Doctor Advice

[LillyThePink]

Hi

A friend of mine from another board lost 2stone in 55 days by eating 500-800 cals per day. She claims she has done this with the support and advice of her GP. An average day's food is as follows:

Breakfast:

Cereal: 173C/2.2g
Juice: 150C/0g


Lunch:

Wafer 102C/4.2g
Juice 150C/0g

Dinner:

Noodles 126C/3.4g
Juice 150C/0g

Snack:

Water 0C/0g

Total: 851C/9.8g

That was typical of the beginning of the month, and I also have slimfast which I find great for me.

Breakfast:

Slimfast 215C/2.6g

Lunch:

Slimfast 215C/2.6g

Dinner:

Slimfast 215C/2.6g
Total: 645C/7.8g


I'm finding it hard to believe that this diet can be healthy - my understanding is that a person needs 1000 cals per day just to function.

I'll confess I'm worried about her. Is there anyone medical on here that can say whether this kind of diet might be a standard recommendation from a GP??

Cheers in advance.

[MRC_Hans]

Edited to add: NOTE, I am not a doctor (but I have some experience/knowledge on diets).


Mmm, is she (relatively) young and healthy? If she does this once, getting down to a normal BMI (body mass index), then changes to a diet/lifestyle that allows her to maintain that weight, I think it is acceptable. It certainly is a crash cure and such fast weight-loss is not the most healthy, but if it works for her, I think the overall benefit is positive.

Where it might go wrong is in two things:

1) If she does not stop when she reaches a normal weight.

2) If she stops dieting, gains wight again, takes a new crash cure, etc. Such successive weight changes are downright dangerous.

Hans

[LillyThePink]

She's fairly young, but does no exercise.

On enquiry, she states that she "was in double figures and now isn't" - I take this to mean that she dropped from 11stone to 9 or similar.


Could no vegetables/fruit/fats be good for you over a 2 month period? I think my teeth would be falling out!!

[The Don]

Not a doctor, do have some experience of losing (and keeping off weight).

Any qualified nutritionist or doctor would only support such a restrictive diet if the person's weight was so great that the risk of presents is considerable. Your estimate of 1,000 - 1,200 (k)calories is pretty decent as an minimum calorific intake. Risks of lower intake include the body thinking it's in "famine" mode and converting muscle into fat (upping your body fat % age).

Of course the only way to keep weight off is to change lifestyle (less lard more activity) and your friend is doing nothing about this.

Because body fat is 3500(isk) (k)calories per lb, it would appear that your friend is consuming around 1700 less than she meeds each day. This implies that her requirements are in the 2200 - 2500 (k)calories per day range. Using the rule of thumb of 15(k)calories per lb per day to maintain weight (and 10 to lose it b.t.w), this would indicate that your friend started off weighing around 13 stone and is now around 11. This would hardly warrant such extreme measures (I believe)

If your friend is larger than this, it may be that she is actually consuming more (k)calories than she thinks. If she started off at (say) 15 stone then she's probably consuming over 1,000 (k)calories a day - so less need to worry (though she'll almost certainly pile the weight back on as soon as she stops).

Some of the wieght loss may also be due to de-hydration which means she's running a smaller intake defecit and hence is actally consuming more calories.

[LillyThePink]

OK, I have now found out, she's 5'8" tall, and went from just over 11 stone to just over 9.

WHY would anyone recommend such a harsh weight loss plan when her BMI was in the healthy range to start with??

My BMI is overweight, and I know this and have started eating less/going to the gym. I just don't get the GP who prescribed this extreme plan!?!?

[The Don]

As far as I'm aware they wouldn't. In fact, I would recommend reporting the doctor to the GMC if she is doing this under GP supervision.

Is it possible that a "Doctor" rather than a Doctor is supervising ?

[LillyThePink]

she says it was her GP

I say he wants shooting :D

[MRC_Hans]

Mmm, this is an internet friend, right? Always take such info with a grain of salt.

Mmm found my calculator. So she has been loosing a bit over one kg per week. That is a good deal, but not overly dramatic. The ideal rate is ½kg per week (~one pound). I would say the following:

1) She probably gets more calories than she indicates (and she probably overestimates her weight loss).

2) I'm surprised a GP would sanction something like this, but maybe he/she just did not actually forbid it.

3) She should certainly stop now.

Hans

[Benguin]

I know most low-calorie dieters struggle because they underestimate calorie intake, forgetting to count fizzy beverages, crisps, chocolate bars and things. And (perhaps most significantly) alcohol.

I'd be a little sceptical about how closely your friend adheres to this diet.

I'd bet Slimfast would strongly recommend against someone trying to survive for any period on their product alone!

I managed to shed around 12 kilos (26 lb, just under 2 stone) in two months with a much less frugal regime than that ... I'd estimate my calorie intake at 1200-1600 per day.

[LillyThePink]

MRC, as usual, you are right. I was forgetting it was the goddamn internet, full of liars and attention whores. Its possible she's just trolling, as a lot of women in the "other place" are huge and would probably do very well at losing that sort of weight.

If I need to lose 2 stone, how long should I give myself. Assuming that I go to the gym for cardio-vascualr twice a week, and also assuming that I restrict my calorie intake? Lets say I cut it to 1100 a day...

What do you think - how long to do it healthily?

[The Don]

You'd be best of losing 1-2 lbs per week. Looks like it'll take 4-6 months.

I found it useful to follow WeightWatchers but that's because of the type of person I am. Whatever you do its wise to:

- consider EVERYTHING you consume in your (k)cal total (even food eaten standing up or acquired for free)
- include all food groups (including the chocolate and beer groups) so you don't obsess about forbidden foods
- be aware of butter/spreads often they contain as many calories as the bread
- consider it as a change in lifestyle, you'll need to adopt this diet (or a version of it) for the rest of your life otherwise the weight will pile on again
- realise exercise helps but in itself it won't help you lose too much weight (I think I calculated that you nede to run 20 miles to burn the calories in 1lb of body fat)
- change lifestyle with a friend or friends. After all misery loves company

[LillyThePink]

I've cut out cooking oil entirely, using the spray stuff & tend to fill up on green veg/salads.

My downfall is milk & sugar in coffee and dressings. I LOVE dressings (esp mayo!!)

I don't do beer, and very rarely do chocolate (need an angelic icon!) so that's not a biggie for me.

WW points plan seems like a good one. The other one which is v.popular is Slimming world, but I don't think I could do "red" and "green" days - I like to mix my food groups!

The worst thing will be giving up curry. I think a tikka masala is my ENTIRE days points or something!!

[Benguin]

On the exercise thing, I've been advised to do low intensity stuff. Anything that raises the heart rate above a certain level causes the body to burn energy in a different way and will, apparently, not help weight loss. And, as Don says, you need to do an incredible amount to burn an appreciable number of calories.

I got that from a fitness instructor, and it seems to be widely accepted in their industry. Seemed a bit counter-intuitive to me (surely more exercise=more calories=more weight loss?) but I followed their advise, and it does seem to work.

If you notice the heart-rate graphs on the equipment at the gym, you'll see CV is a band above calorie-burning band.

I've had a look around for a decent reference on this, but can't seem to find one. All I can remember of the 'theory' is that you are aiming to raise your BMR so you burn more calories all the time, rather than push your limits and make yourself crave calories.

Weight loss resources (http://www.weightlossresources.co.uk) can be generally quite handy.

[The Don]

Originally posted by LillyThePink
I've cut out cooking oil entirely, using the spray stuff & tend to fill up on green veg/salads.

My downfall is milk & sugar in coffee and dressings. I LOVE dressings (esp mayo!!)

I don't do beer, and very rarely do chocolate (need an angelic icon!) so that's not a biggie for me.

WW points plan seems like a good one. The other one which is v.popular is Slimming world, but I don't think I could do "red" and "green" days - I like to mix my food groups!

The worst thing will be giving up curry. I think a tikka masala is my ENTIRE days points or something!!
Try something like Lamb or Chicken Tikka (dry) with some low fat mint raita (that's how I weaned myself off Lamb Dhansak) and a couple of Chappattis or half a plain nan rather than the Pilau rice (ask if they'll give you more salad than usual). This way, you'll nd up with a 8-10pt meal which, if you combine it with 40 hrs of strenuous exercise, keeps you within your points for the day.

btw I found that the WW bonus points you get from exercise could be used to "pay" for treats like a curry

[The Don]

For mayo in sandwiches, I substituted )% fat fromage frais (I know Waitrose does it) which I got used to after a few weeks (in fact I haven't used a spead on a sandwich for 4 years or so now).

[LillyThePink]

Goooood tips.

:o) Have tried using half yoghurt half mayo in tuna & sweetcorn... tis a bit odd :D

[The Don]

Originally posted by LillyThePink
Goooood tips.

:o) Have tried using half yoghurt half mayo in tuna & sweetcorn... tis a bit odd :D
Yes it is, half low fat mayo, half 0% fromage frais is (A tiny bit) less odd.

The best cheat I found involves chips. Rather than deep fry them (and having loads of fat), par-boil potatoes for a few minutes, chip them, coat them in egg white and oven bake them. They look like chips, have the mouthfeel of chips and taste like chips.

[richardm]

Originally posted by The Don

This way, you'll nd up with a 8-10pt meal which, if you combine it with 40 hrs of strenuous exercise, keeps you within your points for the day.


40 hours of exercise a day?

I'm too busy to diet. :(

[LillyThePink]

Originally posted by The Don

Yes it is, half low fat mayo, half 0% fromage frais is (A tiny bit) less odd.

The best cheat I found involves chips. Rather than deep fry them (and having loads of fat), par-boil potatoes for a few minutes, chip them, coat them in egg white and oven bake them. They look like chips, have the mouthfeel of chips and taste like chips.

THAT sounds fabulous!! I LOVE chips, but we don't have them often, since potatoes etc are easier..

I LOVE my George Forman grill as well - its excellent!!

[The Don]

Originally posted by richardm
40 hours of exercise a day?

I'm too busy to diet. :(
I may have exaggerated just a touch ;). 8-10 pts is around 700 calories which would only require 5 miles running, so about 40-50 minutes on the treadmill should cover it