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st3

Dr Darden
I?m training a 52 year old woman and we started her @ 1200 calories per day. She?s lost 19 pounds but has been stalled. I reduced to 1100 but no change. She?s in week 12 of her program but needs to drop a lot more. What do you suggest to get her moving again.
Thanks
Steve
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spud

I'm going to reply to this even though I'm not Dr Darden.

First off, do you know for sure that she's consistently eating 1150 to 1250 calories per day?

Here are some words from an article on another site that may help you:

A woman who needs to lose 85lbs tells me she's been working out a lot and eating 1300-1500 calories per day. But yet, she's not losing any weight! In fact, her clothes feel tighter! WTF?

She's considering eating more calories, with the assumption being her calories must be too low (that darn starvation mode strikes again!!!). She has also considered the possibility that, since "muscle weighs more than fat," maybe she's just building lots of muscle and it's hiding her fat loss results on the scale (her trainer actually told her this was the reason).

So I tell her this, because I've heard her story a million times before:

---
"When it comes to fat loss results, someone like you with 85lbs to lose should be seeing some degree of progress pretty much every single week. Your weight should be gradually and consistently decreasing at some realistic rate (0.5-2lbs per week, possibly even more at first). So if that?s not happening, and you haven?t lost a single pound in weeks/months, and your clothes actually seem to be getting tighter on you, then it appears that there isn't actually a deficit present. Simple as that.

How can that be if you?re eating and burning as many calories you say you are? Well, more than likely, you?re somehow miscalculating or underestimating your calorie intake (the most common cause), miscalculating or overestimating calories burned, or a bit of both."
---

This is typically the point in the conversation where the person gets mad at me for insulting their intelligence. Luckily, this woman didn't.

The next day, she responded with this:

---
"I wanted to tell you after considering what you said (and it was hard not to react defensively... in my head I?m saying I KNOW I've been sticking to my diet religiously and haven?t miscalculated) but after that initial reaction I started to examine even more closely after reading your guides and understanding a little better.

The Weight Watchers program uses points. The points equate to about 50 calories each. I get 26 points a day and earn extra points based on my exercise so I was (I thought) taking in from 1300 to 1550 calories a day (less than what I figure I need based on your maintenance calculator).

So in looking at the program all fruits and vegetables are free, meaning no points to encourage one to eat more fruits and veggies. So I have been eating large salads and at least three fruits every day that I don?t count for! That?s at least an extra 300 calories or more a day not being counted!

Plus I noticed I pour a little nonfat milk in my morning coffee. I never count that because it's just a dab but today I measured it and its about a qtr cup or another 22 calories.

Oh yeah, let?s not forget the frozen berries I add to my protein drink each morning... more free uncounted calories! Amazing!!!! I'm quitting Weight Watchers today to follow your plan. Will see if I can find a good calorie counting app and count everything."
---

Happy for her? Definitely. Surprised? Not even a little.

A few days later, she checks back in with an update...

---
"Hi there. Just wanted to touch base after my first week following your guide to thank you. After getting my calorie deficit accurate I dropped 2.6 lbs this week!

I know that won't seem like such a big deal to your readers but it's everything to me. I don?t need to adjust my thyroid meds and for the previous 6 weeks of killing myself 6 days a week at the gym and sticking to Weight Watchers I lost, if lucky a half pound and just couldn't figure it out... didn't know what was wrong and was soooo discouraged.

I have a long way to go (another 75) but now I know I can stick to it thanks to you helping me see how to actually get results! You are an angel. Thank you, thank you, thank you! Thank you for helping others cut through all the confusing crap!"
---

So what's the moral of this story? Besides the fact that I'm an angel? It's pretty simple...

If you're not losing any weight over a significant period of time, it's not because your calories are too low, or because you're in starvation mode, or because muscle weighs more than fat, or because of carbs, fat, meal frequency, meal timing, food choices or any other crazy voodoo bullshit.

It's because there is no deficit. Even if you think there is... there isn't. If there was, you'd be losing weight.


This is where it was from originally: facebook .com/AWorkoutRoutine/posts/638420499509582

The point is this: If you're just relying on her counting her own calories and simply telling you, then that's not enough.

I listened to one of the podcasts with Gary Knight (online HIT/fat loss coach) over at highintensitybusiness .com
and he gets his online clients to send him 2 things every day by email.

1. A screenshot from the MyFitnessPal calorie counting app taken at the end of the day after the client has eaten their last meal. The screenshot shows him their overall calorie intake for the day and the date.

2. A photo from the morning of that particular day showing the readout on their bathroom scales when the client was standing on them so that Gary can see what they weigh.

With these two simple metrics he holds them accountable and monitors progress, only getting more involved and delving deeper if he needs to i.e. weight loss stalls.

As this study shows fat people under report calorie intake and over report activity levels.

https://www.ncbi.nlm.nih.gov/.../pubmed/1454084

Only when you're sure that the intel you're getting is reliable and accurate can you move to the next stage, if in fact you need to.
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Average Al

st3 wrote:
Dr Darden
I?m training a 52 year old woman and we started her @ 1200 calories per day. She?s lost 19 pounds but has been stalled. I reduced to 1100 but no change. She?s in week 12 of her program but needs to drop a lot more. What do you suggest to get her moving again.
Thanks
Steve


I assume she is not a tiny women? If not, then I would agree with the other poster: compliance with her target calories would be the big concern.

There are online calculators which you could use to try to estimate her calorie needs based on size and activity levels.
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spud

I guess what I was trying to say with my long drawn out post above (hopefully of some use) was that you need her to count calories for EVERYTHING she eats a drinks for 7 days and report them accurately and honestly to you.

At that point you do some really simple math. What is average daily calorie intake based on those 7 days of data?

If it turns out to be 1900 per day, then BAM! you've got something to work with. Sh's actually 700 calories per day above where should be. At that point, you definitely don't need to spend time faffing about with online calculators.

In my experience, whilst estimating what someone's calorie intake should be can occasionally be useful, don't ever try to estimate calorie expenditure with an online calculator of any kind - it's a total crapshoot.

There is so much variability between people's bodily proportions, body composition, physical habits, how well practiced (thus energy efficient) they are at certain random movements/skills. You couldn't possibly take all of that, and more, into account.

Most calculators just have basic categories like sedentary, low activity, moderate activity, high activity.

What hell does any of that actually mean? It's really vague and unhelpful. Check out the study I linked to and you'll see that people grossly overestimate their activity level of activity/calorie expenditure as well as how many calories they consume.

You might find, if she's actually been eating 1700+ calories consistently that just dropping her down to 1400 (and sticking to it for long enough) actually gets things moving in the right direction. There might not be a need to go to 1200 or 1100 just yet.

With 1200 or less, I would assume that she is doing some kind of physique competition, is completely sedentary or is very small, or some combination of those things. Otherwise going that close to 1000 is probably not a good thing. I'm just thinking about long term sustainability here more than anything else. Whatever she's doing to lose weight - if she can't see herself sustaining it for the rest of her life, then.....I don't think I need to say any more.
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st3

Thank you for the responses

I just got her weekly check in and she?s down 3.

She?s been very honest from the start. I can only assume it was a hormonal time for her.

I had her make a few adjustments. Slight increase in protein seemed to help.

I have a personal training business and I get weekly tracking forms from ppl. I have a lot of clients and she was one of the few who had stalled.

Thanks again
Steve
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