Obesity due to medical problems. Rare? Common?

Well first of all, it is that simple… if you eat less and exercise more, you will lose weight. But while the “formula” is certainly simple, it takes a lot of discipline to do it. Most fat people don’t have the discipline to lose weight, hence they remain fat.

That and doesn’t your metabolism slow down when you go into “starvation mode?” Sometimes, I understand, the damage is permanent.

Cite?

I don’t have one-that’s why I was ASKING.

If you were asking, how is it that you “understand” the damage is permanent?

I was about 35 pounds overweight and absolutely could not lose it. I tried mightily for at least 2 years.

I developed a bad case of acid reflux and lost 40 pounds in less than three weeks. It can be done, and it can be done very quickly. You just need the right kind of motivation.

Sorry, I should have said, “I heard”.

I don’t dispute the fact that a lot of overweight people lie to themselves about how many calories they eat or how much energy they expend. However, I weigh or measure everything I eat and use a computer program to track everything that passes my lips, even a stick of gum. I know I am not lying to myself or to anyone else. There are those few of us who are overweight yet have more discipline in our little fingers than most thin people have in their whole bodies.

Interestingly enough, my “normal” body temperature is about 96 degrees. I always wonder if that is linked.

Yes, various low-carb diets are used by women with PCOS. Personally, I have been able to lose a small amount of weight by eating only meat and a small amount (1-2 cups a day) of lettuce with vinegar. This diet has also reduced my other symptoms of PCOS.

There is also a medication, which someone else mentioned, called Metformin, which can help reduce insulin resistance in women with PCOS. I don’t have health insurance and am a student, so I have not been able to try it yet, but I have heard stories of women who begin taking it losing 30-40 pounds without altering a thing about their lifestyles.

This does not seem right to me.

But if our bodies can work more efficiently why would they not always work more efficiently?

Also, why would our bodies prefer to consume lean tissue for energy when calorie intake is too low, rather than consume the otherwise useless fat deposits? I thought the reason for fat deposits was to use as energy during times when food is short.

I kind of wonder the same thing. I’ve counted calories (accurately) for decades and I’m pretty familiar with the range of normal metabolic requirements for adults. For 30-40 something adults of sedentary to moderate activity levels it ranges from approx 10-14 calories per lb of body weight per day. It might be more or less at the far end of the standard deviation curve if the body has some metabolic disease or related dysfunction, or if exercise levels are very high, but there are thermodynamic limits to how far that metabolic envelope can be stretched.

Regarding PCOS I don’t see how someone is going to gain weight on an incredibly restricted calorie intake. I suppose anything is possible, but let’'s say with PCOS your body can’t process carbs correctly, and turns them (largely) to fat. So you crunch your calories down to 600 or 800 calories per day. If that’s actually the amount of calories you are eating if can’t see how that’s enough energy to live re just keeping your body temperature to normal levels. You’re violating the laws of thermodynamics at that point.

Now if you’re starting with a substantial fat reserve you could eat 600-800 calories per day for months (or possibly a year or more) without too many problems as long as you got adequate vitamins and minerals, but the PCOS sufferers claim seems to be that I will gain weight at 1000 calories per day and I just don’t see (biochemically & metabolically) how that leaves you with enough energy to live.

Lean tissue itself consumes more energy than fat does. By burning lean and defending fat, energy reserves can last a lot longer.

Sorry for the misunderstand. Speaking for myself and what I meant, I do not gain weight at 1200 calories a day. I gained weight when I ate normally, which was between 1800 and 2500 calories a day. At 1200 calories a day, I stay steady.

Are you obese? If so, you will lose weight if you consume less calories and exercise.

You can dream up excuses all day long. But it is a fact is that you will lose weight if you consume less calories and exercise.

sigh I think the point is that there are some conditions where one’s body does NOT burn calories the way it should, and thus, you have to go on a super low calorie diet, and exercise to extremes before you see results. It’s NOT that people are lazy-some of them may be, of course-but that it’s more difficult for them to lose the weight than others. And they might need medical assistance to try and get the body working properly.

Also “less calories and more exercise” is relative. What amount of calories and exercise works for me will not be the same as that works for you. Got it?

Just like some people have trouble gaining weight (my mother, for example), some people have more trouble losing it.

This is not in dispute, but you must realize by now that some people have medical conditions that means the borderline between:
eating too much and gaining weight;
eating enough to be able to keep active but also low enough in callories to be able to lose weight;
and eating too little, so that being active becomes extremely difficult due to lack of energy due to lack of calorific intake.

For most people it is relatively easy to live in that healthy middle ground, for some that middle ground may be very narrow and difficult to achieve, maybe for some the middle ground has no width at all and they are trapped between either gaining weight or starving.

So though it is true that everyone will lose weight if they consume less calories and exercise. Doing so may be more dangerous for them than the obesity, or at least have more obvious negative effects (such as lack of energy, increased depression symptoms, feelings of nausia, constant hunger, etc. etc.)

I fully expect someone to come back and say that those can all be ignored if they tried hard enough to lose weight. to which I would have to say that you are deluding yourself to think you can resist anything by will power alone.

Thank you for eloquently explaining the point I was trying to make.

I get so frustrated with the attitude of “well, you’re just not doing enough to lose weight,” as that attitude was the reason my symptoms went undiagnosed for fifteen years, until things got so bad that I started hermorraging and ended up in the ER. I get so angry and upset when people take that attitude that it’s hard for me to make a thorough, logical response.

I’ve been trying to think through the logic of this w/r/t the laws of thermodynamics.

Does the mechanism of various health conditions and medications linked to weight gain go something like this?

Person consumes a balanced 2000 calorie diet, which body can convert to fat or burn to give you energy to get through the day.

In a healthy person not taking medication, these calories are almost 100% burned to create energy.

In a person with certain health problems or taking certain medications, those 2000 calories are now processed differently: some are converted to to fat and stored, leaving fewer to be used as energy throughout the day.

I could see how that would be a vicious cycle. Because the person would have less energy, exercise would be harder to do and even normal activity might drop some. Plus, eating less could presumably lead to even less energy.

Anyone with a medical background know if this is what happens with some conditions/medications?

Firstly the theory that carbohydrates are “better” than fats is so outdated it’s not even worth laughing at.

Secondly it is, as mentioned, quite amazing how we underestimate (and sometimes overestimate) food. I recommend anyone - fat, thin or normal - trying out Fitday.com, which offers a free food diary. You input every single thing you eat, and it spits out your daily/weekly/monthly nutrition information. It’s absolutely eye-opening. It’s also interesting and very important to see what vitamins and minerals you’re not getting.

Eg on a lower-carb diet, my thiamin levels are always way too low (around 40% - eating all fresh, unprocessed food). According to wiki:

That certainly sounds like something that could play havoc with energy levels, appetite, weight gain and weight loss if you’re deficient in it.

I defy all but professional nutritionists not to be shocked at the amount of sugar, saturated fat and calories they’re likely eating every day.

Third comment: aerobic exercise is very good for you, but not always very efficient at making you lose weight. I was suprised to find this out, but apparently it’s quite common knowledge among gym types. For weight loss - or rather fat loss - your best bet is weight training.