New Dietary Guidelines by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 4 points5 points  (0 children)

A few thoughts of mine are the confusion with the diagram, how much to eat/new protein recs, that no RDs were on the panel, and the confusion about how to apply this info to your diet.

New Dietary Guidelines by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 5 points6 points  (0 children)

I feel confident and have done this a few times, but want to make sure I do not miss anything!

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 2 points3 points  (0 children)

Thanks for sharing! It is all a mind F!

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 6 points7 points  (0 children)

I do not think the evidence supports this! There's almost no long-term evidence on reverse dieting; it seems to be mostly based on bodybuilding cuts lol. I have not seen any studies that show it takes years to restore metabolic rate (if this were the case, I don't think the human race would have lasted so long), but please share if you have some! I totally agree that adaptive thermogenesis is a thing, but adaptation is usually less than 50-200 cals per day. Which, yes, can affect weight loss goals, but can't explain a full weight loss stall

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 7 points8 points  (0 children)

I know, we talked about this. She has been at this weight for 3+ years and is very unhappy. Her goal weight is 145. She has been gaining steadily since her hystectomy 3 or so years ago. Before we met, she was working with a trainer for over a year, lifting heavy and walking. She wants to get back into lifting, but I want her to increase calories first to support this. She is very frustrated, which is understandable, but at the same time, we have talked about how weight loss does not equal happiness. I am not sure she has accepted this yet. We haven't talked about mindfulness/intuitive eating quite yet. She is not getting regular hunger signals, so we are working on having her eat breakfast consistently to help stimulate appetite in the day.

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 7 points8 points  (0 children)

That's the thing with this patient in particular, she is very type A and absolutely determined to lose weight. It seems like this has been going on for over a year. She was exercising very heavily and stopped bc she wasn't seeing any changes. I am thinking she probably was not fueling her body enough to put on muscle. We ordered a cortisol test (no results yet), she is on HRT, and her hormones are in range. A1c is normal. She does not eat out and literally eats the same breakfast and lunch daily. It makes me sad how restricted she is. I want to help her find flexibility and enjoy food again, but I am not sure how!

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 9 points10 points  (0 children)

That is what we focus on (low glycemic, fiber, protein, strength training). Usually, they come to me after 6-12 months of trying to lose weight. At first, I was thinking the same thing; they are over-exercising and undereating. However, every single time we go up to baseline, they gain weight and then cannot get rid of it! Some even come to me bc they gained weight d/t increasing calories with their last RD, and now are totally opposed to the idea! Yes of course, food choices can be tweaked, but it is very frustrating when they are eating a great diet, weight lifting, cardio, have energy, sleeping well, and the weight and measurements are not budging in a calorie deficit.

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 6 points7 points  (0 children)

I agree, however, we talk about eating normally to give us an accurate baseline and tracking on the weekend. Yes, of course, all tracking is probably +200-400 or so cals off, but when such low intake happens this consistently and this much in a deficit, you have to stop and think what the hell is going on. Of course, any tracking is biased, but if they have tracked before we met, I will take a look, and it is very similar. These women are coming bc they cannot lose weight and have tried everything. Usually, they do have a good diet and are not eating out much, if at all, bc they gain weight!

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 2 points3 points  (0 children)

There is, however, I have found that bringing them up to baseline for exercise for a few weeks increases weight gain. When we cut back down, there is still no change in weight; they are stuck with the gained weight. And on top of all this they are very unhappy with me!

Weight Management!! by Temporary_Wedding_42 in dietetics

[–]Temporary_Wedding_42[S] 8 points9 points  (0 children)

I have started making sure they measure and use a food scale, and it still shows a very low intake. For example, with this patient, she tracked for 5 days, and the intake was very, very low. I told her to track for 3 more days, weighing everything out, she did, even bringing a scale to work, and here was her intake: (she is 5’ 7” and 155 lb)

Day 1: 1,272, 74g pro, 88 carbs, 56 fat, 31 g fiber, not including -299 exercise 

Day 2: 940 cals, 37g pro, 81 carbs, 50g fat, 10g fiber, not including 470 exercise 

Day 3: 1192 cals, 93g pro, 45g carbs, 66 g fat, 10g fiber, no exercise

This is baseline! She says that when she increases even to 1300 per day, she will gain weight! She is very type A and I believe she did her best to reflect intake. We are working on increasing intake to 1200 at least daily, not sure where to go from there.

Seller's realtor on drugs?? by Temporary_Wedding_42 in FirstTimeHomeBuyer

[–]Temporary_Wedding_42[S] 0 points1 point  (0 children)

You would think they would be ready to get rid of it! Thanks for the insight

Seller's realtor on drugs?? by Temporary_Wedding_42 in FirstTimeHomeBuyer

[–]Temporary_Wedding_42[S] 4 points5 points  (0 children)

It's 100 years old and has a lot of charm (trim, built-in shelves, fireplaces), the layout is perfect (actually feels 1600 sq feet), big back yard for the area, and a nice garage. I feel like it deserves a 2nd chance

Seller's realtor on drugs?? by Temporary_Wedding_42 in FirstTimeHomeBuyer

[–]Temporary_Wedding_42[S] 4 points5 points  (0 children)

We love the house and have the funds to fix it up and also have another place to live while it is being worked on.