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Originally Posted by broops100
My daughters body isnt coping to well on Metformin, so we are in the process of trying to get on some other medication.
She has struggled sticking with a low carb diet. Because of this she has become down in the tooth & got her self stuck in a vicious circle, because she indulges (albeit modestly) in the wrong foods (breads her favourite) & then gets exhausted & more black and gains weight... She then feels crap & starts the hole process again ....
She is seeing a counsellor who believes her problems are down to the metformin not doing its job (gives her bad diarreah). Therefore she gets down & very tired. The Professor at the Hospital thinks its down to her being depressed / emotional. This may well be the case, but get the medication right then she can move forward hopefully ....
Everything in the medical profession moves, so slowly & can get very frustrating....
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OK. This is my opinion you can ignore if you like. As her eating is apparently a bit freeform I assume she's a teen not a child (as you'd control a child's eating much more). I also have a teen with weight issues though not medicated (she is losing weight on LC, albeit slowly). I don't know your history so forgive me if any of this is assumptive. But:
This whole "she is psychologically messed up and she's depressed and that's why she eats crappy and/or feels crappy" is CRAP.
Psychological state is an emergent property of physiology. Of course she's depressed! We'd be depressed too! She's got some reasons situational and biochemical and nutritional to BE depressed. (And she's a teen, LOL.) But aside from basic teen hormones, those are
side effects OF, not causes of, the eating issues.
Now. Why does she have problems staying on lowcarb? You mention breads.
1. I assume that when she is at home she eats nothing but lowcarb, and totally free of trigger-foods such as grains and milk and pure fructose (eg fructose fruit jams or sugary fruits), because you have made the effort to make sure your house doesn't HAVE anything but lowcarb so those foods are her only option. If there are other people that want to eat otherwise, you can learn to cook LC that includes stuff they like, and/or they can eat those things outside the house to support her efforts. You do not leave cocaine sitting on the counter for addicts no matter how fun it is for other people in the house without an official addiction problem. She'll have enough issues with life outside the home without sabotaging her inside it. Aside from the irrational religion pushed on the medical field by the unholy union of corporate marketing interests and government, there is NO good reason why any grainfood should ever be available to her in the home particularly since you already know this is a real problem for her. If there is some reason (which I'd have a hard time understanding) why you or others in the house have to eat something like that, it shouldn't be brought in until the meal and they should eat all of it, so it's not sitting around for her. You mentioned "chronic fatigue". Whether you mean that generically or officially, that's just another red flag that grains need to get out of her diet, as such an incredible number of people find these two things correlated.
2. I assume that she has unlimited access always to meat, a decent protein powder* (for protein/aminos with low calories), and to a lesser but still important degree, to something like hard cheeses, and for any veggies she might like that are LC and not 'too' buried in dressings (and only LCish dressings), right. She is growing, she MUST have access to all the protein/amino-acids in particular that her body demands she eat, or she will just eat-eat-eat because the body will DRIVE her to eat, attempting to get by spectrum/quantity the nutrients it needs, and the body tends to be naturally driven to high-energy foods which means carbs. This is a fundamental drive you cannot stop, you understand -- no amount of waxing philosophic about shoulds or lecturing about eating ethics or medically advising about calories means jack in the real world where the body WILL be driven to eat until it gets the nutrients it needs, and this is a very high need for kids/teens.
* by Protein Powder I mean something whey-based. Not soy or caseine for sure. Not insta-drinks but powder you mix with something like half&half or cream. My kid loves 'whey gourmet' brand 'creamy milk chocolate' flavor; it's a treat for her and when she really has the noshing late night she sometimes makes herself a glass of the stuff. I don't mind -- it's got plenty of protein, aminos, the h&h supplies some calories and fats that she needs (esp as she eats mostly meat/veggies with me so her calories are naturally low), she likes the taste and it's something quick and easy and that she can do for herself just because she feels like it.
3. Some people with weight and eating issues have food intolerance issues. Now, you may not be able to afford to get her a gluten/dairy screen at enterolab.com (a few hundred bucks) but if you can, please do. This is a stool test done through the mail that is a great deal more accurate than most modern medical tests and it can point out if she's got actual physical reactive markers to basic foods (the tests vary). This is important because internal inflammation drives obesity and related problem conditions and she definitely should not be eating any foods that her body is reacting to.
4. Most kids/teens are carb/sugar/grain addicts, because culturally we raised them that way before we knew better. This affects neurology (the brain) you understand, it's not just a whim of their eating, this is serious physical stuff. It is important that you make sure she understands-- and that you support this in every way you can-- that she's got to stay AWAY not just from official carbs but grains/fructose/lactose too, as those are likely to trigger the desire for carbs; and that she have ENOUGH protein/fat, as this will give her more nutrition, more energy, and make her fuller and less driven to eat for any residual hunger reasons.
5. Definitely make her part of your own research, talk with her about what you learn; and make her cook with you, making LC stuff, so she is totally comfortable (not just knowledgeable) in how to do this, and has the widest possible range of LC foods that she likes (given that teens are notoriously finicky about anything nonpoisonous LOL). Give her the freedom to plan her food life within reason concurrent with the family's, and give her the freedom to make/cook stuff for herself if she is hungry as long as it falls into the nutrients-not-carbs category and it isn't right before a meal. (It is a serious problem that some medical approaches try to starve kids in the name of reducing calories in the name of reducing bodyfat, when kids *are growing* and have *huge* nutrient needs during this stage including for fat.) Most kids are pretty smart if you let them be part of it.
6. Make sure she is taking some supplements for the nutrition that probably nobody in our culture gets and that as a growing human she will need even more than adults, and deficiency in which may contribute to eating issues. A good multivitamin; making sure that all vitamins are well represented in supplements if they are not in her diet (A [limit 10k daily], B [full spectrum complex and extra of this is ok], C [as much as she can take without the runs], D3 [unless you guys are mostly naked and live in argentina, at least a couple thousand iu daily], E [via mixed tocopherols], K (K2 mostly), as well as calcium, magnesium, potassium at decent intake levels [iron takes care of itself in red meat], some kind of Omega 3, and a supplement that is 'all amino acids' would not hurt either since that's one of the primary building blocks of life (they make capsules like that). I understand all these cost money. Liquid vitamins (keep refrigerated) are often better quality/absorption it seems. The NOW brand of vitamins (netrition.com has these. If you get em locally be sure E, D3, Omega 3, and the multi are refrigerated wherever you find them or don't buy them there) is pretty good stuff and a lot more affordable than most stuff, I've found.
7. I'm not clear on where/how she is getting the food that is offplan. Do you mean like at school lunch? If so, make sure to work with her on what she could be taking for lunch that she will have plenty of food, and be full, and like what she's eating, so she is definitely not buying lunch, and talk with her about the issues with milk (lactose=sugar=trigger) (a diet soda or two with the lunch would be way better than that). I assume you know that there are big thermoses now that are really great, nothing like the kind we grew up with, hold a ton of stuff in internal-containers including liquidy and warm stuff, you're not limited to a paper bag or tiny tin box when it comes to how lunch can be done :-) so a variety of foods she likes can be in there, including the occasional lowcarb treat if it would make her feel less 'deprived' compared to her friends eating chips and ice cream (sigh).
8. You mentioned she was on Atkins. I don't want to mess with that -- I believe in doing diets well, whatever they are -- but I'd just like to suggest that she could probably have up to 35 carbs a day (not just 20) with no harm as long as they are not grain/fructose based. Unless this is just a temporary induction in which case, definitely as few as possible is the way to go -- but that IS temporary and on Atkins will increase as the food choices increase.
Best,
PJ
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