Friday Weigh In – The 160s!

After taking off from weighing last week while I was sick, I weighed in today at 168.2 pound, down 3 pounds!  I was happy with the weigh in, which covered two weeks, but cautious about it as well.  I was sick with a sore throat and haven’t been eating as much as usual.  I didn’t weigh in last week, because I felt that I was missing fluids which was one reason my weight was down.  I didn’t want to have a 2.5 pound loss last week, then gain this week when I had more fluids.  As it turned out, I was sick most of this week so still didn’t eat a lot and lost another half pound this week.  That is all good, but I’m not really confident that it is a true 3 pound loss.  I think part of this is because I’ve eaten less carbs over the past couple of weeks, since I’ve eaten less of everything.  I’ve been at under 100 carbs most days.  Restricting carbs usually causes my body to release water, but when I go back to eating more carbs (and more calories) I expect to start retaining more water.  In any event, I hope to keep all of the loss or maybe just regain a little.  I hope I’ll stay in the 160s as it has been a bit over 2 years since I’ve been in that range.

On another note, today’s meeting was good.   The topic was anchors, which are things – can be an object or a saying or a memory or whatever – that will connect you to some past time which you can then channel to help you succeed in the present.  The leader asked members for any sayings that they used for this purpose and one of the members came up with an awesome saying which she had gotten from her grandfather:

WW meeting

She said she had this saying posted in her home, “I already know too many reasons why it can’t be done…So let’s talk about how we’re going to do it.”  Just a great message and a wonderful anchor!

Anyway – about this week.  I was still sick most of the week so had no activity at all.  I did finally get to go to physical therapy for my knee on Thursday and I was glad to get started on that.  I’m still using the walker, only be allowed to put down a toe for balance.  I am so tired of this and really wanting to be able to walk again.  I’m supposed to go to PT again early next week and then see my doctor on Thursday, my 4 weeks being up.  I have tons of questions to ask him about my future activity and hope he will clear me to at least get rid of the walker (or at least to be able to put more weight on the leg).

The one good thing was that I was super careful what I ate.  Since I was sick I didn’t go out to eat which did help (although my husband did bring in Panera one day which was great).  I am happy that I haven’t let the physical setback get me off track from an eating standpoint.

And, of course, one again, I’m so happy to finally be back in the 160s again!!!!!!

NWI – Sick

Just a quick post to say that I didn’t weigh in this week because I was sick.  In my last post, on Monday evening, I said I thought I was coming down with the sore throat my son had the prior week.  Tuesday morning I woke up with a fever and just felt incredibly wretched.  I had to reschedule my physical therapy appointment to Friday since I figured they wouldn’t want me to come there with a fever and I felt awful anyway.

On Thursday, I added conjunctivitix to my symptoms and my eyes were running and crusty and just totally yucky.  I thought I might be able to make it to weigh in Friday and go to my PT appointment, but I woke up still having a fever so I cancelled both of them and basically stayed in bed the entire day except for bathroom breaks.  That did seem to help me get some needed rest (I had had trouble sleeping due to coughing so much).

I planned to go and weigh in this morning (Saturday) if I woke up and felt better.  I actually did wake up and my eyes were much better and I didn’t have a fever.  But, I decided to weigh in.  Why?  I knew it wasn’t a valid weigh in.  My weight (without clothes) was 168 pounds this morning.  With clothes it was 168.7 pounds which would have been a 2 1/2 pound loss.  I knew that I didn’t have that kind of deficit this past week.  My actual deficit was about .6 pounds.  Now, if it was a little over that, I wouldn’t be surprised by that since sometimes a little bit of loss from the prior week will show up the next week.  But, there is no way that could be a 2.5 pound loss.

I realized that what was really going on is that, due to lack of appetite, I hadn’t eaten much food (or much carbs) the past few days and so I don’t as much water in my body as usual.  I can see this clearly as my scale shows my body fat percentage going up by about a percent over the past few days.  Basically, probably 1 1/2 to 2 pounds of that 2.5 pound loss is just fluids and as soon as I start eating bit more I will gain back that fluid.  I didn’t want to go and weigh in today and have a big loss that wasn’t “real” and then go in next Friday and have a big gain that wasn’t real either.  And, since I still felt fairly crappy, it just wasn’t worth it to drag myself 45 minutes away just to get an invalid weigh in result.

I’ve rescheduled my PT appointment to next Thursday and think I’ll be fine by then.

It’s a Struggle

I am just realizing that I’m struggling a bit this week. Friday was a little bit higher calorie day (a little over 1400) because we went to Chili’s after the Weight Watchers meeting and I ate a little more than usual. That was fine, but I only had about 100 calories deficit for the day because all I really did activity-wise was use the rower for 20 minutes. I was going to use it for 45 minutes, but I noticed my left was hurting and I’m only supposed to use if it if the knee doesn’t hurt.

Rower

All of which made Saturday a very sedentary day. Fitbit said I burned only 1386 calories. That shows how few calories someone my age and weight can burn if I’m not doing much except sitting around. Using a walker without bearing weight on my left leg doesn’t lead to me burning many calories, particularly if I’m not able to use the rower. I decided to take off from the rower until my knee doesn’t hurt any more.

Saturday I didn’t even have a calorie deficit. Usually we go out for lunch on either Saturday or Sunday, but it is hard to do using the walker since the hopping is just exhausting and it’s hard to maneuver the walker in a lot of restaurants anyway. So, I sent my husband out to get Subway. I haven’t eaten there in since early February. I did eat higher calorie than usual, partly because I was feeling sorry for myself. It wasn’t horrible my total calories for the day were still under 1500 calories. But, burning so few calories, Fitbit says I ate 80 calories more than I burned for the day.

All of which was really depressing. Before, if I was eating 1400 and something calories on a weekend day, it wasn’t stellar, but it was still a calorie deficit. Now, it may not be.

Sunday was a little better. I still could feel my knee bothering me some so I didn’t use the rower. I did get in a little activity by doing upper body strength training. Fitbit says I got my calorie burn up to 1458. Had I not done the upper body work I would have only burned 1400 calories or so. I did eat less today so I had a 337 calorie deficit.

On top of everything else, I realized in the evening that I seem to be starting to come down with the sore throat that my son had all week. My head was really hurting and I was coughing and just generally aching all over. None of which makes me happy.

I’m just not feeling in a good place right now. I hate, hate, hate the just sitting around all the time. Doing the rower for 45 minutes or so a day was the one thing that was helping. Now, I have to wait until my knee feels better. And, once it does feel better, if rowing causes it to hurt again then I may have to cross rowing off my exercise list which won’t make me happy either.

Monday I go to my first physical therapy appointment. I have mixed feelings about it. I want to do exercises to help maintain (and maybe gain) strength in my leg. But, I know I’m very limited in what I can do. The doctor’s office said it would be all non-weight bearing, range of motion stuff. Things like leg raises and quad sets. Also, I’m dreading going to the physical therapy office. It is on the 2nd floor of a building (there is an elevator) and even with my husband dropping me off at the front of the building, I will have to do a lot of exhausting hopping to get from where I’m dropped off up to the office. I know it sounds ridiculous to talk about using a walker being hard, but I am not supposed to bear weight at all, so I basically I am just hopping on my right leg. That gets very tiring and unpleasant really fast. At first, it seems fine but once I’ve walked hopped about 30 or 40 steps, it is very hard to do. I actually put on a heart rate monitor one day while doing it and surprised to see my heart rate getting up into an aerobic zone. I wouldn’t actually mind that part, but the hopping on the one leg is very jarring to the body. I just dread the walking from the building to the PT office and then later the walking back outside.

I recognized today that I was in danger of going off track. A part of me just wanted to bury myself in food that would make me feel better. I did manage to stay on track and ended up having a good day in terms of what I ate. But, I know that I’m just frustrated and depressed by how this leg injury is playing havoc with my calorie deficit. I know that I have to recognize that if I don’t have much of a loss (or any loss) for the next 3 weeks, it is no big deal just so long as I don’t go off track and have a large gain. But, it is still a struggle. I feel like I’m doing so much work to watch what I’m eating during this time, but I don’t have much chance of seeing much success at the scale given how few calories I’m burning. And, yes, I know that this is a time when I shouldn’t really be focused on the scale. It’s still hard.

Friday Weigh In

This was a pretty good weigh in under the circumstances with my knee and leg:

WI 5-16

I weighed in at 171.2 pounds at my Weight Watchers meeting and was down 1.2 pounds.  Since I am still on non-weight bearing status with my left leg and am using a walker, I am not burning nearly as many calories.  My calorie burn on Fitbit this week was about 240 calories a day less than it was last month.  And, this was with rowing on my Concept2 rower on 4 of the days.  By itself, that much less calorie burn would cut my weight loss by about half a pound a week.

However, I did eat about 80 calories a day less than I ate a day last month so my actual deficit per day was about 160 calories a day less, which should cut my weight loss by about .3 pound each week.  Still, for this week I lost 1.2 pounds.  Most of that, though, was clearly loss from the prior week that didn’t show up until this week (most of the loss showed up last weekend right after Friday weigh in).

If I continue eating as I am eating and using the rower as I’m using it, I hope to lose between .6 and .8 pounds next week.  I’m not sure that I will keep eating as lightly however.  I was very careful this past week and I’m not sure I can be that careful for the next 3 weeks.  This past week I was below my goal for calories so I may end up upping it a bit, particularly since I want to make sure I’m getting adequate nutrition.  Also, if my knee starts bothering me with the rower I’ll have to stop.  I think I will be able to keep doing it as long as I don’t do it too many days in a row without taking some time off.

On Monday I am going to start going to physical therapy.  I don’t expect it to burn many calories though since I’m mostly doing range of motion stuff that is limited in scope since I am not supposed to bear weight on my left leg.  So, it may help my knee and leg but I don’t expect it to be a major source of burned calories.

When I post next Friday and I’m disappointed in my weight loss, remind of this post.  I plan to try to get closer to losing a pound than not, but I also know that under the circumstances between .5 and .8 is actually good.  And, looking at graph above, I know I have to look at the big picture.  That graphs covers the last 24 weeks.  I had a net loss of 19.4 pounds.  Yes, that is less than a pound a week.  But, it is almost 20 pounds!  That’s a lot of weight to lose.  And, I gained weight at only one of those weigh ins (2 weeks ago).  Every other time I either lost or stayed the same.  In the end, these 4 weeks of reduced weight loss won’t really matter so long as I keep on the downward slope.

 

Doctors Telling Patients to Lose Weight

Yoni Freedhoff, a physician who writes the Weighty Matters blog has a great post urging doctors to stop telling patients how much weight to lose.  He doesn’t really mind doctors having a “respectful discussion” with patients if they think that weight is having a negative impact on the patient.  But, he objects to them pulling a specific number out of the air or from a BMI chart.  And, he also objects to them simply telling a patient to lose weight without giving them any realistic plan to help them do it.  The best quote from the post:

Secondly you need to understand that if you have no useful weight management advice to offer beyond the less than useful, “try to eat less and move more“, all you’re really doing is undermining your doctor-patient relationship as the likelihood of your patients not wanting to lose if their weights are truly affecting their health or quality of life, is likely close to zero, and yet here you are, their doctor, telling them something they already know, inferring quite clearly that you think that if they just put their minds to it they could make it happen, while simultaneously offering them no actionable help or support whatsoever.

This was such a great point on a lot of different levels.  First, most doctors in my experience have little to nothing to offer on weight management advice. Years ago, I remember doctors handing out to me some sort of preprinted diet that was very barebones and generic (I remember one that had cottage cheese on it as a frequent food to eat.  I hate cottage cheese so I didn’t get very far with that one).  In recent years, they haven’t even done that.  But, I haven’t seen them giving any advice that was valuable.

The last part of the quote above is really the heart of the matter.  So many doctors act like losing weight is so easy.  And, if it is so easy, then the only reason you haven’t done it is either that you don’t know you are overweight (ha!) or you haven’t tried.  And, since losing weight is so easy, if you try you will lose weight.  So, all the doctor has to do is to tell you to try and then it will magically happen.  All of which is of absolute no help to you and gives you no tools to accomplish anything.

I am not saying that every doctor does this.  I know that many do not.  The orthopedic surgeon I saw last week was good I thought.  I mentioned that I had lost 35 pounds and he was appropriately encouraging to me.  He didn’t try to tell me how much I needed to still lose and didn’t try to tell me what to do.  We did discuss how walking had helped my weight loss and he mentioned that, when I got to normal weight walking, was not the best choice for me for activity given my knee.  It was clear, in the context, that he thought that I should continue to work on weight loss, but he didn’t try to tell me how much to lose or how to do it.  I felt encouraged by that.

My primary care physician that I had before I moved was good.  He once made a comment that losing some weight might be beneficial to me.  But, he didn’t try to tell me how much to lose.  I felt fine with that.  It was clear in context that he thought that any weight loss was good.  As he saw me losing weight, he did ask me how I was doing it.  When I told him I was going to Weight Watchers, he said he thought it was a good program.  He said that my weight loss was “great”, even though I was still in the overweight range.  I felt very encouraged by that as well.  Had he, instead, started harping on me still needing to lose another 20 pounds I wouldn’t have felt as good about the conversation.

As for whether physicians should mention losing weight at all, I have mixed feelings.  As Dr. Freedhoff makes clear, most overweight patients usually know that they are overweight.  So, it will not be a newsflash for a doctor to tell them.  And, I know that many of us are already trying to lose weight or have made many failed attempts.  So the doctor telling us again can be annoying.   Whenever I was going to the allergist, for awhile the discharge instructions at every visit, always said to see someone for weight management.  Since I was already going to Weight Watchers and was working on losing weight this irritated me, particularly when it was on ther3 every time I went.  It just seemed to be a constant jab at me for no good reason.  I finally asked that it be taken off.  It was getting to a point that I hated going there since I was going to read this every time.

On the other hand, I think there are people who get benefit from a doctor mentioning weight.  First, some people may not actually realize that they are overweight or may think they are a little overweight when they are actually obese.  This may be a bit of a stereotype, but I think that men are more likely to fit into this category.  Second, not everyone has a clear understanding of how overweight may affect a particular health condition.  If I hadn’t told the orthopedic surgeon that I had lost 35 pounds and was actively working on getting to normal weight, I think it would have been appropriate for him to tell me how excess weight can put stress on my knees.  It is easy if you read a lot of blogs or do a lot of online research to think that everyone knows how overweight can negatively impact aspects of health.  But, the world is full of people who don’t do any of that and are not that knowledgeable.

There is also a third group of people.  This is the group of people who know they are overweight and know that it can have a negative impact on health, but they haven’t really focused on what that means for them.  For those people, if a physician really explains it to the patient, then the explanation can be a wake up call.  Of course, there is a right way and a wrong way to do that.  The wrong way is to just tell someone to get to X amount of weight and to give them no helpful input on how to do it as Dr. Freedhoff explains.  Dr. Freedhoff in his post also explains what doctors should do in giving weight management advice.  His post is well worth reading.