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Old 12-17-2009, 06:44 AM   #1  
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Default Health risks with Maintaining?

I am a fellow maintainer. I hit 230 by the time I was thirteen years old (which was very obese, particularly for someone so young and short).

Now I am 27 and have been able to keep my weight in the 150 - 170 range for the past 10 years - oh and I grew taller, that helped.

After reading many of the more scientific-related threads on how maintainers will never really be able to eat the calories of a normal thin person - they will need to eat even less and be even more active (which I find also to be true), I started thinking about growing older.

Some people in this thread have honestly reported, they are hungry all the time and can often even feel their stomach gurgling.

I am sure most women here take a multi-vitamin and/or calcium supplement - but is that enough given the large calorie deficit?

I'm wondering about the long-term health effects of maintaining a weight that may seem on average, thin, but in reality is TOO thin for someone who has been so large (thus has a decreased metabolic rate).

Have any of you spoken with a doctor about this?

For example, 1200 calories is the lowest anyone is advised to take in. Then, add an active lifestyle onto that. This seems okay for 1 year or so, but forever?

Has anyone's doctor advised them to stay on the high end of the BMI "Normal" or possibly a few pounds into the "Overweight", simply because our bodies/metabolic rates are different?
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Old 12-17-2009, 08:14 AM   #2  
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I am determined that maintenance can be different from what you describe.

I am willing to have my weight be somewhat higher than my goal weight, if that's where it has to be. I don't mean gain it all back, however.

None of what I'm saying is medical advice, and I haven't talked to my doctor about it. That's my disclaimer.

When losing weight, I restricted calories and increased exercise. No surprising strategy there!

However, in maintenance it doesn't make sense to me to continue that level of restriction and exercise. At the same time, one definitely cannot go back to the old ways of doing things.

What I am currently experimenting with is this: I set my calories at a level that a woman of my age and height should be able to eat to maintain if she weighs 142 and has a moderate level of activity. (I do not weigh 142--in fact, I'm about 20 pounds above that at the moment.) And, I set my exercise at a frequency that I feel is sustainable in the long run, which is 4 days a week. (I was having problems with my joints from exercising more often.)

In choosing my foods, I pay attention to nutrition, not just the number of calories. I try to get enough protein especially. I do take supplements--particularly vitamin D (1000 mg a day--directed by my physician) and calcium. Also multivitamins from time to time, and some glucosamine to help my joints.

The main thing is, my focus is on keeping within my average weekly calorie range (1500-1600) and getting my exercise. I am not concerned at this point with what the scale does, although I do weigh.

Also, from my experience with losing weight, I know which foods I have to restrict or leave out completely, I know how to measure foods, and I know how to avoid being around foods I shouldn't eat. This part is the lifestyle change, along with regular exercise.

For a couple of years after I lost the 50 pounds, I seemed to be on a cycle of gaining a couple of pounds, freaking out and going back to dieting (that is, the strict weight loss plan), then being unable to sustain the effort. Each time I did this, I gained a little bit more, even though I never completely stopped paying attention or stopped exercising.

Isn't this really just yo-yo dieting with a pretty short string? The common lore is that yo-yo dieting doesn't work for weight loss, so why should it work for maintenance?

Anyway, my experiment is ongoing and the results aren't in--however, I hope we'll hear from others who have been doing something similar to this approach. I do know that I feel much less stressed out.

Jay

Last edited by JayEll; 12-17-2009 at 09:17 AM.
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Old 12-17-2009, 09:27 AM   #3  
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Quote:
Originally Posted by bonnnie View Post
Some people in this thread have honestly reported they are hungry all the time ....
I am sure most women here take a multi-vitamin and/or calcium supplement -
but is that enough given the large calorie deficit?

I'm wondering about the long-term health effects of maintaining a weight that may seem on average, thin, but in reality is TOO thin for someone who has been so large (thus has a decreased metabolic rate).

Have any of you spoken with a doctor about this?

For example, 1200 calories is the lowest anyone is advised to take in.
Then, add an active lifestyle onto that.
This seems okay for 1 year or so, but forever?

Has anyone's doctor advised them to stay on the high end of the BMI "Normal" or possibly a few pounds into the "Overweight",
simply because our bodies/metabolic rates are different?
Speaking for myself, I am in my mid-60s and in excellent health.
I do not have any medical issues nor take any medication (vitamins only).
I've been working to maintain a large weight-loss for many years.
17 years ago I had a gastric bypass with no malabsorption, every calorie still counts.
For that entire 17 years I've kept an 80 lb net weight loss.
A great deal of that time I ate under 1200 calories a day.
A bit over 5 years ago, I finally stayed on a low-calorie diet (1250 calorie 16 month average)
long enough to drop an additional 75 lbs, and I've been working to maintain it for the past 4 years.

Yes, I am often hungry before eating.
Hunger is not an abnormal feeling, just the body's reminder to eat.
I've learned that my body adapts it's hunger feelings to whatever amount of food it is used to getting.
Regarding my mind's hunger.. and my appetite..that is a separate issue.

Different bodies require different amounts of food intake.
For most of us, the smaller and older the body, the less food is required.
I don't choose to do intense exercise in order to get a few extra daily calories.
I, personally, hate doing more than 1 hr a day of low-impact exercise even more than I like to eat a tiny bit more.
The net value of the calorie equivalent of a cookie or two just doesn't cut it for me.

Re: the value of a doctor's advice..
(even though my own doctorate is in law NOT medicine)
I've learned that the majority of doctors know far less about nutrition/food/weight issues than I do.
I've also learned the arbitrary 1200 calorie number limit is wrong for many people...including me.
It isn't difficult for a small, older person who is educated in nutrition to fulfill all nutritional requirements while eating less than 1200 daily calories...or less than 1000 calories...or even less than 800 calories.

The specific calorie number that it takes for me to maintain my weight
is rather low, but when I'm maintaining my weight there is no calorie deficit.
A calorie deficit is the difference between the food (energy) going into the body, and the energy used by the body.
There is NO CALORIE DEFICIT if the food intake, and the body's energy burn is the same.
For example if the body burns 1000 calories, and one eats 1000 calories, there is no deficit.
This is the same for a burn of 800 and food intake of 800 calories...(hopefully not less, but it happens for some).
My opinion is that a daily multi-vitamin provides all (or most) essential vitamins and minerals, irrespective of one's weight or food intake.

The body's metabolic rate is what it is.
It is an involuntary function, like breathing, temperature, cell division and repair etc.
Metabolism is a favorite topic of many of the Diet Gurus,
but, in truth, thinking and talking about metabolism is pretty much worthless,
(unless you are medical personal involved in research)
because there is almost nothing that anyone can do to increase it.

I, personally, don't feel I have a great deal of "choice" in exactly what I weigh.
In order for Maintenance to work for me, I must work as hard as necessary (with my food intake) to stay a size I find personally acceptable.
I've learned that letting myself get larger than that size is detrimental.
Deciding that I can keep on an additional 5 to 10 lbs is disasterous for me.
For me, 5 lbs up quickly becomes 10 or 30 lbs up, and then up and up.

There is no limit to how fat I can become.
I am very much like a forum friend of mine,
who, after maintaining a large weight loss for over a year, was at goal the end of May 2009
He decided to take a little vacation from dieting.
By the end of August 2009 he had gained 86 lbs.
3 months = 86 lb gain.
Now he's working to take it back off,
but he rightly expects it will take at least one or two years of solid effort to accomplish this.

I've spent my lifetime working to become a "normal" weight,
and maintain it.
Finally, I'm successful.
Does it matter that I get to eat very little?
It's a daily choice that I must make every day...
if I decide not to choose to do whatever it takes,
I'll be fat again...
Not just a little bit heavier than I am now,
but morbidly obese.
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Old 12-17-2009, 09:46 AM   #4  
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Bonnie, I think that if this is something you are concerned about you should talk to your doctor about it (or better yet, a doctor who specializes in people who are formerly obese or bariatrics). Health-wise I don't think there is anything wrong with staying on the high end of the "normal" range -- after all, that's why normal is a range, not a single number. There have been a few people who posted some studies indicating that being in the low end of the "overweight" range may not really be harmful either (it's not like when you cross the magic line you suddenly are more likely to die, right?).

As for being hungry all the time or needing to eat extremely low calories, that also varies from person to person. There are people out there maintaining on 1200 calories and people maintaining on 2200 calories. Some people are hungry all the time, some people are never hungry. Some people exercise an hour a day, some people don't exercise at all. The general wisdom is that the fewer calories you are eating, the more sensitive you need to be to the nutritional content of those calories.
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Old 12-17-2009, 09:54 AM   #5  
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I'm going to suggest that you read a book by Anne M Fletcher called THIN FOR LIFE.

The author interviews several people who have lost a significant amount of weight and kept it off for a significant amount of time. Their stories vary greatly.

It has been the most impactful weight loss read for me.
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Old 12-17-2009, 10:09 AM   #6  
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I agree with what paperclippy says--there are many different paths, and each individual must find out her or his own.

One thing I also believe is that someone who has been overweight/obese cannot go back to eating the way they did before they lost weight. I did this more than once in the past, with predicable results. Bright Angel's friend could have seen it coming as well--in fact, one wonders why he waited three months to stop, at a rate of a 20 pound gain per month.

There is no upper limit to how many calories we can consume. Unfortunately, there is a lower limit below which the body simply isn't getting enough. That's one reason why people who stop watching what they're doing with food altogether can gain so quickly, but need so long to get those pounds back off again.

Jay
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Old 12-17-2009, 11:17 AM   #7  
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I'd advise speaking with your doctor if this is a concern for you.

I actually did speak with my doctor, during a time period in which I was trying to eat what I believed to be a reasonable number of calories for my weight/activity level and was steadily gaining weight (I had purchased a heart rate monitor device that calculated calories that would be burned by an average person based on heart rate, age, weight, etc and was wearing it 24/7...it would tell me repeatedly that I'd burned 3500-4000 calories per day, so I raised my calories to 1800-2000, thinking that perhaps I was stalling because I wasn't eating enough. Turns out that I'm just way, way off the average on this).

His advice to me was that, so long as I was eating nutritional foods that were carefully chosen to meet my needs, he would rather see me eat less and maintain my weight (which, btw, is a bit into the overweight range, mostly due to muscle and frame size....my body fat percentage and waist measurements are both in healthy range). He then called in the staff nutritionist who said that, particularly for someone who is post-obese, the risks of weight gain are worse than the risks of a slightly lower calorie intake and resultant lowered nutrient level.

He did say that if I found myself starving, I should eat. I don't really get to that point, though, even on 1300-1400 calorie days, because I eat so much fiber, whole grain, vegetable matter, etc. I am eating giant, vitamin-filled portions of food. If I had to compare my plan, with 1400-1500 calories of vitamin rich food, to a standard American diet of more calories, I know that I'm getting more vitamins, minerals, and fiber.
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Old 12-17-2009, 11:28 AM   #8  
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Quote:
Originally Posted by Bright Angel View Post

The body's metabolic rate is what it is.
It is an involuntary function, like breathing, temperature, cell division and repair etc.
Metabolism is a favorite topic of many of the Diet Gurus,
but, in truth, thinking and talking about metabolism is pretty much worthless,
(unless you are medical personal involved in research)
because there is almost nothing that anyone can do to increase it.
.
I have come to the same conclusion but wonder about Lean Muscle and that impact on metabolism, and thus weight loss or maintenance. Do you think one can significantly increase their muscle mass (especially middle aged women) to alter metabolism and make either weight loss or maintenance easier?
Karen

Last edited by Karen925; 12-17-2009 at 11:30 AM.
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Old 12-17-2009, 11:34 AM   #9  
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I think calorie level may not be as important as where those calories are coming from, and how efficient your body is at making and utilizing the nutrients in what you're eating.

Exercise, lifestyle, and environment no doubt also play a key role.

I'm not sure even a doctor's or dietitian's answer would help, in that I've never asked the specific question, but have asked doctors, dietitians, pharmacists, and diabetic educators very similar questions (such as how will I know if my diet is balanced "enough").

Virtually all told me there's really no way to ensure you have the perfect balance, except through symptom monitoring and routine checkups and tests.

So whether you're eating 2500 calories or 1200 (even on a varied, whole foods diet), you may or may not have issues with vitamin and mineral deficiencies. Eating a generically well-balance diet will help, but it won't guarantee that you won't have issues.

A daily multi-vitamin (and possibly a fish oil supplenent) and an annual check-up are probably a better "insurance" than choosing a higher calorie range.

I've often heard 1200 calories quoted as the point at which it becomes very difficult to eat a sufficiently balanced diet without requiring the use of supplements. However, I doubt this is a written-in-stone number (because I believe there's so much variation between individual that there is no such number). For that matter, I don't think there's a diet that is optimal for everyone - so essentially it's all a matter of trial and error (and healthcare management).

Another thing to consider is that there are no guarantees that your end-of-weight-loss-diet metabolism will be your metabolism for life. There are ways to boost your metabolism, even if only somewhat. Many people find that they can eat far more calories, for example if the restrict carbs or high-GI carbs.

Trial and error, is pretty much all we've got.
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Old 12-17-2009, 11:52 AM   #10  
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Bright Angel- It really struck me when you said "Does it matter if I get to eat very little?". I'm going to try and change my attitude to match yours.
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Old 12-17-2009, 11:56 AM   #11  
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I don't think there is one across the board "correct" amount of calories for any one person. I'm not an average person by any means and for me to go by "standard" guidelines would be a death sentence.

I've been adhering to a 1200 calorie diet for years now, though I do go higher on most weekends (1500) but then again I've gone lower here and there as well. I can't recall ever being truly hungry. I do my best to avoid that by eating frequently and what I do eat is high quality, satiating, voluminous foods. If I were hungry - I'd eat. I'm not willing to go hungry.

I've never been healthier (or happier). I'm 46 years old and my doctor says I'm the picture of good health and wishes everyone would do what I do. And no, I don't take a multi-vitamin. It's not necessary. My doctor sees not need for it what so ever. According to blood tests, I hit above the mark on each and every vitamin with the exception of D, the sunshine vitamin. So the only supplement I take is a Vitamin D plus calcium pill. I'm getting more nutrition from the 1200 calories I'm consuming now than I did when I was consuming 4 times that amount daily. More nutrition, lowered weight, more energy - that's what I believe we're aiming for.

It is MUCH healthier for me to adhere to 1200 calories of nutrient rich foods and there by maintain a "healthy" weight, then to go higher on my calories.

So no, I'm not concerned one bit about the long term affects of the diet that I adhere to. Just the opposite. I used to worry all the time about my health. That is no longer the case.
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Old 12-17-2009, 03:37 PM   #12  
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Wow, what an interesting thread.

I am be consuming fewer calories then when I was obese, but the quality of the food I'm eating is amazingly better.

Whereas my old diet was mostly processed foods, Taco Bell, pizza, Starbucks lattes, nachos and scones, I now eat lean protein, tons of fresh vegetables, fruit, low fat dairy, complex carbs and healthy fats.

I have never felt that I've had to eat so few calories a day that I worried for my health. I am able to maintain nicely around 1800 calories (yes, I am lucky!) and I feel like I am taking in plenty of vitamin-rich foods. I eat plenty of small meals/snacks throughout the day, so I'm not overly hungry or have to listen to my tummy gurgle (much, heh).

For me, maintenance is not a health risk. My old way of eating was a health risk!! With my lifestyle change, I have given myself the gift of energy and health.
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Old 12-18-2009, 12:03 AM   #13  
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I found this line by Bright Angel to be particularly compelling.

In order for Maintenance to work for me, I must work as hard as necessary (with my food intake) to stay a size I find personally acceptable.
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Old 12-18-2009, 09:44 AM   #14  
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Quote:
Originally Posted by bonnnie View Post
After reading many of the more scientific-related threads on how maintainers will never really be able to eat the calories of a normal thin person - they will need to eat even less and be even more active (which I find also to be true), I started thinking about growing older.

Some people in this thread have honestly reported, they are hungry all the time and can often even feel their stomach gurgling.
Very interesting thread. I have enjoyed reading everyone's responces. I somehow don't seem to fit in with the norm, (What a shock...) I eat more now than when I was losing. Quite a bit more. I don't go to the gym or do repetitive exercise either. I move a lot, but nothing set in stone. I have been able to raise my calories and maintain my current activity level to keep my weight constant between 141-145

I read probably daily on 3FC where obese members are told to eat more, eat more. The most common answer to any "Why am I not losing" question is to EAT MORE. I have never really understood it, but then again, I never had a plateau until now...which is self induced, by choice. I also never understood why a person with an excess of 100+ pounds of natures perfectly designed fuel would need more fuel. I have also challenged this common reply, but that never goes over very well. I often wonder what happens to them at maintaince...do they get to keep eating more?

I started out at 1200 calories a day, after a few months I added some calories for the weekend but still averaged around 1330/day. After I reached my original goal weight I added in more calories for an average of 1500 calories and still lost an additional 15 pounds, now I'm eating between 1900/2000 calories a day and have been very happy with the results. This morning I was at 144.2 and TOM will be here any minute. (can you tell? ) I often wonder if my strategy in weight loss, (starting low and adding back calories at goal and not depending on major excercise to get me where I wanted to be,) is the reason I don't have the issues other have with needing to eat tiny amounts and doing massive amounts of excercise to maintain. One thing is for sure, whatever the cause, I'm truly thankful. At my current calorie level and with my current food choices my doctor (and myself) feel as though I am receiving excellent nutrition.

Last edited by Lori Bell; 12-18-2009 at 10:01 AM.
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Old 12-18-2009, 10:06 AM   #15  
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Lori Bell, I think the obese members who are being told to "eat more" are usually eating under 1200, sometimes even under 1000, at weights of over 200 lbs, and they say they are working out strenuously almost every day.

I don't think you'll see many posters telling someone eating 1600 calories and not exercising to eat more...

Jay
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