Weight loss (and IF) on Tamoxifen and Zoladex

emet1123

Hi! I’m wondering if there’s anyone else on Tamoxifen and Zoladex injections following breast cancer treatment?

I started the Tamoxifen in January and the Zoladex in April.

I’m currently trying to lose 50lbs (or more!) before I get my reconstructive surgery (as per my surgeon’s advice) and I’m so anxious about the meds working against me.

I’m 45, 5’5” and currently 234lbs. I’ve been doing intermittent fasting for 10 days now and I was down 2lbs at my 1 week weigh in.

Any advice or stories to share?

AnnPT77

I took Tamoxifen for 2.5 years, and didn't gain weight. (I didn't have the Zoladex - not sure whether that was because my stage III breast cancer was a long time ago (2000), or because chemotherapy put me in menopause). I took Arimidex, a hormone therapy with a slightly different mechanism of action, but a similar theoretical side effects profile, for 5 years after the Tamoxifen.

If Tamoxifen leads to weight gain - as I know it has a reputation for doing - I believe the mechanism is some combination of appetite increase, or energy-level decrease (moving less, basically).

If you're calorie counting, you will be clear-eyed about the appetite side of that.

The fatigue, if it occurs, could be subtle to the point of being unnoticed/unnoticeable. However, making it a point to exercise and maintain an active daily life routine would both help counteract that possibility.

Some people also experience joint pain or stiffness with Tamoxifen (I didn't). Were that to occur, that might have a similar effect of reducing movement so lowering calorie expenditure.

Personally, I started getting more active exercise-wise soon after breast cancer treatment, while taking Tamoxifen, with the aim of regaining strength and energy level. (I was very physically depleted after bilateral mastectomies, chemo, and radiation. BTW, I chose not to have reconstruction . . . but don't take that as implying I think that's everyone's best route. It's so personal!)

I didn't calorie count at the time, and stayed overweight for some time afterward (until I started calorie counting, and meant it ). But the increase in my activity level may've been part of the reason I didn't see any noticeable weight increase from Tamoxifen, as some people do. I also started trying to eat lots more veggies/fruit after treatment, to improve my nutrition. Since those are quite filling, that may've helped me naturally avoid issues with appetite increase. But that's speculation on both counts!

Regardless, if you log consistently, and correlate your calorie intake with your loss rate, you can adjust your intake to achieve a sensibly moderate weight loss rate long term, IMO. The worst case scenario - not necessarily a highly probable one - would be that you might have to eat slightly fewer calories than MFP (or a TDEE calculator or fitness tracker) estimate you'd need for any given loss rate.

Two pounds in a week is fast loss, about as fast as you'd probably want to go at your current weight to keep health risks moderate. However, one common thing is to see faster loss the first week, then slower. But other patterns are possible.

My best advice would be to stick with your current routine for 4-6 weeks, before deciding to adjust your plan, as long as you don't start feeling week or fatigued, or so hungry you can't stick with it. Water weight fluctuations in the first weeks of weight loss can be really crazy, but sticking with a plan for multiple weeks like that can help you see the longer-term trend of your weight, not over-react to those short-term meaningless water-weight shifts.

I'm guessing that you're maybe not having menstrual cycles with that combination of meds, but if you are, compare body weight at the same point in at least two different cycles, because normal hormonal water fluctuations can also be a confounding factor in seeing the fat-loss trend amongst water-retention shifts.

Hang in there: I think you can succeed at this with patience and persistence, and IME it's extremely worth the effort in terms of quality of life improvement. I'm cheering for you!

emet1123

Thank you for all this. I’m like you were and have become more active and conscious of what I’m eating these past few weeks as I try to regain my strength.

I’ve had a successful weight loss journey before which was wrecked by a different medical issue. I’m ready to get back to where I was - feeling strong and looking good.

Sending lots of strength to you too, warrior sister!