Help, I need motivation to lose weight.

May 5, 2008 10:18 AM

I'm fat and diabetic. My first year after diagnosis I lost 50 lbs and stuck to my diet. How do I stick to it for the long term?

I am in my 30s, married, and hugely fat. I am 200 pounds overweight. I was diagnosed with diabetes, spent the first year changing my diet, lost 50 pounds. During this time my husband and I were going under a huge amount of stress, in fact, we were living separately (but not separated) for much of the first year.

We moved back in together and my weight loss slowed. In fact, I have gained some back and my A1C has gone up from 5.2 to 6.2. 6.2 is in the ok range for diabetics but higher than where I want to be.

On top of all of that, I am handicapped and a wheelchair user. My weight has nothing to do with my disability, I was in an accident that destroyed my ability to walk. I have always been fat but prior to my accident I was extremely active working a physical job, exercising and dancing multiple nights a week.

I need help and motiviation. How do I make myself continue to eat properly when it is just easier to throw a fatty dinner together? How do I deal with a husband who loves potatoes and desserts?

I know I am going to die if I don't lose the weight, I understand this. If you have any hints or motivations, you can answer here or email me at [e-mail]

posted by anonymous to health & fitness (20 comments total)

How do I deal with a husband who loves potatoes and desserts?

Does he love you or the potatoes more?

Seriously, have you discussed with his how difficult it is to maintain your diet when he's shoveling all kinds of carbs down his throat? I'm speaking in hyperbole here, but I know that's how it can feel.

When I was diagnosed with type II diabetes about 2 years ago, my wife made all the diet changes with me. That made it much easier to do. I'll admit that I don't stick to the diet as well as I should(nor does she), but I know I'm doing better than if I was going it totally alone.
posted by owtytrof at 10:26 AM on May 5, 2008

Are there exercises you can do in a wheel chair? It seems to me that you should be able to do a range of upper body exercises with free weights. There's also wheel chair basketball, or getting a pair of sturdy gloves and a non-motorized chair and going for a 'run' every day. Would any of these work?
posted by Phalene at 10:27 AM on May 5, 2008

Could you swim? Even paraplegics can swim with the right equipment.
posted by notsnot at 10:33 AM on May 5, 2008

OK, first of all, there needs to be clear, CRYSTAL CLEAR communication between you and your husband about your life goals. This will be a difficult (if not impossible) process if you do not have constant support. He needs to be your rock right now, accompanying you to see a nutritionist, to the gym (yes, the gym. Weights and swimming will help you out tremendously and you can do both without your legs), and to the organic, fresh produce at the grocery store.

Basically, your habits need to change. And this won't happen overnight. You need to replace salty snacks with almond and craisins trailmix. Replace fatty foods with leaner foods (lean chicken for beef, salmon for pork). Snack on fruit, veggies, yogurts. And reward yourself with lowfat ice cream once a week, or a chocolate chip cookie. You can't quit a bad diet overnight; it will take time and patience, and this is when your hubby needs to straighten out his own diet and support you in yours.

In order to maintain your current weight, you would need to multiply your current weight by 13 and then consume that number of calories in a day. If you want to lose weight, you need to consume AT LEAST 500 calories less a day. How to do this? Portions! Buy smaller plates and bowls and don't even fill them to the top. Cook less and don't be afraid of leftovers. Cook with limited (or no) oil; avoid fried foods at all costs and get some yummy vegetarian cookbooks (you can use chicken instead of tofu, I just think vegetarian cooking has a lot of flavor). Your husband should accommodate you: there are tons of recipes out there for delicious, low-fat desserts (just think: low fat vanilla yogurt with fresh strawberries in it? Yum!) and verbally and emotionally encourage you at all times. This is a tough, tough road to travel, and you might consider enlisting the help of a psychologist who specializes in weight issues. Often, these people also have nutrition experience and can really help you with the stress, anxiety, and depression that can come with such a daunting process. And remember: one day at a time. And don't berate yourself if you fall off of the wagon. Be gentle with yourself! Find a support group and other women who are going through (or have gone through) the same thing.

You CAN and WILL do this! Good luck!
posted by cachondeo45 at 10:35 AM on May 5, 2008

I read several blogs of varying schools of diet-thought (mostly paleo or vegan, both great diets for diabetes, though they are really different) and I think it helps my motivation to read people's success stories and the latest scientific studies.

My favorites are:
Modern Forager
We Like it Raw
Art De Vany
The Migraineur
Weight of the Evidence

I think if you eat mostly whole foods, with a focus on uncooked salads, you'll eventually lose your taste for many bad foods. I used to eat a Snickers every single day and now when I eat when I think it's gross and greasy. Same goes for bagels, twinkies, most pizza, soft-drinks, most ice cream, and a lot of other foods that now just taste...gross. My boyfriend eats that stuff, but it doesn't tempt me anymore. I feel sorry for him haha.

Maybe try out different diets? High-fat low-carb might work better for you and there is good evidence that it's just as good, if not better, than low-fat high-carb (see Gary Taubes Good Calories Bad Calories. I'd also check out Why Some Like it Hot by Gary Nabhan. It's about the value of traditional diets and why paying attention to your genes is important.
posted by melissam at 10:39 AM on May 5, 2008 [2 favorites]

Try weightwatchers online. It helps you hour by hour, day by day.
posted by baggymp at 10:54 AM on May 5, 2008

In order to maintain your current weight, you would need to multiply your current weight by 13
Please do not use this completely unscientific 'formula' to calculate your caloric needs - its incredible inaccurate, it takes no account of age, height or activity level. When I started on a dietitian prescribed diet my calorie need was calculated professionally (and was very accurate based on the weight loss achieved). If I'd have multiplied my current weight by 13 I'd have been consuming nearly 1,500 calories more than I actually needed (or 1,000 less if you use kg instead of lbs - it wasn't specified).

While still just an estimate (bmr varies based on body composition) , the Harris-Benedict formula is far more accurate. You can calculate it online here (multiply this number by 1.2-19, depending on activity level to get your daily calorie need)

My #1 diet tip is: plan your meals in advance; if you know what you're going to be having, you're less likely to fall back on microwave meals and take-away. If you're pushed for time, cook larger meals when you have the time then you have leftovers you can reheat when you're not in the mood or don't have time to cook.
posted by missmagenta at 11:17 AM on May 5, 2008

I've had a lot of trouble losing weight in the past, and I found that when I was struggling, one of my core beliefs matched this quote from your post exactly:

How do I make myself continue to eat properly when it is just easier to throw a fatty dinner together?

This isn't always true. You have to find a way to make it just as easy and appealing to eat a healthier meal than it is to eat a "fatty" meal. Until you find a way to do this, it will never be a habit you can live with.

How you do this depends on your personal tastes and what you have around you and what you're used to eating, and even what your values are in life. For me, I was addicted to take-out and delivery because I hated cooking, and thought there was no way to eat healthy, tasty things that didn't involve slaving in the kitchen. And, well, now I know that was wrong, and I have found ways to make sure I have everything I need to make a quick dinner that appeals to me and fits into my diet plan. It took a lot of work and self reflection to figure out how I could make it work for myself...to look at every excuse I make, and argue with that excuse, and find a way to make that excuse null.

So, what are your excuses? Your husband cannot be an excuse. If he is asking you to make him foods that he knows you can't eat, then you need to assert yourself and say NO. He is asking you to put your life at risk, and if he thinks it's easy to just "not have some", then he is simply trying to sabotage you. He is a big boy (I assume you aren't married to a toddler) and if he badly wants dessert, he can do what my husband does ... he can go out and get himself an ice cream or a cookie or a doughnut. There is no reason to keep sweets in a house when someone in that house is triggered by them and is trying to manage their weight and/or LIFE THREATENING ILLNESS.

I wonder if you are falling into all-or-nothing thinking. Whereas you are either eating salads and salmon and being "good", or eating pork chops and mashed potatoes and chocolate pudding pie and being "bad". There is a middle ground, where meals of pork chops and mashed potatoes made with broth & not butter are complemented with giant servings of vegetables, and dessert is eaten weekly and not daily.

Motivation is bullshit. No such thing exists. You need to (1) Know what you need to do (2) Know what makes it hard to do what you need to do (3) Find some new ways to do what you need to do, that take #2 into account.

It's hard and takes trial and error, but there's a solution to every problem if you are willing to put the work into it.
posted by tastybrains at 11:19 AM on May 5, 2008 [1 favorite]

I'm not a doctor and I may be misinformed but: I saw 60 minutes a couple weeks ago and it talked about gastric bypass. Within the first week those that had diabeties II are cured. Not sure what type you have or if you are a candidate for it. Just thought I throw that out there.
posted by bleucube at 11:52 AM on May 5, 2008

I eat better when I plan ahead. I sit down with my (reluctant) fiance every Sunday before we go shopping and plan out meals for the week. I only buy what we need to make those meals, and whatever cereal and milk we need for breakfast. If I already know I'm making chicken on Wednesday night, and have the stuff to do so, it's one less excuse to order pizza. And if I don't buy cookies, I can't eat them. It really helps to have a partner in this. (So, yeah, give your husband the "if you love me, you'll skip dessert, too" talk.)
posted by Green Eyed Monster at 11:53 AM on May 5, 2008

Tried to find the clip and stumbled across this.
posted by bleucube at 11:54 AM on May 5, 2008

Seriously, go to Amazon.com right now and buy a copy of Good Calories, Bad Calories and read it cover to cover. Don't listen to people who tell you need to cut all meat from your diet or all fat. The key for a lot of people, and especially diabetic people who have insulin resistance, is carbohydrate reduction. Without eating carbohydrates every few hours you'll have far fewer spikes in insulin level and won't have that sharp need to eat something right now. You'll get hungry still but you might be amazed at how much your cravings go away.

General tips for making weight loss easier:
1. Make snacks before hand and keep them in the fridge. That way when you need something to eat right now you don't go hunting for the potato chips.
2. Freeze dinners beforehand so that you have something at hand for a quick meal.
3. Take lunch to work (easier said than done I know).
4. Give yourself a reward for every so many lbs you lose. Not food, but something like an hour to read a book you've been wanting to.
5. Become a member of a weightloss forum. For low carb dieters I highly recommend . You'll find many people there who are going through similar issues and a lot of support and advice. You might be inspired to stick to the diet by the amazing results people have gotten there.
All the best!
posted by peacheater at 12:17 PM on May 5, 2008 [1 favorite]

If you really are 200lbs overweight then maybe you should talk to your doctor about a gastric bypass. The doctors told my Dad that when they do the surgery and bypass the duodenum it often gets rid of type II diabetes (we're talking like 2/3 people). Most insurance will cover it now because its cheaper for them in the long run then paying for the complications that come with obesity and diabetes.

You have many factors in your life affecting your weight that are out of your control. Done properly the psychotherapy and coaching that lead up to a GB and the group support afterwards are can really change your life. My dad was 65 and only 150lbs overweight when they did his but know he's looking at 20+ years of life left instead of maybe 5+.
posted by thewalrusispaul at 1:10 PM on May 5, 2008

According to several studies, gastric bypass surgery can have a mortality rate of 2% in the first 30 days. That's one in every fifty patients dead within a month of the surgery, and that's with an experienced surgeon. Even the 0.5% mortality rate (one in every 200 patients dead) reported by industry groups is dramatically higher than the mortality rate for diabetic patients who do not have surgery. Please discuss the risks of surgery in detail with your doctor, and get a second and third and fourth opinion. Surgery is not a replacement for making lifestyle adjustments, and it should not be undertaken lightly as a way to make those lifestyle adjustments easier for yourself.
posted by decathecting at 1:35 PM on May 5, 2008

Here's some anecdotal motivation for you. My SIL passed away at the age of 52 due directly to her obesity -- and it wasn't the heart or diabetes that did her in. Her fat tissue literally started to die off and, for a variety of reasons, the doctors could not remove all the dead tissue. It may sound harsh but her own fat killed her.

The reason I point this out is that the first thing you have to change is what's going on between your own ears. What you eat and how much starts in your mind, with the choices you make on a moment-by-moment basis.
posted by trinity8-director at 4:08 PM on May 5, 2008

A few things that I figured out during my recent weight loss (50+ pounds, went from obese BMI last April to normal, have been maintaining since January):

On the husband front: Make sure you're not eating the same portions that he is. I think that's part of how I gained weight originally; mr. epersonae is 6' and so he can (and should) eat more than I can.

But I grew up in a family situation where you had to insist on your fair share of things. So I would split food down the middle, because I have that weird am-I-getting-my-fair-share feeling, and ended up with too much food. Just as a matter of course.

Now if I'm making something for both of us, then he gets 2/3 and I get 1/3. And I remind myself that we're being proportionally fair. :)

On the food front: It helped me to make sure I wasn't totally depriving myself, that I was at least once in a while eating the foods that I enjoy most, calories be damned. I just make sure to eat less of them than I used to.

And as for motivation: You've got lots of good advice in this thread about how, but motivation is IME about why.

When you're reaching for more food, or thinking what a hassle it is to make something fresh, remind yourself as vividly as you can why you're doing this. I don't know what moves you: maybe it's the thought of something you want to do in 5 years, or something you want to be able to wear again, or a number on a chart.

Morbidly enough, I reminded myself periodically of my father's funeral. (Heart attack, age 45. Smoker, overweight.) I don't want mr. epersonae to suffer the way my mother suffered, and that's more important than a slice of pizza or just a little more ice cream.

Also, finding supportive people, in whatever venue makes sense, can help a lot. I'm a big fan of physicsdiet.com, including the forums.

Good luck, and remember: you've already done a fantastic amazing thing. You can keep it going.
posted by epersonae at 4:16 PM on May 5, 2008

Warning: I am a fat acceptance activist. I do activist work toward trying to get folks to give fat people an easier time as we go through life.

Advice: Go talk with a sane, non-fat-prejudiced (non-fat-terrified) nutritionist. Maybe also a similar doctor. A good start to finding one in your area would probably be to go here: http://www.naafa.org/

You might also want to research the health initiative called "Health at Every Size" or "Healthy at Every Size". This is one backed by a number of fat acceptance activists (some doctors and nutritionists) who think it's possible to be healthy and fat. Here's a starting point: http://www.healthateverysize.info/nutrition/index.html

I am not a doctor. My last reading of medical journal articles did not indicate a causal relationship between being fat and having diabetes. There is a statistical correlation (a higher percentage than simply random of diabetic patients are fatter than a random sampling of folks), but we have still not apparently scientifically established that being fat makes it harder to survive diabetes. At this point it's equally possible that having diabetes makes you fatter, which would probably make it harder to lose weight, but easier to get totally stressed out about trying to lose it.

I am not saying that your body size isn't causing any health problems for you. It's possible, but not a foregone conclusion. Please don't go through life thinking that you're going to die immediately because of your body size. We all die, but it's usually a bit further out than 30. It's possible that the stress alone could kill you faster than any health problems caused by your body size.

Among my friends (fat and thin), overall health seems to be at least as related to overall fitness (which is different for every person) and overall stress levels (which don't get better if you dwell on how unhealthy you are) and not nearly as related to simply being fat as we are all led to believe these days.

This seems to echo largely unpublicized contemporary research that shows that fatness is rarely the actual problem when one has health issues that are traditionally tied to weight (and cholesterol, too, interestingly). Fatness seems to be more often a symptom than the cause of the disease or disorder.

But if you have the energy, do go do your own research and form your own opinion.
posted by kalessin at 5:22 AM on May 6, 2008 [1 favorite]

Don't listen to people who tell you that you need to reduce carbs to combat diabetes. See Dr McDougall's diet for example.
posted by davar at 6:31 AM on May 6, 2008

You sound like an ideal candidate for an adjustable gastric band. This is a much less severe surgery than gastric bypass, as none of the internal organs are sliced and diced and as it states, it is adjustable and can even be completely reversed. You also have none of the malabsorption issues of a bypass.

In the hands of an experienced surgeon a band is a 45min-90min procedure.

Long term weight-loss maintenance when you can't take lots of excercise is nearly impossible. If simply cutting down on calories long-term were psychologically possible there would not be an obesity epidemic. (I advise a weight loss surgery support group and have talked to thousands of patients over the last 4 years ). I have met many "ex"-diabetics thanks to banding. You should talk to your physician to see if you are a candidate.
posted by Wilder at 8:07 AM on May 6, 2008

I had gastric bypass a year ago last Friday. Even though I did not have diabetes, I'm almost certain I was well on my way to adult-onset, as well as already having high blood pressure and high cholesterol issues. I've lost 130 lbs. to date and all my issues have disappeared. You might want to think about gastric bypass....and to help get you started and to get some answers, I'd recommend you go to the ObesityHelp website - it's an incredible site for information and support, for people thinking about one of the WLS surgery types, or for people who just need to lose weight. I have read posts from many diabetics who have "recovered" as a result of their surgery.

Obviously you shouldn't even think of proceeding without consulting your primary care physician.
posted by schoenbc at 1:49 PM on May 6, 2008