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In the Name of God بسم الله
Islandsandmirrors

Psychiatrist low-key fat shamed me—I want to lose weight

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I’ve been trying to lose weight, and while I’ve lost inches and fit into smaller pants than I did a while ago, my weight hasn’t budged. So obviously I’m going somewhere wrong.

Now, I visit my psychiatrist every 2 months, and I get weighed every time and my vitals checked. 

As of last year, I am up 20 pounds. So of course, my psychiatrist would have to monitor and bring up my weight if there are major fluctuations. 

I’ve mostly been skinny up until I got married and I now have a BMI of 23. My psychiatrist has been telling me for the last two visits indirectly that I should be losing weight. Before I left, she said, “Hope you lose some weight the next time I see you.”

I’m not new to counting calories or measuring my food or myfitnesspal. I know how to lose weight, however, every time I cut back my intake by even 500, I feel the urge to binge and feel like I’m starving. I’ve tried explaining this and she said that my urge to binge was psychological rather than physical, which I do agree with. But I would like to lose 5 pounds by my next appointment (which would be in two months) just to get her off my case.

I’ve never been this weight before, so finding the appropriate calories has been a challenge for me. (For both maintaining and losing weight.)  I want to lose the weight slowly. (Less than a pound a week.) What would be an appropriate deficit? 

@Qa'im

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I think it’s highly inappropriate since she’s you’re psychiatrist and not your fitness trainer

jeez don’t lose weight for people, weight is always changing. Personally for me fitness and weight go hand in hand, shouldn’t be about the BMI but how you feel. About getting healthier(and feeling it! No binge etc) and feeling stronger and mentally healthy like that

but this psychiatrist seems to think you probably want to lose weight(may be she has set description of you) and thinks this kind of tactic might help. Like she probably thinks oh she’s probably stressing about looking a certain way and she’s always been a certain weight and women tend to stress a lot about that, so to combat that I’ll give her cues like this..

I don’t know though about how effective that is

I will always recommend to whomever to gain muscle and lose fat. Meaning get stronger and healthier and not rely on diets. Exercising always helps to get the little bit of stubborn weight off

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6 hours ago, Ralvi said:

ut this psychiatrist seems to think you probably want to lose weight(may be she has set description of you) and thinks this kind of tactic might help. Like she probably thinks oh she’s probably stressing about looking a certain way and she’s always been a certain weight and women tend to stress a lot about that, so to combat that I’ll give her cues like this..

I do have anxiety about my weight gain, (and want to lose some weight) and she did offer me pointers like the benefits of fasting and “fine-tuning” my calorie intake, because I mentioned the anxiety over how much I’ve gained. That, and my weight has always been stable. So I do understand why she said I should lose the weight. 

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17 minutes ago, Islandsandmirrors said:

I do have anxiety about my weight gain, (and want to lose some weight) and she did offer me pointers like the benefits of fasting and “fine-tuning” my calorie intake, because I mentioned the anxiety over how much I’ve gained. That, and my weight has always been stable. So I do understand why she said I should lose the weight. 

Yeah so she definitely has that under your profile with her and so she’s just trying to combat your anxiety preemptively 

nothing wrong with Losing weight, and being anxious over it is something a lot of young women will inevitably experience

women are designed to retain fat and have low muscle. So thats what can really make it hard. That’s why for women a long term plan for fitness is best IMO. Especially since you won’t have a time constraint or short time to stress about. doing things that are healthy and exercising  (just running in the morning is already great) not only will your weight reflect this, but your skin, complexion and anxiety will reflect it too. 

I believe with anxiety having a constant measure (like proper diet and excercise) can really combat it. Because its always a work in progress. And not a rush with a finish line. 

Plus being moderate in your diet is always nice too. You should treat yourself once in a while y’know?

I myself naturally practice intermediate fasting after seriously getting sick from not eating right and it’s just better for me. I had food sensitivities I didn’t even know and now I’m permanently scarred lol

Although nowadays I’m just fasting for Allah and Duas etc 

Some thing work for others and some things don’t. You should really try it if you can.

But don’t beat yourself up about It. 

Genetics plays a huge role too. My sisters and brothers were so chubby when young and during puberty. And now as they’ve grown older they’ve grown into their bodies and have lost weight. It’s just how it is in our family. Some people grow into their bodies at different stages of life. The anxiety They might have had as youngsters was probably not due to them but their genetics and growth stages. Unfortunately the body changes but the anxiety remains. 

Just approach it with that in mind, and take things at a reasonable pace. Don’t worry about meeting standards. As long as you have a routine(which long term wise is the best for overall satisfaction). Because then even if you’re in a really bad and down mood you’ll probably stick to your routine and not fall off the wagon and go nuts and eat bad all the time haha. Lifestyle change is always better. If you’re already pretty fit then the changes will be minimal to lifestyle but you’ll see the changes to your body and mind! 

Edited by Ralvi

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I think there are certain things that are incontrovertibly true:

  1. A certain BMI is unhealthy. Perhaps it varies by ethnic groups and the people from Samoa can get away with a higher number. But there will be a range that most people should stay within.
  2. As a health professional, I think the psycho is right to draw attention to this, not least because of its effect on mental health and their correct observation that eating behaviour can be psychologically driven rather than due to physical hunger.

The question then is how you can manage the situation. The following are based on my own experience, given my need to manage weight for cardiac reasons.

  1. For home consumption just don't buy foods that are fatty/sugary. When you are out shopping on a full stomach the urge just won't be there. Buy stuff that it is unlikely you will binge on, no-one ever binged on carrots or lettuce, but if you are feeling peckish, they are a great snack. And if you do buy chocolate get the 90% cocoa variety, again hard to binge on, I think.
  2. So no cakes, biscuits, soft drinks, fruit juices etc. in the house.
  3. Have unshelled nuts. Again hard to binge on nuts when you have to go through the effort of opening them up. I think pine nuts were created for the express benefit of people who like to peck. Huge amount of effort needed to shell them for very few calories.
  4. I quite like foods that have an intense taste to calorie ratio. Seaweed, kimchi and wasabi peas come into this category. They also help leaven the bland taste of healthy foods.
  5. Satiety is an important concept, IMHO. I've previously mentioned how beansprouts for some reason do for me what carbs would otherwise. I've just discovered that mashed up butter beans have a very similar taste to mashed potatoes. Water-based soups are good.
  6. You have to change your habits and routines. I have changed my travel plan so that for one journey there's an 8km walk built in. If you know you are going to have to exercise and you know that more weight makes this difficult, then you'll better appreciate the cost of eating cake.
  7. Children are a great motivation. If you can't change lifestyle for your own benefit, you'll do it for the kids. I walk Maryam back from her school. So she gets a 4km walk and I get 8km in the process.
  8. Prepare more meals yourself, I find the actual process of preparing meals takes away the hunger.
  9. Obviously, don't go to all-you-can-eat buffets.
  10. You will come across people who, for the reasons of social desirability, will diminish the importance of weight management, they'll come up with excuses for you to deviate from good habits etc. You need to tune out those messages.
Edited by Haji 2003

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5 hours ago, BowTie said:

With all the experts around the world and around you, whether around you, on social media, forums, etc...and you ask Shiachat :party:

:salam:

Well at least we can make a dua for the sister to get relieved of her sufferings.

@Islandsandmirrors

May you feel well, mind body and soul wise by the grace of Allah (سُبْحَانَهُ وَ تَعَالَى)

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Salams @Islandsandmirrors

I don't want to appear as a Prophet of Ketosis on ShiaChat but a great thing about this diet is that with time it eliminates cravings and if you stick to the foods that are allowed, you feel full even when you are in a significant calorie deficit.

The only way to curb your cravings is to eliminate carbs from your diet. The maximum you should eat is 20g to 30g carbs a day plus those accidental carbs that come with leafy greens. Consume only good fats and moderate proteins as per your macros and you'll start losing weight in a healthy way. Use carb manager to figure out your macros.

Eat at a calorie deficit of a minimum 500. But keep in mind that counting calories alone is a meaningless exercise if you don't know the proportion of carbs, fats, and protein you are consuming. A 100 cal of carbs is NOT equal to a 100 cal of fat or protein. On keto diet your macros should be: Fats 75%, protein 20% and carbs 5% only. Look up the food list and keto recipes and prepare as many meals at home as possible. 

Combine your dietary regime with intermittent fasting. You have only 8 hours window to eat. Fast for the rest of the 16 hours. Eg, eat your fist meal at 12 pm and your last at 8 pm. No snacking in between. Start with 3 meals but reduce it to 2 after a couple of weeks. You can have a black coffee in the morning and one later on but no more. Drink lots of water.

If you feel hungry at any time, I have found that a tbsp of psyllium husk, a tbsp of organic apple cider vinegar mixed in a glass of water keeps my engines working and suppresses cravings. The health benefits of both cannot be exaggerated.

After nearly five months of this diet I am at a point where my cravings have totally disappeared. Currently I'm fasting 20:4 (I,e; 2 meals a day during the 4 hour window and no eating for the rest of 20 hours). My first meal is 2 pm in the afternoon and 6pm is the last bowl of veggies. I never thought I'd say this, but when I sit down to eat my breakfast after 20 hours of fasting, I still DO NOT feel the hunger. Yes, there is a little twitch of hunger sometime but nothing that can't be tolerated. This is because I've eliminated the things that cause cravings: carbohydrates. ALL carbs except for fibrous carbs. I'm 38 lbs down and counting.

Good luck.

 

Edited by Marbles

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BMI of 23 is the problem, or the sudden increase? 

I tend to gain a little weight when I'm happy and healthy, and drop a lot when I'm super stressed. Any sudden change is reason for concern. Have you changed your diet or activity level since getting married? 

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1 hour ago, Marbles said:

Combine your dietary regime with intermittent fasting. You have only 8 hours window to eat. Fast for the rest of the 16 hours. Eg, eat your fist meal at 12 pm and your last at 8 pm.

Why not time it for the local fajr and maghrib times and get the thawab for mustahab fasts as well?

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12 minutes ago, Haji 2003 said:

Why not time it for the local fajr and maghrib times and get the thawab for mustahab fasts as well?

'Water, mum,' I said when she suggested the same.

If the purpose is to lose weight, it is important to drink plenty of water during the fast times to flush out the burned fat. Keeping water intake within the eating window may be difficult and cause bloating and too many visits to the washroom, which would be further trouble if one's eating window ends late into the night or early morning. 

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9 hours ago, Islandsandmirrors said:

I know how to lose weight, however, every time I cut back my intake by even 500, I feel the urge to binge and feel like I’m starving.

I do intermittent fasting and what I drink a cup of black coffee which suppresses my appetite and cravings m, so I highly suggest you try that but make sure its black!!!

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Cravings are your body's way of telling you it needs something. Unfortunately, it isn't very discriminating with the message. While you might need some carbohydrate, you probably don't need a pack of Oreos or a donut. Just don't keep any junk food in your house and you'll be forced to pick healthier options. (As a bonus, your husband will eat healthier too!)

If you're eating healthy and moderately and still gaining weight, try increasing your exercise. Maybe your metabolism is slowing - it will happen as you get older. 

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3 hours ago, Marbles said:

Salams @Islandsandmirrors

I don't want to appear as a Prophet of Ketosis on ShiaChat but a great thing about this diet is that with time it eliminates cravings and if you stick to the foods that are allowed, you feel full even when you are in a significant calorie deficit.

The only way to curb your cravings is to eliminate carbs from your diet. The maximum you should eat is 20g to 30g carbs a day plus those accidental carbs that come with leafy greens. Consume only good fats and moderate proteins as per your macros and you'll start losing weight in a healthy way. Use carb manager to figure out your macros.

Eat at a calorie deficit of a minimum 500. But keep in mind that counting calories alone is a meaningless exercise if you don't know the proportion of carbs, fats, and protein you are consuming. A 100 cal of carbs is NOT equal to a 100 cal of fat or protein. On keto diet your macros should be: Fats 75%, protein 20% and carbs 5% only. Look up the food list and keto recipes and prepare as many meals at home as possible. 

Combine your dietary regime with intermittent fasting. You have only 8 hours window to eat. Fast for the rest of the 16 hours. Eg, eat your fist meal at 12 pm and your last at 8 pm. No snacking in between. Start with 3 meals but reduce it to 2 after a couple of weeks. You can have a black coffee in the morning and one later on but no more. Drink lots of water.

If you feel hungry at any time, I have found that a tbsp of psyllium husk, a tbsp of organic apple cider vinegar mixed in a glass of water keeps my engines working and suppresses cravings. The health benefits of both cannot be exaggerated.

After nearly five months of this diet I am at a point where my cravings have totally disappeared. Currently I'm fasting 20:4 (I,e; 2 meals a day during the 4 hour window and no eating for the rest of 20 hours). My first meal is 2 pm in the afternoon and 6pm is the last bowl of veggies. I never thought I'd say this, but when I sit down to eat my breakfast after 20 hours of fasting, I still DO NOT feel the hunger. Yes, there is a little twitch of hunger sometime but nothing that can't be tolerated. This is because I've eliminated the things that cause cravings: carbohydrates. ALL carbs except for fibrous carbs. I'm 38 lbs down and counting.

Good luck.

Salam @Marbles. Thank you so much for your in depth response. I greatly appreciate it. I have heard lots of great things about Keto and I have a friend who has dropped 20 pounds since starting three or so months ago. 

I’ve seen some keto recipes that use a copious amount of veggies in place of carbs, and I was wondering if it helps with energy levels? When I try to go into a deficit, I feel drained. And feeling drained propels a binge for me. 

My psychiatrist also recommended IF and said she’s been doing so on and off for 40 years. I’d like to give it a try sometime, but I’m worried about metabolic adaptation since I’ve heard fasting may lower your tdee levels with time (by delaying breakfast.)

I’m so glad to hear Keto has worked for you. 38 pounds is an impressive loss. I’m really hoping both Keto and IF help with my energy levels. If my energy stays the same while on a deficit, it should be easier for me to lose the weight. Thanks again for your response. 

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10 hours ago, Islandsandmirrors said:

I’ve mostly been skinny up until I got married and I now have a BMI of 23. My psychiatrist has been telling me for the last two visits indirectly that I should be losing weight. Before I left, she said, “Hope you lose some weight the next time I see you.”

Perhaps she said that to you because she knows how important your weight is to you.

This won't be a popular reponse,  but a newlywed, female or male, should be eating a healthy diet (not restricting heart healthy foods), because there is a possibility of pregnancy and you both want your child to be as healthy as can be. :cuddle:

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9 hours ago, Haji 2003 said:

I think there are certain things that are incontrovertibly true:

  1. A certain BMI is unhealthy. Perhaps it varies by ethnic groups and the people from Samoa can get away with a higher number. But there will be a range that most people should stay within.
  2. As a health professional, I think the psycho is right to draw attention to this, not least because of its effect on mental health and their correct observation that eating behaviour can be psychologically driven rather than due to physical hunger.

The question then is how you can manage the situation. The following are based on my own experience, given my need to manage weight for cardiac reasons.

  1. For home consumption just don't buy foods that are fatty/sugary. When you are out shopping on a full stomach the urge just won't be there. Buy stuff that it is unlikely you will binge on, no-one ever binged on carrots or lettuce, but if you are feeling peckish, they are a great snack. And if you do buy chocolate get the 90% cocoa variety, again hard to binge on, I think.
  2. So no cakes, biscuits, soft drinks, fruit juices etc. in the house.
  3. Have unshelled nuts. Again hard to binge on nuts when you have to go through the effort of opening them up. I think pine nuts were created for the express benefit of people who like to peck. Huge amount of effort needed to shell them for very few calories.
  4. I quite like foods that have an intense taste to calorie ratio. Seaweed, kimchi and wasabi peas come into this category. They also help leaven the bland taste of healthy foods.
  5. Satiety is an important concept, IMHO. I've previously mentioned how beansprouts for some reason do for me what carbs would otherwise. I've just discovered that mashed up butter beans have a very similar taste to mashed potatoes. Water-based soups are good.
  6. You have to change your habits and routines. I have changed my travel plan so that for one journey there's an 8km walk built in. If you know you are going to have to exercise and you know that more weight makes this difficult, then you'll better appreciate the cost of eating cake.
  7. Children are a great motivation. If you can't change lifestyle for your own benefit, you'll do it for the kids. I walk Maryam back from her school. So she gets a 4km walk and I get 8km in the process.
  8. Prepare more meals yourself, I find the actual process of preparing meals takes away the hunger.
  9. Obviously, don't go to all-you-can-eat buffets.
  10. You will come across people who, for the reasons of social desirability, will diminish the importance of weight management, they'll come up with excuses for you to deviate from good habits etc. You need to tune out those messages.

1. I do know that some ethnicities in general have smaller builds. Persians tend to be lithe, but there are people with larger frames such as myself. I went to a nutritionist back when I was sixteen and she my bone structure was larger than average for my ethnicity. I was at a BMI of 23-24 then, and said based on that, I shouldn’t weight less than a BMI of 21. I went a dietitian at eighteen who wanted me at a BMI of 22 and no smaller taking into account my frame size and muscle mass.

2. I think feeling the urge to binge is psychological, for the most part. What happened after I got married is I started to eat more because I was happy, and slowly put on 5 pounds. I freaked out, and cut back on my intake, but then started to binge after two weeks. So for months I was binging/restricting until I had no energy left for a deficit, and I decided to up my calories a bit by 500. (Making it to 2000 calories.) I increased my calories overnight and suddenly, within three weeks, I put on more than 10 pounds, and the weight gain slowed after that and now I haven’t been gaining much and stayed rather stable.

I agree with the rest of your pointers. Just thought I’d clarify a few things. Thanks for your response. 

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3 hours ago, notme said:

BMI of 23 is the problem, or the sudden increase? 

I tend to gain a little weight when I'm happy and healthy, and drop a lot when I'm super stressed. Any sudden change is reason for concern. Have you changed your diet or activity level since getting married? 

I think it’s the sudden increase. 

I have upped my normal intake from 1600 to 2000 because I wanted a relief from the binge/restrict cycle (which made me gain the first 10 or so pounds.) and I haven’t binged in two months as a result, so I know I’m making progress. 

My activity levels have pretty much the stayed the same. Some days, however, I’m more sedentary.  

Edited by Islandsandmirrors

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As for the comment, yeah it's a bit rude, but it's coming from a good place, as they are concerned about your mental and physical health. Sometimes that pressure is needed to make a positive change.

As others have said, your metabolism takes a big hit in your 20s. At 24 I went up 40 pounds without making any serious changes to my diet (170 to 210). So I quit all sugary drinks cold-turkey and lost about 15 pounds right there. I'm 28 now and I weigh 185. I'm finding it very difficult to dip beneath that, despite my low carbs / low sugar / calorie counting, so I'm still learning about my body and where my metabolism is currently at. Granted I'm not doing much physical activity (I've been sick), so that is the next step.

I think modern humans just consume way more food than they need to. It seems that our bodies can go up to 2 months without any food -- and about 3 weeks without suffering any permanent damage to your body. As Marbles said, intermittent fasting seems to really cut cravings and portion sizes. Tell yourself that every hour that you are hungry is time where your body is eating away your fat. I've told myself that I'm not going to stop dieting until I hit 170, even if it takes me the whole year, and I really want this more than anything right now, so the ends will justify the means.

Fast fii sabeelillah at least the 3 recommended days every month, as well as any other recommended fast days. Eat slowly, sit down for every meal, and stop eating before you are full. Look at the food the same way you look at medicine. Cut sugary and fried foods cold-turkey until you hit your goal -- consider them poison.

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13 minutes ago, Hameedeh said:

Perhaps she said that to you because she knows how important your weight is to you.

This won't be a popular reponse,  but a newlywed, female or male, should be eating a healthy diet (not restricting heart healthy foods), because there is a possibility of pregnancy and you both want your child to be as healthy as can be. :cuddle:

I think that might be the case, because I did mention a bit of anxiety over my weight gain and she started to give me pointers then, but also she said, “I know when you get married, you’re happier and you eat more but” (basically telling me to watch it.) 

:cuddle: thanks Hameedeh. :) I’ll keep that in mind for the future. 

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