So I know what most of you are going to say CICO, intermittent fasting, exercise, keto… Except I’ve done all that and lost nothing and still gained weight on Olanzapine, Lithium, Lamictal. I used to be at 85kg and now during a period I didn’t look after what I ate I am at 100kg which I hoped I never reached. I still exercise because I do a sport I love and enjoy and it’s so good for my mental health and my body to move. But I swear I’ve been eating reasonably, there’s no added sugar in my diet, I stopped ordering take out, I stopped fast food. My meals are usually whole grains, legumes or vegetables or both, yogurt and fruit as desserts. I used to be on Metformin and it didn’t help me lose weight at all. My psychiatrist doesn’t want to hear anything I told her I was unhappy with the weight I gained and she said to me “would you prefer being overweight or in depression? We tried other meds they didn’t work”. But like okay we could still look into other meds we didn’t try at all like Latuda, Depakote? I can’t even change psychiatrist. It’s tiring.
I am seeing a nutritionist on December 9th. I hope he’ll understand my struggle.
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Eh, hold out for the nutritionist before you start fucking with your diet and exercise regime as it is.
But, yeah, it’s possible. It’s just a fuck ton harder than it already would be without them. What they do is fuck with your overall chemistry, which changes insulin sensitivity, the way glucose is managed, and satiety. So not only are you likely to not feel full as quickly, your body converts that food to fat sooner and faster, but slows down when and how fast it burns.
So you’ll need to be more precise with your intake tracking, and be willing to adjust on the fly, probably while having trouble feeling hungry even when you know you shouldn’t be. I’m lucky enough to have never needed them, but I had plenty of patients that did back when I was a caregiver, and the pattern of it is so common as to be the default with people taking antipsychotics.
But, like I said, don’t fuck with your current regime yet. The nutritionist is likely going to want you to track your intake precisely as part of the evaluation, and they’ll be better able to help if they have your actual baseline rather than what you think it should be. You’ve already cut as much as you should without specialist guidance.
It comes down to your shrink being partially right. Short term, a little weight gain is worth stability. You need time to work on the underlying mental health issues with the cushion the medications give. Get that in line before you start changing meds. The good news is that a nutritionist really can help you regain control of your body. Outcomes for people with access to that kind of specialist are not just good, but great. It can take a few months to get things dialed in, but the results are comparable to things like metformin, and are less side effect prone.
There’s been some fairly good research into the subject over the last decade or two, and it’s been reproduced and reviewed, so the chances are that the conclusions that your situation of staying on the current meds, and working on nutritional intervention is going to get you back to a healthy weight while also keeping the benefits of the medications.
Now, part of the regime is going to include the idea of CICO, but what people don’t realize is that CICO isn’t simple. It’s actually a pretty complex thing to get right, particularly when there’s exacerbating factors that can’t be changed, like a medication or condition that screws with insulin sensitivity and glucose metabolism. When that kind of metabolic fuckery is involved, you can end up with an intake level that’s not sustainable and still not lose fat. So CICO almost always needs to be combined with other methodology to be effective.
But exercise is the other big factor, and the one that’s most effective in countering not just the weight gain, but in modulating the very factors that are causing the weight gain because it shifts insulin effectiveness back towards normal even without also changing intake.
Plus, you know, the exercise also helps with the stuff that people need the antipsychotics for in the first place, boosts other hormones and neurotransmitters, and just plain feels good across the board.
Which, in case you haven’t heard it, this isn’t in your head. The changes in your body from the medications is a thing. It’s extremely common and is not about willpower or any factor other than the medications. Hell, I don’t think I’ve ever met anyone taking the ones you listed that didn’t put on weight, plus have spikes in cholesterol and triglycerides.
With all of that said, keep thinking long term. As much as it sucks to put on unwanted weight, it is temporary. With the plan you’re currently building with providers, you’ll get back in control at some point, likely inside of a year. And then you’ll be able to whittle it off again, and have relief from the psychiatric/psychological issues as well. In a few years, you’ll be so much better across the board that it’ll be worth it. But the next year or so is kinda gonna be a pain in the ass.
Thank you it means a lot
Have you tried tracking what you eat each day with food tracker? Could try weighing everything out for a week and make sure it matches what you think you’re eating.
My nutritionist asked me to write down everything I eat before the first appointment so I do that for about 2 weeks now.
If you’re taking medications that mess with your hormones, they could be preventing your weight loss.
As your medical advisor said, for some conditions the treatment has trade-offs, and you have to balance those with the outcomes you want.
Especially given the number of medications you’re taking, I would be hesitant about making drastic diet changes without looping in your health care provider. Dosages, and the effectiveness of medication, can be drastically impacted by diet.
Metabolic mind foundation has a good write up, that you can use to consult with your health care provider. To come up with a going forward plan. https://www.metabolicmind.org/families-and-peers
You said you had tried time restricted eating, and low-carb high fat (keto) before - what was the outcome?
The outcome of both of those was feeling extremely tired, like no strength at all, having a foggy brain, and become dehydrated even though I drink a lot of water (this one is especially for keto).
We’re you taking 2g of electrolytes while you did those? What you describe is similar to what is often called keto-flu when people’s electrolytes are low.
