I've been pretty much a chronic "dieter" for the past couple of years. I'm of Northern European descent. I've gone from 301 lbs (height 6'4) to 221 lbs using a strictly low calorie diet and ingesting a lot of caffeine, and unfortunately, smoking tobacco. This was back in college where I spent quite a bit of time walking to class and around campus as well so I didn't really add in any extra exercise. When I graduated, I ballooned back up to 270 mostly because of poor food choices and quitting smoking (almost 10 months now).
Prior to discovering paleo, I had gone down to 249 using a semi-low-calorie diet and eating purely natural/organic food (but including grains). Reading about paleo piqued my interest and I decided to give it a try because it seemed along the lines of what I was already doing (the organic/natural part) but, I guess, healthier. After beginning paleo on February 2nd, my weight has fluctuated between 247 and 252 constantly, and has essentially plateaued.
Now, the problem is that I really don't have time to cook or follow any strict exercise regime because I am now currently a second year medical student and have board exams coming up in June. I spend at least 10-12 hours everyday sitting and studying. I try to walk around my apartment for around 30 minutes a day to get some sort of exercise but that's pretty much the max. I also consume a whole lot of caffeine through coffee, tea, diet energy drinks, and diet soda and I cannot give this up or afford to go through caffeine withdrawal at this time.
My average mealplan in a day looks like:
Breakfast: 2 Cage-free omega-3 Eggs w/ nitrate-free organic chicken sausage or nitrate-free pork bacon, tomatoes, onions, and various spices. I usually have coffee with breakfast, often black, but sometimes with a little bit of coconut milk and stevia. I also take my fish oil supplement around this time. When I'm not feeling like eggs, I have some eggplant and zucchini doused in olive oil.
Lunch: Lately, it's been around 3 servings of organic, nitrate-free beef meatballs w/ spices and sundried tomatoes. But I also sometimes have a spinach salad with whatever I have around at the time. Chipotle salad bowl loaded with chicken and guac is a mainstay in this section as well.
Dinner: This one varies the most as I feel that I don't have enough time to cook. It's usually a few organic, nitrate-free beef hot dogs, some frozen chicken breast (that I have breaded in almond meal and spice mix before frying and then baking), buffalo wings (1 carb), with some asparagus or other vegetable. Though, I have in the past, made coconut curry and various cauliflower-based stir frys. I use organic coconut oil whenever I fry anything (and on that note, what is a good dairy-free substitute for coconut oil frying when you just don't feel like that coconut flavor.) A rotisserie chicken from whole foods with some whole foods egg salad also works in a pinch. On weekends, I'll have a few glasses of red wine at night to relax post-meal.
Snacks: This will usually be a handful of macadamia nuts (due to low omega-6 content) or sometimes sunflower seeds or almonds. Hard-boiled eggs are also a constant snack, and from time-to-time I have indulged in dates, figs, and larabars.
The only "non-paleo" items that I have consumed during this time was grass-fed cheese (though, the jury is still out on that one and dairy in general), half and half, and sour cream (from chipotle), and a bit of BBQ sauce that came in a restaurant-ordered pulled-pork meal.
I'm not really sure about the calorie content that I'm eating per day, but from years of calorie counting, I could probably ballpark it to around 2000 calories on an average day. So now I'm here looking for advice as to what to do because my patience for paleo is wearing thin when it doesn't seem to be working. Now I know that steady exercise, and occasional heavy-lifting/sprinting is an important part of this regime, but other than the daily walking, I really cannot afford to be distracted from my studies or feel more tired/sore than usual at this time. To reiterate, I steadily lost weight following a non-paleo diet without any change in exercise prior to this and the weight loss only stopped when I switched to paleo.
Should I stop paleo and go back to my old way of eating until I have time to fully dedicate to the regime (which practically may be never or at least not for years in my field) or is there any other advice that you guys can give me?
asked byAlex_9 (1044)
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on April 16, 2011
at 08:03 PM
You have boards coming up, which means pretty much screw everything else. Now I've managed to not only switch over to "paleo" during my first year, but stick with it. But I don't need to tell you that sometimes, notably around exam time, it goes out the window. We gotta suck down ridiculous amounts of caffeine to make up for our already ridiculously down regulated adenosine receptors. At some point we have to give up getting enough sleep and at some point we have to deal with the cortisol and all the other crappy stress that comes with medical school. You're pretty much at the finish line.
That all said, you've got what, 6 weeks before boards? You should be done with classes now. So all you have to do each day is get in the requisite 12 hours of studying. So that leaves 8 hours to sleep and 4 hours to do the other things, like cooking and working out. Thus, you ought to be able to cook more, and you ought to be able to get in an hour of exercise. The thing that strikes me about your diet is that it seems kind of starvation like for a guy your size (2000 calories at 250 lbs? That is probably like 40% of BMR or something). And it is really heavy on the chicken (e.g. omega 6 rich). More good fats, less chicken.
You can just say to hell with it until after boards, or you can stop making excuses and just get disciplined with it now. There's a few crossfitting, paleo eating folks in my class. We find the time. It can be done. There are paleo eating residents. There are 3rd and 4th year rotation students who keep disciplined with the diet and exercise. It can be done.
That all said, boards are the most important thing right now. Period. End of story. Whatever it takes for you to rock the boards is the first priority. You know this. I found my studying got better with better diet and more exercise, but you know what works best for you now (I hope). Own the boards and then get everything else in order...you should get a little time there before rotations start.
on April 16, 2011
at 06:10 PM
You should stand while you study to increase metabolic rate. Or sit on a recumbant cycle/stand in an elliptical-style machine or walk on a treadmill. Tape lectures(voice recorded) and listen while working out, etc. Your problem lies with energy balance and more must come out than in: watch your production not consumption, therein lies the problem.
on April 18, 2011
at 11:42 AM
We're like twins. I've been in your shoes more or less for the last 7 years of my life. I came from a nutritionally defunked home and never knew how to eat until I went to college. By the end of my freshman year and endless buffets, I was 6'1 and 310#. It's been the struggle of my life, and through different diets I have managed to fall below 200#, although it has peaked above that after stressful blocks of med school.
I'm only a first year, but I have always lived a stressful life through family or career. It's hard to make the choices of when to eat the right foods. I'm married to a woman who doesn't cook and also is a carb-o-holic. When I cook, I have to look at cooking 2 meals. It's a little stressful at dinner time.
Like you, I've been through so many diets I'm to go to guy for critiquing them for friends who try them. I guess that'll serve me well in the office when patients tell me what they're doing. But it's not something I like in my closet. I've finally found refuge in the paleo diet, and like it's mentioned above, it's a lifestyle now. Here's how I make it work with my life.
I live in a neighborhood away from the busy main street. Whether I'm studying at 10AM or 2AM, Every 45 minutes I go for a run to the stop sign and back. that's 3/4 of a mile. At first I was so winded getting back it took 10 minutes to focus again, but now, it's great. I can think about what I read, think about why I hate that class, or think about what I'm reading next. When I don't feel like running, I walk it, and it takes a little longer, but I feel just as good. And I say every 45 min, but through the day I still only get out 4-5 times max. I just have to have a goal or I'd only go once. Goals are key to getting through this (duh, you're in med school).
I'm fortunate enough to have saved enough money to build a mini-gym in my garage collected from craigslist sales. A bench, a bar, 250lbs, and 35lbs of dumbbells. I have a tiny lifting schedule that I crank out in 20min max 3x a week. Sometimes I miss it. This should only cost you $150 or less and a small footprint in a garage or bedroom. It's worth it when you've got a cramped life. 3rd and 4th year will be busy too.
Food - YOU MUST PREPARE FOOD AHEAD or you will fail. I take the longest break that I MUST CREATE on some day to dice the hell out of anything I might eat raw or need for cooking later. While my wife wont cook, she will shop for me. That saves an hour or so each week.
Cooking, I love to cook so it helps. But there are some paleo tricks. Have a love affair with your crockpot. If you're in med school and not using it, you're missing out. You can cook great meals in a crock pot that last 2-3 days. My next advice is crazy - google sous vide, watch a video, and then buy one. It's wicked steep, but I live like a king off that machine. It's like a $600 upfront investment to buy or ~$250 to build , I stop by the grocery store I pass 1-2 a week and clear out all of their discounted meat for the day and then drop it all in my sous vide for a day and I have prime rib, pork chops, insane chicken, and soft vegetables. Hell, I can toss in apples and pears on sale and have dessert. It's hard to explain here, but google it, read up on it, buy it, love it. Best money I ever blew my financial aid check on because I always have the protein I need 7 days a week. It's stupid simple. If you don't have the cash, make a sous vide for $150 + vacuum sealer. Google those plans, they work.
Boards blow, and maybe the only thing I have on you is I started studying for them the second week of school so I could not spend 12-14 hours a day the month before them to take them. Who knows, I might be in the same boat in a year, but I hope not.
Here's a little med school wisdom I found early, and it's too late for you to enjoy, but it seems like there are other med school ppl here. There is most definitely a declining rate of return on studying. I'm about as type A as they come, and I would study study study study and get lets say a 87 on a test, when I realized what was getting neglected, I gave up 10 hours in the week and I might have gotten a 85, sometimes I could have gotten a 90, depends. The point is, I learned how to let go to find balance, and it paid off in my health and my grades. I'm not suggesting you gamble with the boards, these are the key to your (our) future, but I must recommend finding balance now and in the future. It really will pay off.
So, the moral of this rant - I'm not a role model, I still have flab in the middle. I have managed to find a way to make it work, but I have days that don't work because I havent been home in 36 hours and the vending machine is everything but paleo. I know that balance is a metaphor better related to chasing a speeding car down the highway on foot when you're in med school, but you can do it. And if I can help you anymore, hit me up.
Time for lab.
on April 17, 2011
at 12:21 AM
If you'll indulge me in a bit of respectful speculation, have you tried being too busy to eat?
I'm not a doctor, I'm a writer. And when deadlines are crashing down on me I don't have time to spend in the kitchen. Where Paleo has helped me immensely is that I can be hungry for hours with little-to-no discomfort or loss in performance. That combined with being busy means I can spend seven hours at a time typing away before getting up to eat something. At that point weight loss becomes a bit of a happy accident.
Now you need to be at your absolute mental peak pretty much all the time, so maybe you can't afford to be hungry at all, but it seems to me (as a bystander in the peanut gallery... or the almond gallery, if you will) that if your body does allow you to go without for a while, then saving your time to make one healthy meal a day might be better than three unhealthy ones.
Again, maybe this won't work for you now, or ever. Maybe you're just not wired that way, but I would not advise completely abandoning something that's worked for you just because you're busy. After all, residents don't exactly have a lot of free time either. What kind of diet will be sustainable for you then that isn't now?
on April 16, 2011
at 06:04 PM
The Paleo diet is not a race it is a lifestyle. Weight loss like the process of going through medical school takes time. There is no real need to hurry for results because ultimately its about how you feel and thrive with overall great health. A lot of people who go on diets strive to look the part of a thin, stereotypically and socially acceptable image of a person BUT as there have been discussions about this, people can be rail thin but still have a higher fat percentage than a average-sized individual. Of all things, I feel that prepping for medical school would worry me more than seeing a number move on a scale. There are many wonderful websites and resources available for you to check out and take from their own experiences and incorporate it into your lifestyle. Go with how you're feeling and keep up the great work!
on April 16, 2011
at 06:40 PM
My husband was a heavy drinker of diet sodas for many years. We discovered that even artificial sweeteners were causing an insulin dump and subsequent inability to lose weight even while eating paleo. Once he stopped consuming artificial sweeteners he started dropping weight again.
on April 16, 2011
at 05:55 PM
There's lots of doctors that do it. There's lots of poor students that do it. There's lots of moms that have no time on their hands that somehow manage to keep their whole families doing it. You can do it too. It all just comes down to better choices and self-control.
on April 18, 2011
at 02:36 PM
I have that too.....use it four times a week
on April 17, 2011
at 10:10 AM
Why would one expect a non-paleo diet to be preferable, either for your studies or weight loss? It's difficult to think of reasons why grains, vegetable oils, immoderate fructose, lactose or casein would be necessary for either of these goals. Eating a diet of meat, veg, fat and starch if you like, oughtn't to be too trying.
I think it's important to wonder why weight loss might stall on paleo diet. I don't think we can blame the paleoicity itself, for the above reason (it's difficult to see why the exclusion of non-paleo elements would cause you to stall). It's worth noting (and is evident from lots of questions even on here) that people reach a 'plateau' on almost every diet. I don't think that the fact that your weight loss has stalled is indicative of the relative inferiority of the paleo diet, even though you "steadily lost weight following a non-paleo diet...and the weight loss only stopped when [you] switched to paleo."
So one wonders why you did suddenly stop losing weight. Aside from the fact that you may have plateaued naturally, or that you've stopped losing due to the extra stress, or that you switched from your apparently functional diet to paleo because of some other problem which is the real issue here, what might be the problem with your new diet? I note that you talk about your prior diet as "low calorie." There are a couple of other questions on here that follow the trend of people being on a calorie restricted or indirectly low calorie vegetarian diet, switching to paleo and deciding to drink glasses of heavy cream and eat the fattiest steaks they can find, like everybody else and finding that they stop losing weight. Certainly a diet that is just plain lower in calories might lead to more weight loss than a more calorific paleo diet (though paleo has other benefits). It might be that since going paleo you have added more calories and it may be that something about your new diet is leading to you consuming more calories. The sausages and meatballs, being processed, might well contain quite a lot of fat, relative to protein, and so be unsatiating, if you're relying on them for your protein requirements (I assume they don't contain any other unsavoury elements). It may be that if you're trying to eat some fatty paleo meat at every meal, then you're just eating more than you would eat for satiety, were you eating salads and muesli, or whatever it was you ate. If you just want to nibble on things while working (as I find very pleasant) then just eating some low calorie plant could plausibly be better than a more quintessentially paleo snack of hard boiled eggs.
As to the practicalities of eating paleo, while you can't cook, I'm not sure why cooking meat need be more time-consuming than cooking sausages and bacon or chicken breast breaded in almond meal and spice mix before frying and then baking. Just frying (or even microwaving) some ground beef, or sticking a huge joint of meat in the oven (3kg of beef = ~5 days meals sorted), sounds even less time consuming. I suppose if you were just eating raw oats and soy milk (as I did during a period of my student days), then that would be even easier than cooking paleo, but otherwise, there's no particular reason why you ought to switch to a non-paleo diet, until you can "fully dedicate to the regime."
Also a couple of quick suggestions: Maybe you could swap the sweetened caffeine beverages for just more tea/coffee/caffeine pills? Also what about intermittent fasting? Eating most of your calories in one big meal, or during a short couple of hour period seems very time efficient.
on May 09, 2011
at 11:15 PM
When you go to a hospital, do you feel you are in good hands and will you survive your hospital experience? Alex, see this question. Hoping you can add to the discussion. http://paleohacks.com/questions/37626/when-you-are-admitted-to-a-hospital-through-the-er-what-standard-of-care-do-you#axzz1LtOQXRIn
on April 16, 2011
at 07:35 PM
Unfortunately, weight loss often comes down to calories. They do count. Not as much as mainstream media would have us believe maybe, but they still matter. Since you're not moving much, 2000 calories may be too much. When I had knee surgery I was completely sedentary and ate about 1400 calories a day, but now that I am active again I'm eating 2500+ calories a day. I would try moving more and decreasing calories slightly. Cutting out snacks or eating only 2 meals a day would probably be a good way to do this.
Have you tried walking while studying? It sounds weird, but I've found it to be very effective. I use flashcards and walk around my house. It is my preferred way of studying now and I feel that I learn significantly quicker than before. It has evolutionary backing too because when you move to new places you need to create new neural connections. Increased blood flow can't hurt either. I got the idea from Seth Roberts, and he has a few posts on it on his blog. (I can't link, sorry, I'm on my phone).
I'd also suggest investing in a pedometer. It really provides motivation for walking by giving you a hard number as to the amount you've walked that day.