Looking for advice: Damaged metabolism, PCOS, Loose Skin, etc

[FemmeFatale]

Hi - I'm a longtime reader/lurker here, but only recently dug up this old account so I can talk with all of you.

So, here's my situation:


I'm 24 years old and have lost over 100lbs. I did it mainly through crash dieting/starvation because no matter what "reasonable" diet I did, I couldn't seem to lose any weight. The only 'okay' thing I did while losing weight was go keto for several months. I hit a plateau but continued to eat that way for a long time (six more months) because for the first time in my life, I was eating *and* maintaining my weight.

Recently, I discovered that I have had PCOS since puberty, and adding that to my teenage situation of unnecessary psych meds (Depakote's a bitch) and foodstamp nutrition (ramen, ramen, ramen)...yeah, I got fat. And my testosterone levels are through the roof!

I received this diagnosis _after_ losing the weight. Now, riddled with loose skin (that is clearly still full of fat), I'm almost convinced that my only real option is massive surgery that I'll never be able to afford.

I've been advised to return to a low-carb/ketogenic way of eating. Okay, no problem, right? I know how to do that! Wrong, apparently. I'm now taking metformin for my PCOS-induced insulin resistance, which by all accounts should be making weight loss easier, ESPECIALLY in a very low-carb lifestyle. Yet it seems I can't seem to make the remaining weight/fat budge, even after over a month of religiously eating under 20g net carbs daily and taking the medicine with every meal.

I realize that exercise is a big one here, and having just come out of the deepest depression of my life, I'm happy to say that I'm ready for action, but I have no clue what the hell I'm doing. Some very serious social anxiety keeps me shying away from the gym, but I'm starting one of those 'work out at home for fat, sad shut-in' programs immediately, since I need to be doing SOMETHING. Hopefully this will help accelerate things for me.

I'm looking for anyone with experience or ideas in this department, do you have any nutritional advice/recommendations for me? Bear in mind that I am in college, do not qualify for foodstamps, have zero parental assistance, and pay for everything with the paltry student loans I am allotted.

At this point I eat a lot of eggs, chicken, ground beef, broccoli, cauliflower, asparagus (when it's on sale...), and tea.

(5'5", highest 263lb, current 165lb after a ~10lb backslide)

Thank you guys in advance =)

[Miranda]

how many calories are you eating and how is your diet set up?

[FemmeFatale]

I'm frankly not counting calories because of the carb-counting thing, but that's an excellent point that you make - maybe calories are more important than I thought.

An average day for me looks like this:

Breakfast - 2 eggs, 1 oz cheddar, coffee with half&half and splenda

Lunch - Usually a few handfuls of almonds, a low-carb (3g-ish, NO sugar alcohols) protein shake, or chicken breast (~6oz) with steamed broccoli or cauliflower

Dinner - Generally 6-8oz of chicken, turkey, ground beef, ground pork, etc and another heaping portion of the broccoli/cauliflower, sometimes with a small amount of butter or cheese.

On a very rare occasion I will eat a "low-carb" tortilla, but generally I stay away from them because they can trip me up.

Occasionally I cook my own soups, made from stock, vegetables, and meat just for variety. I use a lot of spices.

[Miranda]

it doesn't matter what you eat. fat loss is about eating less calories than you burn. start weighing and tracking everything you eat to calculate how much it is.

if you feel better on keto and it has helped you in the past, it's fine, but it's not free-for-all just because you're not eating carbs.

[FemmeFatale]

it doesn't matter what you eat. fat loss is about eating less calories than you burn. start weighing and tracking everything you eat to calculate how much it is.

if you feel better on keto and it has helped you in the past, it's fine, but it's not free-for-all just because you're not eating carbs.

I don't treat it like a free-for-all. I don't really agree with the "doesn't matter what you eat" thing, since in the past RELIGIOUS calorie counting has failed me time and time again, and even my doctor told me that with my level of insulin resistance, carbs are essentially the devil.

But I do think that maybe I need to try counting both.

Thank you for your advice. I will start right this second =)

[Miranda]

I don't really agree with the "doesn't matter what you eat" thing, since in the past RELIGIOUS calorie counting has failed me time and time again, and even my doctor told me that with my level of insulin resistance, carbs are essentially the devil.

that's not what i meant. what i meant is that you can stall on keto despite not eating carbs because your overall calories add up to maintenance. if you lost 100lbs despite not counting on keto, it's because the calories on it were so low as to create that fat loss.

you have to account for the fact that as you weigh a lot less, you maintenance has gone down with it. if you don't count calories and eat the same as before, then of course you're not going to lose fat, because you're likely eating your 'old' dieting calories. but you can't tell, because you have no idea how much you eat.

and you don't need to be 'religious' about counting calories. you need to be accurate about counting calories

[catskills]

Damaged metabolisms are very difficult to repair, but at least you caught it at a young age which is great. Did you say you still need to lose bodyfat? If you still need to I would recommend that you go to a few online calculators and try to figure out how many calories you should be roughly eating a day. Then I think you should try tracking your daily calories and macros as accurately as possible. Even though you are keto, your diet still seems to be low in fat, which is fine but with PCOS you need to sacrifice some of the protein for the fat, at least that is what I have had to do. You seem to be doing fine with the carbs, you just might need to find the right optimal level of protein. When you decrease the protein, you up the fats. Eventually you will find the right balance that gets you undereating in order to lose the excess body fat. One thing I would be very cautious about is the exercise. My doctor recommended exercise to me and it actually aggravated the problem. My condition when unchecked for years until the point where I had severely damaged my metabolism and it made it even more difficult. Make sure your exercise regime would be considered "normal." In my opinion more than 1 hour a day including your weight lifting is too much, especially for people with PCOS and problems with insulin.

[discdoggie]

you have to account for the fact that as you weigh a lot less, you maintenance has gone down with it. if you don't count calories and eat the same as before, then of course you're not going to lose fat, because you're likely eating your 'old' dieting calories. )

I was just about to point that out.

[megdaig]

A big red flag for me is....

Lunch - Usually a few handfuls of almonds, a low-carb (3g-ish, NO sugar alcohols) protein shake, or chicken breast (~6oz) with steamed broccoli or cauliflower

That alone can blow your calories through the roof. 23 almonds = 1 oz..which is 150 to 170 calories...you can fit way more than 23 almonds in a single handful...multiply that by 3 or 4 and you are already 500+ calories.

[FemmeFatale]

Wow, everybody has been so helpful!

Miranda, thank you for clarifying.

Catskills, I will take the dietary fat advice into account. However, I've found that the online calorie-needs calculators GROSSLY overestimate how much _I_ should be eating. Every time I've followed one I've gained weight.

Meg, you make an excellent point. I didn't think it was a big deal if it was an on-the-go substitute for lunch, as opposed to in addition to lunch.

Yes, it appears I need to be more diligent with my numbers.
Thanks guys.

[latebloomingmom]

ummm where is freebirdmac?
did anyone advise you to take a month off of dieting and let your body recover?
maybe I missed this..


also did you say you were on a good lifting program now?
man I better go up and read again


you are young and your skin does have elasticity
how much ? I dont know
remember its like when ya blow a balloon up and then let the air back out again
you can shrink but how much sometimes differs from person to person

[latebloomingmom]

calories in vs calories out
but the problem is you got no calories going out
getting burned as fuel


you arent not reving your engine

so you must restrict , restrict, restrict...til that metabolism tanks out..

you have to continuously take in less and less to keep losing


rev up that engine girl!!

<<< 44 year old college student
you spend your days sitting in class
sitting in library, sit, sit , sit.....
so do I
you actually have to schedule in gym time

[wakechica]

Wow, everybody has been so helpful!

Miranda, thank you for clarifying.

Catskills, I will take the dietary fat advice into account. However, I've found that the online calorie-needs calculators GROSSLY overestimate how much _I_ should be eating. Every time I've followed one I've gained weight.

Meg, you make an excellent point. I didn't think it was a big deal if it was an on-the-go substitute for lunch, as opposed to in addition to lunch.

Yes, it appears I need to be more diligent with my numbers.
Thanks guys.

Use the calculator here in the sticky. Weigh and measure everything. Make sure your fat intake is at least 1g/kg of bodyweight.