Weight Loss: Health Concerns and Monitoring Strategies

Weight loss

Hello, doctor.
I am a 30-year-old woman.
Aside from a period during college when I diligently ran and exercised, reducing my weight to around 60 kg, I have generally maintained a weight above 70 kg.
Since August of last year, I have been trying to lose weight primarily by reducing carbohydrate intake, skipping breakfast, eating normally for lunch, and replacing dinner with vegetables.
I also do sit-ups or squats for about 15 minutes daily.
My weight has dropped from 71 kg to the current 56 kg (from August last year to June this year).
However, for the past month, I have stopped exercising.
My diet has remained similar, but I have started to include light snacks like rice balls and sandwiches for dinner, and occasionally eat out without strict limitations.
Despite this, my weight has remained stable, fluctuating slightly between 54 kg and 56 kg, which makes me a bit concerned about potential underlying health issues.
Additionally, about four or five years ago, I frequently experienced upper abdominal bloating and pain at night, which I could not relieve through belching or passing gas.
This would resolve by morning or after inducing vomiting.
After reducing my intake of greasy foods, these episodes have almost completely stopped.
In November of last year, my pre-meal blood sugar was 81, hemoglobin A1c was 4.9, TSH was 2.080, amylase was 35, and CA-199 was 11.10.
However, I did have a urine ketone level of 1+.
Currently, aside from occasional mild pain in the right lower rib during breathing and the weight loss, I have no other noticeable abnormalities.
I would like to know if there are ways to monitor whether my weight loss is normal or what types of tests I can undergo for confirmation.

Ms. Hsu, 30~39 year old female. Ask Date: 2022/05/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

Further observation is recommended, and if necessary, an ultrasound and gastroscopy should be performed.

Reply Date: 2022/05/30

More Info

Understanding weight loss and its associated health concerns is crucial, especially when significant changes in body weight occur over a relatively short period. In your case, you've successfully reduced your weight from 71 kg to 56 kg over approximately ten months, which is commendable. However, it's essential to monitor your health closely during this process, especially since you've recently experienced changes in your eating habits and a cessation of regular exercise.

Weight Loss Monitoring Strategies
1. Regular Weigh-Ins: Continue to monitor your weight weekly or bi-weekly. This will help you identify any significant fluctuations and understand your body's response to dietary changes. It's normal for weight to fluctuate slightly due to water retention, hormonal changes, and other factors, but significant or rapid changes should be noted.

2. Body Measurements: In addition to weighing yourself, consider taking body measurements (waist, hips, thighs, etc.) to track changes in body composition. Sometimes, even if the scale doesn't move much, you may be losing fat and gaining muscle, which can be reflected in your measurements.

3. Dietary Tracking: Keep a food diary to track what you eat daily. This can help you identify patterns, such as emotional eating or unintentional calorie increases. Apps that track calorie intake can also be beneficial.

4. Physical Activity Log: Document your physical activity, even if it's not as rigorous as before. This will help you understand how your activity levels correlate with your weight and overall health.

5. Health Check-Ups: Regular visits to your healthcare provider are essential. Given your history of abdominal pain and the presence of ketones in your urine, it may be wise to discuss these symptoms with a physician. They might recommend further tests, such as an abdominal ultrasound or gastrointestinal evaluations, to rule out any underlying issues.

Health Concerns
1. Nutritional Deficiencies: Since you've altered your diet significantly, it's crucial to ensure you're still getting all the necessary nutrients. A diet low in carbohydrates and high in vegetables can lead to deficiencies in essential vitamins and minerals. Consider consulting a registered dietitian to evaluate your diet and make necessary adjustments.

2. Ketosis and Urine Ketones: The presence of ketones in your urine suggests that your body may be in a state of ketosis, which can occur when carbohydrate intake is very low. While this can be a part of some weight loss strategies, it’s essential to ensure that it’s done healthily and under supervision, as prolonged ketosis can lead to complications.

3. Gastrointestinal Health: Your previous episodes of upper abdominal pain could indicate underlying gastrointestinal issues. It's essential to monitor any recurrence of these symptoms, especially if they are accompanied by changes in bowel habits, weight loss, or other concerning symptoms.

4. Thyroid Function: Your TSH level appears to be within the normal range, but if you have concerns about weight fluctuations, it might be worth discussing with your doctor whether further thyroid function tests are necessary.

Conclusion
In summary, while your weight loss journey has been successful, it’s vital to approach it holistically. Regular monitoring of your weight, dietary intake, and physical activity, along with routine health check-ups, will help ensure that your weight loss is sustainable and healthy. If you experience any concerning symptoms or significant changes in your health, don’t hesitate to seek medical advice. Remember, weight management is not just about the numbers on the scale; it’s about overall health and well-being.

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