Overweight but doesn't eat apparently - possible?

[Mozismyhero]

So, my DM is massively overweight. She is also diabetic. She says she doesn't eat, 'I've only had one piece of toast all day. I couldn't possibly eat all that (when eating out/at our house). And yet she doesn't lose any weight. Is that possible? Surely the weight would be falling off her if she didn't eat? Or do I just not understand diabetes?

AIBU to think that she must do it for attention and that she's secretly eating packets of biscuits and crisps?

& to the PP - Thyroid conditions, Celiac & PA are massively under diagnosed. Medications that cause weight gain, including antiDs are too often prescribed like sweets

Plus 99% of the population is not the OPs DM

Many years ago I shared a flat with two nurses who were both quite overweight, though not exactly obese. They ate very little that I ever saw - it was always, 'Oh, just a bit of salad for me.'

However I came home from work unexpectedly very early one day to find them tucking into an enormous roast dinner, with a big pud to follow.

It wasn't as if I gave a toss what they did or didn't eat, but their faces were instantly a picture of blushing pink guilt - caught in the act of eating the sort of blowout meal they pretended they never had.

Until then I'd been naive enough to believe the 'just a bit of salad' thing.
It was something of an education for me.

'Massively overweight' people are generally massively over-eating.

I don't think it's anything to do with wanting attention though. It's usually to do with NOT wanting attention so telling everyone they're not over-eating because they don't want people being critical.

There's a lot of secret eating with associated self-loathing and not wanting to tell anyone. Because you already feel disgusted with yourself and weak.

Or it's self-delusion. Eating specific meals that are very low calorie but eating lots in between that they just don't consciously 'count'. Because I had a slice of toast for breakfast and that's in my plan so fine. But most people eat a few things in between meals and dont count it don't they? I ate loads when I was thinner and that slim girl at work is always munching on chocolate and she's not fat so it must be okay.

'Mindless eating' - When you don't really register eating those biscuits or chocolates on the table at work or eating the kids leftovers at tea.

Or lack of knowledge around high calorie food or drink and portion control. Rewarding yourself with a bottle of wine after a day being 'good'. Thinking fruit and museli and yoghurt is 'healthy" but packed with sugar and having a mixing bowl sized portion every day for breakfast isn't good.

Knowing salad is low calories but putting a third of a jar of mayonnaise on it or tablespoons of olive oil twice a day.

Restricting food but drinking can after can of full-sugar coke or red bull because the food restriction makes you feel low in energy.

It's utter bollocks. If you consume more calories than you burn off etc etc, you'll put on weight.

It sounds like she's yanking your chain. More like cake retention than a medical condition

Oh dear, anyone saying it's simply science - calories in and calories out - well they don't know science I'm afraid.

That's not "newtonian physics", it's a massive over-simplification.

I should stipulate it IS that simple MOST of the time, but there genuinely are circumstances when that model does not fit.

eatsleep
That's not "newtonian physics", it's a massive over-simplification.
Do, tell me how a human body gets energy other than through food?

I'm well aware of the massive differences between sources of calories (carrots v. gin for example)
but the underlying fact is that if you really ingest less than your BMR, you will lose weight.

Ask the people of Aleppo how many of them are struggling to lose weight at the minute ?

Total secret eater, I have met many people like this, say they eat nothing but constantly snack and don't count or binge when outside work. Likewise I have met many skinny Minnie's who can eat anything they want, the reality being they have fairly modest eating habits, ok may have a Maccie D at dinner time, but they eat no breakfast and had an apple and ham sandwich in two slices of bread for lunch. Average daily calorie intake 1300 calories.

I don't believe people who say they eat nothing. I am a stone overweight after a lifetime of being slim, the reality is, this is because I have developed a liking for wine followed by a pudding, I am therefore for the first time in my life eating more than I am working off. Not happy, but I ain't in denial.

I should stipulate it IS that simple MOST of the time, but there genuinely are circumstances when that model does not fit.

& where the OPs DM is Diabetic, that is a HUGE sign that she is highly likely to fall into the latter group!!!

I agree she is probably picking at stuff all day and doesn't realise just what she's actually had. If she doesn't walk or exercise much then weight will soon pile on unless you have a v quick metabolism.

No point being mean about it I agree. I doubt it's for attention. A lot of perpetual eaters are often bored, lonely or comfort eating for some reason. If she wants to do something about it or would be open to doing something about it you can maybe suggest she writes down everything she eats and drinks for a week so she can see what she actually does have. It's easy to believe you aren't eating much (especially if you aren't sitting down to 3 meals a day) when you are actually having a lot of smaller amounts of calorie dense food/drink throughout the day.

Have you read my previous posts talkin?

Clearly if your body is efficiently metabolising an insufficient amount of food, or inefficiently metabolising a sufficient amount of food you will lose weight.

What I'm saying is your with your metabolism, you're not using every single bit of energy in the food you eat, you're just passing a lot of it right or again. You reduce the amount you eat, your body will continue to waste the same proportion and use the same proportion; you will lose weight. If we give your same reduced portion to someone of the same size whose metabolism means they are NOT wasting any of the energy or indeed is storing it rather than passing it out (perhaps for reason of illness or medication or whatever) they will NOT lose weight.

Exactly Talkin, it's unpalatable but true. And yes, medications can cause weight gain - I've put on FOUR stones in a year, due to the massive amount of steroids I now take, plus my daily exercise has gone from walking 10 miles a day with the dogs, looking after and renovating a 4 storey 5 bed fucking millstone house and caring for a garden and lots of animals. I was really active, and now I'm lucky if I can shuffle to the end of the drive. Oh, and I have hypothyroidism too.

I have managed to dump 1.5 stones on Slimming World, so again, it IS still possible, it's just fucking difficult.

rockin exactly!

If she is eating like this when she does eat her body will hold onto every bit of fat it can make out of that bit of toast with both hands. I eat very little in comparison to my thin friends but I'm still the biggest. It isn't always as simple as eat less loose weight. If she only eats a handful of chocolate biscuits all day and nothing else she may still find she remains big.

eatsleep
You need to read up a lot more about BMR "base metabolic rate"
The amount of calories your body needs to stay alive - it will circulate them till they are fully burned or excreted.
Once they are excreted they cannot be stored.
Once burned they are gone.

If a person consumes less than their BMR, no matter what medication they are on, they will slowly starve (or lose weight as we call it in the West)

I really do not get why you and rockin have such an issue with the fact that 99% of obesity is self inflicted.
Surely you should both support more targeted use of resources to those who need it ....

I've agreed that 99% is as you describe, and we're not talking about base metabolic rate are we, we're not taking about people strarving, at least I'm not. I haven't mentioned it once I don't think

I'm taking about the relative quantities "normal" or "overweight" people consume and its relation to their size. If we're only talking about strarving people I don't think we're at odds!

People who have poorly controlled diabetes are unable to properly convert food into energy because they either are not producing enough insulin or their bodies are unable to use the insulin they produce properly. This becomes excess glucose circulating in the blood, but the body can't use all that extra glucose circulating in the blood and so it is eliminated in the urine. Then, once they start taking insulin they have enough insulin circulating in your blood to help the glucose get into the body's cells where it can be used as energy. So the glucose produced by the food they eat is no longer spending time in the bloodstream and being excreted out as urine - causing weight gain.

High blood glucose can make them feel more hungry because not all the food they were eating was able to get into the cells as energy. Then, once they start taking insulin — and continued to eat the same amount of food -because the body has enough insulin to process the food, they gain weight.

Is her diabetes a recent thing and is it under control?

I really do not get why you and rockin have such an issue with the fact that 99% of obesity is self inflicted.
Surely you should both support more targeted use of resources to those who need it

Talkin

I don't, for a large part you are probably right, but I do take offence at yours & similar vein replies to the OPs question.

As the OPs DM is DIABETIC, your replies are generalisations that are far less likely to apply here, as there are several reasons why her health issues can mean she is overweight through no fault of her own.

Sadly though, the OP already questions her ill DM as secretly being at fault & so turning this into a fat shaming thread, as your stance & others do, both misses the point of the OP & feeds the posters view that her DM is to blame

I DO take offence at the huge ignorance & unkindness in that

I have autoimmune hashimotos thyroiditus. I have such a slow metabolism that even with 1000 calories a day and at least 20 miles of running per week, along with 14 k steps per day I only just maintain a normal weight.

Yes, it's possible. If she is diabetic, she is predisposed to thyroid disease. You usually get autoimmune diseases in threes. I also have Addisons and Reynauds.

Not rtft only the OP but yes if you have insulin resistance you put on weight much more easily and can find it very difficult to loose weight.

Your body metabolises fat in a different way - so for example if you eat something worth 100 calories in a normal person they may burn off 50 calories for energy, and store 50 calories as fat. A person with insulin resistance who eats the same amount and has the same level of physical activity will burn say, 30 calories and store 70 as fat.
Someone with insulin resistance will also not burn as much fat during physical exercise.

Medications like metformin can be very helpful here, as well as making lower fat/sugar food choices

There are a lot of reasons for being overweight and it's not just to do with calories in. The OP's DM is obviously upset and trying to rationalise the weight gain but it can be very complicated. She needs to have some genuine help from people who understand diabetes and who understand how attitudes to food can be very complex. Judging her, however well meant, will lead to further weight gain.
For example, my FiL was an NHS counsellor and a number of his clients were referred by GPs for weight gain that seemed inexplicable. In each case, he discovered that they were quite good on nutirition. Where they had children, the children were properly fed and not overweight. What was going wrong had either to do with bad, ingrained habits - e.g. The man who got his breakfast from the drive-thru Macdonalds every morning so just needed to break a bad habit or the woman who didn't eat for two days and then went mad on Day 3. Problem with that is that the body can react to regular starvation by storing fat when it gets a chance. if you add diabetes to the mix, eating very little followed by trying to eat carbs to feel ok again could be what's causing the problem.
OP's mum needs to count her carbs not just her portion size and adjust her insulin according to the carbs consumed and she must talk to a dietician who knows about diabetes or a specialist diabetes nurse who can advise her exactly how to do this - it's a faff because you have to weigh carbs and do a bit of maths but it really does work.

If she has Type 2 diabetes, she may have insulin resistance, where her body is making large amounts of insulin but her body can't use it properly. Being overweight hinders insulin absorption but as insulin causes carbohydrate to be stored as fat it is a vicious circle. Not helped at all by the NHS advice to eat masses of carbs at every meal.

And Type 2 isn't always weight related either. Certain races are a lot more prone to it and there are strong genetic tendencies. Plus there is now a theory that weight gain may be a symptom of the developing diabetes rather than the cause of it.

But whether OP's mum is eating one slice of toast a day or is secretly binging, neither will be doing her blood sugar levels any good at all.

Also (this doesn't sound like it applies but still relevant) in my case I am in recovery from anorexia and as soon as I went to eating my TDEE (similar to BMR only more accurate because it includes all energy expenditure too) I put on a huge amount of fat around my middle because the body wants to protect your organs. I'm now advised to eat more than my TDEE because otherwise my body will try to hold on to that fat because it thinks I'll starve it again. So although for most people its calories in vs calories out, it's not always without complexities.

Albadross, thank you for the insulin post - that was a good explanation. If you don't mind me asking, what do you mean by the body 'thinks'? I mean clearly it can't plan, in the way we might plan to stock a cupboard for winter.

I weighed 9 stone, I got pregnant and had gestational diabetes. I had hypermesis, ate hardly anything. At the end I weighed 17 stone.

If I eat anything with sugar I put on masses of weight. I think with diabetes your body turns sugar to fat quickly to be rid of it.