Diet, strength training, BMI and what my doctor wants

[TheOpeningActofSpring]

I am at a loss of what to do so would really appreciate some help.

I am waiting for a certain treatment and can only get it on the NHS if my BMI is under 30. I’ve never had a BMI under 30. I’m 15.5 stone; 5.7’ and a size 16, so fully accept that this does not
look great on paper. I’ve always been heavier than I look (which I know is subjective). I’ve got a thyroid issue but that’s medicated and under control.

I’ve sorted my diet out and now eat what I consider to be much more wholesome. Low-ish carb but have porridge for breakfast and might have some
quinoa or potato (maybe twice a week if that); no white flour pasta or similar. No snacks. Other than that lots of vegetables and protein. I’ve also got back into strength training and regularly do dumbbell workouts for upper and lower body, core etc.

Ive started to see result - my waist is getting smaller for example (trouser feel loose; tummy flatter), my arms are shaping up etc. I feel stronger and really like it … but hardly any weight loss. I got told off by my doctor for not putting in the effort to lower my BMI.

If I ditch the strength training and eat lower calorie, will I lose more weight, even though it won’t make me feel as ‘good’ as my current plan? Or will it need more time until inches lost translate into weight loss?

Well done for all the good and positive changes you are making.

It's fine to go with your instincts within reason - building up muscle is an excellent move because the more muscle mass you have the more calories you burn when you do cardio exercise. This can mean that weight goes up rather than down in the early stages of a new routine.

Your diet sounds fine and I wouldn't suggest any changes to what you eat in terms of types of food etc. You may be able to make a difference if you just get used to slightly smaller portions of everything. Without going overboard try eating 90% of what you have been eating previously, and stick for thar for 2 weeks and see how you feel. If you are ok then reduce a bit further.

You don't want to starve yourself but your body is a focused famine-survival machine with enormous subconscious instincts to eat more than you need for immediate energy needs in order to build up sufficient fat reserves to survive months of winter scarcity. This means you need to be ok with feeling a little bit peckish most of the time between meals. View that "little bit peckish" sensation in yoir brain as an annoying committee member on the board who keeps saying "hadn't we better get in a bit more energy storage in case we need it?". When you start feeling hungry, go for a brisk walk for half an hour and don't start preparing your meal until you get back (assuming you'll take half an hour to make dinner) rather than satisfying your hunger immediately.

This both helps increase yoir cardio exercise (it's really important that at least 3 times a week, more if possible, you are doing exercise that actively gets you breathless, not just strength work although your strength work is brilliant) and also works well with your body's actual needs - your body will tend to trigger the "I am now really actually hungry, not just a bit peckish" feeling about an hoir or so before you really actually need to eat (to give you time to go oit hunting or gathering obviously)

Swimming can be good cardio if you are really pushing your muscles to go as fast as possible and you are getting properly breathless with the exertion. When I swim I tend to keep it slow and steady and I don't get breathless so it's more like a strengthening and toning exercise for me.

Cycling can be a good low-impaxt cardio workout, so long as you choose a route where you'll be putting plenty of effort into pedalling.

Don’t over complicate it op. To lose weight you need to create a calorie deficit. Use an online calculator to see how many calories you need then use an ap like my fitness pal to track it. And make sure you weigh, could be hundred of calories difference in what you deem to be a spoonful of peanut butter / small
avocado etc. Tbh your diet sounds decent so a few tweaks / substitutions/ reduced portions will do the trick.

Defo stick to your workouts for another month or two (if time is on your side). You could add in cardio alongside your routine (eg a couple
of minutes on a bike between sets or burpees of working out at home). A daily step goal will help you to increase the calories you burn on a daily basis and will do wonders for weight loss.

Everything @OlizraWiteomQua said!

Regarding calorie counting: I did this for a month or 2 some years ago, just to see approximately how much food I could eat and still lose a few pounds. I've never counted since because I now have a pretty good idea of how much, and what types of foods, are 'enough'.

But @TheOpeningActofSpring has said:

I really don’t want to get into calorie counting as I feel if could make me quite obsessive

Thank you, @BIWI. I really don’t. I’ve been reading in the low carb threads to optimise my eating.

Exactly what OlizraWiteomQua said

The only way I can lose weight (and indeed maintain weight) is to feel pretty hungry most of the time. I work out seven days a week (mix of cardio, strength, stretch for 1-2 hours a day), eat all the right stuff, but as soon as I start eating to a point where I feel what I would consider optimum satiation, my weight goes straight up. It's brutal.

I know absolutely nothing about it so may be totally out of touch but is Ozempic a possibility as a temporary measure to get you to the GP desired BMI?

You have to count calories and stick to them. You can lose weight on a Big Mac a day if you don't eat much else (not that I'm recommending it).

My body will not shed weight if I'm not sleeping properly, eating nutritious food and am not stressed.

And this was confirmed by recent cortisol which was high.

I did IVF and was v. bloated with it so it will be difficult to tell what's going on.

If you're doing strength training it will increase your metabolism so keep doing that.

Honestly I do think in these situations, the only solution is to eat less. Cut portion sizes gradually, as you lose weight you will need less food anyway.

I don't think you need to calorie count all the time. I do think it's useful to weigh some of what you are having to get an idea of what an actual portion should look like. It's easy to think you aren't overeating and be serving yourself twice what you "should" be having.

Once you know what it looks like, you don't need to keep doing it or counting calories

Bear in mind that ivf will mess with your water balance and anything thyroid based will also be likely to make it incredibly hard to lose weight. Early days of strength training you will carry more water from the muscle damage and also from increasing your glycogen stores. Your doctor is a wanker who should be encouraging you not giving you a hard time for what you have achieved. Well done, and be proud of yourself for making such positive changes.

High fat diets are not recommended pre-conception or during gestation.
Eat normal fat, not high and especially not high saturated fats because they are linked to female infertility.

I really feel for you I ve never fitted into BMI, I went private for a operation and still had pressure to loose weight. Something needs to be done about the BMI.

Can you provide a link for those claims please, @TheFirie?

Just concentrate on the calories - you would have to do SO much exercise to burn off a serious amount of calories, it's simpler and more time efficient to eat fewer calories.

Weigh/measure out about 10 different meals then stick to the portion sizes. Cycling round the same meals might be boring after a while but worth it if you really want this !! I lost 2 stone in 10 weeks by sticking to 1700 cals/day - I'm an inch shorter than you and started off a stone heavier, obviously everyone is different

@TheOpeningActofSpring apparently I need to provide a link , even if nobody else was asked to when giving you advice on how to reach your combined goal of being successful not only at losing some weight but also being able to conceive.

High dietary fat intake, even without the obese phenotype, is likely to induce metabolic and reproductive dysfunction. Therefore, it is important to consider that HFD exposure alone can result in impaired fertility even in lean individuals. https://academic.oup.com/endo/article/158/8/2407/3861741

High dietary fat intake, with or without the development of obesity, impairs female hypothalamic-pituitary-ovarian (HPO) axis functionality and fertility.
https://pubmed.ncbi.nlm.nih.gov/28586412/

In relation to the diet, it is emphasized that the high intake of saturated fats, trans fatty acids, proteins of animal origin, could have a detrimental effect on fertility, whilst the intake of complex carbohydrates, fibre, monounsaturated fats and omega-3 fatty acids could have a benefit effect.
https://pubmed.ncbi.nlm.nih.gov/30351153/

And it is not in women only. Quality of sperm as well is impacted

Men in the highest third of total fat intake had 43% (95% confidence interval (CI): 62-14%) lower total sperm count and 38% (95% CI: 58-10%) lower sperm concentration than men in the lowest third (P(trend) = 0.01). This association was driven by intake of saturated fats.
https://pubmed.ncbi.nlm.nih.gov/22416013/

Now, I have given you four links and there are plenty more if you want to research " high fat diets and fertility" and I would also encourage you to research papers and articles on "high fat diets and neurodevelopment" because high fat diets also impact the development of baby.

Thank you for the links @TheFirie

I asked for the links because you were making a pretty serious claim about a high fat diet which, given that the OP is undertaking fertility treatment, was important to substantiate - or at least give her the science and evidence behind the claim.