Cannot lose weight through diet or exercise - how do I get the endo to help me? Please help solve my mystery!

[drinkingvodkasingingkalinka]

I've always had a really slow metabolism. I was a slim child but put on a lot of weight when I hit adolescence despite eating relatively healthily and doing a lot of exercise. I tried god knows how many diets but put on weight rather than losing it in most cases and eventually realised it was because my normal diet was lower in calories than pretty much all actual diets (Rosemary Conley etc).

Eventually I just decided to keep cutting calories until I lost the weight. I had to cut to 500 calories a day in order to look healthy (I was told loads of times I looked great despite the fact I was living off apples and my periods stopped). I still have photos from that time and I look perfectly well although I was undoubtedly anorexic despite not looking it. I also realised when I was calorie counting that exercise does not affect my weight one way or the other. Apparently this is the case for one in five of us, according to research.

I started eating more again for health reasons but never went above 800 calories a day for years (periods started again on this level and I put on weight). Then I was prescribed medication for a sleeping disorder which has lead to a lot of weight gain. Since being on this medication I cannot lose weight no matter what I do and I cannot come off it without causing myself other serious problems.

I cut to 200 calories a day and lost a little to begin with but then it stopped and now I do not lose anything, even though this is below my anorexic calorie count. My periods are also unaffected on this level of eating. I lived on 200 calories a day for many years which doesn't make sense and shouldn't be possible but I was so scared of putting on weight that I couldn't lose I didn't dare to eat more. I eventually persuaded my GP to refer me to someone to measure my metabolism. Measurement said I was at the lower end of normal (!?) and that I could afford to eat 1200 calories a day. I was desperate to believe this was true and while I didn't fully believe it could be I slowly upped my calories to this level. I have put on two and a half stone eating at this level but thankfully the weight gain has now mostly stopped (although sometimes I wake up a few pounds heavier than yesterday and don't know why - I calorie count everything). I now eat a healthy normal amount, however, which has solved half the problem as I was very worried about my health with me not getting enough nutrients. But I am left with the issue of not being able to lose weight. I can live at the weight I'm at (12.5 stone) but worry about pregnancy. If I were to ever get pregnant and put on a few stone I would never ever be able to lose it again. I've had my thyroid tested umpteen times and it always comes back "normal" although I understand there is some controversy over thyroid ranges etc.

I've written about this before but many moons ago under a different username that I've completely forgotten (I can't namechange for some reason and mumsnet haven't replied to my emails asking why so always set up new accounts). My apologies to have to repeat the question but as I'm now in my thirties I'm thinking about having a family seriously and I need to solve this problem before I do or else I fear I am destined for a life of being overweight with no way to get back to healthy.

I have an appointment with a private endo on Wednesday but I'm not sure how to approach it or what to ask. Does anyone have any experience with unshiftable weight even when dieting and exercising properly? I'm open minded as to whether this might be a thyroid problem or some other type of problem altogether.

[drinkingvodkasingingkalinka]

Should say I've also had those glucose tests done too (where you drink a whole thing of lucozade) and they always also come back as normal.

[GoogleMonkey]

Aside from any other problems (thyroid, hormonal etc) that you may or may not have I think you need to consider that your calorie counts may be off.

Quite frankly if you managed to maintain a functioning body on 200 calories a day for 'many years' you need to be studied because your body holds the answer to the energy crisis.

[Mide7]

What do the doctors say about your weight and "slow metabolism"?

[idontlikealdi]

I think your metabolism may be fucked from eating 200 calories a day. That's anorexic not a normal amount to eat.

[bloomburger]

What does the 200 calories consist of?

[GobblersKnob]

What did you eat a day to only eat 200cals that's a tiny bit less than three apples, or one and a bit slices of brown bread.

Do you know what you weighed when you were considered 'the lower end of normal' ?

How much have you gained and how long did it take you to get to 12.5 stone?

1200 is still a very restricted diet, unless you are very sedentary and trying to lose weight.

[TheHubblesWindscreenWipers]

Are you on mirtazipine?

[drinkingvodkasingingkalinka]

I was eating half a can of baxters soup and two pieces of fruit/vegetables when I was on 200 kcal a day (sometimes ate different stuff but that was typical). But I wasn't ever hungry, despite the fact that when I was on 500 kcals a day as a teenager (and properly anorexic as my periods stopped), I was always hungry. Since going on the sleeping pills I am hardly ever hungry no matter how much or how little I eat.

My sleeping pills are amitriptyline (primarily used as an anti-depressant but they can work for sleeping issues too). They're known for weight gain although from what I've read on forums this is usually because they make people hungrier then they eat more, which wasn't what happened for me. Apparently metabolism and sleeping are controlled by the same part of the brain though so problems in one are quite common if you have problems in the other, and as I have a severe sleeping disorder (lived on 2-3 hours sleep for over a decade until I got put on the amitriptyline), one doctor told me it made sense for me to have severe metabolism problems. He didn't know how to solve them though.

Some doctors obviously don't believe me, some say they do but don't know how to help.

I was about 10 stone when I was the "lower end of normal" and that was on 200 kcal a day for a good few years up to that point, weight was stable.

I've gained 2.5 stone, I gained the first 1.5 stone very quickly, with a full stone going on in the first week when I was upping the calorie intake gradually. Then I went up another half stone quite soon after then it seemed to stabilise and the rest has gone on in dribs and drabs over the last 2 years.

googlemoneky - I have been thinking about raising money to pay a doctor or scientist to live with me for a few weeks and I could show them the severe calorie cutting not leading to weight loss. I haven't been able to afford to do something like that but I've made some changes workwise and I'd do it if I could raise the money. I reckon a lot of doctors don't believe me and I don't really blame them. Although there was a guy who went without food for at least a year in a scientific study (he was very overweight though so his body used the energy from the fat and I think he did actually lose weight) and he was ok, able to function. There have been some other studies done on severe calorie deprivation and they found people are surprisingly able to carry on as normal after an initial period of difficulty.

[bittapitta]

How tall are you? 12.5 stone shouldn't be so overweight you have trouble conceiving or having a healthy pregnancy (unless other issues of course), unless you are very very short?

[pollyblack]

I think you need to stop focussing on calories and think more about nutrition. Cut processed food and sugar and see how you get on.

[bittapitta]

What exercise were/are you doing on a typical week OP?

[Changeasgoodasis]

Can you change your attitude to weight and think about health instead? If you have all the standard blood tests in range, strong bones (I think you should have a bone scan if you seriously lived on such a diet for a time) and good muscle strength, regular periods, basically the usual health markers - then it doesn't matter that you are "overweight". Life expectancy and health are shown to be good for people in the "overweight" BMI range and no worse in the pre-obese range than the underweight range.

[TheHubblesWindscreenWipers]

They can lock you in a sealed calorie chamber actually... Can't say it looks much fun!

Lack of sleep can really fuck you up metabolically but no one should be gaining weight or unable to lose it on 200kcal a day. Just your internal organs use that much - your brain and kidneys need more than 200kcal a day to just keep turning over, even if you're in a coma. 600 is seen as the starvation level. So something is off about your calorie calculations. I don't doubt you're not overeating but it's not physically possible to be eating 200kcal a day and not look like a skeleton.

Amytryptaline doesn't cause weight gain directly but it does seem to make you crave carbs and then muck up carb metabolism somewhat. So....

My advice would be:
Get your actual thyroid results and post back here ( full panel not just TSH, you need free T4/3 and antibodies.)
See the endo. Discuss your worries.
See your GP. Ask for a medication review. I have awful sleep problems and I've found melatonin to work very well indeed.
Switch to a lower carb higher protein and fat diet. Nothing extreme, just eat say fish with a pile of green veg for tea, a salad for lunch and an omelette for breakfast. Aim for 3-400 kcal each meal of nutritionally dense foods. Canned soups etc are just full of Salt and crap.
Do weights at the gym. Increase your muscle bulk and this will increase your energy needs at rest.

[drinkingvodkasingingkalinka]

I'm 5ft 5 - My BMI is apparently too high according to my doctor but to be honest I can live with the weight I'm at now even if I'd ideally like to be slimmer. What worries me is not inability to conceive due to weight. The issue is that I am almost certain I will gain weight during pregnancy/pregnancies and given I can't lose it I will then be stuck with any weight I do put on for the rest of my life. I really really don't want to be vastly bigger than I am now. I have a few friends who are quite seriously overweight and they get abuse shouted at them in the street and they do a lot of crying when they come home. It's no life and that's before taking account of all the corresponding health problems.

I do a bit of walking most weeks but not much since exercise doesn't affect my weight. I've been through phases of doing 9 hours of aerobic exercise a week plus a lot of walking and a few months where I did 6-7 hours of walking a day then worked a 7 hour shift on my feet at night five days a week. I didn't lose any weight from this exercise and nor did I gain any when I stopped, which I did since continuing seemed pointless. I didn't change my calorie intake when I did more exercise either, I've had to count calories every day of my life since I was 14 or so and I'm 100% sure that I'm eating the amount I think I'm eating. I know it doesn't make sense but it's honestly true (or was - the 200 kcals a day was a few years ago now and the 1200 I'm on now makes for a far happier life although there's the constant stress of not being fully in control of it.

The calorie chamber looks interesting! I'd be up for giving it a go!

My most recent thyroid results: TSH 2.4 // T4 13.

I had a full set done a few years ago but will hopefully get the private doctor I'm seeing next week to do another full set.

I should also mention I exclude alcohol calories from these totals simply because alcohol also doesn't seem to influence my weight one way or the other. Cutting it out completely results in no weight loss and drinking vastly more than normal results in no weight gain. There is some science saying that some people are like this and I seem to be one of them. I don't drink all that much though at the moment any way.

I tried melatonin but it didn't do anything for me unfortunately. I've tried a few other things too that also didn't work but it's hard to know what you haven't tried as some doctors don't suggest things just because they're unaware of them. Even the specialists.

[TheHubblesWindscreenWipers]

Ok your TSH is too high. It should be 1.25 max. It's still well within range and it's not disastrous, but it's indicative of a thyroid slightly under strain . Not actual thyroid disease but strain in the system.

Alcohol calories do count. All calories count. If you're drinking they are empty calories. If you're drinking and eating 1200 a day it's very easy to go over what you need. So you need to count all your calories. Milk in tea, alcohol, everything. Mfp is good. I'm five foot three and seem to need about 1300 to maintain my ideal weight.
I'm at much higher than that now because frankly, I eat too much. I have various excuses (breastfeeding, tired, baby doesn't sleep, I'm getting 1-2 hours token sleep a day , bit down) but basically if I'm honest I eat too much.
Don't forget it only takes a tiny excess over time to put quite a bit on.
You may not put much weight on if pregnant- I had horrific hyperemesis and lost weight in trimester 1-2. By the end id put a couple of kilos on but I left hospital in regular clothes. It's not inevitable you'll pile on weight in pregnancy. I was lighter after.

My advice stands. Eat nutritionally good goods - predominantly lean meat, fish, and piles of various coloured veg. Cut out the bulk of carbs, just have small portions of complex carbs. No sugar, no processed stuff, no alcohol. Do plenty of aerobic excercise but also do weights.
Massive sympathies on the sleep issue - as a lifelong insomniac I've had to accept that not much works for me.
My baby is a non sleeper to the point that if I'm horizontal for more than about 30 sec I drop off, which I have to say I never thought would happen... I am currently getting 1-2 hours a day, and that's broken, not 1-2 hours in a row. It is very hard to deal with.

[Thefitfatty]

You need to do a total 180 on your thinking about exercise, food, and weight. Exercise is a lot more important to your health than just losing weight, as is food. You should be trying to eat healthy meals, get good exercise (you don't need to do 6 or 7 hours, you can do an hour), sleep and accept your body for what it is.

If you get pregnant, you need to focus on being healthy for your baby, not losing weight.

You're hurting your body far more being on 200 calories a day and walking for 6 or 7 hours than you are by being a few stone overweight but otherwise leading a healthy lifestyle.

[TheHubblesWindscreenWipers]

^ good advice.

[drinkingvodkasingingkalinka]

Thanks guys but alcohol calories just don't affect me in the way food calories do so it doesn't make sense to count them. If I were to cut 200 calories a day of alcohol (hypothetical example), and ate 200 calories of extra food I would put on weight (I've tried this in the past and this was the result). There is some research that shows that some people are like this - they just don't put on weight from alcohol (or lose it by cutting it out - I've tried both multiple times and am 100% certain alcohol calories don't affect me). I always count calories for milk in tea although I only drink tea once or twice a month.

Same with the exercise. I know a lot of people aren't aware of the research but there is a solid set of studies that show exercise has almost no positive affects at all for around 20% of the population. So it's pointless for these people to do it unless they enjoy it. It doesn't improve their health in any way. I already eat pretty healthily so I don't think there's much I can do to be even healthier. The only processed food I really eat is soup and that's partly because there's something in processed tomatoes that's really good for you that doesn't exist in the non-processed ones. I think it's the only food that is made healthier by processing so I try to get my fix. I drink highlights hot chocolate too but other than that I mostly eat fruit, veg, fish and wholemeal bread. And a bit of cheese to make me happy.

That's interesting about the TSH though. I'm curious to see what the private endo says when I have my appointment on Wednesday.

[drinkingvodkasingingkalinka]

Would you consider amitriptyline for your sleep issues Hubbles? I have to live with some crappy side effects but for me it's completely worth it. I was really depressed on 1-2 hours sleep a night. Your body starts breaking down too.

[TheHubblesWindscreenWipers]

Mmmm... Not sure really. I know plenty of folk who taken it for depression and nerve pain...frozen shoulder and whatnot. They've all been a bit knocked out by it (which I guess is the point...) I'm not keen on taking it long term and with a small baby right now I don't want to take anything that'd make me groggy as we co sleep.
I've read the research on the people who get less benefit from excercise - the conclusion was really not that it was non beneficial - at all ... I don't think anyone would recommend those people not to do excercise - it has so many benefits in so many systems and that study only looked at certain parameters. You also can't say you're one of them unless you've had the full physical workup - you'd need to actually measure VOmax and all the other stuff they did.
You do need to count alcohol calories. (I'd be interested to see that study) if you're serious about counting calories you've got to be quite anal about it . Which is another reason I don't ...
I think it's lycopene in tomatoes - at least that what I tell myself when Dh covers everything in ketchup 😁
Get yourself a good workup - hopefully the endo can look at everything from your thyroid to your pituitary and (hopefully) reassure you or if there's anything a bit off it can be treated.,
Oh and ask them for their advice on diet. I do think that different ways of eating and excercising suit different people. I'm a bit of a pit pony (small but durable) and I do best on long slow hikes, jogs, etc. Others I know prefer sprints, explosive stuff. We are all different.

[Thefitfatty]

I've read the research on exercise too (a while ago to be fair) but I definitely didn't get the impression that there was no benefit, just that there was no weight loss benefit.

I'm a bit similar to you with alcohol though. Never seemed to notice a difference if I cut it out or not. Just have to make sure I don't mix with full sugar stuff.

See what your endo says. Good luck.

[Lorelei76]

hi OP
bit late to this
I have seen an endo but they ran a series of tests, anything I told them seemed to be irrelevant!

btw may I ask, how is metabolism tested, in the medical sense?

Re alcohol, I have friends who consume a vast amount of wine and the calories have not affected their slimline figures in the slightest. It is very odd.

I hope you find a solution. I am convinced, by my own experience and my mum's constant eating of sugar - resulting in a tiny figure and low blood sugar - that there is much more at work here than what anyone knows!

[TheHubblesWindscreenWipers]

Re alcohol, I have friends who consume a vast amount of wine and the calories have not affected their slimline figures in the slightest. It is very odd.

They will just be cutting down in other areas. Or very active. I'm much, much bigger now than I used to be. I eat much less. Ten years ago I was eating go huge meals and drinking gallons of wine on nights out/weekends away with friends. I also had a job that kept me on my feet all day, biked ten miles a day to get to and from work, ran in the evenings and my social life was sporty and active.

Small differences in daily movement and calorie intake make a big, big difference to weight over time. You only need a tiny, tiny excess a day to put quite a bit on over a few years.,

[Lorelei76]

Hubbles, easy to say, but then people like my mother are a complete mystery - couch potatoes, lots of calories - she admits herself she has no idea why she is so tiny.

I think some kind of "nervous energy" - especially for mates in stressful jobs - has something to do with this.