Losing weight with chronic illness. Advice?

[tyrettes]

I have multiple chronic health conditions that cause disability and are heavily exacerbated by any physical ability beyond careful and slow paced walking. I use various mobility aids to be able to get around at all. This caused me to gain 55kg (~120lbs) over the course of 3 years, and I am now trying to lose 45 (~100) of them.

I count all my calories (by weighing/measuring and doing the math, not guesstimates) and aim for a 750kcal deficit per day. I started with a 1000kcal deficit, but that was a bit too hard. In the past two weeks I have only had a 0.2kg (~0.4lbs) loss, which very well might be natural fluctuations in weight. Will have to wait and see. I am aware it often takes much longer to see results, but I am bracing myself for this being a very difficult journey.

Are there any chronically ill people on here who cannot exercise and still managed to successfully lose weight depiste inactivity and medication? I'd love to hear your input.

PS. I am going to talk to a clinical nutritionist. Just have to get a referral and wait for a spot first.

[Heybales]

Diet is for weight loss - if done right just fat loss, if done wrong includes muscle mass.

Exercise is for heart health and body shaping - if done right supports fat only weight loss, if done wrong helps muscle mass loss.

The only thing exercise does for diet is allow you to burn more in a day, which may make it easier to eat less and adhere to it.

You don't need exercise to lose weight, you need to eat less than you burn in total.

The rate of loss depends on how much fat needs to be lost, what YOUR body considers extreme undereating so that it adapts, and what stress your body already has.

For 100 lbs to lose, 2 lbs weekly would normally be reasonable - if you had the range due to normal activity level, and average healthy body.

You sound like you have neither, sorry to hear about the issues being dealt with.

So 2 lbs weekly, as you discovered already, didn't seem reasonable.

Even 1.5 with 750 cal deficit may be adding extra stress you really don't need on the body. But test and see. You could have days you could attempt that, other days you may need to drop to 500. Other days you may need to eat at maintenance.

I've known many chronically ill that have lost weight. They already had a good read on their body compared to most folks don't.

Obviously if anything flares up worse - remove the stress the diet is causing - not eating more to gain weight, just to eat to maintenance.

Please don't have step goals - likely not a realistic or positive goal for you.

Walk if you can for heart health, recommend some resistance training using band or tube resistance, major muscles. Body weight squats if you can. Whole range of things can be done with water in jugs if you can do that level of resistance, or can't get bands/tubes.

And eat enough protein, about 2g per kg of goal weight daily.

Reasonable diet, enough protein, and resistance training - the 3 required things to NOT lose muscle mass in a diet. And you really can't afford to lose any, as I'd be doubtful your ability to add any later with your limitations - your goal should be to keep what you got.

Also, counting calories by weight of food, because calories is indeed per gram. Not cups, spoons, or "about 3 servings per package" volume measurements.

Confirm the food entry matches the label in your hand.

Your meds could cause many water weight fluctuations besides normal expected ones - suggest getting a weight trend app like Libra to track long term, not getting discouraged by water weight changes.

You are going to have a long slog - just keep things realistic.

I'd say figure out meal timings and macros to help feel sustained on what level you can eat at.

Obviously nothing but marshmellows could leave you very hungry, but other extreme nothing but broccoli could have you falling off the diet very frequently.

Find the 20% enjoyable eating you can squeeze in, find the 80% foods that will keep you in the came.

Accept any deficit depending on a difficult day, from that 750 to maybe just 50. But don't slide to maintenance because of emotional eating, only if physically needed.

Meds could cause hunger pains, or extra water retained - know those things top out, and they don't have to control what you eat, though it can make it more difficult.

Just some thoughts.

[Glenda]

Excellent, caring, thoughtful suggestions Heybales.  You give great answers.

[Emly_]

Your advice is game on.

My husband has worked with me for years. It's been a long, long road because I can not work out or exercise in any form these days. Used to be bedridden for years, in a wheel chair before that. But when i thankfully found a Dr that was able to properly diagnose me with not just one but multiple chronic illnesses (& referred me to specialists that aided in that)...which got me out of the wheel chair.

Long story short, bc of that, I am still unable to work and drive, stay at home all the time and mostly in bed but have been able to work on losing weight.

Losing weight has helped my health tremendously! I was 130lbs before getting sick then dropped to 99lbs then went all the way to 260lbs.. and have just been up and down and all around!! My body's been through it, from my conditions and medications made it so much harder!

But you are right! Just need to learn that the medication doesn't have to control you! Even ones that make it harder to say no!

And make you get the munchies!

I've been on keto for years (before it became popular) and it's helped lower my inflammation and helped with weightloss. It really helped with my digestive issues as well. I now just see eating as a function to help me live. 

Have stopped losing weight and just been maintaining, but I won't give up. 

I'm back under 200 and it feels great 🙂

So don't lose hope! What I found that rly helped me was not just getting an app and counting calories & macros. 

But the main thing- in putting what I was going to eat that day so I would not stray. And know for sure I'd hit everything.

That worked better than fasting, IF, anything. But still did low carb and high protein. A high protein keto if u will.

Good luck!

Em

[TheOldMe]

Thank you so much Heybales I have been trying to loose weight for years, exercising, counting calories, WW... I have read a few of your responses to people’s concerns and you have me in tears - through your kind, in-depth, empathetic and sage advice I feel like I finally understand, you have made it so simple to understand and inspiring. I feel like I’ve woken up.  Thank you, thank you, thank you! 

[Heybales]

@TheOldMe  - I'm glad you found the nice responses! 😊

So many in pretty decent health, outside of needing to lose weight, bang up against and cross over their body's line of what is reasonable and what would be seen as extreme - and that's with plenty of studies giving some average of where that line might likely be.

When body already under stress healing from injury, dealing with disease, even lack of recovery from life or workouts, lack of sleep (recovery too) - it's just another road block to dealing with the weight issue, and seems unfair to have no idea where that line may be.

And the annoyance that usually when you cross the line and get negative effects - it takes time to cross back to safe side and not have the body respond too fast to future attempts.

Ways around it, but I understand the difficulty of needing to handle it so much slower or differently.

I view it like driving a car on route with lots of corners and hills in the wrong place (or right place if you find it fun) like the Ozarks I'll drive through to go camping.

Everyone can push the speed such they can reach a point they lose grip on the road, sometimes that means a little slide but still in control, sometimes it could mean hitting that sandy patch and off you go flying.

A healthy body is good steering and suspension system and higher speeds can be reached without issue.

A problem body is some loose steering and bouncing suspension and you can't reach those higher speeds at all, lose grip much easier.

Some may always have to deal with the problem car with no repairs possible, and see others speeding by them. And may even see some of those turned over on the side of the road further on as they pass.

[TheOldMe]

Honestly the generosity of your time and wisdom is incredible. Thank you very much.  Have you thought about writing a book or starting a program or podcast (perhaps you already have and if so how can I access them :).

You are such a fantastic example of kindness... thanks again.

[Heybales]

Thought about it but then find others already doing good jobs sharing good info where it's part of their job. I'll reference them if it seems someone wants a deep dive.

Besides, it's nice to be able to throw the peanuts from the gallery, rather than being on the stage trying to catch them in the mouth!

[Emly_]

Hey sweetie, I just wanted to write again and let you know that I am here if you ever need to talk. I can't get on often because of my health issues, but I try to when I can. 

Feel free to send me a friend request if you are interested in keeping in touch. I would love to be able to help in anyway I can. As a reminder from above, I do have multiple chronic illnesses as well, going on 10+ years now. Stay in bed most of the time, try not to, so I try not to say "bed bound" but I've been house bound other than Dr. appointments for awhile now.

Since I am working on losing weight as well, and I have been trying to decondtion but I just set myself back because I over due, even on a recumbent bike for less than a minute 😕

I don't know what your health issues are, so that matters, and don't feel like you need to share I know it's a very private matter, but a friend that has a condition I do passed something on to me .... She got one of the recumbent bikes u set under the desk (I think they're like $25 @ academy or something) and u can either sit and do it, or with our condition, we have issues with our heart and BP so we have to lay and do it... So u can also try doing it in bed.

Another thing that I find alot less taxing, yet get more out of is to do a squat Everytime you sit down (and I'd you want stand up.)

Or, if it's easier, do 5 at a time. Or however many you can do till it's just hard enough, but don't over due so you can continue on later that day with another repetition, or the next.

When I first started off, and I couldn't do a squat, I got in front of a hard chair like I was about to sit down, and did a squat OVER the chair. Like I was about to sit down, but I didn't sit. I tried to come back up.

If you make that a part of your daily routine, you should see improvement like I did.

It's really the only thing I have been able to stick to.

I couldn't even do physical or aquatic therapy. Therapists (tried diff times too) sent me home because it was too taxing on me.

So, I sadly, unfortunately, understand where you are coming from with your struggles.

Just know you aren't alone, I'm here if you ever need to talk, and do have weight loss advice as well!

I lost.... About 70lbs (took a few yrs lol) But you'll get there! Just don't give up!

Oh, and eat healthy. A QUICK piece of advice I can give, is to help you feel full on less calories, eat a veggie before your meal. Try and eat a bunch of veggies! Depending which you get, barely any cals at all!

And extremely filling! 

By the way..

(If you get off sugar, your body will get used to it. I promise. I used to have the biggest sweet tooth and now I literally hate sweets. Took awhile to get there though. I don't even like other healthier sweeteners now like monk fruit, etc. 

I'm sorry for what you're going through.

Hang in there. And good luck. I hope things improve for you! 

[prefixla]

Well, the proper diet can be really helpful in your case, and you are right about approaching the clinic doctor for consultation. Also, I would suggest you ask the professional help from these guys https://medicalweightlosslehighvalley.com/. They specialize in cases like yours, so you will get the proper help and lose weight. Remember that the main thing you need to do now is deal with your health problems first. Your weight can wait. You have other important problems to deal with.

[jmc035]

Hi, I have a small, kind closed group of people with chronic illnesses on the app. Add me as a friend and let me know if you'd like to join. No pressure. We encourage each other with our special situations.

Take care!

[SalemRemi]

Losing weight while dealing with chronic illness and limited physical abilities can be challenging, but it's certainly possible. Prioritizing nutrition by focusing on a balanced and healthy diet is crucial. Carefully tracking your calorie intake and aiming for a moderate calorie deficit can help with weight loss. It's important to be patient and understand that results may take longer to see. Connecting with a healthcare professional, such as a registered dietitian, who specializes in working with individuals with chronic illnesses, can provide valuable guidance tailored to your specific needs.
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