Saturday, November 21, 2015

What It Takes to Not Gain Weight on Prednisone

 (pic from about a month ago, since I apparently don't get myself in front of the camera anymore)

If you've been following my blog for a few months, you might have noticed that I stopped doing "Body After Baby" posts on my postpartum weight loss progress.

My excuse?

There hasn't been any progress, at least not to anyone else's eyes.

The truth is, I had been losing about a pound a week steadily since about two weeks postpartum, a fact I was feeling pretty happy about (although I would have liked the weight to come off even faster, of course, but I was trying to be realistic). All of my plans with losing the weight seemed to be going, well, as planned, and it seemed that nothing was standing in the way of my weight loss--I was all set up, in fact, to be back at my pre-pregnancy weight by six months postpartum if I continued at the pace I'd been going at.

Enter my autoimmune disease diagnosis, along with its accompanying prescription for a corticosteroid called Prednisone. Enter the seemingly impossible uphill battle of fighting the almost-inevitable weight gain that comes as a result of taking a steroid at high doses for several months.

It's kind of been the pits.

For people unfamiliar with the medication, Prednisone basically takes over your body's production of cortisol, and it works to fight against the inflammation in your body by suppressing your immune system's response. It can be a lifesaver in dealing with whatever disease it's been prescribed to combat, but it sure comes with some nasty side effects, two of which are a redistribution of fat in your body (especially in your face, stomach, and the back of your neck) and gradual weight gain.

I've been half-joking recently that I never knew how vain I was until I started taking Prednisone--apparently I was used to feeling at least semi-attractive and semi-in-shape most of the time, because taking a medication that actually has side effects called "moon face" and "hump back" has been a very bitter pill for me to swallow (pun intended). Awhile back, I was determined to lose weight on the Prednisone no matter what it took, but despite all my efforts, I have not lost an ounce of weight since being put on Prednisone almost five months ago.

However, I have managed not to GAIN any weight either, which apparently is a small miracle while being on this particular medication (as anyone who has ever been on it tells me frequently, as does my doctor).

So, in case anyone else in a similar situation is wondering what it takes to maintain your weight while on this drug, this is what I've had to do:

- When I was on especially high doses (I started out at 60mg daily), I had to basically cut out sugar and most carbs. I didn't buy bread for months, and I stopped eating breakfast cereal for the most part, too.

- Since my autoimmune disease has a muscle weakness component, I was pretty limited on exercise, but I did regularly exercise under the limits prescribed my doctor, which meant jogging/walking a mile or two when able, taking regular walks with the baby in her stroller, and doing a hip-hop aerobics class once a week.

- As my time on the medication increased, my dosage went down, but it also became more and more difficult to keep the weight off. I eventually got permission from my doctor to keep my calorie count around about 1800 calories a day (once I was down to about 20mg/day, and after being on the medication for two and a half months, I was granted permission to start training for a 5K (but not to set any speed goals). I also basically cut out all red meat and started going meatless for about half my meals.

- Currently, my dosage has finally been tapered down to 5mg every other day, which is the dosage that many people say is when it becomes a little less difficult to fight the weight gain (perfect timing for the holidays!). I still eat around 1600-1800 calories a day, most of which come from good sources of protein (like yogurt, chicken, beans, even fish sometimes) and fats (like avocados and cheese) rather than carbs. I will usually eat a little bit of sugar every day, but I try to keep it at no more than about 150-200 calories. As far as exercise goes, I wear a Fitbit every day and tend to get around 8,000 steps on most days. I also do that hip-hop aerobics class on Tuesdays, take a 25-30 minute walk once or twice a week with Raven (often up a hill or two), and take a 2.5-mile (or so) run on Saturday mornings. I've also finally been cleared to start doing some weight lifting in the past couple weeks, so I've been gradually incorporating a bit of that into my schedule, too.

For the first several months of my time on the medication, I was super frustrated that I was putting forth all this effort and not losing weight. Had I been doing all this at any other point in my life, I'd be dropping at least a pound a week, easy. But with time, it's just kind of become my new normal, and I'm trying not to freak out about it too much. Sometimes, when I'm tired of not being able to eat like I'd like to or I feel like I want to sit on the couch and veg out instead of exercising, I'm tempted to just give up on the whole thing and let myself go until I'm finally tapered off the dang stuff already (especially since the medication also has the side effect of increasing your appetite).

But I think the biggest thing keeping me going with it is that I've always considered myself to be a pretty slender person, so this new body I've been dealing with lately just doesn't feel like "me," and I'm determined not to let it become a permanent part of my identity. I'm not sure if that makes sense, but it's the truth.

Something that's also helped when I've gotten frustrated is to remind myself of a few things--firstly, that I'm grateful that there is a medication that can be used to treat my condition and that it has been working on the part of my disease that has to do with my muscles. (In fact, at my last doctor appointment, my doc ventured to say that he thought the muscle weakness portion of my dermatomyositis was in remission, which means that I'm now cleared to up my running distance slowly each month to whatever mileage I want to work toward.) Secondly, even though I feel like I haven't seen any obvious results of all of my discipline and hard work, I actually have made progress--I can now run a mile about a minute and a half to two minutes faster than I could when I first started running again after having Raven, and I can also run for quite a bit longer without stopping---the distance of a 5K, actually. And I'm slowly but surely working my way up. Also, I couldn't even do one full push-up when I was in the throes of the disease, but now I can do a round dozen. Sure, these accomplishments seem like nothing if I compare my body to what it could do about two years ago. But considering everything I've gone through, I've got a lot to be proud of.

(And it's good to remind myself of all this so as to keep myself at it, seeing as I still have at least a month to go until I taper down again, and who knows how long after that until I'm off the stuff entirely...)

If anyone is reading this who is also on this medication, I hope this helps to give you a little hope that it is possible to maintain your weight while on Prednisone--you just have to be willing to be consistent and diligent in your daily choices, no matter how frustrating it gets. (And by all means, feel free to commiserate with me in the comments!)

3 comments:

  1. Well, I definitely can commiserate! I've actually gained a LOT of weight while on Prednisone, so good for you for keeping it off because it definitely is easy to do -- especially with the increased apetite. Like you, I try to think of the upsides of the medication. And you're right -- if you didn't think you were vain before, you figure out that maybe you weren't as impartial about your looks as you thought. I had lost maybe about 50 lbs over maybe 5 years or so and so it was hard to see that come back and more. I am at the highest weight I have ever been. But I also figure that once I am off it, things will eventually go back to how they were. I try not to think about it too much but I can definitely relate to pretty much everything you wrote! Thanks for sharing Torrie! :)

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  2. Torrie, this is very challenging and I really admire how you are handling your AI disease with such grace. Prednisone is so wonderful and so horrendous at the same time. Most patients I have seen on long term prednisone look puffy and tired but you have managed to continue looking healthy and radiant. I'm sure it's because of your active personality and hard work. Keep it up! And remember that there is SO much research on AI diseases right now that there will certainly be new treatments and procedures soon!!! In addition, if you ever feel the need to pursue it, you live close enough to SLC that you can access some of the best specialists in the world there. Keep up the good work!

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  3. Thanks for the encouraging words, Heidi! It's a bit of an uphill battle to keep on going with my new habits, but it's been a blessing that I've been able to keep the weight off. I actually do go to one of the state's top specialists, a guy down in Murray who is through the U of U. But, even with all his expertise, the treatment has been pretty standard fare so far (methotrexate and prednisone). I'm really hoping that more research comes out soon for natural remedies or for drugs that don't have so many stinking side effects! Thanks again for your sweet comment :)

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