Contradiction & Dilemma

[JRTwalker]

I appreciate anyone with patience reading my post and am sure this isn’t the first occasion someone has encountered contradiction depending on the particular dietician that you see.

I have previously been screened and had many blood tests over the years but always been told all was fine but with caveat that some weight loos would be good for general benefit and reduction of risk. I chose to see NHS dieticians and they encouraged a bit more exercise and a low-fat, calorie controlled & balanced diet that achieved very little. My weight seemed to stand still on a lot less than 2000cal per day but they kept telling me I needed at least 2500.

In September last year, I experienced some symptoms that following blood tests, led to a diagnosis of T2 with referral to see the DB Nurse. My BG was around 20 and HbA1c 100! And I was prescribed 1.5g Metformin and 10mg Statin.

The DB Nurse didn’t give me my blood test results – these were handed out at a subsequent DESMOND course where more dieticians encouraged again a bit more exercise and a low-fat, calorie controlled & balanced diet. My DB Nurse however did suggest I look at the Diabetes.org.uk website, do some research and consider off the record, the LC diet.

This I did and I’ve I’ve tried really hard with increased power-walking daily (5K+), as low Carbs as I can (20-40g approx.) and still low calories to aim for weight loss (c800-1000 a day).

In January, to the amazement of same DB Nurse, my HbA1c was now 37, weight loss 25Kg and fasting BG around 6 and as a result I was rewarded with a reduction of metformin to one 500mg a day and a pat on the back.

Now the only ill effect I’ve had more recently is general fatigue and loss of muscle but I’m still chasing further weight loss so I’ve thought no-pain, no gain. BMI is still around 32.

Yesterday a new dietician gave me a very stern instruction that I need to increase my carbs, fats and calories and not worry at all that I get morning BG levels of 8 and that what I am doing is making myself very ill. She also says that I should forget exercise as this doesn’t help with weight loss and can help to increase my BG levels. She wants three meals a day with intake captured in a food diary. She also found it incredulous that by blood results taken in September could have been turned around so quickly by January.

I feel like going my own way and cancelling future appointments with these people because they seem to make it up as they go along, one contradicting the other. Am I justified thinking this way or should I take heed? Depressingly at noon today after a balanced diet including seeds as she’d suggested gave me a mid-day BG reading of 9.5 which is highest I’ve seen yet. Not very happy!

 

[Bluetit1802]

To be honest, I think your calorie restriction is too low. With the exercise you are doing you need more energy (hence the fatigue). You will get this by increasing your calories from fats. You seem to be too intent on weight loss. If you low carb correctly, the weight should come off, but if you continue as you are you will mess up your metabolism, lose muscle, and the weight will never come off. The lower your carb consumption, the higher your fats must be. Like a see-saw. The Newcastle Diet (800 calories) was only for 8 weeks. No longer.

Your latest dietitian wasn't completely wrong. She was only wrong in telling you to increase the calories by eating carbs. Ignore the carbs but increase the fats and fibre, and eat normal protein. She was also right that exercise doesn't help you lose weight. Only diet can do that. Exercise is good in many ways and to be encouraged, but it won't help with weight.

 

[Brunneria]

I feel like going my own way and cancelling future appointments with these people because they seem to make it up as they go along, one contradicting the other. Am I justified thinking this way or should I take heed? Depressingly at noon today after a balanced diet including seeds as she’d suggested gave me a mid-day BG reading of 9.5 which is highest I’ve seen yet. Not very happy!

Your last paragraph sums it up for me.

All these professionals are giving you advice based on their training, and their expectation that T2 is a deteriorating condition. None of it comes from personal experience, individual testing or specific tailoring.

Meanwhile, you with a proven track record, excellent control, a fantastic attitude, and a good understanding of what works for your body, are being pulled this way and that, by conflicting advice - some of which is now disproven, debunked or was always nonsense.

(although Bluetit's comment about calories and fuelling exercise is a very good point! )

My own experience, and several recent studies, find that exercise is good for us in many ways, but it is of very limited use in losing weight. And the calories maths have never added up, because they are based on faulty calculations.

I would just say, eat to your meter, exercise to your pleasure, and don't mess up your metabolism.

(sorry for the multiple edits. I kept hitting 'save' before I finished! )

 

[Chook]

Well, just my opinion, but if her expert advice resulted in your BG increasing then I wouldn't bother with visiting her or following her recommendations any more.

You seem to be very successfully sorting out your own diet but maybe 800-100 cals per day is a bit on the low side for a prolonged period - try raising it a bit while keeping t low carb to see if that helps with your fatigue.

 

[Kristin251]

I vote for an avocado a day. Does very little to bs, an awesome healthy fat filled with fiber. Keeps my energy steady all day long. It eat some with all 3 meals and a snack if there's some left over.

I agree with all the above. Calories are a bit too low and some fats could be added. In the absense of carbs, fat does not make you fat. It's fuel.
One should never do low carb and low fat.

Those macro calculators are always way off for me. Recommending twice the calories I eat. I do eat low cal but not as low as you. BUT I eat an 80% fat diet. Avocado, a few nuts, olive oil, olives, mayo make up the majority

 

[Brunneria]

Hi again,

I just realised that you are fairly new to this, so you may not fully understand what we mean when we bang on about 'messing up your metabolism'.

This link should make it clear.
https://intensivedietarymanagement.com/biggest-loser-diet-explained/
Basically, if you apply the 'eat less, move more' principle too hard, your body starts protecting itself by becoming super-efficient on energy usage, and the weight loss slows down and stops, while our bodies resist further weight loss.

Doesn't always happen, but for those of us to whom it does, it is a major pain in the derriere!

 

[JRTwalker]

Thank you all for your responses and advice - this os very much appreciated.
I am also feeling better than earlier when I got my 9.5 reading at midday as I immediately went for my 5K dog walk on a rare lunch-time opportunity and then had scrambled eggs & a few walnuts just after 1pm for lunch and now just retested and I get 5.4!
Now need to work out a cunning plan of how I'm going to increase my calories without increasing my carbs too much.

 

[Kristin251]

Avocado mayo nuts/seeds. All small but calorie and fat dense. Low carb.

 

[Bluetit1802]

You don't need to increase your carbs at all. Just increase the fats. Fats are very calorific. Use dairy (real dairy that is, not low fat rubbish), olive oil, avocado, real mayonnaise, cream, eggs, bacon, oily fish, mushrooms fried in butter. It is all trial and error, and no need to overly concentrate on calories if you get the balance right and keep losing the weight.

 

[JRTwalker]

Hi again,

I just realised that you are fairly new to this, so you may not fully understand what we mean when we bang on about 'messing up your metabolism'.

This link should make it clear.
https://intensivedietarymanagement.com/biggest-loser-diet-explained/
Basically, if you apply the 'eat less, move more' principle too hard, your body starts protecting itself by becoming super-efficient on energy usage, and the weight loss slows down and stops, while our bodies resist further weight loss.

Doesn't always happen, but for those of us to whom it does, it is a major pain in the derriere!

That's so revealing of me Brunneria! I have often joked in the past to friends saying that I had defied science and seem to survive on so much less than everyone else yet carry weight that they don't!

 

[Resurgam]

I have been on outstandingly unsuccessful low calorie diets in the past - and was totally shocked to discover that all I needed to do was eat low carb for the weight to drop off so fast I needed to eat more to slow it down - half a stone in 3 days was not a good idea.
As you are losing muscle you really need to find some way to stop that - eating more fat would be one thing to try out as that is something I have noticed doing Atkins, my lean body mass was slightly reduced when taking Metformin and statins but since I gave up on them it is staying the same.

 

[douglas99]

Increasing calories will decrease your weight loss normally.
But usually it's worth trying short term though, even if you don't feel hungry, then, if you don't lose weight, decrease again.
The increase gives your metabolism a kick start, then it'll start to burn your body fat again when you decrease the food intake.

 

[Resurgam]

I was, at one time, under doctors orders to eat 800 calories a day - he tried to get me to reduce to 600 as I was not losing weight - but I was white as a sheet, cold, confused, and likely to burst into tears at the slightest problem.
When I began to eat low carb the first time, to a scheme of my own devising I dropped down to just over 9 stone, the lowest weight of my adult life, but it was at just over 1000 calories a day. The problem was that after a few weeks I was totally ravenous and I started to eat carbs quite madly, as I did not have enough fat in the diet - it was at the height of the demonization of fat, so it was another few years before I found Dr Atkins and tried again with pretty spectacular results - but having been a slave to the calorie counter for so long I ceremonially burnt them all in the back garden as fuel for a barbeque and have refused to consider the calorific value of anything since.
For me, calories are an illusion. As I can eat more calories and lose weight very happily, that is what I will do from now on. On low calorie diets I starve, on low carb diets I can live very well.

 

[Concordjan]

I appreciate anyone with patience reading my post and am sure this isn’t the first occasion someone has encountered contradiction depending on the particular dietician that you see.

I have previously been screened and had many blood tests over the years but always been told all was fine but with caveat that some weight loos would be good for general benefit and reduction of risk. I chose to see NHS dieticians and they encouraged a bit more exercise and a low-fat, calorie controlled & balanced diet that achieved very little. My weight seemed to stand still on a lot less than 2000cal per day but they kept telling me I needed at least 2500.

In September last year, I experienced some symptoms that following blood tests, led to a diagnosis of T2 with referral to see the DB Nurse. My BG was around 20 and HbA1c 100! And I was prescribed 1.5g Metformin and 10mg Statin.

The DB Nurse didn’t give me my blood test results – these were handed out at a subsequent DESMOND course where more dieticians encouraged again a bit more exercise and a low-fat, calorie controlled & balanced diet. My DB Nurse however did suggest I look at the Diabetes.org.uk website, do some research and consider off the record, the LC diet.

This I did and I’ve I’ve tried really hard with increased power-walking daily (5K+), as low Carbs as I can (20-40g approx.) and still low calories to aim for weight loss (c800-1000 a day).

In January, to the amazement of same DB Nurse, my HbA1c was now 37, weight loss 25Kg and fasting BG around 6 and as a result I was rewarded with a reduction of metformin to one 500mg a day and a pat on the back.

Now the only ill effect I’ve had more recently is general fatigue and loss of muscle but I’m still chasing further weight loss so I’ve thought no-pain, no gain. BMI is still around 32.

Yesterday a new dietician gave me a very stern instruction that I need to increase my carbs, fats and calories and not worry at all that I get morning BG levels of 8 and that what I am doing is making myself very ill. She also says that I should forget exercise as this doesn’t help with weight loss and can help to increase my BG levels. She wants three meals a day with intake captured in a food diary. She also found it incredulous that by blood results taken in September could have been turned around so quickly by January.

I feel like going my own way and cancelling future appointments with these people because they seem to make it up as they go along, one contradicting the other. Am I justified thinking this way or should I take heed? Depressingly at noon today after a balanced diet including seeds as she’d suggested gave me a mid-day BG reading of 9.5 which is highest I’ve seen yet. Not very happy!

Just to say well done for getting your bg levels down so quickly. You can get a lot of help and advice on here. Perhaps you do need to increase the fat. When I first went low carb hf I lost weight even though I didn't really need to and I ate lots of fat - mainly nuts and cheese!

 

[JRTwalker]

Thank you all, you are helping me in mind and spirit no end. I have been on diets all my life from the days of been the fat kid at school having been fed on rubbish. I cured my weight at age of around 19 and became a marathon runner until an age where fitness became a lesser priority and family and work commitments took over. My weight started to increase from age of around 40 up to max of 136Kg last year. During this period of weight gain I was walking, cycling and swimming far more than my friends and apart from eating carbs thinking they were healthy, I've never been a big "pie-eater" despite the public gaze & opinion that I must be!
Right now at age 55 and 104Kg my challenge is that I have very little appetite and am not wanting to eat a great deal and I am struggling to get much beyond 1000 cal a day despite the increased dairy, nuts and adding some meat back to my diet since previously I was vegetarian. Onward and upward but hopefully not in terms of weight or BG! (7.6 mmol/L fasting this morning).

 

[Bluetit1802]

I have very little appetite and am not wanting to eat a great deal and I am struggling to get much beyond 1000 cal a day despite the increased dairy, nuts and adding some meat back to my diet since previously I was vegetarian.

That could be the Metformin. It is an appetite suppressant.