stay-puft no more

November 1, 2008 8:10 AM

I need serious professional help to lose weight -- not a personal trainer or an exercise class. Am I looking for a nutritionist?

I am twenty pounds overweight. I am ashamed of my body and I have not dated for over two years. I have a very time-constricted schedule. Good food is the only indulgence in my life.

Now it turns out I can't just diet and hit the gym, because I have plantar fasciitis and/or tarsal tunnel syndrome and I have constant pain in my feet. There is a good chance this would have been caused by the fat. My feet need rest. But my ass needs exercise.

Whether I exercise or not I will be damaging my body and I feel trapped. I need serious advice. Who do I talk to, what do they generally charge (US, East Coast)?

Email if you want: [e-mail].

posted by anonymous to health & fitness (27 comments total)

Talk to your doctor first. Read this post to him/her -- they will be the best person to advise you what to do no next considering your condition.

Just a thought: swimming is good, low-impact exercise.
posted by nitsuj at 8:29 AM on November 1, 2008

You're looking for a nutritionist or a dietician BUT.....

20 lbs overweight isn't a big deal, in the big scheme of things. If you really want to change, you can do all of this without paying for help.

There's a lot of diet advice in previous threads. Honestly, I think you would get $1000 worth of free advice there, but the basics are this:

1) Watch what you eat. Right now, count your calories of your current program over the course of a week.

2) Now, you can calculate how many calories (on average) you eat a day. To lose the weight. Take this number and subtract 500 from it. This is your new target. Count your calories and don't go over this amount.

3) If you're looking for alternate forms of exercise, you don't just have to run. Would biking hurt your foot? What about the elliptical? What about swimming? What about walking? Try to get at least 30 minutes of "activity" a day.

If you're really diligent, you can lose about 2 lb a week. 20 lb would take you 10 weeks. 2 1/2 months! If you start TODAY, you could be ready for New Years looking all hot and fresh!

It's all up to you. You're not trapped- help is everywhere- here, other places on the Internet, and friends that have already lost weight and or in great shape.

Good luck. Remember, weight is just a number, also. I just recently lost almost 80 lbs (started in Feb), so it is possible.
posted by unexpected at 8:32 AM on November 1, 2008

Been there. Twenty pounds is not the end of the world. If you think it is, you don't need nutritional help. Before you do anything with your diet please read this.
posted by larry_darrell at 8:33 AM on November 1, 2008

20 pounds is not the end of the world for anyone, but even a 5% gain can be a serious problem for people who already have joint issues, plantar fasciitis, or other conditions.

Shouldn't effect your dating life, though.

Good luck. Give yourself 3 months and look into perhaps physical therapy for whatever problems you are having with your feet. Pain tends to make you move incorrectly, which causes new problems, and you need to break the cycle.
posted by Lesser Shrew at 8:39 AM on November 1, 2008

I have foot pain, too, and have found there are several cardio excercises that I can do. Swimming for sure, some yoga. Seated weight training would be great because I've seen some improvement pretty quickly after starting just a few weeks ago. And believe it or not, spinning classes. The foot positions can be manipulated on the bikes, and I've been able to find a position that's comfortable.

Good luck!
posted by raisingsand at 8:54 AM on November 1, 2008

A little off topic, but if you do decide to seek help, you should know that anyone can call themselves a nutritionist -- you would probably be better served seeking out Registered Dietitian
posted by nnk at 9:46 AM on November 1, 2008

Putting the weight issue aside for the moment, "no exercise" is not really a good idea long term. Exercise is necessary for lots of other reasons than weight control...for example, weight-bearing exercise can help guard against osteoporosis when you get to that age (if you're female, of course). Plus, it can help with creeping weight gain as you age. If you're suffering from plantar fasciitis, you should see a podiatrist and have orthotics made. There are other things you can do to ease the pain...a friend was told to never be barefoot, even just going to the bathroom in the middle of the night.

A nutritionist will outline an eating plan for you and tell you to keep a food diary. It can help if you really have no idea what you should be eating or if you need to be held accountable by having someone review your food diary periodically.

I hate to say it because I don't like to be that person on AskMe, but maybe you should consider a therapist on top of all of this. Clearly, being overweight is not healthy and it's understandable why you would want to lose the weight. But you might also have body image issues that losing the twenty pounds won't fix, and that's what therapy is for.
posted by cabingirl at 9:57 AM on November 1, 2008

I can't just diet and hit the gym, because I have plantar fasciitis and/or tarsal tunnel syndrome and I have constant pain in my feet

There is no such thing as plantar fasciitis and/or tarsal tunnel syndrome - the pain is due to the fact that you have anxiety over your situation and your mind is creating the pain to divert your attention away from it. Google "Dr. John Sarno" for the facts. I had the same pains (worse) in my back and legs. Unless you have had some kind of trauma to the area, the pain is being created by your brain as a way to sort of "absolve" you of having to deal with your real problems.

The good news is that the real secret of losing weight is mostly through proper diet. If you eat well and not a much the weight will come off with only minimal excercise.

Please read one of Sarno's books and absorb the info and remember losing weight is almost all about what you eat (and what you don't eat).
posted by Zambrano at 10:05 AM on November 1, 2008

Have you tried seeing a podiatrist? Maybe there are shoe inserts or something that could help.

Good luck.
posted by amtho at 10:06 AM on November 1, 2008

Here is what I would do - sign up for a food service where all of your food is delivered to you and you do not go to the grocery store (unless you have a list from that service, for fresh items) nor do you go to a restaurant. You eat only what is delivered and prescribed, no more and no less. I am thinking of jennycraig type of food, and of their competitors'. Visit a few of these places, decide which one works best for you - but hand over the menu composition to them. Sign up for a few weeks, and see how it goes, decide to renew if all goes well.

In addition - sign up for a month or two of personal training. Get that butt in gear, and let the professional know about your PF issues. S/he will prescribe an exercise routine that will help you buff up.

And remember to drink those eight daily glasses of water :)

All - we don't know how tall anon is or their gender. So although an excess of 20 pounds isn't much on a 5'7" man's frame, it can mean quite a lot on a 5' female.
posted by seawallrunner at 10:12 AM on November 1, 2008 [1 favorite]

i also came in to suggest seeing a podiatrist about your foot pain. i have the same kind of pain, and it hurt to even walk--felt like i was going to shatter my ankles. going to the podiatrist and getting some customized orthotics was a godsend. best money i ever spent. alleviating that pain will be good for you even if it doesn't get you to the gym, but if you're not in pain anymore, you might start exercising.
posted by misanthropicsarah at 10:14 AM on November 1, 2008

Zambrano: "There is no such thing as plantar fasciitis"

Of course there is.

It is a common affliction among runners (no matter their weight) and ultrarunners. Medical personnel use the term, sports medicine specialists use the term. It is an inflammation of the muscle fascia in the feet, caused by repeated striking from running the miles on hard pavement. Treatment includes massage, rolling tennis balls or golf balls underfoot while working at one's desk, and lots of specific stretching. Anon, check out the book called Stretching by the Andersons.

Plantar fasciitis is not a psychosomatic issue, far from it.
posted by seawallrunner at 10:23 AM on November 1, 2008 [5 favorites]

The good news is that the real secret of losing weight is mostly through proper diet. If you eat well and not a much the weight will come off with only minimal excercise.

This is not true. Potter around this site a little. The evidence that diet changes are a good way to lose weight are just not out there. You'd be very unwise to forgo your 'only indulgence' in the hope that it will lead to permanent weight loss.

Your weight does not make you unattractive, and may not even be harming your health. Google 'fat acceptance' and 'health at any size'.

You should definitely see a doctor/podiatrist about the foot problem. You shouldn't be in constant pain. As suggested above, try exercises that don't put strain on the feet in the meantime.

Also, this

And remember to drink those eight daily glasses of water :)

is a myth.
posted by Acheman at 10:33 AM on November 1, 2008

And remember to drink those eight daily glasses of water :)

is a myth.
posted by Acheman at 10:33 AM on November 1

Perhaps, if you're looking at it purely as a question of whether or not it's vital to good health and weight loss, from a physiological standpoint. But drinking those eight glasses of water is a great way to keep yourself from eating as much. Whenever you're hungry, drink a glass of water. Then see if you're still hungry.
posted by the luke parker fiasco at 10:42 AM on November 1, 2008

Go see a podiatrist. I had custom orthodics made for my feet and it made all the difference in the world. After you see the podiatrist, go to an athletics store and have them fit you for some good cross-training shoes. If you buy athletic shoes from Payless or Target you're going to be disappointed in the results. Here's a good article on buying the right shoes.

Custom orthodics + correct shoes = happier feet
posted by geekchic at 10:45 AM on November 1, 2008

Saying that a condition is psychosomatic does not make it any less real. Pain is pain. What's important is breaking that pain-spasm-pain cycle.

Twenty pounds is not a lot of weight, but to you it feels like a monumental challenge. So just like a journey is begun with the first step (so cornball, I know), take your diet one pound at a time. One meal at a time. We all love good food, but you can make better choices with your food and not feel like a dietary monk.

There's a lot of self-loathing in your post, and getting to the root of that is more important than embarking on a dieting/exercise plan. Chances are, you would reach your goal and still not be happy with what you see. What seems to be making you unhappy as much as (or more than) your weight is the lack of control you seem to have. Which is very wrong. And just to roll out another chestnut of wisdom before I go, you are responsible for your own happiness, and you have the power to make this happen.
posted by computech_apolloniajames at 11:31 AM on November 1, 2008

I posted this a while ago. Calorie counting AKA Doing The Math worked for me.

I am a great lover of food and eat a small number of calories many days of the week (I do this so I can go out a couple of times a week), but I kind of enjoy putting meals together that fit in the mathematical constraint of wanting to spend no more than three hundred calories for breakfast and lunch. I'm over thirty and not very tall and come from a long line of tiny-boned people, so some days I'm rocking the 1300 calorie mark. An additional six hundred calories gets me a nice dinner, that I enjoy cooking and eating, and if there's some delicious thing that I simply must have I have it at one of the two dinners a week where I don't count calories.

When I have time constraints I like the bagel and cream cheese for breakfast, cheese/bread/fruit model for lunch, pasta for dinner. I usually include wine, it makes me feel indulged and like a civilized adult. If I have more time, I cook more elaborate items, just with a pen in hand and a scale nearby, so I weigh food and control portions but I eat a wide variety of delicious things.

Anyway, it's just math. I guess your level of geekery have something to do with how much that resonates with you. I'm pretty nerdy.

So, that's what I do, that's what's worked for me--but here's a thing--you sound like this is seriously stressing you out and that maybe your unhappiness runs a little deeper. I'm basing this off 'I haven't dated in two years'--if everybody who was twenty pounds overweight stopped dating we'd be screwed as a nation reproductively speaking. Twenty pounds isn't that big a deal, even if you're shortish, certainly not an 'and now I must die alone' amount. Lots of people are attracted to a little extra weight, and lots of people look good in it.

If you want to lose weight, it's fine, it's mostly diet, it's okay if you can't exercise much at first, maybe you could swim or something--all that stuff. There are lots of approaches. But there is no reason to approach losing weight as a miserable hard slog of self-hatred until you burst into a bright shiny world of thinness and all of a sudden it's okay to like yourself again. It's okay to like yourself NOW. You don't have to wait.

If you're experiencing depression, consider addressing it in a more holistic way than weight loss alone--you sound like you may be becoming socially isolated and overextended. If you can fix the causes, maybe you should. If you it's a long term problem, maybe consider therapy or antidepressants or both. But don't flog yourself into losing weight -- you will hate every second of it and it will be a hundred times harder.
posted by A Terrible Llama at 11:40 AM on November 1, 2008

In graduate school, I saw a Registered Dietician once a week in order to lose some weight and get a better handle on healthy eating. After an initial hour appointment, we met for 15-30 minutes a week. She created an eating plan for me, yes, but she also taught me about nutrition, talked me through my issues surrounding both gaining and losing weight, and encouraged me and was a great source of accountability. What I've learned from her ten years ago I still apply daily to my life--and feel that I've been solidly provided with the ability to weather diet trends and advice, and my own lapses in good nutrition judgement. Some feel RD's aren't going to give them much more than one could learn from a book or the internets or peers, but my total health profile and emotional and intellectual state was taken into account--it's individualized help. You will learn the science and art of healthy eating and living (if you have a good RD) as it applies to you and you alone. Also, since and RD is a board-certified designation, you can often get insurance coverage via physician referral.

Finally, an appointment with an RD is a kind of assisted first step--someone is right there beside you while you make a lifestyle change--no small thing. My experience, as well, is that RDs enjoy working with weight-loss/healthy lifestyle clients because it's a chance for them to have a patient that is not ordered to come to them after a heart attack or diabetes diagnosis. You're coming in a preventative spirit which gets things started in the right frame of mind. You may find that kind of positivity helpful to you at this point. My best to you!
posted by rumposinc at 1:34 PM on November 1, 2008 [1 favorite]

My father has serious foot problems and trouble walking/running/swimming/yoga and other normal 'exercisy' things too, but those recumbent style (feet out front) stationary bikes don't seem to bother him, so he uses those to 4-5 times a week to stay in shape.
posted by delladlux at 3:16 PM on November 1, 2008

Can I suggest - that perhaps instead of launching on a program to loose those 20 pounds, feeling like you need to whip yourself into line - you could start trying lots of different physical activities just for the fun of it. You might find something you really enjoy.
posted by compound eye at 4:29 PM on November 1, 2008

I have plantar fasciitis, and I run 25 miles a week. How do I do it? Superfeet!

Seriously, good orthotics like Superfeet (I actually use the hiking green Superfeet and not the running ones because they work better for my arches), two aspirin twice a day for the inflammation and stretching your feet before you stand up in the morning will win the battle against fasciitis.

I took a month off from running in the hopes of beating it. I basically did nothing different except I didn't run, and my condition didn't change. Then I decided to get serious about treating it so I bought the orthotics (and keep them on my feet until I go to bed), commited to upping my aspirin intake and put a tennis ball on my side of the bed so I could roll it around under my arch and stretch it before I stood up. And I feel confident that the way things are going that the fasciitis will be a memory in a month or six weeks.

Doesn't answer your initial question, and you may still elect not to run, but you should do yourself a favor and get serious about your fasciitis because it's not going away without some changes. I know from experience how it's affecting your quality of life. Get serious about beating it so you can have an additional positive change along with the weight loss you're looking for!

And despite your hopes, it's NOT going away even if you lose weight. The weight might have brought the inflammation, but losing is not going to make it subside on its own.
posted by Mayor Curley at 5:33 PM on November 1, 2008

[This is a followup from the anonymous asker.]

I want to thank everybody who answered. I feel less desperate now. Apparently I have some nutritional treatment coverage in my insurance, which may help. I have five weeks to wait for the podiatrist appointment, which sucks, and I am trying to get options on that. I just got Dr. Scholl's insoles with "pain relief" arch inserts and they feel pretty nice.

I love the water, but I don't know if I can handle gym fees & the time for visits for swimming. I did not know any bike riding could be compatible with foot trouble. That's encouraging.

Zambrano: what the hell. One of my feet swelled up so badly a doctor said it looked like snakebite. Could I do that out of anxiety?
posted by cortex at 5:41 PM on November 1, 2008

Exercise is more important than diet. Diet without exercise, if it works at all, will turn an out-of-shape fat person into an out-of-shape (and unhappy) thin person. There are plenty of exercises that don't stress the feet, and don't even need to be done standing. Situps and crunches, bench weights, free weights, pushups, most of yoga ... any of these done consistently will help you.
posted by aeschenkarnos at 6:41 PM on November 1, 2008

Quickie plantar fasciitis tips from my sports medicine doc:

* pick up marbles with your toes and drop them in a cup.
* put a dishtowel flat on the floor and scrunch it up with your toes.
* stretch your Achilles tendon slowly and carefully.
* ice it (1 liter bottle filled 3/4 full and frozen, then put a sock over it and roll it under your arch).

When mine is flaring, I like to swim and use the elliptical trainer. Bicycles are good too, especially if you have toe cages or clip-on pedals/rigid-soled shoes.
posted by catlet at 6:56 PM on November 1, 2008

Nthing cycling of any sort. Biking has made my plantar fasciitis virtually disappear--just biking around town, to work, to the store.

Zambrano says this all the time and gives consistently dangerous advice around this idea that pain is imagined. Zambrano does not know what zie is talking about.
posted by liketitanic at 7:07 PM on November 1, 2008 [1 favorite]

This works.

Stop eating anything with corn syrup or sugar in it. This includes fruit.
Take a multiple vitamin.

Join a gym, focus on cardio. Most gyms have recumbent exercise bikes. No stress on your feet, pure motion. Ride in bike mode without much resistance. (most have electronic settings, just hit "bike mode" easy on your feet) Increase your time on the bike by one minute a day. Go to the gym at least a five times a week. It doesn't have to be for hours. Get in, do what you have to do and get out.

Use free weights in a sitting position. Use the other machines that place no stress on your feet.

Three months later... the 20 pounds are gone.
posted by Bighappyfunhouse at 8:20 PM on November 1, 2008 [1 favorite]

I agree with Mayor Curley - Superfeet are the bomb. I really thought I would have to give up exercising completely because my feet hurt so badly. Those things are awesome. I replace them (and my sneakers) about every 6-9 months. Dr. Scholl's do not compare.
posted by jrichards at 7:31 AM on November 3, 2008 [1 favorite]