Need help, kick up the *** or something. Potted history

[SlimLizzy]

Diagnosed PreDiabetic end July 2018, panicked at first, then found Carbs and Cals book. Did well with diet initially, aiming for 100 carb a day. Thought I had it cracked, then discovered was losing too much weight. Am 1.67m tall. Weight fell from 56.8kg down to 50kg, still falling. So now aiming for 120carbs. On checking calories discovered some days was 800ish, although it seemed as if had eaten plenty. Three meals, snacks, not hungry, or tired, or thirsty.
Am not working, have no income, have not managed to establish routine. Cannot seem to find the right balance. Some days overeating, not often carby stuff, others too much alcohol. Maybe three glasses instead of one. Family very concerned about weight loss.
Little to no support from Doc or diabetic nurse ( For some people diabetes is inevitable) Although am on the Xpert Health Preventing Diabetes course. Its making sense, but still finding it hard to apply to myself. Before diagnosis was on reduced fat diet which has successfully controlled IBS for 20 years, and fairly sedentary. Have managed to increase fat slightly, but initial problem is still there. Am assuming was getting lot of calories from carbs and alcohol. Cut those and increase activity, bound to lose weight. Will this fading away continue indefinitely?
Moving house sometime soonish. OH retiring, will be living on one pension for several years. Loadsa stress.
Does not help when OH ( joke takes me to coffee shop and has cake. Whinge whinge
Please excuse abrupt style of writing. Its an attempt not to drown you in self pity when so many people have far worse situations.
All suggestions will be considered.

15-01-19
Thank you all for your supportive comments. Am feeling lot better today, lets hope this "blip" is over
New HbA1c and cholesterol levels test. Now waiting for results.

edited to give update

Further research into the dawn phenomonom seems to indicate that people can be more sensitive to carbs first thing in the morning and that early morning tea is a good idea, as apparently eating something can stop the liver dumping glucose.

New eating plan: Fewer carbs for breakfast, more at at lunchtime. Does this mean I can reinstate the sandwich?
This is almost going back to how I was eating before diagnosis!
Yoghurt and fruit for breakfast, maybe will need slice of toast with peanut butter as well to add calories, sandwich or something on toast at lunchtime. Before would have had carb rich dinner, thats not going to happen now.
One more week, then the course shifts to monthly meetings. Really need to have a better plan by then.

 

[PenguinMum]

Hi @SlimLizzy I am far from being qualified to answer your questions. The standard reply to losing too much weight when low carbing is to increase fat. However because of your longterm IBS that seems to be reactive for you. I am someone who just cant eat a lot of dairy esp cheese which is fat heavy in even small quantities. However there are other fats like oily fish (fresh or canned), meat is a big one and nuts (which can be carby). I just wondered which fats affected your IBS most, might be worth exploring. All the best.

 

[Antje77]

With 800 calories, I think you're basically starving yourself, depite not being hungry. How are your blood sugars (or when did you have your last hba1c and what was it, if you're not using a meter)?

Some days overeating, not often carby stuff, others too much alcohol. Maybe three glasses instead of one. Family very concerned about weight loss.

,
What do you reckon overeating, if it's not carby stuff, and why is it a problem? Sometimes 3 glasses of alcohol instead of 1 isn't very excessive. I agree with your family.

 

[Guzzler]

If you have counted the empty calories in your booze as part of your daily intake I would suggest swapping them out (or swapping some of it out) for something nutrient dense.
While it is said that a glass or two of red wine is beneficial this is obviously as an adjunct to a good dietary plan that suits you as an individual.

 

[SlimLizzy]

With 800 calories, I think you're basically starving yourself, depite not being hungry. How are your blood sugars (or when did you have your last hba1c and what was it, if you're not using a meter)?
,
What do you reckon overeating, if it's not carby stuff, and why is it a problem? Sometimes 3 glasses of alcohol instead of 1 isn't very excessive. I agree with your family.

800 cals is not normal.
Overeating, um. embarrasing to admit. Eating all the weeks supply of almonds in one day, ten slices of cheese. several small bars of chocolate. You get the picture? Pretty well whatever is available, all day. Then cooking and eating evening meal. Regretted the nuts, was not comfortable for next two days. so far have managed to hold off the biscuits.

 

[Antje77]

800 cals is not normal.
Overeating, um. embarrasing to admit. Eating all the weeks supply of almonds in one day, ten slices of cheese. several small bars of chocolate. You get the picture? Pretty well whatever is available, all day. Then cooking and eating evening meal. Regretted the nuts, was not comfortable for next two days. so far have managed to hold off the biscuits.

Still doesn't sound very excessive to me, although of course I don't know what your weekly amount of almonds is or how small your bars of chocolate or how thick your slices of cheese. Still, if you mostly eat 800 calories a day, couldn't it be your body telling you you need food?

 

[SlimLizzy]

If you have counted the empty calories in your booze as part of your daily intake I would suggest swapping them out (or swapping some of it out) for something nutrient dense.
While it is said that a glass or two of red wine is beneficial this is obviously as an adjunct to a good dietary plan that suits you as an individual.

the low cal day was
breakfast, full fat yoghurt, berries honey and almonds
lunch homemade winter vegetable soup, onions, celery, carrots, swede. slice of burgen bread
dinner sea bream fried in butter, small potato, cauliflower, beans, and curly kale.
tea and coffee throughout the day
that was around 800 calories
had large glass of wine to add cals not carbs

 

[SlimLizzy]

Still doesn't sound very excessive to me, although of course I don't know what your weekly amount of almonds is or how small your bars of chocolate or how thick your slices of cheese. Still, if you mostly eat 800 calories a day, couldn't it be your body telling you you need food?

not mostly that was the lowest day, others are more likely around 1200-1600

 

[DCUKMod]

@SlimLizzy - When you decide what you're going to eat; what are your deciding factors? Do you do a calorie count up beforehand, or is that count on a retrospective basis? Have you had another HbA1c test since you were diagnosed, to understand the impacts of your dietary trimming?

Secondly, even at 12-1600 calories a day, that doesn't "feel" to me like very much.

You are I are of vaguely similar volumes. I am 1.60cm, weighing in at c48-49kg. I eat LC, but not necessarily that LC. I don't count my carbs or calories regularly, but on the few times I have counted calories, I eat 2000-2500 in order to maintain my weight. Maybe you just need to eat a bit more of everything.

I don't have ABS, but if I overdo the fats, I end up with steatorrhea, which isn't pleasant. If I'm finding my weight slipping, I have to up my fats, but slowly.

Have you had a decent broad spectrum of blood tests, to test your vitamin levels and for any malabsorption issues?

 

[SlimLizzy]

@SlimLizzy - When you decide what you're going to eat; what are your deciding factors? Do you do a calorie count up beforehand, or is that count on a retrospective basis? Have you had another HbA1c test since you were diagnosed, to understand the impacts of your dietary trimming?

Secondly, even at 12-1600 calories a day, that doesn't "feel" to me like very much.

You are I are of vaguely similar volumes. I am 1.60cm, weighing in at c48-49kg. I eat LC, but not necessarily that LC. I don't count my carbs or calories regularly, but on the few times I have counted calories, I eat 2000-2500 in order to maintain my weight. Maybe you just need to eat a bit more of everything.

I don't have ABS, but if I overdo the fats, I end up with steatorrhea, which isn't pleasant. If I'm finding my weight slipping, I have to up my fats, but slowly.

Have you had a decent broad spectrum of blood tests, to test your vitamin levels and for any malabsorption issues?

Did spend a few days eating more, making an effort to get 1600-2000 calories. During that time i felt overfull, was eating without being hungry and after four days got terrible upset stomach, IBS again, so several days not able to eat much at all. Now eating as the Xpert health course suggests, "to appetite" Ususally count up at the end of the day. Its difficult to increase calories without overdosing on fat and getting upset stomach.
Am due to have HbA1c in about six weeks. That will be my six month check. Unless he decides to do it tomorrow, seeing doc about non diabetes issue. Tomorrow is also weighing day.
Doc is pretty useless, he spent about two minutes on dietry advice, going on about low fat without realising I already have reduced fat diet (have slightly raised cholesterol, which I have decided to ignore diet-wise for the time being, hoping my more active lifestyle will help with this) and suggesting what I now know to be a low GI approach. Would change doc, except we are moving house in a few months. To France: the land of delicious bread, croissant, cheese, pate, wine and pattiserie - all of which, according to my doctor, are bad for me. No wonder I am depressed.

 

[Sue192]

Please excuse abrupt style of writing. Its an attempt not to drown you in self pity when so many people have far worse situations.
All suggestions will be considered.

Big hug, @SlimLizzy. You say that there are people in far worse situations - that is of course true, but you are not in their situation and they are not in yours, and at this point in time you are struggling between a rock and a hard place. You are also under a lot of stress and that does all sorts of negative things to one's body and mind. With LCHF, some can go straight into it, having butter on cheese, embracing double cream in everything and really cutting the carbs; others due to their physiognomy cannot, for instance with IBS. I don't suffer from that but I can feel queasy if the HF is really high and have to tone it down. I think there are quite a few members who are moderate carbs and fats and still keep a good BG level, and I also think that a period of adjustment after the initial change to LC is required for some. When your OH does the coffee shop thing, could you take some LC muffins? They are great with yoghurt and soups and can help to up the calorie intake without damaging the carbs intake - there's loads of recipes on the 'net but I like the ones in Dr Cavan's cookery book. Above all, be kind to yourself and no self-flagellation: sometimes you have to deal with one thing (the stress) and then tackle the next thing (diet). @DCUKMod's suggestion of broad spectrum tests is really good - bang on your doctor's desk if need be. Good luck.

 

[Sue192]

Did spend a few days eating more, making an effort to get 1600-2000 calories. During that time i felt overfull, was eating without being hungry and after four days got terrible upset stomach, IBS again, so several days not able to eat much at all. Now eating as the Xpert health course suggests, "to appetite" Ususally count up at the end of the day. Its difficult to increase calories without overdosing on fat and getting upset stomach.
Am due to have HbA1c in about six weeks. That will be my six month check. Unless he decides to do it tomorrow, seeing doc about non diabetes issue. Tomorrow is also weighing day.
Doc is pretty useless, he spent about two minutes on dietry advice, going on about low fat without realising I already have reduced fat diet (have slightly raised cholesterol, which I have decided to ignore diet-wise for the time being, hoping my more active lifestyle will help with this) and suggesting what I now know to be a low GI approach. Would change doc, except we are moving house in a few months. To France: the land of delicious bread, croissant, cheese, pate, wine and pattiserie - all of which, according to my doctor, are bad for me. No wonder I am depressed.

Oops, we posted at the same time so please ignore some of my previous post. If you can hang on until you are settled, then hopefully you can find a more sympathetic doctor. Once you have made the move and have found your feet, I am hoping that your stress levels will diminish.

 

[DCUKMod]

Did spend a few days eating more, making an effort to get 1600-2000 calories. During that time i felt overfull, was eating without being hungry and after four days got terrible upset stomach, IBS again, so several days not able to eat much at all. Now eating as the Xpert health course suggests, "to appetite" Ususally count up at the end of the day. Its difficult to increase calories without overdosing on fat and getting upset stomach.
Am due to have HbA1c in about six weeks. That will be my six month check. Unless he decides to do it tomorrow, seeing doc about non diabetes issue. Tomorrow is also weighing day.
Doc is pretty useless, he spent about two minutes on dietry advice, going on about low fat without realising I already have reduced fat diet (have slightly raised cholesterol, which I have decided to ignore diet-wise for the time being, hoping my more active lifestyle will help with this) and suggesting what I now know to be a low GI approach. Would change doc, except we are moving house in a few months. To France: the land of delicious bread, croissant, cheese, pate, wine and pattiserie - all of which, according to my doctor, are bad for me. No wonder I am depressed.

SlimLizzy - If you increased your claories from c800 to citrually double that overnight, I wouldn't necessarily expect tummy issues, but I certainly wouldn't be surprised that a person experienced them.

Our bodies like to work to routines. In fact our first insulin response when we eat is based on historic eating and nothing to do with what we're eating at the time. That's why eating something different can return a disproportionate blood sugar response. I know we're not talking blood sugars here, but the same applies to digestive enzymes.

In your shoes, I would be taking a structured approach to any increase in eating. In fatc, this is what I did when I needed to halt weight loss. Initially I just upped my portion size a little bit. Once I had established that wasn't enough for what I needed, I added a "dose" of cheese. A dose of cheese would be a chunk of cheese. Not half a block, but about 1oz, and stuck with that for a while, then I moved onto adding a dose of nuts, which eventually balanced the weight loss scales.

I haven't carried on with the cheese and nuts, but what that strictly structured approach did was to give me consistent results from a consistent effort, allowing me to swap out the cheese or nuts (I rarely eat nuts these days) for more variety. However, if I start to lose weight, as long as I'm eating well, but just haven't had quite enough, then I'll add the cheese back in again to halt it.

As I said before, I don't have IBS, but the steatorrhoea evidences itself in similar ways, including needing an assured clear route to the smallest room.

If you are seeing your Doc tomorrow, I suggest you ask for a decent broad spectrum blood panel, including an HbA1c. If you A1c is in a good place, you may have some leeway to include a few more carbs, if that helps you manahe your diet.

In terms of your planned move, I found France and the tropical French Islands fabulous for eating. Of course there are boulangerie on every corner, but similarly there are charcuterie and delis similarly placed.

I think the bottom line is you have to experiment, but slowly. If you adopted your "perfect" IBS diet today, I wouldn't be surprised if you didn't immediately run into issues, based on my earlier statements.

 

[SlimLizzy]

SlimLizzy - If you increased your claories from c800 to citrually double that overnight, I wouldn't necessarily expect tummy issues, but I certainly wouldn't be surprised that a person experienced them.

Our bodies like to work to routines. In fact our first insulin response when we eat is based on historic eating and nothing to do with what we're eating at the time. That's why eating something different can return a disproportionate blood sugar response. I know we're not talking blood sugars here, but the same applies to digestive enzymes.

In your shoes, I would be taking a structured approach to any increase in eating. In fatc, this is what I did when I needed to halt weight loss. Initially I just upped my portion size a little bit. Once I had established that wasn't enough for what I needed, I added a "dose" of cheese. A dose of cheese would be a chunk of cheese. Not half a block, but about 1oz, and stuck with that for a while, then I moved onto adding a dose of nuts, which eventually balanced the weight loss scales.

I haven't carried on with the cheese and nuts, but what that strictly structured approach did was to give me consistent results from a consistent effort, allowing me to swap out the cheese or nuts (I rarely eat nuts these days) for more variety. However, if I start to lose weight, as long as I'm eating well, but just haven't had quite enough, then I'll add the cheese back in again to halt it.

As I said before, I don't have IBS, but the steatorrhoea evidences itself in similar ways, including needing an assured clear route to the smallest room.

If you are seeing your Doc tomorrow, I suggest you ask for a decent broad spectrum blood panel, including an HbA1c. If you A1c is in a good place, you may have some leeway to include a few more carbs, if that helps you manahe your diet.

In terms of your planned move, I found France and the tropical French Islands fabulous for eating. Of course there are boulangerie on every corner, but similarly there are charcuterie and delis similarly placed.

I think the bottom line is you have to experiment, but slowly. If you adopted your "perfect" IBS diet today, I wouldn't be surprised if you didn't immediately run into issues, based on my earlier statements.

Thank you for responding. The IBS has been under control for about two decades, had adjusted diet to suit, was no longer even thinking about it. Habit kept it in abeyance. Its resurfaced now because am trying to replace most of the carbs with fat and protein. So as you suggested have been adding in more cheese and nuts. Have changed to full fat live yoghurt, that works, not even more expensive, and much nicer. Cheese slices, the smoked german ones are only 5% fat, make a handy snack, instead of a couple of biscuits. So do sliced meats. but the cost difference is going to be a problem, when we will be living on one pension between two of us for several years.
The goverment screwed me on that.

 

[SlimLizzy]

Big hug, @SlimLizzy. You say that there are people in far worse situations - that is of course true, but you are not in their situation and they are not in yours, and at this point in time you are struggling between a rock and a hard place. You are also under a lot of stress and that does all sorts of negative things to one's body and mind. With LCHF, some can go straight into it, having butter on cheese, embracing double cream in everything and really cutting the carbs; others due to their physiognomy cannot, for instance with IBS. I don't suffer from that but I can feel queasy if the HF is really high and have to tone it down. I think there are quite a few members who are moderate carbs and fats and still keep a good BG level, and I also think that a period of adjustment after the initial change to LC is required for some. When your OH does the coffee shop thing, could you take some LC muffins? They are great with yoghurt and soups and can help to up the calorie intake without damaging the carbs intake - there's loads of recipes on the 'net but I like the ones in Dr Cavan's cookery book. Above all, be kind to yourself and no self-flagellation: sometimes you have to deal with one thing (the stress) and then tackle the next thing (diet). @DCUKMod's suggestion of broad spectrum tests is really good - bang on your doctor's desk if need be. Good luck.

Thank you for you sympathetic reply, think you are probably right and about moderate carb and fat, have been aiming for 100-120 g carb, is that moderate? Have not much idea how much fat am eating atm.. will try to work it out. Am already adding knob of butter to veggies, snacking on cheese,( 30g is about an ounce) having almonds with my full fat yoghurt and fruit. Ofc all this is counter to doc insisting I need to be cutting butter out altogether, along with the cheese and nuts. Argh! Doing my head in.
To be fair OH doesnt have cake in coffee shop nearly so often since my diagnosis, but he did last week. Think I was already feeling low and that tipped me over. Last night he made cottage pie with a roasted root vegetable and cauliflower topping, no potatoes at all, so he is trying.

 

[SlimLizzy]

Oops, we posted at the same time so please ignore some of my previous post. If you can hang on until you are settled, then hopefully you can find a more sympathetic doctor. Once you have made the move and have found your feet, I am hoping that your stress levels will diminish.

Am not looking forward to trying find doctor in France, we will be living in rural Normandy, not many english speakers around. Do have some french, but not enough.

 

[SlimLizzy]

Big hug, @SlimLizzy. You say that there are people in far worse situations - that is of course true, but you are not in their situation and they are not in yours, and at this point in time you are struggling between a rock and a hard place. You are also under a lot of stress and that does all sorts of negative things to one's body and mind. With LCHF, some can go straight into it, having butter on cheese, embracing double cream in everything and really cutting the carbs; others due to their physiognomy cannot, for instance with IBS. I don't suffer from that but I can feel queasy if the HF is really high and have to tone it down. I think there are quite a few members who are moderate carbs and fats and still keep a good BG level, and I also think that a period of adjustment after the initial change to LC is required for some. When your OH does the coffee shop thing, could you take some LC muffins? They are great with yoghurt and soups and can help to up the calorie intake without damaging the carbs intake - there's loads of recipes on the 'net but I like the ones in Dr Cavan's cookery book. Above all, be kind to yourself and no self-flagellation: sometimes you have to deal with one thing (the stress) and then tackle the next thing (diet). @DCUKMod's suggestion of broad spectrum tests is really good - bang on your doctor's desk if need be. Good luck.

oops, doctors is tuesday, was Xpert health course on monday. Cheerful stuff all the possible complications from diabetes...

 

[Sue192]

oops, doctors is tuesday, was Xpert health course on monday. Cheerful stuff all the possible complications from diabetes...

I hope the doctor was a little more helpful today, and that you are perhaps feeling a little better? (Depending on their attitude of course.)
On the subject of cottage pie, I thoroughly recommend this https://www.dietdoctor.com/recipes/keto-shepherds-pie - I realise that the recipe may be too fatty for you but the topping is yummy, never mind the underneath! I usually reduce the fat/cheese/cream content in dietdoctor recipes as it's sometimes too much for me, and none have suffered in taste.

 

[JAT1]

Hello SlimLizzy. I can relate immensely to your problem. I'm underweight too, however I have not lost any further weight for 6 months now, basically since the time I was diagnosed Type 1. I don't have IBS but if I eat too much I get painfully bloated. I keep my weight up by eating at least 900 grams of cheese (33%fat) every day !!! That's in addition to my regular meals. I tried to lower my carbs but just ended up feeling too sluggish so I have approx 150 to 200 carbs a day, mainly from veggies and 2 to 3 fruit. I eat no starch stuff, only home-cooked and no sugar or sweets. I nibble the cheese slowly over the course of the day. The cheese gives me, according to the package 3600 additional calories a day. You have to find something fatty you can eat so you don't lose more weight ! Maybe nibbling would help you as it does me. I am nearly always eating!

 

[Alexandra100]

Am not looking forward to trying find doctor in France, we will be living in rural Normandy, not many english speakers around. Do have some french, but not enough.

I discovered a wonderful free resource to help me with my French:
https://www.conversationexchange.com/s_map/learn.php?language=French
It works rather like a dating site, except you don't post a photo or mention your physical characteristics. You compose your profile stating which language is your mother tongue, which language you wish to learn and your current ability level, where you are and what kind of person you would like to talk to. People communicate mostly by skype, but also by email and even face to face etc. You can search for the type of correspondent you fancy. Did you say you are moving to Normandy? You can even search for French speakers in a particular location. And I have twice been contacted by young French people who had come to my town. I have found it wonderful, not only to improve my French speaking skills, but also just meeting some lovely, interesting French people. And of course if you have queries abut how things work in France, they could help. Highly recommended!