Monthly Archives: January 2017

Asking Why You Can’t Lose Weight After Your Medication?

The media is glutted with advertisements for weight loss: after all, this is January. And it is assumed that by denying calories and increasing physical activity, some weight will be lost by March at the very least. This assumption is based on the belief that the weight was gained because excess calories were consumed, and physical activity minimized.

But what if you were thin, fit, ate healthful foods, loved to exercise, and never been on a diet? Then sometime in 2016 you started on antidepressants for a variety of reasons: depression, anxiety, grief, fibromyalgia, or menopausal hot flushes. The medication helped, but there was a problem. Six weeks or so after starting treatment your clothes started to become tight. You no longer were satisfied with normal portions, but started eating larger amounts at meals. And, horrors of horrors, you could not stop snacking. Your physical activity decreased because the medication made you tired.  You ended up 23 pounds heavier at the end of 2016 than you were the beginning of last year.

So now you are off your medications, and you try one of the various weight-loss programs advertised. But weeks go by and you have lost practically nothing, even though you follow the plan exactly and exercise. Your distress is like someone who became bald during chemotherapy, and months later is still hairless.  You assume that like everyone else who is trying to lose weight in January, you should be successful. In fact more so, because unlike other dieters, you never had an overeating problem until you started taking antidepressants!

Help will not come from the people who develop the diet plans because the regimens are for the ordinary obese individual who gained weight the traditional way. Help won’t come from weight-loss support groups for the same reason. And so far no department of psychiatry has a weight-loss program for its patients who have gained weight on their medications, even though such programs are sorely needed.

So you alone are going to have to figure out how to lose the weight the medications caused you to gain.

Here’s what you need to know: Some medications stay stored in the body for some time after they have been discontinued. You can determine whether the medications are still affecting your appetite and physical activity even though you have stopped taking them; simply ask yourself if you are eating larger portions than you did before you started on the medication.

If you were craving and eating sugary, high-fat snacks when you were on the meds (cookies, cake, ice cream) do you still have these cravings?

Do you find it hard to feel satisfied even when you are eating enough food to make your stomach feel full?

Is your body still fatigued from the meds, or even from a residual depression? Does this make it hard to exercise with the same intensity and duration you had before you went on the medication?

Do you think you have lost muscle mass?

If you detect a lingering effect of your medication on your appetite and physical activity, then consider this one possible reason why it is so hard to lose weight.

Forget what the advertisements for weight-loss programs promise. They are not directed toward people whose appetite control and ability to exercise have been hijacked by their medications.

Instead, give yourself more time to lose your weight. If carbohydrate cravings persist, satisfy them with fat-free, healthy carbohydrates like steamed rice, oatmeal, whole grain pasta, polenta (an Italian version of grits, but without the cheese and butter), popcorn, pretzels, and whole grain bread. You need to eat only 30 grams of such carbohydrate on an empty stomach two or three times a day to take away your cravings, and increase your sense of being full.

And you may have to increase gradually your workout time and intensity since your body may not be able to jump into the type of exercise you did so easily before you took the antidepressants.

Be patient. Eventually the residual medication should leave your body, your control of appetite and ability to exercise will return, and you will lose weight.

But, if none of the above applies to you, seek medical advice. Before meeting with your health provider, accumulate data to show that your inability to lose weight is, a) not your imagination, b) not due to overeating and not admitting it, and c) not related to a sedentary lifestyle.

Keep a food log and exercise log. If possible, use apps that will do it for you and allow you to print out the results. The results will look more impressive than some pieces of paper covered with food stains or sweat. Allow at least three or four weeks of record keeping before presenting them to your physician. That is a long enough period of time to lose one or two pounds and if you have lost none, you can make a convincing case for something being wrong. At the very least, the health care provider should investigate possible reasons for the weight refusing to be lost.

Enough people have experienced difficulty in losing weight after they discontinued their antidepressants to make this a not rare occurrence. So far there has been mainly silence from both the psychiatric and obesity communities in response in part because of the belief that it should be possible to lose weight after the drugs are stopped. Presenting evidence that pounds gained during treatment are not lost with dieting after treatment is stopped, may indeed generate research to find a solution to this unwelcome side effect of antidepressants.

Are Reality Cooking Shows Really Fantasy Cooking Shows?

A group of us were chatting about a local restaurant whose chef was eliminated from the Food Network show, “Chopped.” The restaurant was popular; the show was not.

“The problem,” said someone, “is that the contestants are supposed to combine weird ingredients like Marshmallow Fluff and mushrooms into something edible and do it in 30 minutes or less.  How can of you make an entrée with side dishes in thirty minutes?  And using ingredients that are familiar, not Halloween candy and duck breast?”  We laughed but the question resonated and the group’s response was, “No way.”

As one person commented, it would be possible if we employed a full time assistant who would do all the basic prep work like chopping onions, peeling garlic, dicing carrots, and washing greens. And also making sure that water for pasta was always boiling, sauté pans were at the correct temperature and, we all chimed in, “Cleans up as the cooking goes along.”

“Watching the cooking shows, and then expecting to make the same dishes in 30 minutes or less, is like watching an international tennis match and then expecting to serve the same way,” said one of the women. “Even assuming I have all the ingredients on the counter before I start to cook—and that is a big assumption—it takes me twice as long, if not longer, to prepare the same meal.  And the shows are so deceptive. The cook will say something like, “…wilt the onions or beat the egg whites… and 3 seconds later it is done. Tell that to my onions! “

The women were of a certain age; that is, they had raised children, prepared thousands of meals, entertained, and had done this while working most, if not all, of these years. They may or may not have been good cooks, but they were experienced. And the consensus among us  was that cooking shows, whether competitive ones or in demonstrations by individual chefs, were deceptive. It looked too easy, too fast. Indeed, one woman said that she wondered if a younger generation, inexperienced in meal preparation, would end up serving undercooked food if they tried to imitate what they saw on television.

Wouldn’t it be useful to have one cooking program that was closer to reality? Onions would be burnt because the cook forgot to turn down the heat while answering the phone call from a telemarketer. The chicken would still be half frozen and dripping reddish chicken juice, the cat would leap onto the counter and poke around at the fish, the brownies would be overcooked around the edges and too moist in the center, and the food processor, used to puree the squash soup, would thrust its contents all over the floor like an erupting volcano.  But of course who needs to watch this on television when one can see it in one’s own kitchen?

Unrealistic menus or meal preparations are nothing new. During the 19th century and early 20th centuries, women studied and practiced a discipline called Home Economics, whose goals were to teach housewives basic nutritional requirements for their families and healthy cooking techniques on how to prepare food for the household. The goals were worthy, but some of the so-called nutritional meals were anything but. Cream sauces were poured over just about everything.  Salads consisting of Jell-O cubes, canned pineapple chunks and maraschino cherries were considered elegant enough for a luncheon. And, often disdain was shown toward ethnic dishes prepared by new immigrants, despite the fact that they were nourishing and familiar.  Women’s magazines often promoted recipes, not for their nutritional content, but because they used ingredients of their advertisers. The famous string bean dish in which the vegetable is drenched in canned cream of mushroom soup and sprinkled with canned fried onions rings certainly promoted the sales of these products.

But of course, in those far-off times in the last century, people were still cooking. Today one cannot assume that younger generations will or even want to cook at all.  Thus, if a non-cooking younger generation is to be weaned from supermarket or fast food take-out, prepackaged meals, or a diet of smoothies and shakes, they have to be shown, realistically, how to prepare a meal with more than two ingredients (salt and pepper).  Fortunately, the Internet is replacing the food channels in meeting this need. A little bit of searching will produce videos on how to prepare anything from baked potatoes to a soufflé.  And since they can be viewed as often as necessary, a refresher view is possible if it has been several months since the dish, say meatloaf or roast chicken, has been made.

Ingredients in a box that cook into a meal for two or more, delivered to your door, are becoming popular. Certainly the advertisements looks compelling, especially to cooks like this one who always seem to be lacking one or more ingredients essential to the recipe.  These could be considered starter meals. As they are more expensive than meals assembled from one’s own kitchen, they are unlikely to be a permanent substitute for reading a recipe, finding the ingredients, and cooking. Or maybe not.

Programs on the food channels are entertaining, which is their intent. If a recipe looks worth trying, it is always available on the website of the television personality who prepared it. But just don’t try making it in 30 minutes or less.

How To Stay Full In 2017 When You Are On A Diet

January can be depressing. The predictable cold, snow, ice, wind, and bills are accompanied by, for many, the need to go on a diet. It is hard to ignore the pounds you’ve accumulated since Thanksgiving, and even if you do try to disregard them, advertisements for weight-loss programs won’t allow you to.

Diets tend to be dismal, adding to January gloom, and they are often boring. If someone suggests that we have been all wrong in eating X and avoiding Y, then there is at least the possibility of talking about a novel approach to dieting. But, alas, a quick survey of the diet books appearing now indicates that most of them are still promoting low-or carbohydrate-free diets (ho-hum).

Promoting a low-carbohydrate weight-loss regimen while one is enduring the long hours of winter darkness seems somewhat counterproductive. Such diets exacerbate the toll the lack of sunlight takes on serotonin levels and the grumpy moods, excessive sleepiness, uncontrollable food cravings, and lack of motivation to exercise that may consequently follow. And most relevant for the dieter is the absence of a sense of satiety, or fullness, also conveyed by serotonin.

Eating carbohydrate is the only way the brain makes more serotonin, and a diet that denies or limits starchy carbs like potatoes, pasta, bread, cereals, rice, beans, lentils and corn meal will leave the brain serotonin deprived.  It is a better plan to wait until May or June to stop eating carbohydrates in order to lose weight. The days at this time of year are so long that serotonin levels are not affected by carbohydrate depletion.

But, New Year resolutions being what they are (here today, gone tomorrow), many people feel that they’d better grab onto their will power and start dieting immediately.

So if you can’t eat carbohydrates because the diet books tell you not to, then you might consider an extract from a magical fruit called Garcinia Cambogia. (The name sounds a new dance step.) If you missed hearing about this fruit whose extract not only melts away extra pounds but, based on pictures on the Internet, leaves dieters looking as if they have had head-to- foot plastic surgery, then here is the information.

The fruit is tropical, apparently shaped like a pumpkin but grows on a tree, not on the ground, and is also known as the Malabar tamarind. Its popularity as a promoter of weight loss has shifted on and off for the last 20 or more years and had a resurgence this past year. Its virtues were extolled by the television medical personality Dr. Oz a few months ago, and like dandelions after the rain, companies sprang up to sell a particular ingredient in the fruit. Carcinia Cambogia contains hydroxycitric acid, aka HCA. Rodent studies done many years ago suggested that HCA might cause weight loss by blocking chemical reactions in the body that transform glucose into fat.

Fat or triglycerides are composed of two parts: glycerol, which makes up the backbone of the molecule and three fatty acids. So if your body produces fewer fatty acids, then fewer fat molecules are produced. This is what HCA seems to accomplish. It decreases the conversion of glucose  (all carbohydrates are digested to glucose) to acetyl-CoA. Acetyl-CoA is the building block of fatty acids.Rat studies found that when a high carbohydrate diet was eaten, HCA prevented some of the glucose from being changed into fatty acids. Moreover, as a value added sort of feature, people claim that HCA gives them a feeling of fullness or satiety, so they eat less. Serotonin, the neurotransmitter responsible for satiety, is thought to be increased by HCA, but there is as of yet no evidence for this.

A couple of pesky problems are associated with using Garcinia to lose weight: cost and sketchy purity. It is not cheap. One company is selling the extract HCA at a cost of $50.00 for 60 caplets and since it is recommended that a dose be taken before each meal, the cost can add up. The quality of the preparation is inconsistent among brands. ConsumerLab.com analyzed the content of hydroxycitric acid in several supplements and found the actual amount far less than claimed on the package label. Moreover, the HCA seems effective only when a very high carbohydrate diet is eaten.

There is a much cheaper way to prevent the transformation of carbohydrates into fat, while increasing satiety. It’s simple….eat only moderate amounts of carbs so what is eaten is used for energy, not to build up the fat cells. And consume some of those carbs, such as a half a cup of oatmeal or a toasted English muffin, about a half an hour before meals. Serotonin will be made naturally, the appetite will be decreased naturally, and you will lose weight naturally. Stay on this plan and the weight will even stay off long after the snow has melted, and the rest of the New Year’s resolutions have been forgotten.