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Second opinion] Can I please get some help setting up an…

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second opinion] Can I please...
second opinion] Can I please get some help setting up an achievable diet and exercise plan? I need to work with someone who can take into account my other health concerns.
Submitted: 1 year ago.Category: Bariatrics
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Answered in 5 days by:
7/27/2017
Bariatric Physician: Dr. Scott, Doctor replied 12 months ago
Dr. Scott
Dr. Scott, Doctor
Category: Bariatrics
Satisfied Customers: 1,149
Experience: Physician
Verified

Hi there,
I am Dr. Scott - it is my pleasure to assist you today.
Please give me a minute to review your question and type up an answer.
Please note that the answer provided is for information purpose only and does not substitute a Doctor - Patient Consultation in Clinic

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Bariatric Physician: Dr. Scott, Doctor replied 12 months ago

What are your other health concerns?

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Customer reply replied 12 months ago
I have severe RLS with insomnia (no PLMS) which causes daytime symptoms including occasionally in my upper limbs, trunk and face. I have various psychiatric diagnoses as well, which I can provide detail about if you think they are relevant. Based on my Fitbit sleep metrics (and they make sense with RLS considered) I get too little slow wave sleep and too much REM. The excess REM is probably related to my PTSD as well as the RLS. At any rate, I get crappy sleep and am generally very stressed so dealing with high cortisol levels which probably accounts for the disproportionate gains in the abdominal region in the last 3 yrs since PTSD and RLS diags.
Bariatric Physician: Dr. Scott, Doctor replied 12 months ago

I see.

How far do you walk daily?

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Customer reply replied 12 months ago
I was doing 8-10k steps regularly but recently started working from home so it is much less, 3-6k on average but weight gain was during 8-10k time frame. Right now I am maintaining but want to lose minimum 20 lbs and ideally 40 lbs. 5' 5" 187 right now
Bariatric Physician: Dr. Scott, Doctor replied 12 months ago
What's your normal diet?
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Customer reply replied 12 months ago
I haven't been calorie counting as much as I once did when I was younger, but I eat very nutritious foods. Lots of veg and lean protein, whole grains, some pasta, hardly any rice, very little bread, not too big on sweets. I occasionally do yogurt. I drink diet sodas and stevia sweetened drinks and teas. I don't get as many fresh fruits as I would like. My weakness is french fries and I realize those need to go. I think mainly my issue is that I eat out a lot. I don't make terrible choices, but my body is slowing down and struggling and it is all I can accomplish to maintain. Losing is hard right now.
Customer reply replied 12 months ago
Oh and also cheese. I love cheese. That is a problem for me. I am trying to cut it down, but I formerly ate at least 1oz daily.
Customer reply replied 12 months ago
I am open to vegetarian or vegan diets but probably would prefer to just reduce meats. I was vegetarian previously. I am concerned about dietary imbalances and nutritional deficiencies with those diets, however, and don't personally believe supplements for b vitamins, creatine etc. are as good or effective as getting nutrition from your food. Any help you can offer would be appreciated, including any dietary suggestions to support healthier GABA levels.
Bariatric Physician: Dr. Scott, Doctor replied 12 months ago

A healthy weight loss goal is 1 to 2 pounds (0.5 to 1 kg) per week. It takes 3500 calories to lose 1 pound (0.5 kg). That means cutting out 500 calories every day for 7 days. You can lose these 500 calories per day by eating fewer calories, by burning them through exercise, or both.

It may be easier than you think to cut 500 calories from your daily intake. You can:

  • Switch from whole milk to 1% or skim milk

  • Switch from regular cheese to fat-free cheese

  • Use healthier condiment choices

    • Fat-free sour cream or salad dressings

    • Spray butter

    • Diet syrups or jellies over regular

  • Try frozen yogurt as a dessert rather than eating ice cream.

  • Skip the chips and French fries. Snack on carrots, vegetables, or fruit. If chips are a favorite of yours, try the baked style.

  • Eat boiled, seared fish or skinless chicken rather than red meat.

  • Try flavored no-calorie waters. Do not drink soda and juices that have many calories.

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Bariatric Physician: Dr. Scott, Doctor replied 12 months ago
  • Eating smaller meals more often may be helpful. This will help keep your metabolism high and your hunger low. This will keep you from overeating at your next meal. Also, eating meals slowly helps you feel full faster.

    • If eating 3 meals is a part of your lifestyle, choose to eat more low-fat protein and fiber at each meal to fill you up for those 3 meals. Skip the snack at night if you can. Drink a calorie-free beverage instead.

  • Do not skip meals. Most often if you skip a meal, you eat too much at the next meal.

  • Eat smaller portions. Use a smaller plate for meals, or when you are eating out, eat half and take the rest home.

  • Plan ahead. Plan your meals and grocery list before going to the store. Planning will keep you from getting meals from fast foods or restaurants.

  • Do not go to the grocery store hungry. You are more likely to buy snacks that are not good for you.

  • Portion out snacks. When you are having a snack, instead of grabbing the whole bag, portion a small amount out to give yourself a stopping point.

  • Drink water before and after your meals to help fill you up without the calories.

  • When eating starchy foods, choose whole-grain products. These have a lot of fiber which will make you feel full. Fiber also helps lower cholesterol and helps with bowel function.

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Bariatric Physician: Dr. Scott, Doctor replied 12 months ago
  • Choose low-fat meats:

    • Boneless chicken breast

    • Pork loin

    • 90% lean beef

    • Lean turkey meat

    • Fresh fish (not fried)

  • Choose low-fat dairy products:

    • 1% or skim milk

    • Spray butter or margarine

    • Low-fat or fat-free cheese

    • Frozen yogurt or low calorie ice cream

  • Choose fresh fruits, green vegetables, beans and lentils, and whole wheat products more often.

  • Choose smart snacks:

    • Baked chips

    • Pretzels

    • Popcorn with no butter − use some pepper or other spice to taste

    • High fiber, low-fat crackers

    • Reduced fat cookies

    • Diet or no-calorie beverages

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Bariatric Physician: Dr. Scott, Doctor replied 12 months ago

In addition, try to walk 20 minutes daily.

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