wanting to lose weight is SO FRAUGHT

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Routine Doctors Appointments

Why have my insurance plan and my annual schedule conspired to make January the month when I have All the Appointments? I was trying to make plans to write with a writing friend and I looked at the calendar and it is PACKED. I feel like January is nearly over and it has only just begun. 

One of my upcoming appointments is with my OB/GYN, and I have been steeling myself to insist a little more forcefully that I believe I am in perimenopause. You will likely not recall that last year, my tentative questions about it were dismissed due to my age. The array of symptoms that seem to be perimenopause-related continues to grow, so I just want to confirm that a) yes, this is happening and b) there is nothing I can really DO about any of it, beyond what I am already doing. (TMI note: I take oral contraceptives which both prevent a period, so I don’t have that to clue me in as to actual menopause, and, according to the OB/GYN, oral contraceptives are supposedly the first line of defense against perimenopause symptoms anyway.) I had also been steeling myself to ask for a physical exam this year, should it be bewilderingly optional as it was last year, but I am pleased I am relieved I see from last year’s post that I should expect a pap test this year so that shouldn’t be an issue.

The other upcoming appointment is with a new-to-me internist. I have been mildly fretting about the appointment for, oh, several months now. I am eager to have a primary care physician again; my last PCP, whom I adored, prescribed me a new medication two Decembers ago, then went on leave until March, then left her practice to become a concierge physician. I love her enough that I strongly considered following her to her new practice, but I did not. Anyway, I have ostensibly been without a PCP since December of 2023. The old practice has been kindly refilling my prescription all this time, but I will be relieved to have a regular doctor again. (Yes, it has taken me since approximately March of 2024 to get in to see a new physician. This is both because I wanted a doctor whose office is closer to where I live now and because I wanted the specific provider my husband recommended.)

The thing I am fretting about is that this appointment is about establishing me as a patient… but I also have A List of things to discuss with the doctor. So I am worrying both about coming across as someone the new doc wants to have as a patient… and about addressing my concerns. 

Is the first fret ridiculous? Yes, yes it is. I can acknowledge that without being able to eliminate it from my worry database. I am sure this doctor sees a thousand middle-aged women just like me; I am not going to be any more or less desirable as a patient. Plus, physician’s job is to deal with the patient in front of them, not reject them based on some sort of Simon Cowellian checklist. (Is Simon Cowell still a contemporary reference?) And in any case, physicians treat patients all the time that they might not otherwise hang out with or befriend; we do not need to be besties. 

STILL. I want to make a good first impression. That’s weird, right? And yet, there it is. 

Let’s move on to the less-ridiculous portion of my frets, which is how to address all the things I want to address without overwhelming the doctor or myself, and without doing that thing where I make a careful list and then get to item three and suddenly feel like I’m overstaying my welcome or talking too much or whatever. I cannot tell you how many times I have gone to see a doctor with Very Specific Things To Discuss, and have decided in the moment that they are silly and I won’t bother the doctor with them. Even when I bring a written list with me, I still do this. 

(You might think that having grown up with a physician for a parent, and then marrying a physician would negate some of the awkwardness I feel when at the doctor. But no.) 

Since three seems to be the magic number, I think I have narrowed my Must Discuss List to three topics: 

  1. Fatigue. I am tired all the time. Like, more tired than in years past. (I feel like I’ve been chronically tired since at least 2012.) So tired that I see the effects of the tiredness in other areas of my life. Is this… The result of a medication I’m taking? A symptom of perimenopause? A deficiency of iron or vitamin D or something else? Because I am terrible at sleeping? Subset of the previous: it is because of my horrifically restless legs? Is the terrible sleeping a result of poor sleep hygiene? Or perimenopause? Or some lifestyle choice I am making? Is the tiredness (and/or terrible sleeping and/or restless legs) fixable? Or is this just my current phase of life (The Tired Phase) and I need to accept and lean into it? 
  2. Medication. I started taking anxiety medication in December 2023 after a series of escalating panic attacks. The medication has been very helpful. I think I am in a less anxious state now than I was then; is it time to try to discontinue the medication? If so, how do I do that? And what happens if I decide it was a terrible plan to discontinue it? Yes, 2023 was a wildly exciting and action-packed year which ended spiking my anxiety to new heights, but it’s not like I was NOT anxious before that. I am not opposed to taking medication when it is helpful, but I also don’t really want to take medication if I don’t need to.
  3. Weight. Due to some fairly significant weight gain over the past year, I am heavier than I have ever been in my life. Aside from not being pleasant in a variety of ways for a variety of reasons, I am wondering if I need to Be Worried. Is my weight gain a side effect of the aforementioned anxiety medication? A symptom of perimenopause? The result of too many nachos? Something else? Is it causing any problems I should be aware of, aside from the expected and unwelcome not-fitting-into-my-clothing and poor-self-esteem issues? (Like perhaps my extreme tiredness?) Beyond trying to eat less and move my body more, is there anything I should be doing?

You may notice that this very tidy list of three contains many, many subtopics. That feels a little like cheating. (I imagine myself telling the new doctor, “I want to discuss three health concerns with you!” and then bombarding her with restless legs! and perimenopause symptoms! and anxiety! and insomnia! as she crumples to the floor under the weight of my hypochondria.) (Yes, I do realize this is not how doctors work.)

You may also notice that “weight” is at the bottom of the list, in case three topics ends up feeling like too many topics with which to burden the doctor. (I know; I cannot stop thinking this way.) I put it at the bottom because it is the topic that, to me, seems to have the most obvious solution (eat less and move your body more), and also because it is the topic that I feel least comfortable bringing up. It’s such an uncomfortable topic! And possibly the doctor will bring it up anyway, without me having to say anything. 

I have a new, third fret: that I will inadvertently turn my New Patient Appointment into a Sick Visit. Why yes, this fret IS brought to you by two weeks of my family being sick plus waking up at four o’clock this morning with a terrible headache and a sore throat that feels worse than yesterday’s mildly scratchy throat and ear pain and a low-grade fever. 

What happens if I AM sick for my appointment? Is that… allowed? I feel like the “rules,” insofar as I (don’t) understand them are that you can’t be treated by a new physician until you have established with them as a patient. This is why I have been scrupulously healthy this year, because I would much rather go see my PCP than visit urgent care. 

If I AM sick for my appointment, then identifying/treating that illness probably jumps to the top of my list of concerns… but can I also address the other less-urgent topics?

Should I perhaps be badgering my husband with these questions instead of fretting about them on the internet? I mean, yes, but what is the internet for if not for airing ridiculous worries.

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Dinners This Week, Keto Update

I mentioned in my Road Trip! Round Up that I weighed exactly the same amount when I got home as I had when I’d embarked on the trip. Even though I’d gone completely off Keto for the duration of the trip, and even though our dinners consisted of many burgers and beers, and even though I ate many many bags of chips. 

This was so disheartening, Internet. I cannot express how my heart dropped when I saw that number on the scale. I mean, on the one hand, it was pleasant to not have that grit-teethed feeling of needing to start over from scratch. But on the other, more emotional hand, I felt like, “WHAT THE HELL HAVE I BEEN DOING ALL THIS TIME?”

It was already pretty clear that Keto – or my specific brand of low-carb eating – wasn’t working for me anymore. I’d been stalled at the same not-quite-ten-percent-of-my-body-weight weight loss since May, after all. I probably would have done Something about it earlier if we hadn’t been planning this Road Trip. But I have to admit I was hoping that a) things would correct themselves or b) I could buckle down after the Road Trip.

And then when it turned out I didn’t have to be on Keto to maintain my current weight… well, I didn’t get back to it. Instead, I kept eating like I was on a Road Trip. (Plus, I ate ALL the beans. Turns out the food I miss the most when I am doing keto is… beans. Black beans, navy beans, chickpeas. Burritos, tacos, stir fries, soups. ALL THE BEANS.) And now I am back where I was when I started this particular Keto journey in February. UGH UGH UGH. 

I don’t know what to do now. Do I try Keto again? I think if I were really strict with it, it might help. But my husband refuses to follow it strictly, which makes it difficult for me to do so. He is all for doing low carb again, but that wasn’t working for me. I feel like the only two options are 1) Keep going the way I am going, which is unpleasant for many reasons or 2) Start counting calories again, which makes me want to walk into the sea. There are probably other options, but those seem like the most currently workable of them all.

Listen, we all know how FRAUGHT the topic of weight loss is. I don’t have the energy to rehash it here. But I DO want to lose weight. I do. So… I don’t know what I’ll do. We’ll see. That’s my Keto update, I guess: not doing Keto, not sure if I should try it again, not sure what to do instead. (Except stopping eating like I haven’t seen food in months.)

In the meantime, it’s clear that I NEED my Dinners This Week posts. Otherwise I end up staring despondently at my husband every night asking him, “What should I make for dinner?” And then we stare at each other, neither one of us offering any ideas, occasionally lifting our eyebrows hopefully in the other person’s direction, until we turn to stone. 

Plus, groceries are SO out of control expensive right now that I absolutely CANNOT continue doing the thing where I come up with an idea for one single meal and go to the store and get ingredients just for that meal and end up spending $75. That’s not financially responsible. Nor can we eat takeout as much as we are currently doing. It’s not helping anything, weight-wise, plus it no longer feels like a treat, plus ALSO expensive.

Another reason I need to get back to planning is that my in-laws are coming to visit and I expect they will want to eat with us a good number of nights (they are staying in a rental)… and I really need to plan that in advance or my sanity will crawl out of my ears. (My current plan of AHHHHHHH and lots of takeout doesn’t seem reasonable.) Plus, we are having friends over for dinner at some point and I need to plan THAT. (Tacos. There, planned.)

Dinners for the Week of August 1-7

Salmon Cakes with Something Green: I don’t know why, but I’ve had a hankering for salmon cakes lately. My husband is not a salmon fan, but perhaps since it’s cakes and not straight salmon, he will eat them without too much complaint. I’m not sure what to have on the side. Green beans? Let’s say sauteed green beans.

Oven Baked Pork Chops with Broccoli: My husband requested these specifically, so on the plan they go, along with some steamed broccoli. I have some freezer potatoes (more appetizing than I am making them sound) to add if we’re feeling carby.

Chicken and Ginger Stir Fry: Here’s another one for weird cravings – I am really in the mood for a very ginger-y stir fry. Maybe this one would be better. Or this one. What I really want is a stir fry with no sauce (yes, it is me writing this; no, do not call the police) but instead just lots of fresh ginger and maybe some garlic in there. I haven’t found a recipe that meets these standards though, but I will keep looking.

Parmesan Garlic Fish with Something Green: This sounds yummy. Maybe I would try it without the breadcrumbs. And as for a side… sauteed spinach? Or maybe some roasted Brussels sprouts? Carla picked out a Brussels sprout at the grocery store and said she wanted to try one – JUST ONE, she made sure to clarify.

Baked Chicken Breasts with Zucchini: I love Nagi’s oven baked pork chops (and pretty much any of her recipes I’ve tried), so these are bound to be good. And the preparation seems very simple, which is always nice to have in one’s back pocket.

What are you having for dinner this week?

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Keto Favorites

When my husband and I did Keto in 2020, we went hog wild. We bought ALL the Keto-specific products. We bought cheese by the cartload. We bought packages and packages of crunchy cheese snacks. We bought almond flour and flaxseed meal and xanthan gum. We bought avocado oil and MCT oil. We bought Keto pancake mix and Keto maple syrup. We bought Keto powdered erythritol and liquid stevia. We had all these plans to make Keto recipes and made many of them. But we found that a lot of the things we tried were either unpalatable or palatable only once or twice. 

This time around, I have been trying to live without Keto recipes and Keto items as much as possible.

But I have found a few Keto-specific items that I really like. This is, perhaps, in part due to the passage of two years’ time. Keto still seems very popular, and I think more and more products have become available since 2020 – and the products that are coming out keep getting better and tastier. 

My primary care doctor recommended two of the first Keto-friendly foods I tried this go-round, and they turned out to be two products that I really like:

Two Good Yogurt: Each container of yogurt contains 3 net grams of carbs. I don’t love this yogurt (it has a slight aftertaste, which I associate with stevia, and it is a little on the tangy side for my taste), so I don’t eat it every day. But it definitely scratches the yogurt itch. And it comes in a lot of different flavors, which adds some nice variety to my life. My favorite is mango, followed by raspberry and vanilla.

Protein Bread: My doctor told me that this was ONLY at Aldi’s, and so far, that’s the only place I can find it. (Strangely enough, Aldi also sells bread that has “Keto friendly!” on the wrapper, but turns out to be… a lot of carbs.) This particular bread has 4 grams of net carbs per slice. That is a lot – more than 20% of my daily allotted carbs – but sometimes I just need some bread. And I find that this bread is VERY satisfying. It tastes fine – nutty and wholesome. But more important, it is BREAD. My husband made a loaf of “Keto bread” in 2020, and it was NOT bread. It was crumbly and bitter and did not count as bread in my mind. But this protein bread is definitely bread in taste and texture. It’s pretty hearty, too, and since I usually pair it with cheese or avocado, it makes for a very filling, satisfying meal. I don’t eat it every day, so I remove a few slices and then freeze the rest. I find that it takes longer than most breads to toast – I like a nice, crunchy piece of toast. Putting it in the oven helps. 

There are a ton of low-carb and “Keto” breads on the market lately… but I have only tried this one. Because of my experience in 2020, I am wary of spending money on foods I end up hating. But… I am curious about some things. The last time I went to Whole Foods, I found a low-carb bread that I want to try. It was out of stock, of course, but if I ever get my hands on it I will test it out and let you know. 

One of the things that I crave the most while on Keto is pizza. And many of the Keto-friendly pizza options I have tried are not great. Most so-called “low-carb” crusts are not actually low-carb. Like the cauliflower pizza crust at Trader Joe’s is 16 grams of net carbs for one-sixth of the crust. If I am going to blow 16 grams of carbs on one meal, it better be for an entire pizza. I have made “Fathead Dough,” which is a low carb pizza dough… and it is so hard for me to make. It never comes together correctly. I think the one time I got it to work, it was fine, but it wasn’t worth the work or the frustration. Plus, it’s still 2 grams of net carbs per one-eighth of the total crust, which… again, I want to eat more than one slice of pizza, you know? And I want to be very clear: I am not eating pizza crust made out of chicken. That sounds… highly unpleasant. (Although my husband has tried it and thought it was fine.)

To address my pizza craving, I turned to tortillas. And I was pleasantly surprised to find several low-carb tortilla options. Here are my two favorites:

Protein Plant Powered Tortillas:  Each of these tortillas has 3 grams of net carbs, and when you add sauce and cheese and pepperoni, it bakes up to be a very satisfying pizza. The tortilla is slightly sweet, and it’s very soft and thin. It crisps up decently in the oven, and I find it to be a really good option for a Keto pizza crust. I have not tried it for other purposes (yet), but I’m guessing it would be a perfectly adequate substitution for burritos or even tacos. 

Street Tacos Carb Balance Whole Wheat Tortillas: These little tortillas are smaller than the above ones, but they are thicker and – I think – tastier. You get two of them for 3 grams of net carbs. Because they are a little thicker, they make a nice sturdy crust for a mini pizza. I always make at least two mini pizzas, sometimes three, and they definitely help curb the pizza cravings. Somehow I haven’t tried these with tacos yet either, but I think they would be delicious.

Keto Blueberry Cinnamon Nut Granola: I bought this on a whim at Costco, and I am very glad I did. (Apparently, you can also buy it on amazon. There are multiple flavors, too!) One of the things Keto lacks is an abundance of crunchy foods. (Outside of vegetables. And dehydrated cheese.) One-third of a cup of this granola has 3 net grams of carbs. (Hmmm. On the Nutrail website, it says 2 grams of net carbs… but on the bag it says 3… Either way, a decently low carb count for what you get.) Pair it with the Two Good yogurt and you have a very satisfying breakfast on your hands. Like the yogurt, it doesn’t taste exactly like regular granola. I feel like the monkfruit sweetener is noticeable, although it’s not bad. But it has a great texture and I love the addition of the dried blueberries. 

Keto Ice Cream: I don’t miss sweets a whole lot on Keto. I think I’m too busy missing black beans and soups and chips and pizza and garlic bread and pasta and beer. Ahem. Where was I? Oh right, sweets. I’m just not a big sweets eater. But once in awhile, I do miss ice cream. Fortunately, there is an abundant variety of frozen desserts available to us. What a time to be alive. Continuous outbreaks of war and ongoing gun violence, but grocery stores have frozen desserts as far as the eye can see. My two favorites are Halo Top Chocolate Cheesecake (from its Keto series; not sure if there is a chocolate cheesecake flavor in its other series) and Keto Mint Chip. If you have never tried these before: they take some getting used to. The texture is so very, very different from real ice cream. It’s… crumbly. But if you let it sit out for a very, very, very long time, or if you grow deeply impatient and microwave it for 15 seconds or so, it starts to melt and become creamy. At least around the edges. Texture aside, I like the flavor of both of these ice creams. The Halo Top is satisfyingly chocolatey, and has these weird (but tasty!) little cream cheese pellets that add a nice cheesecake essence. I am describing it accurately but not appealingly, I realize that. I do actually LIKE it. The Keto option is refreshingly minty and has a profusion of good-size chocolate chips. I have yet to try any other flavors, but there are LOTS.

Atkins Keto Caramel Almond Nut Clusters: I mentioned these before, but I am including them here as well because they are just really so good. At just 2 grams of net carbs per cluster, they are the perfect response to a candy bar craving or to the feeling of FOMO one gets when one’s entire family are eating chewy, delicious molasses cookies with a thick layer of cream cheese frosting. And the crunch of the nuts and the chew of the caramel makes them extremely satisfying. They do have that slight aftertaste of erythritol, but it’s not bad. And sometimes you just want something that is as close as possible to candy without being candy. 

Okay, so those are all the things that are made low-carb on purpose. But there are also some products that exist free of Keto/low-carb boundaries that I nonetheless turn to frequently.

Milkadamia Unsweetened Macadamia Nut Milk: When I did Keto in 2020, I used almond milk for my tea, which is a great option that I still love. (The brand of unsweetened almond milk I bought was 1 gram of net carbs per eight-ounce serving. Some brands have a LOT more carbs though.) But when Nicole mentioned that she had switched to macadamia nut milk, I decided to give it a try. It strikes me as slightly thicker/creamier than almond milk, and the flavor is unobjectionable.  It also has less than 1 net gram of carbs per eight-ounce serving, and I use a full cup of it in my tea every day. 

Moo is moot. Apparently.

Low-Carb Sauces: One of the things I love most in life is sauces and sauces are tricky on Keto. A lot of sauces have sugar or other carb-heavy ingredients. That’s why ketchup is a no-no on Keto. I make do with copious amounts of sriracha and mustard… and then I try any no-carb sauce I come across. I picked up this delicious no-carb Lemon Herb Aioli at my grocery store and love it. It’s excellent with salmon. Rich and creamy and flavorful. It does not taste like a diet food and that’s because it is NOT a diet food. I bet it would be tasty with artichokes or asparagus. I loved it so much, I grabbed the Sriracha Aioli (which has 1 gram of net carbs per tablespoon, so I would use it more sparingly) (not that I use a TON of the lemon herb aioli; a tablespoon goes a long way) the next time I went to the store. I’m going to put it on shrimp and roasted cauliflower and see if it works as a marinade for grilled chicken or pork. Stonewall Kitchen has a bunch of flavors, and I want to try the Chipotle Aioli and the Habanero Mango Aioli. Perhaps that is too much aioli for one person to have in her refrigerator, I don’t know.

Bubly: For that dangerous hungry time between five o’clock and dinnertime (which, for me, is usually 8:00 or later, sigh), I find myself craving wine. What a delightful discovery when I learned that a can of Bubly sparkling water with a squeeze of cherry Koolaid liquid works just as well as a glass of chardonnay. Especially if I pair it with some slices of sharp cheddar cheese. The cherry Bubly is my favorite, but I also love the raspberry and the blackberry. The grapefruit is good (and pairs well with gin/tequila and lime juice!) and the passionfruit is decent. The only Bubly flavor I do not care for is blueberry.

The one thing I haven’t found yet is a good Keto tortilla chip. It seems like there are several options that contain only 3 to 4 net grams of carbs per bag, but I haven’t come across any in the wild… and don’t really want to spend $20-$30 to order a bunch of chips I may not end up liking. If I find a single bag at a grocery store somewhere, I will definitely try it and report back.