A question for nutritionists with clients

boooosted · 03-19-2009, 05:19 PM

How often is it that you get a client who is overweight and is eating a significantly lower calorie intake than they need to be? And do they tend to turn off your nutrition advice when you tell them that they need to eat more to lose weight?

Wowzer · 03-20-2009, 12:45 AM

Quote:

Originally Posted by boooosted

How often is it that you get a client who is overweight and is eating a significantly lower calorie intake than they need to be? And do they tend to turn off your nutrition advice when you tell them that they need to eat more to lose weight?

I work in a hospital setting rather than a private practice, but the people are generally the same. Being on the cardiac ward I see many overweight/obese people who have just had some kind of cardiac event.

I have never come across an overweight patient who is eating too little. I assume you are implying the whole 'starvation mode' theory. This does not occur in reality. If overweight people eat vastly less calories they will always lose weight. Always. I have put several people on very low calorie diets (ie 800cals per day, usually with Optifast or some such supplement) for very fast weight loss before surgery. A person who sticks to the diet will always lose weight, regardless of how few calories they eat (that is the whole point after all).

There are many people who think they don't eat very much, until you sit them down and go through a diet history. In a diet history we write down everything a person eats in a 'normal' day. Most often people forget to count calories from drinks, or vastly underestimate the calories in different foods.

I have never once told an overweight patient aiming to lose weight to eat more food.

boooosted · 03-20-2009, 04:42 AM

That seems like it would be the case but so far I've sat down with my mom, my friend's mom, and his sister. My mom has a cup of coffee for breakfast and nothing else, a bowl of steamed packaged carrots for lunch, and when she gets home from work she has either more carrots, other veggies or something light, and then once in a while some popcorn before bed. I've had her write down everything she's eaten in the past and it comes out to less than 500 calories per day for most days. She is overweight and has not lost any for a long time.

My friends mom is the same way. Coffee is her only breakfast and her lunch is extremely small. Her only meal for the day is when she comes home from work at about 10pm. Calories i want to say are about 750 and is overweight without losing anything. If calories aren't the problem then what is. They can't possibly need to eat fewer calories to lose weight and I would never suggest to one of them to cut back either.

boooosted · 03-20-2009, 10:35 AM

anyone else have a thought on this? reps for help

Blindead · 03-20-2009, 10:38 AM

then it's probably not a short term starvation diet but long-term effects from deficiencies in a multitude of things. could be vitamins and minerals, even if they eat veggies i really doubt they're hitting all their requirements with just carrots. their thyroid and hormones could be supressed from a lack of fat (this seems very likely to me). they probably have no muscle mass to speak of and don't exercise, because why work out when you can starve yourself?! or their body could just be in starvation mode. are they feeling sluggish?

boooosted · 03-20-2009, 10:49 AM

Quote:

Originally Posted by Seamless

then it's probably not a short term starvation diet but long-term effects from deficiencies in a multitude of things. could be vitamins and minerals, even if they eat veggies i really doubt they're hitting all their requirements with just carrots. their thyroid and hormones could be supressed from a lack of fat (this seems very likely to me). they probably have no muscle mass to speak of and don't exercise, because why work out when you can starve yourself?! or their body could just be in starvation mode. are they feeling sluggish?

i can't really say for my friends mom but my mom isn't, and even walks/jogs 30 mins or more a day. My boss doesn't eat breakfast and doesn't stop to eat anything for lunch either, so for the first 10 hours of the day he is sluggish. I know its not a short term thing because its been like this for years. Is this a common thing because it seems like the older people i know who are overweight don't eat even 1k cals a day.

Theenforcer1 · 03-20-2009, 11:17 AM

Sodas, liquid cals, incidental food around the office, candies, other things you may not see.

There is a reason behind overweightness.

boooosted · 03-20-2009, 11:41 AM

Quote:

Originally Posted by Theenforcer1

Sodas, liquid cals, incidental food around the office, candies, other things you may not see.

There is a reason behind overweightness.

not in these cases. i've had my mom write down everything and she had no reason to sneak candies on me lol. And i work with my boss i see him the whole day. He does not eat one bite of anything.

Blindead · 03-20-2009, 01:54 PM

it's probably a lack of fat. I went on a low fat diet a long time ago and it killed my test production and I didn't lose much fat either.

yanceys · 03-20-2009, 02:25 PM

Metabolism sounds like it's probably out of whack. So, each time they might eat a meal, their body stores whatever calories they consume as fat. Your body will store calories as fat if your metabolism is out of whack...i.e. not eating meals on a regular schedule. If they ate a breakfast, lunch, and dinner (at the least), I bet they would see a difference after some time. Something obese people need to remember in their quest for weight loss is that the fat took a long time to put on, so don't think the fat wont take a long time to take off.

reefpicker · 03-20-2009, 03:17 PM

Quote:

Originally Posted by boooosted

That seems like it would be the case but so far I've sat down with my mom, my friend's mom, and his sister. My mom has a cup of coffee for breakfast and nothing else, a bowl of steamed packaged carrots for lunch, and when she gets home from work she has either more carrots, other veggies or something light, and then once in a while some popcorn before bed. I've had her write down everything she's eaten in the past and it comes out to less than 500 calories per day for most days. She is overweight and has not lost any for a long time.

My friends mom is the same way. Coffee is her only breakfast and her lunch is extremely small. Her only meal for the day is when she comes home from work at about 10pm. Calories i want to say are about 750 and is overweight without losing anything. If calories aren't the problem then what is. They can't possibly need to eat fewer calories to lose weight and I would never suggest to one of them to cut back either.

There was a study published a few years ago that show a strong correlation between people that do not eat breakfast and high BMI.

Having said that, lets digress a bit... Lets go back to physics 101. Energy is not created. Work needs energy.

Calculate your mom's minimum caloric spending. Unless her metabolism is almost shut down, I bet she is using more than 500 cals.

Unless her basal metabolic rate is abnormally (i.e. thyroid issue) low, she would get that energy from somewhere.

If she consumes 500 calories, then she should be loosing weight.

If she is not loosing weight, then she is consuming more than 500 calories.

Otherwise, she is breaking the Thermodynamics laws. And she would be a phenomenon.

In my experience, Wozer is right. Your mom is probably getting calories from something else. Sodas, flavored water, sugar in the coffee, etc.

Finally, the scale you are using to weight her could be bad.

IME I also have seen that people that do not eat breakfast, are usually overweight too. Not everyone, but most.

Wowzer · 03-20-2009, 04:50 PM

Quote:

Originally Posted by boooosted

not in these cases. i've had my mom write down everything and she had no reason to sneak candies on me lol. And i work with my boss i see him the whole day. He does not eat one bite of anything.

I had a similar situation with my girlfriend. She was trying to lose weight and I thought she was quite motivated. We went through what she was eating in a day and it was quite healthy and energy seemed quite low. I was really struggling for a reason as to why she wasn't losing any weight.

3 months later she told me she was having biscuits, pieces of cake and other sweets that were passed around the office, plus a large latte coffee in the morning. Now that she has cut those out completely, she has lost 6kg in 2 months.

There is no reason for your mom to be lying to you, but in all likelihood she is. That or she is forgetting the little things like the occasional biscuit which are quite high in energy.

Is your boss a big drinker? Or have much takeaway food?

Dr. Horse · 03-20-2009, 05:58 PM

Quote:

Originally Posted by Wowzer

in all likelihood she is. That or she is forgetting the little things like the occasional biscuit which are quite high in energy.

X2. Obese individuals lying about their diet has contributed to the myth that if you don't eat enough you won't lose weight. The notion is absurd. Eat less, lose weight. Eat even less, lose even more weight.

boooosted · 03-20-2009, 06:19 PM

alright guys thanks a lot that really clears a lot up for me. Makes sense that they wouldn't be losing weight and yes my boss is a big drinker and does a lot of takeout you nailed it on the head wowzer.

Theenforcer1 · 03-20-2009, 07:43 PM

Quote:

Originally Posted by boooosted

alright guys thanks a lot that really clears a lot up for me. Makes sense that they wouldn't be losing weight and yes my boss is a big drinker and does a lot of takeout you nailed it on the head wowzer.

Didnt you respond to me saying the same thing that I was wrong? LOL

Gr3g_Lycan · 03-20-2009, 07:46 PM

Quote:

Originally Posted by boooosted

How often is it that you get a client who is overweight and is eating a significantly lower calorie intake than they need to be? And do they tend to turn off your nutrition advice when you tell them that they need to eat more to lose weight?

Broscience. I have yet to find a source to say adding calories helps you lose weight.

http://forum.bodybuilding.com/showth...hp?t=113443111

Quote:

Originally Posted by Wowzer

I work in a hospital setting rather than a private practice, but the people are generally the same. Being on the cardiac ward I see many overweight/obese people who have just had some kind of cardiac event.

I have never come across an overweight patient who is eating too little. I assume you are implying the whole 'starvation mode' theory. This does not occur in reality. If overweight people eat vastly less calories they will always lose weight. Always. I have put several people on very low calorie diets (ie 800cals per day, usually with Optifast or some such supplement) for very fast weight loss before surgery. A person who sticks to the diet will always lose weight, regardless of how few calories they eat (that is the whole point after all).

There are many people who think they don't eat very much, until you sit them down and go through a diet history. In a diet history we write down everything a person eats in a 'normal' day. Most often people forget to count calories from drinks, or vastly underestimate the calories in different foods.

I have never once told an overweight patient aiming to lose weight to eat more food.

This goes down as the best post ever in the nutrition forum. Covers many points I have discussed over the years.

You hear the opposite all the time round here.
"Q. I dont think I'm eating that much, I cant lose weight.
A. Eat more "

Gr3g_Lycan · 03-20-2009, 07:54 PM

Quote:

Originally Posted by boooosted

That seems like it would be the case but so far I've sat down with my mom, my friend's mom, and his sister. My mom has a cup of coffee for breakfast and nothing else, a bowl of steamed packaged carrots for lunch, and when she gets home from work she has either more carrots, other veggies or something light, and then once in a while some popcorn before bed. I've had her write down everything she's eaten in the past and it comes out to less than 500 calories per day for most days. She is overweight and has not lost any for a long time.

Carrots and popcorn are high carb. She may be a carb addict maybe without knowing it, which may suggest blood sugar issues.

With all these carbs is she getting enought protein? How do you know she is overweight? What is her bodyfat percentage, weight and BMI? Many older women that thyroid issues, has she had it tested? How is her blood insulin, glucose & protein levels?