How do I lose weight, when I am supposed to severely limit my walking and standing?
December 1, 2010 8:06 PM   Subscribe

How do I lose weight, when I am supposed to severely limit my walking and standing?

I'm a woman in my mid-30s.

I weigh 114 kg (250.8 lbs) and have a BMI of 43.4.

I have arthritis in my knees, as well as an acute knee injury.

My doctor told me that my weight makes both my arthritis and my knee pain worse.

Clearly, I urgently need to lose weight.

But, my doctor also told me to severely limit my walking/standing to avoid aggravating my arthritis and doing more damage to the injured knee.

I also have a very fraught emotional relationship with food... ...just thinking about severely restricting calories makes me feel panicky and feel like bingeing.

So, what can I do to lose the weight?
posted by anonymous to Health & Fitness (48 answers total) 11 users marked this as a favorite
Swimming? It would keep all the weight off your knee.
posted by ThePinkSuperhero at 8:10 PM on December 1, 2010 [17 favorites]

Address the food issues, perhaps in therapy. Dieting will then be a much easier route to losing weight than exercise.
posted by zippy at 8:12 PM on December 1, 2010 [1 favorite]

You don't need to exercise to lose weight. That's not saying you shouldn't exercise, but don't let your physical limitations become an excuse. The more weight you lose, the more active you will naturally become.

I really, really recommend Weight Watchers. I dropped fifty pounds this year and by no means did I severely restrict my calories. I did, however, have to learn to eat again. No small feat, but definitely doable.
posted by theraflu at 8:15 PM on December 1, 2010

I've heard good things about Weight Watchers, especially for people with an abnormal "relationship" with food, and they don't restrict calories all that much.
posted by halogen at 8:16 PM on December 1, 2010

Luckily, you don't need to severely restrict calories in order to lose a great deal of weight, especially at the weight where you are.

Why not try shooting for one or two pounds a week, with most of the weight loss, at least at first, coming through exercise rather than through diet?

To lose one pound a week, you have to burn 3500 calories... 500 per day.

According to this activity list, for a 200 lb person, an hour of *leisurely* non-lap swimming burns 558 calories.

Say you wanted to add another half pound per week of weight loss to that, through diet. You would need a deficit of 250 calories per day, below what you normally eat to maintain your current weight. 250 is the amount of calories that there are in like an apple and a half. Does the idea of giving up an apple and a half per day or the equivalent and eating everything else you normally eat make you panic and feel like bingeing?

I think if you take it really, really, really slowly and make diet and exercise changes gradually, you won't flip out and the process will be much easier.
posted by Ashley801 at 8:16 PM on December 1, 2010 [1 favorite]

Weight Watchers is an excellent program. I would also strongly recommend that you seek a referral to a physiotherapist - they will be able to design an appropriate exercise program for you to assist with the WL, arthritis symptoms, and treating the knee injury.
posted by purlgurly at 8:17 PM on December 1, 2010

I've linked to this article before – the fact that you won't exercise makes practically no difference for women when it comes to weight loss (acknowledging that weight loss and fitness are two different concepts). Eat less.
posted by halogen at 8:18 PM on December 1, 2010 [1 favorite]

It'll sound crazy, but be careful if you decide to do a lot of swimming without being really carefully our diet. One summer I swam a mile every other day and *thought* I was keeping my diet the same. Apparently not - I gained 12 pounds and none of it was muscle. (Unless it was really attractive muscle that made it hard to button my pants.) Swimming makes you HUNGRY. My back felt great that summer, though. I like exercising, but none of my attempts to continue my normal (bad) diet while upping exercise have worked at all. I think I am eating the same, but it doesn't work out that way.

If I were you, I'd try a low carb diet. If I try to just eat less, I get sort of crazy and cranky, but if I am on Atkins, I'm never hungry and I lose weight. Also, not only do I lose weight more quickly with Atkins + Exercise, the exercise makes me look better than diet alone.
posted by artychoke at 8:21 PM on December 1, 2010 [1 favorite]

without being really careful with your diet.

I don't know what happened to that sentence.
posted by artychoke at 8:22 PM on December 1, 2010

Eat less.

You can't really lose weight without feeling hungry. Not necessarily all the time, but some of the time. Hungry is your body saying "I am losing weight."

In an existence where food is instantly available all the time, we have almost no tolerance for the feeling of hunger.

So harden up and lengthen the time that you can handle feeling hungry.
posted by jjderooy at 8:34 PM on December 1, 2010 [2 favorites]

with most of the weight loss, at least at first, coming through exercise rather than through diet?

I think that's a bad idea for you anon. Poor diet is what most likely led to this to begin with. People who eat poorly but then start to exercise tend to eat even more as a reward system, and since they have an actual appetite.

Based on what you said I believe you should probably see a nutritionist. I could give you surefire simple way to lose weight listed bullet point by bullet point but you aren't going to follow it based on your current relationship with food.

If it makes you feel any better, you aren't going to want to SERVILELY restrict calories anyway. You're going to want to go 300-500 below your current maintenance and readjust monthly.
Start off with dropping soda, or sugar\candy, or bread and then keep adding on to that pile until you get a real plan worked out.
Eating clean allows one to eat huge amounts of food without worrying about each calorie.

With that said, start doing something different, anything as soon as possible. Doing anything is better than waiting around trying to do whatever is "perfect."
posted by zephyr_words at 8:44 PM on December 1, 2010

Drink 16 oz (500mL) water before you eat *any*thing.
posted by notsnot at 8:45 PM on December 1, 2010 [3 favorites]

haha, or *Severely, I think being obsequious about your calories would be good =]
posted by zephyr_words at 8:47 PM on December 1, 2010 [2 favorites]

Weight loss is primarily about what you eat. Exercise helps, but your eating habits matter so much more. When I was losing weight, I could stop exercising and notice it, but I'd still lose weight because I was religious about counting those damn weight watchers points. That being said, I'll nth its recommendation, because it WORKS.
posted by cgg at 8:50 PM on December 1, 2010

But, my doctor also told me to severely limit my walking/standing to avoid aggravating my arthritis and doing more damage to the injured knee.

Things like running, stairstepper, and elliptical obviously aren't going to work then. What about a fixed exercise bike? Most of your weight is supported on the seat... might be enough to relieve your arthritis.

Swimming is also a great idea, but maybe not so easy for the self conscious. Instead of just jumping into the pool during free swim, try an aquatic aerobics type class. Not only is is structured, but everyone's focusing on the teacher and not each other.

But yeah: a good swimming workout can make you hungry. I'm talking ravenous. Watch out for that. I'm not going to say "don't eat" afterwards... just be smart about it. A salad sans dressing will quiet the stomach but add hardly any calories.
posted by sbutler at 8:50 PM on December 1, 2010

Row? Sit down bike? There are probably a million other ways to get your heart rate up without putting strain on your legs.
posted by darkgroove at 9:31 PM on December 1, 2010 [1 favorite]

Nthing Weight Watchers. You can do it online if going to live meetings isn't feasible for you.

This is something you can transition into. You don't have to severely restrict calories. And if the idea of dieting is something that induces panic, think instead about doing one thing at a time. Do you drink soda? Can you cut it out? Or do you overdo it on desserts or cheese or chips or bread? Pick one thing and trim it down. Delete it entirely if you can. If you can't, reduce it and keep doing.

If at all possible, try to keep a food diary of every single thing you eat. This can also be panic-inducing at first. Promise yourself that it's just for you, that no one else will ever see it. If you can bear to write things down, it will help you focus on where you're going off the rails. When you write down what you're eating, also write down what time you're eating. You may find that you eat well all day but splurge at night. In that case, maybe try simply not eating after 6 or 7pm.

Lastly, I suggest gentle yoga. It's very good for starting into exercise. If there's a yoga studio that's convenient and affordable to you, go there. Or try the local YMCA/YWCA. Or the big corporate gyms that will offer a decent monthly rate and then any class you take will be without additional charge. Look for yoga classes that have these words in their name: restorative, gentle, therapeutic, relaxing, etc. You can also try a pre-natal yoga class -- though you aren't pre-natal, those classes are usually gentle.

Or, try a yoga DVD. Here are two that get good reviews on Amazon.

Above all -- don't panic. Take it one day at a time. You can do this. Just start moving. Just start looking at what you eat.
posted by BlahLaLa at 9:42 PM on December 1, 2010

While I am a serious advocate of exercise, it is a common misconception that it has the biggest role to play in weight loss. Read this, for a pretty good and recent overview.

Listen, as others have said, there is no way around it but to change your diet. Diet is the #1 factor in weight loss, not exercise. #1. Find a way—whatever that may be, as long as it is healthy (I suggest Michael Pollan's simple dietary advice as a good place to start)—and stick with it. That doesn't mean starving yourself but it certainly means changing your relationship with food from a purely pathologically emotional one to one that is about healthy physical and emotional sustenance (the emotional relationship to food never goes away, but it can be positive!). This has to be a fundamental lifestyle change or it will not work. Based on your statement within your question about how thinking about changing your diet makes you feel, this may have far more to do with getting therapy than getting into the gym, as trite a prescription as that is on Ask MeFi...

Good luck, sincerely. It's hard but you can do it. You really can.
posted by dubitable at 10:02 PM on December 1, 2010

Oh, halogen already linked to the same NYTimes article...I guess that says something not sure exactly what though
posted by dubitable at 10:05 PM on December 1, 2010

After abdominal surgery I used this diet to lose weight quickly and I'm currently still doing so. There are no calories to count, although you should still be conscious of portion size. The hard part is eating virtually the same thing every day, but there really is no such thing as a fun diet (otherwise I would look like Kate Moss already). For extra advice check out the comments below the post. It will take you a while to get through them all but there is some practical advice in there. You should definitely talk to your doctor to make sure that a high protein diet is the healthy way to go. I like Weight Watchers and it works really well, but sometimes I just want a straightforward meal plan with a few basic guidelines.

Also, no matter what diet you pick, drink a ton of water. You will be so surprised that it really helps you lose. I up my water intake during a plateau and it seems to help.

Good luck! I know it's tough, but you have already taken the first step.
posted by Cheminatrix at 10:11 PM on December 1, 2010 [1 favorite]

1. Change your diet. Nthing Weight Watchers or something similar that restricts calories and isn't some crap fad cabbage soup diet.
2. Find methods of exercise that don't require your knee. Other advice in this thread notwithstanding, calorie restriction alone is NOT enough for healthy and effective weight loss. Metabolism is a complicated mechanism, and humans weren't meant to be sedentary. Nthing swimming, also isometrics and floor exercises. Just figure out how to move!
3. Drink more water: Water-induced thermogenesis.
4. Get help. Join a weight losing group, or an overeater's group, or start therapy. Talk to your doctor and ask for guidance. Everything's easier when shared with others! You're not alone, and your goals are good and true. You can do it!

Good luck!
posted by goblinbox at 10:13 PM on December 1, 2010

Weight loss is actually extremely simple. I'm not saying it's not very difficult for many people, but the formula for doing it is actually stunningly simple and in theory at least has nothing to do with exercise programs, low carbs, no carbs, proteins, etc. etc. The formula is consume less calories than you burn. That's it.

You can figure out everything you need to know from a website like this one.

The reason why most doctors recommend exercise to lose weight is because most people will find it easier and faster to lose weight if they both reduce their caloric intake and exercise.

Therapy and/or some sort of weight loss support group would probably be a good way to deal with your fears and anxieties about food and restricted calories. Weight watchers is one, but check with your local health department/clinic/etc.. They might have or know about local weight support groups you could join.

As for exercise, an injury does not eliminate all possibilities of exercise for you. You just need exercises that are not going to be hard on your knee joints and there are many. Swimming is one, but there are many others. Might I suggest seeing a physical therapist? They can help with your knees, and also suggest exercises you can do for your general fitness that will not be hard on your knee joints.
posted by katyggls at 10:15 PM on December 1, 2010

Swim! Low impact, builds up muscle mass, muscle mass helps burn more calories. Also, the exercise will reduce the arthritic inflammation (IANAD).

You can also try pilates.
posted by TheyCallItPeace at 10:30 PM on December 1, 2010 [1 favorite]

You can't really lose weight without feeling hungry.

Yes you can - for many people, a low-carb way of eating will do exactly that. I was put on Atkins (by a doctor, for a specific health condition not directly related to weight) seven years ago and was amazed that for the first time in my life I rarely felt hungry. This is a very common benefit of low-carb eating - the lack of processed food and simple carbs in the diet stabilizes blood sugar. Low blood sugar is what causes that "starving" feeling.

Following a strict low-carb eating plan, I lost 50 pounds (without exercising other than the fact that I walk a lot) and have had no trouble keeping it off. I had trouble with my knees when I was overweight, and since losing the weight my knees no longer bother me.

There are lots of low-carb resources on the web; I'd recommend starting with Dana Carpender's site if this is an approach that interests you.

(FWIW - when I was overweight, I was a devoted gym-goer. As in, an hour or more every day. Two years of that and I don't think I lost an ounce. The minute I cut the processed carbs out of my diet, the weight just melted off - and at the time, I was unemployed so the gym membership had lapsed.)
posted by chez shoes at 10:47 PM on December 1, 2010 [5 favorites]

Lots of excellent suggestions. I once weighed much more than I do now, and here's what I found useful:

1. I didn't focus on caloric restriction for the first bunch of months. Instead, I focused on pleasurable, healthy eating. Walter Willett's Eat, Drink, and Be Healthy book provided some great, reasonable, and scientific guidance. Other books have come out since that may also be helpful, but this was several years ago.

2. I limited my portions of meat, dairy, and whole grains to recommended portion sizes, such as 3 oz. of meat, etc.

3. I did not limit my portions of fruits and vegetables.(Some suggest limiting fruits to 2-3 portions per day because of the sugar content. I didn't.) I used small amounts of olive oil and seasonings on my veggies.

4. I didn't drink my calories, but I occassionally had a small diet coke with lemon, and a glass of wine with dinner.

5. I taught myself to chew slowly and taste my food. I trained myself to stop and rest one third and two thirds of the way through my meal to extend enjoyment and to allow my body to register fullness.

6. If I wanted a sweet, I got a small portion of the best quality item possible, and never had it on an empty stomach. Usually this was one or two small pieces of chocolate, which I had with really good coffee or tea, and I savored the flavors.

This doesn't have to be unpleasant at all! Find fruit and veggies you love, and find ways you like to eat them.(I'm a huge fan of roasting them, or making soups.) Fill up on those, and augment with proteins and whole grains. Enjoy!
posted by metarkest at 2:54 AM on December 2, 2010 [1 favorite]

IANAN, but when I went to a nutritionist, she set goals for healthy eating, rather than restricting my calories. The first thing she asked me to do was to increase my fiber intake. In order to do that, I had to eat---the message wasn't "don't eat". Very clever.

I suspect that in addition to getting a lot of calories, you may be eating nutritionally empty food.

Also---ask the doc who told you to restrict standing and walking what he/she expects you to do. Or see a doc who specializes in obesity.

This is not unresolvable. But it is like taking on a whole new hobby--so I feel for you.
posted by vitabellosi at 3:10 AM on December 2, 2010 [2 favorites]

250 is the amount of calories that there are in like an apple and a half.
Not to detract from your main point which I agree with, but that's only true if you have very large apples. According to the USDA database, a medium apple (which at 3" sounds already pretty large to me) has about 95 calories.

If you have difficulty losing weight for mostly psychological reasons, it could be helpful to read a book that deals with that (for example Changing for Good). I think there were askme threads about that before.
posted by davar at 4:24 AM on December 2, 2010

Great suggestions here re: diet and some potential exercise solutions. I just wanted to add another exercise option to the list: Arm Bike. Like a bike, but for your arms! You just plop it on a tabletop and spin away. I used one of these during physical therapy for a wrist injury, and it can be a good workout.
posted by dondiego87 at 4:30 AM on December 2, 2010

Weight Watchers is very good. I and many I know have had great success. But, they talk about food all of the time. So I urge therapy in addition to it. I don't want you to avoid WW for that reason -- I'm just giving a heads up.

Swimming is great, and if you have access to an arm bike that would be great. I've only seen one at my PT's office, but maybe you could check into it.
posted by jgirl at 4:31 AM on December 2, 2010

This is what water aerobics was MADE for. Plus, it's fun!
posted by St. Alia of the Bunnies at 4:43 AM on December 2, 2010 [2 favorites]

Cut carbs and swim.
posted by flabdablet at 4:44 AM on December 2, 2010 [1 favorite]

Ignore those who say that losing weight is as "simple" as eating less calories than you expend. Those of us who have battled with weight problems know it isn't as simple as that.

I recently started eating a low/no carb diet, based loosely on Paleo/Primal diet theories, although I haven't been too strict. Weight has dropped off me and the only exercise I do is walking to the store.

Read Good Calories, Bad Calories by Gary Taubes. Maybe also check out this incredible article

Make this your mantra: Carbohydrates = Insulin = Fat

Eating a high protein diet, you won't feel hungry. Giving up carbs is hard, but once you start to see results (within a week) it's enough to spur you on.

Good luck.
posted by pandini at 5:33 AM on December 2, 2010 [9 favorites]

OA and weightlifting.

Worked for me, more than 100lbs lost.
posted by unixrat at 6:19 AM on December 2, 2010 [2 favorites]

Nthing therapy. If you are panicking thinking about eating less, then relearning to eat will be an emotionally fraught experience. And more than likely, you already know how to lose weight. You've probable heard 100 different diets that have helped people. Everyone has their own personal way that has worked best for them, but you need to find what works best for you. And you need someone there to guide you through the emotional hurdles that will cause you to stumble.

I have found, as a first step, is that counting every calorie I eat gives me the knowledge I need to take control of my eating. It's a necessary first step, you are overeating, you need to know where and how you are doing this. You don't have to change what you eat, just be honest and accountable to yourself. Once you have data, you can figure out a plan that works for you.

(And don't pretend like you'll do this forever. Because you won't. And when you stop doing it, you'll feel bad about yourself, and you'll think, "oh I'm a failure, and I'll be fat forever," and you'll end up eating more. Just think, "I'm going to do this for two weeks to collect some data on my eating habits," because two weeks is totally doable.)
posted by Tooty McTootsalot at 6:22 AM on December 2, 2010 [4 favorites]

Therapy therapy therapy before diet or exercise. If you don't address your emotional and mental struggles with food, any attempts at calorie restriction or low-carbing or weightwatchering will stress you out and ultimately backfire. However you ultimately plan to lose weight, it will be much easier to do when your relationship with food is healthy and happy.
posted by Metroid Baby at 6:46 AM on December 2, 2010

Echo everything people are saying.

A Big Mac has 576 calories. If you were walking, you'd have to walk for much more than an hour to compensate for that. Much easier to eat something lower in calories. Exercise can speed weight loss, but diet can make a much, much more significant impact.
posted by kryptonik at 6:52 AM on December 2, 2010

You've probable heard 100 different diets that have helped people. Everyone has their own personal way that has worked best for them, but you need to find what works best for you. And you need someone there to guide you through the emotional hurdles that will cause you to stumble.

Tooty speaks truth!
I started exercising by doing water aerobics because it was easy on my joints. I also worked with a trainer to get me on a strength training program. At my old gym I got used to this on weight machines and now I have switched to free weights and body weight exercises.
Finding what works for you will be trial and error, but you will likely find something or some combo that clicks for you. Good luck!
posted by pointystick at 7:01 AM on December 2, 2010

Ignore those who say that losing weight is as "simple" as eating less calories than you expend. Those of us who have battled with weight problems know it isn't as simple as that.
I used to be obese. Now I am not. I lost weight by cutting calories. I know many people who did. Other people in this very thread say it works for them as well. For many people who have battled with weight problems it actually is as simple as that.

Read Good Calories, Bad Calories by Gary Taubes.
Good Calories, Bad Calories is a great read, but be sure to also read this article to see some criticism about the book. It is a good article, with lots of references.
posted by davar at 7:48 AM on December 2, 2010

> (FWIW - when I was overweight, I was a devoted gym-goer. As in, an hour or more every day. Two years of that and I don't think I lost an ounce. The minute I cut the processed carbs out of my diet, the weight just melted off - and at the time, I was unemployed so the gym membership had lapsed.

This has been my experience too--I did the classic "less in than out" using standard WW-type thinking, you know, portion control and more lean meats and whole grains and tons of fresh fruit and veggies, plus a fuck ton of conventional lady-type exercise--walking or running almost 25 miles a week, pilates, etc.--and I got run down with brittle hair and I felt starving and shitty and tired all the time and STILL kept gaining weight. I'd dial it back thinking my body was conserving fat in defense mode and would just gain faster. Nothing worked. It made me want to scream. This went on for like over 2 years. I was beginning to feel delusional and insane because people tell you over and over how simple though difficult it is and it just was not lining up with my experience, and I KNEW I wasn't fudging or overlooking something in the equation of this blueprint, it just was.not.working. I thought I was doomed to just keep gaining weight forever and ever and I was freaking out like "what the hell is wrong with my body?"

About 6 months ago thanks to all the Mefi talk about Taubes I read his book and sniffed around the usually linked places--those SA forums on weight training and low carb/paleo approaches, Stumptuous, MarksDailyApple, etc. Decided to give it a go on my own terms--did some futzing with CRONometer and SparkPeople not with the idea I'd be monitoring forever, but to analyze my macro balances and nutrient breakdown within a certain calorie limit, see how I could optimize it for my goals by reaching for, say, this veggie over that fruit, or this snack of nuts over an apple, or whatever. Once I saw how the easiest approach looked for me--mostly locking down breakfast into a meal that is perfectly balanced with way more protein than standard that I find affordable and tasty every day, but this is just me--I was on my way. I guess I eat under 100g carbs a day (probably usually between 50-80g), eschew most packaged foods (I did before anyway so this was a no brainer; I love to cook with raw materials, always have), eat smaller meals more often, eat slowly and enjoy my food, eat in ways that smooth my insulin and metabolic response--the protein and fats before the carbs if all 3 are part of a meal, say, and any alcohol or caffeine AFTER eating, not before, eat the carbiest stuff around exercise time and not right before going to bed--and stopped the endless cardio and replaced a lot of it with weight training and high-impact short-burst stuff like jumprope, sprinting, stairs, whatever (this doesn't apply to you but I'm just mapping out my progression to give you an idea).

The gist of all this was to look at my insulin response and the hormonal aspect of it and try to get that under control. The way I was gaining weight felt very hormonally driven (and super feminized frankly, which Taubes et al talk about). Once I learned the tricks to smooth out my hormonal response to eating and keep it in check the weight finally began to come off. And I eat way more now than I did when I was trying the more conventional approach, aaaand am much stronger and feel better--I sleep well, have lots of energy, haven't gotten those run-down colds I kept getting the years before, my hair and skin look great, etc. And bonus, I don't have exercise like it's my full-time fucking job anymore--I don't know who has more than 2 hours a day to spend exercising but it ain't me.

I know people hate us low carb fanatics but seriously, that's just how it worked for me. The conventional approach to all this stuff is not the whole story, there is so much that we don't understand yet about food and weight gain and all that...if the standard things aren't working at ALL and you know something's off, keep an open mind.
posted by ifjuly at 8:04 AM on December 2, 2010 [13 favorites]

If mobility is a problem, there is a DVD called "Yoga in Bed" or words to that effect. You don't have to worry about getting up and down off of the floor.

MeMail me anytime you like.
posted by jgirl at 8:17 AM on December 2, 2010

Good Calories, Bad Calories is an excellent book, but the hormonal mechanisms in it are incomplete and in some cases possibly inaccurate. The long and the short of it is that for most people, some types of carbs are completely fine. Good carbs include sweet potatoes, turnips, beets, other tubers, and fruits. Grains are not fine, besides possibly white rice on occasion. Metabolic syndrome can impair one's carb tolerance so for the OP it might be better to cut them out anyway.

I eat roughly Paleo with some (full-fat or better) dairy. I started losing 2 lbs per week the second I began paleo, without conscious calorie restriction. Low carb had not brought my weight down much. I actually have to eat more than I want to in order to maintain my weight now - I am trying to put on muscle because I do weight training.

Also, seconding the people who recommend weight lifting or resistance training. It's not a "get huge" exercise. Exercise doesn't affect your weight much, and when it does it's more through hormonal and metabolic changes than direct calorie burning. Weight lifting improves body composition far more than most other forms of exercise.
posted by Earl the Polliwog at 8:24 AM on December 2, 2010 [1 favorite]

It's also a possibility that cutting out the inflammatory or sensitizing foods in your diet (e.g. vegetable oils, wheat) and upping anti-inflammatory foods (e.g. omega-3s) could reduce your knee pain.
posted by Earl the Polliwog at 8:34 AM on December 2, 2010 [1 favorite]

It doesn't much matter what exercise you do if you're still overeating. If you're not willing to reduce what you eat, don't expect great results. You need to actually put effort into this.
posted by splice at 9:05 AM on December 2, 2010

I have arthritis in my feet and knee problems, and when I lost 50 pounds I did it by purchasing a recumbent stationary bike and counting calories.

With the bike, I aimed for 20 minutes a day, every day. I achieved it about 5 days out of 7. If I was on the bike and felt like going for longer, then I did so, but 20 minutes was all I *had* to do. With the recumbent bike, it didn't hurt my butt and I didn't have weight pressing down on my knees and feet. I started at the lowest resistance setting there was, and gradually increased it as it started feeling too easy.

With the calorie counting, I signed up on and logged everything I ate, even on the days I overate. What KEPT me on the eating plan was working out how many calories my favorite foods had and incorporating them into the plan. One of my comfort foods is bean and cheese chalupas. 3 tostada shells, 1/4 cup refried beans on each, 3/4 cup shredded cheddar jack scattered over them, 10 minutes in the toaster oven: 750 calories. That means I've got about 900ish calories left out of the 1700ish I'm aiming for that day, and can eat slightly less for the other two meals WITHOUT feeling deprived, and I'm indulging in a serious comfort food. I used to eat 4 chalupas at a time. Cutting to 3 made very little difference in my enjoyment, I found, and if I felt the need to rebel against my eating plan - very important for me! - I just ate four instead. As long as I didn't do that *every* time, I still ingested fewer calories.

I also allowed myself indulgences as long as I made it difficult in some other way. Want buttered popcorn? Great! I jut can't use microwave popcorn, and have to make it on the stovetop, in a pot, and use the really expensive European cultured butter. My popcorn intake dropped by over half after I instated that rule, and I enjoyed the popcorn I *did* eat so much more, because it tasted better. I could also eat as much chocolate as I wanted as long as it was the expensive Scharffen Berger bittersweet stuff that cost $9 for 10 ounces. I could have as much ice cream as I wanted, provided I got in my car, drove to the ice cream shop, bought it there - in the mid-size container, not the half-gallon - got back in my car, and drove home before eating it.

That stopped me feeling deprived: these foods were NOT forbidden, just difficult to get.

Factor in your favorite restaurant meals. If they're very calorie-heavy, order a salad and eat it before the meal, then immediately divide the entree in half when it arrives and take the other half home for tomorrow. If you normally order an alcoholic drink, appetizer, or dessert at a restaurant, either eat out less or start saving the extras for special occasions. Most chain restaurants have the nutritional information available online: check it out before going and plan what you're going to order.

DO NOT believe the people who say you have to start eating 1200 calories a day right now. You will go hungry, unless you're eating nothing but fiber-full vegetables, and you will feel deprived, and you can lose weight while eating more than that. Use the calculators on places like to figure out a target range for your height/weight/level of activity and aim for that.

I ended up eating 1700-1900 calories a day depending on my activity level while I was losing weight. Some days I indulged and overate, but instead of beating myself up about it and telling myself I was a loser and might as well not go back on the diet, I ENJOYED THE FOOD and went back to the plan the next day. Over-eating on one or two days doesn't mean you're gaining weight, it means that you're losing weight slightly slower that week. (Unless you're doing 3000+ calorie binges regularly, in which case you may need to seek professional help for compulsive overeating.)

I am not finished with my weight loss yet, but I weighed more than you when I started, now weight a bit less than you, and my knees feel SO MUCH BETTER. There is hope!
posted by telophase at 9:42 AM on December 2, 2010 [3 favorites]

Meant to add: MeMail me if you want more info on what I'm doing or just to commiserate about it with someone going through the same process at the same time.
posted by telophase at 9:46 AM on December 2, 2010

all of these people are giving you diet advice, and i'm sure it's great. but what stood out to me in your question was: I also have a very fraught emotional relationship with food... ...just thinking about severely restricting calories makes me feel panicky and feel like bingeing.

i used to be you. i have been on every diet ever. cognitive behaviorial therapy with a psychologist who specialized in eating disorders was extremely helpful for me. it's not a quick and easy fix, but for me it's been a lasting one. food and i get along much better now - without any sort of diet other than my own decision to make good choices about what i eat. and the weight sort of fell off once i was able to find coping mechanisms other than eating emotionally.

here's a book that helped me a lot.
posted by woodvine at 10:59 AM on December 2, 2010

just thinking about severely restricting calories makes me feel panicky and feel like bingeing.

You can restrict without severely restricting. Just like you can workout without living in the gym, and just like you can save some money without selling your house and moving into a cave.

Example: I love sandwiches, but I've switched from two 90-calorie-per-slice pieces of bread, to a single 90-calorie piece of flat bread (about the size of a tortilla). Same flavor, fewer calories. Ditto for soda: I switched from Coke to Coke Zero. (Yeah, the chemicals will probably kill me. So be it.)

There are a thousand similar ways to cut calories without sacrificing much of anything.
posted by coolguymichael at 12:20 PM on December 2, 2010

Just wanted to n-th what the people above are saying about low carb and the insulin response. Seriously, seriously, for God's sake just give it a shot. At the beginning of the year I was a tight size 16 and felt terrible. A year of low carb eating (and not so very much exercise, really) and I'm 40 lbs lighter and am in between a size 10 and a 12. Next I want to figure out the exercise part of the equation -- lots more strength training for one thing -- but for the first time I'm pretty confident I'll get the body I want. At a BMI of 43.4 I think you'll find that the lbs just peel off once you restrict carbs a bit and that's going to be a huge encouragement to keep going. Don't worry, this really truly can be done!
posted by peacheater at 1:43 PM on December 2, 2010 [1 favorite]

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