Super morbidly obese. Where do I start?

[Anonymous]

I've been as high as 275 and weigh 225 today. I never had real health issues until mid 40s and now early 50s and believe me, they are coming on fast (type 2 diabetes, high blood pressure, joint issues, etc). I was always fine in my career, marriage, kids, friends so thought none of the usual worries about obesity applied to me. But you have to start paying attention when your health starts crumbling. So -- good for you for looking at this now! You are ahead of the game!

I find the #1 thing that helps is food tracking. Even if you eat a whole pint of ice cream, just write it down. If you can keep your calories lower (and at 3,000 calories a day you would lose weight right now), you'll lose. All of the other stuff is icing on the cake. Trust me, it's true.

[Anonymous]

Congratulations OP on recognizing that you need to deal with your weight issues now, while you’re still young. Recognizing that you have a problem is the first step.

The next step is to schedule a physical with your doctor. Talk openly about your desire to lose weight. If you’re cleared for exercise, walking is great - and free! My MIL lost over 100 lbs (and has kept it off) by just walking around her neighborhood every day. As the weight started to drop, and she felt more comfortable, she added more distance. She now walks about 5 miles/day no matter the weather.

Good luck!

[Anonymous]

I'm glad that all the replies have been supportive.

We believe in you, op!! Keep us updated!!!

[Anonymous]

OP, this post and your courage is giving me inspiration to get back on track with my own weight and health challenges. Thank you!

[Anonymous]

Anonymous wrote:You need to start with a doctor and a full blood workup. It's possible, even likely, based on what you describe that you may have Type 2 diabetes or are at least pre-diabetes. You almost certainly have metabolic syndrome and a fatty liver.

Once you have the blood work you can create targets. You'll want to get your sugar and A1C down if you have diabetes. You can do this through a combination of eating better, moving more and maybe medications like insulin or a GLP-1 like Ozempic.

I have lost 45 pounds since February since getting the diabetes diagnosis doing the above. What works for me:

-- Writing down everything I eat in an app. Every meal. No heating.
-- Aiming for under 125 carbs a day total. This isn't keto -- it's more reasonable than that. But forces you to be more mindful of what you're eating.
-- Along those lines, eating at least 30 grams of fiber.
-- More vegetables. Some fruits, although you have to be a little careful with fruit because it can spike your blood sugar. Like, don't eat a banana.
-- Keeping calories to between 1,500 and 1,800 a day.
-- No alcohol or sugar at all. At ALL.
-- Walking 4-6 miles per day. I usually do at least one 45-minute brisk walk.

You didn't get this way overnight. It will take months, if not years, to correct. Be good to yourself. But having reachable goals will help. Mine was to get my A1C down from 9. I did that -- it was 6 at my last appointment. My fasting glucose now most days is about 95-100. It's how I know I am maintaining.

I just started on Ozempic. The doc is taking me off the insulin. She says once that happens, the weight loss will accelerate.

BTW I started out at 285. My goal is 185.

PP where are you? If you're in the DC metro area, would you mind naming your doctor and/or at least the practice group? I'm not OP, but am morbidly obese and have been working with my PCP since October (6 months!) I've wanted to try Ozempic (Wegovy not covered by my insurance) but she has been dragging her feet while I met with a nutritionist, met with a weight loss focused doctor, etc. etc. I've done everything asked of me and have not lost any weight (and in fact gained 15 lbs!) so am very frustrated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You need to start with a doctor and a full blood workup. It's possible, even likely, based on what you describe that you may have Type 2 diabetes or are at least pre-diabetes. You almost certainly have metabolic syndrome and a fatty liver.

Once you have the blood work you can create targets. You'll want to get your sugar and A1C down if you have diabetes. You can do this through a combination of eating better, moving more and maybe medications like insulin or a GLP-1 like Ozempic.

I have lost 45 pounds since February since getting the diabetes diagnosis doing the above. What works for me:

-- Writing down everything I eat in an app. Every meal. No heating.
-- Aiming for under 125 carbs a day total. This isn't keto -- it's more reasonable than that. But forces you to be more mindful of what you're eating.
-- Along those lines, eating at least 30 grams of fiber.
-- More vegetables. Some fruits, although you have to be a little careful with fruit because it can spike your blood sugar. Like, don't eat a banana.
-- Keeping calories to between 1,500 and 1,800 a day.
-- No alcohol or sugar at all. At ALL.
-- Walking 4-6 miles per day. I usually do at least one 45-minute brisk walk.

You didn't get this way overnight. It will take months, if not years, to correct. Be good to yourself. But having reachable goals will help. Mine was to get my A1C down from 9. I did that -- it was 6 at my last appointment. My fasting glucose now most days is about 95-100. It's how I know I am maintaining.

I just started on Ozempic. The doc is taking me off the insulin. She says once that happens, the weight loss will accelerate.

BTW I started out at 285. My goal is 185.

PP where are you? If you're in the DC metro area, would you mind naming your doctor and/or at least the practice group? I'm not OP, but am morbidly obese and have been working with my PCP since October (6 months!) I've wanted to try Ozempic (Wegovy not covered by my insurance) but she has been dragging her feet while I met with a nutritionist, met with a weight loss focused doctor, etc. etc. I've done everything asked of me and have not lost any weight (and in fact gained 15 lbs!) so am very frustrated.

Dr. Catherine Ellis in Lansdowne. She is an endocrinologist.

[Anonymous]

Anonymous wrote:35 F
350 lbs
I've been big my whole life. In my teenage and early 20s, I'd start a diet, then quit within days or same day. I eat at any time of the day, mostly sweets, lots of carbs, take-out about 3x a week, rarely ever any fruits, vegetables or water. I often overeat, even when feeling full, and regret it later. Haven't seen a PCP in about five years but pretty sure I'm Diabetic, I know I have high blood pressure, and probably other issues. Currently not taking any medication or supplements except a multivitamin.

I work outside the home but usually evenings and physical activity isn't needed much so I'll read or watch shows in my down time. Never exercise. I'm completely independent and don't need assistance with anything.

I'm well aware that I have to do something to turn my health around/stop this path or I'll die soon. I don't know how to start. Any tips for someone like me who needs to lose 200+ lbs? It just feels so overwhelming (completely my fault, I know.) I'm going to make an appointment with PCP to see if I can get a check-up and necessary testing but as far as lifestyle changes for losing weight, I'd love tips. TIA.

OP, at this point, I would work with a registered dietitian nutritionist who specializes in this area. Go to the web site of the Academy of Nutrition and Dietetics (www.eatright.org), put in your zip code and you will find references by specialty.

Good luck with this. It's difficult to get started, I know, but please take this seriously. Walking some every day is a good first step.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to start with a doctor and a full blood workup. It's possible, even likely, based on what you describe that you may have Type 2 diabetes or are at least pre-diabetes. You almost certainly have metabolic syndrome and a fatty liver.

Once you have the blood work you can create targets. You'll want to get your sugar and A1C down if you have diabetes. You can do this through a combination of eating better, moving more and maybe medications like insulin or a GLP-1 like Ozempic.

I have lost 45 pounds since February since getting the diabetes diagnosis doing the above. What works for me:

-- Writing down everything I eat in an app. Every meal. No heating.
-- Aiming for under 125 carbs a day total. This isn't keto -- it's more reasonable than that. But forces you to be more mindful of what you're eating.
-- Along those lines, eating at least 30 grams of fiber.
-- More vegetables. Some fruits, although you have to be a little careful with fruit because it can spike your blood sugar. Like, don't eat a banana.
-- Keeping calories to between 1,500 and 1,800 a day.
-- No alcohol or sugar at all. At ALL.
-- Walking 4-6 miles per day. I usually do at least one 45-minute brisk walk.

You didn't get this way overnight. It will take months, if not years, to correct. Be good to yourself. But having reachable goals will help. Mine was to get my A1C down from 9. I did that -- it was 6 at my last appointment. My fasting glucose now most days is about 95-100. It's how I know I am maintaining.

I just started on Ozempic. The doc is taking me off the insulin. She says once that happens, the weight loss will accelerate.

BTW I started out at 285. My goal is 185.

PP where are you? If you're in the DC metro area, would you mind naming your doctor and/or at least the practice group? I'm not OP, but am morbidly obese and have been working with my PCP since October (6 months!) I've wanted to try Ozempic (Wegovy not covered by my insurance) but she has been dragging her feet while I met with a nutritionist, met with a weight loss focused doctor, etc. etc. I've done everything asked of me and have not lost any weight (and in fact gained 15 lbs!) so am very frustrated.

Dr. Catherine Ellis in Lansdowne. She is an endocrinologist.

Thank you! I had reached out again to my PCP just this week, and she wanted to schedule yet another in-person appointment with yet another copay for us to discuss options. This has been going on for 6 months so clearly I need a different plan of action.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need to start with a doctor and a full blood workup. It's possible, even likely, based on what you describe that you may have Type 2 diabetes or are at least pre-diabetes. You almost certainly have metabolic syndrome and a fatty liver.

Once you have the blood work you can create targets. You'll want to get your sugar and A1C down if you have diabetes. You can do this through a combination of eating better, moving more and maybe medications like insulin or a GLP-1 like Ozempic.

I have lost 45 pounds since February since getting the diabetes diagnosis doing the above. What works for me:

-- Writing down everything I eat in an app. Every meal. No heating.
-- Aiming for under 125 carbs a day total. This isn't keto -- it's more reasonable than that. But forces you to be more mindful of what you're eating.
-- Along those lines, eating at least 30 grams of fiber.
-- More vegetables. Some fruits, although you have to be a little careful with fruit because it can spike your blood sugar. Like, don't eat a banana.
-- Keeping calories to between 1,500 and 1,800 a day.
-- No alcohol or sugar at all. At ALL.
-- Walking 4-6 miles per day. I usually do at least one 45-minute brisk walk.

You didn't get this way overnight. It will take months, if not years, to correct. Be good to yourself. But having reachable goals will help. Mine was to get my A1C down from 9. I did that -- it was 6 at my last appointment. My fasting glucose now most days is about 95-100. It's how I know I am maintaining.

I just started on Ozempic. The doc is taking me off the insulin. She says once that happens, the weight loss will accelerate.

BTW I started out at 285. My goal is 185.

PP where are you? If you're in the DC metro area, would you mind naming your doctor and/or at least the practice group? I'm not OP, but am morbidly obese and have been working with my PCP since October (6 months!) I've wanted to try Ozempic (Wegovy not covered by my insurance) but she has been dragging her feet while I met with a nutritionist, met with a weight loss focused doctor, etc. etc. I've done everything asked of me and have not lost any weight (and in fact gained 15 lbs!) so am very frustrated.

Dr. Catherine Ellis in Lansdowne. She is an endocrinologist.

Thank you! I had reached out again to my PCP just this week, and she wanted to schedule yet another in-person appointment with yet another copay for us to discuss options. This has been going on for 6 months so clearly I need a different plan of action.

Has your PCP ordered blood work?

They probably shouldn’t be managing this. See an endocrinologist.

[Anonymous]

Anonymous wrote:The first step is asking for help like you are today. That's not easy. Make a commitment to yourself that you will take a step toward healthy living every day. It does not have to be a huge step every day. This could be, walking around the block, drinking more water, booking an appointment with your doctor. This is a very emotional process. Allow yourself to have good days and bad days. Keep a journal, that includes a gratitude process. Your emotional well being during this process is just as important as your physical. Its really not possible to stick to this unless you are taking care your your mental wellbeing at the same time. It's more than calories and exercise. Hang in there!

This is great advice.

[Anonymous]

Anonymous wrote:35 F
350 lbs
I've been big my whole life. In my teenage and early 20s, I'd start a diet, then quit within days or same day. I eat at any time of the day, mostly sweets, lots of carbs, take-out about 3x a week, rarely ever any fruits, vegetables or water. I often overeat, even when feeling full, and regret it later. Haven't seen a PCP in about five years but pretty sure I'm Diabetic, I know I have high blood pressure, and probably other issues. Currently not taking any medication or supplements except a multivitamin.

I work outside the home but usually evenings and physical activity isn't needed much so I'll read or watch shows in my down time. Never exercise. I'm completely independent and don't need assistance with anything.

I'm well aware that I have to do something to turn my health around/stop this path or I'll die soon. I don't know how to start. Any tips for someone like me who needs to lose 200+ lbs? It just feels so overwhelming (completely my fault, I know.) I'm going to make an appointment with PCP to see if I can get a check-up and necessary testing but as far as lifestyle changes for losing weight, I'd love tips. TIA.

Telling yourself you could die or other people telling you this is not likely to produce long term weight lose. After all, you didn't just think of that at 35, you have thought it before and viola you still weigh 350 lbs.

You should search out a PCP who can acknowledge your weight issues AND any other medical issues that you are experiencing. Try to find one that you can build a relationship with that won't only focus on weight loss but also treating any other issues you may have.

Go to an info session about bariatric surgery. Since you said you have been overweight for a very long time, this is your best bet to lose weight and keep it off. You don't need to make a decision regarding surgery right away but start talking to surgeons and maybe visit a support group for those who had surgery. It's not quite as easy as you might think but it most definitely is helpful. Realize saying things like "well people regain weight so I shouldn't do this" or "its the easy way out!" means that you aren't ready to actually lose weight and what you really want is to hang on to being able to eat all you want, whenever you want.

Have an evaluation for ADHD. Impulse control is often a problem for those with ADHD. You might not be able to take medication for that right now given your high blood pressure and weight but it's also helpful to understand that overcoming the impulse control is very difficult and is not something you can "therapy" yourself out of

Which then brings me to therapy, in regards to eating, think about when you overeat or when you want to overeat. Does it happen when you are bored, angry, lonely, happy, or joyous? If so, every single emotion is tied to the habit of eating so knowing which emotion you have won't stop the eating habit. Therapy can really be helpful but don't expect it to result in a lot of weight loss.

Focus first on diet and don't worry about to a gym. Walking is always a good thing to do. Start slow and build up. It might mean you can only do a 15 minute walk and that's ok. There are very easy beginner "workout" programs that are designed to be used by people who haven't exercised in years. They are a combo of seated and standing but no jumping or running. The idea is to help someone who has not been exercising build up without overtiring and stressing the muscles. The point of the programs are to help someone build up to where they could actually do a regular beginner workout.

[Anonymous]

Anonymous wrote:I would start with walking. Walk every day for 20 minutes. After two weeks make a different goal.

And join weight watchers. Count and track your points for a week without changing anything. Then look at where you can make a small change. Maybe you decide not to drink your calories except coffee creamer. Or maybe you realize that switching from a bagel to yogurt can help you reduce points.

Take it one step at a time. Ask a friend to help you keep accountable.

Don't freak out if you backslide. Two steps forward, 1 step back.

I want to second the weight watchers recommendation. I have had two friends that were obese and lost significant amounts of weight and kept it off for over a decade using weight watchers.

[Anonymous]

I don’t think WW will work for SMO. Their physiological profile is much more complex.

[Anonymous]

Find a doctor that specializes in obesity to talk about your options. Good meds are available now (semaglutide) but I think weight loss surgery would be the best option for you, likely duodenal switch or roux en y instead of gastric sleeve.

[Anonymous]

Anonymous wrote:You need to start with a doctor and a full blood workup. It's possible, even likely, based on what you describe that you may have Type 2 diabetes or are at least pre-diabetes. You almost certainly have metabolic syndrome and a fatty liver.

Once you have the blood work you can create targets. You'll want to get your sugar and A1C down if you have diabetes. You can do this through a combination of eating better, moving more and maybe medications like insulin or a GLP-1 like Ozempic.

I have lost 45 pounds since February since getting the diabetes diagnosis doing the above. What works for me:

-- Writing down everything I eat in an app. Every meal. No heating.
-- Aiming for under 125 carbs a day total. This isn't keto -- it's more reasonable than that. But forces you to be more mindful of what you're eating.
-- Along those lines, eating at least 30 grams of fiber.
-- More vegetables. Some fruits, although you have to be a little careful with fruit because it can spike your blood sugar. Like, don't eat a banana.
-- Keeping calories to between 1,500 and 1,800 a day.
-- No alcohol or sugar at all. At ALL.
-- Walking 4-6 miles per day. I usually do at least one 45-minute brisk walk.

You didn't get this way overnight. It will take months, if not years, to correct. Be good to yourself. But having reachable goals will help. Mine was to get my A1C down from 9. I did that -- it was 6 at my last appointment. My fasting glucose now most days is about 95-100. It's how I know I am maintaining.

I just started on Ozempic. The doc is taking me off the insulin. She says once that happens, the weight loss will accelerate.

BTW I started out at 285. My goal is 185.

This seems like extremely fast weight loss.