That’s about 1500 – 1700 calories a day, with nearly everything in my apathy diet included.
I am remaining in the 170 – 173 pound spot. Obviously, this calorie range keeps me squarely in this weight range. (I have been here for a year and a half?)
I go from 170 to 175. I get excited to see 1-6-9, and then, poof, right back into 170’s. I have always shared (in my BBGC support group) that I believe in 10 – 12 calories per pound maintains my size.
Which also means, if I am EVER going to shake off this excess, I must drop back the calories OR ramp up my daily activity by at least 500 – 700 calories per day.
HUGE APATHETIC SIGH FILLED WITH TOAST. “BUT I DON’T WANNNNNNAAAAAA EAT LESS.” I have become way too comfortable with over-eating. I can eat me some 1700 calories with ease. I can polish off a bowl of Anycarbs! like nobodies business. Hand me Anycarbs! (…except cereal and milk, gag) and I’ll overeat it for you!
What made me realize this? One of my daughters decided to start looking at portions. She pulled out the measuring cups. And DOG KNOWS I AM A PROFESSIONAL MEASURER OF ALL THINGS NUTRITIVE and I can tell you how many calories are in all the things — but — do I bother measuring my own foods?
Nah. scoop scoop scoop
When I looked at her wee bowl of pasta and realized (for the millionth time) that 1/2 cup of pasta is only > this < much? And I have been serving myself with > this < much stomach + THIS MUCH + just because it’s there? Thud.
Last night while watching My 600 LB Life — I noted that Dr. Now puts all the patients on a 1200 calorie diet. It works. What I am doing, is not working. It’s maintaining my obesity. What does this mean for me? I am going to make a conscious effort to aim for 1200 calories. I know that my aiming for that I may or may not – but it’s not a huge deal. If I can hit it some days, I’ll make progress. My goal is 150 pounds, so a loss of 20 pounds. To do that, I’ll need to CUT THE CARBS back. I may need to cut out a meal or snack or three. Add shakes in? Maybe. I haven’t “dieted” in so very long it’s hard to even consider? I see lots of my online friends having great success with super low carb plans, some even KETO, but, I need something that is very flexible – even – ready to go – with no planning. I’m just … chaotic. But I’ll follow anything and be likely to succeed if I can get with it, you know?
Are you following any plans right now? Do you have excess weight to lose?
Earlier this year, the Food and Drug Administration approved a new weight-loss procedure in which a thin tube, implanted in the stomach, ejects food from the body before all the calories can be absorbed.
Some have called it “medically sanctioned bulimia,” and it is the latest in a desperate search for new ways to stem the rising tides of obesity and Type 2 diabetes. Roughly one-third of adult Americans are now obese; two-thirds are overweight; and diabetes afflicts some 29 million. Another 86 million Americans have a condition called pre-diabetes. None of the proposed solutions have made a dent in these epidemics.
Recently, 45 international medical and scientific societies, including the American Diabetes Association, called for bariatric surgery to become a standard option for diabetes treatment. The procedure, until now seen as a last resort, involves stapling, binding or removing part of the stomach to help people shed weight. It costs $11,500 to $26,000, which many insurance plans won’t pay and which doesn’t include the costs of office visits for maintenance or postoperative complications. And up to 17 percent of patients will have complications, which can include nutrient deficiencies, infections and intestinal blockages.
It is nonsensical that we’re expected to prescribe these techniques to our patients while the medical guidelines don’t include another better, safer and far cheaper method: a diet low in carbohydrates.
Once a fad diet, the safety and efficacy of the low-carb diet have now been verified in more than 40 clinical trials on thousands of subjects. Given that the government projects that one in three Americans (and one in two of those of Hispanic origin) will be given a diagnosis of diabetes by 2050, it’s time to give this diet a closer look.
When someone has diabetes, he can no longer produce sufficient insulin to process glucose (sugar) in the blood. To lower glucose levels, diabetics need to increase insulin, either by taking medication that increases their own endogenous production or by injecting insulin directly. A patient with diabetes can be on four or five different medications to control blood glucose, with an annual price tag of thousands of dollars.
Yet there’s another, more effective way to lower glucose levels: Eat less of it.
Glucose is the breakdown product of carbohydrates, which are found principally in wheat, rice, corn, potatoes, fruit and sugars. Restricting these foods keeps blood glucose low. Moreover, replacing those carbohydrates with healthy protein and fats, the most naturally satiating of foods, often eliminates hunger. People can lose weight without starving themselves, or even counting calories.
Most doctors — and the diabetes associations — portray diabetes as an incurable disease, presaging a steady decline that may include kidney failure, amputations and blindness, as well as life-threatening heart attacks and stroke. Yet the literature on low-carbohydrate intervention for diabetes tells another story. For instance, a two-week study of 10 obese patients with Type 2 diabetes found that their glucose levels normalized and insulin sensitivity was improved by 75 percent after they went on a low-carb diet.
At our obesity clinics, we’ve seen hundreds of patients who, after cutting down on carbohydrates, lose weight and get off their medications. One patient in his 50s was a brick worker so impaired by diabetes that he had retired from his job. He came to see one of us last winter, 100 pounds overweight and panicking. He’d been taking insulin prescribed by a doctor who said he would need to take it for the rest of his life. Yet even with insurance coverage, his drugs cost hundreds of dollars a month, which he knew he couldn’t afford, any more than he could bariatric surgery.
Instead, we advised him to stop eating most of his meals out of boxes packed with processed flour and grains, replacing them with meat, eggs, nuts and even butter. Within five months, his blood-sugar levels had normalized, and he was back to working part-time. Today, he no longer needs to take insulin.
Another patient, in her 60s, had been suffering from Type 2 diabetes for 12 years. She lost 35 pounds in a year on a low-carb diet, and was able to stop taking her three medications, which included more than 100 units of insulin daily.
One small trial found that 44 percent of low-carb dieters were able to stop taking one or more diabetes medications after only a few months, compared with 11 percent of a control group following a moderate-carb, lower-fat, calorie-restricted diet. A similarly small trial reported those numbers as 31 percent versus 0 percent. And in these as well as another, larger, trial, hemoglobin A1C, which is the primary marker for a diabetes diagnosis, improved significantly more on the low-carb diet than on a low-fat or low-calorie diet. Of course, the results are dependent on patients’ ability to adhere to low-carb diets, which is why some studies have shown that the positive effects weaken over time.
A low-carbohydrate diet was in fact standard treatment for diabetes throughout most of the 20th century, when the condition was recognized as one in which “the normal utilization of carbohydrate is impaired,” according to a 1923 medical text. When pharmaceutical insulin became available in 1922, the advice changed, allowing moderate amounts of carbohydrates in the diet.
Yet in the late 1970s, several organizations, including the Department of Agriculture and the diabetes association, began recommending a high-carb, low-fat diet, in line with the then growing (yet now refuted) concern that dietary fat causes coronary artery disease. That advice has continued for people with diabetes despite more than a dozen peer-reviewed clinical trials over the past 15 years showing that a diet low in carbohydrates is more effective than one low in fat for reducing both blood sugar and most cardiovascular risk factors.
The diabetes association has yet to acknowledge this sizable body of scientific evidence. Its current guidelines find “no conclusive evidence” to recommend a specific carbohydrate limit. The organization even tells people with diabetes to maintain carbohydrate consumption, so that patients on insulin don’t see their blood sugar fall too low. That condition, known as hypoglycemia, is indeed dangerous, yet it can better be avoided by restricting carbs and eliminating the need for excess insulin in the first place. Encouraging patients with diabetes to eat a high-carb diet is effectively a prescription for ensuring a lifelong dependence on medication.
At the annual diabetes association convention in New Orleans this summer, there wasn’t a single prominent reference to low-carb treatment among the hundreds of lectures and posters publicizing cutting-edge research. Instead, we saw scores of presentations on expensive medications for blood sugar, obesity and liver problems, as well as new medical procedures, including that stomach-draining system, temptingly named AspireAssist, and another involving “mucosal resurfacing” of the digestive tract by burning the inside of the duodenum with a hot balloon.
We owe our patients with diabetes more than a lifetime of insulin injections and risky surgical procedures. To combat diabetes and spare a great deal of suffering, as well as the $322 billion in diabetes-related costs incurred by the nation each year, doctors should follow a version of that timeworn advice against doing unnecessary harm — and counsel their patients to first, do low carbs.
Sarah Hallberg is medical director of the weight loss program at Indiana University Health Arnett, adjunct professor at the school of medicine, director of the Nutrition Coalition and medical director of a start-up developing nutrition-based medical interventions. Osama Hamdy is the medical director of the obesity and inpatient diabetes programs at the Joslin Diabetes Center at Harvard Medical School. A version of this op-ed appears in print on September 11, 2016, on page SR1 of the New York edition with the headline: The Old-Fashioned Way to Treat Diabetes.
For the holidays — I got dental work. BEAM. You know we are PRACTICAL up in here. You should know I have been putting this off for YEARS. I needed approximately a cars-worth of work done – and one surgical procedure. This is going to be a minute of one or two-at-time visits.
No lie. I had the worst two done a couple weeks ago, and two done yesterday.
Oddly — I noted that my cyclic left eye twitch stopped immediately when the dentist injected me with novocaine. Perhaps novocaine is a cure for my eye twitch (… brain twitch?!) I only mention that because the eye twitching often precludes my seizure activity, to which I say Give Me More Novocaine?
I remained Numb In Mah Wips for about six hours – and definitely drooled coffee on myself while attempting to sip and shortly thereafter gave up on lunch.
Dental Work = An Awesome Diet Plan. *Not that I am dieting because I don't.
I am doing THIS. This is yesterday's gym time – -900 calorie burn.
*Except I'm back to normal today – and eating old leftover cold rice because I am in week five (…six?) of no kitchen.
Did your nutritionist give YOU guidance in regards to carbohydrate intake after your roux en y gastric bypass surgery?
Background: Exact carbohydrate levels needed for the bariatric patient population have not yet been defined. The aim of this study was to correlate carbohydrate intake to percent excess weight loss for the bariatric patient population based on a cross-sectional study. The author also aimed to review the related literature.
Materials and Methods: A cross-sectional study was conducted, along with a review of the literature, about patients who underwent Roux-en-Y gastric bypass at least 1 year previously. Patients had their percentage of excess weight loss calculated and energy intake was examined based on data collected with a four-day food recall. Patients were divided into two groups: 1) patients who consumed 130g/day or more of carbohydrates and 2) patients who consumed less than 130g/day of carbohydrates.
Limitations: The literature review was limited to papers published since 1993.
Results: Patients who consumed 130g/day or more of carbohydrates presented a lower percent excess weight loss than the other group (p= 0.038). In the review of the literature, the author found that six months after surgery patients can ingest about 850kcal/day of carbohydrates, 30 percent being ingested as lipids. A protein diet with at least 60g/day is needed. On this basis, patients should consume about 90g/day of carbohydrates. After the first postoperative year, energy intake is about 1,300kcal/day and protein consumption should be increased. We can, therefore, establish nearly 130g/day of carbohydrates (40% of their energy intake)
Conclusions: Based on these studies, the author recommends that 90g/day is adequate for patients who are six months post Roux-en-Y gastric bypass and less than 130g/day is adequate for patients who are one year or more post surgery.
The author concludes that maintaining carbohydrate consumption to moderate quantities and adequate protein intake seems to be fundamental to ensure the benefits from bariatric surgery.