sharkbyte

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I start intern year in a few days and I've realized now that I've put on a lot of weight during the past year or so, especially in the last few months on quarantine. M4 year with free time and residency interviews kind of kickstarted things and then it's basically spiraled downward the last few months due to laziness and overeating.

Any tips on ways I can lose weight while balancing life as a resident? Any particular recipes, meal plans, workouts/exercise regimens you all would recommend?
 
Oct 22, 2019
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I start intern year in a few days and I've realized now that I've put on a lot of weight during the past year or so, especially in the last few months on quarantine. M4 year with free time and residency interviews kind of kickstarted things and then it's basically spiraled downward the last few months due to laziness and overeating.

Any tips on ways I can lose weight while balancing life as a resident? Any particular recipes, meal plans, workouts/exercise regimens you all would recommend?
Keto diet + interval training worked for me. I lost 30 lbs in my second year of med school. I ate meat and salad mostly. The key is to not cheat on the diet very often. It's actually pretty tasty as long as you enjoy eating lots of meat. Vegetarian/vegan keto is possible, but a lot harder to pull off from what I've observed. I also had an 8 hour feeding window when I first started the diet, so I'd skip breakfast and not snack after dinner.

For exercise I'd just jump rope before class in the morning. It gets the heart rate up fast. Also, resistance training is great if you can fit it in. Even 1 or 2 days a week will make a difference if you hit it hard when you go to the gym. Use free weights so that your workout is more physically dynamic - this will get you better results and save you time.

I personally hate running, but you can get good bang for your buck time wise. I took up running when my gym closed due to covid and I needed a quick dose of cardio. Start slow though. Once you get injured it's hard to shake off.

One more thing. If you can bike places instead of driving, go for it.
 
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sharkbyte

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Keto diet + interval training worked for me. I lost 30 lbs in my second year of med school. I ate meat and salad mostly. The key is to not cheat on the diet very often. It's actually pretty tasty as long as you enjoy eating lots of meat. Vegetarian/vegan keto is possible, but a lot harder to pull off from what I've observed. I also had an 8 hour feeding window when I first started the diet, so I'd skip breakfast and not snack after dinner.

For exercise I'd just jump rope before class in the morning. It gets the heart rate up fast. Also, resistance training is great if you can fit it in. Even 1 or 2 days a week will make a difference if you hit it hard when you go to the gym. Use free weights so that your workout is more physically dynamic - this will get you better results and save you time.

I personally hate running, but you can get good bang for your buck time wise. I took up running when my gym closed due to covid and I needed a quick dose of cardio. Start slow though. Once you get injured it's hard to shake off.

One more thing. If you can bike places instead of driving, go for it.
Thanks so much! This is great advice.

For the workouts, did you find that you were still able to get through them OK even without carbs?
 
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GoSpursGo

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I also lost 35lbs in Med school.

For me, it was a matter of cutting out snacks and limiting how often I treated myself. Ie, if it’s not breakfast/lunch/dinner, don’t eat—even if there’s free food, even if someone is having birthday cake, turn it down. Take your coffee black. If you’re eating out, get a salad. Maybe once a week let yourself splurge a little—but only for one meal, and only a little. Finally, hold yourself accountable with a calorie counting app because we’re all terrible at guessing how much we’re eating. Don’t go crazy measuring all the different macronutrients or whatever—if your goal is weight loss, you will do just fine looking at the bottom line of calories.

I must have start/stopped 10 times before I got it right, because the hardest part is accepting that you’re gonna be hungry for the first couple of weeks while your body adjusts. But that’s normal—it means your body is starting to lose the weight. If you can make it through the first couple of weeks your body will adjust and you’ll feel less hungry. I feel like this is one of the more difficult plans to start, but if you can do it then it’s more sustainable IMO than some other ideas out there.

Exercise wise, I highly recommend finding any of the 30 minute workout series out there (p90x3, t25, whatever else that’s new out there) and stick to it. I’ve actually done those during fellowship because I just have no time for driving to the gym after work. And in the long run it’s cheaper. They can get a little boring and repetitive but eventually any workout routine does, and let’s be honest, you’re not going to the gym after a 12 hour shift. Finally, don’t overestimate how much you can eat just because you exercised—the normal amount of calories one burns with a workout is ~300 cal, which is just enough to get you 1.5 beers or so. Don’t totally cancel out your workout by overeating after.
 
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Thanks so much! This is great advice.

For the workouts, did you find that you were still able to get through them OK even without carbs?
Yes. After a short transition period my body felt totally fine without carbs. I can workout and study without having eaten recently.

A lot of the discomfort associated with the feeling of hunger is your body expecting food. The hormones that aid in digestion are getting your GI tract ready for that bolus, and when it doesn't come down the shoot, you get that feeling like your stomach is eating itself. That feeling doesn't mean you're actually in need of food but it does suck. That feeling goes away eventually once your body stops expecting a meal at a particular time.
 

gutonc

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Good advice above, and similar to what I would recommend.

1. Pay attention to what you eat.

Track your calories. There are a million diet plans (I prefer to call them eating plans) out there that work for people. The one thing they all have in common is that they make you pay attention to what you're putting in your face. (Side note...I love the rebranding of the Atkins Diet as "Keto". Makes it more bro-palatable.)

2. Exercise.

This is both easier and harder than you think. I've always been a cyclist. I biked to work virtually every day of residency and fellowship, and still bike to work as often as I can now. Some weeks I'd only get in my commuting miles, others I'd have the chance to add on 10-100 extra miles on days off. I figured I was doing fine. Then I decided to try one of those branded HIIT workouts at a studio that popped up in my neighborhood. The difference in intensity was incredible and I realized why I hadn't been losing weight before.

So your exercise needs to be focused, intentional and intense. Mixing things up helps keep it from being boring, but as above, running has great bang for the buck in terms of time and money spent. I can burn 400-500 calories on a 30 minute run...that takes an almost 2h bike ride to accomplish. And you can do it for the cost of a good pair of running shoes (do not skimp on this) and some clothes you already have in your dresser. Taking walks whenever you have a chance, even just 15 minutes, helps, as do simple things like taking the stairs instead of the elevator. The other exercise thing that I do is rowing, with a water rower. We bought one when quarantine shut our gym down. It wasn't cheap (but now that I think about it, it was cheaper than the last 4 bikes I've bought, so maybe it was) and has a similar time/calorie equation to running, with the benefit of adding core and arm work into the mix (where running is just legs and cardio).

3. Be realistic and have some grace with yourself.

Is it possible to lose 30# in the next 6 months? Absolutely. If you don't do that are you a failure? Absolutely not. In the last year and a half that I've been more intentional with my exercise (4-5 intense workouts/week), while eating "better" but not super focused, I've lost ~5#. But I've also turned a lot of fat to muscle and "moved things around". I have patients who haven't seen me for 3, 6 or 12 months tell me I've lost a lot of weight because of how I look, not what the scale says.

The mirror is sometimes a better tool to check your progress than the scale. And I feel better, which is ultimately what matters to me.
 

jurassicpark

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I start intern year in a few days and I've realized now that I've put on a lot of weight during the past year or so, especially in the last few months on quarantine. M4 year with free time and residency interviews kind of kickstarted things and then it's basically spiraled downward the last few months due to laziness and overeating.

Any tips on ways I can lose weight while balancing life as a resident? Any particular recipes, meal plans, workouts/exercise regimens you all would recommend?
Depending on what you're doing you may lose weight by being on your feet all day and stress alone :) Just kidding, maybe.

It will be hard, especially since for the most part you will rely on cafeteria food, and whatever you can afford to send your med student to buy for take-out during overnight calls (read: junk food). Unless you have a very nice Attending who throws down some menus and say, "choose." I remember most of my meals were hamburgers, big plates of pasta and Panda Express feasts.

Part of it definitely is running across the hospital all day long, and being on your feet > 24 hours. Some of it is gonna happen by skipping meals. Since high school I don't think I've ever consistently had breakfast. I think my coffee black, much like my soul at this point.

But always, no matter how tired I am I try to at least do a few minutes of exercise when I get home. My regimen of late has been : Max pushups followed up max situps. Some weights, pull ups. And since I can't go to the gym, at least walking/running the dog in the AM and PM.
 

MedicineZ0Z

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1. Spend several hours a day fasting, nothing fancy.

2. Lots of water in the morning.

3. Minimize sugars. Cut out fast food.

4. Lift and do cardio 4x a week. Have some sort of progression week to week on your workouts. Everyone has time for this. Even on 80 hour/week rotations, there is time.

And that's it. You don't need some fancy name diet or to fast for 10 hours a day or whatever.
 
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I’ve lost 25 pounds since thanksgiving: Intermittent fasting.

I’m also someone who normally gains 17 lbs if I have one chocolate shake but so far I’ve been able to drink coke daily and eat dessert a few times a week. I’ve noticed with the intermittent fasting my hunger drive is down and my portion control is significantly better.
Maybe I’m a bad example because I’ve actually increased in delicious unhealthy foods during this time but 2/2 the aforementioned reasons I’ve lost weight. I’m sure my arteries aren’t happy but hey one step at a time lol
 

gutonc

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Corollary to the food tracking thing. It's really easy to crawl up your own a** on this.

- If you find yourself meal prepping for more than 2 days a week, you're in danger of intubating your terminal ileum with your nose.
- If you find yourself posting your meal prepping on IG, you're almost back to the GE junction.

Don't be that person. Nobody likes that person.
 

samc

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I gained 40 lbs. in med school, omg. Ending intern year now and getting serious about losing it. PM me if you'd like to be my friend on myfitnesspal. If you don't want the social functions (which I find really helpful), cronometer has a much better interface than MFP.
 
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GoSpursGo

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It will be hard, especially since for the most part you will rely on cafeteria food, and whatever you can afford to send your med student to buy for take-out during overnight calls (read: junk food). Unless you have a very nice Attending who throws down some menus and say, "choose." I remember most of my meals were hamburgers, big plates of pasta and Panda Express feasts.
OK, I'm going to push back on this just little--there is nothing actually forcing you to choose those options. There's always a sad salad bar in the cafeteria, or a Subway where you can order a 6" turkey with mustard, or even sushi. Are those going to be as satisfying as the options you suggested? Of course not, and sure, you may actually be "entitled" to a feast when you're working at 14 hour shift, but if your stated goal is to lose weight then you've gotta have some self control.

Corollary to the food tracking thing. It's really easy to crawl up your own a** on this.

- If you find yourself meal prepping for more than 2 days a week, you're in danger of intubating your terminal ileum with your nose.
- If you find yourself posting your meal prepping on IG, you're almost back to the GE junction.

Don't be that person. Nobody likes that person.
Agree. A big part for me was realizing that you don't need to have every single meal be the most exciting culinary experience of your life. In fellowship, probably 4d/wk I have the same boring lunch: turkey on wheat, bag of baked chips, granola bar=650cal. 4d/wk I have the same boring breakfast: peanut butter toast, banana/apple=200cal. Yeah, it gets old real fast, but it keeps me on track, and then I can enjoy my dinner and do basically whatever I want on the weekends. Plus it's cheap, with almost zero time spent to get them ready.
 

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Losing weight is very easy. Hell, you can lost 5 pounds in a week just doing Slim Fast.

What you're looking for is a way to get healthy, which also includes losing weight. The answer to that is also easy, but hard to do if you're not used to it.

It's a cliche, but it's true that everything is okay in moderation, assuming no medical co-morbidities. I strongly disagree with diets - any of them. I disagree that you should eat salad if you go out (many salads have more calories than most other items on the menu) or that you can't have junk food now and then.

The equation to weight loss is taking in less calories than you're burning. That means, be mindful of what you're putting in your body. Fruits and veggies are a must and most of the time, you should be eating lean meats. It's okay to have carbs, but do so in moderation and good portion control (one of the main reasons people gain weight is lack of portion control).

You can have that cheeseburger and fries now and then. It shouldn't be a habit. You can have that candy bar after Step 3. It just shouldn't be after every other hard thing you do.

My rule of thumb:
Breakfast: protein and fruits, maybe a piece of toast

Lunch: sandwich meat (on wheat bread) with condiments. I'm not a fan of mayo so that's easy. I usually have a side salad I make -- spinach, cucumbers, olives, chickpeas, feta and fresh lemon juice or homemade Greek dressing for dressing. I sometimes have low-cal popcorn or low-cal chips on the side. Or I make my own fries by peeling a potato, pouring salt, garlic, and paprika on it with a touch of olive oil and baking it in the oven at 400 degrees for 30 minutes.

Dinner: lean meat, usually chicken for me because I like it, with brown rice or pasta. I always have veggies, usually roasted broccoli or a cauliflower/potato mix.

For snacks, I have nuts, turkey slices, low-fat cheese sticks or Baby Bell cheese, grapes, strawberries (I sometimes buy these frozen because it's cheapter), or raisins.

I also drink tons and tons of water by choice. I've always liked water.

If it's someone's birthday, I always eat cake. If we're at a party, I eat what I want. If we go out to dinner, I usually get a lean meat and ask for veggie replacements for the side (instead of fries, I have broccoli for instance). Or if I really want the burger and fries, then I know the next day, I should eat really clean and have lighter meals and/or do an extra workout that week. Salads are often more fattening at many restaurants so don't assume a grilled chicken salad is better for you than the grilled chicken dinner. If there are a number of events I attend in one week (birthday parties, work parties, mingling events, conferences), I'm mindful of what I'm eating and make up for it either during the rest of the day or I avoid the fried, fattening foods and opt for the buffet salad where I can decide what I put on my plate.

The main thing is I never put absolutes on myself. I never say I can never have something. I just play it by ear and remain smart about my choices. Restricting yourself is almost definitely sure to fail in the long run even if you initially lose weight.
 
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jurassicpark

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OK, I'm going to push back on this just little--there is nothing actually forcing you to choose those options. There's always a sad salad bar in the cafeteria, or a Subway where you can order a 6" turkey with mustard, or even sushi. Are those going to be as satisfying as the options you suggested? Of course not, and sure, you may actually be "entitled" to a feast when you're working at 14 hour shift, but if your stated goal is to lose weight then you've gotta have some self control.
Sorry, didn't mean it to sound like they were forcing us to choose. They were giving options on what they were willing to buy, and as a med student or lowly resident who was I to say no to free food? :) As a matter of fact, I still go to all the drug rep dinners whenever I can. Abundant crazy good food and open bars, did someone say Pappy or Louis XIII? Heck yeah.

To be fair, they stopped taking us to the bars that have those, they realized we knew what we were ordering..
 
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mistafab

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Losing weight is easy, keeping it off is hard.

Any method of diet, exercise, or whatever can be an effective way to lose weight. The issue is, that most people gain it all back, because the intervention eventually goes away or is simply unsustainable.

The only guaranteed way to lose weight and keep it off is lifestyle change. I used to have a 205 pound lifestyle. I did not exercise, I drank wine every day, and I would eat plentifully (though not over the top). An example of my 205 lifestyle was this:
1. wake up, eat bagel with butter and 2 coffees
2. drive to work
3. eat sandwich for lunch
4. drive home
5. eat a handful of nuts, an apple and banana
6. go on a walk
7. drink wine and play video games
8. eat a small dinner, usually rice, salad, and meat.

Doesn’t seem like a lot of food or too much excess, does it? However, compare it to my 185 lb and jacked lifestyle now:

1. wake up, drink milk and coffee
2. eat beef, bell pepper, brocolli, spinach, mushroom, and cheese breakfast
3. go to work walking
4. Eat beef, cheese, and mushroom lunch
5. go home after work walking
6. exercise, cardio or lifting, for 40 minutes
7. eat eggs, quinoa, beef, and brocolli dinner.
8. eat handful of nuts, apple, and blueberries

If you look at my diet side by side, the calorie amount is actually pretty even in both scenarios. My carb amount has decreased, and my sources of carb changed to those only of vegetables, fruit and quinoa. The biggest difference in this lifestyle from 205 and dad bod to 185 and jacked is that 1) exercise is part of my lifestyle and 2) alcohol is no longer part of my daily lifestyle. Again, it did not take a lot of change. However, changing those two primary parts of my lifestyle, and staying consistent for four years, is what it took for me to be here. Alcohol is something I do only socially, and no more than once or twice a week now.

Anyway, hope this helped some. Maybe write out what your lifestyle is now, and think about what might be your lifestyle 10 pounds lower and make those changes. Best of luck.
 
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chocomorsel

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Americans have terrible eating habits. Who the hell needs to eat dessert three or four times a week?
OP, stop eating junk, buy a healthy cook book that emphasizes veggies fresh veggies and whole grains instead of processed carbs and exercise using YouTube videos three times a week.
Stop buying junk, stop eating junk and don’t eat just because there is food around and everyone else is doing it.
 

Fatalis

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Intermittent fasting for diet regimen. This NEJM paper even has prescriptions you can give to patients. This is essentially bulletproof if you can do it. Not so hard as an intern- just don't eat breakfast and be careful how late you have dinner. No random snacking.
I am sold, today is day 1 of doing it! Might take a hit with lifting heavy weight at the gym but we will see
 
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