"I can not undersatnd why I am so heavy... I do not eat anything.. so why am I not losing weight?? "

this is the most frequent statement I hear from our pts with BMI over 30..

Of course when challenged to keep a food diary ..we find the calories..often in thier drinks or the ocassional snack of crackers ..or three bowls of ice cream or whatever....

what lines do you hear?

I had to buy a scale that goes up to 400 # as we had several pts I could not weigh on my scale that topped at 350..

I think it is sad

Is this a a sign of our times?

Darla

I recently had this poor gal who was 350+ (weight more than scale would weigh). She told me she only ate one bowl of cereal a day and one sandwich. She said she was too heavy to do any exercise. I asked her how much water she drank a day. She said she was well hydrated because she drank 7 (seven!) gallons of regular Koolaid a day! She was really upset when I told her how many calories were in Koolaid, said she would not give up her Koolaid. I honestly could not make her understand!

So unfortunate.

Kirsten

I recently had this poor gal who was 350+ (weight more than scale would weigh). She told me she only ate one bowl of cereal a day and one sandwich. She said she was too heavy to do any exercise. I asked her how much water she drank a day. She said she was well hydrated because she drank 7 (seven!) gallons of regular Koolaid a day! She was really upset when I told her how many calories were in Koolaid, said she would not give up her Koolaid. I honestly could not make her understand!

So unfortunate.

Kirsten

If you see her again, see if she might consider switching to sugar free Kool-aid. True, it's more expensive (like 2 bucks for 4 packets) but once you get used to the Nutra-sweet, it tastes exactly the same as regular Kool-aid! I used to live on the stuff. My co-workers used to laugh about it - apparently Kool-aid isn't cool for adults - but their mouths would water when they saw me with a big jug of the red stuff!

Yes, I know water is the best, but you have to compromise sometimes!

Another suggestion is sweetening regular Kool-aid with Splenda or Stevia instead of sugar, as I think they don't have as much of an after-taste as Nutra-sweet.

:)

Maybe she could wean herself off by mixing regular and sugar free together, gradually decreasing the regular and increasing the sugar free.

What other options did you give her?

I spoke to her about sugar free Koolaid, "Don't like diet anything, I tried it and it was horrible." I also talked to her about stevia, Splenda and maybe trying to water the Koolaid down to wean her self from it...I don't think she is at a point where she really wants to do anything to loose the weight yet. I have found it takes a couple of weeks to psych myself up to lose a few pounds so to her it may seem overwhelming. (BTW, Koolaid ROCKS! and I could see myself putting a 1/2 gallon away in a day, easy.) She is set in her ways and very low income so a lot of what we discussed she thought would be out of her price range. I told her by just losing a small percentage of her body weight she would feel so much better and have better control of her BP and not battle with hemorhoids so often. Hard to get any fiber from Koolaid, white bread and lucky charms.

BTW, Koolaid ROCKS! and I could see myself putting a 1/2 gallon away in a day, easy.

Yep, used to make it in a 2-liter bottle and drink one per day. The good thing is that your lips will always be stained red so you don't need lipstick! The bad thing is that if you don't brush your teeth or chew sugarless gum, you teeth will be red too! :chuckle

I hope she finds a good plan when she feels ready to start losing weight. I should know how hard it is...I'm still trying to get myself going!

what lines do you hear?

A lot of times I don't think they are 'lines'..even in this day of health awareness on tv, the web, ect.. so many people are still very unaware of how their diets effect them..that's why they have us to help 'um out with education..real solutions :)

"I can not undersatnd why I am so heavy... I do not eat anything.. so why am I not losing weight?? "

That's half the problem, you know. They don't eat anything. I've had some women say to me that they skip breakfast, eat only a little bit for lunch and eat a "sensible" supper. But when you figure in what they eat during the day (including the sensible supper) it essentially adds up to a diet that is a little above starvation, devoid of most of the food groups. The body thinks it's in a starvation situation and the metabolism drops waaay down. These women also typically allow themselves a "cheat" day where they eat what they want which causes the body to save the calories as fat. Then they lament that they're not losing weight.

What's hard is convincing them that skipping meals is not the answer. They have to eat to lose weight. They have to exercise. The food is not the enemy, there's nothing wrong with enjoying food. It's eating too much and not moving it off. That's the hardest thing to get across.

Yes, you're right, it is sad.

hi everyone... i do agree that there are alot of overweight people who have very little knowledge about nutrition or do have the knowledge but do not make changes for their health.

but i would like to say that as an overweight person i received many many many rude comments from docs and nurses who did not believe me when i said i gained more pounds than i care to mention..at that time i didnt know what i know now..and all the regular blood tests came back fine and then i was told..you need prozac and a diet.

years later i was finally diagnosed with hypothyroidism and polycystic ovarian syndrome.

my point to this is..when i was a patient i just wanted someone to believe in me and help me find the answers..not blame me... i hope when i finally become a nurse..i can do the same xoxo jenn

Hi Jenn

We are very patient in our office with alll the obese pts..Each day out of the 28pts seen in this IM office I would say at least 1/3 have BMI over 28

We stand still and listen , (my sister is overweight .I have an empathetic ear) However, the 320 pound person who states they cannot understand thier

wt problem can be a little challenging

. the doc I work for always does an obesity eval..occasionally we find the person with hypothyroidism /PCOS etc. and the physical problems are adressed

What do you think about the psych component to obesity?

You are right..so much is about education..but ther are to many people looking for a pill to fix it

I am glad you are doing better

Thanks for posting

Darla

I figure I can speak to this since I have been there.

I used to be 280 and now I am an apprx. 146.

If you look at many of these people the women normally are in very abusive (physical and/or emotional) relationships. They are told they are ugly and stupid and eventually begin to believe it. I used to be a teen model and started gaining weight when I started dating my ex.

People get so many conflicting messages as to how to lose weight. I became a vegan and just ate carbs. And I DO eat more now than what I did when I was heavy. But what I eat is very differant. I grew up in a family that ate very heavy sausages and sauces. We had no suger (not even sweetened cereal) but I did not learn good eating habits either.

The first thing I did was get rid of my husband who was very abusive. I tolerated it for 10 years and finally I reached a point where I just could not take it any longer. I lost 5 lbs the first week he was gone!

I got all toxic people out of my life. I cut off friendships and I cut off my father's family. I havent spoken to them in over 8 years.

People do not understand in regards to exercise. Exercise hurts when you are that heavy. I was too heavy even for a treadmill. I got a bar to help me do situps. I could only do 4 a day. Now I do 400 a day. I started lifting weights. Then I added yoga. Then I got a little jumpy trampoline and started adding that.

But I do want to point out that just because someone is thin doesnt mean they are healthy. If they are cramming down twinkies but are thin they are not healthy.

People also think that they support people losing weight..but they arent really. It isnt just saying, "you look good". It is more than that. If you buy them food as a gift that is not being supportive. If you ask them over for dinner and serve hamburgers and hotdogs that is not supportive. If you work with someone who is trying to lose weight and bring a cake to work...that is not supportive.

I actually thought about gaining the weight back on purpose and have met others who have. The reason is that I was always in the background and then I wasnt. People treat you so differant. Especially men.

I did lose to much weight (I got down to 130 and am 5'10"). It wasnt because I was anorexic or bulemic but I still thought I was 280 and continued to wear size 28. It took a long time for my mind to catch up.

Oh, and remember the BMI has a disclaimer at the bottom. It doesnt work for people who lift weights or who exercise on a daily basis.

It doesnt consider that muscle weights more than fat. Many people who lift weights are considered obese with the BMI.

Re: the person that drinks 7 gallons of Kool-aid-has she been tested for diabetes? Polydipsia is one symptom of diabetes. Also, ask if your overweight clients have tried water aerobics (or just walking in the pool).

Stephanie RN CDE