Hi,
This post is about my girlfriend and some questions about her process.
HISTORY
She has always been normal weight at around 50-60 kg and about 1.6 m tall. However about 3 years ago when she was about 19 years old, without any changes in lifestyle or habits, she gained about 45-50 kg in the span of 10-12 months and lost her periods. She didn't know where this was coming from and it affected her self esteem a lot. In response she had several doctors appointments and no one thought much of it until she became emotional and then did some tests on her and found nothing abnormal. At some point they saw slightly elevated testosterone and when re-tested its was normal. They said nothing was wrong, no PCOS or similar, but still prescribed her some birth control pills to evaluate. When she used them she had her periods, less body hair growth and lost about 10 kg. Not much happened after that point weight wise, but she stopped gaining weight as prior. She is still prescribed the pills but will not be having a follow-up since nothing was shown and the pills worked for the time being. The dose was however lowered over time.
CURRENT SITUATION
I've been helping her with training and diet plan, taking a step at a time developing sustainable habits. At most she weighted about 100 kg and it stopped when she started with the birth control (estrogen) and also lost about 10 kg. She lost about 25 kg after being on a caloric deficit and training over the span of 10-12 months and it has been maintained without issue for some time. The problem is that she isn't losing beyond this stage, plateau for about +10 months on 74-76 kg. At the moment she is burning about 500 per day from cardio and eating 1000 calories. We have tried being on a caloric intake of 800 calories as an experiment, 1000-1200 calories and 1500 calories with the calculated TDEE being 1800. Figured it might be related to metabolic adaptation and added some regular diet breaks and even longer refeeds on 1700-2000 calories. Nothing happend even at this point. The only thing we have noticed is that she is maintaining her weight on a ~1000 caloric intake and 500 calories burned daily, changes to this balance and she gains weight quick. I do not want to suggest anything that is not sustainable, like striving below 1000 calories (IMO that is even below minimum) or doing crash diets, especially for someone training and having an active lifestyle. There is no rush and she wants to be able to maintain the changes.
She Isn't that bothered because she likes to do cardio and exercise, have fun cooking and planning meals. But we can't figure what to do at this point for further progression. I'm starting to wonder if its related to pathology, hormonal issues that were never really followed-up. We did a complete blood work panel on our own where everything looked normal and within range like liver, kidneys, blood values, minerals, T4, T3 and much more. We didn't however have access to check for prolactin, testosterone and estrogen at the point. The only notice is that doctor did adapt / lower the estrogen dose over time.
How do we proceed from here? Thankful for input.
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