I (27F, 5’7”, 169lbs) have lost 21 lbs since the beginning of March. There have been some ups and downs, but overall it’s clear that my diet is working. I want to lose at least 10 more pounds.
I’m sharing my story so far as well as some tips. This is a very long post, but I hope it's helpful for someone.
I reached my highest weight of 190lbs at the end of February. I was terrified of gaining any more weight and of ever being 200lbs. I don’t say this to disparage anyone who is that size or heavier—I only mean to explain how I personally felt. I felt extremely ashamed of that number and my appearance, and I started to feel concerned for my health since I was right on the edge between being ‘overweight’ and being ‘obese.’ The BMI scale is scientifically flawed, of course, but I’ve internalized the rhetoric of the so-called obesity epidemic and it made me feel awful about myself.
At the beginning of March, I decided to start taking phentermine. I don’t feel like it’s my place to recommend it to anyone else since I am not a medical professional. However, I do want to be transparent about using it and explain my decision. I read as much as I could about the drug and possible side effects beforehand. What I found was that phentermine is quite dangerous when combined with fenfluromine (the combination is known as fen-phen), but the risk of serious side effects are minimal when phentermine is taken on its own for a short period of time. You should consult with a doctor if you’re considering it. Common side effects are dry mouth, constipation, anxiety, and increased heart rate. I noticed some elevated heart rate when I took a full (37.5 mg) dose, but not when taking a half dose (18.75 mg) once or even twice a day. I did experience an increase in anxiety, but I also transitioned off of my anxiety medication around the same time. I admit that I should have probably given myself some time off the anxiety medication before starting phentermine.
From the beginning of March to mid-April, I lost about 12lbs. I took 1-2 doses of phentermine daily. Phentermine doesn’t directly cause weight loss; it acts as a strong appetite suppressant that can help people reduce calorie consumption. During this period, I ate between 900 and 1300 calories most days. I did not have any days in which I ate more than my TDEE/maintenance calories (~1900 at the time).
I decided I wanted to try losing more weight without phentermine, so I did not refill my prescription. Between mid-April and mid-September, I gained about 2lbs. I decided to get back on phentermine in mid-September. In the 2 months since, I have lost 11 pounds. My total weight loss as of today is 21lbs in a little over 8 months.
I have been carefully tracking my calories and ensuring that I am in a calorie deficit. I track my calories and weight on MyFitnessPal.
Tips for calorie counting & staying on track:
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Count everything, even on ‘bad’ days. If you overeat and aren’t sure of the calories you should record your best estimate. If you miss recording one day, start again the next.
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When in doubt, round up. If I’m not sure if something is 450 or 500 calories, I assume it’s 500. I also round up to the nearest 5 instead of counting every single calorie.
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Focus on eating in a calorie range rather than a strict number every day. On a ‘perfect’ day when I eat my exact target calories I may be on track to lose 1.5lbs a week, but even eating at the high end of my calorie range means I’ll lose .5lb per week. I even allow for some days where I eat at maintenance (for me that’s about 1850). I try to stay in the range of 1250-1550 most days. Having a calorie range also helps with the problem of perfectionism or the “all-or-nothing” mindset—if I’m under 1850, I’m losing weight. If I eat 1850 one day, 1550 one day, and 1250 five days in a week, I have a total deficit of 3300 calories (just under 1lb) for that week. If I exercised at all or was more active than normal that week, then I’ll have lost at least a pound even though I wasn’t eating perfectly.
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Don’t eat back your calories burned. Calorie trackers are usually wrong. Consider eating at the high end of your calorie range on days when you work out, but don’t eat an extra 500 calories because your fitbit said you burned 500 calories at the gym. Exercise is a bonus—it’s good for your overall health and it can help you reach your weight loss goals, but what you eat is more important.
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I skip breakfast most days (phentermine makes this easier for me). I don’t do “intermittent fasting” in any sort of formal way, but avoiding 300-500 calories in the morning starts my day off right. I usually have a latte with almond milk and sugar free syrup (~80 calories from Starbucks, ~25 when I make a smaller one at home) in the mornings. I often have a mid-morning snack around 10 or 10:30.
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Eat protein. Eating more protein makes a big difference for me in terms of controlling my hunger. It’s also good for maintaining muscle.
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Make simple swaps to reduce your calories. I think of it as harm reduction—you can at least make an unhealthy meal or snack healthier. For example, if I go to Panda Express for lunch, I get string bean chicken with half chow mein and half supergreens. The entrée is the lowest-calorie option on the menu, having half supergrens reduces the total calories by about 200, and I still get some chow mein. Similarly, my tall Starbucks latte with almond milk and sugar free vanilla is 80 calories, compared to 200 calories for a tall latte with 2% milk and regular vanilla syrup.
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Find low-calorie options at convenient restaurants. The chicken power menu bowl at Taco Bell is only 450 calories, and it’s delicious.
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Keep healthy, portioned snacks around. I usually have an apple and ¼ cup of nuts around in case I get hungry and need something right away. If I didn’t have these options, I might end up buying Cheetos from the vending machine. Make sure to pick healthier snacks that you actually like and that will keep you full.
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Avoid drinking alcohol except for special occasions. That way you’ll be satisfied with less alcohol on the occasions that you do drink (if you drink at all).
Other tips:
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Weigh yourself first thing in the morning with little to no clothing, after using the restroom and before eating or drinking anything.
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Don’t weigh yourself every day. Every other day is OK, once a week is better.
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You can skip a weigh-in if you had a bad day. One bad day won’t derail your weight loss, but it might look like you gained a few pounds if you’re bloated the next day. I usually try to have 1-2 good days before weighing myself after a bad day.
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Focus on your measurements, how your clothes fit, and how you look over the number on the scale. These factors are more important and less variable than your weight.
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I follow two weight loss dieticians on Instagram, The Sorority Nutritionist and The Millennial Nutritionist. TSN has some annoying “girl boss” rhetoric and uses slang that irritates me, but she offers good tips and quality content to keep me motivated. TMN is similar, but I find her much less annoying. Both of these dieticians also have paid weight loss coaching programs, but I just follow their Instagram accounts for tips and motivation. They also have free blogs and podcasts.
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You don’t have to talk about your diet or weight loss with anyone. When people ask if I’ve lost weight, I either say that I don’t know or something noncommittal, like “yeah I think so” to show that I’m not especially interested in the conversation. If they persist, I say I don’t want to talk about it or something like “I’m sure no one cares about my boring diet! How are things going for you at work?” I don’t personally like to talk about my weight or diet because of some longstanding issues with my body image. I find these conversations hurtful even if people are “complimenting” me. That’s my own issue to work through, but I don’t have to engage with the conversation when I know it will make me feel bad regardless of the other person’s intentions. This is especially important for me with family. Many of my issues with my body image come from family members’ comments or behaviors in the past, so I choose not to have any conversations with them about weight or appearance at all.
One more thing... Even when I was much thinner (~130lbs when I was 18-19), I was extremely unhappy with my body. I was probably more insecure at my lowest weight than I was at my highest weight because of my mental health. I have recently realized that part of my issue with my body is my apple shape, rather than my size or weight per se. I think I focused too much on losing more and more belly fat when part of what I dislike about my body is that my butt and hips are small in proportion to my waist. Now when I exercise, I focus on strength training for building up my butt/hips rather than on making my waist smaller. I want to have more of an hourglass shape instead of just the smallest possible version of an apple shape. I still need to lose belly fat, but now I have a more realistic sense of how to achieve the shape I want so that I won’t continue to feel unsatisfied no matter how much weight I lose.
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