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[IP] Weight control -- what my mama never told me (long)

Hello all.

Please note that _all_ of the following is YMMV.

I've been a Type 1 for over 30 years and I've been using a pump for
over 3 years. I'm short -- 5' 4 1/2" -- and have a small frame -- I
currently weigh about 128 lbs. It's been easy to stay short, but it's
been a real struggle to stay slim.

Both my parents have had weight problems. I, OTOH, decided early on
that I would _not_ succumb, no matter how strong the temptation. I
hoped that my small frame would somehow protect me, but I've found
that size, or the lack thereof, is of no help. I also thought that my
adherence to an exchange diet would somehow protect me, but I was
wrong again.

Thirty years ago, when I attended the Joslin Clinic, my weight was 110
lbs. At discharge, I was placed on a 2400 cal/day diet. Over the two
decades that followed, my weight climbed 10 lbs. and I gradually cut
back on the size of my meals to compensate. At one point, I finally
cut out lunch. As time marched on, even that wasn't enough. My weight
has recently ranged as high as 140 lbs. on a diet that averaged less
than 1500 cal/day. I've been able to lose 11 lbs. by sticking to a
diet that averages less than 1200 cal/day.

Here's what I eat on the days I eat (in exchanges):

1. small breakfast: 1 med. fruit, 1 bread, 2 meat, coffee

2. no lunch, but 4 - 100 g containers of no-fat/very-low-sugar
   fruit yogurt spaced throughout the day

3. decent dinner: 2 vegetables, 1 bread, 1 med. fruit, 4 meat,
   3 fat

4. snacks sufficient to regulate bg (treat/avoid hypos)

Three days per week, I'm on "yogurt rations":

1. 6 - 100 g containers of no-fat/very-low-sugar fruit yogurt
   spaced throughout the day

2. snacks sufficient to regulate bg (treat/avoid hypos)

Following this regimen, I can lose 1/2 lb per week _max_. It's
agonizingly slow.

Throughout this process, I've made some observations, all of which
apply strictly to me (YMMV):

1. My caloric need has just about halved over the last 30 years.

2. My caloric need is far lower that what is typically predicted:
   ... predicts 2000 cal/day

3. I can't afford to eat lunch, even a small one. AFAIC, three-
   meals-per-day means more-weight-per-day.

4. I can't afford to bolus for snacks... ever. OK, I allow myself
   one "treat" per month. If I exercise heavily (50 mile bike ride, 10
   mile walk), I get no snack allowance. I reduce the basal, eat a
   small snack to cover the higher basal already administered, and go.
   I eat no snacks during the activity (and no meals, either) except
   what's required to control bg.

5. Once I reach my weight goal (123 lbs.), I estimate I'll be able
   to eat one additional day per week, but I'll never again be able to
   eat two meals per day seven days per week.

6. The pump both facilitates and impedes weight loss. If my basal
   requirement stays stable, I can "dial" a bg of 125-150 mg/dl, which
   enables me to go through the day without feeling hungry -- a
   definite advantage compared to a non-diabetic. OTOH, if my basal
   requirement drops or I underestimate my caloric needs for the
   activity under way, I'll need to consume calories that wouldn't be
   necessary for a non-diabetic. Overall, I think it works out about

7. One pound of fat is a helluva lot of calories -- about 4000 --
   or enough to keep me going for almost 4 days. My weight loss of 11
   lbs., then, would be enough calories to sustain me for over a
   month. IOW, I need to cut out a *lot* of food to lose one pound of

8. Ten pounds of extra weight increased my waistline by over 2
   inches. By taking off that weight, I avoided replacing the bottom
   half of my wardrobe. ;-)

My body is certainly atypical. Nevertheless, I wonder:

a. Why are we led to believe that we "need" three meals per day? I
   certainly don't now, though I needed at least that as a teenager.

b. Why are we led to believe that we "need" to eat every day? I
   certainly can't and maintain my ideal body weight.

c. Why aren't we ever warned that our caloric needs may diminish
   *drastically* compared to what we needed as teenagers? I never read
   this and I never heard this. I've sure enough lived it.

d. If middle-aged adults are to succeed in maintaining an ideal
   body weight, what do they need to expect to change in the way of
   how/when/why they eat?

e. If I'm having such problems losing 15 lbs., what's it like for
   others with similar metabolic states that want to lose more than
   that? Where's their guidance?

As to why my mama never told me about all this... she may have been
busy making cookies. ;-)

regards, Andy
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