Slow loser needs advice from good losers

[jillrn 0]

Published by Jampolis (2004). A 51 year old patient complained of a 15 lb weight gain over the last year despite beginning a strenuous triathlon and marathon training program (2 hours per day, 5-6 days per week). A 3 day diet analysis estimated a daily intake of only 1000-1200 Calories. An indirect calorimetry revealed a resting metabolic rate of 950 Calories (28% below predicted for age, height, weight, and gender). After medications and medical conditions such as hypothyroidism and diabetes where ruled out, the final diagnosis was over-training and undereating. The following treatment was recommended:

• Increase daily dietary intake by approximately 100 Calories per week to a goal of 1500 calories
  
• 32% protein; 35% carbohydrates; 33% fat
  
• Consume 5-6 small meals per day
  
• Small amounts of Protein with each meal or snack
  
• Choose high Fiber starches
  
• Select mono- and poly- unsaturated fats
  
• Restrict consumption of starch with evening meals unless focused around training
  
• Take daily multi-Vitamin and mineral supplement
  
• Perform whole body isometric resistance training 2 times per week

After 6 weeks the patient's resting metabolism increased 35% to 1282 Calories per day (only 2% below predicted). The patient also decreases percent fat from 37% to 34%, a loss of 5 lbs of body fat.

Jampolis MB (2004) Weight Gain - Marathon Runner / Triathlete. Medicine & Science in Sports & Exercise, 36(5) S148

the adrenal glands secrete the hormone cortisol as a reaction to stress, and excess cortisol leads to weight gain, especially in the abdomen area, along with sleep disturbances, mood swings, irritability, loss of memory and poor digestion.

Elevated cortisol also aggravates sugar distribution, which contributes to development of high insulin levels and ultimately diabetes. When the adrenal glands pass the point of stress they go into exhaustion, which creates physically damaging conditions like Chronic Fatigue Syndrome, arthritis, hormonal problems, inflammation and heart attack, just to mention a few.

Estrogen dominance is another fairly common factor that contributes to inability to lose weight; we eat meats, eggs and dairy products that have been treated with synthetic hormones. Estrogens create Water retention and fat deposits; in time of pregnancy, estrogens are vital in protecting the fetus, but elevated estrogens otherwise create havoc for our endocrine and digestive systems.

Weight Control

Most athletes are concerned about their body weight. Many sports place heavy emphasis on maintaining specific body weights for competition. It is important to understand that weight control is influenced by more than just calories in verses calories out. When setting a healthy target weight, one needs to consider many factors, including; height, activity level, diet, sex, genetics, and daily energy needs. There is no specific “ideal weight” that can be assigned to one individual. The goal weight should be realistic and healthy for the athlete.

Factors that influence calorie-burning rate

Basal Metabolic Rate (BMR):

Level of energy needed to keep involuntary body processes: pumping heart, breathing, generating body heat, perspiring. The higher this rate, the more likely one is to lose or maintain a healthy body weight.

Age:

BMR declines with age. Changes in hormones and body composition slow down the BMR. In fact, the BMR declines 2% per decade after age 20. NOTE: physical activity can help keep BMR high.

Genetics:

Genetics also influence differences in BMR. Some individuals genetically inherit higher metabolisms then others.

Body Composition:

Muscular, lean bodies have higher BMR’s than soft, rounded bodies with fat tissue. Ounce for ounce, muscle burns more energy than body fat. Therefore, the greater proportion muscle to fat, the more calories needed to maintain weight.

Height:

A tall, thin body has more surface area than a short body. Therefore, the taller individual will have a higher BMR in order to maintain normal body temperatures.

Gender

: Males typically have less fat and 10-20% more muscle than women, and therefore typically have higher BMR’s than women.

Temperature:

Extreme hot or cold temperatures also raise the BMR. The body has increased energy needs for regulation of body temperature.

Physical Activity:

Depending on length and intensity of workout, physical activity can increase BMR for several hours afterward.

Caloric Intake:

Severe caloric restrictions can slow down the rate in which the body burns energy from food. The body’s metabolism slows down to accommodate for lower caloric intake. This is the reason why one can actually gain body fat on a diet of 1200 calories per day. NOTE: When cutting back calories, never go below 1200 calories for women or below 1600 calories for men.

Digestion:

Digestion and absorption of nutrients uses approximately 10% of daily energy expenditures.

Figuring Your Energy Needs

1.

Figure your basic energy needs (BMR)

. Multiply your healthy weight (in pounds) by 10 for women and by 11 for men.

Weight x ___(either 10 or 11) = _______calories for basic needs.

2.

Figure your energy needs for physical activity

. Check the activity that matches your lifestyle for most days of the week:

____

Sedentary

: mainly sitting, driving a car, lying down, sleeping, standing, reading, typing, or other low-intensity activities

____

Light Activity

: (for no more than 2 hours daily): light exercise such as light housework, grocery shopping, walking leisurely

____

Moderate Activity

: moderate exercise such as brisk walking (and very little sitting), heavy housework, gardening, dancing

____

Very Active

: active physical sports, or in a labor intensive job such as construction work or ditch digging

Multiply your basic needs by the percent that matches your activity level: sedentary: 20%, light activity: 30%, moderate activity: 40%, and very active: 50%.

______ calories for basic needs x _____% for activity level = _______ calories for physical activity

3.

Figure energy for digestion and absorbing nutrients

. Add your calories for basic needs and calories for physical activity, then multiply the total by 10%.

(______calories for basic needs + ______calories for physical activity) x 10% = ________

calories for your total energy needs

Example: A football player is figuring his energy needs. He currently weighs 350 lbs, however determined that 325 is his “healthy weight”. He calculates his estimated daily energy need to reach this weight:

Basic energy needs: 325 lbs x 11 = 3575 calories

Energy for physical activity: 3575 calories x .50 = 1788 calories

Energy for digestion and absorption: (3575 + 1788) x .10 = 316 calories

Total energy needs:

3575 + 1788 + 316 =

5679 calories

4.

Figure appropriate carbohydrate, Protein, and fat ratio.

Remember for athletes; 60% of calories should come from carbohydrates, 20-25% from fat and 15-18% from protein.

Example: Using the football player example from #3, we will breakdown the 5679 calories by:

CARBOHYDRATES: 5679 calories x 60% = 3407 calories

¸

4 calories per gm =

852 gm Carbohydrates per day

PROTEIN: 5679 x 15-18% = 852-1022 calories

¸

4 calories per gm =

213 – 256 gm Protein per day

FAT: 5679 x 20-25% = 1136-1419 calories

¸

9 calories per gm =

126 – 158 gm Fat per day

SOURCE: Duyff, Roberta, MS, RD, FADA, CFCS. ADA Complete food and Nutrition Guide 2<SUP>nd</SUP> Edition.

Last August there was an article in the NY Times called

Fat Factors

that illuminated past and current research investigating the possible correlation between microorganisms and obesity. I was so thrilled, that I immediately e-mailed it to my doctor friends who love to reduce weight loss to simplistic math: calories in - calories out.

Fat Factors

tells the story of a research patient, Janet, who agreed to 3 months of hospitalization (in exchange for free gastric bypass surgery at the end) to allow her weight to be closely monitored and regulated. The researchers calculated the precise amount of calories Janet needed to maintain her weight, and prepared each of her meals. In two weeks, Janet gained 12 pounds.

A next logical train of thought might be that Janet is genetically pre-disposed for obesity, that her fat is in her genes. The first obesity gene was discovered in 1994, and about 50 more, with regulatory effects ranging from fat metabolism to knowing how much to eat, have been identified since. And the genetics theory encounters practical challenges of its own, such as identical twins with similar eating habits and extremely dissimilar weights.

Enter “infectobesity,” a term coined by a physician at the Pennington Biomedical Research Center in Louisiana who studies the relationship between excess weight and a common virus. Other microbiologists at Washington University in St. Louis are studying the trillions of gut microbes to see if any of them may play a role in making bodies fat, and more researchers at Virgina Commonwealth University, having “successfully” created obesity in chickens, rats and marmosets by infecting them with microbes. Now they are retrospectively surveying humans to evaluate correlation between body weight and antibodies that indicate past microbial infection.

Our inner community of gut microflora plays a wide variety of metabolic roles in the human body. And to quote the article’s author, Robin Marantz Henig, about one in particular, “It helps extract calories from the food we eat and helps store those calories in fat cells for later use – which gives [it], in effect, a role in determining whether our diets will make us fat or thin.”

Fat Factors

is a long article with wonderful stories about researchers and research subjects alike. The short of it is that evidence is accumulating to support some sort of relationship between microbes and obesity, at least in some cases, and that, sadly, the clinical application of this knowledge is still many years away.

Most of all, it’s a wonderful reflection on the traps of over-simplified thinking (such as our cultural view of fat = lazy or the standard math of calories in – calories out) and a reminder that we are never alone, that wellness is a team effort – you and your microbes, working symbiotically to create a body of health.

Here are just a few research articles (not written by me) that show they are many factors involved the body is sooo complex and metabolism, cardometabolic sydrome, hormones, body flora etc all play a big roll in weight loss. If it was as simple as cal in vs cal out I would have been thin LONG ago!

[Oregondaisy 2,021]

Thank you for posting that. It's a very interesting article.

I am sure my age has something to do with it, the fact that I am so short, and the hormones play a part in it too.

I'll just keep plugging away at it. I might try to do liquids for a week and see what happens. Wasabubblebut is losing great and has to stay on liquids because she is having band problems.

I was surprised I lost 22 lbs in four weeks on liquids.

[jillrn 0]

That is all you can do is keep plugging away. Liquids may help you but obviously wont keep you satisfied long so make sure you are not consuming too much liquid calories. Some people are just slow losers although I think you have done VERY well with 22 lbs in 4 weeks. I have only lost 30 in 12 weeks. I am happy though it is the most weight I have ever lost. I am extremely slow loser, I dont think it would have happened with out my band!

[Oregondaisy 2,021]

Jill, I got banded at the end of Dec. (12_29) I am going on 4 months. I lost the 22 during the first 4 weeks. Since then I have lost 2.

[kyethra 0]

How much of a portion are we supposed to eat at one time?

I dont' use a lot of sauces, except for a little ketchup on my ground turkey meat loaf.

I am 5'2'' tall and I am at 188 right now. I started at 212. I am 54 years old

and I am afraid it's because I take hormone replacement therapy. I have heard that people just can't lose if they take hormones, but I don't how that can be true.

I do track my calories at Spark People. I avereage about 1,000

My doctor has nothing to say about this other than it's harder as we get older. I am afraid to get another fill because I do get full fast, and I have to eat really slowly because food gets stuck . I don't pb though. thanks again.

I don't know about hormone replacement, but I am on hormones (cause my birthcontrol is too low hormone. I need more estrogen) and I know that getting on the estrogen helped me a lose a few pounds. Before I got on it I had gained some-- every actually suspected it was my thyroid before the whole estrogen thing was figured out. But if the weight just own't come off it might be worth it to ask your doc about checking the hormone levels and various things to make sure your thyroid is ok and so forth.