Saturday, July 16, 2016

Medifast without Medifast foods? A step above a post-WLS Diet


I've been thinking really seriously about getting the sleeve, and talking to some folks who have had it done. I have a local friend who had some kind of WLS and has had a ton of trouble (although she is thin now) and am going to talk to her about her experience tonight. This is the first time in my life that I am *seriously* considering doing this. In the past I have always been too afraid to die, leave the people I care for, etc, but I think I am entering a different mindset of making myself an at least equal priority to my family. With the kids moving out I have been sorting and tossing a lot of things I never thought I could let go of. I am starting to phase myself out of the caregiver role and into more of a role that involves taking care of ME. I still have kids with medical issues that need care, but somehow I feel differently, like I matter. That's kind of a hard thing for me to say, because it implies that I have felt like I *don't* matter. I know I matter! And yet, if I am honest with myself, that is exactly how I have acted and subconsciously felt at times. Everyone else is important, but I only matter because I am taking care of them and they need me. Once they no longer need me, I won't matter. And that's not a healthy way to think, even if it is buried under the knowledge that of course I matter. I just need to bring the "mattering" to the surface and start caring for myself with the intensity that I have always cared for others. I have been putting myself last for 26 years. This year, I am getting a promotion.

What I have been doing to avoid weighing, measuring, and counting calories and carbs (which I hate) is this: I have started using more pre-packaged foods that are already portioned and are higher in protein, lower in carbs. For a long time I have eyeballed labels looking for "Medifast substitutes"... foods that are similar in nutritional content to a Medifast meal (about 90-110 calories, 11-15 grams of protein, 8-15 grams of carbs, 4-5 grams of fiber, under 4 grams of fat). A lot of people who used to do Medifast got tired of the skyrocketing prices and have looked for alternatives such as the WonderSlim and BariWise diet foods from DietDirect.com (affiliate link... I use their products a lot), Quest bars, and other packaged foods that they could use as a meal in the 5&1 Plan, getting the same results at a lower cost. Heck, I have even seen people sub things like a low fat string cheese for a Medifast meal because the most important thing of all on that plan is to keep your carbs low, and string cheese generally has 0 carbs. Anyway, the old 5&1 Plan on Medifast was just 5 protein meals and one meat/vegetable meal per day. It was nice because you never had to track ANYTHING. You just eat the 5 meals, and all you have to measure is your meat (weigh it, 5 to 7 ounces) and your vegetables (3 servings, a half cup each but for raw greens you get a full cup for a serving). If you eat those things, it automatically will be 800-100 calories, over 72 grams of protein and under 100 grams of carbs every day without tracking. That was so easy but boring. I am thinking I could do the same thing with random protein meals and whole foods that have a similar nutritional profile, and then eyeball the dinner to be about the same as a Lean & Green meal on Medifast. I am not going to get obsessive and count and measure spices like Medifast asks you to do; instead I could make one of the meals each day a no-carb snack to allow some wiggle room for the carbs in seasonings. What do you think? Can I do "Medifast" without actually using Medifast products? Would it be easy and stress free and result in weight loss? I'd be getting a solid 900-1000 calories a day which is probably slightly more than I am eating now, and also more than I would be eating after a VSG. If I am willing to eat well under 1000 calories a day after WLS, it can't be any worse to do it now. If I can't stick to it then so be it, I will try and get the surgery and that will force me to eat that way.

Today's menu (updated after dinner):

coffee with half and half
a hard boiled egg
a small nectarine
a packet of protein pretzels with a spoonful of hummus
a bowl of fresh kale that I cooked with onions and chicken broth
a protein bar
a large heirloom tomato from the CSA box, diced, tossed with fresh basil also from the CSA box, one chopped string cheese (because I had no fresh mozzarella), a drizzle of olive oil, and salt & pepper

I will have something as a snack later, maybe protein pudding or something else around 100 calories.

Walked the dog and biked 25 minutes. Input welcome.

26 comments:

Anonymous said...

This is an interesting packet about WLS. Page 32 has a few sample days that are around 1,000 cals but are real food.

https://www.tuftsmedicalcenter.org/~/media/Brochures/TuftsMC/Patient%20Care%20Services/Departments%20and%20Services/Weight%20and%20Wellness%20Center/GBP%20Diet%20Manual12611.ashx

Anonymous said...

Page 27 but the whole packet is interesting if you are considering WLS.

Lyn said...

Anon, thanks! That's a great resource!

Anonymous said...

I am 100% behind what you are doing. I remember when you posted that the author of Refuse to Regain advised you to go back on Medifast. I always thought that would be the key for you. However I do understand that since they are not providing you free food anymore, you may need a different approach. This sounds like the best of both worlds: the Medifast Plan that works for weight loss, and the freedom to use other products and whole foods as well. Brilliant! I am sure this will work for you, as long as you stick to it.

Anonymous said...

Where does a nectarine fit on a Medifast diet? I thought no fruit was allowed.

Lyn said...

Anon 100%~

thanks! The more I think about it, the more sense this makes!

Last Anon~

You're right, there's no fruit at all on the Medifast 5&1 plan. That's the beauty of having this flexibility! A nectarine has about the same number of carbs as a Medifast meal, but almost no protein. So combine a nectarine with a "protein water" packet that has lots of protein but no carbs, and you get similar stats to a Medifast meal!

Lyn said...

I am updating this post with the rest of today's menu, for anyone interested.

W said...

I think Medifast is a ketogenic diet, correct? If that's true, and ketosis is what suppresses hunger while on Medifast, simply looking at carbs as 8-15 per meal might not be enough. For example, I googled the nutrition info in a Medifast chocolate meal bar, and it had 13 carbs, 4 g fiber, and 4 g sugar alcohols. So since in theory the carbs in fiber and sugar alcohols don't affect blood sugar, the Medifast bars are 5 "net carbs". Generally 20-30 net carbs will keep you in ketosis, though I know different people react to sugar alcohols differently.

Apologies if you've already considered all this! I'm doing keto so it's on my mind constantly LOL

Lyn said...

W~

thank you! Technically Medifast isn't ketogenic, at least that is what the nutritionist told me. A lot of people on the Medifast forums used to get all upset because they would buy those strips that detect ketosis in your urine and they never showed they were in ketosis. If I remember right it has to do with the level of carbs (probably net, as you say) being just high enough to not cause ketosis. But I don't know what level of net carbs there were overall in a typical Medifast day. But assuming most of the meals are similar to the one you looked up and have about 5g net carbs, then that would be 25g net carbs/day just from Medifast meals. Then you have whatever the net carbs are in 1.5 cups of cooked veggies... so it sounds like it might be borderline ketosis. That's a really interesting point I hadn't considered, thanks!

Kristi said...

This is truly what I did. After doing medifast with you and lose 60 pounds, I quickly gained it back. I decided that this was rediculous and attempted many different things. I finally looked at what wls would let me eat and figured I could eat that without wls, and not have surgery, leaving me the option to eat other things I wanted. After 16 months of eating that way, I've lost 156 pounds and have kept it off for now 6 months. I eat small meals and only ate between 800-1000, usually it was 900-1000 because that was what I felt best at. I figured out something that I liked and used those as my meals. One thing I did was that I wanted to eat more of a whole food, not processed, bagged meals like medifast because I have kids at home and I want them to see me eating good, nutritious foods. I would have an oatmeal packet in the morning, carrots and hummus (2 oz prepackaged) for lunch, usually a Greek yogurt of a snack, and for dinner I would make a huge salad (an entire lettuce prepackaged bag, and I would add different things like a veggie burger or some chicken or cooked beans, salsa would be my dressing and if I wanted it a little creamy I would add a tablespoon of sour cream, sometimes I would add cranberries for a little chew) that would allow me to eat and chew to hearts content. I would also end the night with 1/2 oz serving of almonds. To this day, I still have this as my basis for meals. I now add several different things like an apple, a few more nuts, part of an avacado, etc to eat about 120-1400 calories that I need to eat to maintain my weight and not lose more. It is freeing because I don't have to think about what I am going to make, it's all the same which really doesn't bother me. Now a days if I want something different I just switch out that meal for something comparable, if I'm really wanting an ear of corn I will eat that instead of my lettuce and just have my protein on the side. I go out with friends and my husband and pick out a salad at that place too, make all the substitutions I want to make it like I would at home and life is good. It feels freeing not to have to think about food, I do measure when I add something to my rotation to make sure I can eyeball it next time, but after that, I am good to go. I am grateful it has worked for me and that I didn't have to rely on the surgery. Not only was I worried about my results but I want my kids to see that if they start to have a weight problem later in life (like 60%+ of society today), they can do something about it and not turn to wls. That they have the power in them to do it--they are that strong.

Lyn said...

Kristi~

wow, congratulations on your weight loss! That is great and I really appreciate you sharing what you did. That sounds very doable and reasonable. Thank you.

nic0ll3tt3 said...

Hi, Lyn! I couldn't help but jump in here when you mentioned "ketogenic diet". :)

Because, I follow a ketogenic diet! I would be happy to answer any questions you might have to the best of my ability about this diet, if you want (I'm not a doctor/dietician/nutritionist, so YMMV), or point you in the direction of a few resources. Medifast could qualify as being mildly ketotic, but it would be dependent on the person and which meals were being ingested.

However, everyone's body ends up being different, so what might be a ketotic level of carb intake for one person, may not result in ketone creation in another person. But, it's a generally held belief that if you ingest less than 30g of net carbs per day, you'll be creating ketones for sure.

Another trademark of a ketogenic diet is that keto diets are Moderate protein (not high protein). Most people shoot for a macro breakdown of 30g or less of NET carbs (total carbohydrate minus fiber), and 80g to 100g of protein (depending on activity level). The last big piece of the diet is FAT! Glorious fat, comprising up to 70 to 80% of the total calorie intake.

I'm sorry, I don't mean to rant about this on and on! But, a ketogenic diet really has changed my life, so it's hard to not get excited about it. :)

Wishing you all the best,
Nikki

Lyn said...

Thanks Nikki! That is great information and sounds a lot like what we did on Medifast except for the fat. They wanted us to stay under 30% of calories from fat. But the carbs and protein sound about the same. Are you currently losing weight on your ketogenic diet? I am curious about how many calories you generally eat a day, if you count, and how your losses have been.

nic0ll3tt3 said...

I'll try to be as short as possible and not leave you a novel-wall of text! :)

I've been dabbling and on/off a keto diet for about a year and a half now (I've had a couple of months off the wagon, and regretted it each time). As an aside, I have struggled a lot with emotional eating and bulimia in my past, so there's other emotional stuff, but keto has been helping me immensely work through these things.

The thing to remember with a ketogenic diet is that it's not a magic diet. What it does do is helps to keep your insulin low, which allows your body to mobilize fat out of the adipocytes (fat cells) and allows the body to start using fat as fuel. In the presence of carbohydrate, the body will naturally turn to using carbs as fuel, because its easier for the body to burn carbs (path of least resistance). Once carbs are out of the picture as a primary fuel source, the body will turn to using fat for fuel.

By eating a ketogenic diet, I am able to ingest a deficit calorie intake, which allows my body to use up my fat stores to make up the deficit. Once upon a time, I lived by the low-fat mantra pushed by our current society. And, I was always trying to count calories and hold myself to 1500 calories. All while getting more and more hungry, having more episodes of bingeing (because I was hungry). I frequently felt like a failure because I couldn't starve myself thin.

By eating keto, I don't experience the hunger like I used to. I still have hunger signals, but they feel "normal" to me and they are manageable. Eating ketogenically allows me to stick to a lower calorie intake and lets my body use up my fat stores.

As long as I follow the keto diet, I lose weight. I have noticed that weightloss on keto is much less linear; one week I might lose 6 pounds, then next week nothing, then next week up 2 pounds, then next week down 3 pounds. Water weight tends to be in flux much more on keto than when eating carbs (there's a reason for this, I'll spare you the details!). And I notice that my weigh-ins will trend with my menstrual cycle and hormones more closely than I've ever experienced before!

This is the best keto calculator I have found: http://keto-calculator.ankerl.com/
Set your activity level to "sedentary" (the calculator likes to get wonky if you set any activity), set carbs to about 20 or 30 (wherever you feel most comfy), and set calorie deficit to no more than 20%. Know that carbs are a hard limit, don't go over them. Protein is a true goal, your body *needs* the protein to spare lean muscle mass from getting used by the body (again, I'll spare you the details here!). Fat becomes a sliding scale that you can use to achieve satiation.

I do count calories every day. I feel comfortable enough that I could get away with not counting, but now it's just habit so I keep doing it. I aim for 30g net carbs or less per day, and try to get 100g of protein per day (I do Crossfit and need the extra protein to repair muscle). I use fat to fill in my calories, so that my total caloric intake ranges from 1200 to 1500. I eat to satiation though. Some days I might only eat 1100 calories because I'm just truly not hungry. Other days, I might eat up to 1600 calories. Some of this is dependent on my cycle; I'm hungrier during the luteal phase, which is very common (progesterone is high=more hunger).

I've been following your blog for a long time (dare I say since 2010, I believe). Given the ups and downs that you've documented, I think you have a lot of history that shows that a ketogenic diet might be exactly what your body needs. AIP appeared to be pretty close to a ketogenic diet, but I definitely eat a lot of eggs on keto. :)

Email me if you want more info!

-Nikki

Lyn said...

Thanks so much Nikki! I love the calculator, too. That is great and predicts what I would need to do to hit 199 by January 1. If I start to count carbs again I am going to pay attention to net carbs, something I have never done.

Steffanie said...

I posted on a previous post about having WLS- Sleeve. I don't think it's possible to follow a WLS food plan without having the actual tool of weight loss surgery. I could have never stuck to it. So basically you are on liquids for a week, soft foods for a week or so and you slowly introduce different foods. The group I went to which is award winning and a leader in WLS does not believe in using any pre-packaged food or protein shakes. This is uncommon in the weight loss surgery world but I'm very grateful for it. After the first few weeks the plan basically calls for small portions 1/3 cup-3/4 cup for the first year. Always protein first, then veggies, and then carbs if there is room...which there is usually not. The first 6 months no bread, rice, pasta, etc. Your protein need is based on your height and you are encouraged not to take in too much protein as it is hard on your kidneys. I'm 5'2 and my protein needs were in the 50g range. Some poeple with WLS are taking in over 100g which my group would consider dangerous. I've lost 70-75 lbs in a year and am now maintaing around 135. I eat around 1200 calories with a healthy balance of protein, fats, and carbs. I don't track everyday but just once in a while to make sure I'm on track. I like Myfitness pal.

Lyn said...

Steffanie~

Congratulations, that's wonderful! That is a very unusual approach from what I've read. Almost all of them use protein shakes. It sounds healthier to use whole foods if that is doable. So are you talking 1/3c - 3/4 c total per meal? Or per item eaten?

Lissa said...

Hi Lyn,
1) I love your blog. You have such courage and persistence.
2) second look at NSNG? It means no sugar no grains, and it's a mishmash of paleo, Atkins, and a whole foods diet. I belong to their Facebook group and it's FULL of helpful people with good information.
3) did the Gary Taubes book become available yet? It's very readable, quite scientific but also readable. And I love how it points out that obesity is a hormonal issue, not sloth or gluttony!!
4) Taubes video here, for those interested: https://m.youtube.com/watch?v=qEuIlQONcHw&feature=youtu.be

Good luck!!!

Lyn said...

Lissa~

yes! I am on chapter 2. I've been meaning to see if you wanted to talk a little about it via email. I'd love to hear more about what it's done for you. Thanks for the video link :)

Lyn said...

oh... and 1) thank you :) and 2) yes, I am now "minimal" sugar and grains. I'd have to look back over my menus before I could claim I've eliminated them.

Steffanie said...

Lyn...1/3- 3/4 cup per meal. You are never supposed to eat over a cup at a time for the rest of your life. They want you to try not to snack...but I usually do simply because my days are so long. I'm over a year out and my day might look something like this.

Breakfast- oikos zero greek yogurt and a few bites of fruit, coffee with almond milk
Mid morning snack- Kind bar
Lunch- small street taco (corn tortilla, protein, cabbage or cilantro, sometimes cheese)
*the first 6 months one of my favorite meals was the inside of a taco
Mid afternoon snack- mini babybel, fruit, pumpkin seeds?
dinner- 1/2 cup protein and a few bites of veggies, a bite of carbs
night time snack (sometimes)- dark chocolate square, glass of wine (when I reached goal only)

My labs are perfect. I take two centrum orange chewables, b12 sublingual, and calcium citrate. I was a little high on b6 most likely due to a my higher level of nut intake. I still get hungry but it's different. I'm much more in control. VSG surgery has been amazing for someone like me who has been overweight my entire life. I do have some extra skin and would love a tummy tuck but I don't seem to struggle with that issue as much as others because I truly had the surgery for my health. \

Josie said...

Hi Lyn,

I had the Vertical Sleeve Gastrectomy this past May. It's done lapiscropically so it's minimally invasive and the mortality rate is low low low. The Lap Band has had so many complications, my surgeon won't perform it any longer, and the VSG is so much better for you than by-pass surgery.

If you have any questions about the VSG surgery feel free to email me at veryjosie@aol.com. It's not for everyone and it's not a quick fix. I had to be part of a program before surgery where I changed my habits and I had to lose 10 lbs before they would perform it. Again, this is not the easy OR quick fix that everyone thinks it is, but it does work.

Good luck!

Lyn said...

Josie~

Thanks! That's great to hear how well it worked for you. I may email you later, thanks for the contact info and I appreciate your help and support :)

Catherine H. said...

I have been reading your blog ever since 2008. I deeply admire your persistence in your search for health. Please consider finding a doctor who can help you before you go through weight loss surgery. Look for functional medicine doctors in your area. That's how I found my doctor, and I have since discovered I had Bartonella, which is a tick-borne disease. My children were affected as well. We are slowly healing and finally getting our lives back. For the longest time I thought I could do it myself through various diets (low carb, ketogenic, paleo, perfect health, GAPS) but none of them helped because they couldn't change the underlying cause of all my problems, which was the bacteria from a tick bite. It took an experienced professional to see what I needed. Maybe there's an underlying issue that's been holding you back, too--something out of your control. Please consider finding out before you turn to surgery.

Lyn said...

Catherine~

wow, I've never heard of that. I haven't been to a functional medicine doctor but it sounds like it could be helpful. Thank you for the information.

Anonymous said...

What do you do when you have reached goal? Do you have to eat a keto diet the rest of your life?