Weight Loss Case Study 1 by Sue Kira

Stubborn weight shifts with the right diet

by Sue Kira, Naturopath & Clinical Nutritionist

Client name and identifying information changed

Rowena who was 65yrs old, came to me at 110kg (242lbs), which was 30kgs (66lbs) over her preferred weight and she was quite unhealthy looking. For her height, I felt Rowena’s ideal weight should be around 60kgs (132lbs), but she would have been happy to be around 80kgs (176lbs).

When some people lose so much weight that they look different, they don’t always cope well emotionally with that. It’s also ironic when people lose weight and are healthier that well meaning friends question if they have a health condition and perhaps they need to ‘fatten up’.

Rowena’s blood tests showed quite a bit of inflammation, insulin resistance and elevated cholesterol. She was low on a few nutrients including vitamin B12, vitamin D and zinc. These three nutrients are needed for good thyroid function (our metabolism regulator) and for healthy hormones in general, which include insulin.

Rowena’s diet was a mixture of healthy and unhealthy. The healthy part was lunch most days at her local salad bar for a nice big healthy salad with some protein like chicken. I had been there myself, so I knew it was good quality, unlike some places that have salads that are not fresh and doused with loads of fattening dressings.

Rowena’s breakfasts were usually cereal which she thought was good because it was low calorie. But it didn’t satisfy her, so she would then snack on nuts and fruit till lunchtime. Dinner varied – sometimes pasta or rice with vegies, or maybe meat with salad or vegies.

Rowena had been overweight most of her life since puberty and had tried many diets along the way, but they were mostly the low-calorie style of eating.

Calorie counting diets do work for many people, but they are difficult to sustain and run the risk of increased insulin resistance, because many of the foods can still be sugar and starch filled carbs.

Now, not all carbs are bad. The carbs that come from cereals, grains, pastas, breads, cakes etc are a nightmare for anyone trying to lose weight. Then there are the good carbs in fruits and vegetables, especially vegetables, as some fruits are high in sugar.

Sugar is a big problem. Fat is not the enemy and neither is protein, but sugar causes insulin to spike, and as insulin is the fat storing hormone, too much causes insulin resistance.

I educated Rowena about the importance of watching the amount of sugar in her meals. Most people think of sugar as just straight white sugar and if they don’t add sugar into tea or coffee or recipes, then they think they are sugar free. Unfortunately, there’s sugar added to all sorts of products, which could be under the guise of high fructose corn or fruit sugars. And then there is a heap of sugar in some foods naturally, like the starchy carbs mentioned above in breads etc.

Keeping sugar low is the key ingredient (or should I say, non-ingredient) for successful weight loss.

There are of course other factors such as lack of movement, good gut bacteria and eating too much of any food which overloads the digestive system.

Rowena thought she wasn’t eating any sugar, but when we reviewed her diet, she was amazed with how much she was really consuming, but also very pleased to know how to tackle the situation. We talked about some different options to make her breakfasts more sustainable to cut back the snacks.

These included eating more protein such as eggs with salad or steamed greens, or some leftover meat, fish or chicken in a veggie soup. I also recommended salad or vegies with protein for lunch and dinner.

I shared that while it’s easy to eat the same thing each day, it was better for her to mix and vary her meals so she had a good balance of nutrients and didn’t get bored with her meals.

I suggested snack ideas such as small amounts of nuts, or carrot and cucumber rounds with hummus, liver pate or avocado dip. Also, to only eat one piece of fruit or a handful of berries if she needed something sweet. There were a few other treat ideas I shared for weight loss that have no sugar and still taste sweet (such as coconut berry jellies, or cacao vanilla squares etc) so she didn’t feel deprived.

I told Rowena to initially just do the diet without adding any extra exercise (she walked most evenings) until we could get her inflammation levels down, otherwise she might injure her body and then would not be able to exercise. After about six weeks on the diet, Rowena lost 6kgs and her inflammation markers had dropped back to the ‘normal range’ which was great progress.

Rowena was then called into work for extra night shifts and ate canteen food for three weeks. There was no further weight loss and she felt horrible, sick, and tired. Knowing how badly this affected her body, she elected to drop the night shifts and go back to her base level of four days a week during normal business hours. The extra pay was not worth what it did to her body.

With this self-loving act, Rowena got back on track. She continued to lose more weight over the next three months and when we checked her blood again, all looked very normal including her cholesterol level, which her doctor was very pleased about as he was considering medicating her. He told her to keep doing what she was doing as it was undoubtedly helping her body in many more ways than just looking better.

After a few months, Rowena started an exercise program with a local trainer who organised a nice gentle program for her, rather than a boot camp style which would not have suited her. Consequently, she started to feel fitter and more energetic and the training helped her to develop more muscle mass, which expedited further drops in her fat mass. By increasing muscle, Rowena’s metabolism increased which helped her to burn calories faster. Rowena measured her results so she could verify the changes in her body.

Over six months she lost 15kg (33lbs) which was quite significant. While she wanted to lose more weight, she had made great progress and because of the change in her ratio of muscle to fat, she looked much better.

Two years later I saw Rowena in the local shops, and hardly recognised her as her weight was down to 75kgs and she looked fantastic. This was a reduction of 35kg (77lbs) from her initial weight when she first visited me.

She was very proud of her achievement and I’m sure her body loved it. She thanked me for putting her on track with the diet that suited her best and for encouraging her to keep up with the weight training and mild cardio workouts.

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