Weight gain problems.... Any advice very welcome...

[GemmaJ]

Hello Everyone,

I’m hoping you may be able to offer me some advice. I joined this fab community about a month ago and outlined my problems on another thread. I received some good advice from Stavia and SusanJ which I have since followed and I thought I’d continue in a new thread in case anyone is having similar problems.

I have suffered on and off with Anorexia throughout my life and since I left it behind about 4 years ago have struggled to reach a healthy weight. I am 5’5” and usually weigh 47.5kg, that’s an unhealthy BMI of 17.4. Three years ago I moved to Spain with my kids and a routine gynecology appointment resulted in the discovery that I have osteoporosis. I’m on calcium, Vit D and other medication for this and have had a DEXA every year since but it hasn’t improved much.

I found out I was APOE 4/4 at the end of April this year and immediately started on a low-toxin, low sugar diet as advised by DNA Health, who did the test for me. I feel much better in myself but lost 3-4kgs and am now around 44kg, which is a dangerously low BMI of 16.1. I’m particularly upset about this as I had a hard uphill struggle to get my weight up to even 47.5kg after anorexia. I’m determined to stick to the diet that I have followed for about 8 weeks now but need to get some weight back on. In fact, just this morning I saw a specialist who has told me to leave all medication and put on weight. My problem is how when following a diet that is good for us 4/4s?

Stavia advised me to use cronometer to log what I eat, which I have done so I’m going to share my averages here as well as my most recent relevant blood test results from this week.

So, my nutrition report from chromometer for the last week tells me that on average I consumed 1196 calories a day and burned 1879…(Yes I’m already seeing the problem..!). 15% was protein, 53% fats (325% omega 3: 109% omega 6), 33%carbs. I have a deficit of 682.9 calories!

Nutrient-wise 107% was fibre, 50% iron, 65% calcium, 524% Vit A, 154% Vit C, 124% Vit B12 and 79% folate.

I’m pretty rigid in what I eat - the only meal that varies much is lunch when I’m working as I’m in a school and it depends on the choice that day. A typical day would be:

Breakfast (at least 12 hours after dinner): oats with almond milk, chia seeds, linseeds and fresh blueberries, water.

Midmorning: A couple of oz of mixed unsalted nuts (no peanuts), cup of tea with splash of milk.

Lunch (varies): Usually fish/lentils/omelette with vegetables and salad, apple, water

Mid afternoon: nothing if running, a natural yoghurt (115g pot) if not

Dinner: Big vegetable salad with spinach or kale, couple of ozs of raw broccoli, couple of ozs cooked cauliflower, red or yellow pepper, cucumber, tomatoes, at least a few ozs of avocado, a few walnuts, sometimes pumpkin seeds, sometimes tinned sardines/tuna/hard boiled egg/lentils/beans/wholegrain couscous/bulgar wheat or quinoa, lots of EVOO, apple cider vinegar, lots of black pepper and other dried herbs depending on the ingredients, yoghurt (if I didn’t eat it earlier), water.

I get really full up with the dinner but am still not consuming enough calories. I’m avoiding grains as much as possible but wonder if I should add a few more in now…

Exercise: At the moment I run 3 times a week - 30 mins, 45 mins, 60 mins. I can’t afford to join a gym and running is easier to fit into my busy schedule (I work full-time as a teacher and have two kids, 12 and 10). Reading the primer and forums, I was determined to up it to try and eventually be doing something every day, however I’m so scared of losing more weight that I daren’t at the moment.

The spanish nurse was not keen on me having all the blood tests I wanted so at the moment these are the significant ones:

HbA1c = 5.7% (this surprised me as I’ve literally not touched sugar, except for in a few blueberries and one apple a day, for 8 weeks now and I know from Stavia’s primer that it should be below 5.5%).
HDL = >120 - That’s all it said, in March it was 138md/dL
LDL = 67mg/dL in March - today’s results said in was ‘incalculable’, whatever that means!
Triglycerides = 59mg/dL
D3 = 85 ng/mL

They wouldn’t test my fasting insulin or B12 but I’ll go to the private doctor in a few weeks and try again for that.

I’m also a bit worried about my BG as fasting it’s low - 75mg/dL. However, yesterday I accidentally (long story!) found that after an intense 40 minute run it had risen to 115 and I hadn’t eaten for 5 hours. Is that normal? I’m worried that the 3 kg weight loss I’ve experienced over the last few months has caused some sort of imbalance or something….

I really hope someone out there can help me. I know I need to eat more but WHAT?! After anorexia I used weight-gain shakes and would again as it’s an easy way to add in the required calories, however I think they’re all sugar-laden….

Any ideas anyone? THANK YOU!

[Starfish77]

I saw the heading on your post and was all set to reply having had weight gain problems all my life until the last three years. When I started reading, I realized you had exactly the opposite of what I experienced. You were interested in gaining weight. I am totally not equiped to answer your post. I admire how well and how quickly you have begun eating a diet that is excellent for an E4/E4. I'm sure with some advise from some of our members you will be able to fine tune your diet to be able to keep your weight up.
Starfish

[slacker]

Hi Gemma;
You are not alone, there are several of us that struggle to stay above a BMI of 18.5 on this diet, myself included. Your Chronometer results are giving you important information about insufficient calories. Can you try to eat more of what you are already eating? The Functional Medicine doctor I am working with suggested adding some legumes or starchy veggies prior to adding in grains for weight gain. Unfortunately, I am already eating all of the above!

I did a website search on "weight loss", and the Ketogenic Diet thread under Prevention and Treatment has various conversations on how to avoid underweight. You might want to start there to read prior discussions. Life is such a balancing act...

[Stavia]

Gemma you are simply not eating enough. And consequently as well your protein intake is borderline at 15% of 1200 cals. (its barely 40grams).

Exercise increases blood glucose via the Cori cycle whereby lactic acid in the muscles is converted to glucose. Its normal for glucose to go up after your runs.

There is no way you are insulin resistent on the data you have given us. I don't think it's helping you checking your blood glucose yourself. The HbA1c has a significant margin of error.

I suggest you add back anything that increases your weight. If its grains or shakes, so be it. Your weight is your main significant health risk now.


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[WhatNext]

Disclaimer: I'm not a nutritionist or medical professional but I'm into healthy snacks--I get hungry when I'm working at the computer. Your mid-morning and mid-afternoon snacks sound pretty meager; you could increase the calories in those snacks. You said you're eating a "couple of ounces" of mixed unsalted nuts--no peanuts. How about increasing that to "a few" or even "several"? Just adding an ounce of pumpkin seeds to your nuts would add about 125 calories, although they're higher in carbs than the nuts. My go-to snack is a mixture of unsalted raw almonds, walnuts, and pumpkin seeds. Walnuts are good for Omega-3 and antioxidants. Almonds are about 23/23/53 c/p/f. They have 0 glycemic index so they don't raise blood sugar. Almonds sold commercially here in the US have to be pasteurized, but I get around that by ordering unpasteurized almonds directly from a grower in California. How about a decadent snack like guacamole with sweet-potato chips made with healthy oil? I buy sweet-potato chips at Whole Foods Market here; there must be a health-food store where you are? Olives are also a healthy snack: I buy mixed pitted Greek olives from the "olive bar" at Whole Foods. If you're okay with occasionally eating bread, I love thin-sliced French bread dipped in olive oil and balsamic vinegar.

[ru442]

I have to agree with Goddess Stavia on this one, Gemma you just gotta eat more, you SHOULD NOT be CR (Calorie Restricted) at this point in your journey, and I certainly would not worry about your glycemic numbers at this time. I've had some recent weight loss and am having issues getting to where I was at and healthy feeling. While I have not made drastic food changes/choices, I am eating as much as I can in my eating window as I can handle (I still fast 14-16 hours each day). I may have posted this somewhere else but I have added:

1) Quest protein bars (not sure if they are available across the pond). Usually I will eat one of these before lunch, or between lunch and dinner. These are also easy to bring with to work or wherever if you need to snack.
2) Lots of nuts... I keep bags of them around the house (un-shelled pistachios, macadamia mostly) and grab a handful whenever I pass em by, and also keep em at my desk to graze on.
3) Doubled my proteins.... while I do eat some animal it's mostly shrimp/crab/oysters/sardines. Used to eat 4-5 large shrimp, now I do 8-10 depending on size. Instead of 1 can smoked oyster in EVOO, I do 2. I've also added some almond crackers to the mix for more protein (else I wont eat the oysters/sardines.... gotta have the crackers!!)
4) Adding more eggs when I can remember to.... wife usually has 1/2 dozen or so available to grab for a snack or add to salad.

This is IN ADDITION to a 12-14 cup salad at least once a day with lot's of EVOO, onions, olives, etc.. I've managed to put about 5 lbs/2.2kg back on in a couple months, so slow going but working!

Eventually your numbers will fall in line... it's a journey and not a race!!

RU

[SusanJ]

Gemma, I think those of us who are small, sometimes have problems eating enough before getting full. In addition to protein, I found I needed to add more carbs, like sweet potatoes or other root veggies (beets, parsnips, turnips, etc) to gain weight.

If I were you, I'd wait to up your running until you get your calories up, but maybe you could add in some weight lifting on the off days? You can do a lot with just a good set of hand weights, including squats and lunges. And with the extra protein, it might help stabilize your weight some.

[GemmaJ]

Thank you everyone. You're all just great.
I feel a fool to be honest - it's so obvious, isn't it? Eat more! But the truth is, until I logged everything on Cronometer for a week I really didn't realise how little I was eating. I was just so determined to do the right things by my genes..
I'm taking all your advice on board. I'm going to leave cronometer and worrying about numbers for a couple of months and add in a protein shake or two and definitely seek out those Quest bars when I'm in the uk in a few weeks' time.
Wow! What a minefield this truly is - I couldn't negotiate it without you all.

THANK YOU for all the advice.

[Stavia]

Gemma I was worried I would offend you by being so blunt. You are very brave to take our advice so well. Of course its easier to look from the outside dispassionately. Impossible from the inside especially when fearful.
Add in whatever you need to up your weight. I doubt very much that you will ever need management of hyperinsulinaemia. Your previous eating disorder will never let you get overweight. I'd be happy glycaemic control wise with you up to 65/67kg which is my weight as we are the same height. You will never ever be there.
I think that your strategies AD prevention wise will be to keep your weight up, exercise without losing weight, sleep, stress management, cognitive enhancement and selected supplements. These, coupled with being lean, will be exactly what I would like for you.
Brave and honest lady!!
Please eat some carbs honey.
And we are all here for you.

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[SusanJ]

+1 for Stavia's comments. We are here to help each other get through this minefield of diet.