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Female Bariatic Physician 'Struggling' With Personal Weight Loss Efforts

Controversy ensued early last year when President Barack Obama appointed Dr. Regina M. Benjamin to serve as the nation’s 18th surgeon general. It’s a highly prestigious position for any respected physician because you are looked at as America’s top doctor (sorry Dr. Oz, it ain’t you!). The U.S. Surgeon General sets the tone for public health policy and becomes the face for those decisions–and therein was the problem for the 52-year old Dr. Benjamin. As you can see from the photo posted to the left, she is overweight. The argument from the skeptics of this nomination stated that she was unqualified to hold the position of surgeon general because of her weight since we are currently facing an obesity epidemic and we need an example for Americans to follow. But with grace and honor, Dr. Benjamin dismissed what she described as “hurtful” criticisms stating that although she weighs more than she’d like, being fit and healthy is “more than just a dress size.” She added that because of her own struggles she is able to understand the plight of what upwards of two-thirds of Americans are dealing with. I can certainly relate to this as I’ve written about quite often as an encouragement to others who are trying to get a handle on their weight. The good news is that livin’ la vida low-carb has indeed made me healthy by all measurable metabolic markers despite the extra pounds. That’s the solace I find in my chosen diet plan.

One of my readers who is a medical professional specializing in obesity wrote to me recently sharing quite openly of her frustration and struggle to shed the pounds. Although she helps literally thousands of patients find their path to weight loss success, she’s been unable to make it happen for herself. She poured her heart and soul out looking for answers to her weight problem after literally exhausting everything she knows to make it happen for herself. Like Dr. Benjamin and myself, she’s looking for the answers to why she’s dealing with extra pounds despite seeming to do everything correctly.

Here’s what she wrote:

I am a 31 year old female struggling to find balance and lose weight. I own a very large health and wellness clinic and I counsel tons of patients on how to lose weight and get healthy. I just can’t figure it out for myself!

I currently weigh 140 pounds, am 5’5″ and fairly athletic. I divorced my husband after 6 years of marriage a couple of years ago. My whole routine changed at that time and I started eating very low (400) calories many days. I am embarrassed to say I lost my period for two years doing this! With covering myself in work and my business, I started controlling stress by controlling food! Prior to my divorce I weighed 128 pounds.

Trying to fix this mess, I have consistently eaten 1200 calories/day for four months. I eat between 30-140g carbs/day now. Weekdays may be lower with 1500-2200 calorie days on the weekend. I lift weights and do 20 minutes of high intensity cardio 3x/week. My weight will not budge. My current MD suggested I not exercise at all right now.

What can I do? I am afraid if I add more exercise I will create too much of a calorie deficit! If I add calories then I’ll gain. I am so unhappy at this weight and I feel it’s holding me back. Please help!!!!

Dr. XXXXXX

How many of us have had thoughts like these during our weight loss efforts? I’d venture to say just about everyone reading this has at some point or another questioned what they’re doing to produce weight loss–myself included. It can be incredibly frustrating, especially for someone who helps others with this struggle like my reader. I’m sure it can be a challenge working through it yourself knowing we are all different and respond to different things.

It sounds like her issue isn’t so much with calories as much as it us the QUALITY of the calories she is consuming along with what the food is doing to her insulin levels. I believe this is the #1 issue she should be concerned with based on what we know about the role carbohydrates play in raising insulin levels and the way increased insulin levels control fat accumulation. Getting the insulin under control by restricting her carbohydrate intake should be her main priority in reeling in her diet to see optimal results.

As you know, dietary fat is the best quality calorie macronutrient you consume because it satiates and tastes good. Saturated fats like butter, coconut oil, eggs, full fat meats and cheeses, avocados, nuts and seeds and more will comprise most of your caloric intake up to 70% of calories. And the good news is there is very little impact on insulin levels when you eat fat. Plus, in the absence of carbohydrates in your diet, dietary fat becomes your top fuel source.

Adding in moderate amounts of protein to that makes it a veritable 1-2 power-packed punch of healthy nutrition. Protein is usually included with most natural fat sources like eggs and meat, for example. Avoiding lean proteins such as chicken and turkey to prevent overconsumption of protein which can spike insulin levels and slow weight loss because of gluconeogenesis is a must!

Finally, carbohydrates should be keep to a minimum during weight loss mode to maximize the impact. Green leafy and non-starchy veggies such as broccoli and cauliflower are the staple of your diet to no more than 30g carbs daily. This will put your body in the best possible position to keep insulin minimized so you can shed pounds. If you’re consuming too many carbs, then your body must use them for energy FIRST before fat loss can commence.

Most importantly about high-fat, moderate protein, low-carb eating is your health markers will dramatically improve. Blood sugar and insulin control, higher HDL, lower triglycerides, reduced blood pressure, increased size of LDL particles, and more await you. The weight loss will come as a pleasant side effect if you commit to eating this nutrient-dense real foods dietary plan that worked for our early ancestors to make them vibrant and healthy.

If you need help beginning a routine like this, then check out my “Get Started” page for helpful links and tips to make the transition to a healthy low-carb lifestyle change. YOU CAN DO THIS!!! The key is to find a plan that will work for you, follow that plan exactly as prescribed and then keep doing that plan for the rest of your life. If you do that and are happy with what you are doing, then you can’t help but be successful.

As I’ve said many times before, too often we put the focus on weight loss almost exclusively when there’s so much more to health than that. Sure, it’d be fabulous if we could all attain the look we desire for our bodies and many people could certainly make that happen for themselves with some basic changes in their diet and exercise routine. But others of us will bust our tails nutritionally and physically just to keep ourselves from ballooning up to morbid obesity again.

No, I’m not at a perfect weight on my 6’3″ body currently, but I’m a whole heckuva lot better off than I was at 410 pounds at the beginning of 2004. Low-carb hasn’t failed me–it’s saved my life from what was a certain life of chronic disease and likely premature death. That ain’t happening for me now because I’ve chosen to be healthy through my diet choices. And the same applies to my bariatric physician reader as well as our Surgeon General who care enough about this to do something pro-active to make it happen. Whether they ever reach their so-called “ideal weight” or not isn’t as important as remaining engaged in the journey to be as healthy as they can possibly be. There’s a lesson in that for all of us.

  • Rosemary444

    Ummmm…. 140 and 5’5″//that’s NOT fat!

  • gharkness

    I am having a little bit of problem with this. This lady gains 12 pounds and calls it a struggle with obesity? Jimmy, is there a typo in this post? If so, then I understand her concerns. If not, and she really has only gained 12 pounds, please….this is not a person who’s weight is out of control.

    • http://www.livinlavidalowcarb.com Jimmy Moore

      That’s not a typo, Georgene. Get to be over 100 pounds overweight and let’s talk about struggle, right?

  • http://www.free-heatlhy-diet-plans.com Misty

    Great advice Jimmy! Those last few just don’t come off as easily as in the beginning. When one is that close to a goal, they must really evaluate what it will take to get down to a desired number and most importantly, will she be able to do what it takes to stay there.

    I must point out too that the variation of carbohydrate consumption seems wildly fluctuating.

    It seems to me that a 5’5″ woman might re-evaluate her lifting to get to a particular size.

    In good health and I hope your reader finds peace.

    • http://www.livinlavidalowcarb.com Jimmy Moore

      Misty, I agree her carb intake is probably the culprit, but she has to work through those issues.

  • Ginger

    I could lose 12 pounds and would still be obese, needing to lose another 60 *BUT* I will put my lipid panels up against anyone’s, thanks to LC eating. I do agree that her carb fluctuation is quite high and that should be the first part of the equation to address.

  • http://www.undergroundnutritionist.com Barry Cripps

    Going between 30 and 140g of carbs, without any kind of consistency certainly isn’t going to produce consistent weight-loss. Most people can’t establish Ketosis with a carb intake over 100 grams of carbs per day. I think a good couple of weeks at a “consistently” low carbohydrate amount (with appropriate calorie intake) would get her weight moving in the right direction. It’s all relative. When you’re talking about 400 calorie days, 30 grams of carbs as a percentage of 400 calories, easily becomes a major macronutrient at around 30% of total calories!! Obviously at this point, 30g of carbs will have a much larger impact on insulin and blood sugar levels……especially if the carbs are from a poor source, like from the average snack machine or the like. She would still be at a calorie deficit, but insulin could be stopping the release of Triglycerides from existing stores. We’ve all seen studies where obese mice literally starve to death, because of insulin stopping their bodies from utilizing fat for fuel. Just my 2 cents. :-)

  • Jennifer

    She should check her thyroid levels. Stress (divorce, the dieting, her practice) can mess with the percentage of T4 converting to T3, so her Reverse T3 is probably through the roof,her Free T3 is probably in the cellar, and her metabolism has slowed way down.

    As for her dieting, the body sees that not as “dieting” but as “starving”. Her adrenals may have taken a hit, as well, trying to keep the body going as the thyroid levels have changed.

    I’d be curious if she’d ever recommend a 400 calorie a day diet to any of her patients.

  • Sue

    Okay, 12 lbs does not sound like much, but as an almost 5’4″ woman, I understand her completely. 12 lb at short stature can be more than a couple of sizes and feel really uncomfortable!
    I second the idea that she look at her carb count, try to stay around 50 or lower for a while, and I would also recommend some intermittent fasting – especially preceding her intense workouts. Even just once a week I think will help her in a big way.

  • http://carbsanity.blogspot.com/ CarbSane

    The level of desperation over 12 pounds screams eating disorder to me. Combining her line of work, where she may feel compelled to be setting a “perfect” example for her business and the emotional upset of a divorce (even amicable divorces can be stressful) and whammo.

    No doubt her extreme low calorie diet did some damage and it will take her metabolism time to heal.

    I doubt highly that insulin has anything to do with her problem. Even 140g = 560 cals which would fall into a moderate %. I might question the nature of those carbs – e.g. are they coming from real whole foods or mostly refined grains and sugar?

    I would suggest she devise a diet around sufficient protein. This is almost always lacking in CRD’s at levels when women lose. Going VLC may be one way to get a handle on it and worth a try.

  • Carole Mauloff

    I love reading the wisdom of all of the above folks. I agree that this lady needs some help with her expectations, perhaps some counseling about reality would help her. I also agree that her carb level is way too high for someone still attempting to lose weight. The larger question remains, “Why is she still trying to lose weight?” Unfortunately when we are in the weight loss business, we sometimes think we have the correct answers. I hope she finds someone to help her sort out her issues other then weight ones.

  • http://relievemypain.blogspot.com Lori

    Having been 140 pounds at 5′-4″ a year ago, maybe I can shed some light on why the doctor is in a tizzy.

    1. She’s doing what she thinks are all the right things, but can’t get back to her old weight.

    2. She’s probably hungry and tired from a low-calorie diet and tough workout routine, yet can’t lose the fat.

    3. As a doctor who counsels patients on losing weight, she may feel like a hypocrite. Much of what she learned in school and from colleagues is probably wrong.

    Everything that Jimmy said in his reply worked for me. I cut way, way back on the carbs to around 50g per day and over 20 pounds of fat fell off. I’m 116 pounds, and that’s about right for me. My lipids and blood glucose levels are great, and I feel like I’m 20 years old at age 41.

    As an aside, the 400-calorie-per-day diet after a divorce is the heartbreak diet. It’s not necessarily a choice so much as having zero appetite.

  • Keira

    I think therapy couldn’t hurt and she needs to give it a try. She seems to have an unhealthy relationship with food. Food is not the enemy. Realistic expectations for her body type could help and then coming up with a healthy eating plan. Since she is in the business, she can easily find the resources.

  • http://relievemypain.blogspot.com Lori

    Actually, people have been harmed by therapy when seeking psychological treatment for eating disorders. The controversy involves so-called recovered memories of child abuse, some of which may have been created by therapy.

    I don’t think 128 pounds for a 31-year-old 5′-5″ woman is an unrealistic expectation, especially if she used to be comfortable at that weight. It seems to me it’s better to nip a 12-pound weight gain in the bud than to wait for a 50-pound weight gain.

  • Zach

    “Avoiding lean proteins such as chicken and turkey to prevent overconsumption of protein which can spike insulin levels and slow weight loss because of gluconeogenesis is a must! ”

    epic fail. i find such an egregious mistake in nutritional guidance appalling

    • http://www.livinlavidalowcarb.com Jimmy Moore

      So, is there no concern over the glucose-producing impact of consuming high amounts of protein absent copious quantities of fat to offset it, Zach? Please expound upon your comment further because I’m not hearing your solution or alternative hypothesis.

  • vlado2020

    Jimmy, gluconeogenesis is cortisol dependent operation and cortisol is a catabolic hormone so it will eat existing muscle to make glucose regardless if you eat protein or not

  • Leanne

    Um… 5’5″ and 140 pounds is a healthy weight, by pretty much anyone’s standards (solidly “normal” BMI of 23.3). Seems to me that her focus now shouldn’t be on weight loss and calorie counting, but body composition and quality eating. Instead of following her doctor’s recommendation to not exercise at all (?!), she should be doing a consistent weight training program and interval training so she can increase muscle mass and improve her overall physical fitness.

    If she’s not losing fat (assuming she has excess body fat even though she is *not* overweight), it’s probably down to her diet (not enough food overall, too much of what she doesn’t need, not enough of the good stuff)… and, well, stress level. Cortisol is a definite factor when it comes to holding on to excess fat. Working in a health and wellness center can be a good thing, because you have access and encouragement to live a healthy lifestyle, but it can also be bad, because it pressures you to be perfect at all times (have to be a role model for the clients, right?). I think if she relaxed a bit and stopped worrying so much about losing *weight* and started focusing on nutrition, stress reduction, correcting any hormonal and nutritional imbalances she has, etc. then everything will fall into place. She may need to accept that 140 is the weight her body wants to be at, and that her job is to maximize her body *composition* at that weight, and not to worry so much about being lighter.

  • mrgjr

    I’m not sure how this will be taken, but I’ve found that when I start gaining again even though I’m still doing the correct things if I start eating more for a few days and have my wife make sweet Potato pie and indulge I actually start losing again when I go back to the correct way of eating. That’s not a scientific study, but just something that has worked for me many times over the years.

  • Jack Valens

    Thanks for the great post Jimmy! I wasn’t aware of the controversy surrounding the new appointment….
    At the end of your post you raise a key factor that really helps me…. “remain engaged in the journey”. You have to know what you want from that journey! When I used to go through the motions of eating right, or go through the motions of working out because “that’s what I had to do” I would invariably hate the whole process. When I began changing my thoughts and started really seeing and feeling “why” I wanted to be fit ad started seeing in my mind’s eye the healthy and energetic “me” that I knew I wanted, the journey became a lot less stressful and a lot more fulfilling and easier to stick to day to day…