Chris, I post on this on the Healthy Living forum (although probably not as often as I should!).
I've known for years that I needed to lose weight. My health isn't good, I don't burn off calories because I can't exercise aerobically. Then I saw a specialist about my liver being in bad shape (we don't know why, none of the usual reasons) and he said it was due to my weight, I MUST lose weight.
"yeah, right. And just HOW am I going to do that?" I said to him. "I'm capable of dieting, then my body goes into famine mode and the weight loss stops, then goes back on, but with a metabolism slowed even more."
he gave me the usual rubbish about "All you have to do is cut calories enough and the weight will begin to come off."
I said, "Yeah - in theory. But I hve to diet at malnutrition levels to lose weight."
Then he said something enlightening to me. "Ok, so do it!"
So I did. To help me, he gave me a prescription for diet pills. At first he was going to give me Xenical, but all it does is train your body to eat a low-fat diet. I was already doing that; probably the low-fat diet had aggravated the problem, because it tends to be higher in sugar. So he gave me Reductil (I think it has a different name in the US). It is supposed to stop your body going into famine mode. It also is supposed to suppress your appetite. Not that I noticed. It also cost me A$95 a month, but I figured if it worked, it was worth it. The doctor had said I was heading for gastric bypass surgery, and I didn't want that.
So I rememvered what he said about cutting calories enough even to the point of malnutrition, and did it. If I was heading for gastric bypass, then I would eat as if I'd already had the surgery.
Other restrictions he gave me - no sugar, no fat. My insulin resistance was up and I was one step away from Type II diabetes.
Taking it all together, I'm a mess. So I began the diet.
The diet pills he prescribed work best if you begin the diet AFTER you start them. I bought the best diet book in Australia (it's endorsed by CSIRO, it's like getting a diet book put out by FDA) and modified it. The book had a calculation so I could work out how many calories a day I burn, and I worked out my diet based on that. I had to cut back to 800 calories a day.
My premise - no fat. No sugar. Cut overall calories by cutting back on a lot of carbs where possible. Switch all refined carbs for wholegrain. Eliminate all carbs that can't be so switched. Take multivitamins to make up for what I wasn't eating.
Final diet - I make my own oat-free muesli. It's my magic trick for wishing fat away. If I'm hungry I have another serve of muesli. It's about 50% bran by weight. The rest is mostly puffed brown rice, some nuts, some finely chopped dried fruit. I use a one cup ramekin for my breakfast bowl and use skim milk.
Over the day I drink at least a litre of water (or water equivalent - Greek-style iced coffee - decaf - which is mostly water) and eat a handful of prunes for the fibre and to keep things moving. Two small pieces of 70% cocoa chocolate (a vital vitamin pill). I try to keep lunch to four small bites - two pieces of salmon sushi, or a small open salad sandwich with smoked salmon, or maybe some fried brown rice with prawns. Lean protein for two of three meals a day at least (enough protein to match the size of the palm of your hand). This can include two fried eggs as long as you use a non-stick pan and the thinnest smear of oil.
To take those pills you need to keep an eye on blood pressure; if it's already high, the diet pills won't be permitted. But frankly, I don't think they made much difference to me. I've stopped the pills but not gained back any weight (until Christmas - I've gained about 3 pounds but I've already lost half of it).
One piece of fruit a day, for me, because natural sugars in fruit are also a problem. Strawberries are an exception - I eat a punnet a day sometimes. No worries - they don't count. My one piece of fruit I would often have as frozen fruit juice, as dessert. I've since found a lo-carb ice cream that tastes decadent but is low carb, low fat, no added sugar at all. I eat it with fresh mango.
No alcoholic drinks (except an occasional sip from my husband's glass). No fruit juice. No sweetened drinks (unless using artificial sweeteners).
I had to be strict with myself, but quickly found I was coping better than I thought.
I was on the diet pills for 7 months but lost most of the weight in the first four months. Since then I'm losing maybe a kilo a month at most. I lost 24 kilos in all - that's 53 pounds.
And after all that - my liver is MARGINALLY better. So maybe that specialist will now take me seriously, when I say I don't think diet is responsible. The thing is, my weight wasn't helping my liver. It's just tat there's something else wrong. But hey, I've finally lost tat weight, I'm buying clothes off the rack from high fashion stores and I now walk past the "plus sizes" stores I used to haunt. Even their smallest sizes no longer fit me. I used to look middle-aged, people now tell me I look 20 years younger. I'm slimmer than my eldest daughter. I wear hand-me-downs from a 15 year old. Hand-me-ups. I can wear high heels again - I NEVER thought I would be able to do that, with my weak muscles.
I will always have to be careful, but I feel I have successfully changed my lifestyle. My body now instinctively recognises food I shouldn't eat, and I feel happiest when I can get the healthier food. But I'm very happy to eat a smoked salmon or Thai prawn salad for lunch and the occasional coconut cream chicken curry for dinner (with brown rice, of course).
I still indulge, I just eat more carefully.
Eating out is a huge problem - I've found ways to cope.
It can be done. I never thought I could, I look back in photos and I've been large since difficult child 3 was born, somewhat large even before. I can't exercise much but I was walking around the block. Then I got a torn muscle (gardening, squatting beside the vegetable bed) and I couldn't even walk around the block! But I still lost weight.
I had people sabotaging me, very annoying. Watch for that one. mother in law would tell people loudly (especially people who complimented me on my new figure), "She looks terrible! She's overdoing it, she's wasting away, she looks such a ghastly pale colour..." (it was winter - I always look a ghastly colour in winter). So I began to wear a small amount of blusher, to disguise my pale face. Finally husband spoke to her. She still offers me cakes and biscuits, I've learnt to keep saying no.
I had serious health problems as my incentive. I now have my improved looks as incentive to stay slim. Well, slimmer. You will also need an incentive. As you lose weight, it can snowball and help you continue. But it WILL slow, because among other things you will weigh less and therefore burn fewer calories. You will need to 'tweak' your diet when the weight loss slows.
But only you can do this. Only you can keep it going. I was the only one dieting in a household of people some of whom need to GAIN weight. I'm the chef. I had to turn my obsession with food into obsessing about preparing tasty food I couldn't eat, for other people. Watching them eating comfort food had to become my comfort. I've been perfecting recipes to try out on other people.
Must go, I've planned to make chocolate pots for dessert while sister in law and her kids are visiting. I might even allow myself to eat one - each one contains slightly more than my daily ration of chocolate, plus a little milk and egg. I'll just leave the cream off the top of mine.
Marg