Sorry, this is long.
I'm an older woman who has been fat since I could walk. My mother was very strict with my eating. Indeed, she put me on my first diet when I was two. Yet, I remained obese.
Fast-forward through dozens of diets, pills, shots, gyms, home exercise equipment. Fat, fat fat. Atkins, keto, WW, Southbeach. Always fat. Never overate. Maybe at Thanksgiving. Lost weight four times as an adult by starving and exercising like a maniac, then gained it back with bonus pounds. I never got below 195 pounds at 5'2". I would have been shorter if not for the human growth hormone from cadaver pituitary at nine.
Now my back and joints are breaking down in ways no surgery will help. I have to lose some weight. Swimming is the only aerobic exercise available that doesn't cause excruciating pain. I lift weights and do physical therapy exercises.
Twelve years ago I started eating one meal and a snack a day and s-l-o-w-l-y lost weight. "Maybe my metabolism won't go into starvation mode if it's slow," I thought. But it did go into starvation mode. My heartrate and body temp are quite low. Year by year, my daily meal had to be smaller or the weight would creep back. I dropped the snack.
After 12 years, I'm at 198 with 70 pounds off. I'm down to eating 500 calories a day. I used https://tdeecalculator.net/ to calculate what my energy needs should be—about 1600 calories with sedentary lifestyle. I should lose 10 pounds a month, but I lost one pound a month since January. And I'm on semaglutide, although miraculously not diabetic.
But this is not sustainable. Exercising more is not an option. I used to exercise when the pain was 5/10, but now that it's 7/10, it's too much. I also have exertional asthma.
I feel like I'm walking through a cave and the walls are getting narrower and narrower, closing in on me. The next step is a complete fast—nothing but water. I can't turn back to fatter.
This can't be normal. Maybe there have been scientific advances, now that medicine has realized there's money in fat. Maybe it's genetic. I've called Stanford, UCSF, UC Davis, and Sutter Health, but they're like mighty fortresses, and I'm a buzzing mosquito. Without an M.D. name or referral, there's little hope of getting in. I can't get past the receptionists. I leave messages for the Patient Advocate. No call back.
I'm a Kaiser member. All they have is bariatric surgery. My appetite isn't the problem. And they won't refer me out, even though I'm paying.
Can anyone in Reddit land give me the name of a competent obesity specialist who can do a workup to make some recommendations that might help? I prefer Northern California, but I can travel or do Telehealth.
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/u/Dr_ELO
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https://www.reddit.com/r/loseit/comments/13ni15h/i_seek_the_collective_wisdom/
