I've just spent a year on doctor-mandated strict diet, and it worked. I also was on diet pills, the ones that stop your body going into famine mode. I don't know how much help I got form them, because since stopping those pills in October, I haven't gained any weight, which is apparently what usually happens (you gain back a bit, but it all stabilises at a much lower weight than when you began).
What my doctor told me - "you're over-nourished. I don't care what the dieticians tell you about how much you're supposed to be eating, you were getting too much for your body, your age and your condition."
The other part of the problem for me, and I gather it's fairly common, is that the liver gets loaded up with fat and when it's not working as well, it makes it much more difficult for you to lose weight. Throw in the problem of repeated dieting over the years slowing your metabolism, and you are where you are now. Menopause just adds to the whole thing. Or at least, peri-menopause.
The thing is, I've been trying to lose weight literally for decades. The weight was slowly piling on, then at times not so slowly. I successfully lost weight but couldn't keep it off because the diet I lost weight on, was unsustainable.
I do think, from my vantage point now of a year down the track and able to maintain, that a big part of the problem is twofold:
1) the food available to us is too plentiful and too loaded with simple carbs; and
2) we are conditioned to beleive we need to eat far more than we really do. When I say "we" I mean "we" as middle-aged women. I increasingly now believe that the amount a person needs to eat varies wildly, depending on who that person is.
I had access to a very useful and informative book - it's an Aussie book, the CSIRO Total Wellbeing Diet book. It's written by a government-funded scientific organisation, CSIRO, so it's got good cred. And in that book there was some very useful info on how to calculate the amount of calories you burn, and then how to adjust this to calculate how many calories you should cut back to. If you overdo it, you go into famine mode and your burn-off slows.
What I learned from the scales and the calculations - males lose weight far more easily. Younger people lose weight more easily. All because they burn more calories, just by breathing. You burn more when you exercise more, but exercise also makes you hungry. As you lose weight, your calorie burn also drops simply because there is less of you to carry around. So not only do you risk having your metabolism slow (and hence drop calorie burn) but you naturally slow down calorie burn as you lose weight. That's why when you start a diet and it's working, you lose a lot more to begin with than later on, when you can get discouraged. You actually have to cut back even further, when you begin to plateau due to the weight loss.
My doctor scared me, badly. I was borderline diabetic, my liver was 95% saturated with fat and I was feeling sick constantly. Looing better didn't figure into it. I had seen dieticians who said that I actually needed to eat more, not less, because I had been trying to diet for so long that I was already eating less than most dieticians consider enough for a "normal" diet. And still I gained weight.
Now, from my vantage point, I can see that for me, the dieticians were badly wrong. The charts that say I should be eating four slices of bread a day, two serves of fruit and five serves of vegetables, also assume I'm able to exercise a lot more and I'm far more active. They also claim the same amount for a 20 year old male, as for a 50 year old female. Ludicrous!
Over the past year, I've learned that I can get by on far less.
My doctor's final instructions were twofold:
1) "Cut out all fat, all sugar and cut your calorie intake back far enough so you begin to lose weight. I don't care how far you have to cut it back - eventually you will reach a low enough calorie intake forthe weight to begin coming off. Ignore what is supposed to be a 'normal' diet. It's not normal, for you."
2) "I know you're not that big, but your liver is that full of fat and your diabetes is ready to tip over into full-blown. If this doesn't work, I will have to recommend gastric bypass. That will definitely cut your calorie intake."
I thought about that second point and figured, I know I have the self-discipline to cut my calories. So why wait until I've had gastric bypass? I may as well begin now, eating as if I have already had the surgery. of course I will be hungry, but it's better than having to have the surgery. So I will live now, as if I've already had the surgery. People who have had gastric bypass have to make radical adjustments tro their diet and whatever a dietician says, no longer applies. And they can get along quite well for years and years, eating a vastly less amount.
So that's what I did.
In past diets, I also observed just how much our fast food is packed with carbs. Even 'healthy' fast foods, such as a Subway sandwich, is served on a large 'spare tyre' of bread. If you order Chinese or Indian food, it is generally served with a large amount of rice. Serve sizes are huge. I remember buying a rice paper wrap thinking it was a healthy option, to find it packed with rice vermicelli - the simple carb load was more than 50% of the snack. There was a thin sliver of chicken and about two snow pea sprouts, and the rest was rice flour in some form.
So I followed the rules I was given, plus swapped all carbs I could for wholegrain options, plus cut carbs back. Not so far as on Atkins, because that is too far and is unsustainable, but still a lot. I would still have stir-fried Chinese food but with brown rice (about quarter of a cup of cooked brown rice) instead of white. I would cook a larger quantity of brown rice and keep it in the fridge for a few days, microwaving a small serve to have with a mostly protein and vegetables meal. I even used brown rice to make fried rice (a low fat version in a non-stick pan).
Other rules on this diet - eat small meals often. That was the "gastric bypass" part of the diet. If I was ravenous, I would find something like a healthy mini-meal and eat about four bites. It was generally enough to stop the hunger pangs. If I got hungry a couple of hours later, I would do it again. But I also found tat often, when I thought I was hungry then a big drink of water (or water equivalent) would slow me down. So I got into the habit of having the big drink FIRST and THEN eating.
Water can be boring, but low-cal drinks make a good substitute. I make an iced coffee (Greek-style) that is virtually no calories but very thirst-quenching. I use decaf coffee to avoid the problems of caffeine. I try to have at least a litre of this a day.
Because I don't eat enough for a healthy diet (according to all the charts - but I look good and I feel good) I began to take extra vitamins. especially calcium. Because I have bladder problems (which actually have got a lot better since losing so much weight) I also take cranberry capsules. Don't drink cranberry juice (or any other juice) because it's loaded with fruit sugars and is a waste of your calorie allowance.
For other vitamins, I take a sugar-free vitamin supplement. Mine is high in B and C, but mainly because I can't take most vitamin supplements.
My diet (according to the book I mentioned) had me cutting back on fruit to one serve a day, max. For a while I had this as mango nectar, frozen, as dessert. I've since found a "no added sugar" ice cream which is really very nice. It's also low fat, but tastes really sinful. I'm currently having this two ways - either with a fresh mango chopped up all over it, or as affogato (a shot of unsweetened concentrated espresso coffee poured over it, hot).
I also have two squares of good quality dark chocolate a day. It's also got some valuable vitamins in it, plus it helps me feel as if I'm not deprived.
My biggest secret weapon is what I call my Magic Muesli. I make my own muesli with wholegrain ingredients, some nuts and some unsweetened dried fruit. And lots of bran. I fiddle with it until it's how I like it, and make a large amount at a time and keep it in an airtight container. I've put the recipe up here already a couple of times. I eat it in a one cup ramekin, because it really is very filling. And when I get the munchies, regardless of when, I sometimes have another bowl of it.
I had to change my mindset and turn away from food pyramid, and the usual quantities we're told we should be eating. When I compare what I eat now, qwirth what a dietician would say I should be eating, I estimate I'm eating about a quarter the amount. No wonder I was gaining weight! And yet I wasn't eating as much as a lot of other people.
I now look at how much other people eat, and wonder. I really wish I could burn off more calories than I do, so I could eat more again, but I now understand that I'm eating the right amount for me. I haven't really lost any more weight for months (probably six months or more) but I'm maintaining. I also feel good - no feelnig of being drained and weak due to not eating right.
And the best thing - I've turned around the diabetes. Plus my liver is improved. It still has a fair way to go (hence I need to maintain for another few years if I can).
I also look good now. According to weight charts I'm still overweight, but according to my dress size, I'm normal. Average. But all that is a bonus. It does help keep me motivated.
One last tghought - a previous time when I was trying to lose weight and having trouble (because I was doing what rthe dietician said!) I was, for a while, keeping my weight constant. The doctor I saw at that time said that for pre-menopause and not able to exercise, simply maintaining was a good achievement.
So Jane, if you are able to NOT gain, then you are achieving.
I reckon I'm into menopause now, through peri-menopause. It's been surprisingly easy for me (once I went on HRT to stop the unbeleivably heavy periods) and I had to go off the HRT when my blood pressure began to climb and actually had little trouble. I've been on this diet during this period - taking the HRT and then having to go off it instead of being put on blood pressure pills. I'm currently taking prednisone, which has made me hungrier, but I've managed to avoid weight gain. It's been harder.
It really isn't easy, and I think that's why so many of us find it hard - because it is, and because we're conditioned to think we MUST eat everything we're told.
If you do what I did, be prepared for people to be horrified, and to tell you you're making bad choices. To that end, make sure you have good medical support for what you are doing. My doctor is a gastroenterologist who actually did a PhD on fatty liver. Having him back me up gave me the confidence to keep going even when other people said it was insane.
And the way I am now - it's the justification for it all.
It worked. At last.
Marg