Morbidly obese but needs to follow low fibre diet

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nohogirl
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Joined: Thu Jun 07, 2012 12:58 am
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by nohogirl on Thu Jun 07, 2012 1:08 am

Morbidly obese but needs to follow low fibre diet

Hello new to forum so please be gentle.

I have lived with IBS and Solitary Rectal Ulcer Syndrome for over 20 years. I have to eat a low fibre diet to manage my symptoms.
I have struggled with my weight all my life and now my BMI is 40. So unhappy with myself. Have tried dietclubs and failed (although I did lose 4 stone, fell pregnant and put it all back on)
So desperate I am considering Lighterlife, although worried about fibre content. Anyone else with IBS tried this?

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Denise Kennedy
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by Denise Kennedy on Thu Jun 07, 2012 9:19 am

Re: Morbidly obese but needs to follow low fibre diet

Thanks for your post. It seems like you have quite a lot going on!!

Symptoms of IBS vary significantly from person to person, for example in some symptoms can include diarrhoea and in others it can be constipation. Some people have more wind and bloating symptoms, while others get abdominal pain and cramps. Dietetic advice tends to vary depending upon the symptoms, for example in IBS with diarrhoea first line is often to cut down insoluble fibre (from wholegrains, bran etc) and have more soluble fibre (from fruit and veg) possibly avoiding pith, skin and pips. There is also a new dietary regimen called FODMAPS, which systematically eliminates certain known triggers in the diet to help identify causative factors. This is quite a new diet, developed at King's in London, and may not be available everywhere. Stress is also a known trigger in IBS. Whatever your symptoms there are some basic rules to follow:- eat regular meals, don't skip meals, take time when eating and chew food well, enjoy and relax over meals.

SRUS is very rare and not something I have come across personally. You will be much more expert than I am on this condition, but a quick scan of scientific articles indicates treatment with bulking agents to soften the stool so that there is no straining. This could of course conflict with advice for IBS.

Losing weight will be more difficult if you are having to limit your intake of low calorie fruit and veg, but not impossible. It is still about limiting your calorie intake through food and drink and increasing your energy expenditure through activity and exercise. Most people find exercise really helps their IBS and this will also help you to lose weight, so I would aim to make this your priority - develop an activity regimen that you can build up and stick to. Aim for at least 30 mins five times a week, and increase it from there if you can.

LighterLife is a meal replacement programme, provided along with counselling. It is what is considered to be a Very Low Calorie Diet (VLCD) and people can lose weight very quickly. At some point you have to go back onto a normal diet and learn to manage your weight on normal food. I am not sure how this type of diet would affect yoru IBS and SRUS, and really believe that you would be better aiming to lose weight by changing your normal diet.

I suggest that you talk to your GP and ask for a referral to a dietitian local to where you live. They should be able to help you to develop an eating regimen that will allow you to manage your IBS and SRUS, whilst at the same time losing weight. They can also assess the adequacy of any diet that you end up on and recommend how to correct any specific deficiencies. This may take a bit of time and some trial and error. While you wait for this I would also suggest you keep a food and symptom diary - this can help you and the dietitian to identify how food is affecting you and look at how yoru intake can be modified.

It may take some time but slow and steady is the best way to lose weight. The dietitian should be able to help you set some realistic, but achievable targets.

I hope this helps and best of luck. Denise
Denise Kennedy
Registered Dietitian and Nutritionist

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Wendy Green
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by Wendy Green on Fri Jun 08, 2012 3:56 pm

Re: Morbidly obese but needs to follow low fibre diet

Hi noho girl,

As Denise says, if you have IBS with diarrhoea (IBS-D) you do need to avoid insoluble fibre, which is found in bran, wholemeal bread, weetabix etc. as well as the skins of fruit and vegetables. However, soluble fibre is helpful for this type of IBS and could also help ease your SRUC symptoms - as these can be worsened by a lack of fibre - therefore I'd strongly recommend that you include some in your diet; as Denise says you could eat peeled fruit and vegetables - apples, and pears are great sources of soluble fibre. Another food I'd recommend is oats in the form of porridge and oatcakes. Beans, peas and lentils are also great sources of soluble fibre - but they can exacerbate wind and bloating in some IBS sufferers.

Another benefit from eating these foods is that you'll feel full for longer and therefore you should find that you lose weight too.

I agree with Denise and would give the Lighter Life programme a miss, as it could have an effect on your IBS and SRUC symptoms. Also, it doesn't teach you how to manage your weight when eating a normal diet and could be costly.

As Denise points out, becoming more active could help you to lose weight and benefit your IBS symptoms. Given that your BMI is 40 I'd suggest that you start
off by doing 10 minutes of moderate intensity exercise like walking, or even household chores like vacuuming, mopping, cleaning and dusting, or gardening. Swimming would also be great, as the water supports your weight and it's a great all-round toning exercise that strengthens the heart and lungs and burns lots of calories! As you lose weight and get fitter you could gradually increase this to 20 minutes and then 30 minutes of exercise daily. Eventually you should manage to be physically active for one hour a day.

I hope this helps and good luck!
Wendy Green
Health Expert and Author

http://www.talkhealthpartnership.com/on ... _green.php

nohogirl
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Joined: Thu Jun 07, 2012 12:58 am
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by nohogirl on Sat Jun 09, 2012 2:05 am

Re: Morbidly obese but needs to follow low fibre diet

Thank you both for your replies.

Yes you are right I've got to know what triggers me off by now.

I know I use food as a crutch, and only I can break the cycle. Will pluck up courage to speak to Dr as I have a thyroid check up next week.

I know I Could do more exercise too, I'm running a 10k in a weeks time, as a step up from 5k.

Just think I'm tired of failing all the time.

Need to give myself a damn good kick up the numbers (no pun intended)

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Wendy Green
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by Wendy Green on Sat Jun 09, 2012 10:25 am

Re: Morbidly obese but needs to follow low fibre diet

Hi nohogirl,

Please don't be so hard on yourself - you should give yourself a pat on the back for going running! :D

I notice that you wrote both of your posts on this site during the early hours - am I right to assume that you don't sleep very well? Lack of sleep can cause weight gain because it affects the hormones that control hunger and feeling full. If this is the case you would definitely benefit from taking steps to improve the quality of your sleep. Not only would it help you to lose weight but it could also improve your IBS symptoms and general health.

Please let me know if you'd like any help/advice on how to sleep better.

All the best,

Wendy
Wendy Green
Health Expert and Author

http://www.talkhealthpartnership.com/on ... _green.php

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