Morbidly Obese- where to start?

[Anonymous]

Anonymous wrote:I am in a similar position. I'm 45, 5'4 and weigh 270 (started at 275 2 weeks ago).

I know myself. If I try to make drastic changes, I get frustrated and quit after a few weeks. I'm trying to set realistic goals for myself. Right now I am focusing on not eating fast food or ice cream. Those are my weaknesses. I started 2 weeks ago and I have stuck with it. I have been cooking dinner (I'm single and live alone) and packing my lunch every day. I do not buy any unhealthy snacks when grocery shopping.

Once I stop losing weight with these goals, I'll start counting calories. I also need to start adding exercise to my daily routine.

I'm certainly not an expert, but I can relate. Start slow and stick with it.

Awesome! Good for you! Keep it up and good luck.

[Anonymous]

Semaglutide and nutrition counseling. Your insurance should cover both.

[Anonymous]

Anonymous wrote:Semaglutide and nutrition counseling. Your insurance should cover both.

Not the original poster, but someone who is also trying to lose a significant amount of weight. I get tired of people telling me what my insurance "should" cover. I have a fairly good PPO plan and it doesn't cover any kind of nutrition counseling, nor does it cover semaglutides because I'm not diabetic. Also, even if the medication was covered, the copay for it still makes it financially prohibitive for most people. Insurance companies are a joke when it comes to covering anything related to weight loss. Apparently they'd rather wait and pay for health related issues caused by obesity. It's ridiculous and incredibly frustrating.

Sorry for the off topic rant.

[Anonymous]

So pay out of pocket for compounded semaglutide. It's about $200/month. I'm sorry your insurance won't pay but many of them will, based on my friends' and coworkers' experiences around here.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Semaglutide and nutrition counseling. Your insurance should cover both.

Not the original poster, but someone who is also trying to lose a significant amount of weight. I get tired of people telling me what my insurance "should" cover. I have a fairly good PPO plan and it doesn't cover any kind of nutrition counseling, nor does it cover semaglutides because I'm not diabetic. Also, even if the medication was covered, the copay for it still makes it financially prohibitive for most people. Insurance companies are a joke when it comes to covering anything related to weight loss. Apparently they'd rather wait and pay for health related issues caused by obesity. It's ridiculous and incredibly frustrating.

Sorry for the off topic rant.

Check your plan in detail - I have Carefirst PPO and they cover Noom. I also was prescribed Mounjaro and got it covered after appeal. Pay $25 for a 3 month supply.

[Anonymous]

Anonymous wrote:I have a lot of luck with food tracking. I use Lose It, but there are lots of other apps you can use too. Just having to actually log everything I eat makes me less likely to eat mindlessly. It's shocking how many empty calories I can eat in a day when I'm sitting around my house. Another big thing for me is not drinking calories.

When you are larger (I am also not a small person, OP) you can actually still eat a fair number of calories and still lose weight. So I have my goal set at 1.5 lbs a week and it's enough to eat a healthy 3 meals a day. It makes me shift to more vegetables and less carbs because of the calorie balance. I don't do it perfectly (I don't measure or weigh everything) but as long as I am strict about it, I lose weight. Cutting 750 food calories a day is a lot easier than trying to burn 750 calories.

This, OP! I have been bigger than OP and lost a lot of weight doing this.

If you are obese, you can still eat a lot of food lol. Start by just tracking (I Use My Fitness Pal). Just the tracking helps you cut down because you become mindful of it.

It is not necessary to cut out entire food groups and never eat dessert. I find when I do that, then if I blow it, I feel I may as well live it up, which turns into a long binge. Just log the calories, cut them a reasonable amount, and eat what you want as long as you keep losing.

Get a kitchen scale. I was sort of shocked I could lose weight eating ice cream and cereal as long as I legit weighed my portion and didn't eyeball it. If you make healthy meals for your family, weigh all the ingredients a few times so you have an accurate calorie count, and log it. Add a little more vegetables and a little less pasta and meat. I like to make meals that are about 250-300 calories per serving so I can have seconds at dinner if I want or save my calories for a hearty snack later.

You don't need to start an elaborate exercise plan. Walking is fine.

OP, you might want to get labs, take measurements, and take photos so you have a good before and after shot, but you don't have to. You don't have to turn this into a big huge special project. I say this because I've done the overthinking before. Putting it off because I am afraid of going to the doctor, or because I don't want to join the gym, or because I have to finish eating all the junk in the house before I can commit... just start tracking your calories, today. Get a baseline and look up your BMR and what you need to eat to lose 1.5-2 pounds per week.

[Anonymous]

Anonymous wrote:So pay out of pocket for compounded semaglutide. It's about $200/month. I'm sorry your insurance won't pay but many of them will, based on my friends' and coworkers' experiences around here.

It's at least $250 per month, with some places going up to $400-500 per month.

OP should still have lab work done to make sure nothing alarming pops up that would prevent her from starting.

[Anonymous]

OP, is it possible for you to go overseas for a few months?
The reason I am saying is that no everyone can break down food in the US. Almost everything, including most fruits and vegetables are GMO.
When I’m overseas, I eat almost anything I want and lose a considerable amount of weight. Upon my return from a 6 week summer vacation, people tell me I look totally “ deflated”. Back in the US, I eat almost no carbs, go on a 16/8 fast, mostly raw vegetables, some fruits, small portions of protein and unsweetened yogurt (about 1300 per day) and end up putting on all the weight back within 4-5 months (30 lbs loss in 6 weeks).
I am not taking semiglutides as I am allergic to many medications.
It may be that your body cannot break down GMO food.

[Anonymous]

Anonymous wrote:OP, is it possible for you to go overseas for a few months?
The reason I am saying is that no everyone can break down food in the US. Almost everything, including most fruits and vegetables are GMO.
When I’m overseas, I eat almost anything I want and lose a considerable amount of weight. Upon my return from a 6 week summer vacation, people tell me I look totally “ deflated”. Back in the US, I eat almost no carbs, go on a 16/8 fast, mostly raw vegetables, some fruits, small portions of protein and unsweetened yogurt (about 1300 per day) and end up putting on all the weight back within 4-5 months (30 lbs loss in 6 weeks).
I am not taking semiglutides as I am allergic to many medications.
It may be that your body cannot break down GMO food.

Even if this is the case, and even if OP can go overseas for a few months and lose a bunch of weight, what is she supposed to do when she returns to not gain the weight back???

[Anonymous]

I have been working with the NCWW for the last year and have lost a lot of weight. It's a holistic program (diet, exercise, and group sessions re: e.g., emotional eating, motivation, maintenance). They are wonderful.

https://centerforweightandwellness.com/

[Anonymous]

Try Revolution Medicine in Bethesda or Revive Medicine in Fairfax (Revolution takes insurance, Revie you file on your own) - they are obestiy medicine practices and can work with you. Good luck!

[Anonymous]

I do not know what your diet is like right now, but it might help you to adopt new habits one by one. Do one for a few weeks then ADD another.
- eat a high fiber diet. I mean really high fiber. All bran buds cereal is good- you can eat as cereal with milk or add to yogurt. Start with half a serving and work your way up. You could add fruit if you like something sweet. There are also shakes and bars out there if that is more of your thing. I think someone on here posted they eat beans for breakfast.
- drink at least 64 ounces of water a day. Coffee, soda, anything else is bonus. I find it helpful to make goals throughout the day. Drink 8 ounces when I get up. Another 8 ounces before I eat breakfast. Another before I eat lunch.
- increase your lean protein.
- increase your intake of vegetables. You can still eat fun food, but eat a smaller portion and pair with a salad or raw or cooked vegetables.
- look for bad eating habits to remove or reduce. I realized that over time I had started eating way too much cheese. So I cut out all cheese for a month (a horrible month). Now I only let myself eat cheese if it is a necessary part of the food. So no cheese on sandwiches, but i will eat pizza.

It might help to measure portions for awhile. It is very eye opening how little a portion of most food is.

You can do this!

[Anonymous]

To start exercising, you need to start by working on toning your muscles. Right now, your muscles have become used to a lower level of activity and exertion. If you try to exercise, even walking, it might be hard to start because your muscles will tired quickly and not be able to sustain activity. So ramp up slowly. I go through periods of exercise and each time, I have to start with something low impact that will help me develop some tone and stamina.

One suggestion of something to do in the privacy of your own home, are low impact chair exercises. You are basically getting your muscles used to sustained movement again. When you start, do not be ashamed or discouraged if you need to stop and rest periodically during the exercise. When you are able to get through the workout without pausing and can do so regularly, then you can look for a more advanced exercises or start walking. As you build up your stamina and strength, you will be able to do longer exercises. Initially your focus should be on developing the stamina and strength to make it through exercises without pauses. Then you can work on longer or more significant workouts that will have a greater impact.

Here is one set of exercises (only 10 minutes) that can help you get started.

[Anonymous]

Start intermittent fasting. It will help you lose weight, but more importantly, it teaches you how to handle hunger. Once your body gets used to longer fasts, it's like your brain rewires how it handles hunger. Years ago, before I started intermittent fasting, I used to get uncontrollable hunger which often led to overeating and constantly thinking about food. Now I can easily skip a meal, if I need to. I will probably be hungry, but it's like I don't care as much as I used. Fasting taught me that it will be okay if I don't eat for a while.

You also need to go to the doctor to make sure nothing else is going on that is making you hold onto the weight. If you go in and let them know that you are ready to make a change they won't give you a hard time. As other have said, increasing fiber, protein, and healthy fats with also help a lot.

[Anonymous]

OP you are 45 and have been overweight / obese your entire life. You really need to work with professionals as this isn’t just about taking an exercise class or cutting out sugar or doing IF. None of that will work for you long term. You need to see this as a health / medical issue and work with health professionals just like you would with another health issue. All the best! You would be better to post to see who has found a helpful weight management team or program. Many hospitals / medical centres have them.