Hi,
It just immediately struck me when you said this, that your question is almost exactly like my sister's a few years back. She was at her wits end. There was one thing different though. She had asked her doc on and on again, but when she asked him to do tests, he wouldn't, saying things like "Well, experience shows that it most likely is diet related", showing that he did not trust her when she said how little she ate. Finally he gave in though, showing her that he would do the tests to satisfy her, to prove that he was right, not that he thought something was wrong. Well, her tests were real bad. She was really sick, her thyroid tests were almost as high as a person she later read about who died from hypothyroiditis. Her doc apologized over and over again. She realized though, that she had beat herself up over asking him about these things, feeling that she was a hypochondriac for bringing things up, and that she really did not feel good about her doc even if she used him for 20 years. So she changed and got a young and real great guy who she immediately felt she could say anything to. And they got a real good cooperation relationship, one where she feels respected etc. So they started on getting her thyroid problems figured out and get the right medication levels etc. She was told that most likely her weight would just "run off" by itself.
But NO... Her med levels were perfect, but she didn't lose a thing. And she really ate like a bird. She never allowed herself anything extra and ate very healthy. Her doctor gave her the diet pill that was such a big "revolution" a few years back (I just can't remember the name, even if I know it). But that didn't help at all, after all, what it does, is to stop your body from absorbing the fat you eat. Which may be a great case if you eat a lot of fat, but she barely had any, so it didn't help at all, it was a waste of money (expensive and not covered).
Eventually she figured that there had to be some other problem, and contacted a dietician. She asked her to make a diary to show what she ate over a week or two. She couldn't believe it when she was told that the problem most likely was that she ate way too little and had done it during all those years with undiagnosed thyroid problems. So her prescribed diet was to start eating, 6 meals a day. She decided that it was difficult and she needed support, so she joined a diet club, one that is more focused on a healthy lifestyle than specific diets which you stop with when you're done. She got guidelines for what to eat and started. It took a little while before things started changing, but not very long. She sort of had to jumpstart her metabolism again. To help it, she also exercised a lot. She has knee arthritis and quite bad back problems (has had back surgery and has much scar tissue etc.), so she has some limitations, but she walks three times a week (most often walking in the forest, where it is so much softer than on paths etc.) and she joined a fitness club which is meant for ordinary people who need some exercise, it is not too demanding and she just drops whatever she knows isn't good for her. She also has a bike, and uses it to and from work a couple of times a week when she can. She also has a stationary bike in the basement (with a TV in front of it), so when the weather is bad, she can use that. Riding a bike is a quite good exercise choice for those of us who have bad knees, as you can keep them going and strengthening those thigh muscles that are so important for bad knees, but without weight bearing. I know many love those "air walker" fitness machines, if you know what I mean. They used to sell them at shopping networks etc. They are more like cross country skiing without the strain of e.g. using a threadmill or walking. You can do very nice and smooth movements using those. I searched google for "air walker" and not bad, I found one. It has a picture so you can see what I mean (hope I can post a link here):
http://www.amazon.co.uk/Carl-Lewis-AWD15X-Foldable-Walker/dp/B0006HIXECWith one like that, you can use a lot of muscles, also strengthen your arms, and you can get a good aerobic exercise without strain on your knees.
Anyways, I do not know at all if eating too little can be the case with you, but in case it should be, I would like you to hear about it.
My sister was about the same weight as you too, I think. She got on with it and after the course at the club was over, she joined a support group that met I think every 2 weeks (instead of every week as the course). Some years back, when I needed to lose quite a lot myself (I might add that we to begin with very easily gains weight, and that is in our family too, several morbidly obese people, some who died very early from it too) I went on a course at the same club and I think it was very, very useful. Especially the support from the others, and the good "peer pressure" and motivation you get from it. And also many discovered that they knew very little about nutrition, things they thought were OK, surely weren't etc. So it was very good.
Maybe it would be a good idea for you to contact a dietician and/or such a club? If you didn't try that too already.
Also, in order to be able to exercise, maybe hot water pool is what you should try. That you can do however bad your knees are. I like using a jogging vest while in the pool, it much looks like a diving suit vest, which covers your upper body and goes between your legs as well. It keeps you upright in the water so that you can do exercises, run, dance, do aerobics etc. What you do is that you go to the deep end of the pool and do it, so your legs do not bear any weight at all. It is pretty cool actually. I know that some go to the YMCA for such things. They amongst others have hot water pool aerobics, which is a lot more fun than traditional hot water pool exercise. But if you find the right place and trainer, even that is a lot of fun. If you know somebody who have joint problems and/or weight problems, maybe you could go together? It's so much better and even more fun if you have somebody to share it with, you can support eachother etc. But even without exercise it should be possible to lose weight, but it is more difficult and challenging.
Hope you find a way to do it, so you don't need to have surgery. After all, it is a lot easier and better if you can do it without surgery. Such surgeries doesn't come without risks. But if you have tried everything, surgery of course is an option. A friend/neighbor will be having gastric bypass this fall. She has been going through a program of counselling etc. for around a year now to prepare for it and to prevent her from having some of the problems postoperatively as many battle. She is now going on a diet too, to lose as much weight as possible before the surgery, especially since she had real problems during abdominal surgery a while ago. They had real problem getting her to wake up again and she had breathing problems etc. Quite scary and the heavier you are, the more risk of such problems, I think. She has tried everything too, and suffer real bad arthritis and hypermobility in knees and ankles. She has an awfully hard time walking, she can barely go out with her dogs anymore, and at times it has been so bad she hasn't been able to bear any weight on one of the legs, she has had to use crutches quite a bit etc. At times she would certainly qualify to get a wheelchair... When she is done with the weight loss surgery, and her weight is better, the first thing she will be doing, is having surgery on her ankles which are real bad. But she is not getting surgery now, because the risk of complications because of her weight are too bad, they won't risk it "just for" her ankles...
Good luck and take care!
