What am I doing wrong?

[HereKittyKitty]

Having type 2 diabetes, weight loss surgery and being at half your old body weight goes a long way to explaining being somewhat weight neutral at such a low calorie input. There is not lots of science on long term metabolic adaptation to weight loss, but it is definitely possible that low metabolic rates persist for years and possibly permanently after massive weight loss. Does not help your situation much though.

For most of my life I was HWP and a Masters swimmer. Trauma does awful things to a person.

 

[Jfrick11]

I don't think anyone knows how GLPs and "starvation mode" (whatever that effect really is) interact with each other, but I feel like OP would notice it if their body had ramped down enough for that to be the full story there (like constantly cold and lethargic

Hmm… 900 calories a day while doing cardio and resistance training 4–5 days a week?

We don’t even need to get into the whole “starvation mode” debate. That’s just very low intake for that level of output. At some point the body will conserve energy.

Also, not everyone experiences the dramatic “constantly freezing and exhausted” symptoms people associate with severe restriction.

If the GLP is suppressing appetite so much that 900 calories is all she can eat, that a pretty good sign the dose is too high right now.

 

[tubby]

Hmm… 900 calories a day while doing cardio and resistance training 4–5 days a week?

We don’t even need to get into the whole “starvation mode” debate. That’s just very low intake for that level of output. At some point the body will conserve energy.

Also, not everyone experiences the dramatic “constantly freezing and exhausted” symptoms people associate with severe restriction.

If the GLP is suppressing appetite so much that 900 calories is all she can eat, that a pretty good sign the dose is too high right now.

I mean the body can perform some pretty amazing adaptations, but it's not magic.

I'm not a huge fan of using calories as the ultimate yardstick to measure food intake, but I'll concede that as calorie intake drops far enough, there are certain thermodynamic realities that hormonal control systems simply cannot overcome and calories will rule.

If OP is still able to communicate in coherent sentences and get by without wearing a thick sweater to stay warm indoors, that suggests their body still has additional energy conserving levers it hasn't pulled yet. 😉

At the same time, I believe OP, as I've known other highly-experienced folks in the extreme extreme diet space who have found themselves in similar pickles before. And there are certainty unique medical disorders like lipedema (which I'm not suggesting the OP has mind you, just bringing up as an example), in which something has happened in which the body either can't or won't unlock what appears to be stored fat.

So while true that not everyone on a very-low calorie diet will experiencing shivering, extreme fatigue, or mental incoherence, I just have a really hard time believing that OP has both stalled under those conditions AND done so without the body having to unlock any of the extreme adaptations that I listed.

 

[Jfrick11]

I mean the body can perform some pretty amazing adaptations, but it's not magic.

I'm not a huge fan of using calories as the ultimate yardstick to measure food intake, but I'll concede that as calorie intake drops far enough, there are certain thermodynamic realities that hormonal control systems simply cannot overcome and calories will rule.

If OP is still able to communicate in coherent sentences and get by without wearing a thick sweater to stay warm indoors, that suggests their body still has additional energy conserving levers it hasn't pulled yet. 😉

At the same time, I believe OP, as I've known other highly-experienced folks in the extreme extreme diet space who have found themselves in similar pickles before. And there are certainty unique medical disorders like lipedema (which I'm not suggesting the OP has mind you, just bringing up as an example), in which something has happened in which the body either can't or won't unlock what appears to be stored fat.

So while true that not everyone on a very-low calorie diet will experiencing shivering, extreme fatigue, or mental incoherence, I just have a really hard time believing that OP has both stalled under those conditions AND done so without the body having to unlock any of the extreme adaptations that I listed.

I think we might be over theorizing this a bit.
900 calories a day while doing cardio and resistance training 4–5 days a week is simply very low energy intake.

You don’t have to be shivering in a sweater or unable to form sentences for the body to start conserving energy. Sometimes the “adaptation” just shows up as a stall.

If the medication is suppressing appetite to the point that 900 calories is all that fits, that’s usually a pretty good sign it's higher than needed, especially when someone is close to goal.

 

[tubby]

Sometimes the “adaptation” just shows up as a stall.

You're looking at this backwards. The stall isn't the adaptation technique. The stall is the result of the adaptation technique. If the body is forced to cope with CI of 900 calories paired with an active lifestyle it may adapt in certain ways (e.g. extreme cold or limiting other key processes). The body doesn't simply invoke magic and say "CO is 900 now with no trade offs in functionality." The body has to find a way to drive CO down to 900 calories (while maintaining a physically active lifestyle) and the only way to do that is to give up some functionality.

 

[Jfrick11]

You're looking at this backwards. The stall isn't the adaptation technique. The stall is the result of the adaptation technique. If the body is forced to cope with CI of 900 calories paired with an active lifestyle it may adapt in certain ways (e.g. extreme cold or limiting other key processes). The body doesn't simply invoke magic and say "CO is 900 now with no trade offs in functionality." The body has to find a way to drive CO down to 900 calories (while maintaining a physically active lifestyle) and the only way to do that is to give

I’m not saying the body doesn’t reduce energy expenditure somehow. I’m saying those adaptations aren’t always dramatic or obvious.

A lot of the time it’s subtle reductions in NEAT, hormonal shifts, and improved metabolic efficiency that people don’t consciously notice.... and the result can absolutely be a stall.

Either way, 900 calories with that activity level is still extremely low, and if that’s all someone can eat because appetite is suppressed, it’s fair to question whether the dose is simply too high right now.

 

[meeklady]

I had this problem when I switched from Sema to Reta. It took a few months and finally getting to 8 mgs for the weight loss to restart. When it restarted I got to goal weight in 8 weeks! Give it time and keep titrating and hopefully you'll get there.

 

[tubby]

I’m not saying the body doesn’t reduce energy expenditure somehow. I’m saying those adaptations aren’t always dramatic or obvious.

A lot of the time it’s subtle reductions in NEAT, hormonal shifts, and improved metabolic efficiency that people don’t consciously notice.... and the result can absolutely be a stall.

Either way, 900 calories with that activity level is still extremely low, and if that’s all someone can eat because appetite is suppressed, it’s fair to question whether the dose is simply too high right now.

Agree on that. And that's kind of my point. If OP was at 1500 calories I'd buy into subtle reductions that go unnoticed (and even then I might be a little skeptical with that much exercise). It's just wild to be at 900 calories, extremely active, and still have reductions go unnoticed. Obviously I don't know what I don't know and you and I might have different mental cut-offs for what qualifies as very low calorie.

 

[HereKittyKitty]

Thanks for these replies. I left a message for my RD to schedule an appointment. Let's see what she recommends.

I'll gladly back off my dosing!

 

[Grogu]

How long have you been in a deficit? Long periods of deficit can lower your metabolic rate. Might look into refeeds/diet breaks.

View: https://youtu.be/8HVdLMnr40M?si=S-ISshxcVQ2nB7uR

Thanks for the video! I really enjoyed the content. I've been on the "refeed"diet and I didn't even know it....

My TDEE maintenance calories are about 2,700 calories and I eat about 1,800 calories M-F and then on Saturday and Sunday I don't track what I eat, so I have no idea, but I'd have to say probably around 2,500 to 3,000 calories, with Saturday being the higher of the two days. It's kind of allowed me to continue M-F with restricted calories knowing I have a couple of days of extra calories in the future. Hopefully that's help not crash my metabolism rather than staying on say 2,200 calories for 7 days straight. I'm also not shivering or unable to put coherent thoughts together, although my colleagues my argue otherwise 🤣, but that's an entirely different issue.