Medication and Medically supervised weight loss

elphie754 · October 2020

Hi everyone! Long time no see!

So several years ago I went from 300 lbs down to 180 by calorie deficit and exercise. Unfortunately, after getting pregnant (3 years ago, not actively pregnant) I have just been gaining weight. Right after I gave birth, I was diagnosed with an autoimmune disorder, and currently taking 3 medications that are all known for weight gain (one of them being a really high dose steroid).

I know that weight loss comes down to calories in vs calories out, and I know how to create a deficit/weigh food etc, but no matter how hard I try, I keep gaining weight instead of losing because I can’t seem to stick to even the most minimal calorie deficits (the steroids and other two medications give me such an increased appetite that I can’t stay in a deficit), so I’ve been considering taking medication to try and help me stay in a deficit.

One of the nurses I work with reccomended TourchRX. She said it helped her stay in a deficit while working with doctors and a health coach and she had great results.

I know that these forums tend to be antimedication, but I’m starting to feel like without medical intervention I’m going to just keep gaining until I’m so unhealthy I can’t do anything (just now at 310 I’m having trouble with daily activities without being in pain). I know it’s not a long term solution, but maybe it can help me get on the right track.

Has anyone used tourchRX here? If not anyone use a medication that really helped them that I could discuss with my doctor (like saxenda, quysma etc)?

Note: not looking for negative posts that are just going to tell me not seek medical and medication help at this point. I’ve been trying to stay in a deficit for 5 months and its time to consider getting help because I can’t stay in a deficit.

Deviette · October 2020

I have very little to say that's going to be helpful, but just wanted to wish you luck. I know that MFP can be quite anti medication, but that's normally because it's seen by the user as a quick fix. It's clear that your issues are not through lack of trying.

I don't know how your medication is at managing your condition, but maybe you could see if there are alternatives that have less of an effect on your appetite. While weight is important, managing your condition is equally so, so if they work wonders for managing your autoimmune condition, ignore this suggestion.

And yes, speak to your doctors in general. Tell them that you want to lose weight. That you're trying. Tell them you want help and you want to find out about your options. Explain the problems you're having with your current medication. And tell them that you are not satisfied with the current situation.

Best of luck xx

elphie754 · October 2020

Unfortunately there really are no alternative medications. If I stop any of the 3, I am at risk of spontaneous idiopathic anaphylaxis and end up in the ICU. It’s taken a long time to figure out why I was always in the hospital and now that I’m stable on medication, it would be really dangerous to try and change that.

Dogmom1978 · October 2020

The steroid is going to seriously increase your hunger. I don’t know if an appetite suppressant would work to counter that without interacting with the medications you need to take for your condition.

I know the nurse suggested something, but I would speak with your doctor to see if he/she knows whether or not that would work in combination with your other meds. Best of luck!

nanastaci2020 · October 2020

I appreciate that you acknowledge that the medications you're on lead to increased appetite, and thus eating more than you need which is why you've gained. So many people seem to miss the links in that process.

No personal experience except to say that we each have to find our own path and yours may not be as simple as 'just eat less'. Research the side effects of the medication, talk it over with your doctor to make sure it has not contraindications with your current medications.

I have a good friend who did bariatric surgery last December and has since lost 130 pounds to get to a healthy weight. Constantly under doctor's care. Her reason was not because she just couldn't do it the 'regular' way - but because she had other health stuff going on. She needed back surgery - was facing potential paralysis without it - and needed to get her weight down FAST to be able to do the back surgery. She has now had the back surgery (it was postponed somewhat by covid) and is in the long process of recovery. It will be months before she can do full/regular activity, but she is doing well in her process.

NovusDies · October 2020

I am not anti medication. I do want to point out one thing though. Your necessary medication is not making you gain weight. It might be influencing your hunger but that is a different issue. You may be able to learn to eat in a way that better controls your hunger and/or learn to ignore your hunger.

Weight management is forever which is why some of us try to discourage the use of pills that you may not want to be on for, well, forever. Also the diet pharma industry has had some pretty negative chapters.

If you are on the pills only long enough to lose the weight but you do not change the underlying habits and mindset you may be just taking a vacation from it.

With all that said... as long as the pills are not dangerous to you in some way I do believe that getting on the road is a necessity. If you need help losing the first X pounds and that will help you adapt, it is better than doing nothing.

The problem with your question is that you may get responses from people who have been taking it for 3 months and lost x amount of weight. All methods of weight loss has an overwhelming fail rate and most people can stick to something for a time. You would need to find that super small percentage that took the pills, lost all their weight, and maintained that loss for 3 or more years without the pills. Even that would not mean it would work for you. Choosing a method is a completely individual pursuit. It only matters how you will respond and how you will adhere to it.

I can tell you are feeling stuck. I know that feeling well even if my situation was different. I tried for 30 years to lose weight and was rewarded nearly each time I failed with gaining back even more weight. I tried most everything and that includes pills and shots. I felt my situation was locked in and I lost all hope. That was a bigger enemy to me than the weight.

Things turned around for me. I lost some weight without trying. A lightbulb went off. I then developed a new set of tools and I have lost more than 250 pounds. I didn't type this last part to brag or inspire. I just want you to know that I have not said anything to you in judgment. I want you and everyone who carries more than they need to succeed.

AlexiaC47 · October 2020

I am not saying you are, but do not allow your meds to be a crutch/excuse.

I have had hypothyroid for over 20 years. Left uncontrolled, it slows metabolism and causes gain. I have had it controlled with medication.

And also for over 20 years, I have generally kept my weight down - I have mostly eaten healthy, watched my weight, been on WW, and exercised.
Yet, when I gain weight, I am tempted to lie to myself and blame it on the thyroid (needs re-checking, need to adjust meds etc). But, to paraphrase Novus, it is not the meds nor the disorder -- these things can present challenges to loss- but do not actually cause you to gain. You gain when you eat too much and move too little.

Eat high protein foods to fill you up -- eggs, nonfat yogurt, if hunger is the issue

elphie754 · October 2020

So all tree medication have weight gain as a side effect. Some of it being water retention, but the other part being it literally slows down some of my metabolic processes, as well as supressing my immune system. I know those saying it’s not the medication but rather it making me feel hungry are trying to be encouraging, but it’s actually not encouraging at all. In fact it makes me feel like an even bigger failure because if the medications aren’t hindering the weighloss, then I’m just doing everything wrong. Like seriously, that’s not helpful at all.

Yeah, I’m sounding defensive right now because I have multiple specialists telling me that two of the three medications cause metabolic processes to slow down, which means my calories out is not what it should be. That’s why we have been talking and thinking about medication. The anti medication drivel and how it’s not the medications fault (when it partially is) does not help at all.

Last month, I literally ate 1200 calories a day (weighed so no I was not eating more than I thought) and only lost 2 lbs. At 300+ that’s ridiculous. That was when I was on an all liquid diet because my jaw was wired shut.

I’m sorry I posted this question. I feel even worse now. Will justbwork with my doctors and forget about community support, because it’s not “supportive” anymore.

Dogmom1978 · October 2020

Wow, rudeness. People are trying to help you and then you come here and rant about how they aren’t helping you. If you don’t want help, don’t ask for it.

I never understand when people ask for help and then go off like this. I mean, seriously, I reread this thread and see 0 reason for you to flip out like you are...

Best of luck to you

NovusDies · October 2020

elphie754 wrote: »

So all tree medication have weight gain as a side effect. Some of it being water retention, but the other part being it literally slows down some of my metabolic processes, as well as supressing my immune system. I know those saying it’s not the medication but rather it making me feel hungry are trying to be encouraging, but it’s actually not encouraging at all. In fact it makes me feel like an even bigger failure because if the medications aren’t hindering the weighloss, then I’m just doing everything wrong. Like seriously, that’s not helpful at all.

Yeah, I’m sounding defensive right now because I have multiple specialists telling me that two of the three medications cause metabolic processes to slow down, which means my calories out is not what it should be. That’s why we have been talking and thinking about medication. The anti medication drivel and how it’s not the medications fault (when it partially is) does not help at all.

Last month, I literally ate 1200 calories a day (weighed so no I was not eating more than I thought) and only lost 2 lbs. At 300+ that’s ridiculous. That was when I was on an all liquid diet because my jaw was wired shut.

I’m sorry I posted this question. I feel even worse now. Will justbwork with my doctors and forget about community support, because it’s not “supportive” anymore.

This is a message board so I hope you consider the possibility that you have taken what was said the wrong way.

I am not going to try and right this ship because from my message board experience when someone decides that you are being negative there is not much to do to fix it. I only defend myself when I think there is a chance.

I do suggest you get a referral to a registered dietitian to go over everything. Based on your results from a 1200 calorie diet and losing 2 pounds that would put your TDEE at 1450. Your normal sedentary TDEE at over 300 would have to be at least 900 calories higher (2300+). Even in a coma you could not survive that much slowdown.

It takes longer than a month to establish a rate of loss so a true professional (RD) trained in diet and nutrition will be more helpful than a doctor. I suggest you do that whether or not you get medication.

Best of luck to you.

nanastaci2020 · October 2020

I'm confused. You said you can't stick to a deficit because the medicine makes you hungry and then you eat more which prevents you from losing weight. I did not mean it as an insult when I complimented you for being aware of where you are in that cycle. Now you say you ate at 1200 to only lose 2 pounds in a month. (Which, yes, would be frustrating considering the weight you need/want to lose.) If your medications also slow your metabolism and lead to water retention, that is knowledge you own that we do not. Good luck working with your doctors to find a path that works for you.

kshama2001 · October 2020

Pen/Fen worked great for me. It was truly amazing. When Fenfluramine was taken off the market, I tried pairing other medications with Phentermine, but this didn't work as well. (Note: Phen is risky for the heart as well, but apparently not so risky as to be withdrawn from the market.)

I believe I gained all but 10 pounds back when I stopped taking Phentermine, and so I am concerned about this happening to you as well. The medications with which I am familiar are not meant to be taken long term.

I don't see short term medications as truly being helpful to get one on the right track. It's like suppressing your appetite with an amphetamine - the appetite suppression is artificial and comes roaring back after the drug is out of your system.

You mentioned Torch Rx above. I see it is not a drug but a program, and so I bet is more expensive than just picking a WL drug with your doctor.

https://torchrx.com/pages/faq

I imagine just as people react differently to various antidepressants, so do they with WL drugs. How about reading up on the ones you mentioned and discussing with your doctor?

The nurse you mentioned is also working with a coach. A dietitian and something like Cognitive Behavioral Therapy might be helpful to you. (In general "Coaches" make me nervous due to lack of licensing standards, but perhaps you could work with the same coach as your nurse?)

yrmom · October 2020

Hi! I'm new to this community also. I understand your dilemma - the meds contributing to weight gain and/or inability to lose weight at a rate that feels progressive. I lost 40 lbs over a year with calorie/carb counting and increasing my daily activity. Since the pandemic, I've gained 14 back. As an RN, I discussed my concerns with my physician and she recommended Liraglutide - a prescription medication that is self-administered via injection once per day. It acts on the pancreas/liver/small intestine to slow gastric emptying to tell the brain you are full. Side effects seem rough- severe indigestion and possibly vomiting. My dr. did not recommend any of the stimulants as they can be very hard on the heart and blood pressure, which are already an issue for most overweight folks. I took the prescription but have yet to fill it. I would love to have the initial encouragement of a 10 lb weight loss in a month, but I've been overweight now for about 15 years, so I do know in my own case, I'd probably just gain it back. I'm hesitant to risk the potential side effects (vomiting, pancreatitis) for the potential immediate weight loss. My dr. felt like it was safe, so I'm going to keep considering it. But in the meantime, I know I have to continue reducing my calories. I also know personally, I can't go above 50-60 grams of carbs per day, or I simply won't lose - and of late- I will gain! I hate that, but it's my reality. Lowering carbs brought my cholesterol and sugar into normal zone and after the initial adjustment I felt so much better day in and out. So WHY did I go back to the old way of eating? Sugar addiction. It's a life long work in progress with the harsh reality being I have to reduce the carbs. I can eat what I want, but keep that limit where it is. I have to know if I eat potato chips, I'm going to want way more than is healthy. Conversely, I love a good salad and I can eat all of that I want.
Sorry this turned into my life history

I do understand your thinking on why medication might help. Do your own research and make an appt. with your doctor to discuss your questions and concerns. Good Luck!

elphie754 · October 2020

NovusDies wrote: »

elphie754 wrote: »

So all tree medication have weight gain as a side effect. Some of it being water retention, but the other part being it literally slows down some of my metabolic processes, as well as supressing my immune system. I know those saying it’s not the medication but rather it making me feel hungry are trying to be encouraging, but it’s actually not encouraging at all. In fact it makes me feel like an even bigger failure because if the medications aren’t hindering the weighloss, then I’m just doing everything wrong. Like seriously, that’s not helpful at all.

Yeah, I’m sounding defensive right now because I have multiple specialists telling me that two of the three medications cause metabolic processes to slow down, which means my calories out is not what it should be. That’s why we have been talking and thinking about medication. The anti medication drivel and how it’s not the medications fault (when it partially is) does not help at all.

Last month, I literally ate 1200 calories a day (weighed so no I was not eating more than I thought) and only lost 2 lbs. At 300+ that’s ridiculous. That was when I was on an all liquid diet because my jaw was wired shut.

I’m sorry I posted this question. I feel even worse now. Will justbwork with my doctors and forget about community support, because it’s not “supportive” anymore.

This is a message board so I hope you consider the possibility that you have taken what was said the wrong way.

I am not going to try and right this ship because from my message board experience when someone decides that you are being negative there is not much to do to fix it. I only defend myself when I think there is a chance.

I do suggest you get a referral to a registered dietitian to go over everything. Based on your results from a 1200 calorie diet and losing 2 pounds that would put your TDEE at 1450. Your normal sedentary TDEE at over 300 would have to be at least 900 calories higher (2300+). Even in a coma you could not survive that much slowdown.

It takes longer than a month to establish a rate of loss so a true professional (RD) trained in diet and nutrition will be more helpful than a doctor. I suggest you do that whether or not you get medication.

Best of luck to you.

I’ll asmit, it’s very possible I just took it the wrong way because you can’t tell tone through text. I was also having a really bad day so its possible I was taking it out on people who are trying to help. I’m sorry.

elphie754 · October 2020

kshama2001 wrote: »

Pen/Fen worked great for me. It was truly amazing. When Fenfluramine was taken off the market, I tried pairing other medications with Phentermine, but this didn't work as well. (Note: Phen is risky for the heart as well, but apparently not so risky as to be withdrawn from the market.)

I believe I gained all but 10 pounds back when I stopped taking Phentermine, and so I am concerned about this happening to you as well. The medications with which I am familiar are not meant to be taken long term.

I don't see short term medications as truly being helpful to get one on the right track. It's like suppressing your appetite with an amphetamine - the appetite suppression is artificial and comes roaring back after the drug is out of your system.

You mentioned Torch Rx above. I see it is not a drug but a program, and so I bet is more expensive than just picking a WL drug with your doctor.

https://torchrx.com/pages/faq

I imagine just as people react differently to various antidepressants, so do they with WL drugs. How about reading up on the ones you mentioned and discussing with your doctor?

The nurse you mentioned is also working with a coach. A dietitian and something like Cognitive Behavioral Therapy might be helpful to you. (In general "Coaches" make me nervous due to lack of licensing standards, but perhaps you could work with the same coach as your nurse?)

Great suggestions. Will look into it.

elphie754 · October 2020

yrmom wrote: »

Hi! I'm new to this community also. I understand your dilemma - the meds contributing to weight gain and/or inability to lose weight at a rate that feels progressive. I lost 40 lbs over a year with calorie/carb counting and increasing my daily activity. Since the pandemic, I've gained 14 back. As an RN, I discussed my concerns with my physician and she recommended Liraglutide - a prescription medication that is self-administered via injection once per day. It acts on the pancreas/liver/small intestine to slow gastric emptying to tell the brain you are full. Side effects seem rough- severe indigestion and possibly vomiting. My dr. did not recommend any of the stimulants as they can be very hard on the heart and blood pressure, which are already an issue for most overweight folks. I took the prescription but have yet to fill it. I would love to have the initial encouragement of a 10 lb weight loss in a month, but I've been overweight now for about 15 years, so I do know in my own case, I'd probably just gain it back. I'm hesitant to risk the potential side effects (vomiting, pancreatitis) for the potential immediate weight loss. My dr. felt like it was safe, so I'm going to keep considering it. But in the meantime, I know I have to continue reducing my calories. I also know personally, I can't go above 50-60 grams of carbs per day, or I simply won't lose - and of late- I will gain! I hate that, but it's my reality. Lowering carbs brought my cholesterol and sugar into normal zone and after the initial adjustment I felt so much better day in and out. So WHY did I go back to the old way of eating? Sugar addiction. It's a life long work in progress with the harsh reality being I have to reduce the carbs. I can eat what I want, but keep that limit where it is. I have to know if I eat potato chips, I'm going to want way more than is healthy. Conversely, I love a good salad and I can eat all of that I want.
Sorry this turned into my life history I do understand your thinking on why medication might help. Do your own research and make an appt. with your doctor to discuss your questions and concerns. Good Luck!

Thank you

Ddsb11 · October 2020

yrmom wrote: »

Hi! I'm new to this community also. I understand your dilemma - the meds contributing to weight gain and/or inability to lose weight at a rate that feels progressive. I lost 40 lbs over a year with calorie/carb counting and increasing my daily activity. Since the pandemic, I've gained 14 back. As an RN, I discussed my concerns with my physician and she recommended Liraglutide - a prescription medication that is self-administered via injection once per day. It acts on the pancreas/liver/small intestine to slow gastric emptying to tell the brain you are full. Side effects seem rough- severe indigestion and possibly vomiting. My dr. did not recommend any of the stimulants as they can be very hard on the heart and blood pressure, which are already an issue for most overweight folks. I took the prescription but have yet to fill it. I would love to have the initial encouragement of a 10 lb weight loss in a month, but I've been overweight now for about 15 years, so I do know in my own case, I'd probably just gain it back. I'm hesitant to risk the potential side effects (vomiting, pancreatitis) for the potential immediate weight loss. My dr. felt like it was safe, so I'm going to keep considering it. But in the meantime, I know I have to continue reducing my calories. I also know personally, I can't go above 50-60 grams of carbs per day, or I simply won't lose - and of late- I will gain! I hate that, but it's my reality. Lowering carbs brought my cholesterol and sugar into normal zone and after the initial adjustment I felt so much better day in and out. So WHY did I go back to the old way of eating? Sugar addiction. It's a life long work in progress with the harsh reality being I have to reduce the carbs. I can eat what I want, but keep that limit where it is. I have to know if I eat potato chips, I'm going to want way more than is healthy. Conversely, I love a good salad and I can eat all of that I want.
Sorry this turned into my life history I do understand your thinking on why medication might help. Do your own research and make an appt. with your doctor to discuss your questions and concerns. Good Luck!

Hey welcome!! I hope you stick around for a while, I can’t wait to see what you think and believe after a year of learning from this community. You’ll find your resolve will completely change in regard to what you think your body is capable of, and how you can reach your goals. Please please, start with the stickies at the top. Trust me, you can lose track of time reading all the goodies MFP has in there. Ciao for now!

domeofstars · October 2020

Duromine might work but you gotta talk to your doctor about it.

2021WLjourney · March 2021

yrmom wrote: »

Hi! I'm new to this community also. I understand your dilemma - the meds contributing to weight gain and/or inability to lose weight at a rate that feels progressive. I lost 40 lbs over a year with calorie/carb counting and increasing my daily activity. Since the pandemic, I've gained 14 back. As an RN, I discussed my concerns with my physician and she recommended Liraglutide - a prescription medication that is self-administered via injection once per day. It acts on the pancreas/liver/small intestine to slow gastric emptying to tell the brain you are full. Side effects seem rough- severe indigestion and possibly vomiting. My dr. did not recommend any of the stimulants as they can be very hard on the heart and blood pressure, which are already an issue for most overweight folks. I took the prescription but have yet to fill it. I would love to have the initial encouragement of a 10 lb weight loss in a month, but I've been overweight now for about 15 years, so I do know in my own case, I'd probably just gain it back. I'm hesitant to risk the potential side effects (vomiting, pancreatitis) for the potential immediate weight loss. My dr. felt like it was safe, so I'm going to keep considering it. But in the meantime, I know I have to continue reducing my calories. I also know personally, I can't go above 50-60 grams of carbs per day, or I simply won't lose - and of late- I will gain! I hate that, but it's my reality. Lowering carbs brought my cholesterol and sugar into normal zone and after the initial adjustment I felt so much better day in and out. So WHY did I go back to the old way of eating? Sugar addiction. It's a life long work in progress with the harsh reality being I have to reduce the carbs. I can eat what I want, but keep that limit where it is. I have to know if I eat potato chips, I'm going to want way more than is healthy. Conversely, I love a good salad and I can eat all of that I want.
Sorry this turned into my life history I do understand your thinking on why medication might help. Do your own research and make an appt. with your doctor to discuss your questions and concerns. Good Luck!

Hi Elphie and Yrmom!

I was wondering how you have decided to move forward since these last posts were written.

I am in a very similar position and have done a fair bit of reading and tried out a crapload of OTC things.

When weight gain related to medications comes into play, it’s not just about “calories in vs calories out” anymore.
There are so many variables to consider and I truly believe that addressing this side effect with your doctor is important.

Sadly many primary care physicians don’t have much experience in obesity management and there is still so much weight bias and stigma at play.

It takes a lot of self advocacy to be heard and helped.

That being said, I too have obesity (a chronic illness) that is made worse by Rx meds for a different chronic illness.

The Obesity Network Canada is a great resource for more information. I can only say: read it and talk about it with your doctor.

My solution right now will be using Saxenda. Not as a shortcut, but as a preventative medication to lower weight, improve my health and prevent diabetes and heart disease.

But not just the medication. I also have lined up local free exercise groups (walking), obviously using a food diary and a public health therapist to work on other related issues that may cause overeating.

A multipronged approach.
I hope you can find a way that works for you too!

Iwannabeapunkrockmom · March 2021

I just wanted to pop in and give you encouragement. I was diagnosed with RA last year and spent the entire year on steroids. I counted and weighed every calorie and walked daily with a walking cane to try to combat it's effects. My doctors were able to slowly reduce my need for prednisone after I started taking hydroxychloroquine. At the same time, they decided that the IUD I had (Mirena) was contributing to my autoimmune issues and I had that removed. Within days of coming off both meds, weight and inches started melting off. Prednisone had me all swollen up like a blow fish. Some people here say that it's possible to lose weight while taking it, but it was not possible for me. After I changed my meds, I was also put on Wellbutrin for depression, adhd, and cdd and that has helped a little as well.... More mentally, but that matters too. It sucked gaining weight during treatment. And I'm not sure if there is a solution for everyone during treatment. But it's important for you to get your disease under control, once you get there it's much easier to attain your goals. This is not to discourage you. I think it's important to start logging now. But I just wanted to encourage you that there is a light at the end of the tunnel. You can do this. I get discouraged a lot with the ups and downs of my autoimmune diseases. It's so tough. But you can start the habits that will improve your health today.

Medication and Medically supervised weight loss

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