Blood on the Scales

 

Before getting into this post, allow me to tell you how much of a dippy-chick I can be: you know how bad I’ve been feeling? It appears that, while I was preparing my medicine dosette  and concentrating on the Cymbalta dosage for my dodgy two-week period, I (kinda) forgot putting in my morning dose of Lyrica! Duh! That’s 4 days with lower Cymbalta and only a half dose of Lyrica. No wonder I was feeling so awful.

And now to today’s post…

A common challenge for us FibroMAGICians (and my whole entire life) is weight gain.

Many patients complain that weight gain only became a major problem once FM established itself. It is not unusual for a person to put on a 25 to 30 pound weight gain in the first year after FM is diagnosed. Various factors are involved in weight gain and include:

Decreased Metabolism

Various hormone changes can slow down the metabolism: hormone deficiencies or imbalances (due to FM) with cortisol, thyroid, serotonin, and growth hormone. Insulin and other hormones are probably affected as well.

Closely linked with hormones is the autonomic nervous system. The autonomic nerves are the small nerves vital to the co-ordination of the body’s hormones, and thus they play a role in the regulation and delivery of nutrients to our cells.

Overall, neuroendocrine abnormalities may decrease the body’s metabolism, and part of the treatment involves replacing or supplementing hormones to help improve the body’s metabolism.

A slower body metabolism means fewer calories are burned ‘run’ the body. If fewer calories are burned, with no change occurring in calories consumed, obviously weight gain will result over time. Further, women in their late 30s and 40s often develop FM at approximately the same time as early menopause (decreased estrogen). This can further decrease metabolism and increase the potential for weight gain.

Hypoglycemia (Abnormally Low Blood Sugar)

As mentioned earlier, increased sensitivity to insulin will result in too much glucose being removed from the blood stream and pushed into the muscle. All this extra glucose pushed into the muscles has nowhere to go as the muscles have very limited ability to store glucose – the body is forced to go into a fat-storing mode where it converts this extra glucose into fatty tissue!

Contrary to the popular myth that obesity is a result of eating too many fatty foods, obesity is usually the result of eating too many carbohydrates (Bum! That’s my favourite food group). A carbohydrate rich diet causes weight gain by converting the extra glucose into fat and, if FM causes more insulin activity and sensitivity, then the weight gain can be even greater.

Another myth is that most overweight people overeat. Actually, most overweight people do not overeat. They may have a craving for carbs, and the carbs are easily converted to fat. FM facilitates this process. A diet modified in protein and lower in carbs may help (I know! Easier said than done!).

Medicines

Side effects of our medications can cause weight gain by decreasing metabolism, altering hormones, causing fluid retention, and increasing appetite. The most common offending medicines are the antidepressants.

Medicines such as estrogen and prednisone can also contribute to weight gain. If certain medicines are causing weight gain they may need to be stopped or adjusted depending on the individual’s medical needs.

Decreased Activity Due to Pain

FibroMAGICians hurt more (duh!) and are not as active because activity increases pain. It is difficult to increase the energy expenditure or calorie burning related to exercise and activity. Fewer calories burned = weight gain. Any treatment program must include attempts at increasing overall activity level.

The metabolism changes and the dysfunctional carbohydrate responses, especially, contribute considerably to many of our most bothersome (understatement?) symptoms, including: aching; fatigue; brain fog; irritability; anxiety; dizziness; carbohydrate craving; irritable bowel syndrome; food intolerance; and food sensitivity.

Since we developed FM, our ‘old’ diet probably no longer works for us and it’s making us worse:

• Because of our slow metabolism, it is difficult for us to eat less and notice a difference.
• Because of our pain, it is difficult for us to increase our exercise level to burn off more calories.
• Ideally, we need a diet that improves the efficiency of our calories burned by providing us with the right food to enhance our metabolism and calorie-burning abilities.

SPECIFIC DIET STRATEGIES

Think Protein Always
Do not eat any carbs by themselves, even if they are considered good carbs. ‘Single’ carbs increase the risk of hypoglycemia/insulin hypersensitivity in someone with FM, so foods that have some protein in them should be consumed every time we eat. Therefore:

• We shouldn’t eat pancakes and syrup for breakfast because it doesn’t contain any protein (maybe add some bacon – LOL!). Insulin is controlled by the balance of protein and carbs each time we eat.
• If we want a salad for lunch, we should not just eat plain lettuce and vegetables. We need to have a protein source in our salad as well, such as chicken, tuna, turkey, eggs, cheese and more.
• We should not eat a plain spaghetti supper. We should have spaghetti and meatballs (made with lean ground chuck meat) or lean sausage.
• If we crave a snack, we shouldn’t eat a sugar cookie. A small bag of cashews would be a better protein-laden choice for a snack.

Once you are trained to think about protein every time you put something in your mouth, it becomes easier to stay within this kind of framework.

Avoid The Rush
Hypoglycemia is often the result of a sudden surge of glucose in our bloodstream after eating a carbohydrate-rich food. To avoid a carbohydrate surge, take a few bites from protein first whenever you eat.

Eat Until Full
At meals, eat until you are comfortably full but not stuffed. Some people with FM actually do better by eating 5 to 6 smaller meals a day or by eating 3 smaller meals and 2 larger snacks.

Those who are bothered by irritable bowel syndrome sometimes can do better by eating smaller portions more frequently.

Eat slowly and take your time to chew food well – and ENJOY!

 

Chronic Comic 140