I'm not sure if I have a problem or not?

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This time last year I was 12 stone 3, I am a 38 year old female and only 5 ft 1 1/2 so was clearly obese.

In february I decided to do something about it and I now weigh 7 stone 10, at a recent check up my doctor told me not to lose any more weight and said that 20 is the lowest a BMI should be and I am very close to it, I thought 18.5 was the lowest but she disagrees.

Now the thing is I do eat but I am very strict about not going over a certain amount of calories and despite the fact that I am still losing weight I can't bring myself to eat any more than that.

I keep promising myself that I wont lose more but I see the scale go down and feel such a buzz that it's like an addiction.

I weigh myself daily, struggle to accept natural fluctations and count every single calorie I eat.

I also feel really pleased with myself if I have calories left from my allowance at the end of the day and don't eat them.

Part of me thinks yes it's a problem but I allow myself an amount that is supposed to be my TDEE and it's 1390 so it's not drastic low although I still lose weight on that so it probably isn't enough and as I said I feel pleased with myself if I am 100-200 under it every day and feel guilty if I eat right up to it.

Then I think it's normal to be scared of getting obese again because I was like it for 8 years and miserable so I just don't know, I'm not sure if I do have an actual problem or if I am just terrified of going back to how I was.

My husband says it's time to stop but I just keep thinking he only sees me as being thin because he is about 10 pounds overweight so to him 'normal' seems very thin.

I feel a bit silly writing this now, I think I am fine and just don't want to risk getting big again but I will post anyway to see what others think, thank you for any opinions.

0 likes, 10 replies

10 Replies

  • Posted

    There are a number of things going on here.

    Firstly. You have lost a dangerous amount of weight in one year, going from obese to the opposite end. I'll comment on whether your current weight is healthy later on. This weight drop in such a short space of time is incredibly dangerous and puts a lot of pressure on your heart. You should not overlook this and should encourage your GP to get an ECG done if they have not organised one for you already.

    Regardless of your previous weight, rapid weightloss is dangerous even if you move from unhealthy to a more healthy category as a result.

    BMI. I don't know you ethnicity, but for most caucasian Europeans 20 is the minimum BMI. (Most people don't know this and view the scale as 18.5-25). If you are from parts of Asia, such as Bangladesh then the 18.5 -25 would be appropriate due to a lower bone density in these genetics. If you are of African origin you will have a slightly higher point of 22-25 and some arguments would say the upper end (27) should reflect this group better. So I hope this bit makes sense that 18.5 is not a target you should aim for. Equally the lower end is not you should aim for what your body resolves at and that will usually be somewhere in the middle.

    I didn't understand what you meant by TDEE, but I though you might be getting at recommended daily allowance of calories. This is something we regularly get confused. For a female, generally we require 2000 calories to live and breathe. This figure can go up or down depending on our activity levels. My dietitian gave me a great diagram with a breakdown of what calories are used for.

    60-70% of calories are used for basal or resting metabolic rate e.g. transporting oxygen round body, keeping brain thinking and remembering, keeping cells pumping, keeping heart beating, controlling body temperature.

    10-15% of calories are used for dietry thermogenesis which is digesting food and absorbing the nutrients from the food. This is again to keep you alive and to assist with the 60-70 bit.

    The remaining calories are if you are losing weight the bit you reduce, which is very little in comparison. Therefore people who eat under 1000 calories impact on all of the above and compromise this bit. The remaining calories are for activity which is anything other than lying down like walking, running, etc.

    So if you reduce your intake by 60% or more then it will impact on a lot more than weight. Equally if you eat your RDA then you are not going to gain 85% more weight every day.

    *Weight gaining diets are more complex than this and if you are going to do this at any point I am happy to talk through my own experiences at present in more detail as I am having to gain weight back to healthy as an anorexia nervosa recoverer.

    I think it's good you are approaching things with your GP. One thing I would think about is whether this is about diet and poor nutritional advice (which it can be for some people...my eating disorder has helped my parents eat better) or whether there is an underlying emotional reason behind this.

    -Were you always obese?

    -What made you gain the weight if you weren't?

    -Why were you so keen to lose the weight so quickly and why were you so driven that even at below healthy you aren't satisfied enough to stop?

    -Do you value yourself (body aside)

    -Are you happy in life?

    -Has your eating become a way of controlling other things in life...a bit of a coping mechanism?

    -What are you looking forward to in 2016?

    -If someone told you you had to stop dieting immediately. Could you? How would it make you feel?

    Really think about these questions. They are for you not me. You could find some of them not applicable but have a real think and if some of them start to generate some thoughts and feelings, a) write them down and b) when you next see your GP try and see if you can get on the waiting list for therapy for this.

    Remember early intervention in eating disorders (if this is what you have) saves lives.

    Here to talk and listen so do message me if you have any questions.

    • Posted

      Thank you so much, I have had an ECG recently which was fine, I have anxiety disorder and they wanted to rule out physical issues when it got suddenly very bad a few weeks ago.

      You have explained things so well and I really appreciate you taking the time to do that, when I say TDEE I mean the daily energy expenditure so the amount you need to maintain weight, I use an app and I set my activity level, log my weekly weight and it gives me a figure to maintain on.

      The problem is I never maintain, well I did one week but usually I lose and as I said I do feel pleased if I end the day under that figure which deep down I know isn't healthy, when my GP said not to lose anymore weight I asked about how to make it stop meaning how much she thinks would be the right amount of calories, she just said it will stop when I am less anxious but my anxiety has only been severe for a matter of weeks and I think I need to go back and be a bit more specific and honest too, I need to admit that I struggle to eat more and still enjoy seeing the number on the scale go down.

      I am british caucasian so would fit with 20 being the lowest BMI, I did a weekly weigh in this morning, I weigh daily but only record it once a week and I am at 20 now.

      I am going to take your advice with those questions, I will write it all down and go back to the doctor with it and show her so she can have a clearer picture about the way I view things and I will ask her for help too, I don't think I have a disorder at this point but I think I am at risk or possibly even in the early stages and it needs adressing now before it gets worse.

      Thank you again.

    • Posted

      Hey again - well done for being so pro-active about everything.

      Confronting anything like this is hard, and you sound like you're going about it in exactly the right way, taking advice.

      Remember also to be kind to yourself. It's not going to be plain sailing, so don't beat yourself up if a week is great, but the following week is awful. Recovery is not a linear process, it's something you need to commit to fully.

      I love seeing the scale go down, but it doesn't mean that it's healthy. Try and develop some other interests, for example when my weight started to get to a point it was no longer a physical risk, and when my treatment team were happy with me, I was allowed to engage in sport again. This has been brilliant, because it helped with toning, but also gave me something to be competitive about that was healthy. It also releases endorphines.

      People do all sorts of things, such as mindfulness (I'm a strong advocate for this), art, music etc. It's good to find activities which are positive, because so much of your mental energy is consumed with negative goals.  You are more than just a number.

      I hope the information about the TDEE/Recommended daily allowance makes sense. For now, it might be worth not calculating this, and asking for a referral to a dietitian and working with them on this.

      You mentioned that you struggled to maintain, yet you've been actively trying to lose weight, you have also been weighing yourself generally daily. This is probably why. 

      -Do you skip meals?

      -Do you miss out food groups, such as carbs?

      -Do you go through binge episodes?

      -Do you try and limit your snacks?

      Again, if you have said yes to any of these questions, this is probably why.

      Also remember what I said about weight fluctuating 1-3kg over a month. Even weekly doesn't give us an accurate reflection of our weight.

      Anxiety and eating disorders often accompany each other. I would strongly encourage you to work through the anxiety. I mentioned I am a strong advocate for mindfulness. There is a great free app I use called DBT Diary 111, which has some useful guidance on coping mechanisms. You can also google DBT.

      I also use headspace. There are also some good mindfulness 8 week courses and books, which I would suggest. All these require practice, and help you to sit with discomfort.

      They won't solve the anxiety, or make it go away. In the same way the eating disorder won't disappear, but you will start to tackle some of the obstacles in new ways, and develop new behaviours and think differently about situations that perhaps seemed beyond your control.

      Try to take things one step at a time. I realise this is a lot of information at once.

      Keep fighting, you're approaching this the right way.

  • Posted

    P.s. I could write another essay about weight fluctuations and calorie counting. I am trying to break my own habit of calorie counting and it's really hard. If you are new to it please don't let it become a behaviour and phase it out otherwise you will become stuck with it for a long time.

    You need to be patient with yourself and do things bit by bit so this may be something which comes later.

    The weighing. You know this, your weight can fluctuate anything between 1-3kg over a month. Currently I am weighed fortnightly and we chart my weight fluctuations to understand them better.

    Some places also do weekly but anything more is far too much. It will vary depending on anything such as how many cups of tea you drank yesterday to the amount you sweated.

    Imagine you did the exact same thing two days in a row, drink, eat, activity etc. Your weight could still be different two days in a row if the air temperature was different. This is why there is no point weighing so regularly.

    Hope this helps. P.s. it's time for breakfast. The most important meal. Very important for maintaining a healthy weight and preventing mood swings. Include something with carbs.

  • Posted

    Katlouise1989 has made some very good points, i wouldnt like to say if this is an ED but losing so much weight and continuing to could result in this. I have had major issues with fodd since i was 16 and now 50, my current BMI is around 15 and have been in hospital numerous times and a unit for ED, i wouldnt wish my experience on anyone. The anorexia is controlling my whole life, i find just going to the shop a trial and some days i cant manage that.Im only sharing this as i want you to try and get back in control before the restricting calories becomes something more dangerous. \at my lowest when admitted to Ed unit my BMI was 13 and i could hardly walk. Every day is a struggle with guilt if i eat more than 500 calories which i know is insain but im stuck in this cycle of binging and using laxatives. \please go back to your doctor and ask for help, by recognising it is a problem is a good thing.perhaps ask for input from a dietician as \whilst in ED unit we were given strict eating plans whcih ensured we ate all the food groups you need, if you stuck to this you should maintain a healthy weight and not become

    overweight again. I hope you succeed in getting back in control again

    • Posted

      Thank you and I am so sorry that you have suffered so much and still do, I am definitely going back to the doctor before this gets any worse, I know I need to, thank you for sharing your experience, it's a cold hard wake up call that someone like me needs to stop this now before it goes too far.

      I hope you can find a path to recovery, I can only imagine how awful it must be for you, wishing you strength x

    • Posted

      It can happen to anyone.

      Don't judge yourself either.

      With Christmas here, it isn't easy either.

      I wrote a good blog on coping with Christmas. Try and think through what your Christmas coping plan is.

      "When I reflect back to last year and think about my preparations for the festive season then, and how I have prepared mentally and physically this year, there is a wealth of difference.

      As I write, I have just been given clearance from my dietician to take up sport and exercise again (healthily) and I am starting to think about food, nutrition and well being with a much healthier approach.

      The same could not be said for last year, the year before and so on.

      I have found Christmas and the festive period to be a challenge every year, where food dominates and family stresses run high. Even when I have previously had a routine that has been working, the festive season kicks in and that has been a challenge to keep up with, with the regular family gatherings, buffets, snacks and high calorie meals.

      "It's the most wonderful time of the year"...unless you have an eating disorder.

      Last year, in the midst of a relapse, I'd just been discharged from NHS services, told that I didn't meet the criteria for outpatient support, despite the fact I desperately needed it. The timing was particularly poor as a number of external events were also affecting my stress levels. As Christmas drew closer, I felt myself both mentally and physically preparing for Christmas by restricting, in readiness for the festive binge that was about to unfold. I've described this as like running a marathon without doing the training; my body and mind simply could not cope. It's not just Christmas day, but a whole fortnight and each day went by, me feeling increasingly aware of how much I'd eaten, feeling desperately unhappy and extremely unwell.

      I came home early, and went into an extreme cycle, punishing myself and as a result ended up in hospital with dangerously potassium levels - a result of laxative abuse, over-exercise and malnutrition.

      Experts warn against this very pattern, as there are a number of problems which can occur, which adequate preparation could mitigate against.Severely malnourished people should be aware of re-feeding syndrome; and when re-introducing food should introduce food gently, rather than in a desperate binge that could put pressures on the cardiac system.

      The starve-binge-purge cycle leads to extreme mood swings, which at a time of year when tensions are high, can increase stresses especially if emotions surrounding food and eating haven't been dealt with. Eating irregularly also contributes to low mood and increases susceptibility to bingeing on high energy foods, making the sufferer feel increasingly out of control.

      A year on, and I've been really lucky to have had almost a year's worth of therapy and dietetic support (albeit, it's been private), but it's got me to a much more stable place.

      I have been slowly getting towards a place that involves a more "normal" pattern of eating, although I admit my amounts of food are far from what is normal for a person of my age and activity.

      I have recently discussed with my dietician a meal plan for the festive period, considering managing difficult scenarios, such as our buffet that is traditional for our family on Christmas day and problem solving by only putting some food out in the first instance, and allowing people to help themselves later on.

      A second coping strategy has been developing my assertiveness, and self confidence. I have experienced people challenging the portions of food I'm having, or questioning why I am not having x or y...I have discussed with people such as my mum the why and the importance of what I am doing. I have a container I use to portion out food, which is making me feel safer. Sometimes, I need to remind people around me that I'm doing this and this is aiding my recovery, because people aren't perfect. Assertiveness and being confident in your own judgement is a skill, but if it helps you, then keep doing it.

      Plan, plan, plan! I've sat down with my dietician and my family to discuss the food I will be eating (and what the family are having) and made compromises where necessary. I have my plan on my laptop and I can mentally plan ahead, as well as physically, such as remembering to bring breakfast and lunch for when I go to stay with other members of the family.

      Make your plan manageable.

      I looked over my plan and I reviewed it a couple of times and took some things out and on a couple of days decided to not push myself so much, because I'm already taking a significant step this year. If your big step is getting in three small meals, can one of those meals be a banana on one day for example? On Christmas day, I know this is an indulgent day for the family, so I have decided not to push myself with breakfast and have gone for a lighter breakfast.

      Always set manageable goals.

      Try and allow days to indulge

      One of the things that I've learnt is that in normalising my eating, Christmas is where people do indulge. I don't have to eat everything in the fridge/house etc. I don't need to eat loads, but I could eat some things that are luxurious on the festive days. It's worth building this in, because everyone else around you will be eating like this. But it doesn't mean that you need to eat everything that everyone else is having, for the whole day and for the whole of the period.

      Think about timings

      You should aim to space out eating to roughly every 4 hours, to allow yourself to below satiated.

      When you're eating, mindful eating is important to allow your body to feel full.

      Breakfast should be consumed usually 30 minutes after getting up, and is also really important in regulating your moods, but also keeping your weight low...so definitely worth it over the festive period. By having small regular meals (generally) and also over the festive period, you're less likely to eat the whole box of Lindor.

      Give yourself time...

      It's not going to be easy - if you found it easy that would be great.

      Allow yourself some time to yourself if things get stressful.

      I like listening to music to de-stress myself, I also find watching TV really helps.

      Going for a walk (or in my case, taking my dog for a walk).

      Talking to a friend is another good coping mechanism. I've asked my friends to send me motivational messages.

      If you have hobbies which you can do over Christmas, then try and find space and time to do these whilst you're feeling things are difficult; finding time to unwind when you're feeling vulnerable helps to bring your mood up again.

      I also recommend yoga or mindfulness.

      There's a great online forum called the Big White Wall, which is another good option if you simply need to talk to someone virtually. They also have options to express yourself creatively.

      Pacing yourself is important. It's better to take things bit by bit, and being nice to yourself.

      Stay positive, and remember you're not alone."

    • Posted

      Thank you, your replies have been so helpful, your explanation about TDEE does make sense but you make a great point too in saying that it may be better to work with a dietician on that, I feel that I need some ongoing support with it.

      I will have a look for that app, I am currently using some self help techniques for my anxiety and am waiting for an appointment for therapy, I have had it in the past but really need to have some more, I have OCD too which complicates everything including my eating habits so I am hoping that can also be tackled with therapy.

      I'm sorry you had such a struggle last year over Christmas, it really is a tough time because everything is about food and indulgance and I hate the idea of all that food around me but planning is something I have been working on too, I knew my husband would question why I wont eat chocolate for breakfast that day like I used to at Christmas and I have explained that if I have fruit instead it will mean I can join the family for dinner and feel okay about it and enjoy the meal.

      I also know that the evening will be hard because everyone in the house will be having lots of snack type foods so I thought perhaps I could put aside a small amount of those things for myself and that way I get to join in but not have the pressure of everyone expecting me to eat huge amounts, I never binge or feel the urge too, I just feel disgusted by large amounts of food especially unhealthy food and I need to feel that I wont be pushed by my husband or older children.

      I love music and find it very relaxing and I have been thinking about taking up yoga for a long time so I am finally going to take the plunge and do it, I think it would benefit me greatly.

      I'll have a look at that Big White Wall forum too, thank you for that and thank you for sharing your own experiences and coping techniques.

      I think it really is a good idea to take things bit by bit and one step at a time, today I was in this mindset that I wanted to lose just 2 more pounds and I know that is not good, it's just setting a new goal and an unhealthy one at that, I was going to make sure I didn't reach my calorie target on my app but instead I calmed myself, I reminded myself that I need to be healthy, I am a wife and a mother and I need to look after myself and I actually ate my whole allowance today, every single calorie of it, that is one day of positive news at least.

      Obviously I am following an app that may well be wrong about my calorie needs and that is why I agree that a dietician would be a good idea for me but for me to reach that figure is a really big thing and I felt happy that I had done it.

      Thank you again, you have been so great and so helpful, I will return to my GP and be more honest and open with her, I have written lots of things down already to show her so hopefully it's a step in the right direction.

       

    • Posted

      This makes me so happy hearing how commited you are. It will serve you well smile

      I'm doing well. My blog was written last Christmas about the year before, and I hope this Christmas will be better again smile

      Be kind to yourself too. It won't be easy. Today was brilliant reflecting on what you have achieved. Do something you enjoy to reward yourself such as having a bath, or watching a movie, or having some nice scented candles (which seems to be my latest thing at the moment). You deserve it.

      Small steps. Well done. You can do it.

    • Posted

      Thank you smile

      I'm so glad you are doing well and I hope you have a wonderful Christmas this year.

      I think I will do just as you suggested and reward myself for today with a favourite movie, it should help my anxiety too,thank you so much.

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