Medical Conditions Which Affect Weight: Separating Fact From Fiction
PeachyCarol
Posts: 8,029 Member
First let me say I know this can be a delicate topic, so I'd really hope to keep this discussion as civil as possible.
For example, I have hypothyroidism, but I know that undiagnosed hypothyroidism is only responsible for a slowed metabolism which accounts for a minor weight gain. Overall caloric intake will ultimately determine how much weight is gained before diagnosis.
Some people with conditions which account for only minor metabolic slow downs gain a lot of weight and it's frustrating for them, so that's why I'd like the discussion to tread lightly.
With that in mind...
A lot of medical issues/medications effect weight and are mentioned on the boards frequently. But there are a lot of misunderstandings and misconceptions surrounding them and their ultimate impact on weight loss.
I know we have members of the medical and scientific communities among us, I'm hoping they weigh in on this thread with some real knowledge to get information out there.
I should mention that this thread is for conditions which impact weight in any way, including those which include rapid weight loss.
For example, I have celiac disease. When it reached a crisis point before diagnosis, I lost 30 pounds in 2 months due to malabsorption issues. It was not a pleasant experience, I literally was not fully digesting food or liquid and was constantly dehydrated. My body turned to its fat stores for energy. At the time, I had a starting weigh of 160 pounds.
So, weigh in (see what I did there?) with your experiences and expertise so we can, together, separate fact from fiction!
[Edited at OP request]
For example, I have hypothyroidism, but I know that undiagnosed hypothyroidism is only responsible for a slowed metabolism which accounts for a minor weight gain. Overall caloric intake will ultimately determine how much weight is gained before diagnosis.
Some people with conditions which account for only minor metabolic slow downs gain a lot of weight and it's frustrating for them, so that's why I'd like the discussion to tread lightly.
With that in mind...
A lot of medical issues/medications effect weight and are mentioned on the boards frequently. But there are a lot of misunderstandings and misconceptions surrounding them and their ultimate impact on weight loss.
I know we have members of the medical and scientific communities among us, I'm hoping they weigh in on this thread with some real knowledge to get information out there.
I should mention that this thread is for conditions which impact weight in any way, including those which include rapid weight loss.
For example, I have celiac disease. When it reached a crisis point before diagnosis, I lost 30 pounds in 2 months due to malabsorption issues. It was not a pleasant experience, I literally was not fully digesting food or liquid and was constantly dehydrated. My body turned to its fat stores for energy. At the time, I had a starting weigh of 160 pounds.
So, weigh in (see what I did there?) with your experiences and expertise so we can, together, separate fact from fiction!
[Edited at OP request]
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Replies
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I have/had hypothyroidism after a bad neck injury. I believe that yes it may "contribute" to minor weight gain but ultimately exercise and a defecit will stop that from happening! In my case I never had to take medication but I do find that I definitely used hypothyroidism as a bit of an excuse to my unhealthy eating habits..
Anxiety medication on the other hand can be a huge factor (In my opinion) with weightloss and weight gain. The first week I was on medication I barely had no appetite and was feeling physically ill to try and eat the recommend intake. But it also can make you have crazy food urges as well0 -
Great thread carol !
I have nothing to add as far as medical conditions but would like to mention prescription medicine .
When I was first starting out, I went to the doctor and said " my depo birth control shot is causing me not to lose weight !"
He said, that's actually a myth. Google the words" birth control and weight gain" , you'll see thousands saying the same thing but its only because that's how misunderstood people are. He explained that it can cause an increased appetite , thus causing people to eat at a surplus and gain weight. But people like to leave out the surplus part and go straight to the weight gain part . if you ask 100 girls did they gain weight on depo, 75 will say yes and zero will admit to overeating. So that's how the " weight gain from depo " thing goes.
It came down to calories. Not the shot . once I truly was ready to give up the excuses, I was able to lose weight.
There Will always be people who enjoy having an excuse. They really don't want it. I was once one of those people so I know all about it.
Its often very hard for people to let go off the myths and excuses. Weight loss will always come down to calories . some will have to work a little harder then others but it still comes down to calories .0 -
I'm fascinated with cortisol levels right now. I've had a significant amount of trauma in my life the last 2 months. I'm also type 1 diabetic. I went to my endocrinologist this week to help with my suddenly out of control high blood sugars. I also asked her about the 8 pounds I gained almost overnight despite diligently counting calories, weighing food, exercising, etc. The weight gain, high blood sugars are all stress/cortisol induced. She gave a very scientific explanation of how excess cortisol causes weight gain even when you do not change your eating habits. So I'm still weighing my food and eating at a deficit but I'm also actively trying to reduce cortisol levels.0
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Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.0
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Cortisol can have an impact on weight for sure. One reason I think a lot of people don't gain as much weight as they might expect on a vacation is because they lowered their cortisol levels by being relaxed.
One of the reasons it's suggested to take breaks from eating at a deficit is that long term dieting is itself a stressor. I think I might be coming to this point myself.0 -
Sometimes, it's also not one medical condition, but a confluence of them that causes an issue. Maybe you handled it with one condition, but when a second came on, everything took a turn.
That was my case. I was doing ok, then another condition hit and I was suddenly swamped, which caused another condition that added to it. From a healthy, active 220 to a borderline dying 306 in 20 months. That's why when someone says, "I've always been heavy but healthy. Suddenly, things took a turn," my first thought is "medical" not "you're overeating."
Great thread @PeachyCarol0 -
Perhaps what you are trying to do is reduce the short cuts people make?
I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.
What 'fiction' do you think needs to be addressed?
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None cause (effect) weight, though some can influence (affect) it, if people don't change how they eat.
That seems to have been adequately addressed in this thread...
as well as the myriad of others saying exactly the same thing.0 -
EvgeniZyntx wrote: »Perhaps what you are trying to do is reduce the short cuts people make?
I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.
What 'fiction' do you think needs to be addressed?
I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.
Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.0 -
None cause (effect) weight, though some can influence (affect) it, if people don't change how they eat.
That seems to have been adequately addressed in this thread...
as well as the myriad of others saying exactly the same thing.
You feel that they've been adequately addressed? I see so many thyroid and PCOS threads with misinformation in them every day on this forum. Both conditions lead to marginal weight issues, but you wouldn't think that from some of what you see here.
Neither of them necessarily call for a special diet, except by choice either.
I know I've seen studies to back up what I'm saying. I'll try to find them in a bit and post them.0 -
PeachyCarol wrote: »EvgeniZyntx wrote: »Perhaps what you are trying to do is reduce the short cuts people make?
I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.
What 'fiction' do you think needs to be addressed?
I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.
Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
Ah, I missed that thread - but saw some of the fallout.
I agree with you - few drugs cause direct weight gain (or some of that weight gain is transient from oedema).
Ok, I understand better what is your intent. I'll pop in with a few examples or can explain some physiological effects.
Here is another breakdown example: How hyperthyroidism might lead to weight gain.
Initially, untreated hyperthyroidism leads to rapid weight loss. It tends to down-regulate hunger and significantly up regulate metabolism directly - a person, like my ex, can experience 10-20lbs of weight loss per month (or even more), directly. This type of rapid weight loss not only results in fat loss but also screws up hormones and muscle mass.
Almost systematically, when the hyperthyroidism is treated (chemically or surgically destroying the thyroid) and replacement therapy occurs - the effects on satiety hormones, energy levels, mood and also reduced metabolism due to prior weight loss tend to lead to weight gain beyond the weight loss. It is very hard, in the absence of strict calorie management, to self regulate during this rollercoaster. The person ends up with a 10-40 lb gain without the relevant LBM gains and might struggle with mood and energy still.
Can it be avoided? Yes. But not without drastic calorie management methods.0 -
PeachyCarol wrote: »Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
BOOM!
It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.0 -
Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.
Haha... I love this "warm things not made of salad" - I've definitely been there!!0 -
Liftng4Lis wrote: »PeachyCarol wrote: »Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
BOOM!
It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.
People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
I do wonder if we truly know the effect of some medicines, however. So I'll reserve comment on that.
I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.
With most things like this I take a "mile in your shoes" approach. I can't imagine how frustrating it must be for folks with underlying medical conditions who ARE finding it tough to shift the weight. As a menopausal woman, I have only a tiny glimpse of what it must be like. cheers to all who do find it hard.
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Sabine_Stroehm wrote: »Liftng4Lis wrote: »PeachyCarol wrote: »Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
BOOM!
It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.
People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.
Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.0 -
I'm a type 1 diabetic (I just realized I was diagnosed two years ago today), which can manipulate what nutrients are absorbed within my body. Prior to my diagnosis, I lost 55 pounds in less than 3-4 months, because many cells in my body were unable to use carbohydrates for energy due to my pancreas not producing any insulin (insulin is the "key" that allows glucose into the cells). Of course, this led to a ton of other issues which would have killed me had I not be diagnosed when I was.
With the insulin, it promotes the uptake of glucose by the liver and adipose cells. Within two months of beginning insulin therapy, I gained 15 pounds while eating below my "maintenance calories" as my glycogen stores were replenished (which makes sense, because the body can store about 500g of glycogen. With the increase in glycogen, my water weight also increased as glucose is very osmotically dense -about 4g water per g glycogen) and my body recovered from being starved for months. Even now, I realized that I lost a ton of muscle mass due to the diabetes, and my TDEE is likely to be lower than the average person with my stats (decreased CO).
Now that I have been on insulin for a while, I need to be very careful of how much I take in relationship to my weight loss/maintenance and calorie goals. If I take too much insulin, my blood glucose can drop to dangerously low levels and requires me to eat fast-acting carbs. If those carbs push me above my maintenance, I gain weight (CI>CO). If I don't take enough insulin, my blood sugar rises, and some of the calories I consume might not be utilized by the body (the kidneys will filter out glucose into the urine if BG levels are high enough), which means that I might lose weight if I am trying to maintain (CI<CO). Of course, a type 1 diabetic can really slash her insulin dosages and lose a ton of weight quickly -it is actually qualified as an eating disorder under the DSM5 (diabulemia)- but then that person also risks developing a ton of microvascular and macrovascular complications due to the prolonged high BG. I would much rather be fat and losing the "old fashion way" than be blind/on dialysis/without a foot.
Honestly, it's still CICO. I simply need to adjust to the fact that my CO is a bit lower than average and my CI is dependent on my BG. I'm not a special snowflake.0 -
Liftng4Lis wrote: »Sabine_Stroehm wrote: »Liftng4Lis wrote: »PeachyCarol wrote: »Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
BOOM!
It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.
People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.
Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.
Thanks for illustrating that point. Wow. 40LBS is a lot.0 -
When I was starting out at 145, yes. It took me a long time to recover my lady curves....shiver. Okay it was gross!Sabine_Stroehm wrote: »Liftng4Lis wrote: »Sabine_Stroehm wrote: »Liftng4Lis wrote: »PeachyCarol wrote: »Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
BOOM!
It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.
People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.
Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.
Thanks for illustrating that point. Wow. 40LBS is a lot.
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Liftng4Lis wrote: »Sabine_Stroehm wrote: »Liftng4Lis wrote: »PeachyCarol wrote: »Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
BOOM!
It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.
People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
I don wonder if we truly know the effect of some medicines, however. So I'll reserve comment on those.
I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.
Yes. People blame all sorts of things on weight gain. On the opposite side of the coin, (I'll use myself as an example), when going through my second divorce with my husband (two young kids), I had dropped 40 pounds in 3 months. I was to a very, unhealthy weight for my size and it was a very scary time, when I could actually see this. The point is that "divorce" didn't make me lose weight. NOT eating did. Again, it comes down to CICO.
Calorie needs are never constant, they are affected by such a variety of factors that CICO isn't as simple as many seem to present here.
It's like saying it is all due to breathing and oxidation reactions! (Which is true.) But it doesn't explain how that is regulated.
What part of the CICO equation describes HOW your divorce affected HOW MUCH you ate?
Imagine if we could reduce all autopsy to "well the heart stopped, and then the brain signal stopped too". How is important. Oh, but it all comes down to heart and brain function!!
CICO is only part of the process and a complex part at that.
PS - glad you recovered.0 -
There are a lot of warm foods that can fit in a caloric deficit and a lot of salads that might not.Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.
It's not hard to see how that could be seen as just a long list of excuses more than anything else.0 -
Sabine_Stroehm wrote: »Liftng4Lis wrote: »PeachyCarol wrote: »Another type of fiction is that certain drugs cause weight gain. Well... yes and no. They don't directly just magically produce weight gain. They either lower metabolic rate or increase appetite, but that would only account for a certain margin of gain. Gains beyond that point come down to consumption.
Fiction is a loaded word, but it scans nicely with fact, so I went with it. I'd like this thread to explore the real causes of weight gain or loss with medical conditions as you did with explaining what happened to your friend there.
I find when we truly break these things down, it leads to understanding the component issues so that they can be addressed.
BOOM!
It's disturbing to so often see people say "blah blah" caused my weight gain. NO, eating too much causes weight gain. You may have different caloric needs now, for whatever reason, but it still comes down to CICO.
People attribute their weight gain to many things, don't they? I see threads here all the time where new jobs or break ups "caused" weight gain.
I do wonder if we truly know the effect of some medicines, however. So I'll reserve comment on that.
I do believe that with some conditions caloric needs may not remain constant, thus making it even harder to find the sweet spot for losing.
I am finding this true with my restrictions on sodium. I sometimes reach my upper limit of sodium before I reach my calorie goal. I have had to change many foods that I was eating before to get that sodium level down. Due to surgery on my right arm food prep has become hindered.
Due to the injury to my arm... the surgery...hypertension...the meds...I lost 10lbs in two weeks. Trying to balance all of that while at the same time becoming sedentary (because of the arm and a faulty EKG) it has been difficult. I am working on it but it has been havoc on my weight loss goals.
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PeachyCarol wrote: »Cortisol can have an impact on weight for sure. One reason I think a lot of people don't gain as much weight as they might expect on a vacation is because they lowered their cortisol levels by being relaxed.
One of the reasons it's suggested to take breaks from eating at a deficit is that long term dieting is itself a stressor. I think I might be coming to this point myself.
I had never considered the cortisol/vacation/relaxation thing but it makes sense to me.
I think that describing medical conditions as indirectly leading to weight gain can be appropriate. The example that @EvgeniZyntx gave about his friend's paralysis and weight gain can be described that way. If his friend were to say "my paralysis made me gain weight" I wouldn't assume that she meant that she woke up paralyzed and *boom* gained 50 pounds. No, I would think that she was using shorthand to describe how one condition led to another.
While I do appreciate that people need to "face the music", so to speak, and understand how their eating and physical activity habits are the keys to weight gain/loss/maintenance, it seems that many people overlook colloquial conversation habits, which often include skipped words/phrases for the sake of expediency. That happens on MFP with regard to medical conditions, "toned", and "muscle weighs more than fat". I'm sure there are other examples that escape me right now too.0 -
PeachyCarol wrote: »EvgeniZyntx wrote: »Perhaps what you are trying to do is reduce the short cuts people make?
I'll take an example - I have a friend that became wheelchair bound four years ago (lateral paralysis) - this had led to her being obese. Obviously the chair didn't CAUSE the obesity but the conditions of difficulty in limiting consumption, depression, reduced mobility and the associated difficulty of increasing energy expenditure for someone that has difficulty moving resulted in consuming more calories than those expended.
What 'fiction' do you think needs to be addressed?
I think the fiction is dependent on the condition, Ev. There was a recent thread where someone brought up his own DKA, and he grossly misstated the mechanism of it and implied a medically impossible outcome of it. That's one type of fiction.
As far as DKA that I brought up in a prior thread (2 prior threads, actually), you claim that my experience is impossible. That's not correct. Before I go any further, I'm going to stress that DKA should never be intentionally caused to occur. It is potentially fatal. Those who have diabulimia should consult appropriate professional help.
Here's how diabetic ketoacidosis (DKA) works:
Insulin breaks down glucose in blod and delivers it as fuel to cells... usually. When someone has very little or no insulin (type 1 diabetics fit this criteria), blood glucose (BG) rises and cells starve.
When BG rises: When BG rises above 225 mg/dl (average based on current research, but can be more or less), osmotic diuresis ocurs to remove BG through urine.
When cells starve: Gluconeogenesis occurs. Cells are calling for energy, but getting none. So you start breaking down fat for energy. The fat gets broken down and deposited into the blood as glucose. Then the cells should be able to get to that BG, but without insulin, the process of breaking down fat continues. Some of the BG is removed (see explanation abov of osmotic diuresis), but not all of it and certainly not as quickly as one is creating more glucose from fat. A by-product of this process are ketones.
Some on these forums will understand ketones because they are experiencing gluconeogenesis in a non-diabetic context. In DKA, ketone levels are significantly higher than in ketosis. High levels of ketones are toxic.
In addition to extreme thirst and frequent urination (because of osmotic diuresis), DKA also causes vomiting and very strong "ketone breath." Because cells are starving (most pathways for cells to get energy require insulin, which isn't present in this scenario), they start weakening and eventually organs will stop functioning altogether. Often this leads to a coma before death.
Here's what happened in my situation:
I was a teenager, and pretty much just gave up and decided I didn't want to deal with diabetes any more. I figured if I didn't eat anything, I would just run a little bit high and not have any immediate issues.
I was on multiple daily injections (MDI) of insulin, and last took insulin on Friday. On a Sat., I ate nothing and took no insulin, except late morning, I was super thirsty and drank 3 cans of regular soda (which propelled my BG even higher). I was feeling lethargic by Sat. evening and was urinating frequently.
On Sun., I ate nothing. Early in the day, I started vomiting and continued to urinate frequently. I was also still extremely thirsty and was drinking lots of water. I remember a particular point where I drank a glass of water, and ran to the bathroom (in this house, the kitchen and bathroom were connected - an unusual design today, but this was an old rural house and these rooms were added together when plumbing was installed). So the bathroom was about 10-12 feet away from where I was standing as I drank water, and I vomited all of that water within seconds of drinking it (except it was yellow when it came back up - obviously because it included other substances). There was another point where I thought I had vomited everything in my stomach, but was still heaving. What came out was a thick dark red - black substance. I was very sick at this point with DKA.
On Monday, I skipped school and was still sick after spending all night drinking lots of water and then vomiting and urinating (I was urinating about every 7-10 minutes at this point). My parents called the endocrinologist, who said to take some insulin and wanted me to be taken by ambulance to the nearest hospital (around 15 miles away) and then by helicopter to the nearest major city, where her hospital was located (around 80 miles by car). At this point, I had lost 47 lbs. from the last time I weighed (a week prior). I couldn't see clearly and had so little energy I could barely walk.
My parents decided (my dad decided, as my mom wanted to go with the endo's suggestion), for whatever reason (probably cost), to drive me himself for the whole 90-100 mile trip to the hospital. I took an ice cream bucket, which I continued to vomit and urinate in throughout the trip... I'm sure I lost at least another 3 lbs. on the way, but I usually say "about 50 lbs." because that is a rounded number and the specific amount beyond 47 is unknown. On the way down, I started going in and out of consciousness.
When we arrived at the emergency room, I was unable to even stand on my own power. My dad held me up as we walked in. The first stop was a water fountain, as I was still extremely thirsty. After I sat down, I noticed the tips of my fingers were starting to turn an indigo color.
When they were starting to take vital signs, I vomited on the nurse. They didn't finish, as it became clear how serious of shape I was in. Right away, they started taking me to the ICU (I was in a wheelchair at this point). I remember being pushed into an elevator on the wheelchair, and then losing consciousness again. The next time I awoke, for a brief moment, was in a bed in the ICU with lots of medical personnel surrounding me working very quickly. My dad was standing behind them at the foot of the bed with a very worried look on his face. The next time I awoke, there were just a couple of medical personnel on the other side of the room (it was a large room with several beds and just curtains), but nobody around me. I had an IV in the major blood vessel that runs through my groin.
On Tues., they transferred me out of the ICU to an intermediate area, and on Wed., sent me to the general section of the hospital. The endocrinologist visited, as did the CDE (because they thought I didn't have enough training, when it was just that I didn't care enough). So they sent a psychologist to talk to me, and I was released from the hospital on Fri. When I got home, the scale said I had only lost 24 lbs. compared to 2 weeks prior. They had been pumping plenty of fluids in me, but I'm leaving open the chance that I was still slightly dehydrated. The 50 lbs. is approximate because of what I described earlier. I'm guessing around 60% of that was water weight because of how much was re-gained in the hospital.
You can tell me that what happened to me didn't really happen to me, but I assure you it did. Just because you don't understand it doesn't mean it isn't possible.0 -
Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.
Well, this post is a bit swings and roundabouts too.
Undiagnosed hypothyroidism is one thing. Once it's treated, a person has a normal life, though. I live with Hashimoto's, so I'm speaking from experience.
However, as a post-menopausal woman with psoriatic arthritis? I'm always cold (thanks to menopause) and fatigued (thanks to the PsA). Those are both excuses for weight gain, not causes. I've managed to lose 70 pounds and pursue an active life with both conditions. Neither of them make it hard unless I choose to allow them to make it hard. I used to allow them to do so, and I felt more fatigued for it. Exercise improves fatigue. In fact, it's one of the medically recommended remediations for it. When it's cold and rainy? I jog around inside the house or do one of the Leslie Sansone videos on youtube.
As far as soup vs. salad, you could have calorie for calorie a slight difference in thermic effect between the two, but the difference is negligible. This comes down to smart decision making. My soups aren't terribly caloric, and some of my salads can be.
No one is advocating ignoring hypothyroidism. It should always be diagnosed and properly treated. However, I will reiterate: once it's properly treated, your body operates as a healthy person's body operates.0 -
I'm hypothyroid too due to requiring the removal of my cancer infested thyroid! Now I get to take meds for the rest of my life and my oncologist wants me forever hypothyroid in order to keep the chances of a cancer reoccurrence at its lowest percentage. One risk factor he told me about was possible weight gain due to my decreased metabolism.
I'm still losing weight. But others might not because we're all different!0 -
I have been tiny all of my life until the doctor changed my blood pressure medicine to coreg, it does not stimulate my appetite, but it does make me feel tire and no energy so I am sure that is part of the weight gain issue, I have been on this med for 2yrs and have gained a whopping 30 lbs, I have tried several times to loose but get discouraged because it takes so long to loose 1lb. I have been dieting now limiting to 1200 calories a day and exercising when I have the energy since Sep. 1 and have only lost 8lbs, it is so frustrating.My doctor won't change my medicine because we have tried a lot of others that don't keep my bp and heart rate under control but they didn't cause me feel like this. Any advice would be greatly appreciated0
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I have PCOS and, YES, it does make it harder to lose weight. I am not sure about anyone else's journey; but I know that I have to approach things a little differently. I have hormonal spikes that make it nearly impossible for me to stop eating on certain days. Being insulin resistant makes converting carbs harder than the normal person. I am not blaming the PCOS for my weight; but it does mean I have to work harder and in a different way to achieve my goals. I try to limit my carbs to 30% and I supplement with GTF Chromium, Nettle Root Extract, Saw Palmetto, and Vitamin D3 to combat the PCOS and insulin issues. I had to have my gallbladder removed so I use a probiotic to help in digestion. No matter what anyone says, losing weight with PCOS is possible but incredibly hard. You have to reach that point where you are determined before it will happen.0
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Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.
When the weather turns cold, the warm thing I want to eat instead of salad is broccoli
Regarding being tired - checkout http://community.myfitnesspal.com/en/discussion/10278538/do-you-workout-even-when-youre-tired
Many people said if they didn't workout when they were tired, they'd never workout.
I often have to force myself to start, but am fine once I get going.0 -
kshama2001 wrote: »Hmm this is a bit swings and roundabouts. Hypothyroidism may slow your metabolic rate and make you burn less calories. True but it also makes you cold and tired that ultimately has more impact as it's hard to get up from sofa and go running when you feel already tired and freezing and it's raining outside. Being cold also makes you want to eat warm things that are not made of salad. This is as real effect of hypothyroidism as metabolic slowdown so overlooking it is not helpful. Correct diagnosis and sufficient replacement therapy to treat the condition are the way forward not ignoring it or it's impact on health as whole.
When the weather turns cold, the warm thing I want to eat instead of salad is broccoli
Regarding being tired - checkout http://community.myfitnesspal.com/en/discussion/10278538/do-you-workout-even-when-youre-tired
Many people said if they didn't workout when they were tired, they'd never workout.
I often have to force myself to start, but am fine once I get going.
Sadly, I can't remember the last time I wasn't at least a little bit tired.0 -
@midwesterner85 - This is now the 11th thread in which you're discussing DKA. Since it's so dangerous and has absolutely nothing to do with weight management, how about making this the last thread?
http://community.myfitnesspal.com/en/search?adv=1&search=dka&title=&author=midwesterner85&cat=all&tags=&discussion_d=1&comment_c=1&group_group=1&within=1+day&date=0
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