Family worried

[SueEK]

Hi everyone, I have been doing well with the low carb but have recently had a problem with my shoulder causing a great deal of pain and am signed of sick for 4 weeks. My family, one by one have talked to me about how much weight I have lost and that they think I am too thin, pale and quite unhealthy looking. When I popped into work today all my colleagues said pretty much the same thing except more delicately. I have lost 20lbs since January and now weigh 9st 13lb but am 5ft 9in and I admit I don’t look great. I have not been this weight since before my daughter was born 31 years ago. I am very tired and have little appetite but am making myself eat even if it is snacking on a banana, nuts, cheese and had a small portion of rice and chicken yesterday, am trying to eat a meal each day but I continue to lose weight. I saw the dietician last week who was lovely and understood the low carb thing but did suggest I eat more carbs to increase my weight and give me more energy, she has also arranged some blood tests. I am loathe to do this as my bg’s are very good at the moment. Please does anyone have any suggestions or ideas as to what I can do, my children have suggested protein drinks or bars but I’ve no idea if this is a good idea or not. Your experienced advice would really be much appreciated. Thanks. Sue x

 

[eggyg]

That’s nearly a stone lighter than me and I’m only 5ft 2ins! I could do with loosing a stone admittedly! What about cream/ full fat milk in your coffee or tea, a cooked chicken, boiled eggs, slices of ham, Babybels for snacks as well. Do you eat red meat? Nice juicy sirloin steak with 2/3 new potatoes smothered in butter and loads of salad with an oil dressing. Maybe the protein drinks are a good idea but watch out for the carb content, I think maybe @Madeline has had experience of these. It’s difficult if you’re not fancying anything or aren’t hungry. It’s protein that gives you energy, carbs definitely give you energy quickly but too many carbs will have you feeling sluggish. It’s a fine line unfortunately. Do you eat bread? You could try a high protein bread to make a sandwich, a packet of Pom Bears are under 9 grams of carbs to accompany your sandwich. Maybe try little and often meals rather than just one meal a day. Sorry if you’ve tried all these things. PS feel for you and your shoulder pain, I’m a martyr to my shoulders! Search “ shoulders” on the forum, there’s loads of posts!

 

[SueEK]

Thanks, I have had full fat milk in my coffee but strangely have not fancied coffee since starting the Metformin. I have tried all the things you suggested other than high protein bread, didn’t know there was such a thing, I have resorted to having some toast in the morning and occasionally a sandwich at lunch time as I simply cannot continue losing weight. I nibble all day on things like cheese strings, dairy Lea triangles, nuts, couple of chunks of 85% dark choc, small portion of vanilla ice cream and a small meal in the evening. I can understand losing more weight recently because of the amount of painkillers I have been taking I felt blooming awful and you can’t eat when in pain but this is getting beyond a joke and I’m at a loss but thank you so much for your suggestions (and sorry for your shoulder pain too)

 

[Docb]

As usual I come back to the numbers. Your height and weight give you a BMI of about 20. That means you are in the middle of the healthy range so at the moment there is no need to get worried about being under weight so its likely that your family and colleagues are reacting to the change in your appearance rather than your appearance itself especially if the pain in your shoulder is showing in your expression.

The normal method for treating people who need to gain weight is to ban nibbling and snacking and to get a routine for eating proper meals established. In an eating disorders unit, there is breakfast, lunch and dinner with a mid morning and mid afternoon snack. In that enviroment meals are planned and nutritional values calculated for individuals as appropriate. Not in anyway suggesting that you need to do any of that but the basic principal of eating proper regular meals even when you do not have any appetite is the best way of maintaining or gaining weight. You will never get a proper nutritional balance and enough calories by snacking.

Hope that helps.

 

[Pollyanna]

Have you tried the pain patches or the gels like volterol ?

 

[rebrascora]

I agree that one meal a day plus snacks is not going to keep your weight stable. Two meals a day plus snacks is holding mine steady. I have a 2 or 3 egg mushroom omelette for breakfast with salad leaves and avocado (minimal carbs), snacks of nuts, cheese or a little fruit and yoghurt at lunchtime and then a proper meal (meat or fish and veg) with a small portion of starchy carbs on an evening and maybe some berries and yoghurt or sugar free jelly for afters.
By the way, I think you would be better off with a chunk of good cheddar rather than processed cheeses like cheese strings or Dairylea which will probably contain unhealthy fats.

 

[SueEK]

Have you tried the pain patches or the gels like volterol ?

Thankfully the pain has eased somewhat now and I can’t have anything with anti inflammatory in it as on lifelong aspirin but thank you.

 

[SueEK]

I agree that one meal a day plus snacks is not going to keep your weight stable. Two meals a day plus snacks is holding mine steady. I have a 2 or 3 egg mushroom omelette for breakfast with salad leaves and avocado (minimal carbs), snacks of nuts, cheese or a little fruit and yoghurt at lunchtime and then a proper meal (meat or fish and veg) with a small portion of starchy carbs on an evening and maybe some berries and yoghurt or sugar free jelly for afters.
By the way, I think you would be better off with a chunk of good cheddar rather than processed cheeses like cheese strings or Dairylea which will probably contain unhealthy fats.

Thanks, I can’t each much for breakfast, never have done and I agree with you and Docb that snacking is not really helping, it’s hard to eat proper food when you are so tired and not hungry, again you are right about the cheese, I must change it. I do tend to have the sugar free jellies in the evening so other than your breakfast I feel that I am probably eating as much. Before the problem with my shoulder I was doing fine food wise but was still losing weight, do you happen to know of any supplements that are ok to have? I suppose my appetite has never been huge so going low carb is really having an effect on me. Thank you for your advice.

 

[SueEK]

As usual I come back to the numbers. Your height and weight give you a BMI of about 20. That means you are in the middle of the healthy range so at the moment there is no need to get worried about being under weight so its likely that your family and colleagues are reacting to the change in your appearance rather than your appearance itself especially if the pain in your shoulder is showing in your expression.

The normal method for treating people who need to gain weight is to ban nibbling and snacking and to get a routine for eating proper meals established. In an eating disorders unit, there is breakfast, lunch and dinner with a mid morning and mid afternoon snack. In that enviroment meals are planned and nutritional values calculated for individuals as appropriate. Not in anyway suggesting that you need to do any of that but the basic principal of eating proper regular meals even when you do not have any appetite is the best way of maintaining or gaining weight. You will never get a proper nutritional balance and enough calories by snacking.

Hope that helps.

Thanks for your comments Docb and you are probably right about the weight thing, I have been the same weight for about 25 years so everyone has noticed the change, probably doesn’t help that I haven’t been able to put any make up on, however even when I was coping well with the low carb I was still losing a good pound a week which can’t go on forever. I will try to make more effort to eat three times a day but breakfast is a real challenge as I simply can’t eat more than some toast or small bowl of cereal (bg numbers have been good with these). Just don’t really want to lose any more weight. Thanks for your advice

 

[Docb]

When I was writing I was thinking about the complications of throwing in a low carb routine as a means of controlling blood glucose. I have lost a little weight on my low carb diet and I am OK with shedding another kilo but my DN did warn me to watch my weight when low carbing because I am not in the "overweight" diabetic group and she was concerned that I might get underweight if I did not watch it. Like you I have a fairly light breakfast but have a decent lunch and early evening meal making sure that what is lost in carbs is gained elsewhere.

Bit like being a gymnast on the beam. Its all about getting the balance right.

 

[SueEK]

When I was writing I was thinking about the complications of throwing in a low carb routine as a means of controlling blood glucose. I have lost a little weight on my low carb diet and I am OK with shedding another kilo but my DN did warn me to watch my weight when low carbing because I am not in the "overweight" diabetic group and she was concerned that I might get underweight if I did not watch it. Like you I have a fairly light breakfast but have a decent lunch and early evening meal making sure that what is lost in carbs is gained elsewhere.

Bit like being a gymnast on the beam. Its all about getting the balance right.

I agree and did think I had pretty much got the food sorted as best I could but those little one pounders a week add up. My dietician did advise I up my carbs which I have. Perhaps I have lost track due to the shoulder pain and host of painkillers which has also made me sleep a lot, doesn’t do a lot to give you an appetite. If I continue to lose weight I will ask to see her again if changing my diet again doesn’t help. Again thank you.

 

[AndBreathe]

@SueEK - I'm a very slight person, and work to keep my BMI at or above 18.5. I'm currently trying to gain a kilo or two.

To stabilise weight, I would suggest you try adding either some protein, and/or some fats. I needed both to halt weight loss 5 years ago. I recently dropped a couple of kilos on a trip overseas, so I've upped the protein and fats again. It's not a fast process, unless there are additional carbs involved, for me anyway.

I'd suggest you target stabilising in the first instance.

I'd further suggest you record everything you eat, drink and any exercise you take, so that you can look back to to asses what worked,..... or didn't.

 

[SueEK]

Thanks @AndBreathe certainly I could up the protein but my cholesterol is a little high so need to cut out my cheesestrings and dairy Lea so better not up my fats. I didn’t think this would be one of the problems of diabetes but it is certainly multi layered and it’s good there are others experiencing the same that can help and thank you very much

 

[Grannylorraine]

Not sure if anyone else has mentioned this, but could it be the Metformin causing the weight loss? My mum has lost loads of weight since starting taking Metformin just before Christmas and she hasn't changed her diet very much just cut out the sweet treats. She looks really thin now which is not good as she is 83, plus says she doesn't have any appetite any more.

 

[Grannylorraine]

Thanks @AndBreathe certainly I could up the protein but my cholesterol is a little high so need to cut out my cheesestrings and dairy Lea so better not up my fats. I didn’t think this would be one of the problems of diabetes but it is certainly multi layered and it’s good there are others experiencing the same that can help and thank you very much

this is the other problem the juggling act between different conditions and the food restrictions they bring.

 

[everydayupsanddowns]

I think if you are opting for low carb and not upping other sources of energy like fats, then overall you will have significantly reduced your energy intake and weight loss is likely to follow. The tiredness you are describing would be a worry for me.

Looks like you’ll need to increase your carb intake a little, if you are not keen on upping your fats? (though I’m endlessly confused as to whether and how much what you eat actually affects your chol level - I gather about 80-90% is down to your liver?)

Alternatively adding nuts and seeds, cheese and some protein might help?

I think the suggestion to keep a food diary and to try to establish a pattern of more regular meals and a little less grazing is worth considering, but ultimately it’s your diabetes and you have to find a system that works for you 🙂

 

[Drummer]

I suspect that doing low carb by eating small amounts of high carb foods is not a good option. On top of all that Metformin you are not pushing your metabolism into ketosis, which I think is the healthier option for type twos.
Although cereals and bread are fortified, they don't fill the niche where veges and salad stuff should be in your diet, and they are likely to be low fat which is not a good idea for anyone - fats are essential.

 

[Pine Marten]

Not sure if anyone else has mentioned this, but could it be the Metformin causing the weight loss? My mum has lost loads of weight since starting taking Metformin just before Christmas and she hasn't changed her diet very much just cut out the sweet treats. She looks really thin now which is not good as she is 83, plus says she doesn't have any appetite any more.

I wonder about this too - I was quite taken aback when I discovered that Metformin was being dished out to trendy young things who wanted to lose weight!

 

[SueEK]

Thanks all for your help and advice. I have been thinking a lot about what you have all said. I can see that others are really noticing the difference in me because I never look any different, 11st 5lb for over 25 years so yes there is a big change in my appearance. Because of the pain and very limited movement in my arm I haven’t been able to do my hair or make up and wearing loose baggy clothes that are easy to get into. I only found out the other day on chatting to GP that I shouldn’t have anti-inflammatories and was taking the maximum dose plus tramadol and paracetamol for over 2 weeks which has obviously had an effect on my appetite and making me lethargic. You are also right that I need to cut right down on the snacking and make more of an effort to eat larger meals even if it is only at lunch and evening meal. I won’t have a problem upping protein but am loathe to up the fat. Hopefully improvements in my pain will lead to more energy and I can think more about a food diary.
My weight loss may well be partly due to the Metformin but I have to stay on this amount for the foreseeable future (according to GP), I was shocked to hear it has been used just for weight loss.
Again thank you all so much and thank heavens for this brilliant forum.

 

[SueEK]

I suspect that doing low carb by eating small amounts of high carb foods is not a good option. On top of all that Metformin you are not pushing your metabolism into ketosis, which I think is the healthier option for type twos.
Although cereals and bread are fortified, they don't fill the niche where veges and salad stuff should be in your diet, and they are likely to be low fat which is not a good idea for anyone - fats are essential.

Hi Drummer and sorry to sound so ignorant but what do you mean by ‘pushing your metabolism into ketosis’?