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What I Learned from Taking a Drug that Causes Weight Gain

Today’s post will be somewhat personal because I’ve been quite sick. The problem, as usual, is my digestive system – the ulcerative colitis that originally inspired the Normal Eating method. When an emotional eater has health-mandated eating restrictions, he or she must resolve emotional eating in a very deep way to avoid getting triggered. And thus the Normal Eating method was born.

This time around my challenge was a little different. I wasn’t trying to follow a special diet that I hoped would cure me (though I did make certain changes I’ll talk about shortly). I was – and am – taking a drug that I know from past experience causes pronounced increase in appetite and water retention, potentially leading to rapid weight gain and "moonface" (puffed out cheeks): the dreaded Prednisone.

First key point: When you are sick enough to need this drug, it puts the importance of appearance in perspective. When you are so sick that you cannot leave home or enjoy life at all, a fast 20 pound weight gain and a head like a basketball seems a small price to pay to be functional and pain-free. That said, I did not gain 20 pounds this time.

When Your Body Betrays You

The first time my doctor put me on Prednisone for colitis, I wasn’t forewarned about the increased appetite and water retention. I felt endlessly hungry so I endlessly ate. I gained weight very quickly, and my usually oval face became perfectly round. People I knew didn’t recognize me. I didn’t realize how much my appearance had changed until I saw myself in a photograph, and then I cried.

The worst part was not actually the weight gain, but the moonface – the puffed out cheeks from water retention. I didn’t feel pretty anymore, but moreover I didn’t feel like me anymore. I felt like I was in someone else’s body.

My overwhelming feeling this time around was that I didn’t want to put myself through that again. I wanted to spare myself the pain of reliving that experience. My main thought was PROTECT: Protect self from pain.

This is important because how you think about your food choices has everything to do with how you feel about them. What you do out of self-love and self-protection is freely chosen and empowering. Then it’s not about the food you’ve chosen to eat or not eat, it’s about the benefit you want to give yourself. You’re moving towards something, not away from something. Your main focus is not the food, but rather the goal you are trying to achieve (incidentally, through food choices).

Freely Choosing

How do you get to the point where you can freely make food choices in your own best interest, without feelings of conflict or deprivation? In the end, it comes down to how you think about it – what you say to yourself in the moment when you are deciding what you will or will not eat.

What I said to myself was, "This is war, and I am fighting for my life. I am going to get well, and I am going to do it on my own terms, without losing my physical sense of self, to the extent it is possible for me to control this."

I’ve been able to minimize the Prednisone side effects this time because I have developed the inner freedom to make food choices that feel like choices, exercises of personal power, and not restrictions imposed from without. I was able to decide what to eat without any sense of inner conflict. This is what the Normal Eating method is all about.

I also learned some interesting things along the way.

Mindfulness versus Habit

When I started the Prednisone, I became very conscious and deliberate about what I chose to put in my mouth, much more so than before. My strategy was this:

  • Pay scrupulous attention to hunger and satiation. Know that my body’s cues are distorted because of the drug, and eat the bare minimum needed to satisfy hunger.
  • Avoid foods with high calorie density and low nutrition (e.g. sweets) because my body is leading me to eat more than it really needs. Don’t go hungry, but minimize foods that will encourage fast weight gain.
  • Minimize salt to reduce water retention.

At first it was easy – the Prednisone hunger doesn’t happen immediately. And I had a surprising realization: I’d been eating slightly more than my body needed, simply out of habit. For example, I didn’t need a whole bagel at breakfast. My body only wanted half that.

I’ve always gained weight easily, but much more so since turning 50. I weight 10-15 pounds more now than I did at 30. Until this exercise in hypermindfulness, I didn’t think there was anything I could do about it. I wasn’t eating emotionally or compulsively – I was eating what I always had eaten. But I weighed more.

Now I realize that this was the problem. I was eating what I always had eaten, but my body was not as it always had been. I was older and had less muscle mass. Perhaps I also moved less. I wasn’t eating to fill emotional needs, but in eating out of habit I was not fully eating according to my body’s hunger and satiation cues. It turns out that going on autopilot is a great way to gain weight with age!

In the first two weeks of my hyper-mindful eating, I actually lost 5 pounds. I gained this back when the relentless Prednisone hunger kicked in, but the gain stopped at the 5 pounds I lost.

I’m now starting to taper off the Prednisone, and my only side effect has been a slight moonface and hoarseness from the water retention. Maybe when I’m off the Prednisone my weight will return to what it was when I was 30, just by paying more attention to my body and not eating out of habit. That would be nice.

Age, Beauty, and Health

All things being equal, everybody would prefer a vigorous, healthy, youthful, normal-weight body. After all, this defines beauty. We are genetically programmed to be attracted to health. A youthful shape signals reproductive capability.

But all things are not equal.

If you are over 50, you’ve probably noticed that your proportions have changed, even if your weight has not. I always used to be a full size smaller on top than on the bottom, no matter what my weight. That is no longer true. Suddenly I’m bigger on top. People tend to get thicker around the waist with age.

This doesn’t only apply to women, but as an example, look at pictures of Betty White over time. Notice what happens to her figure as she ages. She doesn’t get fat, but she gets thicker around the middle and other things shift and change. That’s part of life, and to stress about it is a waste of energy. It’s self-respecting to look the best we can, but beauty is not the most important thing in life and, as we get older, it becomes increasingly out of reach.

On the plus side, though appearance doesn’t improve with age, wisdom and peace of mind do. I may have looked better at 30, but I’m a lot happier at 54. And everybody else I know in my age group feels the same way.

But most important is this: No matter what your age, if you are healthy, you are blessed. If you’ve never been seriously ill, you don’t fully realize how blessed.

Honor yourself by looking your best, but try to keep it in perspective. It’s not the most important thing.

Please post your thoughts and experiences. I’d love to hear from you!

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14 comments to What I Learned from Taking a Drug that Causes Weight Gain

  • Lisa Lisa

    This hit home for me in a number of ways. As I wait to have my 2nd child (any day now!) at age 39, I feel less panicked than I did the first time around about losing the baby weight ASAP. I’ve had monstrous hunger and thirst this time around, particularly cravings for dairy and fruit. Part of me recognizes the powerlessness over the bodily changes caused by carrying a baby, as well as the bodily changes caused by age. Another part of me recognizes that I won’t be at my normal weight after I deliver–probably about 20 pounds higher– and that it will be important to my sense of well-being to readjust my eating and gradually lose the weight.

    This is what I got from your post: accept with grace what I cannot change, while empowering myself to change what I can. At this stage in my NE game, wanting to be thin is no longer a desperation thing, but it is a legitimate desire to feel good in my body… and that’s okay!

  • Thanks for sharing your thoughts. I have been on the “dreaded prednisone” a few times before for my asthma and it has been maddening. I’m grateful for this perspective, should I ever need it again. But I’m also grateful for the reminded that we do have more control over our lives than we like to admit to sometimes. I’m grateful to finally have a level of trust in my body and its wisdom. It is a process I am actively working to improve, but it has brought a great amount of peace into my life.
    Thanks again!

  • > This is what I got from your post: accept with grace what I cannot change, while empowering myself to change what I can.

    Lisa, this is beautifully put and is exactly what I was trying to get at. I wish I’d said it explicitly as you did.

  • Lisa Bee Lisa Bee

    This is really inspiring post Sheryl, to think you are at the place with your eating where you can bring the mindfulness down to this minute level – lordy! hope I get there one day!

    In the meantime, I hope your condition levels out. My only comparison are the very severe blood sugar level swings I get – hypoglycemia – makes certain foods good for me, others really not. I am learning that to stay away from certain can be supportive rather than depriving…thats what I’m hoping for in any case! Sounds like the KEY thing, and this is what really interests me, is how you frame it in your head. The thoughts you tell yourself about a certain food or behaviour seems to dictate the feelings we have around it.

    Cheers
    Lisa Bee

  • helen helen

    hi Sheryl
    ah yes, the dreaded side effects of drugs (i too have been on roller coaster of various meds, not fun!!!)..
    L-Glutamine!
    – on bodybuildingforyou i found a small paragraph describing all benefits on a google search, but it didn’t copy over.
    I started using this years ago for healing up my gut. Talk about relief! Also for exercise recovery, but mostly for those days when i don’t exercise at all (to keep muscle) – tastes like nothing, just powder in water… as a result of ongoing research for alternatives, my supplements pile has grown as my meds pile has shrunk (yay), so glutamine is one of supps i take quite regularly. Good stuff :) helen

  • Yepperoo on the l-glutamine! I’ve used it for years, and I think I may have gotten it on the Web site you mention. It’s used by body builders to maintain muscle mass, and it also happens to be the main protein comprising the lining of the gut. I take it most days (when I remember). I haven’t noticed any particular effect, but maybe it’s subtle. :)

  • Hi Sherry,
    Don’t usually post but you really hit a chord. I’m much older than most of you (78) but the body image thing is still a problem, Nothing is where it used to be and even at my age I still find myself self-critical, although probaly less than when I was 30 lbs thinner and 30 pounds lighter! I have many physical problems: sone weight=related and some not and cannot be any where active as I was. I truly appreciated your commments today. It’s a reminder of whats important in life.

  • Sundara Sundara

    Sheryl, your words are so inspiring. I really hope you are feeling better. Thanks so much for sharing your ideas with us – there is so much to ponder there – and thanks above all for NE, and for making it so beautifully available to us. peace and health to you! Sun

  • Juda Juda

    Hi everyone I am new to this site but from what I ahve read so far I am very grateful for all the honest sharing and support I have already received…only read 3 of Sheryl’s posts so far…anyway…I am 57 and have been dealing with compulsive overeating since early childhood…what a journey…what I am finding lately is the joys attached to looking after my skin and how that makes me feel way more comfy with how I look.

    Massaging skin cream into my face and body nearly everyday has put me more in touch with my body than I ever though possible. I am not using expensive products just being consistent with a well known brand that doesn’t test on animals.

    These days it’s how I feel that is more important than how I look. And I am finding that if I feel good about myself how look doesn’t matter a hill of beans.

    cheers
    Juda

  • Amia Amia

    Hi Sheryl,
    My name is Amia and I’m a 19 yr old girl who was diagnosed with Crohn’s disease a few years ago. I was prescribed Prednisone as well or some variant of it and decided to not take it and opt for Chinese medicine instead. It’s working very well for me, although I still need to keep up with the status of my illness.

    The important thing is that my illness made me realize many things that I was doing to hurt my body, merely through my eating habits. My emotional issues were a huge factor too in causing/contributing as well, so the other articles on this site have been amazingly insightful. I’ve never been obese, just slightly overweight for a Chinese girl (135, 5′4″).

    Through these 2-3 years since diagnosis, I've learned so much about what’s good to put into my body, and I’ve dug up so much information on the psychological side of it as well (psychosomatic disorders). I really like this website and find it really interesting that you’ve suffered from a gastrointestinal disorder as well. In a way, this illness has been more than a blessing, to help me change.

    Thanks for making this site!!

  • Hi Amia,

    I’m curious whether the Chinese herbs helped your Crohn’s Disease. I’ve thought of going that route.

    - Sheryl

  • Nancy Nancy

    Hello,

    I wanted to respond to this because I was on prednisone for one year. In the first six months, I went from 195 pounds to 170 pounds. In the next six months, I went from 170 to around 210 pounds. After I stopped prednisone, I could not seem to lose any weight – I’d lose 5 pounds and gain it right back. I felt like I was eating much less than I had before.

    Then I realized that in the first six months of my illness, I wanted to eat healthy so among other things, I stopped eating flour and sugar and decreased my salt intake. At the six month mark, I had some particularly stressful situations come up and I started eating flour and sugar again.

    So I stopped eating flour and sugar altogether. I immediately lost 20 pounds, even though I felt like I was eating more food. I lost another ten pounds over the next year.

    Bottom line? In my case, I believe that steroids changed my metabolism permanently somehow. I no longer eat flour and sugar, I feel 100% better, and I am at a much healthier weight.

    I hope this information can help somebody!

    - Nancy

  • Gillian Gillian

    Hi,
    I don’t know if anyone is still reading these posts, as years have gone by since they were written. I take antidepressants that cause weight gain. I have no choice about taking them, and I think that the Normal Eating approach will be helpful in dealing with this side effect. Have just started NE and am finding it useful.
    If anyone has any suggestions, I would so appreciate hearing from you.
    Best,
    Gillian

  • Hi Gillian,

    The problem with drugs that cause weight gain is that they distort your appetite so you can’t fully trust your body. To not gain weight on prednisone, you have to eat in almost a “diet” way, ignoring your body’s cues and eating what your head says you need, because the prednisone makes you hungry all the time.

    I know of one antidepressant that does not cause weight gain: sertraline (brand name Zoloft in the US). It’s also very effective, for both depression and anxiety.

    - Sheryl

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