Tuesday, November 27, 2018

Need Help Interpreting Doctor Visit

(This could get long...) So- I’m female, 60, 5’1”, CW 172. I am at my doctor’s office for a two month follow up to get lab results for mostly thyroid. I had just changed to this integrative doctor the beginning of September, after being seen by internal medicine for ~20 years. I became so fearful of the too fat going to get diabetes going to get metabolic syndrome blood pressure too high lecture that I had developed some sort of doctor’s office PTSD or something, and couldn’t even force myself to go for an annual visit, and had run out of thyroid meds, and had not been taking it because they wouldn’t give me a refill, and everything was effed up. I was also at my highest weight of my life this summer, but down about 5 pounds from that thanks to half-hearted calorie counting and failing. (I’ve been down to a pretty decent weight, but some life stuff happened a couple years ago and I gained it all back and more.) So back to today. I’m about 15 pounds lighter than the visit two months ago, and roughly 25 pounds less than my SW. I’ve been eating 1200 calories of homemade food, higher protein, lower carbs, no grains, potatoes, legumes, alcohol. So my liver enzymes were back to normal. The doctor is of course pleased, and says, okay, you’ve done it! Now we just have to get the thyroid dialed in. I’m like, but I really want to get down to 130ish. She is horrified. My liver will not be happy because it has to filter all the toxins out of the fat I’m losing. My gallbladder will, I don’t even know, do something awful. Okay, I’ve read that gallbladder issues are common with rapid weight loss, and especially with a diet of under 1200 calories. The doctor says, no more than 10 more pounds, for this year (and she does not mean until January 1st, she means a year from when I started losing). I say, but I can remember being 135, and was 150 only two years ago! She is quite adamant that I’m at a fine weight now. Still obese, not even down to overweight. I don’t want to make her angry, but I also don’t believe 172 pounds, or even 160, is an appropriate weight for a 5’1” tall female. I work in health care, I have a kind of active job of walking, sitting, moving patients around (lifting). I have recently started running again. I’m fairly athletic by nature, and have run a bunch of marathons and even a 50k trail race, and after that, was really into long distance cycling, working up to a 600k (in one shot) ride, and then cycling to work every day for a year. So, I’m pretty healthy in terms of athleticism, although not at that level now, but I still have nice muscles and a good base- I could go out and run a half marathon tomorrow if I needed to. And diet wise, I’m completely off fast food, prepared food, added sugar, alcohol- I’m cooking everything myself, fresh whole foods, organic, lots of cultured foods- so I feel like my diet and exercise are squared away. Is it true, then, that if I continue to lose weight at a slowed-down to make Doctor happy rate of a pound a week, my liver/gallbladder will not be able to handle that? I mean, they can’t handle being obese, either! I feel pretty let down. I expected a reaction more like, great job, keep up the good work. Do I actually need to worry, if I’m careful to not go under 1200? I’m feeling baffled...

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