Medical conditions, medications, and weight loss

taso42

We often hear that certain medical conditions or medications can hinder weight loss efforts. I am aware of this anecdotally, but not scientifically. How does it work? Is it typically an exception to "calories in vs calories out"? The replies here might potentially be useful to put in the "Unofficial FAQ".

brittni127

I have hypothyroidism which slows down my metabolism greatly, pretty much to a stand still when I'm not medicated. Different hormones also affect weight loss, some women when they are on certain birth control pills gain weight because of the hormone shift introduced from the birth control.

cmriverside

Some medications slow the metabolism, such as blood pressure meds which actually slow the heartrate.

Some meds, like birth control or hormone replacement also affect how the body utilizes nutrients and when.

Thyroid problems affect metabolism, and the medications are a hormone replacement.

The endocrine system is tied to metabolism. Insulin is a hormone, so you can see that relationship.

Like steroids probably affect hormones, (I don't know, I'm guessing) hence the metabolic and behaviour issues associated with them.

ShapeUpSidney

how it works, scientifically, is people in the clinical trials report that they gained weight, and then that is reported as a side effect of the medication

It is very rare that scientists spend any time elucidating the mechanisms by which a particular drug causes weight gain. There are some KNOWN cases of course, like steroids... (for asthma, allergic reactions and autoimmune disease, etc)

taso42

Thanks for replying. Slowing down metabolism I can sort of understand -- TDEE is reduced, making it harder to lose weight even if eating what would normally be considered a calorie deficit for the average person with the same height, weight, gender, and body composition.

I think the hormonal side is what I'm having more trouble getting. Do the hormones directly affect the metabolism, or is something else at play?

cmriverside

Yes. LMGTFY.

NotAllWhoWanderAreLost

i know thyroid function has an impact on weight (gain/loss) but, from what i've read, not to an extreme degree: http://www.thyroidtoday.com/PatientResources/english/Thyroid Hormone_E07.pdf

lor007

There are some KNOWN cases of course, like steroids... (for asthma, allergic reactions and autoimmune disease, etc)

This is true. My daughter always gains a pound or two if she has been through a heavy course of steroids for her asthma. She is only 2, so 1-2 pounds is quite a lot. She eats the same foods during these times, but less of them, so it has to be more than calories in vs calories out at play. (Not that I have ever weigh her myself, her pediatrician monitors her growth very closely.)

LilacDreamer

I have 1 medical condition that requires me to limit my protein intake to 30 grams per day. Unless I was born with it, and unless I choose to get a liver transplant, i'll have it for my entire life.

I also have Hashimoto's Thyroiditis - which is an autoimmune thyroid disease. << Kills my metabolism.

The way I've always seen it: They contradict each other...because people say that protein is the key to weight loss/dieting - and i can't really have that like everyone else can...and then my hashimoto's kills off whatever chance I have left to lose the weight.

Trying to make a real change in a big way, but it is NOT easy.

taso42

Just thinking out loud here.... if the issue is with metabolic slowdown, perhaps a good strategy to try would be HIIT and strength training, and/or anything else with a significant "afterburn" effect, in an attempt to keep the metabolism revved for longer than just the time spent doing the exercise.

Also, wondering out loud, are devices like the BodyMedia Fit and BodyBugg able to see the metabolic slowdown, or would they seem to give numbers that are too high?

Pollyfleming

I have hypothyroidism. It slows metabolism and it makes exercise impossible. Before I was diagnosed, I was falling asleep sitting up. I was tired and sluggish all day long. Medication has changed my life!

RumOne

I was on a Good dose (60mg) Prednisone for 6 months (for Lupus) and it not only makes your metabolism slow but also gave my more energy which made my hungrier and I wanted everything under the sun.

LilacDreamer

Just thinking out loud here.... if the issue is with metabolic slowdown, perhaps a good strategy to try would be HIIT and strength training, and/or anything else with a significant "afterburn" effect, in an attempt to keep the metabolism revved for longer than just the time spent doing the exercise.

Also, wondering out loud, are devices like the BodyMedia Fit and BodyBugg able to see the metabolic slowdown, or would they seem to give numbers that are too high?

Hm...i've seen that talked about (HIIT) but i dont know what it is. I also have a good 70lbs to lose so i dont know when i should start strength training.

BlondeLisa1

I also have Hashimotos. It kills my metabolism and requires me to take meds to try to adjust but even with hard work and carefully diet, I'm not losing like I want to. The only thing I can do is to keep at it, slow and steady and know that eventually, I'll get there. It's going to take longer and be harder than for most people but the end result is still worth it. I'm hoping that when I get down to where I need to be that I'll be able to carefully maintain it. It will probably be a life long battle, which is why I'm going the MFP route instead of the diet pills and crap I could do. It needs to be a life-long lifestyle to have hopes of succeeding and being healthy.

Pollyfleming

i know thyroid function has an impact on weight (gain/loss) but, from what i've read, not to an extreme degree: http://www.thyroidtoday.com/PatientResources/english/Thyroid Hormone_E07.pdf

I agree. I didn't gain a ton of weight when my thyroid went whacko. However, losing weight, was much more difficult. I was so tired! Really, I can't even explain how tired. Once I started medication, I was able to exercise and I was much more active. It's made a difference.

Elizabeth_C34

My issue is a fairly severe case of Mitral Valve Prolapse with regurgitation, which does not directly affect the calories in/calories out, however, my medication to alleviate the symptoms does.

I am on a beta blocker, a medication which lowers my resting heart rate significantly. There is some indication that this lowers my BMR as well, however, there's not a lot of science being done on this. My biggest issue is exercise. My HR cannot get above 130 for any extended period of time without pain, so intense cardio is a problem for me (meaning large burns in reasonable time periods don't happen).

When I do cardio, it has to be longer lower-impact cardio to do the same burn.

taso42

Just thinking out loud here.... if the issue is with metabolic slowdown, perhaps a good strategy to try would be HIIT and strength training, and/or anything else with a significant "afterburn" effect, in an attempt to keep the metabolism revved for longer than just the time spent doing the exercise.

Also, wondering out loud, are devices like the BodyMedia Fit and BodyBugg able to see the metabolic slowdown, or would they seem to give numbers that are too high?

Hm...i've seen that talked about (HIIT) but i dont know what it is. I also have a good 70lbs to lose so i dont know when i should start strength training.

We're going off on a slight tangent here, but that's fine.

HIIT stands for high intensity interval training. It's a form of cardio where you alternate between an all-out effort and a lighter effort over and over again for a period of time (usually around 15-20 minutes or so, but can be as low as 4 minutes). This site has an overview: http://www.intervaltraining.net/highintensityintervaltraining.html

Strength training we usually recommend to everybody. The sooner you start the better. Obviously beginners would start out quite light. Strength training will help you preserve your existing muscle. The more muscle you have, the more calories you burn at rest (not to mention, the better you look).

cmriverside

http://mayoresearch.mayo.edu/mayo/research/endocrinology_research/index.cfm



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CarolynB38

We often hear that certain medical conditions or medications can hinder weight loss efforts. I am aware of this anecdotally, but not scientifically. How does it work? Is it typically an exception to "calories in vs calories out"? The replies here might potentially be useful to put in the "Unofficial FAQ".

It's still pretty much going to be calories in vs calories out, BUT BMR may well be different as a result of medication. Medications can also affect appetite too so that you naturally end up eating more than you need because your brain thinks you are actually hungry in need of fuel. This can usually be kept under control but it does make it more difficult for those who are affected in this way. Some medications and medical conditions also alter your metabolism which means your BMR may well be different from that calculated by MFP and you may burn more of fewer calories when you exercise. This means if your BMR is reduced due to a condition or medication you will need to eat less and this can make it harder to lose weight because at the end of the day it is pretty much calories in vs calories out. If you are burning fewer you have to eat fewer. This does make it more difficult to lose weight and much easier to gain it, especially if you were previously able to eat more because you are used to that higher intake and you'll probably feel hungry.

I'm sure there are other more complex mechanisms involved too, such as ability to metabolise certain foods. But generally, conditions and medications can make it harder to lose weight. It doesn't mean you can't lose weight, just that it will be harder work and may take longer. Sorry for waffling on like that :happy:

vger11

“In many cases a drug increases appetite or makes people crave certain foods”

“Weight gain associated with the use of insulin is probably due to the fact that insulin can lead to periods of hypoglycemia, which stimulates appetite”

“Some drugs alter metabolism, causing the body to burn calories more slowly or to store fat.

“Some corticosteroids make the body less able to absorb blood glucose, and this can lead to fat deposits in the trunk and weight gain.”

“Other medications produce fatigue or shortness of breath, making the person less active (the antihypertensive drugs known as beta-blockers are thought to have this effect), or can cause water retention (a side effect of antihypertensive calcium channel blockers)”

http://www.johnshopkinshealthalerts.com/alerts/prescription_drugs/JohnsHopkinsPrescriptionsDrugsHealthAlert_656-1.html

TALK TO YOUR DOCTOR: You may be advised to stop taking the medication, switch to one associated with less or no weight gain or even weight loss or take a lower dose.

***YOU ALSO MY NEED TO CHANGE YOUR EATING HABITS AND BOOST PHYSICAL ACTIVITY ***

BlondeLisa1

***YOU ALSO MY NEED TO CHANGE YOUR EATING HABITS AND BOOST PHYSICAL ACTIVITY ***




This made me laugh. You think? :P

brearune

I have both a thyroid problem (which kills your metabolism... in my case, anyway. Sometimes thyroid issues can make you LOSE weight fast, by boosting your metabolism.) and am on medication that makes me HUNGRY!! For a depression disorder, which also makes me more at risk for depression eating. Also hormone issues.

so basically i'm screwed.

but how it works for me: Thyroid issue, low metabolism. Medication makes me hungry more often, so I naturally am eating more than others. It takes me more to curb this bad habit, though I daresay I'm doing quite well now, but it's very hard and easy to fall off the wagon, where for otehrs it is a big easier. Depression, again, if I have depressive fits or skip my medicine, I'm prone to binge eating. 2 psychological, and 1 physiological issue.

risefromruin

Excellent thread, Taso! I'm gonna follow it

PirateJenny

Like other people have stated some medications have an effect on the metabolism, causing weight gain without significant behavioral changes in diet or activity level. The effect can sometimes be mitigated with upping activity level & being strict about diet (not dieting), but the level of effect depends on the dosage and the individual's chemistry/physiology.

Other medications cause an increase in appetite and/or lethargy. With these types of medication it is possible to avoid weight gain by maintaining the same diet and exercise routine as prior to taking the pills (as long as the person was happy with their fitness level & weight). Many anti-depressants (dual re-uptake inhibitors & tricyclics for example) can have this effect in some people. However, for others they can have the opposite effect, decreasing appetite and/or making people feel "speedy".

If people have concerns about weight gain associated with medication they should consult a physician and ask if the side effect is a result something that can be controlled (increased appetite) or something that is more difficult to control (slowed metabolism). Most physicians are sympathetic to health and body images issues and can help people manage the side-effects or even suggest alternative medications. When I see a new clinician I openly state that I have serious emotional problems surrounding my weight and that taking medications that cause weight gain outside of behavioral changes is too stressful for me. Since the only medications I have needed to take are for bi-polar disorder and insomnia, most clinicians I have interacted with have been willing to work with me to find alternatives.

Hope this adds to the information pool!