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For the first time in my life I am very overweight. Due to

Customer Question
an illness that has yet...
For the first time in my life I am very overweight. Due to an illness that has yet to be diagnosed I suffer from chronic pain in many of my joints with pretty much no relief. It's ruining my self-esteem. I was always the thin, active pretty one. Now I
feel invisible without an identity. I want to do what is necessary to lose the weight. I eat 1200 calories a day. Getting motivated to exercise through psi after 10 hours a day on my feet is so daunting. I feel like I've lost myself and want to hide. I'm ashamed.
I should add that when I was thin I was always striving to stay that way and never felt thin enough.
Submitted: 2 years ago.Category: Mental Health
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Answered in 12 hours by:
8/10/2015
Mental Health Professional: Dr. Ravoof, Doctor replied 2 years ago
Dr. Ravoof
Dr. Ravoof, Doctor
Category: Mental Health
Satisfied Customers: 5,274
Experience: Experienced Physician in the field of Medicine and Surgery.
Verified

Dear customer,

Thanks for your question.

What is your weight and height? Do you take any daily medications?

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Customer reply replied 2 years ago
197 5'4" I take many psych meds, but I was taking those when I weighed 120. Right now I'm taking Cymbata, Latuda, Lamictal, Plaquenil, Celebrex, Vitamin D, Ambien, And Ativan. I'm also taking Lovaza to help with inflammation, not cholesterol.
Mental Health Professional: Dr. Ravoof, Doctor replied 2 years ago

Dear customer,
Thanks for your reply.

Body mass index (BMI) is a formula that estimates body fat using weight and height. This formula is useful since it has been shown that excess body fat is related to serious health conditions.
BMI values and their interpretation:
Underweight: Less than 18
Normal weight: 18.5-24.9
Overweight: 25-29.9
Obesity: BMI of 30 or more
30 to <35 Stage I obesity
35 to <40 Stage II obesity
≥40 Stage III obesity
Your BMI is 33 and are classified stage I obese.

Weight gain can be due to genetic, hormonal, physical inactivity, as well as excess calorie intake. Also certain medications which are used to treat depression may cause weight gain. One of the most important investigation which can be done is thyroid hormone test since when there is inadequate thyroid hormones in the body this may lead to weight gain and an inability to lose weight despite exercising.

Even a weight loss such as 5 to 10 pounds a year has been shown to cause a substantial benefit such as a 25% decline in mortality. A realistic goal is the loss of 5-10% of your body weight and then maintaining the resultant body weight over a period.

You must eat whenever you are hungry, but just enough to satisfy your hunger. You can have a balanced diet of small meals 4-6 times every day.

Managing calorie intake is the right step towards managing weight. A healthy diet helps.

Regarding your diet the following advice will be beneficial:

Increasing starches:
Wholemeal Bread. Eat plenty of cereal products such as bread, breakfast cereals, rice, pasta, noodles.
Porridge or high fiber wholegrain cereals.
Eat more root vegetables and starchy fruits such as potatoes, plantain,green bananas.
Potatoes, pasta or rice
Include pulses and vegetables in meat dishes
Wholemeal flour in baking

Decreasing fat:
Use as little oil or fat as possible when food is prepared or cooked.
Avoid frying
Choose lean cuts
Trim off visible fat
Don't add meat fat to gravies
Avoid pies and sausages
Cook in vegetable oil which Is changed frequently
Low fat polyunsaturated margarine's
Use semi-skimmed milk. low fat cheese, or low fat yogurt.
Eat fewer cakes. pastries,confectionery, and biscuits as these can contribute considerable amounts of fat.

Increasing fruit/vegetables:
Increase use of wider range in salads
Two vegetables at each meal
Fruit as a desert instead of puddings
Bowls of fruit on display for easy access
Include vegetables In meat dishes, e.g.stews and curries
Decreasing Salt:
Fresh food in preference to tinned or packaged
Use more herbs and spices to add flavor
Minimum use in cooking and at table
Reduce meat and vegetable extracts

Decreasing Sugars:
Decrease use in cooking and at table
Artificial sweeteners
Fresh or dried fruit can add sweetness to taste
Low calories or sugar free drinks
Avoid confectionery

To summarize basically to achieve optimal health outcomes you need a diet rich in complex carbohydrates, particularly whole grains, fruits, and vegetables, along with healthful oils and lean protein sources. Also you need to stop going hungry for extended periods each day, as this will not be beneficial, and you can have free access to low-calorie foods such as fresh fruits, fresh vegetables, nonfat dairy, dried fruit, whole grain breads or cereals.
Though there are many diets and eating plans to help lose weight, the only proven long-term and safe method is to burn more calories than are ingested.

You need to embrace a healthy eating lifestyle by choosing a variety of nutrient-rich foods, including fruits, vegetables and whole grains and small amounts of energy-dense foods like olive oil, nuts and dried fruits, along with exercise, and you can ask your doctor about the right type of activities for you, since even small amounts of activity provide immediate benefits.

Exercise is a must and is an adjunctive to weight loss.
You can also try out low-impact exercises, such as water aerobics and water resistance training. You need to develop a graded exercise regimen in consultation with your doctor.
Start small with a few exercises initially and keep adding new exercises as you progress.
http://www.mayoclinic.com/health/aquatic-exercise/SM00055
Another approach would be Cognitive behavioral therapy which is helpful in changing and reinforcing new dietary and physical activity behaviors.
You also need to sleep adequately with 8 hours of sleep daily to prevent to prevent visceral fat accumulation. Oversleeping and decreased sleep time can cause visceral fat to accumulate.
Lastly decreasing your stress levels will also be beneficial in preventing further visceral fat accumulation, and exercising will also be helpful in decreasing the stress levels.

Take care.

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Dr. Ravoof
Dr. Ravoof
Dr. Ravoof, Doctor
Category: Mental Health
Satisfied Customers: 5,274
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