Struggling with diet due to medication

This topic contains 17 replies, has 10 voices, and was last updated by ruthmel1 8 years, 11 months ago.

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Rowantree

12:34 am
25 Jul 14
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Hi! I’ve been doing this diet for a year or so and at first I lost a reasonable amount (can’t now recall how much but it was a steady weekly loss). Then, because I was suffering from anxiety and depression, I began taking prescribed medication – Mirtazapine for depression, which has weight gain as one of the side-effects. Then recently I was also put on Pregabalin for anxiety – similar side effects! Since being on these drugs my weight’s gone up hugely and I struggle to keep to the diet on low-calorie days as I’m so hungry. I don’t want to give up on it because it’s vital that I lose this weight and then some – I have an enormous amount to lose. But I am losing hope of getting anywhere near my goal. Is anyone else on similar medication, and how are you coping? I should add that I can’t even increase my activity level at the moment because of Achilles tendonitis – otherwise I’d try and walk more (exercise was never my strong point). I need some encouragement and motivation before I give up entirely!

TracyJ

9:36 am
25 Jul 14
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Hiya Rowantree, I’m sorry you’re having these issues and I hope someone else on similar meds can come along and tell you that it gets easier soon but all I can say really is for goodness’ sake don’t give up 5:2. If you think you’re gaining weight while you’re doing 5:2 imagine what would happen if you stopped!!!

Obviously I don’t know any of your stats but if it is hunger on fastdays that is causing you to waver then perhaps pilfering a little extra allowance on those days from your TDEE allowance on non-fastdays would help?

Michael’s “500 calories for women” edict is a totally arbitrary number picked out of the air to make the fasting day bearable to those who just couldn’t face a full genuine day of fasting. So, it doesn’t HAVE TO BE set in stone. I always eat more than 500 calories on a fastday and always have.

My tip would be to look at your TDEE and think, what could I totally live with on a non-fastday between my BMR and my TDEE and try to stick to that (roughly if you don’t want to obsessively calorie count – but if you want to lose weight and you’re going to increase your fastday intake then it does probably need to be AT LEAST 100kcal less than your TDEE) and then look at your fastday and think about what level you think would help make it more bearable. 600 calories? 700? and set THAT as your personal limit. As long as your weekly calorie deficit is still up around the 3000 level then you SHOULD lose at least something each week. If you try to cut down on the carbs and increase the fat & protein intake at the same time then I would guess that would help stop you retaining as much water weight. But I’m not a nutritionist, so hopefully someone else can help you figure out how best to combat the side-effects of your pills with food intake.

Best of luck with it but please don’t just give up – you’re doing something really positive for yourself with 5:2, it would be such a shame to waste all of the time and effort you’ve put in so far.

Rowantree

11:02 am
25 Jul 14
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Hi Tracy,

Thanks for replying -though I still have to get my head round what TDEE and BMR are and how to apply them! I do want to stick to the 500 cal mark because I suspect that if I made it 600 or 700 I’d STILL be nibbling bits of cheese and/or digestive biscuits by evening! I am thinking that it’s partly an emotional thing (nibbling, eating mindlessly) so maybe I have to think of other ways of combatting that. It’s another fast day today, and so far I haven’t eaten anything at all apart from a small glass of tomato juice – I don’t feel like eating at the moment so I decided I would make the first meal a very light lunch instead.
I know you’re right and I don’t really want to give up – but I feel so demoralised. My OH has been doing it too and has lost loads AND his cholesterol has gone down a lot too. He’s never been fat but is totally committed to the 5/2 principles and finds it easy to stick to, whereas I struggle.
Unfortunately I have LOADS to lose: I am in the obese category which is shameful, and it means that I feel as if I’m baling out the sea with a thimble – it will take ages to lose the excess weight and get down to even where I was a couple of years ago (which was still very overweight but at least I felt more like a human being and less like a disgusting blob of glup)

I will persevere – and try harder to stick to the fast days.

TracyJ

12:38 pm
25 Jul 14
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Awww bless. You’re no worse than most people starting out on ANY diet, you just need to remind yourself of that and not let the ONE other person you know’s success make you feel like a failure. You are FAR from that. AND between you, me and the gate post I was 5/6 stone overweight and WELL into the Clinically Obese category when I started 5:2, 2 years ago, so you’re not the only one that’s ever been a ‘disgusting blob’ 😉

It sounds like you DO need to get your head around BMR and TDEE, I think if you did you would feel more in control. Do the TDEE calculation on the ‘How’ tab on this site (just bear in mind that it’s probably one of the more generous calculators out there, so don’t tell it you’re moderately active if you don’t do AT LEAST everything it says for that category every single day – going for 1 activity level down from what you THINK you MIGHT be is the best way – or just go for ‘Sedentary’). Once you have those numbers think of BMR as your minimum intake for a non-fastday and TDEE as your ABSOLUTE maximum. You don’t have to obsessively calorie count all the time but it would be a good idea to do so for a few days or a couple of weeks just to get a good idea of what kind of portion sizes and foods deliver how many calories, then you should have a good idea just by sight after that.

From your description of today as a fastday it seems like you are eating despite not actually being hungry today? Why? Don’t have your ‘light lunch’ unless you are actually hungry – save the calories and have a more satisfying meal later. Lots of people seem to eat by the clock rather than by their actual stomach. I’ve been guilty of this too and sometimes you don’t get a choice but a fastday is special. It only happens twice a week and it gives you permission to be selfish with your eating and save those calories for when you REALLY want them. If your colleagues are all having lunch just take yourself off on a walk with a bottle of water or something. Unless you’re actually starving hungry (and you should know the difference between genuine hunger and the kind that can be put off with some water and a 10 minute wait by now) DON’T waste your calorie allowance on food you don’t need yet.

I’ve never been a ‘little & often’ type, so I don’t understand why anyone would have ‘nibbles’ throughout a fastday. If you CAN: go as long as possible before breaking your fast on a fastday. As soon as you eat ANYTHING it will set your body off wanting more (from my experience) so best to leave that hunger genie in his bottle for as long as possible and have something genuinely satisfying to hand when you finally do.

The ‘Nil by mouth’ (other than water) approach has held me in good stead and helped me stay in control on fastdays – give it a try, it might work for you too.

Rowantree

1:10 pm
25 Jul 14
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Actually that does make a lot of sense – not actually eating unless I’m hungry and saving the calories up till I really need them (hopefully by dinner-time!)
Sometimes in the mornings – possibly due to the effect of my medication – I feel slightly nauseous and dizzy in the mornings and not always like eating, but because breakfast is a ritual, I hadn’t actually questioned whether I really want to eat. And you’re spot on with your observation that eating seems to spark off a desire for more food – I’ve noticed that more at times too.
I am retired so I don’t have to worry about what colleagues are doing – just my OH. Friends are pretty supportive about it. We have our fast days when we’re not doing much socially though because it’s easier.

I need to drink as much as possible, because I’m prone to cystitis, and I enjoy (decaff) coffee and sparkling mineral water (though not together ;)) so I will keep to those. I also have some Swiss bouillon stock powder which is very low calorie for times when I am feeling hungrier and need to taste something savoury without the calories. But I guess that water is by far the best.
Thank you for all your input – it’s extremely helpful!

TracyJ

1:52 pm
25 Jul 14
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There you go then – you’ve cracked it! 😉

I never bother with breakfast anymore. I used to wake up the day after a fastday and have cereal despite not really being hungry and one day I just didn’t and went half the day before I even realised I hadn’t eaten anything yet. Breakfast is a habit, not a necessity. If you don’t need it don’t have it.

I now have just cereal in the evenings on my fastdays because I never eat it anymore in the morning and ‘missed’ it, so now I have it as a ‘special treat’ on my fastdays twice a week. Everyone’s a winner.

HELEN.MCMELLON

10:39 am
1 Aug 14
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I am on anti-depressants and I suffer from Irritable bowel syndrome and my weight goes up and down all the time but I feel if I stick to it it will get easier. I weighed myself again today and I have gone up again by 2 pounds. I am still going to stick with it as I have a lot to lose and I do find it easy and hopefully over time it will improve. People have told me that it is a slow process. I hope things work out for you.

Ejay

2:34 pm
22 Oct 14
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I had been on Pregabalin for a year and didn’t gain weight, but was then also prescribed Mirtazapine. Since then a year has passed and I have gained 2 and a half stone. I have had an underactive thyroid for 20 years due to radiotherapy damage. However I did not have issues with weight gain like most hypothryoid people do, but quite the opposite. So in the past year I have went from 6 and a half stone to 9 stone, since starting Mirtazapine. ( I am 5 foot tall).

I do not want to go back to 6 and a half stone obviously, but want to lose half a stone and some body fat. To complicate matters I feed enterally overnight and take 200ml formula at around 6pm.

I am about to start ADF as I want the weight gain to stop.

Matrika

11:50 pm
8 Nov 14
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Rowantree I am not on antidepressant medication but read your post and feel for you, I too have achey bits that make exercise difficult.
I have had major pain issues and am ony just addressing them. I started to see a psychologist who insisted actually, I am kind of stoic and have always thought I need to tough things out painwise.

So, addressing the pain for me is genuine mood lifter in itself.

I’ve also been using mindfulnesss meditation and CBT for low mood and anxiety and have measurably lessened the effects and lifted my mood that way. Having someone intently listen and pay attention to my problems is great. She makes very helpful suggestions and has liberated me by feeding back to me the effects of pain which were creating an emotional downward spiral that I thought I just had to live with.

I found out I don’t…and have managed to do it without medication which I was aware would probably have side effects. I did have to do a lot of work, applying exercises.

And I found an online course using CBT for low mood. It helped me immensely.

I realize these things are not possible or accessible for everyone but I am posting just because sometimes doctors prescribe drugs when specialist psychologists can really help.

Re the exercise constraints…I have been told not to exercise my upper fbody due to extreme inflammation issues…I am currently walking n a hydrotherapy ool 3x a week and perhaps even more imortantly, I am laying in the sun in my swinsuit for thirty minutes a week (5 mins at a time, I’m fair and it is summer here) to get adequate vitamin D rather than take supplements.

Best wishes to you and I hope the 5:2 can be helpful for you, it is awful to balloon when trying to follow advice and take prescribed treatments.

Thea07

6:00 pm
19 Jan 15
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Hi there

I hope things have become easier for you now. I just wanted to comment on the medication.

My GP prescribed Mirtazipine some time ago for depression. Like you I began to gain weight and so did some internet research where I found that these meds are the worst for weight-gain. As I also have mobility issues due to knee and other probs there was no way I could gain anymore weight. Luckily my GP agreed and prescribed ‘Escitalopram’ (an SSRI) and I’m glad to say no more weight gain plus my anxiety/depression responded well to the medication.

Hope this helps.

snorks

9:42 pm
19 Jan 15
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I was on a similar medication for the last 2.5 years, and basically that’s why I’m here now. To try and get rid of all the weight I gained.

From my experience and what I’ve read, the weight gain on these meds is not so much because it’s changing your body chemistry to get fatter, but more because they give you the munchies and make you think you’re hungry all the time. I didn’t realise how much I’d been over-eating until I came off and went “wait, I was eating HOW MUCH for dinner every day?!” Not sure on ways to combat false feelings of hunger.

It’s probably worth talking to your doctor and perhaps trialing other medications that might have less side effects for you.

Rowantree

1:37 pm
20 Jan 15
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Thank you all and I’m sorry I’ve only just got round to responding to all the helpful posts.
Re the therapy: done that, been there, wasn’t any help for me – had years of different kinds, some very intensive. Would have preferred talking therapy to meds, of course, but I seem to have found a combination which really helps me. The pregabalin, even at the low dose I’m taking, knocks the anxiety on the head and when I do feel anxious it’s manageable. I no longer wake feeing sick and anxious as I had done for so long. The mirtazapine was no use at all for depression, but escitalopram is really working – at the moment anyway!
You’re right that meds can and do give you the munchies. I tend to eat without being aware of how much I’m eating. I would eat cheese, chocolate, sweets or whatever I could find, in between meals, for no particular reason. I am trying hard now to think, ok, I’m feeling peckish but I do NOT have to act on it. I can accept feeling hungry. I am trying to re-train myself, including on days I am not fasting. I can’t see any other way of losing significant weight. So for me it’s not true that you can eat what you like on non-fasting days!

RuthJ

2:06 pm
20 Jan 15
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Hi Rowantree

I’m sorry to read about your issues – I have suffered depression in the past, and know how it can knock all your good intentions sideways. I have also had problems with eating from habit, rather than need, and thought that I would share a couple of tips that worked for me – although I realise that they may not work for you.
– Keep a food diary: not necessarily what you eat with calorie counts, but more the type of food you ate (a chocolate, piece of cheese or whatever) and yur emotional state at the time
– Keep a ‘weight loss’ diary: again, not obsessing compulsively about how much you have (or haven’t) lost, but more how the diet is going, what you find hard and easy, any little triumphs (or setbacks) and how you felt about them
– When you feel the ‘munchies’ coming, get up and do something to take your mind off it: I always used to go and brush my teeth, then I didn’t want to eat and spoil the feeling of a clean fresh mouth.

Maybe some of these will work for you, and maybe they won’t, but they worked for me and helped me to realise when and why I nibbled/snacked and gave me some tactics to face temptation.

Rowantree

3:12 pm
20 Jan 15
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Thank you, RuthJ. Those are good tips, though I’m not good at sticking to things like food diaries. I do keep a weight loss diary though, in a calendar, with brief notes about what might have influenced changes, plus illness, whether I’ve taken painkillers or additional medication and so on.
I think all those suggestions and tactics are helpful because they train you to be more aware and mindful of eating. It’s all too easy to munch biscuits, chocolate etc whilst doing something else so you aren’t aware of the fact that you’re eating or enjoying the experience even, so you tend to eat more. True for me, anyway!

My meds have helped me considerably so I no longer feel bleak and have regained my enjoyment of life to an extent, and my enthusiasm for some of the things I used to enjoy. I can appreciate the good things in my life again, not possible a few months ago. I never thought I would feel positive about anything again and I don’t know how long it will last, but I am enjoying the respite and hoping it will last. But that’s why I don’t want to come off the medication for the forseeable future and will have to try even harder with the diet.
It’s really helpful to read about what has worked for other people and to have ideas to try, so again many thanks! 🙂

Ejay

11:25 am
13 Feb 15
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Hi, sorry I have not replied either, been offline for a while.

I am living proof the Mirtazapine does change body chemistry. I have a fixed intake of calories as I cannot eat or drink normally, but fed via a tube.

Speaking to consultant who initially prescribed the Mirtazapine, ( he got in touch as they wanted to see if I gained weight as they thought I would despite controlled calorie intake) he asked me to do the fasting just one day a week for some time, so they could monitor the results.

So 16 weeks later and I have maintained my weight. I hope to change to 2 days soon as I want to lose at least a stone.

Psychiatrists agreed that CBT would probably not help me, having someone to speak to once a week would be good for me, but they all agreed that my own attempts to counter the depression were exactly as they would have suggested, and in my case the chemical imbalance was the cause of my depression. It was not so much low moods as anxiety, panic, time dragging by, unable to concentrate/leave the house and a horrid feeling of being out of control of my own thoughts and feelings. I was more scared than feeling low.

Mirtazapine has worked for me, and I hear so many times of others trying out various meds before finding the one that worked for them, so I am loathe to come off it.
I have decided to try and cut down from 3 ml a day to 2ml, I took a week to gradually come down and am going to see how I manage over the next 2 months. If I can’t cope I will go back up, if not I will tell GP I have reduced my dose.

I hate being dependent on it, but at the same time, if I still have chemical imbalances that are going to make me so ill again, I would much much rather reduce my calorie intake than come off meds that work for me.

Hope everyone else id doing well.

twistedsister

9:42 am
17 Apr 15
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I was prescribed pregablin for nerve pain and in about 6-8 weeks I gained about 18lbs! I wasn’t eating any different from normal although not fasting or dieting at the time, I was the heaviest I had ever been apart from when pregnant with my eldest. I gained all the weight around my abdomen which actually meant the pain I experience was worse and a combination of this and the weight gain got me down. I gradually came off it, within 2 weeks of being off it completely I’d lost 10lbs and 4 weeks i was back to my pre pregablin weight and i didn’t diet or change my eating habits at that time! This was about 11 months ago.
I have been doing fast diet for about 7 weeks now for health reasons, chronic fatigue and to lose weight i have gained from spending much of the winter exhausted and in bed.

ruthmel1

3:18 pm
12 May 15
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Hi, I have been on Pre-Gabilin for 10 years. i also put weight on but lost it eating the Paleo way. I.e high protein, hogh fat, low carb, not manufactured goods, food as natural as possible. i lost 3 stone on it. Then 2 years ago I wnet on the maximum Pre- gabilin and turned 50. i’m peri menopausal now and I can not loose any weight so I’ve syarted 5:2 to see if it helps. i jave lost a bit pf weight, but if you’re hungry on the 500 days I have made a favb discovery! SHIRATAKE Noodles!!!! They’re yam noodles and have, 7 calories per half a pack!!! yes only 7!! Amazing! On my 500 day for tea I have salmon or chicken woth loads of veggies and ha
F a pack of the noodles and I am full to bursting whilst having around 300 cals!!!!! You can buy em online I get mine from , theasiancookshop.cp.uk, @£1.35perack they taste good and Iut Tamari and lemon jiuce on them and the salmon pr chicken amd ypu have a tasty meal. Best of luck

ruthmel1

3:19 pm
12 May 15
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Sorry about the TYPOS! dont know how to edit!