Category Archives: Weight loss

Therapy PRN?

Image: dinosandcomics cartoon I hate leaving the house, why are you here then, well…, I have to have something to talk to my therapist about

I started seeing a new therapist when my insurance changed in January.  He started spacing our sessions further apart because I am doing well and run out of things to say.  Last month he told me he thinks I just need to see him, as needed, and to contact him if I need an appointment.

I don’t know what to think.  I am happy I am doing well but did not know I could finish, with a chronic mental health condition.  I do like checking in with someone but I have a psychiatrist and support group and people around me.

When I ask people about it they think I am unhappy and tell me to speak up, but that is not the issue.  I am unsure how I feel.  I am getting used to the idea now.

 

I also changed psychiatrist with the insurance change. But, I am having more insurance issues. He is part of a medical group that is covered but they are not recognizing him in their system. They covered the first appointment but denied the second. I filed a grievance and the psychiatrist office says it will be taken care of.  It still makes me nervous.

 

Work is going fine. I work 2 days and they hired someone to work the other 3.  I was wondering what he was doing. Work would be piled up for me when I came in.  I just found out he has not been working there for over a month  I feel silly for not knowing, but no one told me.

 

Weight watchers is going fine.  I had a birthday and celebrated with some desserts.  My weight has been going up and down but at least it I have not be gained.  I am getting back at it. I got a recipe book when I signed up and have made a few recipes.  I made slow cooked oats with fruit and a hash brown and egg meal.  I have coconut milk yogurt cooking overnight.  I plugged in a blueberry muffin recipe and it is 6 pts which is okay for a treat but I have to limit to one.

 

 

I finally got my coconut milk “yogurt” to solidify

Image container of coconut milk yogurt with spoon sticking straight up

I have been attempting to make coconut milk yogurt, but it split into layers and was liquid. I tried different brands of coconut milk and nothing was working. So, I altered the recipe by doubling the gelatin and adding chia seeds. It is a bit of a combo of yogurt and chia pudding. I find it a little bland and am trying to figure out what I can add. Let me know if you have any ideas.

If anyone wants my recipe

3 cans light coconut milk shaken
2 Tb gelatin
I Tb sugar
Probiotics (you can use a store bought yogurt to start. I used 2 lactobacillus sp. Probiotic tablets for this batch . I will use this yogurt for starting the next)
1tsp inulin
8 Tb chia seeds

Mix gelatin with some of the coconut milk and set aside for 3 minutes
Pour the rest of the coconut milk in a pot. Heat over medium heat. Add gelatin mixture and sugar. Whisk while heating. Do not boil. (I am sorry, I don’t know the temperature)
Reserve ¼ c and pour the rest into yogurt maker containers. I use 8 6oz containers
Let cool to about 105 F or less.
Add probiotics and inulin to reserved fluid and mix well
Stir one spoonful of probiotic mixture into each container.
Heat in yogurt maker at 105F for 24 hrs
When done remove from maker. Add 1 Tb chia seeds to each container
Refrigerate until firm.

If it is still liquid add another Tb chia seeds to each and chill.

Weight watchers discourages saturated fats, but I find fat filling. I may change my mind, but for now I am eating many of the same foods, but smaller portions. I was at a conference today and used all my daily points by noon, but I can have eggs and veggies for dinner which is not many points.

From Keto to Weight Watchers

Image: blue circle containing letters WW vertically

I stopped keto in Dec. I thought I would get back to it after the New Year but I have been resisting. It is great for my glucose but I found the diet restrictive in food choices. It is sustainable for some. I am gaining back weight. I know someone involved in a MLM that is geared to weight loss, but it is very calorie restricting and you are supposed to purchase their food. I don’t think that would work for me.

I decided to give WW (Weight Watchers) a try. They have a digital plan that is the app, but I don’t know if I can do it on my own. So, I signed up for workshops + digital. It is more expensive but I think it will make me feel accountable. I signed up for 6 months. I am hoping I pick up enough to do it on my own or switch to the digital plan. They have lifetime memberships where if you lose and maintain your weight loss you can have access for free, but I don’t know how that works.

They give you some zero point foods. Mine are poultry, non starchy veggies and legumes. The more zero point foods you choose, the less total points you have to start with. It is pretty easy to track in the app and it is a little different than calorie counting. They guide you toward making healthier choices. You get points back for activity, drinking water and eating non starchy veggies.

I even went to lunch and the most points were for my iced tea. I had minestrone soup and salad. I normally would have eyed the pasta dishes but I wanted to have some points left over for dinner. There are no restrictions on what you can eat. I checked and a shot of liquor is 4 points (out of my 32 total). I went to a virtual meeting for beginners which was helpful. I am planning to go in person on Fri.

Happy Holidays and Update

Image dog with Santa hat and decorations

Happy Holidays

Hanukkah flew by here with little fanfare. We celebrated the last night at my mother-in-law’s house. Food was great. We lit candles and exchanged gifts. I have been trying to lose weight, stalled at the moment. I received clothes in a smaller size than usual and they fit 🙂 .

We have our little artificial tree up for Christmas. My daughter decorated last night

Image small Christmas tree, stockings and dog

The hearing aids are now ordered. The audiologist said there is a big difference between basic and premium so I am purchasing the premium. They are supposed to be better at cutting down on background noise. They should come in soon and then I will get fitted. I am excited to. Be able to hear better.

Today is my husband’s birthday. He is working tonight. We may celebrate Friday. We don’t usually do big celebrations but we may go out to dinner.

The stock was bought back before they received my paperwork. I will still get the replacement certificate but will need to go through a broker to sell. I have no clue how that works or where to go, I want something inexpensive since it is just one transaction. I contacted the company but they are not purchasing more.

Intermittent Fasting (IF) and Stigma in Plasma Donation

Image of insulin and glucagon levels over time source Digbi Health

I saw the image above of how insulin drops between meals and while fasting. While insulin is low, glucagon can burn body fat. I was intrigued. I am 10 lbs away from a healthy BMI, but still have abdominal fat. I am type 2 diabetic and asked my doctor if fasting would be safe. My glucose is pretty well controlled and I don’t have hypoglycemic episodes. She said it is fine, but recommended 12-14 hour fasts. Which is mainly cutting out the nighttime snacking and eating breakfast later.

So far, no change. My weight has been stalled for awhile. My diabetes medication was reduced in June and my biometrics went south. Glucose up, ketones down, weight up. Thankfully, that stabilized but I can’t get my weight to go down. I log my food on an app (Cronometer) but sometimes I estimate weights. I am going to have to get better at calorie counting to start losing again.

So I am gung ho on intermittent fasting. Watching Dr Fung YouTube videos. Then, I saw this study. https://pubmed.ncbi.nlm.nih.gov/34135111/
A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults

All I can see is the abstract and I heard a review but this is what I got out of it. There were 3 groups. One calorie restricted, one calorie restricted (same as group 1) but alternate day Fasting and a third group with no calorie restriction. The calorie restricted groups both lost the same amount of weight but the non fasting group lost more fat.

It was a short study 4 weeks, I think, and these were lean adults. Also, they were doing longer fasts than I am. But, I don’t know what to make of it. I would have expected the fat loss to either be similar or more for the fasting group since they have lowered insulin during the fasting period. if anyone has any insights let me know in the comments. I will stay with 12-14 hr fasts and keto diet for now.

I tried donating plasma at a donation center. I tried calling ahead to ask about restrictions but they do not give that information over the phone. And, they don’t take appointments for first time donors so I had to walk in and wait. For what it was it was not too bad. First someone checked my veins, which are fine. Then I had to fill out a bunch of paperwork. Then, I watched a video on plasma donation and read through a manual for first time donors.

Then, a woman, I don’t know her title, took me to an office to go over my paperwork. She got to the medications and asked what each was for and looked them up in a huge book. I take 7 medications for various conditions. After she goes through the medications she goes over them with me.

Most were fine. I take antidepressants but as long as anxiety and depression are under control it is fine. But, I take metformin for diabetes. She said that is a temporary deferral. If I was off it for a year I could come back. I don’t know what the likelihood of me maintaining my diabetes by diet alone is, my husband is able to, so possibly. Then she got to abilify which is an antipsychotic although it is sometimes used along with an antidepressant for depression. But, I told her I take it for schizoaffective disorder. That is a permanent deferral.

Bone marrow donation has the same policy. It is not the safety of the product. They consider me a safety hazard. I have been stable for 15 years but still people are afraid of me because of a diagnosis. They should have a sign out front: schizophrenics need not apply. So, I would not have had to waste my time.

The Keto Roller Coaster

Image of roller coaster

I have been on a ketogenic diet for about 5 months to help treat type 2 diabetes. I was taking 2 medications. Metformin and Januvia. I am monitored through a program called Virta. I have a coach and a physician through Virta, it is all done virtually. There is also an online community for people on the program. It is covered by my insurance.

At the beginning of this month I had labs that my endocrinologist had ordered. The results were really good. A1C of 4.8 and fasting glucose 98. Everything else was normal, too. For some reason my endocrinologist office cancelled my appointment so I had to reschedule for August. The Virta dr said that I could try going off Januvia since my labs are so good.

So, I go off Januvia and everything goes screwy. I get ravenous at night and have to eat after dinner. I had been slowly losing, now I am gaining weight. My fasting glucose is higher than before I started keto. I test my ketones and they are low. I chatted with people in the community and they tell me to stick it out, that my body will adapt. I am not so sure. I put in a message to the Virta dr to ask for his opinion but I won’t hear until at least Monday. I did not even know if the Januvia was doing anything but I now notice a difference without it.

I rarely talk about work, but here I go. My opinions do not represent my employer.

I work in peer support in a 20 bed mental health crisis stabilization unit (CSU). I have worked in peer support at an activity center for people with mental health issues and in a residential program. The people we see are much more symptomatic than I had worked with in the past. I am available to talk and offer groups but I don’t get much interaction because people want to sleep, are too symptomatic, want to be left alone etc.

It is a new facility and peer support is a new position for my employer. I have been there about 5 months and still have not found my footing. My boss is aware of the issues of people not wanting to interact and told me to keep being available and offering groups. She is going to give me some additional duties once they are approved.

It also can be anxiety provoking when patients are loud or aggressive. I am not involved with dealing with those situations but I feel tense. I help out where I can. I like the place and what we do.

Medical ketosis for psychiatric illness

Image of highlighted brain

I have been on a ketogenic diet to treat type 2 diabetes, through a company called Virta for about 3 months. I have lost about 1 lb/week, my fasting glucose has dropped 20 pts, and I feel good.

My friend was pushing me to try the diet and now he has been pressuring me to find out information on medical ketosis for psychiatry. He says it has greatly helped his depression. My provider from Virta agreed to talk with my psychiatrist about how a keto diet can affect mental health. But, I started wondering what am I doing. I have schizoaffective disorder controlled with medication and also take medication and use coping skills for anxiety. I don’t know that I want to change anything.

My therapist coached me on how to tell my friend thanks, but I feel pressured. I am not great at setting boundaries. I took her advice and he was cool. He said it is not his business what I decide to do and he is just making suggestions.

Then, I read a post on Reddit where someone is working with a dietician from the Charlie Foundation on a keto diet for schizophrenia. They work on keto for epilepsy in children and have expanded. I emailed and they gave me info on a dietician and I made an appointment for a zoom call on Wed.

The diet I am on now is 30 g total carbs, 13 oz protein containing food and fat to satiate. I am sure the dietician will have something more precise with macro g or percentages. Right now I weigh some but estimate amounts, where I will be measuring more.

My therapist gives me homework. The last thing she gave me was to give examples on where I could be more assertive, like with my friend. And to think of things I am grateful for and proud of. I am grateful for many things. The people in my life, especially my husband and even my pushy friend. My car, dog, food, home… i could go on, but proud of had me stumped.

I work and take care of my family but there is nothing I can identify as I am really proud about. I thought some more. I am proud I have been alcohol free for 6 months and have a plan for moderation. I am proud I have been able to stick with keto 3 months and with the results.

Weight: you gain some, you lose some

 

weight gain and psych meds seem to go hand in hand.  I gained 25 lbs when I started depakote.  I did an Atkins diet and lost the weight but I did not find that sustainable for me.  Zyprexa, I gained 5 lbs typing the  name, works really well at controlling mania for me, but I got fat and I did not care. Until someone asked, seriously, when was I due.

at my highest I was 198 lbs.  i tried calorie counting with my fitness pal.  It is a huge database of foods and their nutritional value. You type in what you ate and it calculates calories and nutrients,  you enter info about yourself and how much you want to lose and it tells you how many calories to eat.  There is a forum community that you can ask questions.  I lost 15 lbs, but stopped.

now, i am back. It adds the calories i burn from my fitbit steps, so i don’t feel too deprived.  I am basically eating the same foods, just smaller portions.  The badge above counts from when i started at 198 lbs.

I am not sure why the meds cause weight gain. I know I get hungry and really tired. I don’t know if they affect metabolism, too.

i have sleep apnea. I wear a specially made mouthguard and a belt that keeps me sleeping on my side. Not terrible fashionable, but I can sleep better. When I did not have it I was always tired. Now, i am able to work a few hours and walk my dog.

Weight loss is not easy, especially on these medications. I went from obese to overweight. My goal is a normal bmi.