I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Transplant Discussion => Topic started by: MooseMom on July 12, 2011, 05:34:24 PM
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I have a cousin who, after three years of D, got a living donor and was transplanted about 3 years ago. He is doing very well and has been able to go back to work full time. However, he has gained a lot of weight (he is now over 200 lbs) and simply cannot get it off by dieting. He is on what I assume is the standard protocol for steroids after transplantation, and it should come as no surprise that this is what his doctors say is causing his weight problems. I've read many posts on IHD about this very thing.
What is it about steroids that cause weight gain? Does your appetite increase? Or do they affect your metabolism? Is there anything that can be done other than stop taking them (which is not possible for him at the moment, obviously)? He swears he eats very little, and I believe him. I'm just curious about the biomechanism behind the weight gain caused by steroids.
Also, I have heard of non-steroidal protocols utilized by some transplant centers. Anyone have any experience with this?
Thank you.
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Yes, steroids affect the metabolism. Prednisone mimics cortisol which is first and foremost a metabolic hormone. Some people produce too much cortisol and are diagnosed with Cushing's disease, whilst others do not make enough and have Addison's (like Jack Kennedy). Someone with Cushing's will almost always be above average weight.
If I were your cousin, I would eat normally and let the weight do what it wants. I try not to impose my personal views about this on anyone, but weight is generally little more than a cosmetic concern. A male at 200lbs, even a short male, does not sound all that heavy to me. He may drive himself bonkers trying to diet, or he may find himself with a serious eating disorder as I did. His doctors are saying it is the prednisone and not accusing him of lying about his caloric intake, right? If so, he is lucky. I also believe that he eats very little because I've been there.
I was never on steroids with the second transplant and as I mentioned in another discussion recently, there are articles claiming that longterm steroid use for transplant patients does more harm than good. There are many steroid-free houses out there. I would have to check, but I believe one article made a case that all transplant patients (except in special circumstances) should be off prednisone within 2 years time. If it really bothers him that much, I would say he should tell his doctors that he wants off. If he needs to do it on his own, warn him to do a slow taper, dropping no more than 1mg a week or so. It can kill you if you do it wrong. Hope this helps!
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Thanks for the explanation; that's exactly the kind of information I was looking for.
I think my cousin weighs in at quite a bit over 200, but he has always been well built, and the added steroid weight probably amounts closer to 250 than 200, but I'm just guessing. My aunt didn't tell me a lot, but what she did tell me makes me think that it's not so much a cosmetic issue for him as it is about comfort. They live in SoCal, and the extra weight makes him quite uncomfortable when it is hot.
Despite not having taken care of his hypertension before having to go on dialysis (he had no idea his kidneys were failing until a routine blood test showed his creatinine at 13!), he does take care of himself now, and that includes eating well with plenty of fruits and veg. I think he just gets frustrated that he is so careful yet sees his weight just going up. But he feels better now than he has in a very long time, so overall, he's happy and grateful.
The next time I talk to my aunt, I will ask her if he might ask his transplant docs about going off the steroids. It may be slightly too early, I don't know. Anyway, thanks for your reply.
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Moosemom the higher dose the Prednisone the more hungry you are. My first transplant I was an eating machine. I also developed Diabetes as well. The Prednsione dose was considerably higher then what I am on even now. I remember taking huge chunks of italian bread and dipping it in a jar of peanut butter...I just couldn't stop. So I did gain weight quickly at first. When the med was reduce my weight did go back into a normal range. The second transplant I am on 20mg of Prednisone and I feel more hungry but I am not out of control like the first time around. I had crazy mood swings as well with the first transplant. I think the protocols for anti rejection meds and Prednisone are a lot lower then what they first use to be so this tends to help with all the side effects. Hope this helps!
xo,
R
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The high doses of prednisone for the first year made me so hungry I could have eaten an entire roast pig at one sitting. And gone back for dessert 20 minutes later. (I know I saw a baked apple here somewhere....)
I'm down to a level of only 5 mg. Even without being able to exercise, I was able to stay at the same weight for the last 5 months or so. I did have to change my diet to do that though - low carb seems to be the only thing that works for me. I think if my sister hadn't tried a strict low carb diet and had such success with it, I wouldn't have tried it myself, and I'd still be gaining weight, though. Apparently, processed flour makes me fat. I still eat lots of chocolate and fruit, but that doesn't seem to matter as much. Perhaps he, too, needs to find that one thing that packs on pounds with his metabolism.
I think the preds mess with it all - your appetite triggers go into overdrive and your metabolism slows down.
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Yep, OK...this all makes sense. I don't know what my cousin's dosage is, and you're right...maybe certain foods don't do him any favors. I wonder what it is about pred that triggers hunger. My ex has a brother with Prader-Willi syndrome; it is quite rare, and among the effects is an unlimited appetite. Whatever mechanism that signals satiation is largely absent, so the temptation to overeat is constant. So, I know that things CAN affect hunger/satiation; I wonder if there is some correlation between how pred works and how Prader-Willi affects this mechanism.
Ooooh, that was wonkish...
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I'm 7.5 months post tx.
I started on, I think, 20mg a day of preds and that made me go mega mad at times with the hunger. (and I'm surprised when I did the 3 shots of 1000mg of methylpred that I didn't jump on the nearest person and try and eat them whole!! :rofl;). Anyway I put on between 7 and 8 kg compared to my dialysis dry weight. Obviously this was a big concern to me and the weight gain has always been discussed as common and something to watch out about. I'm now down to 7.5mg (hopefully down to 5 soon!) and I've found that my weight has, more or less, stabalised. I think it helps that I do a lot of walking for exercise, which definitely helps, but I find the hunger is nowhere near what it was, and probably more normal. There are times when I do crave naughty things like some form of junk, or chocolate, but it's more controllable.
In addition to the exercise I've found that changing to diet/low sugar drinks (eg: coke zero) helps, along with low fat/skim milk helps, and having a "skinny" coffee when I'm out. I think all the little things do add up to keep it under control.
Of course I'd love to get that weight down - the nurses still poke(literally!) fun at my "baby bump" of a tummy, but really if I can stay stable around my current weight, and Danny is doing well, it's not going to be a major concern because I may never get that off (after all, I've also passed the 40 mark, and my father put on a lot around the same time, so it may be as much genetic as steroid driven).
So I definitely keep it in mind, and keep an eye on the scales, I try to not stress about the weight so much if it's stable. Yes, unhappy it lept up so much, but it was expected, and really it is, at most, a 10% gain, which is probably not too bad. I hope anyway!!! :)
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MooseMom, I thought Rush was on the Non Steropid protocol now. At the time I was looking back in 2000 they were not along with Loyola, UofI, and UofC. So that was one of the reasons I went with Northwestern.
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That's really interesting, Richard. I've heard quite a few stories like yours, and I would be curious to know exactly WHY these meds cause an increase in hunger. That just seems to be such a weird side effect. But I agree with you...weight gain is just one part of a big picture. What matters is your overall health as its improvement is the whole point behind going through the rigors of transplantation.
Chris, yes, Rush says on their website that they have a steroid-free protocol, but when I asked about it at my evaluation, they just kind of harumphed as if it just a bogus selling point. But since the waitlist is about 5-6 years, I figure I have, at the very least, four years before I'm close to getting a kidney, so hopefully that will be enough time for them to refine this particular part of their program.
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I was on 10 mg pred for four months and I did eat everything in sight and nothing vegan, fluffy or low calorie. I gained 30 lbs and it took two months before I lost any of it. 6 mos later I have lost 15 lbs. So even a low dose(which was to replace cellcept because of low white blood cell count . Turned out to be either bactrim or valcyte was the real cause) I hope to not get to have that experience again although nachos with a pound of cheese at 2AM are pretty tasty.
Ed
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I would be curious to know exactly WHY these meds cause an increase in hunger. That just seems to be such a weird side effect.
Well, the hunger is hardly the only strange side effect. Mood swings go right along with that - even those of us who only suffered mild ones will testify to that. (Bawling at Maxwell House holiday commercials, anyone? That was my craziest one.) Given how many people who aren't on prednisone eat to deal with mood swings, there's clearly a link that is likely only made worse by preds.
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Given how many people who aren't on prednisone eat to deal with mood swings, there's clearly a link that is likely only made worse by preds.
Oh, now that's an interesting point. Yes, I know for most people, food has an emotional component. My husband is like that. If he has a stomach ache, he eats something. If he is bored, he eats. If he sits down to watch TV, he has to have a TV snack. I've just never found comfort in chocolate; I'm not wired that way, I guess. But yes, if mood swings bring on snacktime, then I can see how pred mood swings would just amplify that effect. Very interesting!
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I gained 20 lbs after my transplant last year. Like everyone else I was super hungry all the time, plus I was eating all the yummy things I couldn't eat while on dialysis. The other problem is while on prednisone, it's really hard to lose weight, and the weight seems to settle weird places, like your belly and cheeks.
I don't think I look bad, and my BP and cholesterol are all good, and I feel great, so I don't worry about it too much. I am working on it, but I still think I look cute. :flower;
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Like Richard said, exercise is the key. A lot of patients say that PD would gain weight. When on PD, I ate whatever I wanted and hardly gained any weight. The 4-5 miles/day walk/run balanced out any things I got from foods and PD solutions. If one eats more, he or she needs to exercise more.
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I would be curious to know exactly WHY these meds cause an increase in hunger. That just seems to be such a weird side effect.
Well, the hunger is hardly the only strange side effect. Mood swings go right along with that - even those of us who only suffered mild ones will testify to that. (Bawling at Maxwell House holiday commercials, anyone? That was my craziest one.) Given how many people who aren't on prednisone eat to deal with mood swings, there's clearly a link that is likely only made worse by preds.
One crazy mood swing i had was when I had to start injecting myself with insulin....oh man I was screaming at my mother and threw the vial against the bathroom wall. The did a slow slide down the wall, with my hands wrapped around me while I cried...it was pretty pathetic. My mom just looked at me and walked out the door...
xo,
R
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I'm going to admit that I have had one incident of Roid Rage since my tx. I had a bit of a meltdown at work - in a staff meeting no less (OMG how embarrassing). I was kind of set up and attacked by a cow-orker in this meeting in front of a manager, and I wasn't impressed so kind of... well.. let them know about it. oops. Luckily later several people, including my (and their) managers told me they felt what they did was inappropriate and they didn't give me grief for my RR attack.
Other than that I feel like I've been fairly stable in that regard.
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aw Richard! :cuddle;
xo,
R
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When I was on prednisone pre-ESRD, I ate raw veggies by the pound. EVERYTHING tastes good when you're on prednisone and I refused to gain weight. It worked. I didn't gain weight even though I wasn't able to exercise while I was on it. Because of muscle-wasting, I could hardly walk and was prone to tipping over (and not being able to get back up again). I started walking as soon as my dose tapered down enough to start to regain some strength and walked my first marathon the following year.
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When I was on prednisone pre-ESRD, I ate raw veggies by the pound. EVERYTHING tastes good when you're on prednisone and I refused to gain weight. It worked. I didn't gain weight even though I wasn't able to exercise while I was on it. Because of muscle-wasting, I could hardly walk and was prone to tipping over (and not being able to get back up again). I started walking as soon as my dose tapered down enough to start to regain some strength and walked my first marathon the following year.
See, now, my neph never put me on steroids pre-D. Instead, he put me on cyclosporine. I was on it for 5 years, and it kept my fsgs in remission pretty well, but then the bottom fell out and it got to the point where the cyclosporine wasn't doing me much good anymore, so to protect my kidneys from even more damage, he took me off. I'm on neither steroids nor cyclosporine; I'm just waiting for complete renal failure. Life is so much fun right now.
So, I don't have any experience with steroids, but at least now I know what kind of thing to expect, thanks to y'all. So, thanks for the info.
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When I had 240 and 200 mg prednisone a day during the first two days post transplant, I need only about 2.5 hours of sleep each day and was full of energy. The prednisone is really wonderful things during a short term. Five days post transplant, I had no more prednisone and I fell like falling down to the earth from the sky. The energy produced by prednisone may need more foods to support, I guess. Another good feature of prednisone that a patient is unlikely to get dehydration when drinking enough water. Prednisone can retain water, which is good when the new kidney has not completely settled down. Of course, when the kidney can adjust water levels in the body properly, retaining water is a bad feature, which may cause high blood pressure.
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Calid- Where you ever on a daily dose of steroids with your first transplant?
Prednisone is the devil and I would love to see it ditched from my husband's "menu". However, he was transplanted in the early 1990s when steroid free transplants were not performed at his center. He also received a cadaver kidney verses a living donor.
I was a bit surprised to find out that my recipient is on steroids. I am pretty sure this is his first transplant at a center I assumed would be steroid free.
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I think in terms of feeling hot in the SoCal sun, that could well be a problem regardless of what your cousin weighs. I felt that prednisone interfered with my system's internal temperature control - I would get hot very easily. Aside from some weight gain, which was blown up into the biggest deal in the universe at my house, I have managed to (so far) avoid the major issues of longterm steroid use. True, once I went hardcore anorexic, I felt cold all the time, but today I weigh in what is considered a "normal" range, but yet again the transplant seems to have interfered with my internal temperature. I get chills and heat flashes. I know it's not a weight issue with me.
People (in general, not referring to anyone here) love to have answers to these things, love to attribute any sort of success - medical or otherwise - to virtuous behaviour, and struggles to bad behaviour. That irritates me, and I have less patience with that attitude every moment that ticks by. I was treated like a goddam criminal for eating, when it seems that the entire world knows that steroids do this to people. It is not the eating! I was put on a ridiculously strict, 1000 calorie per day diet and doctors and control freakish laypeople still got on me for my weight. Think of the mental health I might have enjoyed if they had actually used some of that medical training of theirs to say to themselves "Hmmmm - is everything always the patient's fault?"
It makes me really sad to see patients tell themselves it is about diet and exercise. I was very active and was already on a permanent diet. There is only so much that diet and exercise can do when you are dealing with such a major disruption to the metabolism.
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It makes me really sad to see patients tell themselves it is about diet and exercise. I was very active and was already on a permanent diet. There is only so much that diet and exercise can do when you are dealing with such a major disruption to the metabolism.
I think I get where you're coming from here. For me I feel I understand what the effect of the steroids (and other meds) are and I realise there's only so much I can do physically about it. I don't just exercise to counter that - I do it for general health now that I have my tx it's more important than ever(I was doing a lot of walking while on D too to try and keep my cardio system in reasonable shape for when the op came). So I exercise for general health, but it is also part of it to try to keep the weight gain at bay (and I have, more or less). I try to not stress too much about not being able to bring it down much though because I think this is just the way it is for my body under the corrent regimen. The good thing is that I'm not putting on and turning into Homer Simpson (with the point being the increased potential for diabetes ). Heck I feel good about it too :) Yes, I have changed my diet a bit to also help, but by the same token I am also trying to enjoy life as much as I can with my gift - isn't that half the point of it? I don't know how long it will last for, and while I don't want to be doing anything foolish to cause problems, I also want to be able enjoy all life has to offer. So yes, I will enjoy that bit extra ice cream and chocolate fudge damnit!!! >:D
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It makes me really sad to see patients tell themselves it is about diet and exercise. I was very active and was already on a permanent diet. There is only so much that diet and exercise can do when you are dealing with such a major disruption to the metabolism.
I think I get where you're coming from here. For me I feel I understand what the effect of the steroids (and other meds) are and I realise there's only so much I can do physically about it. I don't just exercise to counter that - I do it for general health now that I have my tx it's more important than ever(I was doing a lot of walking while on D too to try and keep my cardio system in reasonable shape for when the op came). So I exercise for general health, but it is also part of it to try to keep the weight gain at bay (and I have, more or less). I try to not stress too much about not being able to bring it down much though because I think this is just the way it is for my body under the corrent regimen. The good thing is that I'm not putting on and turning into Homer Simpson (with the point being the increased potential for diabetes ). Heck I feel good about it too :) Yes, I have changed my diet a bit to also help, but by the same token I am also trying to enjoy life as much as I can with my gift - isn't that half the point of it? I don't know how long it will last for, and while I don't want to be doing anything foolish to cause problems, I also want to be able enjoy all life has to offer. So yes, I will enjoy that bit extra ice cream and chocolate fudge damnit!!! >:D
Right on, Richard!
(Oh, and I meant to write that it makes me sad to see patients tell themselves that it is ALL about diet and exercise. Obviously, diet and exercise will have some impact if it is important to a person to lose weight. Enjoyable exercise is one of the most superb ways to spend one's free time, for the many reasons that you listed, weight loss being only one possible byproduct of getting out, moving around, having fun.)
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Really I do it because the baby swans I see at the lake I walk around are SOOOO CUTE!!!!!!
:shy;
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It makes me really sad to see patients tell themselves it is about diet and exercise. I was very active and was already on a permanent diet. There is only so much that diet and exercise can do when you are dealing with such a major disruption to the metabolism.
I think this is a conflicting statement. If one can control her or his diet and have a good exercise, the weight gain is not a big problem. If one fails to control her/his diet, this is another issue (failing on diet control does not mean the diet does not work, and there are lots of people who fail to control diet without any steroids). Why some people can control diet and others do not is more than just a metabolism problem. All transplant patients I know with steroids, most of them do not have over weight problems. With steroids, controlling diet would be more difficult than without it, but the key is still the balance between input and output. Diet and exercise are the key to maintain the balance. For patients with steroids, there are very limited options for them besides diet and exercise.
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Im 15 months from my transplant and would be lucky if I've gained half a kilo.
Not everyone gains weight from the steroids and increased appetite gained after transplantation.
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crap! I'm envious!
I've gained around 7-8kg on my pre-tx dry weight. Dude!!!
note to self: cut down on double cheeseburgers - it might help! :rofl;
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It makes me really sad to see patients tell themselves it is about diet and exercise. I was very active and was already on a permanent diet. There is only so much that diet and exercise can do when you are dealing with such a major disruption to the metabolism.
I think this is a conflicting statement. If one can control her or his diet and have a good exercise, the weight gain is not a big problem. If one fails to control her/his diet, this is another issue (failing on diet control does not mean the diet does not work, and there are lots of people who fail to control diet without any steroids). Why some people can control diet and others do not is more than just a metabolism problem. All transplant patients I know with steroids, most of them do not have over weight problems. With steroids, controlling diet would be more difficult than without it, but the key is still the balance between input and output. Diet and exercise are the key to maintain the balance. For patients with steroids, there are very limited options for them besides diet and exercise.
A conflicting statement? What?? Jesus! How dare you come on here and essentially call me a liar. I did not "fail" to do anything, and someone who knows nothing about me has zero call to pretend to know what the hell he is talking about. The diet - which was exactly one thousand calories per day for a growing child, did in fact fail. Were you there? Because I was. It did not matter in the least if I was ravenously hungry, I was a kid and my parents had ironclad control over what I ate. If I reached my calorie limit, I was done eating whether I wanted to be or not. I was also an avid tennis player, went swimming in our lake in summers, skating on the same lake in winters, biked all over the neighbourhood exploring, and many other activities. My parents are both thin, my siblings were all thin (that's called genetics!) and we all had access to the same food - except I had access to greatly reduced quantity.
Wow, Jie, this is easily the most offensive and arrogant response I have ever received to one of my statements, and about my own life no less. I don't care how many transplant patients on steroids you supposedly know. Your anecdotal non-evidence is laughable. I was on the pediatric renal ward and the kids that I saw post-transplant all looked like me. Just because you believe that tired mantra that diet and exercise will lead to everyone being some mythical perfect weight does not make it true. "If one can control her or his diet and have a good exercise, the weight gain is not a big problem." So, everyone on steroids reacts exactly the same!
I have studied the effect of this steroid over years and years. It is notorious for weight gain, it is notorious for adding fat to the abdomen and face. Of course not every patient gains weight, and doses are on balance lower than 35 years ago when I had my original transplant. There is a case study of a man addicted to prednisone in a medical journal, and it was noted that he had none of the expected physical features of someone on massive doses of prednisone. That doesn't mean anything! It certainly does not mean that people who do have that reaction to prednisone are failures.
Cortisol in short doses should make you lose weight - your body is trying to shed baggage under stress in order to allow you to run faster, as in, the fight or flight response. Over the long term, a person will typically (NOT always, there is NO always with human biology) gain weight under long term cortisol exposure - the stress response - because the body is trying to store up reserves to get through whatever crisis it assumes you are in. Yet again, we see basic human evolutionary principles at work.
"All transplant patients I know with steroids, most of them do not have over weight problems." Talk about a conflicting statement. This tells us exactly nothing about the issue under discussion. Do you know what dose I was on as a child? Are you somehow privy to information about my age and starting weight? Even today, some people have to take high doses, some people don't, some people tolerate it with few problems, some get horrific complications, some, many in fact, gain weight despite constant efforts to diet and exercise (and more and more scientists are coming around to the understanding that a higher weight, in and of itself, does not necessarily mean poorer health). You can blame yourself for your own appearance and health issues all you want, but don't you dare come at me with a lecture about what a failure I must have been. I nearly died of anorexia - twice. If there is one thing on this earth that I know I can do, it is stick to a damn diet.
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The members of this site who post here share more intimate details about their bodies and their disease here than they do with their own family. Those who have received transplants are taking a varied cocktail of drugs and supplements that no neph can perfectly tie side effects to one prescription. Even they describe it as more art than science. But one thing comes across pretty clear. Yes the short term high dose steroids begun right before transplant make you feel great for a few days. But for most people the daily long term dose of steroids given either as part of the protocol,for a rejection episode or some other reason(as in my case) causes weight gain, emotionalism and hatred for the steroids in most people. This is not usually just about controlling diet and exercise. I exercised a tremendous amount through hard labor when I was on the steroids and gained 29 lbs and in 6 mos off the steroids I have exercised less and lost 15. I only post about my personal experiences and what I have learned works for me. I would never try to tell another kidney patient that all their steroid problems can be fixed by proper exercise and diet control because for most it wont work.
I read the other members successes, struggles,frustrations and rants and identify with and encourage them to continue the fight Cariad, if I still had a company I would hire you on the spot just for the way you defend your positions. Go girl
Ed
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But for most people the daily long term dose of steroids given either as part of the protocol,for a rejection episode or some other reason(as in my case) causes weight gain, emotionalism and hatred for the steroids in most people. This is not usually just about controlling diet and exercise. I exercised a tremendous amount through hard labor when I was on the steroids and gained 29 lbs and in 6 mos off the steroids I have exercised less and lost 15. I only post about my personal experiences and what I have learned works for me. I would never try to tell another kidney patient that all their steroid problems can be fixed by proper exercise and diet control because for most it wont work.
Thank you, Ed, from the bottom of my cynical old heart. :) Patients hear enough about how they are the cause of their own problems, and weight seems to be the one that brings out the most finger-pointing and shaming.
My mother to this day will, with very little provocation, tell you a story that perfectly encapsulates her quick and cruel education in the medical world: I had just been admitted to hospital, the stupid one that almost killed me with adult doses of Digitalis, totally contraindicated for renal paitients. I was rather emaciated, so not sure why the issue of diet was under discussion, but the attending physician was making his rounds with all the little interns and my mother was sitting in the room with me. The doctor said to everyone within earshot, as if my mother were not even there, "I don't think the mother is properly keeping track of what the patient is eating." My mother always ends this story with "If you ate a cookie, I would not only write it down, I would DRAW the cookie so I could show the doctors how big it was!" That truly awful hospital aside, my mother was obsessive about doing just exactly what the doctors said, seeing as it was likely a tad scary to see one's own child so close to death. The physicians at the second hospital told her not to let me gain weight after transplant, so you better believe this was her all-consuming mission for years. And it did not work. I know from where I speak, both personally and academically.
Cariad, if I still had a company I would hire you on the spot just for the way you defend your positions. Go girl
Ed
For this, Ed, I just cannot thank you enough. You've made my day! Time to go attack that job search with renewed enthusiasm.... :grouphug; :thx;
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I just want to make it very clear that NO ONE is "judging" my cousin in ANY way; we are just all so grateful that he is alive and is doing so well.
I apologize profusely if my initial query in ANY way suggested that there was some "failure" on the part of any patient who was taking steroids that resulted in weight gain. In fact, my question really suggests exactly the opposite. I was just curious to know what exactly was the biomechanism behind steroid-induced weight gain. It would be the same sort of question as "What is it about how phos binders work that can cause constipation", or "What is it about how cyclosporine works that can cause excessive growth of gum tissue?" I just like knowing how and why meds work the way they do; I seriously thought about going pre-med in college, and that basic curiosity still exists in me.
Anyway, I've learned quite a bit about the topic from all of the replies here for which I am grateful, and I am sorry if my initial post dragged up any bad memories for anyone. :cuddle;
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Moosemom,
Our rants had nothing to do with your initial query. I didn't even remember it when I posted.
Never stop asking questions.
Ed
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Moosemom,
Our rants had nothing to do with your initial query. I didn't even remember it when I posted.
Never stop asking questions.
Ed
I know, but I just wanted to make myself clear. The rants are very instructive in their own right.
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Wow cariad, a 1000 calorie diet, I was first on a 1800 and then a 2000 calorie diet and still was thin (well still am :rofl; ). I thought my calorie intake was low as a kid.
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Wow cariad, a 1000 calorie diet, I was first on a 1800 and then a 2000 calorie diet and still was thin (well still am :rofl; ). I thought my calorie intake was low as a kid.
Yeah, and I grew up thinking that 1000 calories was the absolute maximum that I should ever eat. I called my mother to let her know that they were debating whether that calorie intake should be considered torture at Guantanamo Bay. She was not amused. Yet, this is what the diet industry tells adult women they should be eating. Kids, of course, need calories to do little things like grow and develop and should never be calorie restricted. Now, restricting things like glucose in diabetics, absolutely, or limiting any kids intake of processed crap.
My mother was queen of the latest nutritional fads (she still is, though it has morphed into a supplement obsession). There are many classic American foods that I never tried until I went off to prep school, or never. We never had Hostess anything, (I ate my first twinkie right before taking the SATs, and to say I was not impressed is to understate), rarely had kid cereals and the only branded peanut butter we ever had was Knudsen (Peanuts and salt - That's all!). Today, I can see the wisdom in all of that and have adopted many of those policies in my own home. What I have not done is shunned white flour so that even cakes and cookies are whole wheat or bought artificial sweeteners and fake fat by the barrel. My philosophy is if you want health food, don't look for it with cakes, cookies, or a frozen dinner, when you want a dessert, have a proper dessert, preferably made at home with no chemicals, and better tasting. Anyhow, I was not only on a low calorie diet, it was a diet consisting of low-fat (for that was the craze back then) and low-salt, with fake sugar, bland vegetables (at least those were real), skim milk (yuck) and lots of animal protein (until I went veg and never looked back). I was still probably 10-20 pounds overweight, which is hardly anything, but on a kid, it looks worse than on an adult. My mother has even said, sheepishly, to Gwyn that she knows she put us all through a lot with these weird diets of hers, and she did tell me that after major, invasive, dangerous surgery, "you should have been pigging out on protein and fresh fruits". I highly doubt it would have made a damn bit of difference to my appearance, and my mother and I might just be on friendlier terms today.
Anyone on steroids who wants to lose weight, low-carb is going to be your best option. Low insulin levels will stop the corticosteroid from binding to and stimulating the fat cells in your abdomen. That is science, well-established. However, low carb cannot overcome every weight problem, and maybe, just maybe, the weight is not a "problem" after all, it is the rigid, blinkered way that many health professionals view weight. Medicine has advanced so far, but if you are over some stupid ideal weight, it often is no better than the dark ages.
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I think the medical profession's take on BMI is changing already. When I was getting signed up for the list, all I heard was BMI, BMI,
BMI. You need to be.......THIS weight. I was talking about weight loss and gain and diets with one of the docs while I was in the the hospital at the beginning of the month, and saying I was glad to finally have my guts back in place so that I would (eventually) be able to start exercising again. I said my BMI numbers said I needed to be under 145. The doc shrugged and said "BMI isn't as important as you think."
Well, yeah, I agree - when my recommended weight is 145, and I started out all those years ago at 230, I didn't need a formula to calculate that I was fat. I had a mirror and a closet full of plus-size clothes for that.
Besides, thanks to surgery, I'm on a no-fail diet right now. Eat anything but chicken broth or crackers and throw it right back up. I'm 17 pounds under what I was when I went in for surgery, and I don't know if I've lost all the edema yet or not.
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I think the medical profession's take on BMI is changing already. When I was getting signed up for the list, all I heard was BMI, BMI,
BMI. You need to be.......THIS weight. I was talking about weight loss and gain and diets with one of the docs while I was in the the hospital at the beginning of the month, and saying I was glad to finally have my guts back in place so that I would (eventually) be able to start exercising again. I said my BMI numbers said I needed to be under 145. The doc shrugged and said "BMI isn't as important as you think."
Well, yeah, I agree - when my recommended weight is 145, and I started out all those years ago at 230, I didn't need a formula to calculate that I was fat. I had a mirror and a closet full of plus-size clothes for that.
Besides, thanks to surgery, I'm on a no-fail diet right now. Eat anything but chicken broth or crackers and throw it right back up. I'm 17 pounds under what I was when I went in for surgery, and I don't know if I've lost all the edema yet or not.
BMI is such a useless marker. I seethe every time I hear of someone denied a transplant solely on the basis of BMI, a glorified height/weight chart. If there are no other medical contraindications to transplant, then there should be no hard and fast BMI number that excludes patients. And weight loss surgery to be allowed to have a transplant??!! It's the lobotomy of our generation, a horrible medical experiment based on insufficient research, maiming and killing innocent people.
I am glad that you are seeing doctors who can think for themselves, jbeany. I wish more people on IHD would stand up for themselves on this issue. There is no evidence that increased BMI, by itself, creates a greater risk to a transplant patient. In fact, studies in both dialysis patients and the general population have shown that people who fall into the 'overweight' category have the longest life expectancies in their respective populations. If they have longer life expectancies, why is that the overweight category, and not the "healthy" or "ideal" category? Don't anyone bother arguing to me that the diet and medical industries are not colluding with each other. It's bad science.