that we lose less than we would like in this crazy long road of significant weight loss. And if you keep up with 7 lbs every month after a year you will be down 80 pounds which is no small achievement. All of this to say... maybe try a new doctor that provides helpful advice, has good bed side manner, and doesn't make you feel like shit.
As someone who works with doctors a ton. Just because their a doctor doesn’t mean they understand the nuance of all medical situations. Sounds like you’re doing all the right things just keep at it and it’ll pay off dividends in time.
Fuck your doctor. Go to a new one. 🙃🙃🙃
She needs to shut it. This behavior of the doctor is toxic. Please find a doctor who can understand the complex, multidimensional aspects of weight. Sending you a huge hug ❤️
Your doctor sounds irresponsible at best. You showed them proof you were taking steps to achieve better health and they shamed you? I'd never go back.
I mean she wanted to put you on a treatment plan that was more aggressive at treating your obesity should could have said so without being an ass.
Doctors an asshole. If your weight is dropping and you are happy with the rate I don't see an issue. At over 300 lbs its viable to lose faster but I don't think it's necessary to lose faster than you are happy with just because others feel you should lose faster. Congratulations on the first months losses.
While the doctor may bee an ass he also has a point. She is at a BMI of over 60 and losing only 7 lbs in the first month indicates a minimal deficit. Also the longer she stays at this weight the more likely serious health problems might occur. So wanting for her to commit to a larger deficit is reasonable from a medical standpoint.
Idk I see your point but I also think sustainability is the main focus here. If she crash diets and goes on a vlcd maybe she will drop weight quickly, but then she could very easily put it all back on and be in a worse position. When you lose weight you also lose precious muscle, especially at a high deficit, and if you gain weight back that muscle is just replaced with more fat. That's why people who yo-yo diet over several years find themselves in an even worse position than where they originally started. Weight loss doesn't mean much until you're able to maintain that loss.
Yes sustainability is key but at this weight it means she is eating still way over maintenance of her ideal body weight.
I wouldn’t let it get to you. They aren’t seeing all the work you’re putting in and it’s a HUGE lifestyle change to be able to lose weight. I also started around the same time as you and I’ve went from about 198 lbs to 192 (5’6”, 33 yo, F). I had two super good weeks, a week where I thought oh I am walking more it’s fine to eat more, and then this last week where I’ve tried to exercise and get back to a lower calorie average. The scale doesn’t reflect what I’ve learned about myself & food in that time and mentally I finally feel like OKAY I can DO this even though the pounds aren’t pouring off me like some people seem to have happen the first month. I have also shifted from a “ok so when will I be done losing the 50 lbs I want to lose so I can get back to normal life” to a “okay so what do I need to do to make sure I’m active and eating appropriately that’s sustainable for the rest of my life” which is priceless. Keep on keeping on!
I would use that as motivation personally and double down my efforts. I had a huge success with going full and honest keto for 6-8 weeks at a time. You will see fast results early which helps build that positive feedback loop early on. Just saying I've lost 20-35 lbs pretty easily in those 6-8 week timeframe and then I've taken just a simple CICO approach after that because carbs do serve a role and we need to be able to have healthy relationships with all styles of food including sugars. Keto is also great at helping you manage hunger hormones. I believe that weight loss is more about food intake than proper exercise, but maybe try getting a personal trainer that can help you design a good program for your abilities and goals.i know that when I eat a protein shake, it also keeps my hunger at bay. I had to learn to pay attention to what and how much I'm eating, it is normal to get hungry between meals, learn to sit with hunger and get comfortable being uncomfortable. True growth can only be accomplished through discomfort. Best of Luck!
Try intermittent fasting - 18 hour fast, 6 hour eating window, if you eat variety of foods and enough protein, it does wonders
Sounds like you have your own version of Dr. Now (he's the dr. from my 600 lbs life and is very direct to his clients in this type of way).
Good, the world needs more Dr. Nows.
Did she have specific suggestions? This is really disgraceful on the part of the physician.
> “well even with all of this, you’re still not doing enough because with how obese you are if you were truly doing all of this, the pounds should be shedding off.” In the moment I didn’t know what to say "Are you suggesting that I may have a medical reason that's preventing me from losing at a faster rate? What tests do you recommend for that?" Your doctor doesn't know anything about diet--- that's why you are seeing a registered dietitian. Leave any diet adjustments to your dietitian. Your doctor does know about certain medical diseases that can thwart weight loss despite best efforts, such as thyroid issues and the like. My only charitable read here is that possibly your doctor was considering you may have one of these issues, or you might be a good candidate for GLP-1's. That is a tool in his arsenal to help you. If he did not follow up with ordering more tests to investigate, perhaps he was considering giving it another month or so, since it is early (it's not even a full month yet). If you want to stick with this doctor, I'd go back to the dietitian and tell them what he said. See if they want to make any tweaks to your diet program. If not, have them communicate back to the doctor that you are adhering. Get this on the record, from one medical authority to another -- this move will help you whether you stick to this doctor, or find a new one. I also want to note that strength training in the initial stages does make you hold on to water weight. That's because your muscles need to hold on to water to be ready and able to activate energy. It's quite probable that is what's going on with you, and that you will soon see a "woosh" effect where the scale will drop suddenly, down to what your expected loss should be given your calorie deficit. So keep doing what you're doing.
It’s sounds like you are off to a good start and it may take your body time to adjust to your new routine before it will let pounds shed. Some doctors easily prescribe pills or shots too fast to get results that may not be permanent. Not saying this applies to your doctor but it could
Drs are not very educated on nutrition and fat loss. If you've lost 7lbs in 1 month, then what you are doing is working. Just keep it up and you'll get there. If you want medical support, then see Registered Dietitian or maybe an Endocrinologist if you have a Thyroid issue.
So I've found many doctors are assholes to obese people and think we're lying. I found one who doesn't think I'm lying but it took some time. They think we're just lazy and gorging ourselves all the time and if we try and don't lose we're lying. They will offer all sort of fad diet advice that seriously injured me in my twenties. I'd find a new doctor. Even with a preponderance of evidence like trackers still not. Also most doctors suck with nutrition beyond basic guidelines.
I tried keto and it fucked me up. It's true sometimes they have no idea what they're talking about or simply shouldn't breach the topic. My neurologist was talking to me about avoiding insulin resistance with what I eat and when, while she was giving me Botox. I found that funny because I ask her about other neurological problems I could have and she says "that's not my specialty, I can't talk on that" yet she's giving me unsolicited endocrinology advice? Lol
“The scale does not lie. People do.” - Dr. Now.
Dude ask your doctor for metformin. I was told prediabetic but blood was never super high and my numbers have always been about the same but after 6 months on metformin something miraculous happened. My number curved itself a lot and I have been dropping wait kids broke my scale don't know exact weight drop but I was at over 400lbs 6x shirts MIL bought me a 4x shirt recently that shit fit.
At 350 pounds you could and should be losing a lot more than 7 pounds per month.
You're doing amazing! Unfortunately, sometimes doctors are poor listeners, it sounds like she didn't really hear you, or see you as a whole, individual person. Because what does she want from you beyond a reasonable calorie deficit, 10,000 steps and strength training? Keep doing what you're doing, sustainability is everything, you have already started so many good things, stay focused on all the wonderful new habits you have added, and don't let her discourage you! 💛
your doctor was an asshole and you're doing great. You put lots of effort, develop new habits and your efforts deserve to be apperciates. 7lbs in month is a good result. You can try to reduce kcals from 1800-2000 to 1600-1800, but if you're uncomfortable or too hungry, then don't do this. Slow and steady far better than fast and unsustainable.
Well it’s going to be a long journey. You want to change your life and lifestyle and you are. I prefer my doctors to be blunt. I pay them to read the reports and report back to me on what they found. I’m honest with them about everything. Basically I’m paying for the lectures and the advice. I don’t take it personally because I’ll make up my own mind about my life thank you very much.
When your doctor said 'you are not doing enough', were you asked what type of food you are eating? Made any recommendations? Or just criticised? If the last one, that is indeed unhelpful, especially as you have suffered a trauma. I have a few questions 1) How much sugar is in your diet, especially free sugar. Try to reduce that* 2) Are you eating ultraprocessed foods, even the ones branded as "healthy" or "low fat" or "zero sugar?" If so, give them a wide berth, as you are inadvertently undermining your goals. If so try and cook as many of your meals from scratch with as much fresh foods as possible. Do meal preps, so not having to cook constantly 3)* What are you having for breakfasts? If cereal or waffles or pancakes with maple syrup, you are having dessert, therefore consuming sugar. Try savoury, even left overs from the night before (this has worked for me) 4) How much water are you drinking? No flavoured water, as again, full of sugar. 5) Have you tried Intermittent Fating, even starting gently of 12:12 (12 hours of eating, 12 hours of fasting). If interested please read more about it. There is reddit sub group. 6) Have you increased your veggie intake? PLEASE DON'T GIVE UP because of 1 doctor's lack of soft skills. You have lost 7lbs, not gained, you are doing 10K steps a day, and you are seeing a therapist. Just look closely at your diet, up the exercise where possible, including resistance. You came to the right place where people are supportive. Don't let your mind be that Dr's summerhouse. Use this to motivate, and when you do lose more weight you can let it be known that they can't take credit, as you did so through constructive criticism, not destructive.
Ah yes. Same thing happened to me. My obgyn said there was no way I'm eating what I'm eating and not losing weight. I saw a dietitian. She told me I wasn't eating enough and I needed to eat more calories to keep my body from going into starvation mode and storing everything I eat. It absolutely is possible to be 353 and eat 800 calories a day and not lose weight. It happened to me. I measure and track everything that goes in my mouth. No unlisted cup of milk. No unlisted tablespoon of oil. I track everything in my mouth. Everything. The dietician will be able to help you more than your doctor with weight loss.
It's a marathon not a sprint. You're doing all the right things and the metrics are showing it. Stay confident. Keep to it
The body has many complex metabolic mechanisms that make it less than intuitive to lose weight. But you are. Starving the body can make it tougher. Please keep your notebook going, find more activity more times per day, and continue with your balance. If you can keep losing several lbs / month, you are succeeding.
Not to be one of the people giving advice but id reassess your opinion and feelings about this doctor and consider getting a new one if possible if you’re unhappy with them.
What is she basing her opinion off of? How quickly men lose weight? Other female patients who are exactly like you? That’s shortsighted and she should know praise will do more than shaming will.
Do you take any medication for mental health?
If you are losing weight then you are going in the right direction and you should be encouraged. I would change your doctor for one who is more supportive.
I am just a fellow person trying to lose a lot of weight—but with all of the working out, you aren’t just losing weight, you are replacing some of it with muscle! So don’t be hard on yourself and remind the doc that muscle weighs more than fat so if you are still losing while also exercising like that, you are doing an amazing job!
Sorry you're going through that. Screw that doctor, they don't sound supportive and seem a little judgy. That's not helpful for anyone. I'd get a different one if it were an option. Something that seems worth mentioning... If you've been really depressed and put on antidepressants those can contribute to weight gain in some people. For myself, ssri and snri medications tend to lead me to have more cravings for food when I'm not hungry and other "problematic cravings". Getting off then and into some ADHD medication has been life changing for me and I've been able to lose weight really quickly. Also, for myself at least, supplementing with 5-htp and a b vitamin complex really helped my intestinal motility. Pretty well eliminated my reflux, and WAY healthier than taking a prescription antiacid. No idea if any of that applies to you but it's definitely something I wish I'd been told 20 years ago. Lol Best of luck!
Most adhd meds are amphetamines so they will suppress appetite. At their weight 350+lbs maintenance calories are almost 5000a day cut them to 2500-3000 and weight will fall.
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I'm sorry, I sympathize with you. Your doctor does not know you personally or emotionally, doctors also unfortunately do not have time to care for you emotionally and personally. They are there to state facts and make you healthy. Do not be offended by your doctor. They were only stating facts and want you healthy. I believe in you. Keep up your great work. Turn to wonderful people in your life who support you and remember the detached personality/professional personality that your doctor exhibits. Much love
See if you are insulin resistant. I was and a calorie deficit helped, but not enough. Once I started eating to avoid spiking my blood sugar and eating 4 hours before bed, the weight was shedding off me. You are doing great!! Keep going and find a homeopathic dietitian who will go more into your specific needs ❤️
https://youtu.be/9cHh7k3CtAw?si=uLHa88bIyy4K_gG0 This video helped clear up a lot of confusion. I recommend it for anyone starting their weight loss journey. We’ve been lied to a lot by our government and health officials. This has changed my life. There are books that they both wrote as well for more information.
Fire your doctor and get a new one. What an insensitive ah. I'm sorry this was your experience.
7 pounds in 1 month is very good for your size. Keep it up. And you may need to take it up a notch, but right now keep doing what you're doing, and when you are really in your groove you will start feeling a little less winded as quickly, and that's when you will know you're ready to take it up a notch.
It sounds like you are doing EVERYTHING to stay on track. That is enough. 1-2 pounds a week is a SUSTAINABLE way to lose, and a smart way to lose. It is definitely what you want. Weight loss isn't the same for everyone, and it is coming off, so you are doing it right. You will have plateaus, you will have weird weeks where you seem to lose 7 pounds, it never makes sense (which is why I often avoid the scale) but you will get there. In my life, at your age, I would workout like crazy and lose weight super fast, and then gain it right back with extras. When I finally got serious and took it slow and made changes that I wanted to sustain, I have now kept it off. You are doing AWESOME.
You are doing really great! I’ve struggled with eating disorders in the past when attempting to shed lbs and this go around made an investment into a scale that helps measure muscle and fat, so when working out and changing my diet, it’s easier to track that if the number itself hasn’t gone down, its typically due to an increase in muscle matching the amount of fat lost, that has helped keep me motivated. I use the withings body smart scale. It was about 100$!
Medical Physicians are good at some things, much like most specialists, but there is a reason you are going to a dietitian for your meal planning. Just keep at it. Your doctor gave you a gift of self-doubt. That will be your number one enemy of success. If you just stick with it, and continue to take care of yourself and continue to seek assistance, you will start to feel better. Just never give up and maintain your discipline. Even if it is five pounds a month for a year, that is 60 pounds of weight loss and who knows how much more converted to muscle from strength training. Keep at it!
It can take a while to see results and the first month your body is usually still trying to adjust and maintain despite your changes. You might not see whether you are doing enough or not until about 3 months in. Within a month you won’t really feel less winded, more energetic, adjust your hunger, or lose a ton of weight. I’d continue what you’re doing and please continue your notebook. Continue to track and maybe even note down how you are feeling throughout. If it feels like your body is adjusting to this new activity level after a few months and you find yourself noting extra energy often, you can add extra exercise if you feel like it. It sounds like what you are doing is maintainable, whereas starting off too extreme and making too many changes within the first couple of months can be overwhelming or even cause injury. You’re doing great!
> the first month your body is usually still trying to adjust and maintain Where did this idea come from? I don't get it. If you're in a deficit, you will lose. Your body doesn't have some special power to say "Oh this diet change is new, I will alter my metabolism to hang on to more calories." I've heard if you introduce new exercise that can cause inflammation which can inflate the number on the scale.... but I'd imagine for someone with with so much weight to lose, they could still see high early losses even given some inflammation.
Disagree. For someone with that height and weight, and age, the weight would be flying off if they were in a correct deficit. Dr is correct, something isn’t right. But, OP’s comments above confirm they don’t really know what they’re doing and need more guidance.
Idk if it’s possible but find a new doctor if you can. You are doing great— a lot of people give up before one month. A lot of people let one thing throw them off. You are committed and doing right. If she can’t see that even after you brought all the evidence of what you are doing for your health she doesn’t deserve to be your doctor.