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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by saw on December 6, 2004, at 3:06:36
My doctor says I have visceral central obesity. (I can still squeeze in a size 10).
I think doctors who try to understand but just DON'T get it, contribute to eating disorders.
My doctor told me on Friday that my weight gain was not so much due to antidepressants as what it was to do with "me".
I have starved myself, I have binged, but mostly I try to follow a balanced diet that has very little fat in it.
Yesterday I weighed myself. This morning I weighed myself and I was 4.41 pounds more.
In one day? With salad for supper?
And this is my fault?
Starvation, binging, eating correctly - NOTHING works.
I'm sick of this dumb life and always obssessing about the way I look and about how others see me.
Sabrina
Posted by Fallen4MyT on December 6, 2004, at 23:08:04
In reply to Visceral Obesity, posted by saw on December 6, 2004, at 3:06:36
Hi I seldom come to this board because it doesn't really apply to me but I was reading and saw this. A person is now considered obese if they are 20 or more pounds overweight. I do not know what you weigh...as to the pounds around the middle again I do not know your age, heritage or family history but they can be a factors as well as meds...contrary to what your doctor told you weight gain is common on AD's MOST doctors only know what the drug reps tell them I know as I use to work in the medical field. Undereating can cause the body to slow down to help save itself so eating JUST a salad is not a good way to lose weight it will just make your body LESS effective at burning the fuel it takes in. Have they tested you for malnutrition if this was sudden and or liver and intestinal issues?
I keep very fit by exercising at least 1 hour a day. I eat 4 or more meals a day but no refined flour or sugar as they will pack on the pounds and have no value as far as nutrients and all...May I suggest you start to build muscle ...the more muscle you have the more effienctly your body will burn food and you will be trim in that mid section again. I kickbox and do ballet as well as lift weights....I once was pretty unfit but am no longer. I know you can get tapes for home like those by Billy Blanks that work ALL the abs...and eat please eat not bad stuff but eat oatmeal and a few servings of fruit...also whole grains as well as a good deal of protein. Drink a lot of water and best of luck. I hope you can read this I misplaced my glasses :)> My doctor says I have visceral central obesity. (I can still squeeze in a size 10).
>
> I think doctors who try to understand but just DON'T get it, contribute to eating disorders.
>
> My doctor told me on Friday that my weight gain was not so much due to antidepressants as what it was to do with "me".
>
> I have starved myself, I have binged, but mostly I try to follow a balanced diet that has very little fat in it.
>
> Yesterday I weighed myself. This morning I weighed myself and I was 4.41 pounds more.
>
> In one day? With salad for supper?
>
> And this is my fault?
>
> Starvation, binging, eating correctly - NOTHING works.
>
> I'm sick of this dumb life and always obssessing about the way I look and about how others see me.
>
> Sabrina
>
>
Posted by Racer on December 7, 2004, at 0:18:03
In reply to Re: Visceral Obesity » saw, posted by Fallen4MyT on December 6, 2004, at 23:08:04
The RD was just talking about weight gains from day to day at our last session. That four pounds? Not real, just normal variations. That salad for dinner ain't all that great an idea, either. First of all, as Fallen pointed out, if you try to starve down, your body thinks it's hit a famine and will slow your metabolism. When that happens, it gets much more -- um -- efficient at holding onto anything it gets. That's why you're more likely to regain weight after losing with a fad diet -- and why you'll usually regain more than you lost.
Also, doctors are not always really aware of all the implications of the drugs they prescribe. There are still many doctors out there who think that Prozac promotes weight loss! It does, of course, for about the first two months. It's only after that that it packs on the pounds. If your doctor was saying that the meds haven't caused you to gain weight, so much as your tendency to try to starve yourself down followed by binging, that's one thing. If, on the other hand, he's saying that you're gaining weight because you're eating too much, well, he's just following an old and honored tradition in medicine: blaming the patient. Sucks.
That abdominal fat thing is about the ratio of waist to hip measurement. Regardless of your weight, that ratio is a good predictor of health risks. I forget the exact details -- I'm very overtired right now -- but that's a real worry, because it can lead to Metabolic Syndrome X, which you don't want. It's got a lot of portions to it, but the most important is insulin resistance, which will lead to Type II diabetes, which can lead to absolute hell. If that's what he's worried about, get detailed information from him and follow the instructions for diet and exercise to the letter. It can be reversed. (Unless you're on one of the meds that will cause diabetes even without weight gain. And he's unlikely to tell you if one of yours falls into that catagory.)
As for how to get some of that weight to stabilize, drink lots of plain water. Not tea, diet soda, juice, or anything like that. You can drink all those things, but drink plenty of plain water, too. Those four pounds weren't weight in the real sense, they were fluids. The best way to flush that extra fluid out of your system is to drink enough plain water to flush it out. That doesn't mean two gallons per day, just at least 64 ounces. I promise you, it will help. It also helps fill you up a bit. (In fact, that's one of my anorexic tricks, although it was more like two gallons a day...)
Best way to lose weight is to eat a good, balanced breakfast every single day, without fail, to give you energy and fuel to get through your morning. Then, have something healthy as a mid morning snack, like a glass of milk, or an apple. For lunch, eat something with a balance of protein and carbohydrate, with a little fat, but not much. Something like a ham sandwich with lettuce, tomato, maybe onion, mustard and a little bit of mayonaise. Then, when you hit that mid afternoon slump, have another glass of milk, or -- my favorite -- a glass of V-8. That should get you through to dinner, which is where you cut back a bit. Veggies, protein, a little starch. For dessert, have a pear. See? You're having five meals a day, but you're probably eating less than if you try to starve yourself down. (Even when I'm starving myself most, I eat at least three meals a day, usually with a snack, as well. I couldn't get through the day if I didn't.) The more you try to restrict your eating during the early part of the day, the more likely you are to over-compensate in the evening. That will lead to gaining weight.
And here's a big one: check out portion sizes! Get a scale, and find out how much you're really eating. It might surprise you. Check the food pyramid portion sizes, and compare those to what you're eating. That plate of spaghetti in the restaurant? Probably about six portions...
I know, I'm just giving you how tos, instead of telling you the other part of it. I'll make it up now.
These drugs do cause weight gain for most people. A lot of doctors just say it's our fault, not the drugs. Or, my favorite so far, The T From The Planet Unsupervised Intern told me that anti-depressants do not cause weight gain -- it was just like on birth control pills, when you take them you eat more and don't exercise enough. Hello? Earth to TFTPUI? She was young and female and inadequately supervised. I was tempted to take her in printouts from PubMed showing her what an idiot she was, as well as the psychology article I'd recently read about how damaging to clients it was for a T to blame the patient for weight gain...
I'm sorry. I can only tell you that I've done the outrageous weight gain from ADs, and been told it was my fault, and been bloody miserable because of it. I hope it stabilizes soon for you.
PS: I owe you an email. Sorry -- got something major going on, but as soon as it's done, you're first on my list.
Posted by yoshimi on December 7, 2004, at 1:16:48
In reply to Re: Visceral Obesity » saw, posted by Fallen4MyT on December 6, 2004, at 23:08:04
Oh you are wonderful for all this great advice,
but it seems so complicated. im sorry, how do you know what has refined flour and sugar in it. i dont cook at all (remember) and i try to eat veggies and tofu adn stuff like that and i exercise a couple days a week for a few hours. mostly i think i am starving myself a little bit though. i will eat enough that i know i am at least not going to die and if i am going to exercise i eat enough to know i will make it through that, but other than that id rather starve.im sorry for all the dumb queswtions
Posted by yoshimi on December 7, 2004, at 1:18:40
In reply to Visceral Obesity, posted by saw on December 6, 2004, at 3:06:36
hi sabrina,
i am sorry about that happening to you.
i dont know the answer either. those
meds do put pounds on and it is very tough,
regular doctors dont udnerstand a lot of the time.
i wish i had better answers for you but i dont
know anything about nutrition at all.hug for you though i do hope that helps a little.
Posted by Fallen4MyT on December 7, 2004, at 1:42:14
In reply to Re: Visceral Obesity » Fallen4MyT, posted by yoshimi on December 7, 2004, at 1:16:48
Hey there how are you :)? Thank you for saying my advice is helpful. It really isn't as complicated as it may seem and I eat out often, more then I cook :) really!!! Refined flour is in a lot of prepacked foods and will say flour or white flour...the only good bread is whole grain and will say whole grain or stoned ground whole grain first, gravy and breaded things have refined flour...sugar has many names I cannot even begin to list them all but corn syrup, sugar, dextrose, sucrose, brown sugar, heavy syrup, and so on. When I eat in or out I eat say fish no breading and maybe shrimp grilled or a burger NO bun cause at most places to eat the bun is refined and has a lot of sugar...no sauces ..I eat meats and grilled veggies a wrap is fine if it is whole wheat...cheese sticks are cool I pick the breading off..hahaha I bet I am fun to eat with...I do not eat pancakes or cookies, candy...my only vice is ketchup its full of sugar but as I exercise a lot I can burn it before I eat it...I hope you stop under eating cause it really isnt good for your body or mind..in fact they have linked diet and anxiety as well as depression. See the Anxiety and Phobia Workbook and well you can google it...Whole grains have B vitamins which help with depression and mood....juices are not as good as whole fruits cause of the fiber...I KNOW :p you can make scrabbled eggs throw some tomato in the pan umm cut up slices or chunks and not too much, mushrooms and cheese and you have a good healthy meal...add an orange and WHOLE WHEAT toast and you are going good....I am glad to hear you exercise that is good anaerobic is better than aerobic for over all as you tend to build muscle and can do more for sculpting your body and eat more later on too lol plus you burn more insulin and this helps keep the diabetes away or in check if one is already diabetic ... What foods do you eat? I missed you btw :)
> Oh you are wonderful for all this great advice,
> but it seems so complicated. im sorry, how do you know what has refined flour and sugar in it. i dont cook at all (remember) and i try to eat veggies and tofu adn stuff like that and i exercise a couple days a week for a few hours. mostly i think i am starving myself a little bit though. i will eat enough that i know i am at least not going to die and if i am going to exercise i eat enough to know i will make it through that, but other than that id rather starve.
>
> im sorry for all the dumb queswtions
>
Posted by saw on December 7, 2004, at 3:12:57
In reply to OK, gotta go into lecture mode now, saw!, posted by Racer on December 7, 2004, at 0:18:03
Thanks for all the great advice.
This is my typical daily diet.
Breakfast - high fibre cereal, fat free milk, banana
Snack - fruit such as apple (sometimes with peanut butter like you advised), grapes, watermelon
Lunch - 2 slices wholewheat bread (no butter), lettuce, cucumber, cottage cheese
Snack - Rice cake, sometimes a boiled egg, or slice of ham, carrot sticks or baby tomatoes.
Dinner - small portion of whatever I have prepared for my family.
I use almost no fat when cooking, save for a bit of olive oil. Frying is taboo! I steam all my vegetables and potatoes. Should my family want potatoe chips, I oven bake them instead of deep frying.
I prepare a lot of casseroles aswell so these simmer in their own goodness.
By binging, I would mean my occassinal packet of crisps, or the crispy skin off the barbequed chicken, or the sneaked sliver of cheese. I do not have a sweet tooth and rarely feel like chocolate or candy. I am forever craving salty things.
I drink up to 12 glasses of water a day and 2 to 3 cups of decaff coffee, again fat free milk. I drink a little too much wine, but if its any consolation, it is low alcohol, low calorie wine.
I exercise quite regularly and will be bettering this when I join a gym in the new year.
The salad I had for supper was a smoked chicken salad with everything in it, so it was a fairly substantial meal.
I am on a fairly strong diuretic so the 4 pounds really did not make sense. I have lost a half pound since then.
My father did have type II diabetes but led a very unhealthy lifestyle. My thyroid has been checked, no abnormalities. I have just been screened for Lupus Disease, liver enzymes and some others that didn't make sense and am awaiting the test results.
I supplement with Vit B6/12, Omega 3/6 fatty acids, lechitin and a metabolism booster / clearer.
So, I think you can understand my confusion and dismay at my weight gain when my lifestyle just does not promote it. I have gained weight all over but my tummy is bearing the brunt of it.
I am startin Topamax in the next couple of days and eagerly hope its weight loss side effect will affect me.
You mentioned you were busy, so not worried about the email.
PS. I gave up smoking in March but didn't start gaining weight until August, so I doubt that had anything to do with it.
Posted by Racer on December 7, 2004, at 11:23:57
In reply to I eat ok » Racer, posted by saw on December 7, 2004, at 3:12:57
Damn. Sounds as though you do eat well, and all the things I was imagining are not issues. I'd be grinding my teeth, too.
I do, however, have a few more bits of advice to you... You knew I couldn't keep my mouth shut or my fingers still...
First, cottage cheese ain't the best stuff, not enough nutrition, really, to justify the calories. There are better things. Maybe lean ham? (Another anorexic trick, but it's still OK.) And depending on what's in that salad, it might be more caloric than it seems. Just thoughts. Not the real thoughts I have though, which are coming...
Now, what do you do next? Besides the Topamax, that is. Well, how strong do you feel? Feel able to confront that doctor? Heheheh... GOOD! I'm right behind you, in spirit. I got your back, Girlfriend.
Start a food diary. List EVERYTHING you eat, the time, the amount of food, and all of your exercise -- including things like "walked through the mall christmas shopping" and so on. Also record your weight, either once a day or twice a week -- just so long as it's consistent. (By the way, although I weigh myself daily, my RD wants me to stop and just weigh myself once a week. Actually, she wants to weigh me once a week. I'm not there yet, but I see the point. Daily fluctuations are usually not as important as the weekly trends.) When you've got a fair amount of data, take it to your doctor -- a nice, neat computerized report is the best, since he won't have the excuse of not being able to take the time to get through it -- and say whatever your equivalent of "OK, Buster -- show me where this weight gain is my fault, and not the medications. Just show me. You can't? Quelle surprise. What are you going to do about it?"
I really am sorry that you're going through this. I do know it's really lousy to feel this way.
Posted by Fallen4MyT on December 7, 2004, at 12:54:48
In reply to All I can say is... » saw, posted by Racer on December 7, 2004, at 11:23:57
I have to say I had the same reaction to the cottage cheese and salad and lack what dinner really is. A whole banana is really two servings and if you add anareobic exercise it will help. Yes you eat pretty good berries are a better fruit than many. Good luck saw
Posted by stresser on December 9, 2004, at 15:09:31
In reply to All I can say is... » saw, posted by Racer on December 7, 2004, at 11:23:57
I am soon to have my Personal Training Certification, and think I can really help you with your nutrition and fitness/exercise questions. I know you need to think of this differently. The scales can't tell how much muscle you have. I usually weigh myself once every four months....or six months. Really. You know by how your cloths feel. STAY OFF THE SCALES IF YOU HAVE AN EATING PROBLEM. Especially anorexia. I used to weight myself every day, maybe two or three times, but after I gave birth to my second child, my husband got so angry (because I weighed myself the day I came home from the hospital and gained 2lbs of water, ...cried and cried. After all, how do you have a 7 lb baby and gain 9 lbs?) that he opened the door and threw the scales outside onto the sidewalk..... and they broke. He told me never to buy another set again. It took me about five years to buy one after that....... Feel free to babble mail me anytime. I think I have it set up to work, and if it doesn't, please let me know through these posts. ok? -L
Posted by stresser on December 9, 2004, at 15:12:39
In reply to Visceral Obesity, posted by saw on December 6, 2004, at 3:06:36
This is the end of the thread.
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