by Ruth Carr RN, MA, CH, and Mary Ann Starkes, APRN ◊ Mar 21, 2014
Why can’t I lose weight?
Mary Ann Starkes: There are so many reasons why people have weight issues. The plethora of ads and programs offering weight loss without effort indicates the overwhelming need to understand the problem. Being an expert on your condition and the side effects of the treatments related to that disorder is the first step in gaining control over the outcome. If you know that a medication you need to take will likely increase your appetite or slow your metabolism, then you can plan ahead to manage this problem.
As Ruth indicated, people complain that they try to lose weight, but cannot because of medications, depression, stress, diseases, etc. The truth is that there are reasons why it is difficult to lose weight while on medications or dealing with certain medical conditions. Medications, such as those for depression, anxiety, sleep, mood stabilization, psychosis, seizures, blood pressure, infections, allergies, diabetes, and some birth control, all stimulate the appetite and sometimes slow down the metabolism. Certain medical conditions such as Syndrome X, or insulin resistance, cause higher levels of insulin and stimulate hunger. Hypothyroidism slows the metabolism of food. Polycystic ovarian syndrome (PCOS) and ovarian cancer trigger excess insulin and boost androgen hormones, which increase appetite and slow metabolism. Stress, which all of us have, triggers cortisol (like steroid in your system) that stimulates hunger and leads to storage of fat. Cushing syndrome is similar in its impact on hunger and storage of fat. There is even some current research into the genetic factors that contribute to leptin and genetic mutations that leave some people with a tendency toward obesity.
Managing a condition often means making difficult choices, but it can also lead to positive outcomes.
Rena C. is a 55-year-old married female with bipolar disorder whom I have worked with for many years. She is on Seroquel XR, Lamictal, Klonopin, and occasionally Zoloft. She has had many episodes of weight gain. Some are related to depression, some to medications, and others to stress in her life. She has not stopped her medications, as she is aware that doing so would most likely lead to a severe episode and hospitalization. She has instead incorporated several techniques to manage her symptoms. She swims daily, runs frequently during the week, and is careful about her diet. She may oscillate some, but has maintained a healthy weight despite everything and has discovered that the exercise is very helpful in dealing with her depression and stress. It has led to decreased reliance on medications, which then makes it easier to maintain her desired weight. Win-win!
The message to leave you with is this: The more you gain control over your stressors, the better you will feel, and then maintaining or losing weight will be a secondary gain. Even with conditions such as PCOS, losing weight has been known to reduce the size and painfulness of cysts. There is much to be gained by understanding what may be contributing to the difficulty of weight loss, but developing techniques to address the core issues of stress, side effects of medications, or symptoms of a disorder will ultimately help you feel healthier. Then weight loss will be the side effect, not the main focus.
Ruth Carr, RN, MA, CH, can be reached at Behavior Options Hypnosis, 203.286.4545, and Mary Ann Starkes, APRN, can be reached at Whitney Ave Clinicians, 203.248.9110. Email questions to ahealthylife@gmail.com.
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