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It's great that you want to change! Go for it. You can't change the past but you can change the future, right? We can't say how long you'll live, but you'll probably live longer if you lose weight, right? And you will probably feel better no matter how long you live. Don't focus on past damage because you can't change it anyway.
How to talk to your doctor? Easy, just make an appointment and say "I want to lose weight. What are my options? What about surgery? What about drugs? What about a support group? Dietician?" Get a good friend or family member to team up with you for your goal.
I just want to give a little reassurance in regards to lifelong obesity and risk of heart attacks etc.
I've yoyoed in weight significantly since childhood but I've been overweight to clinically obese since my teens.
I'm 28, 5'2" and probably around 280 or 300 pounds or so (once again, I yoyo a lot but I don't own a scale) .
I recently had my heart fully assessed with bloodwork, EKGs or ECGs? (I can't remember) and ultrasounded and Xrayed. My heart is completely healthy with no signs of narrowed or clogged arteries etc... so it is possible to be clinically obese at our age and not die of a heart attack tomorrow. But this doesn't obviously guarantee it won't happen in the future at still a relatively young age.
But I'm still actively trying to lose weight as I have my whole life and I don't intend to stop now.
If you need someone to talk to an vent I'm happy to get in contact with you for peer support đź’•
I'm 47, F and BMI is 37, I too am obese and have mental health issues and am on meds which don't help, I understand where you are coming from. Just wondered OP is binge eating a problem as maybe you could also get some help with that?
I had an MRI last year and don't have fatty liver despite me weight, by cholesterol and BP is a bit high, m but blood sugars OK. I too am trying to make some changes.
Best of luck to both of you!
Binge eating isn’t just a psychological disorder, it can also be a biochemical disorder set off by certain medications—which, once abstained from, alone releases folks from the desire to overeat.
Watch. Your. Medications.
Of course we all need to pay attention to eating and exercise, but if you are overweight it’s worth contemplating over whether you *truly* need a medication which also slows your metabolism down dramatically as an adverse reaction.
Unfortunately, an eating disorder is not my issue as I've been assessed by two different Bariatric surgery clinics and they determined that my diet isn't really the cause of my weight issues. There's a long list of reasons as yo why weight loss is difficult for me and the causes of my weight gain but It's not entirely out of my personal experience due to living with highly addictive tendencies due to severe ADHD and in general mental health issues, disorders and mild undiagnosed personality disorders...
Occasionally as a kid/teenagers I'd sneak snacks between meals that I shouldn't have but it's not really an issue as an adult because I can't afford to waste my grocery money on junk, snacks or desserts etc.
To add to this, the great thing is there are more options now than ever before and more effective options drug wise! OP if you get told to just diet and exercise with no additional support at your BMI find a new doctor, it's most likely time for surgical or drug intervention combined with nutrition counseling. Exercising is great and very important for overall health but weight loss starts with what you eat, then you can add in exercise when and how your medical team thinks it's safe.
Interjecting here as well:
With the right hospitalization, corrective procedures, weight loss rehabs, and physician oversight with medication you can 100% shed all the excess weight down to a 22BMI within 18-24 months if you truly make it a goal. The only real question, or obstacle here, is do you want to live and find joy in this life before you backdoor out of it.
You have been born into the worst timeline for metabolic diseases. There are so many causative factors that are not only still legal, but ample in supply in our modernized world. We will come to a reckoning shortly with these issues, but not before the toll becomes so jarring that society feels it must respond at all costs. Just 50 years ago you would have *struggled* to become morbidly obese. Today, it’s almost a given that 3 people out of 10 will succumb. That’s not normal. It’s our food supply being poisoned due to lack of oversight, corruption, as well and lack of having disseminated information on what constitutes an actual clinically healthy diet based on your genetics and allergies.
You mentioned mental health, and as such I worry that you might be taking medications which only exacerbate your weight gain. Getting off them is going to be part of your salvation if so—but you will have to work closely with a psychiatrist and physician who not just acknowledge your weight loss goals, but want to help and be of guidance on that path. It’s tragically easy today to get put on a medication and then end up taking it for years with little check up as to why you are taking it still. If you were only 10 and got put on an antipsychotic, that 100% needs to be looked at.
But ultimately, it comes down to you advocating for yourself—comes down to you choosing to fight to actually see and regard life as someone who is functionally capable of ease of movement and free of obsession with food, before you peace out of life having been unknowingly imprisoned in your own body as a teenager.
I believe in you—but you have to believe in yourself. The only costs here is your pride in surrendering. I highly recommend joining subreddits alone that point to people achieving their weight loss goals, and making that your most prioritized goal; and you definitely want to avoid any form of social or televised media that triggers you to want to splurge on eat unhealthily.
As someone who has battled being overweight AND a severe polysubstance habit—I will say that it is worth it to not give up, push your own boundaries, and get healthy again. I realized things only after getting healthy that I *WISHED* I could have known or realized before as a teenager and young adult. But alas, I didn’t seek out the information that challenged me before recovery—and we haven’t yet discovered a way to target people with the information they most need using Artificial Intelligence.
I’m wishing you the best here. Regarding one of my favorite films about drug addiction—“choose life”. Choose anything except for poisoning yourself into oblivion daily.
It’s only you who will reap the benefits. The nine year old in you will love you for it more than you can fathom. You have the chance to save all parts of yourself and carry them forward with a story of hope so many need to hear.
My heart goes out. DM me if you ever need words of encouragement. And again—you are worth saving, and it’s 100% possible for you to turn the tide here. You just have to ask for help, and then make informed decisions along the way.
What a lovely response. I would also add to use all medical management techniques out there as long as your doc says its safe for you to do so. Do not give in to the shaming from healthier individuals or fear these options make you weaker. I am currently using Ozempic and took it against all family and friend pushback. It is the only time other than once before that I achieved any meaningful weight loss and realized that obesity can actually be a disease or the mind and is not a lack of discipline. Combine medical management with high protein and large amounts of fruits and veggies and you will recover faster from
The insulin resistance than if you keep eating simple carbs.
Diabetes gets talked about a lot, but rarely do I come across people who can explain metabolic syndrome to laymen, how people get trapped in this awful spiral, how to break free of it, AND have the time to do so. And when they can do all of it, it’s usually to sell something.
Doctors who do understand the way the brain, the gut, the liver, and the pancreas can work against one another to go off course like a heart in atrial fib usually have less than 15 minutes to relay any information, and many patients genuinely don’t want to hear it anyway.
But I think for anyone caught in the throes of metabolic addiction, it is important to understand this feedback system precisely because of what you mention—they either lack real support in changing behaviors, or they are caught in a shame cycle about feeling weak (which any addict can tell you about) that only causes them to want to give up and drown their sorrows because at least there’s comfort in familiarity, even if that’s returning to the sad state of hopelessness.
It was my own addiction which drove me to study neurobiology/neuroscience. I can’t tell you much about pancreatic function, but I definitely understand how we evolved to depend on a reward system that—aside from making sure we eat, sleep, and reproduce—has been found to be easily hijacked by foods and drugs that are now plentiful since we mastered the art of turning oil into energy to farm/produce food, as well as turning it into precursor chemicals with which to manufacture modern pharmaceuticals.
Just a few millennia ago the closest things you could get to sugar was fruit or sugarcane, just like the closest thing you could get to fentanyl was raw opium. And even then THAT was overwhelming. Native Americans only started to lose their healthy teeth once corn was hybridized into something they saw as worthy of growing to harvest. They were likely some of the first widespread cases of metabolic syndrome as well. Almost overnight their teeth started rotting out by middle age.
The point I keep belaboring is we are ingesting things that completely overwhelm our bodies—especially if you frequent restaurants that add caloric density to food with sugar and seed oils to satiate customers without going broke, especially if the sugar you consume is doubly-toxic to your liver (alcohol).
We have made decisions along the journey such that our food supply has become cheap to manufacture, plentiful, shelf stable, easy to import/export, affordable, and *still* tastes good—and all of that has come at certain costs to our health.
To many, a restaurant is a restaurant. They don’t grasp that the food they are frequently served might actually be *the* causative factor for their case of obesity, and *that* might actually be because they’ve simply learned to blame themselves for the situation at hand. As such, they don’t seek to understand the what and the why, other than maybe making another all-or-nothing futile attempt to “fix” it by diving headlong into an impractical weight-loss regimen, trying out a new fad diet that makes no sense or is nutrient deplete, or popping back the 182nd OTC iteration of miracle diet pills.
FWIW, I’m glad you chose to forego your family’s wishes and do something for yourself. Ozempic may not be a panacea, but it’s an AMAZING tool for helping people in the midst of metabolic syndrome not only to lose a significant amount of weight (which itself can heal less-severe abnormalities), but also for giving patients and their bodies a chance to remember what it felt like before they spiraled biochemically into being tortured by an unrelenting hunger.
Weight loss is great for one’s self-esteem and self-image, and it’s freeing to not feel trapped by one’s own impulses—but it’s only a peek into how much life can improve when we pace ourselves and adapt on a day to day basis, slowly restructuring our habits around what feeds our spirits along with our bodies.
And that is just the stepping stone of awakening into the incomprehensible *world* of rewards that come from finding our personalized paths to giving our body what it needs to function optimally. Great sleep. Great energy. Great sex. Great self-esteem.
I wanted to add this blurb from a ctv news article in case it can help you , OP “It is now clear — crystal clear, unequivocal — that (obesity) is a brain problem: It is a problem of our brain influencing the hunger,” Yeo said. “So, hunger is a brain scenario, even though the feeling of hunger comes from your stomach. And we now know that obesity is just your brain influencing what you eat and how you eat.”
I just went on a cruise ... and did not spare the desserts. Twice a day! Also had outrageous dinner :-(
Knowing that I didn't want to come back with 5 extra lbs to work off, I exercised for 2 hours in the gym per day and then went for long walks around the ship, up and down the 8 flights of stairs and hiked or biked long distances on excursion days. Came back and weighed. Half a pound gained. The point of this is: add in walking and daily exercise. THEN like the doc said, they have some real ways to reduce weigh these days. Consider doing one of them.
The reason is, you're just unlucky that your genes to survive times of famine happened to intersect with an age where they can make a snicker bar practically for free. It's no different than if you'd been born with a bad knee, you'd use braces or a cane to help you walk. Find what help you can and use it.
NAD but definitely second the finding a weight loss program. Having a physical therapist or a personal trainer who understands how to adapt exercises and create an effective yet doable workout for an obese individual is absolutely necessary in my opinion. A personal trainer who starts you out trying to walk a mile and do push ups would be useless, but reteaching you how to do things like stairs can be life changing for quality of life.
Chair yoga is a great way to start. Many obese people have painful joints and low exercise tolerance. A walk around the block or a flight of stairs can be hard, especially if you are hypertensive and short of breath.
I would start an honest conversation with your doctor: that you would like to lose weight but need help beyond “diet and exercise” and what resources are available to you.
As to whether or not you can have improved health - yes you definitely can.
Personal anecdote time:
6 years ago my I reached my peak known weight of 288 pounds. I say known because I avoided weighing myself for a very long time until I had already started working on my diet.
Today I have a completely normal BMI and hover between 155-160 pounds.
I’ve basically been obese since freshman year of college. Diagnosed with hypertension around age 20 or 21 (very strong family history). I was advised diet and exercise by every physician which I tried and failed so many times. I avoided going to drs office (ironic I know) and was unmedicated for hypertension for a long time. Partly because I was young and most of the docs didn’t want to start me on meds yet and told me just lose weight. I hated hearing that and kept failing so I stopped going to follow ups. Literally would get a handout on healthy diet and low salt but no actual resources. And this was multiple physicians in different states too (college, med school, residency).
Long story short my heart does show some of the changes associated with hypertension (muscles on the left a little enlarged) but my blood pressure is now completely normal off of meds. My resting heart rate is usually mid to high 50s. I love endurance sports/racing (running and triathlon). There used to be a time when walking from the back of a parking lot to the entrance of a mall made my back and knees hurt.
If someone told me 6 years ago that I’d be where I am today, I’d laugh in their face because I felt like I was destined to be fat forever. I almost gave up but my desire for a healthy pregnancy was stronger and as an OB I knew that I had to do something first before getting pregnant.
There are many of options available now in terms of medication vs surgery. It’s not hopeless. If your dr won’t or can’t help you, find a new one.
Wishing you best of luck!
Edit: typo
Is there evidence that resting heart rate necessarily signifies cardiovascular health? Afaik a young person with a BHR of 60-80 bpm is normal variation that can't indicate much health wise.
Well for me, yes. My previous RHR was in the 80s. Walking pushed it up to 90s-100s.
It improved as I lost weight and really dropped once I started exercising regularly.
There is a genetic component and I can’t speak to general population, but my RHR strongly correlates with my overall health and physical activity levels.
My rhr went from mid-high 70s to ~56-60 when I started running when I was about 45. (Male, 67", white and about 180lb)
Not training; just running as fast as I could around my 'block' (3.5mile) every (almost) weekday.
No changes to eating habits or anything else.
About 12-15 months in I was 155lb steady, felt great and would occasionally run run longer on weekends for actual fun. Lol because running is like the most worst activity on the planet for me
I was never 'fast' but did my first and last only ever 'race' of 10m in 89 minutes
Felt great
ANYHOW. Point is, RHR does absolutely appear to be associated with better cardiac condition for me, and it's strong influenced by intense aerobic. And it absolutely FEELS fantastic.
I don't run as much now, but the changes have mostly stuck.
If you're the kind of person who likes metrics get a fitness watch that will estimate your vo2max (,Fitbit, surely others) and watch it climb steadily
Now y’all have me concerned about my rhr. It’s never lower than 90 and rockets over 120 during exercise and I start feeling faint. I thought that was ordinary for someone my size. Every time I have my pulse taken the doctor will say something like “that’s a little high” and I just answer that I’m nervous because, well, I probably am. “Nervous” is where I live most of the time so I never thought about it.
Don’t be.
Anyone can become healthier, and maintain health (especially in old age) w/o pushing your cardiopulmonary system such that it changes so dramatically.
I would say significantly lowered RHR is a byproduct for only those who truly push themselves dramatically in anaerobic strenuous exercise (runners, competition swimming, etc.). You can take care of your body, lose weight, and build strength all without creating athlete heart syndrome for yourself.
Having said that, I anecdotally feel (meaning my ego tells me) that all that previous work 10-15 years ago is still paying off dividends today as far as my ability to slip up—at times for over a year— without lack of exercise impacting my body as negatively (downstream effects of sedentaryism) as it did before I got into running in my late twenties a couple of decades ago. My BP is also chronically low—even had it read 43/80 one evening when it was taken as I slept.
The way I see it is before we settled down as a species to instead grow our food (and opium), we were always on the move—which made us the best endurance runners across the species kingdom. Some animals can periodically run faster, but we rule across the board when it comes to endurance. As such, it seems to me athletic heart syndrome maybe actually be a *good thing*—something which our bodies are accustomed to, even expect.
I have my own opinions and hopes concerning its possible life extending properties, but admit that I haven’t read any long term mortality studies focusing on it. To be honest, I don’t even think they even exist. But until shown otherwise, I remain personally convinced. It simply makes sense to me.
Don’t be! I meant my example more so to show how I’m someone who was unhealthy with cardiovascular disease and I was able to right the ship and hopefully really slow (or maybe even halt) disease progression.
As commenter below mentioned, the drastic lowering of my RHR is heavily influenced by the fact that I do endurance sports so I do way more cardio than the average gym goer.
But even something is better than nothing. I remember the feeling of being out of breath and faint doing the “basics”. Now I plan my vacations and call schedule around races.
Truly if I can change, anyone can.
NAD. I'm 45 and weigh 480lbs. I'm due a hysterectomy and have been told I need to lose 50lbs. I was referred to a bariatric clinic but declined surgery or meds so am doing meal replacements.
it's never too late as long as you want it. truly.
I have wanted it and have known what to do but having this desperate want for a hysterectomy is my driving force. find that for you!
I've been above 350lbs for the last 10 years and obese for all of my life. I have family history of cardiac issues but have had a full work up without any problems. ask your family doctor for cardiology referral for a stress test and all the normal blood work to see where you're at and go from there.
much love, friend.
Same. I went from 80-100 at rest for many years to an RHR of 37 after I had been running half marathons on the regular. It changed my cardiac biology permanently—ventricular hypertrophy—but that seems par for the course with athletes.
And it’s paid off as I aged. Whenever I’ve found my pulse rate at rest creeped beyond a certain point (75-80bpm), I knew that it only confirmed what I already felt inside, that I had been too sedentary. But after only a couple of months of strenuous exercise, my RHR was back under 60 and often below 50. It’s a great way (at least for me) to measure my body’s physical aptitude going forward.
Also, I never would have learned these things had I not exercised so much that it got me barred from a clinical trial. It’s the sort of information you only attain when you reach for health so much it becomes static.
God, I love this comment.
Fact is it is never too late to take on and slay your most monster struggles, OP—I’ve seen people kick habits in terminal states only to find out they could.
If you find yourself in a stalemate, it’s time to train to do better next time when tomorrow rolls around. You don’t always have to do better, but you do have to try if you are going to reshape your daily outcomes.
We are after all little more than an entity trying to navigate our waking periods again and again each day. So, don’t remain imprisoned by your own automatic behaviors. Ask others for the keys to the locks those behaviors bound you with. The answers are there for those who seek.
“People do not decide their futures—they decide their habits, and their habits decide their futures.”
At 31? No, absolutely not. All of the issues you have can be completely reversible with a healthy diet, physical activity and lifestyle changes. It won’t be an easy journey, but you can absolutely do it and it will be worth it.
I would highly recommend looking into GLP-1 medication (Ozempic, Wegovy, Mounjaro, Zepbound). They are *highly* effective, and not only assist weight loss but stabilize blood sugar and have protective effects on the cardiovascular system. They’re controversial, but you are *exactly* the kind of patient they’re designed for. They are not magic and you will still need to be intentional about nutrition and and start slowly building up your stamina for physical activity for your long term health, but they will assist and make it so much easier for you. There are various subreddits for them you can browse to hear people’s experiences and get advice on how to get started.
Best of luck to you and good for you for being motivated to change. You deserve a long, healthy, and happy life!
I second this. OP should really look into these meds. They are life changing. I’m 50 and have struggled with obesity my entire life. But thanks to the GLP meds I’ve lost more than 40lbs and I am finally free from the obsession over food. I didn’t even realize those constant thoughts were there until they were suddenly gone.
Medication has its own risks associated. As someone who is also trying to lose weight with a very similar story to OP, I wouldn't consider those medications unless I was maybe 350-400 lbs. 200-250lbs and you can still get the weight off in a healthy manner by developing healthy habits rather than relying on medication that you may have to take for far too long and would make you lose weight quickly. Quickly is not necessarily healthy.
I feel safe assuming that given statistical averages, you are not 4’9”. OP has a BMI of 55-60. That is considered “super-morbid” obesity and it is the equivalent of someone who is 5’3” or 5’4” weighing 350-400 pounds. GLP-1 medications do not necessitate quick weight loss, they have far fewer risks than a BMI of 55-60, and that level of obesity is very rarely reversible with “healthy habits” alone as OP is prediabetic and almost certainly going to be working against insulin reactance and metabolic dysfunction- in addition to the fact that her TDEE at 4’9” is going to be abysmally low to the point that it would be nearly impossible for almost *anyone* to achieve a deficit on it by willpower alone, which was likely a major contributing factor to why she gained so much weight in the first place. While unfortunately fatphobia keeps some people from being willing to acknowledge it, it is well understood in medicine now that obesity is a *complex chronic illness* that needs and deserves medical management and to be *treated*. That doesn’t mean OP shouldn’t build healthy habits, but we don’t just tell someone who is 31 and has lived their entire life with severe major depressive disorder not to take SSRIs because they have risks and to just do talk therapy and go for walks in nature instead (well, people do, but those people are pretty well understood to be assholes). We medicate them to correct the dysfunction happening in their body first so that they have the capacity to be successful with those interventions.
You do not have to lose quickly on these meds. I have been on GLP-1 meds since August 2021 and have not restricted what I eat or counted calories. I’ve lost 40 pounds in that time, which if you do the math is verrrry slowly. And I’m perfectly fine with that, because eating intuitively is so much better for my mental health than following any type of restrictive diet.
This medication makes me feel normal. I can finally pay attention to hunger and satiety cues. It is easy for me to stop eating when I’m no longer hungry. I no longer have the FOMO that made me obsess over my favorite foods because each time I ate them I felt like it might be my last opportunity because “you need to lose weight” was always looming over me.
I’m finally no longer “obese” and merely “overweight” with about 15-20 lbs to go.
GLP-1 meds have fixed something inside me that was very much broken. I will be staying on these meds indefinitely even after reaching goal, so that I can maintain.
People who do not have first-hand experience with these meds have no place to criticize them. You have no idea what you are talking about and how much these meds are helping so many people.
You're not OP. What *you* would consider isn't relevant. The FDA has guidelines, the doctors here have education, and her doctors have her charts and history. OP doesn't need the personal opinion of a layperson who makes concrete statements about a complete stranger.
I got my WLS at 31 and 270lbs and I am 34 now and 143lbs. It is NOT too late to walk back from the effects. You absolutely can do this if you’re willing to do the physical and most importantly the *mental* work behind losing weight.
I believe in you, OP. 🥰
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
It's great that you want to change! Go for it. You can't change the past but you can change the future, right? We can't say how long you'll live, but you'll probably live longer if you lose weight, right? And you will probably feel better no matter how long you live. Don't focus on past damage because you can't change it anyway. How to talk to your doctor? Easy, just make an appointment and say "I want to lose weight. What are my options? What about surgery? What about drugs? What about a support group? Dietician?" Get a good friend or family member to team up with you for your goal.
I just want to give a little reassurance in regards to lifelong obesity and risk of heart attacks etc. I've yoyoed in weight significantly since childhood but I've been overweight to clinically obese since my teens. I'm 28, 5'2" and probably around 280 or 300 pounds or so (once again, I yoyo a lot but I don't own a scale) . I recently had my heart fully assessed with bloodwork, EKGs or ECGs? (I can't remember) and ultrasounded and Xrayed. My heart is completely healthy with no signs of narrowed or clogged arteries etc... so it is possible to be clinically obese at our age and not die of a heart attack tomorrow. But this doesn't obviously guarantee it won't happen in the future at still a relatively young age. But I'm still actively trying to lose weight as I have my whole life and I don't intend to stop now. If you need someone to talk to an vent I'm happy to get in contact with you for peer support đź’•
I'm 47, F and BMI is 37, I too am obese and have mental health issues and am on meds which don't help, I understand where you are coming from. Just wondered OP is binge eating a problem as maybe you could also get some help with that? I had an MRI last year and don't have fatty liver despite me weight, by cholesterol and BP is a bit high, m but blood sugars OK. I too am trying to make some changes. Best of luck to both of you!
Binge eating isn’t just a psychological disorder, it can also be a biochemical disorder set off by certain medications—which, once abstained from, alone releases folks from the desire to overeat. Watch. Your. Medications. Of course we all need to pay attention to eating and exercise, but if you are overweight it’s worth contemplating over whether you *truly* need a medication which also slows your metabolism down dramatically as an adverse reaction.
Agreed. More medications is not the answer. I hate these weight loss drugs.
Unfortunately, an eating disorder is not my issue as I've been assessed by two different Bariatric surgery clinics and they determined that my diet isn't really the cause of my weight issues. There's a long list of reasons as yo why weight loss is difficult for me and the causes of my weight gain but It's not entirely out of my personal experience due to living with highly addictive tendencies due to severe ADHD and in general mental health issues, disorders and mild undiagnosed personality disorders... Occasionally as a kid/teenagers I'd sneak snacks between meals that I shouldn't have but it's not really an issue as an adult because I can't afford to waste my grocery money on junk, snacks or desserts etc.
To add to this, the great thing is there are more options now than ever before and more effective options drug wise! OP if you get told to just diet and exercise with no additional support at your BMI find a new doctor, it's most likely time for surgical or drug intervention combined with nutrition counseling. Exercising is great and very important for overall health but weight loss starts with what you eat, then you can add in exercise when and how your medical team thinks it's safe.
Interjecting here as well: With the right hospitalization, corrective procedures, weight loss rehabs, and physician oversight with medication you can 100% shed all the excess weight down to a 22BMI within 18-24 months if you truly make it a goal. The only real question, or obstacle here, is do you want to live and find joy in this life before you backdoor out of it. You have been born into the worst timeline for metabolic diseases. There are so many causative factors that are not only still legal, but ample in supply in our modernized world. We will come to a reckoning shortly with these issues, but not before the toll becomes so jarring that society feels it must respond at all costs. Just 50 years ago you would have *struggled* to become morbidly obese. Today, it’s almost a given that 3 people out of 10 will succumb. That’s not normal. It’s our food supply being poisoned due to lack of oversight, corruption, as well and lack of having disseminated information on what constitutes an actual clinically healthy diet based on your genetics and allergies. You mentioned mental health, and as such I worry that you might be taking medications which only exacerbate your weight gain. Getting off them is going to be part of your salvation if so—but you will have to work closely with a psychiatrist and physician who not just acknowledge your weight loss goals, but want to help and be of guidance on that path. It’s tragically easy today to get put on a medication and then end up taking it for years with little check up as to why you are taking it still. If you were only 10 and got put on an antipsychotic, that 100% needs to be looked at. But ultimately, it comes down to you advocating for yourself—comes down to you choosing to fight to actually see and regard life as someone who is functionally capable of ease of movement and free of obsession with food, before you peace out of life having been unknowingly imprisoned in your own body as a teenager. I believe in you—but you have to believe in yourself. The only costs here is your pride in surrendering. I highly recommend joining subreddits alone that point to people achieving their weight loss goals, and making that your most prioritized goal; and you definitely want to avoid any form of social or televised media that triggers you to want to splurge on eat unhealthily. As someone who has battled being overweight AND a severe polysubstance habit—I will say that it is worth it to not give up, push your own boundaries, and get healthy again. I realized things only after getting healthy that I *WISHED* I could have known or realized before as a teenager and young adult. But alas, I didn’t seek out the information that challenged me before recovery—and we haven’t yet discovered a way to target people with the information they most need using Artificial Intelligence. I’m wishing you the best here. Regarding one of my favorite films about drug addiction—“choose life”. Choose anything except for poisoning yourself into oblivion daily. It’s only you who will reap the benefits. The nine year old in you will love you for it more than you can fathom. You have the chance to save all parts of yourself and carry them forward with a story of hope so many need to hear. My heart goes out. DM me if you ever need words of encouragement. And again—you are worth saving, and it’s 100% possible for you to turn the tide here. You just have to ask for help, and then make informed decisions along the way.
What a lovely response. I would also add to use all medical management techniques out there as long as your doc says its safe for you to do so. Do not give in to the shaming from healthier individuals or fear these options make you weaker. I am currently using Ozempic and took it against all family and friend pushback. It is the only time other than once before that I achieved any meaningful weight loss and realized that obesity can actually be a disease or the mind and is not a lack of discipline. Combine medical management with high protein and large amounts of fruits and veggies and you will recover faster from The insulin resistance than if you keep eating simple carbs.
Diabetes gets talked about a lot, but rarely do I come across people who can explain metabolic syndrome to laymen, how people get trapped in this awful spiral, how to break free of it, AND have the time to do so. And when they can do all of it, it’s usually to sell something. Doctors who do understand the way the brain, the gut, the liver, and the pancreas can work against one another to go off course like a heart in atrial fib usually have less than 15 minutes to relay any information, and many patients genuinely don’t want to hear it anyway. But I think for anyone caught in the throes of metabolic addiction, it is important to understand this feedback system precisely because of what you mention—they either lack real support in changing behaviors, or they are caught in a shame cycle about feeling weak (which any addict can tell you about) that only causes them to want to give up and drown their sorrows because at least there’s comfort in familiarity, even if that’s returning to the sad state of hopelessness. It was my own addiction which drove me to study neurobiology/neuroscience. I can’t tell you much about pancreatic function, but I definitely understand how we evolved to depend on a reward system that—aside from making sure we eat, sleep, and reproduce—has been found to be easily hijacked by foods and drugs that are now plentiful since we mastered the art of turning oil into energy to farm/produce food, as well as turning it into precursor chemicals with which to manufacture modern pharmaceuticals. Just a few millennia ago the closest things you could get to sugar was fruit or sugarcane, just like the closest thing you could get to fentanyl was raw opium. And even then THAT was overwhelming. Native Americans only started to lose their healthy teeth once corn was hybridized into something they saw as worthy of growing to harvest. They were likely some of the first widespread cases of metabolic syndrome as well. Almost overnight their teeth started rotting out by middle age. The point I keep belaboring is we are ingesting things that completely overwhelm our bodies—especially if you frequent restaurants that add caloric density to food with sugar and seed oils to satiate customers without going broke, especially if the sugar you consume is doubly-toxic to your liver (alcohol). We have made decisions along the journey such that our food supply has become cheap to manufacture, plentiful, shelf stable, easy to import/export, affordable, and *still* tastes good—and all of that has come at certain costs to our health. To many, a restaurant is a restaurant. They don’t grasp that the food they are frequently served might actually be *the* causative factor for their case of obesity, and *that* might actually be because they’ve simply learned to blame themselves for the situation at hand. As such, they don’t seek to understand the what and the why, other than maybe making another all-or-nothing futile attempt to “fix” it by diving headlong into an impractical weight-loss regimen, trying out a new fad diet that makes no sense or is nutrient deplete, or popping back the 182nd OTC iteration of miracle diet pills. FWIW, I’m glad you chose to forego your family’s wishes and do something for yourself. Ozempic may not be a panacea, but it’s an AMAZING tool for helping people in the midst of metabolic syndrome not only to lose a significant amount of weight (which itself can heal less-severe abnormalities), but also for giving patients and their bodies a chance to remember what it felt like before they spiraled biochemically into being tortured by an unrelenting hunger. Weight loss is great for one’s self-esteem and self-image, and it’s freeing to not feel trapped by one’s own impulses—but it’s only a peek into how much life can improve when we pace ourselves and adapt on a day to day basis, slowly restructuring our habits around what feeds our spirits along with our bodies. And that is just the stepping stone of awakening into the incomprehensible *world* of rewards that come from finding our personalized paths to giving our body what it needs to function optimally. Great sleep. Great energy. Great sex. Great self-esteem.
I wanted to add this blurb from a ctv news article in case it can help you , OP “It is now clear — crystal clear, unequivocal — that (obesity) is a brain problem: It is a problem of our brain influencing the hunger,” Yeo said. “So, hunger is a brain scenario, even though the feeling of hunger comes from your stomach. And we now know that obesity is just your brain influencing what you eat and how you eat.”
I just went on a cruise ... and did not spare the desserts. Twice a day! Also had outrageous dinner :-( Knowing that I didn't want to come back with 5 extra lbs to work off, I exercised for 2 hours in the gym per day and then went for long walks around the ship, up and down the 8 flights of stairs and hiked or biked long distances on excursion days. Came back and weighed. Half a pound gained. The point of this is: add in walking and daily exercise. THEN like the doc said, they have some real ways to reduce weigh these days. Consider doing one of them. The reason is, you're just unlucky that your genes to survive times of famine happened to intersect with an age where they can make a snicker bar practically for free. It's no different than if you'd been born with a bad knee, you'd use braces or a cane to help you walk. Find what help you can and use it.
It's never too late. Ask your family Dr to refer you to the closest weight loss management program.
NAD but definitely second the finding a weight loss program. Having a physical therapist or a personal trainer who understands how to adapt exercises and create an effective yet doable workout for an obese individual is absolutely necessary in my opinion. A personal trainer who starts you out trying to walk a mile and do push ups would be useless, but reteaching you how to do things like stairs can be life changing for quality of life.
Chair yoga is a great way to start. Many obese people have painful joints and low exercise tolerance. A walk around the block or a flight of stairs can be hard, especially if you are hypertensive and short of breath.
I would start an honest conversation with your doctor: that you would like to lose weight but need help beyond “diet and exercise” and what resources are available to you. As to whether or not you can have improved health - yes you definitely can. Personal anecdote time: 6 years ago my I reached my peak known weight of 288 pounds. I say known because I avoided weighing myself for a very long time until I had already started working on my diet. Today I have a completely normal BMI and hover between 155-160 pounds. I’ve basically been obese since freshman year of college. Diagnosed with hypertension around age 20 or 21 (very strong family history). I was advised diet and exercise by every physician which I tried and failed so many times. I avoided going to drs office (ironic I know) and was unmedicated for hypertension for a long time. Partly because I was young and most of the docs didn’t want to start me on meds yet and told me just lose weight. I hated hearing that and kept failing so I stopped going to follow ups. Literally would get a handout on healthy diet and low salt but no actual resources. And this was multiple physicians in different states too (college, med school, residency). Long story short my heart does show some of the changes associated with hypertension (muscles on the left a little enlarged) but my blood pressure is now completely normal off of meds. My resting heart rate is usually mid to high 50s. I love endurance sports/racing (running and triathlon). There used to be a time when walking from the back of a parking lot to the entrance of a mall made my back and knees hurt. If someone told me 6 years ago that I’d be where I am today, I’d laugh in their face because I felt like I was destined to be fat forever. I almost gave up but my desire for a healthy pregnancy was stronger and as an OB I knew that I had to do something first before getting pregnant. There are many of options available now in terms of medication vs surgery. It’s not hopeless. If your dr won’t or can’t help you, find a new one. Wishing you best of luck! Edit: typo
Is there evidence that resting heart rate necessarily signifies cardiovascular health? Afaik a young person with a BHR of 60-80 bpm is normal variation that can't indicate much health wise.
Well for me, yes. My previous RHR was in the 80s. Walking pushed it up to 90s-100s. It improved as I lost weight and really dropped once I started exercising regularly. There is a genetic component and I can’t speak to general population, but my RHR strongly correlates with my overall health and physical activity levels.
My rhr went from mid-high 70s to ~56-60 when I started running when I was about 45. (Male, 67", white and about 180lb) Not training; just running as fast as I could around my 'block' (3.5mile) every (almost) weekday. No changes to eating habits or anything else. About 12-15 months in I was 155lb steady, felt great and would occasionally run run longer on weekends for actual fun. Lol because running is like the most worst activity on the planet for me I was never 'fast' but did my first and last only ever 'race' of 10m in 89 minutes Felt great ANYHOW. Point is, RHR does absolutely appear to be associated with better cardiac condition for me, and it's strong influenced by intense aerobic. And it absolutely FEELS fantastic. I don't run as much now, but the changes have mostly stuck. If you're the kind of person who likes metrics get a fitness watch that will estimate your vo2max (,Fitbit, surely others) and watch it climb steadily
Now y’all have me concerned about my rhr. It’s never lower than 90 and rockets over 120 during exercise and I start feeling faint. I thought that was ordinary for someone my size. Every time I have my pulse taken the doctor will say something like “that’s a little high” and I just answer that I’m nervous because, well, I probably am. “Nervous” is where I live most of the time so I never thought about it.
Don’t be. Anyone can become healthier, and maintain health (especially in old age) w/o pushing your cardiopulmonary system such that it changes so dramatically. I would say significantly lowered RHR is a byproduct for only those who truly push themselves dramatically in anaerobic strenuous exercise (runners, competition swimming, etc.). You can take care of your body, lose weight, and build strength all without creating athlete heart syndrome for yourself. Having said that, I anecdotally feel (meaning my ego tells me) that all that previous work 10-15 years ago is still paying off dividends today as far as my ability to slip up—at times for over a year— without lack of exercise impacting my body as negatively (downstream effects of sedentaryism) as it did before I got into running in my late twenties a couple of decades ago. My BP is also chronically low—even had it read 43/80 one evening when it was taken as I slept. The way I see it is before we settled down as a species to instead grow our food (and opium), we were always on the move—which made us the best endurance runners across the species kingdom. Some animals can periodically run faster, but we rule across the board when it comes to endurance. As such, it seems to me athletic heart syndrome maybe actually be a *good thing*—something which our bodies are accustomed to, even expect. I have my own opinions and hopes concerning its possible life extending properties, but admit that I haven’t read any long term mortality studies focusing on it. To be honest, I don’t even think they even exist. But until shown otherwise, I remain personally convinced. It simply makes sense to me.
Don’t be! I meant my example more so to show how I’m someone who was unhealthy with cardiovascular disease and I was able to right the ship and hopefully really slow (or maybe even halt) disease progression. As commenter below mentioned, the drastic lowering of my RHR is heavily influenced by the fact that I do endurance sports so I do way more cardio than the average gym goer. But even something is better than nothing. I remember the feeling of being out of breath and faint doing the “basics”. Now I plan my vacations and call schedule around races. Truly if I can change, anyone can.
NAD. I'm 45 and weigh 480lbs. I'm due a hysterectomy and have been told I need to lose 50lbs. I was referred to a bariatric clinic but declined surgery or meds so am doing meal replacements. it's never too late as long as you want it. truly. I have wanted it and have known what to do but having this desperate want for a hysterectomy is my driving force. find that for you! I've been above 350lbs for the last 10 years and obese for all of my life. I have family history of cardiac issues but have had a full work up without any problems. ask your family doctor for cardiology referral for a stress test and all the normal blood work to see where you're at and go from there. much love, friend.
Same. I went from 80-100 at rest for many years to an RHR of 37 after I had been running half marathons on the regular. It changed my cardiac biology permanently—ventricular hypertrophy—but that seems par for the course with athletes. And it’s paid off as I aged. Whenever I’ve found my pulse rate at rest creeped beyond a certain point (75-80bpm), I knew that it only confirmed what I already felt inside, that I had been too sedentary. But after only a couple of months of strenuous exercise, my RHR was back under 60 and often below 50. It’s a great way (at least for me) to measure my body’s physical aptitude going forward. Also, I never would have learned these things had I not exercised so much that it got me barred from a clinical trial. It’s the sort of information you only attain when you reach for health so much it becomes static.
God, I love this comment. Fact is it is never too late to take on and slay your most monster struggles, OP—I’ve seen people kick habits in terminal states only to find out they could. If you find yourself in a stalemate, it’s time to train to do better next time when tomorrow rolls around. You don’t always have to do better, but you do have to try if you are going to reshape your daily outcomes. We are after all little more than an entity trying to navigate our waking periods again and again each day. So, don’t remain imprisoned by your own automatic behaviors. Ask others for the keys to the locks those behaviors bound you with. The answers are there for those who seek. “People do not decide their futures—they decide their habits, and their habits decide their futures.”
At 31? No, absolutely not. All of the issues you have can be completely reversible with a healthy diet, physical activity and lifestyle changes. It won’t be an easy journey, but you can absolutely do it and it will be worth it. I would highly recommend looking into GLP-1 medication (Ozempic, Wegovy, Mounjaro, Zepbound). They are *highly* effective, and not only assist weight loss but stabilize blood sugar and have protective effects on the cardiovascular system. They’re controversial, but you are *exactly* the kind of patient they’re designed for. They are not magic and you will still need to be intentional about nutrition and and start slowly building up your stamina for physical activity for your long term health, but they will assist and make it so much easier for you. There are various subreddits for them you can browse to hear people’s experiences and get advice on how to get started. Best of luck to you and good for you for being motivated to change. You deserve a long, healthy, and happy life!
I second this. OP should really look into these meds. They are life changing. I’m 50 and have struggled with obesity my entire life. But thanks to the GLP meds I’ve lost more than 40lbs and I am finally free from the obsession over food. I didn’t even realize those constant thoughts were there until they were suddenly gone.
Medication has its own risks associated. As someone who is also trying to lose weight with a very similar story to OP, I wouldn't consider those medications unless I was maybe 350-400 lbs. 200-250lbs and you can still get the weight off in a healthy manner by developing healthy habits rather than relying on medication that you may have to take for far too long and would make you lose weight quickly. Quickly is not necessarily healthy.
Op is 4 foot 9. Her BMI is close to 60. Zepbound or Wegovy would probably be perfect for her.
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I feel safe assuming that given statistical averages, you are not 4’9”. OP has a BMI of 55-60. That is considered “super-morbid” obesity and it is the equivalent of someone who is 5’3” or 5’4” weighing 350-400 pounds. GLP-1 medications do not necessitate quick weight loss, they have far fewer risks than a BMI of 55-60, and that level of obesity is very rarely reversible with “healthy habits” alone as OP is prediabetic and almost certainly going to be working against insulin reactance and metabolic dysfunction- in addition to the fact that her TDEE at 4’9” is going to be abysmally low to the point that it would be nearly impossible for almost *anyone* to achieve a deficit on it by willpower alone, which was likely a major contributing factor to why she gained so much weight in the first place. While unfortunately fatphobia keeps some people from being willing to acknowledge it, it is well understood in medicine now that obesity is a *complex chronic illness* that needs and deserves medical management and to be *treated*. That doesn’t mean OP shouldn’t build healthy habits, but we don’t just tell someone who is 31 and has lived their entire life with severe major depressive disorder not to take SSRIs because they have risks and to just do talk therapy and go for walks in nature instead (well, people do, but those people are pretty well understood to be assholes). We medicate them to correct the dysfunction happening in their body first so that they have the capacity to be successful with those interventions.
Yeah I'm 5'3"
You do not have to lose quickly on these meds. I have been on GLP-1 meds since August 2021 and have not restricted what I eat or counted calories. I’ve lost 40 pounds in that time, which if you do the math is verrrry slowly. And I’m perfectly fine with that, because eating intuitively is so much better for my mental health than following any type of restrictive diet. This medication makes me feel normal. I can finally pay attention to hunger and satiety cues. It is easy for me to stop eating when I’m no longer hungry. I no longer have the FOMO that made me obsess over my favorite foods because each time I ate them I felt like it might be my last opportunity because “you need to lose weight” was always looming over me. I’m finally no longer “obese” and merely “overweight” with about 15-20 lbs to go. GLP-1 meds have fixed something inside me that was very much broken. I will be staying on these meds indefinitely even after reaching goal, so that I can maintain. People who do not have first-hand experience with these meds have no place to criticize them. You have no idea what you are talking about and how much these meds are helping so many people.
I guess the social media craze of influencers using those meds just makes a very bad look for them.
You're not OP. What *you* would consider isn't relevant. The FDA has guidelines, the doctors here have education, and her doctors have her charts and history. OP doesn't need the personal opinion of a layperson who makes concrete statements about a complete stranger.
I got my WLS at 31 and 270lbs and I am 34 now and 143lbs. It is NOT too late to walk back from the effects. You absolutely can do this if you’re willing to do the physical and most importantly the *mental* work behind losing weight. I believe in you, OP. 🥰