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Fat Loss for Girlfriend


#1

I need some help...........

My girlfriend is 28 years old and clinically obese, she is 5'2" and 66kg.

Between the ages of 18 and 21 she suffered from anorexia.

I know of no other person who puts as much time, effort, energy and research into their training and diet yet the results her lifestyle 'should' lead to, appear to be unachievable for her.

My girlfriend eats healthily and sensibly, trains like an athlete, gets enough rest and sleep but is unable to shift the fat from around her waist. Her belly is completely out of proportion with her arms and legs.

She has visited GPs on a number of occasions but they have been unable to diagnose a problem or provide a solution. All of her blood tests suggest she is the epitome of health and the doctors cannot explain her inability to lose weight.

5 years ago, whilst living in South Africa, she was prescribed an ephedrine based drug which resulted in rapid weight loss and a loss of appetite but these drugs are obviously not safe or readily available anymore.

Earlier this year she was prescribed 'Orlistat', which is some kind of fat blocker, but 3 months of taking it again proved to be ineffective (presumably because she doesn't have a high fat diet).

She has been tested for Polycystic ovaries, under active thyroid and insulin production but all tests have come back clear.

She has researched and tested a number of theories including metabolic syndrome; weight loss set-points; insulin sensitivity; FODMAP; gluten/wheat free; paleo; Atkins but all were unsuccessful.

She has experimented with various diets and ways of eating:
Low carb - high protein
5:2 intermittent fasting (gained excessive weight)
Carb cycling
Bodybuilder diet - 6 small meals per day (typically chicken and broccoli based)
No alcohol
She has continually played with her protein, fat, carb ratios but with no success.

She has also experimented with her training:
HITT training - cardio and weight based
Heavy weight, low reps
Lighter weight, high reps
Body part splits
Full body training
Steady state cardio
Olympic lifts
Isolation/compound sessions
Circuit training
Plyometrics
Triathlon training
No weights
Just weights
Combinations of all the above

She currently trains 6 times per week for a minimum of 60 mins high intensity weight training- 8-12 reps, supersetting body parts with some additional treadmill hill sprints at the end of every other session. She works HARD, very hard.

She visited a Charles Poloquin trainer who took her '13 point fat measurements' and gave advice on training, nutrition and supplementation, none of which proved to be successful.

3 years ago she undertook the Jamie Eason "Live Fit" programme which enabled her to lose weight but it's simply not a sustainable lifestyle, even for someone as committed to training and nutrition as she is and as soon as she â??normalisedâ?? her diet and training (still careful and intense) the weight returned.

She has reached a point where she is afraid of food, she trains ridiculously hard but she sees no results. Her body consumes 95% of her thoughts and itâ??s gradually becoming more and more socially crippling.

Her training and calorie intake sometimes becomes so obsessive that she suffers from Amenorrhoea and her hair thins, we're both acutely aware of the health concerns surrounding over training and under eating but even at that level of commitment (obsessiveness) she sees no positive results.

My girlfriend trained as a fitness instructor in her spare time in the hope that she would learn how to deal with her issue but this has also been unsuccessful. Using her knowledge of fitness and nutrition she has been able to transform other people's physiques with great success but the same eating and training methods simply don't work on her own body. I myself am a serving police officer but Iâ??m also a qualified PT with a degree in Sport & Exercise Science and I too am at a loss.

I'm hoping that Mike Robertson may be able to offer some advice but any help would be very much appreciated.

Thanks


#2

What is her BF %? 145 lbs @ 5'2" for a woman who trains hard and arguably has more LBM than the average woman should be nowhere near clinically obese.


#3

People with a history of eating disorder unfortunately will always have a tricky relationship with diet and exercise. I also agree 145 is not "obese" on a 5'2" girl, even if she is not super muscled, wt is never a good measure of fitness.

What you are describing in the last bit--"Her training and calorie intake sometimes becomes so obsessive that she suffers from Amenorrhoea and her hair thins, we're both acutely aware of the health concerns surrounding over training and under eating but even at that level of commitment (obsessiveness) she sees no positive results."

Bluntly your girlfriend in the way you describe sounds like her need of a counselor FAR exceeds what a trainer, diet plan, drug, can handle. She has a history of a serious mental disorder--it is.Things won't fall into place for her psychique until she has a grip on the other aspects she is suffering with or trying to come to terms with. You might have the best of intentions but this sounds like a job for a therapist. Especially with her past of anorexia.

She sounds stressed out to me, really. Does she hate her job? Does she have family problems? Are finances tough? Does she feel she has no control over aspects of her life?....in my experience there is usually another thing--major life hurdle- clogging the works when what appears to be all things tried and failed.

I do also think 60 minutes of intense training is the wrong way to go. Diet is a gigantic part of who your body looks and performs, and for her diet has a lot of mental issues attached to it. Maybe finding a sport she can focus on results vs wt loss as well can help her shift the thought process of the end goal always being to look just so. Powerlifting, strongman both are good for that. Focus on strength and improvement, less on "body" as a look but "body" as a tool to help you achieve that cool new goal of a PR.


#4

^^^^^^^^^^^^^^^. This, excellent advice. I am throwing my 2 cents in here, not as an expert, but,as someone who is currently working with a woman recovering from anorexia. We have an informal boxing/ MT/BJJ gathering and she started training with us about 2 months ago. I do know from from working with her, it is not physical. Brute is correct, there are other issues going on. I know after about a month holding pads for this woman, she just casually mentioned she was raped at 11 years of age. Take Brute's advice and if possible, have her seek some type of counseling. From you post, she has already demonstrated a hard work ethic and a desire to succeed. Good Luck and Sir, you have my respect, it is not easy to stand by someone who is going through difficult issues over a long period of time. The majority of people are just too weak and selfish.


#5

based on my experience with my wife plus knowing several obese people, articles i have read, people with eating disorders or problems losing weight have an underlying mental problem
if you are not looking they will eat and not tell you or count the food they eat they will say they went to the gym when they dont,they will lie to them selves and others
read, covert bailey fit or fat,watch the documentery brookhaven institute


#6

Hi Blakey,

I suffer from anorexia, so from my experience and what I can guess from your description, it sounds to me that your girlfriend is probably too stressed and with high cortisol levels. Body/image concern is such a big pressure for us that everything related to training and eating causes a great deal of stress.

Your girlfriend is probably SO DAMN WORRIED about herself that her body holds onto fat. I won't use the word overtraining because I really don't know what she does or how she trains, but she probably is overconcerned... I remember that my leanest was during my holiday week, where I didn't have to go to work or attend to University... I slept fine, worked out without the schedule's pressure, and had plenty of time to cook for myself. Brute_fury's advice is pretty accurate.

Hope this helps!


#7

Thanks all for your input...this is said girlfriend replying to you...

Just to clarify, my boyfriend kindly posted this on the forum on my behalf, we wrote it together and he has by no means posted it as a cry for help behind my back because he can't handle his girlfriends mental issues. We share a passion for training and do so together as well as live and eat together so I can assure you, cavemansam, I am no 'secret eater', but thank you for your suggestions.

We are both trained and tenured fitness professionals and have exhausted all options as to why I am unable to shift a considerable amount of fatty tissue on my abdomen - hence giving this forum a try...anything is worth a shot!

Based on the first couple of responses, I can see how the point of the post could be misunderstood slightly, baring in mind none of you know me, know how I train nor have you seen how I look, you could think i'm bonkers and have a 'ill obsession' but it is nothing but determination to improve my body and the utter frustration of not being able to do so, after 8 years of hard work. Obsessions can be positive, you've all seen the ever popular social media caption that flows through out the fitness industry's Instagram posts '"Obsession is what the lazy call the dedicated". I admit, I do have a daily battle with should I eat this and am I eating too much but for any of you that actually understand Anorexia, you will realise that this is an aspect of the illness that never goes away even when you are happy, fit and healthy both mentally and physically.

The only post so far that rings true and that has made me stop and think about my current stresses and strains is from eressea...You might be right! But how do you fix this? We are off on holiday next week for 10 days...I'll keep you posted :slightly_smiling:


#8

Her training and calorie intake sometimes becomes so obsessive that she suffers from Amenorrhoea and her hair thins, we're both acutely aware of the health concerns surrounding over training and under eating but even at that level of commitment (obsessiveness) she sees no positive results.

the body does not understand what you are trying to do if calorie intake drops to low, physical activety increases,high levels of stress your body thinks famine survival situation
your body tries to hold onto fat , amenorrhoea[i hit google]
like other people said chill out relax take up a sport you enjoy


#9

If you had success with the Jamie Eason program, what about it was not sustainable? She doesn't give set calories and macros until Week 7, or Phase 2. It's pretty much getting people used to eating healthfully up to that point, I believe. And she doesn't introduce carb cycling until Week 9, or Phase 3.

Did you weigh 145 pounds when you started that program? Where did you set your goal weight? I'm guessing you put your goal at something like 105 or 110 pounds, just based off of your height of 5'2"? If so, that's the problem right there. If you did that, it could give you a baseline caloric intake of goal weight x 10. Then for a female, you'd add 200-500 calories.

Assuming you chose a goal weight that was maybe 30 pounds lower, that would cut your caloric intake really severely from where you are now. That's assuming that your health indicators and metabolic rate is all in good shape as seem to be the case if all your health information is still current.

Focusing away from the "NOTHING WORKS" idea here to what has worked in the past... Jamie Eason's program worked. Maybe you could do it again, but in a kinder, gentler way? Like set your ideal weight at 5-10 pounds below where you are? Take some baby steps. Keep your caloric intake closer to the "high range" particularly since you seem to be extremely active. It shouldn't be "unsustainable" if you do that, since all the caloric intake numbers are calculated off of your self-reported "Ideal Weight." Then if it works, see if you can do that again, but with the goal of loosing another 5?

You've mentioned that you have history of an eating disorder. Since you did the Jamie Eason plan and "it worked" until you "normalized your diet," what are you currently eating per day in terms of calories and macro break-down, or are you not keeping track now? How is what you are doing now different from the Jamie Eason plan? I apologize if that was already in your original post.

Have you ever had your basal metabolic rate measured? Ever done a Bodpod or other "reliable" measure of BF to see where you're at a more objective way?

edited.


#10

Thinking out loud here. Your post has had me thinking since you wrote it.

About training - I think Brute and eressea have it right here. If you're loosing your period, hair is thinning, and you're working like a dog day in and day out in the gym, I'd pull back from that. A LOT. It sounds like you've got some issues with hormone disruption, at the least, and the mental energy/ emotional toll it's taking to just be you probably has your cortisol levels all out of whack.

A lot of people get into a cycle of "Do more, eat less." As in, "Dammit! I'm gonna hit it hard, from both ends - Cut calories and train like crazy!" You can only take that so far before you're a wreck.

I'd pull back to a brisk 30 minute walk once or twice a day, and 3x/week go to the gym and do a full body weights workout of no more than about 45 min. Seriously. No intense intervals. No long cardio sessions. No sprinting. That's enough to maintain your muscle. Then I'd just focus on finding an eating plan that will work, maybe a kinder, gentler version of the Jamie Eason plan that you've done before. That's it. That should get you off the crazy train a bit and let your body get out of crisis mode.

Also, if you aren't familiar with it already, I'd recommend reading everything on the I Am Erin Brown blog. She's one of the Girl's Gone Strong writers, and I think you'd relate. Not a good replacement for therapy, but she really knows a few things about female fitness and body image. I like her a lot.

About the situation with hormone disruption in women who are pushing themselves too hard, Precision Nutrition Fitness and Menstrual Health. Also, Paleo Woman is a good source for female fitness/ health issues. You may already know this stuff, but I learned a lot from those.

As other people have said, if you're carrying a lot of muscle - depending on your bone structure - you may not be nearly as "obese" as you think. We've had some women here in the 5'2" to 5'3" range who looked really fit and strong in the 135-140 range. This stuff is so individual, depending on your genetics. That's one thing I really like about Erin Brown. I think she's good about focusing on fitness and performance, but not trying to make her body fit into something that it isn't genetically possible to do, or that requires gargantuan effort that takes far too much away from enjoying the rest of her life.

Best to you!
Puff


#11

My wife has had similar problems, although not to that extreme. 5'4'' and 170. She has talked about getting frustrated when she sees women lose 20 lbs from just cutting down on sugar or alcohol, when she doesn't drink nor eat sweets any more than once every two weeks (and even then in small proportions). She tried Intermittent Fasting with no success, and then she moved onto counting macros. She first put them pretty low, and then started ramping up the training a lot, which led to fatigue and moodiness. She didn't lose weight. Then she upped the calories, which allowed her to keep training frequently, but she started to gain weight. At that point she was doing 5/3/1 with going to barre twice a week, and then doing some extra random sessions in and out as her body could take it. (She's been lifting consistently for about 5 months, before that it was off and on).

The last three weeks she has started to see some really good body changes. She started adding finishers to her 5/3/1 session, like 5-10 minutes HIIT sort of things. Her weight on the scale barely changed after a couple weeks, but we tape measure once a week (Sunday morning, fasted), and she had lost an impressive amount around her belly button over those two weeks.

She started a new 5/3/1 cycle this week, so we tweaked it a little more, so now she is doing the basic lift of the day, some bench assistance work (her bench is proportionately her lowest lift), a fat loss complex, and then a short HIIT movement or Tabata at the end. Her weight is starting to go down, and we're expecting that her measurements will be even better by the end of the week. She handles the training load well, and we're going to reassess in a couple of weeks to make sure that her macros are right for the amount of intensity she's doing. She spends a little longer than an hour on average lifting most days. She could cut it shorter, but exercise time is a de-stressor for her, and spending about an hour exercising in total is what works for her to have a fairly therapeutic exercise session. So she spends about 40 min working on strength related lifts, then the last 25 minutes is related to complexes and HIIT. Before that it was 40 min strength, 20ish min hypertrophy, 10 min HIIT. Both have been working for her.

So, from our experience, here's what I recommend:
-If you're just looking at the scale, start tape measuring and keeping a log.
-Keep the cardio short, HIIT style. If you feel like you need to spend a bunch of time in the gym to feel accomplished (like my wife), focus on strength lifts, taking decent rest intervals before going all out in the last few minutes.
-Don't change anything (diet, exercises in a program) more than once a week, and ideally no more than once every two weeks. It's taken my wife months of tweaks here and there to start seeing real changes, but she's learned so much about her body by making tweaks and then giving her body enough time to show what it does with it; resultantly, we're feeling more and more confident that we're getting it right for her.


#12

have you read the article about metabolic damage by dr.jade teta?

https://www.T-Nation.com/diet-fat-loss/truth-about-metabolic-damage

he also has another good article about cortisol.

also 145lbs is not obese by a long shot (imo), good luck with your goals. :slightly_smiling:


#13

Hattusili - thank you for taking the time to post this, apologies it's taken so long to read and acknowledge it! So much of this resonates with me. It is things that I have tried historically BUT I shall be taking to a tape measure and making small tweaks with enough time to determine what's working and what's not before I give up and change something else.

Could you tell me a bit more about your wife's current nutrition?


#14

Thank you so much for sending that link! That article has just given me (girlfriend in question) so much hope!


#15

Sure, although, it's been kind of all over for the past month-ish (finals, Christmas, then a vacation). But before that it was a pretty normal macro split, I think around 255 carbs, 136 protein, 68 fat. Her total calories per day were 2178. And if memory serves, she upped her training frequency by that point as well.

Incidentally, a little bit after I posted that she started to stagnate. We figured that she was at the low end of maintenance level eating, and the stress leading up to the holidays probably made her keep some weight on. Since we just got back from vacation, she's planning on reducing total calories by 200-300, and see where she's at after a few weeks of that. It's easier to do a gradual decrease than a big deficit. Like the article on metabolic damage points out (more or less), you can always dip a little deeper into a deficit if you need to, but if you start to low, you have no where to go and risk metabolic damage.


#16

x2 on metabolic damage.

Look up Joe Donnely arguably the best stuff on building back up your metabolic rate and has lots very tough and effective women specific workouts


#17

Is it just your stomach area that is holding fat? I had a pregnancy that ripped apart my ab muscles, leaving a gap. As a result, my belly sometimes appears distended, bulging outward. It's not clear what triggers this, but it's definitely not fat. It's just oddly shaped. Is it fat or could it be the shape of your abs? I often feel fat when I look at my tummy, but it's not really fat despite its appearance. My sister also has something similar, despite being very thin everywhere else. People even ask her when she is due!


#18

Mightymouse - You likely have diastasis recti. I've talked about it quite a lot on this site before. If you search you will find several discussions about it.
Look for Postpartum Abs (Diastasis Recti).