Saturday, October 3, 2009

Visit to the Doctor

I saw my internist yesterday. There were a few surprises in the visit.

The first is that my average weight loss over the last several months is 1/2 pound a week. That's a pretty slow rate of loss. My thyroid level will be rechecked next week, but there is no reason to think it is not being well controlled by medication.

I am eating 1000-1200 calories a day; most days closer to 1,000. I'm exercising 6 hours a week. Dr. Fung thinks it would not be safe to eat less than 1000 calories a day, given my activity level. He does not think the issue is my thyroid. He thinks it is genetic history (all the women on my dad's side are very, very obese) and he said there is much that is not known about how genetics affect metabolism. It is clear that there is a link but much that is not known.

He said basically, I have two choices (in the "reasonable" arena, anyway).
1) Keep doing what I'm doing and realize it is going to take a long time. We are talking about 25 pound a year loss, IF I am really diligent about staying in this range. I wondered about increasing my exercise but as you know, that won't help a LOT because it is hard to burn calories with exercise. However, increased muscle does increase metabolism so it seems like at some point, my metabolism would heat up.

2) Go on a medically supervised diet where you are on all liquids for 6 weeks and then add in other foods they provide. It is an 800 cal/day diet but it is medically supervised so your blood is checked for ketones and things like that on a regular basis. I am going to go to the intro meeting just to make sure I have all the facts. As I understand it, you are not allowed to eat anything except the pre-pared food, so no fresh food at all. There is also a concern about how many foods they have to offer that do not contain onion or onion powder so I will research that at the meeting as well. There is a cost, obviously, which I think is about $200/ month.

Neither of these options make me do cart-wheeels. I think I need to make sure I have all the facts on the medically supervised program before deciding.

I am not still upset about this stuff. In some ways, it is confirming of my experience. It is helpful to have been tracking my calories and weighing and measuring so there is no doubt in my mind about my calorie intake. I did not expect there to be an easy answer. Right after my conversation with him I had some "not fair" thinkin which was hooked to my core belief that "Life is not fair." I know that is not true and have "unrooted" that belief and am now ready to make some decisions about how to proceed.

Since Dr. Fung is my third doctor in the last three years to work with me on my weight, I have concluded that medical science has done what it can, aside from option 2 above. I think what he said is accurate -- it "rings" of the truth. I am not willing to undergo surgery and weight loss drugs would not really help since I don't have an appetite issue ( I have not been hungry at all). I'm pretty anti-drug anyway.

That's what I know today. I hope to attend the "option 2" meeting in the next week and then think about how I want to proceed.

Data: Down another 2 pounds this week. Being sick probably had an impact so working to hold onto it and add to it this week!