Monthly Archives: June 2013

Might a Tattoo Prevent Weight Gain?

A quick Google survey of the effect of weight change on the durability of tattoos reassured me that because the tattoo was on her back, it was less vulnerable to weight change than if the tattoo had been on her abdomen, thighs or biceps. And apparently the integrity of the ink would be compromised only if major changes in weight, either up or down, occurred. Extra folds of skin due to weight loss could distort details, and stretch marks from major weight gain might change the shape and even the color of a tattoo. Indeed, some comments on this subject were accompanied by pictures of how the writer's tattoo changed with weight gain and loss, going, for example, from an oval to a circle with the expansion of her tummy during pregnancy.

Given the popularity of this type of permanent body adornment, it occurred to me that tattooing might be an effective way of tracking weight change. Most of us hate to get on a scale when we think we have gained weight. We also don't even try on a piece of clothing that fit us when we were, for five seconds, at our lowest weight. Why punish ourselves with the obvious? We know we are heavier than we should be. So often it is only when we go for our yearly checkup that the news of our extra poundage is conveyed.

What if we had a built-in monitor of our weight fluctuations? What if every time we showered, we became aware that weight was coming on or happily coming off? Might we be more inclined to stop the weight gain before it became excessive, or continue to lose weight because of our initial success?

A tattoo might be the perfect weight-change indicator. It could be located on an area on the body, say the hips, that enlarge and shrink as weight was gained or lost. And its shape should be sensitive to changes in the tautness or looseness of the skin. Think of how useful this might be. You are in the shower on a Monday morning after a weekend of excessive eating and drink and notice that a tattoo of a quarter moon is now turning into a full moon. “Time to cut back,” you'd say to yourself, “I don't want to find a full moon by next week.”

I suspect that more research on the part of skin-weight change specialists and tattoo artists has to be done before such a technique becomes a useful weight-loss tool. But seriously, how are people who are beginning to gain weight going to stop denying what is happening before the weight gain becomes almost too hard to stop? Two friends whom I see about once a month are now gaining back weight that it took for each more than a year to lose. One has gained more than 50 pounds and the other about 20. At this point, it is obvious to them, and to those who know them. Maybe they will stop gaining and, like the ebbing of the tide, start to lose again.

But maybe a tattoo or some other marker on their skin would have aborted their weight gain before it became unmanageable. Years ago, I knew a doctor who outfitted his weight-loss patients with a cord around their waist when they reached their goal. He told them that if they gained weight, the cord would be uncomfortable. Alas, they did gain weight, the cord became uncomfortable and they (as he told me latter) cut it off. A tattoo is different. It can be removed only with difficulty, pain and great expense. And if it keeps people at a healthy weight, then its function will be more than decorative.]]>

Going to a Marriage Counselor to Lose Weight

“I thought of going to your weight-loss clinic,” she added before resuming her eating. “Frankly, though, what I need is a marriage counselor, not a diet program.”

Abigail (not her name) then briefly outlined the stresses that caused her to reach for food continually: Her husband had not earned any money for years and was not interested in looking for a paying job. He wrote books that he self-published and claimed that he was too busy to participate in the logistics of running the house. In addition to holding a full-time job with unpaid overtime, Abigail had to pay bills, do the taxes, clean, cook, shop, and, of course, take care of the children. She sputtered when she told me that her husband even expected her to visit his father who was recovering from a heart attack because he, the son, didn’t have the time.
The husband, who was also considerably overweight, insisted on large, fattening meals along with snacks that he could munch on while he wrote.

“So who also eats the snacks? Who eats all the leftovers? You can see them on me: They are all on my hips and stomach, “she said. “It is easier to eat than to fight with him about everything.”

In the interests of self disclosure, I heard only her side of the story. And who knows, maybe her husband’s obesity could also be generated by his own dissatisfaction with his marriage and his life. Nevertheless, I agreed with Abigail that simply going off to a Weight Watcher’s meeting or getting private diet counseling was not going to solve her weight problems. She knew why she was overeating, but felt equally helpless about solving her weight and her marital problems.

Overeating is often the symptom that something is wrong with some aspect of one’s life. Unfortunately, diet advice to bring the overeater back to a normal weight overlooks the causes of the excessive food intake or offers no help in preventing it other than suggesting the use of will power.

Losing weight should not be deferred until the stresses and triggers that caused overeating are identified and removed. Someone like Abigail, who is so overweight as to make her vulnerable to a variety of health problems, should not wait until the problems with her husband, along with her exhaustion, stress and anger are resolved. But, as she said, she needed a marriage counselor (or life coach or psychologist) as much as a diet plan to be successful in losing weight.

One of the benefits of a slow weight-loss program is to allow enough time, perhaps a year or more, to work on the problems that caused the overeating. Abigail’s problems were complex, and she needed to look at her restrictions and priorities anew, so that she felt entitled to eat foods that allowed her to lose weight and take time to exercise. But how could Abigail shift her palate to better nutritional choices? Could she do this within the confines of her marriage? She needed professional guidance, and not a diet counselor, to help her answer that question. But I convinced her that as long as she stopped gaining weight and started to lose, albeit slowly, she would have the time to work out the answers. And perhaps as she lost weight, she would gain a happier life.
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Recovering Your Healthy Body After Being Depressed

But what if the deterioration of the body is due to mental illness? What if the loss of muscle strength and muscle wasting is due to weeks or even months of inactivity because of the extreme fatigue and weakness that may accompany depression and anxiety? What if an individual is so depressed that moving from a bed to a chair seems too hard, and as a consequence, the lack of days or weeks of physical activity brings about muscle loss and weakness?

Several years ago a woman who had been coming to our weight-management center at a Harvard-associated psychiatric hospital suddenly disappeared. Several weeks later, when her severe depression lifted, she came back and told us that she was unable even to make phone calls during the worst days. The trainer who had been working with her in our program’s exercise routine noticed that she had lost stamina, was unable to do her previous aerobic and strength-building exercise routine, and had trouble with her balance. The days of simply not moving had taken its toll.

She was fortunate, however. The trainer knew what her body was capable of doing before she became depressed and was therefore able to help her regain her former level of fitness.

But what about others whose mental illness causes them to experience periods of physical inactivity as severe as those suffered by someone recovering from injury, infection, chemotherapy or heart disease? Do their therapists recognize the physical debilitation caused by their mental illness? Are the patients given nutritional advice to help them restore lost muscle mass, and are they referred to physical therapists or trainers to restore their lost physical fitness?

While I suspect that these patients are given appropriate medication and therapeutic counseling. But I also suspect that the counseling does not include recommendations as to how to increase muscle mass, increase stamina or improve their balance (a particular problem if the medications make them dizzy).

Because of my decade-long interest in reversing weight gain caused by antidepressants, I have heard from many who have experienced this problem. Most people who contact me write that their medications increased food intake and subsequently their weight. But some insist that they are not eating any differently, and yet their weight increases anyway. They ask if the drugs might be slowing down their metabolism? Unfortunately I am not aware of any studies that compared metabolic rate before and during treatment with antidepressants and mood stabilizers (drugs used for bipolar illness) to see if indeed such drugs decreased metabolic rate. But perhaps if their metabolism is slower, it is not due to the drugs, but due a decrease in muscle mass? Muscles are the greatest users of calories in our body. Thus prolonged inactivity during a depressive episode might deplete muscle mass as readily as it does when someone is forced to stay in bed because of a serious infection or complication of surgery. If so, this would account for a drop in metabolism and subsequent weight gain without a change in food intake?

Fortunately, as anyone who has had a broken limb or bad flu knows, it is possible to reverse muscle loss by exercise and sufficient protein intake. (Women should be sure to eat at least 55-60 grams, and males 75-80 grams, of protein each day.) The same program will work for people who are recovering from mental illness. And if prolonged physical activity has caused major muscle weakness and loss of balance, it should be possible to enlist the service of physical therapist to start the recovery process. It may take time, but certainly will be successful, if given the support it needs.
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