Tuesday, May 26, 2020

Medical Doctors, Genetics, and Weight Loss

I'm (52F) new to Reddit and joined just so I could join this sub. I started losing weight mid-March when the quarantine began. I'm 20 lbs down from 210 (225 was my all-time high). My ultimate goal is to get to normal weight and I'm in it for the long-haul. I am using CICO (~1400/day) and a food log, and it is working. It's been a long road just to get to this point. Here's my story so far, for any of you who are interested.

A couple years ago, I felt like my body was breaking down and there was nothing I could do about it. I had zero energy, couldn't breathe, legs felt like they were on fire when I tried to exercise, had sugar cravings that were out of control. I kept telling myself this would get better if I just lost weight. I avoided doctors because I was afraid they would tell me the same. But I also really felt something was wrong beyond just being fat. So I finally made an appointment with my GP. She wasn't very helpful ("try Whole30 or WW" and come back), so I sought out a naturopath. The naturopath tried multiple things - none of which really helped - except that she also provided a recommendation to a pulminologist for my breathing issues. This pulminologist was literally the best doctor I have ever seen. He took me so seriously and had such compassion I wanted to cry. It was through him that I found out I have a cardiomyopathy. That's a story in and of itself, but end result as far as this post is concerned is, it can be treated with medication and monitoring. There are exercise precautions as well (no holding breath and no taking heart to it's max) but I don't do those anyway. While this helped my weightloss initially (I lost 15 lbs right away), I still was extremely tired all the time, had mad sugar-cravings and ate a lot in the hopes of getting more energy. So I asked myself what else I could change. While I was reluctant to do it, I knew I had to get off my anti-depressant escitalopram/lexapro. It had caused me to gain approximately 40 lbs but really helped with anxiety. So I went back to my GP, said I was still trying to lose weight but that I thought the lexapro was causing me to crave sugar and eat. To which she basically said, duh - it makes you crave "rewards". At my suggestion she switched me over to bupropion/Wellbutrin as an intermediary to getting off lexapro. I don't know how many of you have ever tried getting off anti-depressants, but, wow, it was hard. My anxiety came back with a vengeance, my emotions were all over the place and the "brain zaps" were crazy. I really didn't hold out hope that my GP could provide much help, so I sought out help from a psychiatric mental health nurse practitioner (PMHNP). Next to my cardiologist, going to see her was the best thing I ever did. In addition to helping with the antidepressant situation, I went through several genetic, metabolic and food sensitivity tests. Through those results, we were able to tell where my metabolic problems were and where my genetic variants might be interfering. We have been able to correct the metabolic deficiencies with supplements and a medication. But on the genetic front, I found out that I have a variant to the gene that regulates food intake and weight, and that I have a genetic predisposition to overeat and gain weight (knowing this could have predicted the 40 lbs on lexapro). While this made me feel a little sad, I came to the realization that I didn't *have* to overeat but that it would be so important for me to really monitor how much I put into my body. And it also explains why I failed so miserably when I tried intuitive eating, lol. So, it's taken a couple years to get to this point, but I feel the best I have in a long time. The near-debilitating symptoms I had are gone and I can get to the business of actually losing weight.

So, I guess my main point in sharing all this is to show that if you feel like you are in a deep dark hole with your weight that you can't get out of, don't be afraid to ask for help and find out if there underlying health issues. If they give you crap about your weight and don't offer anything constructive, move on to the next one. I see so much on weightloss sites about calories and diets and workout plans, but not a ton about figuring out if anything is holding you back physiologically. Getting to this point has felt like moving the freaking Titanic. For me it really is a multi-pronged approach. There have been other factors that maybe I'll get to at some point, but this is enough for now.

Also, if you have read this far, THANK YOU!

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