First, let me start off by saying I am not asking for medical advice. I have already consulted a weight clinic (at Massachusetts General Hospital, the first weight clinic of its kind in the country) and had my orientation and I’m waiting to be set up with my team there (endocrinologist, MD, nutritionist) and will most definitely be asking my doctors these questions but it could be 6-8 more weeks before I have my first appt. I also see a psychiatrist biweekly, a therapist weekly, and I’m working with my trans medicine doctor to get my hormones balanced right now. So believe me, I’ve got the medical part covered, I just want to ask some questions in the interim while I’m waiting on my weight clinic appts. I most definitely have an eating disorder. I either binge all day, or I restrict so far that I’m in starvation mode and everything I eat is immediately stored as fat. Last year I was restricting to 600 calories while working 2 full time chef jobs and my hair started falling out. In the past 4 years my weight has gone between 250-190 three separate times. Each time I lose the weight, I lose it super fast, and then keep it off for a couple months or even sometimes a year before gaining it all back in 6-8 months.
1) is 3 pounds a week average too quick for the first two months of weight loss? At first I was losing almost 5 pounds a week, but I was freaked out by that so I started eating more.
Right now I’m doing 1600 calories a day, fasting from 12am-3pm (I’m a chef and my work schedule is 2pm-11pm and I sleep from 2am-10am) and I don’t eat any processed foods. Everything I eat is being made from scratch and contains no artificial ingredients. All I drink is water and coffee with some whole milk in it. I also try to keep my carbs below 30% of my total calories. I don’t eat fast food, drink soda or any sugar or artificial sweeteners, or eat out except every month or so we order takeout Chinese food.
2) how do I account for my calorie needs related to my level of physical activity at my job? I am a chef and I’m on my feet all day. My phone tracks my activity and I average 13k steps a day, 30 flights of stairs (and usually I’m carrying 25+lb loads up the stairs) and that means I’m walking about 4 miles a day. Right now I’m not exercising outside of work but I hope to add the gym back in soon.
3) I have been seeing my regular doctor and my vitamin D was horribly low so I’ve been given a supplement but that’s less diet and more New England winter. I also take fish oil and a multivitamin. Are there other vitamin tests I should be asking for my doctor to check? I’ve been having a lot of issues with my health lately and I am sort of in between competent doctors so I’m having to demand tests that a competent doctor would normally know to order on their own.
Does anyone have any other advice?
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