When is enough loss enough?

(Carolyn aka stokies) #1

CW: weight loss, dysmorphic thinking, risks of disordered eating

First things first… I am a huge fan of this way of life - and I am one who also combines it with fasting. As a therapist, I have noticed a trend in a lot of OTHER forums and groups about this WOE where there is a lot of self-loathing and anger when we slip or over-indulge. I have posted about this before and still advocate self-compassion. And I can appreciate the struggle to break free from lifelong harmful thought patterns that this WOE helps us heal…

What I am noticing is a trend of some people losing to the point of not looking well. I know this is not the norm and we all have our own visions of personal goals. What I worry about are the few who may feel that a perfect size or number on the scale is of primary importance. At what cost? Body fat is not inherently evil and is necessary for functioning especially with female biology.

I know I am hugely biased and am operating from a perspective of aiming for health with a big middle finger to anyone who presumes to judge by appearances, and acutely aware of the reverse irony here. I just worry for anyone who is focused on a potentially unhealthy measure based on an outside expectation or ideas of standards for beauty…

Pardon the random ranting. Just the nurturer in me wants to honor and recognize anyone who might be struggling with these things and remind us all that even though we are not at goals (most of us), we are still all worthy of loving ourselves today. Don’t hold out for happiness tomorrow. You are on the journey and every day deserves you fully present in it <3

#2

Personally I think anyone who doesn’t address the biggest issues that come from toxic diet culture, then any diet will fail for them, even Keto. While some come to Keto because their health leaves them with little other alternative (T2Ds, etc.), I know many come to it just to lose weight. And that’s not invalid. Probably every single one of them has been shamed at some point in their lives for being overweight, and society has taught us that weight needs to be lost as quickly as possible. Lose 20lbs in one week, it says, or you’re a failure.

So many want to get to that image they have of themself, and if it doesn’t happen in a month, then obviously they’ve done something wrong. Our society loves skinny people, skinny people are afforded a privilege over fat people, so naturally everyone wants to be skinny, and do whatever it takes to achieve it. And that won’t change until it’s widely accepted that skinny =/= healthy; how many skinny people are actually SOFI, how many have lost muscle mass to get to that point? This is especially true for girls and women, whom men want to keep small and thin.

One thing I appreciate about this forum (as opposed to the Keto FB ones lol) is that the veterans here stress to newbies that this isn’t a weight-loss diet, it’s a metabolic-correction diet, and that weight-loss is simply a side effect of that. Because goodness knows we’ve always been taught that we need to lose weight to get healthy, but so few people know that the cause and effect are actually the opposite: you have to get healthy before you can lose weight.

Changing diets and getting healthier shouldn’t be as toxic as it is, but Keto’s not responsible for the broader problem of fat-shaming, body-shaming, and sexism.

(Carolyn aka stokies) #3

I so agree that it is a toxic culture that does its best to brow beat the rest of us into conformity…

AND as to why this forum is so amazing <3

Thank you for the thoughtful reply!

#4

I share your concern, particularly now keto is being heavily promoted for weight loss in women’s magazines, ignoring the metabolic shifts it creates. Thus opening an eating disorder can-of- worms in the making. Awhile ago I suggested a separate section for weight loss because of these concerns, but the suggestion got shot down.

I think it is perhaps helpful to have the involvement of an exercise physiologist or keto informed dietitian for anyone doing keto simply for weight loss because they usually would have no tracking doctor in that case and no blood tests tracking if things are going awry.

I am keto for metabolic health and I do have a dietitian, an endocrinologist and a GP who tracks… and I do follow advice.
Dietitian’s advice this week was 10 kilos is enough to lose for now; you mostly eat very little carbohydrate, focus on consolidation at this weight for now and muscle building and eat (x) grams of protein a day now. GPs advice is “You are now healthy”. Said as she almost fell off her chair with my last blood tests, all in totally normal ranges. Endocrinologist is ecstatic and hasn’t yet seen the last results becsaeu I only see her 6 monthly.

I make no pretence at personally having all the information one gains from a sports science degree, biochemistry or nutrition studies and I personally don’t advise anyone of anything much. If people are interested in keto, have a good reputation and I have access to them, I will consult and use their resources. I think that is the wisest way to go about it, to avoid problems developing.

Particularly for those in therapy, especially if there is any body dysmorphia (as there is showing up increasingly around here)… it would perhaps be helpful for the therapist to have their own keto medical referral network. Or to rely on their own supervision for guidance. Seems like a liability minefield otherwise.

Personally I have difficulty with the keto diet for weight loss in people who have no metabolic disorder. I am concerned there will be problems down the track for those people because they have no medical input and no background of testing BGL etc.

I don’t really understand why they don’t just use fasting, which doesn’t have the downside of cutting out a food category, carbs, which they have no metabolic need to avoid. So for “normies” weight loss, fasting and normal feasting in between makes more sense for weight loss without metabolic dysfunction needing addressing…but it isn’t trendy and doesn’t have a catchy name.

I realize I am out of step here with this attitude. I am fully committed but I don’t think there is one solution to eating healthily for everyone. And there are a lot of people who want to be “thin” rather than healthy.

(Doug) #5

A lot of people do get great benefit from fasting, without being keto. I think most of us got messed up by eating too much and too often, and fasting certainly takes things back the other way.

(squirrel-kissing paper tamer) #6

Wouldn’t this be like telling folks to eat crap food but just not all of the time. That fasting might counteract the damage they are doing to their bodies from the times they are allowing themselves to eat. Why isn’t just eating healthier options ALL of the time better advice?

I don’t think everyone striving to lose weight has an eating disorder or even body dysmorphia, really. It’s reasonable that some folks know they are overweight and want to address the issue BEFORE they become metabolically challenged or sick because they’ve seen their parents struggle with diabetes for example.

As someone with ED history I am keen to pick up on this type of behavior and like to remind folks to pay attention to NSV’s instead of solely focusing on weight for that reason. But I also see many folks making an honest attempt at getting healthy by losing some weight. Are expectations higher than reality for many, yes, but that’s where we come in, to help guide and encourage them.

#7

I don’t believe keto is the food solution for everyone, many people do fine on fruit and a balanced diet. Not me but I have a genetic propensity to diabetes. Many don’t have problems except they want to be thinner…they can eat grains just fine as far as I know, with no ill effects.

As far as I know, diets other than keto are not necessarily unhealthy at all for people with normal metabolic health. The people who cannot use carbs healthily are those with metabolic and brain problems not physiological and neurological “normies”.

I am not on a mission to wipe out rice eating in the world. Seems like some are and I don’t get it.

(squirrel-kissing paper tamer) #8

Matrika, you’re right. I shouldn’t have said “crap” food or assumed you meant junk food. Yes, some people can eat fruit and other foods and not have a problem. I think my response comes from my belief, like yours about varying diets, is that not everyone can fast. Maybe especially those with an ED.

#9

Thanks for clarifying PetaMarie. :blush::bouquet:
Personally I have never eaten crap food of any kind and was taken to eat a hamburger in my late forties by a friend who considered I was elitist in my dietary habbits ie I only ate organic and excellent food. That is still the case and I would not eat many of the foods my fellow forum members and keto-ers do because for me, they would contain too many chemicals and I avoid preservatives etc etc…that is not a keto requirement that is a personal choice. I would not presume to suggest to anyone else that my choices are the ones they might make.

I think eating disorders are very prevalent in the keto community (on the internet) amongst those wishing to control weight, particularly the very young.
It appears unfashionable to say so here on this forum.
However, I believe keto as a massive metabolic intervention needs to be tracked and supervised. Nothing says one can’t have a raging eating disorder with keto and it is highly likely to be enhanced because of the appetite suppression. Big tick and appealing for anorexia sufferers. Hence the need for informed support and blood tests etc.

I think people need to find their way with whatever is healthy for them but this ain’t the holy grail of food and dietary science we proles are dealing with here and it isn’t helpful to pretend it is.

It’s been very helpful for me. That’s why I am here.

Apologies if I stepped on any toes, it’s not my intention at all but I think this matters a lot and that is why I previously posted and suggested a separate weight loss section of this forum. Got shot down in no uncertain terms but that doesn’t mean I don’t still think there is a very important principle at stake. IE Do no harm.

(squirrel-kissing paper tamer) #10

You might be right about ED’s in the keto community but I imagine those looking to control weight are dipping their toes in any community that can meet that need for them. The good news is that many folks using keto for metabolic health DO have health professionals in their life even if they aren’t exactly recommending the lifestyle change.

#11

The original poster is a therapist and concerned that people are looking unhealthy with too much weight loss. Those with eating disorders are not necessarily presenting for blood tests and don’t have endocrinologists tracking as diabetics do…hence the problem I see with keto for straight weight loss. People who are not metabolically deranged do not have to use keto for weight loss is my point…there are many healthy options open to them.

And people with body dysmorphia are going to go way too far with keto and get there without an appetite…people pursuing weight loss are doing it mostly on their own.

Perhaps I am alarmist, I don’t know.

(Banting & Yudkin & Atkins & Eadeses & Cordain & Taubes & Volek & Naiman & Bikman ) #12

I dunno if I’m there or not. I’m struggling with whether 210 is goal or not. If it’s goal, it’s maintenance time. If it’s waypoint, then it’s time to get back to basics and keto harder.

As a protein focused ketonian, I’m not terribly worried about sarcopenia. The question I’m struggling with is whether where I am (56 lbs less than I was, roughly 20% body weight) is enough or do I want to do more and put in the work.

And that leads in to your topic. Am I dysmorphic? I don’t know. I’ve never been 46 before, I don’t know what it’s supposed to look like.

(Carl Keller) #13

I’m in this category. I came to lose weight but discovered so much more. Primarily, my chronic inflammation is gone and that’s worth my weight in gold to me. Trudging through life was misery before keto.

Fasting by itself might fix the excessive fat problem but eating low carb can heal and prevent the damage inside of us even if it falls short of a glorified metabolic disorder.

(Wendy) #14

I agree there are people out there who just want to be thin for its own sake. And I also agree there are other weightloss methods that work for some, but I do want to point out that fasting without carb reduction works for some, but many are too hungry because of the carbs, to be successful with this. I know keto works great for me at keeping my appetite down and as a healthy way for me to eat enough and get my nutrients and yet still lose weight.
I’m over 50 and was never horribly obese but I did lose over 70 pounds over a year. And insulin resistance I believe is very common in this culture and usually is not diagnosed until the pre-diabetes levels are hit or later.
Keto is a very healthy way to eat for most people with many long term benefits. This is why I still choose to eat this way even though I am happy with my current weight and do not really wish to lose more.

#15

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(You've tried everything else; why not try bacon?) #16

SO MUCH THIS!

Obesity is a symptom of metabolic disorder, however, whether these folks realize that or not. As for getting them to fast, my understanding is that it is hard to do when one is eating too much carbohydrate. Not to say they can’t get benefit from it, but it’s harder.

Interestingly, though, Georgia Ede seems to feel that a ketogenic diet can be a great help to someone with anorexia nervosa. My impression is that it comes partly from the benefits to brain function that β-hydroxybutyrate provides, but also the renewed satiety signaling.

My concern doesn’t rise to the level of an eating disorder, but is more in the nature of cultural conditioning. I often get the impression, from the way they post, that certain of the new women to the forums are so wedded to the number on the scale that they can’t let it go, to their detriment. In other words, I get the impression that if they gain muscle weight that prevents the scale number from changing, they won’t be happy, no matter how thin they get. Am I imagining things, or does anyone else get this impression, too?

(squirrel-kissing paper tamer) #17

Yes, that pesky scale obsession can really be a detriment. I encourage measuring and noting NSV’s. I think it goes into the same category as “fat is bad” and counting every calorie, etc. It’s conditioning and a hard habit to break.

I also think when you’re doing something new and you’re in uncharted territory it’s normal to want a way to measure progress. How else can they do it when they’re in the dark? I get it, but I wish it didn’t discourage so many people and sometimes make them quit before they even get started.

#18

I think this is a generalization that may not hold up if you drill into it.
20% of people do not get weight loss benefit from keto, according to DeLauer in his interview (I think it was him, its all a blur) on one of The Real Skinny on Fat interviews. He seems informed. I imagine but am not certain that they are the people who do not have any metabolic disorder ie no insulin resistance so dropping insulin is not helpful or healing for them…their insulin levels are normal to begin with, their metabolism is running at a healthy clip and they need other intervention. They are all over the forum querying why they do not lose weight on keto. It is because they do not have an underlying metabolic disorder that will ever be helped by keto. Some gain due to the increased fat intake advised. That will help an insulin resistant person it will be no help to one who is what I consider a “metabolic normie”.

I am tremendously envious of such people.

That is very good to know, thank you, I had not heard this and don’t know who Ede is.

You are not imagining things.I get this impression and it is a concern. Hence my request to have a weight loss section of the forum.

I do not think everyone not losing weight is building muscle. Some are just not losing weight. Without a DEXA scan, they will never know if that is because they are building muscle or just staying where they were…a totally possible outcome for a normal insulin level person.

(squirrel-kissing paper tamer) #19

Where did you get this percentage?

(Diana ) #20

Since it is late in the evening, and my brain is working rather slow, I need to go over this with you folks. If I understand correctly, KETO will only help a person lose weight if they have a metabolic disorder to begin with? Maybe a few pounds at first as they lose water from cells, but then…probably nothing, or even gain a few pounds?