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Suggestions on what I can do differently?


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I know I complain about this a lot (or at least it feels like I do) so sorry in advance.

 

So about 3 years ago I got really motivated and determined to lose weight. I started off about 270lbs. I'm 5'9" and female. The first part of the year, I kept an eye on calories, but didn't cut enough and didn't work out much, so I didn't lose much weight. The second part of the year, I cut my calories a lot more, exercised daily, did not eat back the calories I burned through exercise, and lost 40 pounds. I was eating "healthy SAD" so low fat, lots of carbs, grains, etc.

 

Beginning of the second year I discovered paleo and jumped in head first. I didn't know that much, so my died wasn't as clean as it could have been, but I was very strict about no grains, or legumes. I kept dairy because I've always tolerated it well, though. I lost 15 pounds in 2 months while still exercising but no longer counting calories at all.

 

Then I got really sick for about a month with a chicken pox-like virus. My knees swelled up and I couldn't walk, so I was dependant on my family to get food for me, so I wasn't in control of what I ate anymore, so it tended to be fast food. I was given prednisone to help with the swelling and it left me with debilitating anxiety for several months and heart palpitations that persist to this day (I've been checked out by a cardiologist, the palpitations are PVC, totally harmless, just annoying. Magnesium and potassium supplements help a lot). Needless to say, I was unable to exercise for a while, and even after I could walk again, I was afraid to work out due to the palpitations. The anxiety combined with the palpitations made me afraid to fall asleep because I thought my heart would stop in the middle of the night, and my heart behaved oddly when I did try to exercise. It would beat really hard, but slowly, instead of faster and less hard, which freaked me out more. After I recovered mostly from the virus, I was plunged into my clinicals for school where I was basically working 40 hours a week (for free) and going to school at the same time.

 

So I didn't really exercise for over a year until I got a job and insurance and could get checked out by a cardiologist. On the bright side, I started focusing on food more even if I wasn't exercising and did a whole30. I lost a bit more weight doing that and started to dial in my diet more, learning more about paleo, etc.

 

My lowest weight was 201.5lbs. Last year, I started noticing that my psoriasis was getting worse and worse, so I started investigating the autoimmune protocol. Last January I started the year with a whole30, then immediately started AIP. After 3 months of AIP, my psoriasis was still getting worse, at an alarming rate, so I started taking LDN, which is amazing, and am finally getting the psoriasis under control. I've found several food sensitivities thanks to reintroductions on AIP (mustard, almonds, macadamia nuts, tomatoes, potatoes). I also gained back a little weight. I'm now at 215lbs.

 

So here's where I am now. I eat a modified paleo/AIP diet, but I will admit I let too many treats, carbs, and sugar slip into my diet. I also tend to snack a lot on weekends and don't have a structured eating plan on weekends. I'm exercising more doing the C25K app to get ready for a 5k color run in June, and also doing some bodyweight stuff (lunges, squats, pushups, situps, kettlebell swings) I also have the Turbofire workout video set, but have kind of stopped doing those in favor of the app and bodyweight stuff.

 

I have tried counting calories, but I always go over my calories for the day because exercising makes me HUNGRY. I typically eat 2200-2300 calories a day (My job requires me to be on my feet all day, so keep that in mind too) which is keeping me right about even at 215lbs. I fluctuate a few pounds, but it's usually right about there. I want to lose about 40 pounds.

 

I also hate counting calories because A: it's a huge time sink when I cook every bite of food I put in my mouth myself and B: It tends to be kind of inaccurate, especially when I cook everything myself and can't just scan a barcode.

 

So, other than stripping the rest of the sugar/excess carbs from my diet (which are actually pretty small compared to most people. I literally eat less than 70g sugar a day (mostly from fruit), and less than 150g carbs a day.) does anyone have any suggestions on things I can tweak to start losing weight again?

 

Thanks.

"When I can no more stir my soul to move, and life is but the ashes of a fire; When I can but remember that my heart once used to live and love, long and aspire - O be thou then the first, the one thou art; Be thou the calling before all answering love, and in me wake hope, fear, boundless desire." - George MacDonald

 

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First off, you're still down 55lbs which is a staggering amount, especially considering all the crap life has thrown your way in the last couple of years.

 

Secondly, there really is only one answer to weight loss and about one million approaches to get it done: A caloric deficit. You say that you have tried counting, but always go over - this means that the process is working, but your compliance/methods of achieving a caloric deficit aren't and it's about figuring out why and how to fix it.

 

The first thing that comes to mind is creating more satiety in your diet. Around 100-150g carbs per day isn't a lot, but it's also occupying space in your diet that could be filled with food that keeps you full better/longer and doesn't create as strong of an insuline response which likely is what ends up making you hungry again. In terms of satiety, protein ranks first, fat second and carbs come last, while fiber is its own thing and usually helps keep you full for little calories in return. Fat has the issue that it's a lot more calorically dense than the other two. Also, protein has the highest TEF (thermic effect of food) which means that your body has to expend the most energy, processing/digesting it. What this means is that actually, 1g of protein, while being 4 calories, comes down to only about 3.2 calories if all is said and done. While this doesn't sound like much, using an example of 150g protein per day, your body burns a whopping 120 calories of the 600 calories those 150g have, just digesting them.

 

So with that in mind, I think it's sensible to conclude that your diet could use more lean meat, more dairy that is low in calories or has a good calorie per protein ratio (cottage cheese, greek yoghurt, low fat mozarella/feta/cream cheese) and more vegetables. The latter, in the right amounts, will also provide you with a good bit of carbs, but your body won't have as crass a reaction and have you feel hungry as quickly. 300g of carrots + 350g of Zucchini have about as many carbs as one large apple, but due to all the fiber and their less pronounced effect on blood glucose, they'll keep you full for much longer which will easily offset the difference in calories, where the veggies come out at about 150 and the apple at about 100. This also illustrates, how "expensive" carbs are in regards to meal plan budgeting. I'm currently eating between 1100 and 1500 calories per day and I'd love to eat a Snickers, but if you put a Snickers bar and 2.2lbs of carrots next to eachother (basically identical calories), I know which one I'll eat, just for the sake of sanity. About the same goes for fat. You can put two tablespoons of olive oil next to the Snickers and the carrots, because it, too has about 240-250 calories and while fats are important to a degree (say, 50g/day), it's easy to overeat fats, especially on a primal or similar diet. Yes, fat is quite satiating, but from a budgeting perspective it's also really expensive.

 

Lastly, your A and B I disagree with. Cooking everything yourself is the easiest and most precise way to track, because you're in full control. You only need a digital kitchen scale (less than $20 on Amazon or similar places) and a good website or app with calorie data of food. Myfitnesspal is one, Fatsecret is another and there are probably dozens by now. And the time sink part is only true for the beginning. Once you've dialed in the process and have your dozen or so go to meals down, it won't take much time out of your day anymore. Also, if you really get behind this with effort, you're bound to see some progress in achieving your weight loss goal which should be absolutely worth it.

 

 

So, long story short, my tweaks would be: Get more protein and fiber in your diet and replace fats and carbs with it. Aim to achieve a 500cal deficit every day of the week except for one day, on this one day you will aim to achieve caloric maintenance and eat one "free" meal that can be whatever you like, as long as it doesn't bring you above maintenance calories. Try to be more meticulous with your calorie counting and more compliant when it comes to actually sticking to your deficit.

How about a glass of purgatory with a splash of heaven?

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I will keep it kinda short and just give some general thoughts. I will be happy to fill in extra detail if you desire.

 

First and foremost. You have done awesome. You have dropped a ton of weight. Better than what many people do. I have patients who have heart attacks that still can't seem to find the will to lose that much weight. So congrats!!

 

Next. Learn to accept yourself and be happy with who you are now and not have it depend on your body weight or certain look. Now I didnt read anything to make this actually be applicable but its a topic that seems to not be covered often. If you are saying things like "I will be happy once I lose x" or "I will be happy at this weight x" that means you are basing happiness off that particular thing. Best case scenario you won't be happy until then and the process up until then won't but fun. You will be unhappy with it all.  Learning to love the process will help compliance and overall enjoyment and build long term motivation and success.

 

Next try and build things to keep you in a calorie deficit and those things should make life easy.  Find foods that fill you up and allow you to eat a large volume with little calories. Try and eat 50g of carb from strawberries. I imagine you won't have room to crush a lot of other food especially if you are hitting a good amount of protein in your diet.  Lean sources of protein are great at filling you up. Green veggies. Have these at every meal if you can. Have some handy snacks that are crunchy and calorie poor. LIke carrots, apples are nice too.  Try other things like prepping your food in bulk so that you always have some ready to go meals. Pack gym clothes to have on hand to make sure workouts get done. Try intermittent fasting so you can eat larger meals and not worry about eating for portions of the day.

 

Ok it wasn't short but hopefully there are somethings to help there.

3rd Year Medical Student

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For me it's not just about calories, I also really care about the health aspect of foods. I tend to avoid anything that is artificially low in fat, particularly low fat dairy. If I do use dairy, it's always full fat, because grass-fed dairy fat is an excellent source of fat soluble vitamins that are difficult to find elsewhere. Same with egg yolks. I typically consume 45-55% (120-140g) of my daily calories from fat, about 25-30% (I usually fall short on this one and get 120-ish grams protein) in protein, and 15-25% in carbs - mostly from fruit and starchy veg, but a little is from home-made treats and sugar, which I need to eliminate. I think I need to reduce the carbs and increase protein a bit. It's unhealthy to be low carb AND low fat, because I wouldn't be getting enough calories then, and/or they'd all be coming from protein, which can strain the kidneys.

 

My meals usually look like this:

 

Breakfast:

2 slices of bacon, diced up and rendered, then I add about 2tbs. minced shallots and about 2-3 cups of a criciferous veggie mix from trader joes (brussels sprouts, kale, cabbage, broccoli) and wilt it down. Then I put it in a bowl and in the same pan I add a little butter and fry 3 eggs with runny yolks and lay them on top. Then I either have a couple slices of melon or a mug of coffee with some grass fed half and half (about 1/4c.) and a tablespoon of maple syrup. 

 

Lunch:

leftovers from dinner, always.

 

Dinner:

I vary dinners a lot. Tonight I roasted a chicken with lemon butter stuffed under the skin, with fennel, onions, lemon slices, and garlic all around it, then made a pan sauce with the drippings with some white wine and extra butter. In the pan sauce, I cooked some green beans to have on the side with the roasted fennel and onions. Normally I would have had a baked sweet potato too, but I haven't gone to the store yet. 

 

Tomorrow I'll use the leftover chicken breasts on a large dinner salad, reserving half for lunch the next day

 

Yesterday I made a lamb curry with beets and carrots pureed into the sauce with more carrots and peas mixed into the curry. 

 

I also frequently make grilled burgers, usually a 6-7oz. grass fed beef patty with lots of lettuce, bacon, guac, and sweet potato fries on the side.

 

I usually wake up hungry, I eat breakfast within an hour of waking up (6:30-7am), then my stomach is growling by lunch time at 12:30, then again at 5 when i get off work. Often times I need a snack when I get home while I cook dinner because I'm starting to get a headache. Then sometimes I'm getting hungry again by the time I'm getting ready for bed. I eat until I'm full, but not uncomfortable. I'm already spending over $100 a week on food for just myself, and that doesn't include the fact that I bought half a grass fed cow in november, so all my beef comes from that, plus I have a whole lamb in my freezer too. I feel like if I increase my protein, I'm going to be spending a lot more. Gah! It's just so frustrating. I eat enough to hold me until my next meal and not be starving, but that comes out to more calories than I should be eating to lose weight. I feel like if I reduce my calories I'll just be starving all the time.

 

As for it being difficult to count calories when I cook everything myself, the issue is that when I make something, I have to weigh or measure every item that goes into it, then go online and figure out the nutrition facts for every single item, then add it all up and divide by how many servings it made. The other issue is that I rarely measure when I cook. I know it means I have more control, but it also takes more time. Yes, I know MFP has a thing where you can input a recipe and it will calculate the calories, but I frequently just make stuff up, and like I said, i don't really measure, or I'll change recipes to suit my tastes.

"When I can no more stir my soul to move, and life is but the ashes of a fire; When I can but remember that my heart once used to live and love, long and aspire - O be thou then the first, the one thou art; Be thou the calling before all answering love, and in me wake hope, fear, boundless desire." - George MacDonald

 

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As has been said above, massive congratulations on your progress so far.

That said, you know what you have to do to lose weight so stop making excuses. There's no magical formula to make you lose weight; it's basically all different ways to get to a calorie deficit and stick to it.

I cook everything from scratch and still manage to track calories pretty accurately.

I know this won't be a popular suggestion with some people here, but fats are actually really easy to miscalculate if you're not weighing and measuring accurately and rely on them for 50% of your daily calories. Perhaps cut those back a little in favour of protein before hitting into the carbs.

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Phew..there's so much to unravel here.

 

First, you need to redefine "healthy". What really is healthy or clean has changed a dozen or so times in the past couple of decades ( see http://wannabebig.com/diet-and-nutrition/the-dirt-on-clean-eating/). In the end, what's healthy, is what keeps you fit, alive and helps you reach your goals. In your case, a good protein to calorie ratio is one of the healthiest things you could strive for right now and low fat dairy is one of the very best ways to achieve this. Grass-fed dairy may have vitamins, but so do many other foods and vitamin deficiencies are almost non-existant in the Western world if you believe the respective research instead of the pharma firms who want to sell you unnecessary bullshit multivitamins. Apropos bullshit, protein does not strain the kidneys. This is nonsense that is still taught in medschools to this day, but a healthy human being with normally functioning kidneys that drinks enough can easily have 200g of protein every day without any repercussions. It is only in people with pre-existing kidney or liver issues or a family histury of such, where a lower protein intake might be advisable. Other than that, more protein makes your kidneys work more - good! More calories burned (TEF) and they don't bore themselves to death, nothing bad about that.

 

Second, your current diet is very expensive. I eat a low in carb and fat/high in protein diet with lots of lean meat, veggies, fruit, eggs and low-fat dairy and am as healthy as can be and I spend maybe $30 a week. Switching some of the expensive meat out for dairy will actually save you money. Aside from the money, I really think that this excessive fat consumption does you more harm than good. It obviously leaves you hungry rather quickly, allows very poor food/calorie/portion control and while there certainly are health benefits to fats, I doubt that you'll get just them without any of the downsides at up to 55% of your diet consisting of fat. I also haven't read the words fish or seafood thus far, which would be a great source of omega 3s. I would go as far as to say that some of your health issues might even be due to your body not being entirely able to handle all that fat, but that's for you to find out.

 

One very key thing here that you said: "I feel like if I reduce my calories I'll just be starving all the time." That is the direct result of how you eat and nothing else. Up your protein a lot, replacing some of your your fat intake and take out some more fat/maybe some carbs to create a deficit and you'll be fine. I'm living off of 1100-1300cals on most days right now and rarely do I ever feel hungry.

 

Lastly, not measuring or making stuff up means that you never really have calorie counted. Yes, using a kitchen scale will be annoying at first, as will looking up values, but again, this ceases to be an issue after a bit and seriously, do you want to progress in this matter or do you not? This is not an impossible task, but a very vital one for your weight loss to be successful. Do you really want to forego it, just because it's a nuisance and takes some time? You spend oodles of money and time, buying and preparing food in a supposedly healthy way, yet the healthiest things cost you less/nothing and will bring you actual results. You decide which is more important and makes more sense.

How about a glass of purgatory with a splash of heaven?

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I totally agree that i need to increase protein and reduce fat, but ill never be low fat. I rarely reach my protein goals each day. This morning i tried having 4 eggs with breakfast, ill see how well that holds me till lunch. I could barely get the last couple bites down though. I also skipped the melon and coffee, so much less carbs.

I have counted calories before, back when i was a student and had a lot more time on my hands and ate a lot more processed stuff that came with nutrition lables. Now i have a full time job and a lot less time to be measuring every ingredient i put in a pan and then going and researching it's nutrition facts.

As for the money, i dont buy much meat. I buy a whole chicken every week for $6 to $8 that lasts for 2 days worth of meals, and then usually one or two other days worth of protein. Like i said, i have half a cow and a whole lamb in my freezer. I spend at least half my budget on vegetables alone. This week i bought $30 worth of veg at just trader joes. And i will eat it all, too. I menu plan for each week, so im only buying what i need. Also, i have a lot of food sensitivities. I have to but $6 a dozen pastured corn and soy free eggs because my psoriasis flairs if i dont. I react to wheat, nightshades, some nuts, soy, corn, mustard. So what i am able to eat without making my skin peel off and bleed is a little more limited than most.

Im going to try increasing protein and reducing carbs and fat a little bit and see what that does for me.

"When I can no more stir my soul to move, and life is but the ashes of a fire; When I can but remember that my heart once used to live and love, long and aspire - O be thou then the first, the one thou art; Be thou the calling before all answering love, and in me wake hope, fear, boundless desire." - George MacDonald

 

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Hi Vian,

 

Reading about your struggle with losing weight while eating primal really resonated with me.  I have had a similar experience, eating high fat, moderate carbs from fruits and starchy vegetables, and moderate protein and not losing weight.  I also felt hungry by the time each meal rolled around and found myself succumbing to snacks/treats.  I know how much they preach about the satiety eating high fat brings, but I honestly never felt it.  I wonder if you have to keep carbs really low to get that affect?  Or maybe it just isn't a one size fits all solution: high fat works wonders in terms of satiety for some people but not for others. 

 

For me, I think it comes down to the fact that I like eating big portions, and big portions of high fat foods are necessarily high calorie.  I've had a much easier time lately eating at a deficit by lowering fat a little and raising carbs and protein a little.  I've found that, given I play tennis 3+ time a week and bike to work (14 miles each way) 1-2 times a week, I need the energy boost that carbs so readily provide.  Plus, potatoes and sweet potatoes are very filling even if somewhat calorie dense (referring to baked/boiled, not fried).  You can still stick to primal foods, just shift your macros around a little.

 

Now, in order to shift your macros you need to be able to track them.  A lot has been said about the fact that tracking gets easier.  One thing that I find cuts down on my time a lot is batch cooking.  I don't have time to cook during the week, so I make big batches (12+ servings per recipe, since I'm usually cooking for 2).  I enter the food once, then it's super easy the rest of the week to just enter the same thing.  Sunday is a little time consuming because I have to look up the new things for the week, but the rest of the week it's very streamlined.  Hey, if you switch to a more batch-style of cooking, you can even make more time for yourself to workout on weekdays.

 

I apologize if this sounds very "this works for me, so just do what I do", because I know that fitness is not a one size fits all thing.  I'm just providing my experience so you have some ideas of different ways you can go at it.  Whatever you find that works for you is ultimately the right answer.

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I totally agree that i need to increase protein and reduce fat, but ill never be low fat. I rarely reach my protein goals each day. This morning i tried having 4 eggs with breakfast, ill see how well that holds me till lunch. I could barely get the last couple bites down though. I also skipped the melon and coffee, so much less carbs.

I have counted calories before, back when i was a student and had a lot more time on my hands and ate a lot more processed stuff that came with nutrition lables. Now i have a full time job and a lot less time to be measuring every ingredient i put in a pan and then going and researching it's nutrition facts.

As for the money, i dont buy much meat. I buy a whole chicken every week for $6 to $8 that lasts for 2 days worth of meals, and then usually one or two other days worth of protein. Like i said, i have half a cow and a whole lamb in my freezer. I spend at least half my budget on vegetables alone. This week i bought $30 worth of veg at just trader joes. And i will eat it all, too. I menu plan for each week, so im only buying what i need. Also, i have a lot of food sensitivities. I have to but $6 a dozen pastured corn and soy free eggs because my psoriasis flairs if i dont. I react to wheat, nightshades, some nuts, soy, corn, mustard. So what i am able to eat without making my skin peel off and bleed is a little more limited than most.

Im going to try increasing protein and reducing carbs and fat a little bit and see what that does for me.

Oh, I absolutely wouldn't recommend you go low-fat. It's just that you're currently eating low to medium carb, low to medium protein and high fat which just seems like a really unfortunate mix. High protein medium fat low carb should still suit you and your needs while helping you reach your goals much more easily.

 

And again, since you didn't really bring it up: Low fat dairy is the key to almost all of your problems. You tolerate dairy well so that's an awesome start with all your restrictions. It's dirt cheap, which is great and it perfectly fits the bill: Low to medium fat, high in protein and very satiating. I get the notion of "it's empty food" or "it's bad food" because it doesn't have many other nutrients aside from protein, but the issue here isn't the food, but your attitude towards it. A food being high in protein & low in calories makes it a supreme choice for you, similar to chicken breast, tuna or turkey.

 

Your last sentence is pretty much all that's needed for now. If it's not working or not well enough, adjust some more.

How about a glass of purgatory with a splash of heaven?

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I hate batch cooking. I hate eating leftovers that many times. I can manage having leftovers from dinner for lunch the next day, but beyond that and the thought makes me sick. Plus it doesnt taste good to me.

As for increasing carbs, i dont think that would work for me. I get a carb hangover when i binge on carbs, and by binge i mean eat a half cup of ice cream. I feel best when i keep my carbs under 75g a day, I'm just a sugar addict.

Finally, on the subject of dairy, while i seem to tolerate it well, and i love it so i tend to make excuses to eat it, i dont feel like its making me healthier. I feel like my progress on healing my psoriasis stalls. At the beginning of the year i did a whole30 with no dairy and no sugar. About 30% of my psoriasis healed up. Then i went back to dairy and sugar and it stopped healing and has stayed the same since. So im pretty sure im going to keep dairy limited to a "sometimes" food in the same category as sugar.

"When I can no more stir my soul to move, and life is but the ashes of a fire; When I can but remember that my heart once used to live and love, long and aspire - O be thou then the first, the one thou art; Be thou the calling before all answering love, and in me wake hope, fear, boundless desire." - George MacDonald

 

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I understand the desire to keep the psoriasis at bay as much as possible. I also think it would be really beneficial to find out, whether it's the sugar or the dairy or both that made it 30% worse again. You could even do another whole30 to kickstart this new go at some more weightloss, but do it with a focus on protein moreso than fat and afterwards, reintroduce dairy, but not sugar and see what's up.

How about a glass of purgatory with a splash of heaven?

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