Losing weight while taking Tamoxifen

Ollielav

Hello! I am a 5 year breast cancer survivor and have been taking Tamoxifen for about 4 1/2 years. Losing weight has been a major struggle. I log my food have mostly healthy choices (definitely not perfect!). My calorie goal per MFP is 1,200. I work out at Orange Theory 5 days a week. I’m 53 years old. I can’t seem to make any progress. Any tips?? Thanks! Lori

AnnPT77

What's your current weight and height, what do you do for a living, and what's your routine day like (outside of the exercise)? How long have you been calorie counting? (I see your account has existed for
quite a while, but this is your first Community post, it looks like - that's why I'm wondering). Do you eat back the OT calories, and if so, how do you estimate them? Do you do any cheat days or anything like that as part of your strategy?

I took Tam for 2.5 years, Arimidex for another 5, after surgery/chemo/radiation for stage III breast cancer (diagnosed 21+ years ago), so this is a regimen I've been in, in the past, myself. (I'm even in MI, as your profile says you are, but I'm mid-palm of the mitten. I also machine row - as I'd bet you do at OT - though I'm an on-water rower by preference, when my gosh-danged river isn't frozen.)

1200 should be low enough calories for most women (not all) to lose an observable amount over a multi-week period, so I'm suspecting the calorie goal's less likely to be the issue unless you're quite petite. The weight management complications from Tam tend to be water weight, appetite (which shouldn't be what limits loss if you're counting/sticking to goal), or fatigue (reduced calorie expenditure), or some combination. But it could be something more mundane, too, which is why all those questions in paragraph 1.

Have you been tested for a thyroid condition? (They're more common after breast cancer treatment IMU. I'm severely hypothyroid, but I do have family history, so I can't necessarily blame BC or treatment.)

I'd like to help, if I can. (I lost weight from class 1 obese to a healthy weight back in 2015-16, have been at a healthy weight since, but all of that was well after treatment, for me. I'm age 66 now, 5'5", 127 pounds this morning.)

Best wishes!

Ollielav

Hi AnnPT77, thanks for your response!! And wow, congratulations on all your success, that's so encouraging.
I'm 5'5" and just weighed in for the OTF Transformation Challenge on Friday at 173. I've been tracking my food on and off for many years using MyFitnessPal. I've never posted in the community before, never even thought about it (glad I did!) I have a nutritionist that I've consulted recently that "allows" me a total amount of weekly "cheat" calories - 125/day for a total of 875 per week. Do I eat back my OT calories? Hmmm, that is a good question - I do track my food, but I suspect that maybe I'm not estimating things exactly. I have never been tested for a thyroid condition, but after BC treatments, I was tested to see how well my body absorbs certain nutrients and found that my body doesn't digest and absorb nutrients from food as efficiently as it could so I take several vitamins/supplements which I feel are only helping me (for example, probiotic, digestymes, homocystine and berberine complex, in addition to a multi women's vitamin and Vit D supplement).
Oh, I am a CPA - working in a super stressful tax dept of a public company - things are crazy busy year round and I'm pretty sure the stress does not help in my weight loss journey. With the pandemic, we all are working from home - so I start my day with a great workout at OTF and then pretty much sit/stand at a desk all day. I don't miss the long commute but when I think about it, I got quite a bit more exercise when I had to make the long walk from the parking garage to my office. Plus just general walking around to talk to people, meetings, etc. Now it's all done in Teams.
As I type out all the answers to your questions, it's like having a little light bulb go off - for example the regular movement I used to get vs now. Not that I think that will solve all my problems, but it's opening my mind.
How did you lose so much weight and maintain that? That's really awesome, congratulations again and I would love to hear if you have any suggestions.
Thank you!

AnnPT77

Ollielav wrote: »

Hi AnnPT77, thanks for your response!! And wow, congratulations on all your success, that's so encouraging.
I'm 5'5" and just weighed in for the OTF Transformation Challenge on Friday at 173. I've been tracking my food on and off for many years using MyFitnessPal. I've never posted in the community before, never even thought about it (glad I did!) I have a nutritionist that I've consulted recently that "allows" me a total amount of weekly "cheat" calories - 125/day for a total of 875 per week.

So effectively your calorie goal is 1325, on average. (On average is how all of this works, anyway, since bodies don't reset at midnight. 😉)

Is your nutritionist a registered dietitian? If you're in the US, I hope so. RDs are the people with degrees and credentials. Standards for nutritionists are looser, and in some states, there are none at all. Even without credentials, of course, someone can be good.

My cancer center had an RD that I was able to consult, which was really helpful on the nutrition front.

Do I eat back my OT calories? Hmmm, that is a good question - I do track my food, but I suspect that maybe I'm not estimating things exactly.

IMU, OT is a good workout (some of my rowing buddies have done OT). I wouldn't be surprised if you were burning 300+ calories in a session (though I'm not sure I'd trust what a heart rate monitor estimate, since I understand there to be some circuit training and interval type stuff involved, and HRMs aren't super good at estimating those).

If you eat 1325 (on average), exercise 300, you've effectively eating 1025 calories, net. Underfueling is not a good idea, can be counterproductive for both weight loss and fitness improvement (through fatigue, possibly subtle, which causes downregulated daily life activity, blunted exercise intensity).

If what you're saying is that you might be underestimating food calories, so not eating back exercise is OK . . . well, maybe. Most people do underestimate calories (especially if not going the food scale route), but 300ish or more calories would be a pretty big underestimate.

IMO, at 173, losing faster than maybe 1.5 pounds a week would be sub-ideal (for the next 25 pounds, maybe, then slower when less to lose). Just my opinion, though.

Since you have a stressful job, and we're most of us having a stressful pandemic, plus intense exercise is a stress, and a big calorie deficit (fast loss) is a stress . . . hmm. Stress is cumulative, across all physical and psychological stressors, and even positive stresses like exercise are stresses, in that context.

I'd also observe that MFP's estimates are just estimates (average of people similar to you). Most people are close to average, but it's very possible to be a bit non-average (need more or fewer calories), and a rare few people can be quite far off average. (I'm one, I lost too fast at first at MFP's estimate based on correct profile settings, even when eating back all my exercise calories, got weak and fatigued even though I corrected quickly, took multiple weeks to get back to full normal energy/strength. No one needs that!)

Once you have a month of experience data to average, you'll know better whether you're average or if not, how to adjust. But if you start feeling weak or fatigued along the way for no other observable reason, and you seem to be losing fairly fast at that point in time, I'd suggest eating a bit more.

I have never been tested for a thyroid condition, but after BC treatments, I was tested to see how well my body absorbs certain nutrients and found that my body doesn't digest and absorb nutrients from food as efficiently as it could so I take several vitamins/supplements which I feel are only helping me (for example, probiotic, digestymes, homocystine and berberine complex, in addition to a multi women's vitamin and Vit D supplement).

Oh, I am a CPA - working in a super stressful tax dept of a public company - things are crazy busy year round and I'm pretty sure the stress does not help in my weight loss journey. With the pandemic, we all are working from home - so I start my day with a great workout at OTF and then pretty much sit/stand at a desk all day. I don't miss the long commute but when I think about it, I got quite a bit more exercise when I had to make the long walk from the parking garage to my office. Plus just general walking around to talk to people, meetings, etc. Now it's all done in Teams.

That change in routine can be pretty meaningful. There's a thread here about putting incidental movement into one's day as part of one's weight management strategy:

http://community.myfitnesspal.com/en/discussion/10610953/neat-improvement-strategies-to-improve-weight-loss/p1

Those aren't calories we can count and eat back like exercise calories, but they can be a meaningful contribution to weight management - see the thread for details. Some of those ideas won't suit you, but it's a long-ish thread with lots of people's ideas, so probably some are worth considering.

I hear you on the issue of stress on the job: Pre-retirement, I had a long-hours, high stress job in IT, with responsibilities including computer security, which is kind of the wild West these day. My favorite example is the day I ended up meeting with the FBI - we called them - when that meeting hadn't been on my calendar at the start of the day. 😆

As I type out all the answers to your questions, it's like having a little light bulb go off - for example the regular movement I used to get vs now. Not that I think that will solve all my problems, but it's opening my mind.

Glad to hear you're finding my rambling thought provoking!

I'm sadly very opinionated, and very ramble-y. I can also touch-type, which is dangerous. 😆

How did you lose so much weight and maintain that? That's really awesome, congratulations again and I would love to hear if you have any suggestions.
Thank you!

Wow, that's a big question. I think personalization of tactics/strategies is essential, so I don't assume that what worked for me will work for everyone.

I decided that I wasn't going to do anything to lose weight that I wasn't willing to continue doing forever, in pursuit of finding habits that would help me stay at a healthy weight permanently, other than a sensibly moderate calorie deficit until I reached goal weight. That meant I needed to figure challenging things out during weight loss - different cooking, socializing, restaurant-ing, holiday habits, for example - and it turned out to be good to be doing that while I had the cushion of a calorie deficit in the picture, to soften any failed experiments. 😉

(Failed experiments are part of the process, not "a failure", IMO: Try something, learn from it, adjust plans, and soldier on. Emotional reactions don't burn any extra calories, feel icky, don't lead to better success, so why bother with them?)

That common concept of weight loss as an extreme-measures project with an end date, after which things go back to normal: I don't think that would work well for me. It had to be about new habits.

This thread describes what I did on the eating front:

http://community.myfitnesspal.com/en/discussion/10636388/free-customized-personal-weight-loss-eating-plan-not-spam-or-mlm/p1

It's not a diet, it's an approach to eating that involved starting where I was, gradually remodeling my eating over a period of time, to get to sustainable new habits. What those habits are would differ by person, but the general approach has worked for other people who eat quite differently from me. (But I'm sure that process wouldn't work for every single human on the planet: Personalization! I'm answering your question, about what I did.)

Pretty much, I still eat the range of foods I always did - my starting point eating style wasn't terrible - but I eat them in different portion sizes, proportions on the plate, and frequencies. There are probably a few calorie-dense things that I now eat so infrequently now that you could say I've eliminated them, but I can't think of examples offhand. (If they exist, they were things I didn't enjoy enough to spend calories on, once I understood the calorie "cost", not some kind of sacrifice.)

In maintenance, I choose to "calorie bank", basically the kind of thing you do with the "cheat" calories. (I don't think of them that way: Who or what would I be cheating, y'know? It's just food, not sin.) I eat a little under actual maintenance calories most days, to eat indulgently on an irregular basis. I don't count those over/unders all that precisely anymore (in year 6+ of maintaining), I just try to stay sane, and use the scale as a guide. Most days, I still calorie count, though - for me, it's not obsessive or burdensome.

Reminder: The way I did things and do things may or may not work well for others. Personalization, IMO, is crucial . . . somewhat important for loss, very important for maintenance, because maintenance needs to happen more or less on autopilot sometimes (if life throws other challenges one's way).

On the exercise front, I'd already become quite active starting shortly after breast cancer treatment. (Long, gradual progression there, too, but a pivotal thing a couple of years into the progression was joining a breast cancer survivors rowing team that was forming in my area at the time, and getting addicted to rowing. Most of the time, I feel like I don't "do exercise", it's more like I "have fun".)

I'd been doing that level of exercise (working out 6 days most weeks, including some intensity) for around a dozen years, staying class 1 obese (mid-180s pounds, mostly), before committing to lose weight in 2015. I didn't change a lot of my activity routine during weight loss, honestly. I made it a bit more of a point to keep some strength training in rotation - a thing I usually mostly only do during the rowing off-season, and am lackadaisical about - because I wanted to keep as much useful muscle as I could, alongside losing mostly fat.

As I got lighter, some things became more fun, so I probably gradually have become a bit more active over the last few years than I was when obese: More fun, and less joint strain and whatnot so less discomfort if I push the envelope a little.

Philosophically (and based on what I learned while pursuing coaching certification education from USRowing, some years back), I think the best route to fitness is to start gradually, with something that's relatively enjoyable, and just a manageable bit of a challenge - not miserable and exhausting. (It's the challenge that drives fitness improvement. Doing things that are exhausting - other than maybe just a few minutes of "whew" feeling right after the workout - is counterproductive for weight management and fitness, IMO. (I could explain that, but this is already too long! 😆)).

On the cardiovascular front, if starting as a quite out of shape beginner (like I did), it makes sense to me to build a fitness base first, via mostly longer sessions of lower-intensity cardiovascular exercise. Intensity, intervals, etc., can come later, building on that base. Progression on the strength front is kind of obvious, I think: Start where we are, learn good form to avoid injuries, progress gradually/safely/steadily.

Over time, as fitness increases, the definition of "a manageable challenge" moves. One can increase duration, frequency, intensity, or type of activity in order to steadily keep a bit of challenge in the picture, but maintain overall life balance alongside (i.e., enough time/energy for job, family, other things of importance to an individual).

Well, there ya go: Another crazy-long opinionated ramble. I'll stop now.

Best wishes for continuing progress!