New to LC, son (12) obese, insulin resistant + RSD

[jenniferpa]

I'm new here and I guess I'm just searching for moral support. I'm 35lbs above my "happy" weight (5" 5' 165lbs). 25lbs of this I gained over the last 6 months due to a number of factors - I had a total hysterectomy last year and I can't take hormones because I had breast cancer a couple of years ago - because I can't take hormones I was put on effexor for hot flashes but ended up over medicated (which causes, among other things poor sleep - I eat, and tremendous cravings for sweet stuff). Not only that in February my son was in a car accident and ended up with Reflex Sympathetic Dystrophy (RSD) and couldn't walk for about 4 months, so he was home and suprise suprise, I ate. Even worse is that during those 4 months he put on 40 lbs (he's only 12, 5" 2" and now weighs 200 lbs). Then he was diagnosed with insulin resistance and he's currently undergoing testing for Cushing's syndrome. So I'm doing the LC thing to get his insulin levels under control, and lower both our weight. He has been on a dietician designed Low Calorie Diabetic diet for 3 months and has lost a total of ZERO lbs on it, although to be fair he has grown vertically an inch during that time. When the endo said he'd have to cut down to 1400 cal/day (from 1800) I decided we needed a different approach, so her we are. We started this week and he's lost 6lbs, and I've lost 2 so so far so good.


I have the book carbohydrate addicted kids, and I'm using that (more or less) but the Hellers feel you should not have anything with artificial sweetners in it and this is hard. What do you people think? Its hard enough being a 194lb 12 yo on a diet, without even being able to have an occasional glass of diet soda.

Jay (and Corin)

[doreen T]

Well, I looked and couldn't find anything relating specifically to Cushing's/hyperadrenalism and diet. However, it would make sense that any diet program would address the symptoms. That being said, the diagnosis hasn't been made yet.

Hyperadrenalism, as I'm sure you know from your research, can result from a benign tumour of the adrenals or pituitary gland .. or also from prolonged therapy with cortisone and steroid drug therapy. The metabolic concerns in particular are high blood sugars, hyperinsulinism, and elevated cholesterol and triglyceride levels ... among other things. It's worth noting that 20% of untreated persons go on to develop diabetes ... which means conversely that 80% do NOT.

Your son would do better to follow a lowcarb program that keeps his blood sugar and insulin levels lower and stable throughout the day. Carb Addicts addresses the cravings side of things by allowing one Reward meal consumed within one hour .. and thus the insulin spike is controlled and cravings subdued. This case is different, and that insulin spike is not desirable. Protein Power (PP) and Dr. Bernstein's Diabetes Solution (Dr. B) are two excellent programs you should consider. For an adolescent, the carb intake would be higher than for adults. Also increased protein and calorie requirement. 1400 calories a day is nowhere near enough to meet his needs while he's actively growing. What is wrong with these people??? They only see obese, and nothing more ... :mad: .. (note, Dr. B's book/program is excellent for keeping blood sugar levels stable and preventing complications of high sugars .. and is not just for diabetics)

From the Protein Power's website FAQ's .. http://eatprotein.com/answers.html .. Is this program safe for a 12-year-old child?

Yes, with some modifications. And with qualifications, depending on whether the child is of normal weight and looking for a healthy diet or overweight and needing to make a correction. An excessively over weight adolescent or teen should be evaluated by an endocrine specialist to be certain there aren’t any hormonal disturbances or even benign pituitary gland tumors contributing to the weight problem. If there are no contributing problems, the child could begin a modified Phase II program, deriving calories from lean protein, good-quality fat, and about 60-100 grams of carbohydrate per day, mainly from low-starch vegetables and fruit.

Additional calories, if necessary, should come from protein and fat, not carbohydrate. Growing children (and interestingly enough, the elderly) need more protein per pound of lean body weight than adults. Calculate their protein need based on activity and rate their activity level as one activity category higher than their actual level of exercise. Normal weight children need extra protein and good fat, but can tolerate in the neighborhood of 120-150 grams of carbohydrate daily. It should come mainly from low-starch vegetables and fruits, but a modest amount of starch is acceptable. We would still recommend that you limit or avoid sugar in all its forms.There are also answers to questions about artificial sweetener use, adequate protein intake, and the importance of spreading carbs and protein evenly throughout the day.


From Dr. Bernstein's website .. http://www.diabetes-normalsugars.com/ .. The obese tend to be insulin-resistant as a group, a condition that's not only hereditary but also directly related to the ratio of visceral fat to lean body mass (muscle). The higher this ratio, the more insulin-resistant a person will be. Whether or not an obese individual is diabetic, his weight, intake of carbohydrates, and insulin resistance all tend to make him produce considerably more insulin than a slender person of similar age and height (see Figure 1-3). Many athletes, because of their low fat mass and high percentage of muscle, tend as a group to require and make low levels of insulin. An obese Type II diabetic like Jim, on the other hand, typically makes two to three times as much insulin as the slender nondiabetic. In Jim's case, from many years of having to overcompensate, his pancreas has partially burned out, and despite the huge output of insulin, he no longer can keep his blood sugars within normal ranges. (In my medical practice, a number of patients come to me for treatment of their obesity, not diabetes. However, on examination, most of these very obese "nondiabetics" have slight elevations of their test for average blood sugar.)There is a great deal of well-researched information on insulin resistance and the importance of tight blood sugar control in his book. I highly recommend a trip to the nearest library or bookstore to get your hands on a copy . ;)

On the subject of artificial sweeteners, Dr. B. suggests occasional use of diet sodas or diet Jello .. make sure they are indeed ZERO carbs (use an accurate food counts resource, such as Corrine Netzer's "Complete Book of Food Counts") or our very own handy-dandy Carb Counter - just click on Tools on the red menu bar at the top of the page. Labels sometimes lie. Beware especially of the polyol/sugar alcohols such as sorbitol, maltitol, glycerine used in "sugar-free" candies and chocolate bars. These can cause spikes in blood sugar and insulin despite manufacturer's claims to the contrary. Check out the articles Sweetener Information and also Sugar Alcohols, by clicking on Tips on the red menu bar.

Hope all works out well for the both of you, and continued lowcarbing success .. :)

Doreen

[jenniferpa]

Thank you so much Doreen.



I went out and purchased Protein Power and am currently reading it, but I had no success locating Dr Bernsteins book at my local Borders so I'll order that via Amazon.



While grateful for the Carbo addicted kid book, which I actually picked up at a book sale before this all came up, and which first made me aware of what Corin's problem might be, since actually finding out his fasting insulin levels were 33 uu/ml I've had a sneaking suspicion that the Jump Start program (1 reward meal a day) might not be the best way for either of us to go. It seems to trigger more evening cravings. After doing further research I decided that a more overall low carb approach would be a better way to go. In fact, since Saturday, which is when I decided to let him decide when and what he wanted to eat, within the low carb format he has not asked for anything sweet, or complained that he feels hungry (in fact he missed lunch yesterday, which is unheard of). Further he seems more even tempered, and I know I am.



The best thing about this diet that I've found (apart from steadily losing weight) is that I find that unlike the low fat, high carb type diets, I feel satisfied but not stuffed, rather than stuffed but not satisfied. Not only that I feel more energetic and more cheerful, plus (and this may be coincidental) I have not had a hot flash recently.



Emotionally, I still have a problem accepting that all those things I have always regarded as "bad" (cream, butter, etc) can actually help me lose weight, and I guess it will be some time before I can step on the scales without the fear that my "sins" will catch up with me. Sadly, this state of mind has communicated itself to Corin (are you sure I can have this?) but hopefully it is less ingrained in him.



I have spent the last six months fighting the medical establishment in order to get a diagnosis and thus treatment for him. Thank God for my neurologist and my pain management doctor who actually got him back on his feet (he was essentially bed ridden for three months), and my psychiatrist who confirmed that it wasn't "all in his head", and that doctors in general are not very good at admitting they don't know what's wrong. I'm also reasonably happy with my endo (except for the low calorie diet thing) who was willing to check him for Cushings, just because I want it done, even though she says it isn't. I have spent the last 6 months in the unenviable position of wanting to find something physically wrong with him so that he can get treatment. However, at least with the insulin resistance diagnosis I have, in my own mind, determined what is wrong, even if doctors tend to hum and haw about it.



This has been my first experience with "weightism", and I would prefer it is his last. What has irritated me most is the assumption, stated or otherwise, that any child who is overweight must be either overfed or lazy, neither of which in our case is true. I can only be grateful that the rest of the family do not suffer in the same way as he does, so at least I have some evidence that its not to do with poor eating habits (I've taken to carrying around photos to prove this!). Actually if it wasn't so painful it would be funny - I saw in a magazine a list on 10 things to do to lose 10lbs and I and my family have been doing these things for as long as I can remember e.g. use skim instead of full fat milk, use sweetener instead of sugar etc. I have to say I think its pretty sad when and 11 y o wants a treadmill for Christmas (he got it, and uses it, but he's actually gained about 50lbs since then).



Oh well, I'm sorry this has been so long - I just wanted to get this off my chest. Again, I really appreciate you taking the time to do this research for us - I'm off to check out the diabetic web site.



Many thanks



Jay