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Vent- medications and appetite

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foodieX2 Feb 23, 2013 12:40 PM

*****Let me preface this by saying I am not looking for any kind of medical advice. My Dr . is complete aware and giving me advice. He is not concerned ******

I recently started a new medication that has greatly impacted my appetite. At first I was Cool! I am a big girl (5'7", 190+) maybe I can finally drop some weight. KInd of built in portion control, KWIM? So I ate what appealed to me and "listened to my body".

But after a few weeks I realized that I was barely eating anything. A day would go by and I would find I never had lunch, never had my afternoon yogurt or almonds. Dinner would be no more than a few bites of meat and veggies. Rice, potatoes, etc held no interest. No interest in my evening glass (or two, or three!) of wine. All very unusual for me.

Last week I began tracking my food and on average I am not eating more than 900 calories a day. Sometimes less. Carbs are practically non existent except in the occasional fruit/veggie. I am never hungry, except in the morning and even so I am easily satiated. I am not "dieting", "low carbing", "paleo-ing". I eat no processed foods, cook from scratch and eat when I am hungry and what appeals to me.

And you know what? I have not lost any weight. nada. Instead I am seeing a constant fluctuation of about 2-3lbs. I weigh myself only once or twice a week, most regularly on Saturday mornings. My weight has been 190, 188, 194, 196, 192, 189, 191,194, 192 etc.

Still I don't get how this is scientifically possible. It's all about calories in vs calories out. Day in, day out for the last 6 weeks I have been eating well under what I burn. It takes an average deficit of 500 calories to lose a lb. I know that starvation mode is a myth but still, isnt this crazy??

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  1. p
    pine time Feb 23, 2013 01:31 PM

    It could be the meds: i.e., something like steroids, where you'd normally gain weight, but you're not eating much (or enough), so you're staying the same. I had that happen once. Got back to normal appetite and weight once I was off that med.

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    1. Ruth Lafler Feb 23, 2013 01:37 PM

      Too bad that you're neither enjoying your food or losing weight (I don't see how it's possible, either!). I have a co-worker who has had the same reaction to a medication she's taking, but she's lost a lot of weight.

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      1. re: Ruth Lafler
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        foodieX2 Feb 23, 2013 02:13 PM

        thanks Ruth! I actually enjoy my food when I do eat/get hungry but am easily full and have lost my desire to eat. I made a great omelet this morning-two eggs with a sauté of artichoke hearts, mushrooms and spinach. Normally I would have eaten the whole thing along with some toast. This am I barely ate half and never even thought about toast. I haven't eaten since. I have a great stew in the slow cooker that smells divine but not a lick of hunger!

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      2. w
        wyogal Feb 23, 2013 01:40 PM

        Yes, it could be the meds. Are your clothes fitting the same? Maybe it's water retention or something.

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        1. re: wyogal
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          foodieX2 Feb 23, 2013 02:18 PM

          My doc said one of side effects was weigh loss, not gain. I actually just pulled up the "fine print" and there is no indication of weigh gain as side effect and I didn't see anything about water retention, which was good call. Plus after six weeks of more than 900 calories deficit a day that would be a lot of water, LOL!

          Clothes the same, no change in shape. Oh, I am still exercising 4-5 days a week, mostly cardio.

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        2. alliegator Feb 23, 2013 02:21 PM

          This happened to me when I started taking a migraine prevention medicine that is well known for causing appetite loss. Maybe you're taking this, too? Or maybe not. But the good news is---my appetite came back just fine! It took a few weeks, and I just focused on keeping foods around that I really enjoy. In my case it was cheese, crackers, ice cream... thins that don't have to be a whole big meal.
          Hopefully it will even out and you'll start eating again. about the no weight loss thing, I don't know. I lost some, but put it back on which was fine.
          Best of luck!

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          1. re: alliegator
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            foodieX2 Feb 23, 2013 02:37 PM

            thanks!! fingers crossed.

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          2. o
            ohmyyum Feb 23, 2013 02:21 PM

            Is it that you're not hungry, easily sated, or that food doesn't taste good to you... Or all of the above?

            I wouldn't be overly concerned since you're more or less maintaining your weight and don't seem to be experiencing any symptoms associated with under-nutrition (at least none that you reported). If it really concerns you, I would just make a conscious effort to eat more calorie-dense foods.

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            1. re: ohmyyum
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              foodieX2 Feb 23, 2013 02:41 PM

              It really is all of the above. I am usually hungry in the am but am easily full. During the day I rarely think about food but I am still cooking, enticed by recipes, etc. Food tastes fine except carbs (my normal weakness), Its like all bread, rice, pasta etc have no flavor.

              My doc isn't worried so I am not either. I just don't understand the science! How can you consistently eat significantly less than you burn and NOT lose weight. The amateur scientist in me wants to know, LOL

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              1. re: foodieX2
                Lillipop Feb 24, 2013 04:00 AM

                FoodieX2....I am an RN so I know a bit about nutrition and pharmacology. I can only speak to my personal experience.When I was doing Weight Watchers (points system) I was ingesting mainly a plant based diet (free points) and following things rather rigidly.So initially I dropped like 4 pounds......I continued the plan.....dropped two pounds.....continued the plan.....dropped zero pounds....WTH? I made a bit of a scene in there that day accusing the weigh -in girl of *rigging * the scale and such:( She explained to me that it happens like that frequently.Next week I lost three pounds. I think that your body may just be reacting to the sudden drop in calories and you might experience a loss of weight soon.The other thing is that if you can Google a drug *monograph* for that drug (and any others you might be taking) it might give you more comprehensive and specific information.I would also suggest that you confer with a pharmacist....they are the experts in terms of knowing how every chemical compound in a drug reacts within the body etc.

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            2. juliejulez Feb 23, 2013 02:50 PM

              It could be the meds. Or, your body thinks its starving (which it is) so it's holding onto every last calorie you give it. It's a pretty common thought that eating less calories results in weight loss, but your body does have a minimum it needs to function. For most women it's 1200 calories, and is often more. I started at around your weight and am only 5'3" and was able to lose weight (50 lbs) eating anywhere from 1200-1600 calories a day with no exercise. But, hopefully this is only temporary and you will regain you appetite soon :)

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              1. re: juliejulez
                babette feasts Feb 23, 2013 07:22 PM

                Isn't the theory that consuming too few calories leads to burning muscle instead of fat?

                Maybe foodieX2 keeps building muscle by doing lots of cardio then burning it up again by putting her body into starvation mode, so the muscle fluctuates but the fat stays the same. Just a guess.

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                1. re: babette feasts
                  juliejulez Feb 23, 2013 08:11 PM

                  Yes I've heard that theory. Makes sense. Also by only eating 900 calories and also exercising, that makes a really huge caloric deficit which would definitely cause the body to hold onto everything it's got.

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              2. s
                sr44 Feb 23, 2013 07:28 PM

                Although it seems obvious that calories in equals calories out, I don't think all medicine agrees with that. Were it so, there wouldn't be the obesity problem currently in the US. I hope, as a portly person myself, that they figure out how to change your metabolic balance in the very near future.

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                1. k
                  KrumTx Feb 23, 2013 08:06 PM

                  One of my employees had weight loss surgery 2 years ago. She was so upset the first couple of months because there was no discernible weight loss, but at about 3 months, it started falling off. Maybe your body is just in freak-out mode. I hope that you're able to enjoy the things you've always enjoyed!

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                  1. ipsedixit Feb 23, 2013 08:39 PM

                    I'm guessing you're burning less calories.

                    Even though you might be exercising the same amount of time that does not necessarily mean you're burning the same amount of calories pre-medication / normal appetite phase.

                    I know when I'm operating at a calorie deficit I cannot exercise with the same amount of intensity even though I might be exercising the same amount if time.

                    And lower intensity will result in less calorie expenditure vis-a-vis a higher intensity routine for the same amount of time.

                    Just a thought.

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                    1. sunshine842 Feb 24, 2013 12:04 AM

                      this is purely speculation by a rank amateur (I don't even play a doctor on TV.....)

                      Maybe this med slows your metabolism? So you're burning less calories -- therefore you *need* less calories, so your body never flips the appetite switch.

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                      1. Rodzilla Feb 24, 2013 01:08 AM

                        It's hard to say without knowing the medication - if it's a corticosteroid or other hormone I would expect fluctuations.

                        Unless you're actually measuring out your foods, you may be underestimating portion sizes ..but the examples you gave don't sound too calorically dense (unless you're forgetting to mention butter or something).

                        I know you aren't looking for medical advice, but if you're interested you might have your doc do a thyroid panel. The body does fight pretty hard at times to maintain homeostasis, including size - if you're drastically reducing calories it may be trying to hold on a bit. That said, I would expect at least an initial drop from someone with your build/activity with a diet a few hundred calories over what you're mentioning. Might be worth looking into.

                        or you're sleep-eating...ambien?

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                          foodieX2 Feb 24, 2013 06:52 AM

                          Thanks for all the input everyone. I think I will ask the doc for a thyroid check. I had it checked a few years ago but not since. I have a follow up with him next week. Like I said he isn't concerned and while he would like me to lose some weight I am strong/healthy overall with excellent cholesterol, etc. His feedback was that appetite loss/weight loss are the most common side effects. The "fine print" didn't mention anything about a metabolic change but I think I will ask him or maybe the pharmacist.

                          I have been using "Sparkpeople" for tracking my food which has an awesome recipe function that will break down any recipe by portion size. Most of what I eat doesn't need to be measured/weighed but it is possible that I am over/under estimating. I feel like its more likely I am underestimating since I am not "cleaning my plate" and rarely finishing my meals.

                          This is what I ate yesterday:

                          2 egg omelet with a sauté of spinach, artichoke hearts and mushrooms. The veggies were seasoned with S&P and red pepper flakes. Maybe a tsp of olive of oil. Maybe I should measure that? I ate about half, maybe slightly more as I ate most of the veggies. Note: I enter my serving portion into the spark site, not what I think I actually ate.

                          "Just a Handful" raw almonds from TJ's

                          Aprox 2 cup serving of beef stew made with carrots, peas and potatoes. I just measured the bowl and it holds a about 2 1/2 cups if filled to the very top rim. I hadn't filled the bowl and I barely ate half.

                          Friday I ate the same kind of omelet but with spinach and onions and finished it.

                          lunch was a single size container of 0% Fage plain yogurt with a small clamshell of raspberries-about 170 grams

                          dinner was about a 6 oz chicken breast marinated in lemon juice, olive oil, s&p then grilled along with some roasted asparagus. I finished the veggies and ate about 3/4 of the chicken. I dipped the chicken in sriracha.

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                          1. re: foodieX2
                            Rodzilla Feb 24, 2013 07:43 AM

                            Certainly not eating a lot, but the potential for underestimating is there.

                            160 2 eggs
                            120 oil
                            60 veggies

                            360 2oz almonds

                            400 a heavier beef stew

                            150 yogurt + berries

                            160 2 eggs
                            120 oil + veggies

                            300 chicken (could be more)
                            200 veggies + oil

                            2030 Total

                            so that might be a higher estimation, but even when you cut from that you can see that it may be quite a bit higher than what you thought.

                            I would measure closely for a week or two (just on account of normal fluctuations, especially with women) - don't do any crazy restriction, but enough that you would definitely expect weight loss 1400-1600 cals maybe?

                            Then you can get back to eyeballing things with a little more accuracy, if that turns out to be the case.

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                            1. re: Rodzilla
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                              foodieX2 Feb 24, 2013 08:19 AM

                              The food I listed was over two days so that is an average of 1000 calories a day which seems about right. According to my tracking I average in 900 range.

                              I honestly doubt I am eating twice the amount I think I am. Things like the yogurt, berries, almonds, chicken breasts are already weighed so I know those are accurate. Large eggs only have a 10-20 calorie difference in range per website.The veggies are not the culprit as I could eat twice what I think am eating with only a 50-100 calorie increase. The oil could be off slightly so from now on I will use tsp measure. I only use it for the sauté- no oil on most other veggie as I prefer them simply roasted. I use spray oil for the actual omelet.

                              As an FYI the "Just a handful" of almonds from traders Joe's are small individual packets. The calories are 200. They are awesome to keep in the car, your desk or bag. They stay fresh and are perfectly portioned.

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                              1. re: foodieX2
                                Rodzilla Feb 24, 2013 04:10 PM

                                In that case this does seem very odd. We're you losing weight prior to starting the medication, or not trying to at that point?

                                I'm with everyone else, the most important thing is a balance of health and happiness, but it's sometimes worth looking into.

                                That said, careful if you're the type to search every possible catastrophic outcome from taking a medication, or condition (I'm guilty of this) I would be interested to hear how things develop.

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                            2. re: foodieX2
                              Lillipop Feb 24, 2013 12:49 PM

                              FoodieX2 ....If you are healthy that is the most important thing. Even if you just lose 1/4 to 1/2 of a pound a week that is a loss and a *good thing*.

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                              1. re: Lillipop
                                sunshine842 Feb 24, 2013 01:24 PM

                                and I'll add "AND the condition for which you're taking the medication is made better with the medication"

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                                1. re: sunshine842
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                                  foodieX2 Feb 24, 2013 01:31 PM

                                  Thank you both. I really appreciate it. The meds are kind of long term thing but its nothing serious, thanks goodness.

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                            3. greygarious Feb 25, 2013 02:40 PM

                              Unless you are old enough for menopause, if you are not getting enough nutrition your menses will most likely become irregular, or stop. If you have always had a regular period, let your doctor know of any changes. If you remain on schedule, it supports the position that you are eating enough.
                              It would not hurt to take a daily multivitamin if you don't already, just in case you are not getting the nutrients you need in proper amounts.

                              It does sound impossible that you have not lost weight unless you are retaining water, or building muscle. Muscle tissue weighs more than the same volume of fatty tissue. But if you are maintaining the same weight while building muscle, your clothes should be looser.

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                              1. re: greygarious
                                sunshine842 Feb 25, 2013 11:51 PM

                                if OP is taking oral contraceptives, your advice -- while not incorrect -- may be masked by the effect of the contraceptives.

                                Do ask the dr. about multivitamins -- drug interactions can cause all kinds of trouble.

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                              2. Sarah Perry Feb 25, 2013 07:17 PM

                                That is so interesting - I recently started a new med and it also destroyed my appetite, but I have been dropping weight like crazy despite not exercising at anywhere near my usual (high) level. No appetite, no energy, no exercise. I expect (as does my doctor) that it will stop soon as my body regulates itself to maintain homeostasis - otherwise it'd be the most popular diet drug in America! - but your situation calls into question many of the theories I was feeling were confirmed by my experience.

                                For instance, my experience made me think obesity is much more about food than exercise - but your experience stumps me regarding that one!

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                                1. The Chowhound Team Feb 27, 2013 12:45 PM

                                  Folks, this thread really is getting into medical advice rather than anything that's heavily food related. We wish foodieX2 the best in resolving these issues, but we just don't think Chowhound is the right place for this discussion.

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