# Stopping/reversing dramatic weight gain



## Seirende (May 15, 2019)

I have gained approximately 60 pounds over the past eight months or so. This after years of staying at 180 pounds, which is solidly in the healthy range for my height (6'3.5"). I'm not quite sure what happened, I suspect a medication change. I switched to Latuda around the time I started gaining and I've seen weight gain with medication before (valproic acid had me gaining rapidly, although the weight dropped off after I stopped the med). The only other big thing is going back to school, but I made it through medic school without anything like this.

I definitely haven't been eating right or staying very active and I did see the gain slow down when I started paying more attention to my eating habits and working out on occasion. I really still struggle in both areas, though, with the main problem being with food. I never learned to cook and I dislike cooking, so I eat very little vegetables (despite being a vegetarian) and I eat a lot of sandwiches. I did join a gym a while back but go infrequently.

Anyone here ever manage to lose a significant amount of weight and keep it off? I'm at a loss here, never having had to worry about weight for most of my life.


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## DrParasite (May 16, 2019)

Seirende said:


> Anyone here ever manage to lose a significant amount of weight and keep it off? I'm at a sloss here, never having had to worry about weight for most of my life.


well, i think you found your cause and solution right here:


Seirende said:


> I definitely haven't been eating right or staying very active and I did see the gain slow down when I started paying more attention to my eating habits and working out on occasion. I really still struggle in both areas, though, with the main problem being with food. I never learned to cook and I dislike cooking, so I eat very little vegetables (despite being a vegetarian) and I eat a lot of sandwiches. I did join a gym a while back but go infrequently.


Your body is a machine.  calories in - calories used during the day = net gain or loss of caloric intake.  if you have a net gain, those calories can be stored as fat, while a net loss can result in your body using more stored calories to make up the differences.

That is, of course, a gross over simplification, but it's the basic solution.  if you decrease your caloric intake (eating smaller portions) while increasing you caloric burning (by going to the gym more) you should see the lbs melt off, but keep in mind, it's not a fast process.

If you want some articles on how you can do this, I recommend http://physiqonomics.com/ .  The author is kind of an arrogant prick, but he's pretty entertaining, and he's not necessarily wrong, as most of what he says is backed up by actual scientific research (and he includes them in his articles).  

I've gained 20 lbs over the past year, due to the same reasons you listed.  my goal is to start exercising more, whether that means going to the gym or simply jogging 3-4 times a week. It's hard, but if you put it into your calendar, and maintain the discipline to keep going, you will find yourself sticking to your routine.


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## Carlos Danger (May 18, 2019)

Seirende said:


> I have gained approximately 60 pounds over the past eight months or so. This after years of staying at 180 pounds, which is solidly in the healthy range for my height (6'3.5"). I'm not quite sure what happened, I suspect a medication change. I switched to Latuda around the time I started gaining and I've seen weight gain with medication before (valproic acid had me gaining rapidly, although the weight dropped off after I stopped the med). The only other big thing is going back to school, but I made it through medic school without anything like this.
> 
> I definitely haven't been eating right or staying very active and I did see the gain slow down when I started paying more attention to my eating habits and working out on occasion. I really still struggle in both areas, though, with the main problem being with food. I never learned to cook and I dislike cooking, so I eat very little vegetables (despite being a vegetarian) and I eat a lot of sandwiches. I did join a gym a while back but go infrequently.
> 
> Anyone here ever manage to lose a significant amount of weight and keep it off? I'm at a loss here, never having had to worry about weight for most of my life.



As Parasite says, weight gain or loss does ultimately come down to energy (calorie) balance, but in actual practice it is much more complicated than that. There are just so many factors that effect your metabolic rate, as well as your appetite.

I don't know much about Latuda, but if the weight gain started shortly after you began this med and you can't identify any other big changes in your diet or lifestyle, then it makes sense. I would definitely talk to your doctor about that.

Another thing to think about is aging. We all undergo a pretty gradual slowdown in our basal metabolic rate that usually starts somewhere  in our late 20's or early 30's and continues into our 40's or 50's. Lots of us find it much harder to stay lean starting sometime in our 30's. Maybe that's a factor at play?

Regardless of your age or the medication effects on your weight, it sounds like you might really benefit from increasing your activity level and improve your diet. The key to that for me has been to find an activity that I enjoy (for me it's weight training and walking / hiking) and can fit into my schedule with relative ease. Some activities have a bigger impact on your fitness than others, but really the best routine for you is whatever you enjoy and will therefore stick with. Whatever you choose, commit to doing it at least 3, preferably 4 times a week. For your diet, I think it's best to make small changes. Start with low-hanging fruit like drinking soda or other calorie-heavy drinks. If you do that, just stop, or at least switch to diet. A week or so later, make another change, like switching to some lower-calorie and/or whole grain bread for your sandwiches. A week or so later, make a commitment to eating a couple servings of vegetables each day. I use those steam-fresh ones that come in the bag. Super easy. Small changes like that can really add up over time, and consistency really is key.

It's going to take to some determination to get started, and there will be times that you need to just make yourself go do the activity or cook the food because you just don't feel like it. But it you rely solely on willpower, it probably won't work for long. You need to find a routine and strategy that fits your preferences and lifestyle, and make the time for it. There are lots of options out there.

Good luck.


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## mgr22 (May 18, 2019)

Seirende, you mentioned something about going back to school. Does that mean you've been much less active with EMS? If so, that might have something to do with your weight gain.


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## Seirende (May 20, 2019)

mgr22 said:


> Seirende, you mentioned something about going back to school. Does that mean you've been much less active with EMS? If so, that might have something to do with your weight gain.



I haven't been active with EMS since 2017.


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## mgr22 (May 21, 2019)

Seirende said:


> I haven't been active with EMS since 2017.



Ok, the reason I asked is that I also gained a lot of weight during my first couple of years away from clinical practice. I can't claim any expertise on the matter, but I'm pretty sure my excess poundage was related to the absence of free-flowing catecholamines that were such a big part of my EMS experience. For 20 years I was either doing EMS or thinking about doing EMS -- not a healthy situation, but one that sort of fit my mildly OCD personality. Spending lots of time in a fight-or-flight state probably helped keep my weight constant at around 140 (I'm 5-9).

As soon as I left the field, I started putting on weight and maxed out at about 185. I'm not able to exercise much because of EMS-related disability, so the best solution for me has been to eat only one full meal a day, restrict snacking to no more than, say, 300 calories per 24 hours, and eliminate almost all sweets. It took me a year to get used to that and to stop the weight gain, then another year to start losing. After about four years of my regimen, I've plateaued at around 170, which is ok for me.

Each of us has our own circumstances, but maybe some of this will help.


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## VFlutter (May 21, 2019)

Keto. Can be hard to do and maintain but worked great for me. Lost 40lbs in 4 months and have kept it off at 14% BF for the past year.


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## Seirende (Mar 5, 2020)

After gaining an additional twenty pounds I started an antidepressant in addition to the Latuda which it turns out has the bonus side effect of no longer craving food constantly. I am now losing weight at a rate of about seven to ten pounds a month.


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## Tigger (Mar 9, 2020)

A referral from your PCP to a dietician who works with people who want to be active might be of some use, even with your recent successes.


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## MMiz (Mar 9, 2020)

I've been there over the years.  Though I've never been obese, as I get older it's so much easier to put on weight without noticing.

I've found I've been most successful with the ongoing support of a dietitian, and my insurance covers 100% of the cost.

Ultimately the diet always ends up being low carb, high protein, while counting calories.  I use myfitnesspal.

Exercise helps, and can be an important part of being healthy, but 80%+ of weight loss is diet.

Good luck!


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## hpclayto (Mar 9, 2020)

Macros. The answer is always macros.


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## pregnancywhine (Mar 22, 2020)

hpclayto said:


> Macros. The answer is always macros.


What do you mean macros?


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## hpclayto (Mar 24, 2020)

Macronutrients. Calories. If you consume more calories than you burn you’ll gain weight. If you want to lose weight you need a caloric deficit.


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## StephenLewisreuw (Jun 24, 2020)

Weight loss should be slow because if you lose weight fast you will regain the weight.


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## Seirende (Jun 24, 2020)

Seirende said:


> I am now losing weight at a rate of about seven to ten pounds a month.



The weight loss has slowed down. I've lost about twenty-six pounds so far. My BP isn't quite back to where it was, but it's better. My strategy right now is to eat small meals about every four hours, so I don't get very hungry and I don't overeat very often. I still indulge in my favorite foods.


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## Seirende (Jun 24, 2020)

With the addition of methylphenidate, my appetite has actually decreased to the point that I sometimes have to remind myself to eat, although I still eat plenty. It's funny how medications can affect your appetite so drastically.


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## Summit (Jun 24, 2020)

It's a very hard to fight the battle with diet and exercise when you are dealing with medication induced weight gain and potential endocrine issues. You should attack from all angles. Others have given some good diet/exercise/lifestyle advice.

I'm not your healthcare provider and I don't know your medical hx... generally we see Latuda to be a weight neutral drug, but for some people is not. Vraylar is often an alternative that works quite well as a weight neutral atypical depending on your dx, though there are some minor differences in the some agonist/antagonist activity. Lithium is another more weight neutral rx if the dx is BD. That is all between you and your prescriber, as I have no idea why you have your various rx. There are adjunct meds to consider including Metformin often used in this type of rx to manage the weight and endocrine risk. A good PMHNP or psychiatrist is going to consider the holistic health impact prescribing atypicals as a huge component to weigh with treating the pdx. They should know their options.

If your prescriber is not comfortable doing this on their own, a consult to an endocrinologist is a great idea. They can also work you up... examining where you are in terms of insulin resistance,  various other endocrine disorders (e.g. PCOS) that may be playing into the weight gain as well as being great allies in diet planning to your particular body plus other rx options (besides methamphetamine assuming that isn't rx for other than appetite suppression).

I wish you good luck! School makes everything harder. What are you studying?


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## Seirende (Jun 25, 2020)

Summit said:


> I'm not your healthcare provider and I don't know your medical hx... generally we see Latuda to be a weight neutral drug, but for some people is not. Vraylar is often an alternative that works quite well as a weight neutral atypical depending on your dx, though there are some minor differences in the some agonist/antagonist activity.
> 
> plus other rx options (besides methamphetamine assuming that isn't rx for other than appetite suppression).
> 
> I wish you good luck! School makes everything harder. What are you studying?



My dx is bipolar II. We've actually discussed Vraylar as an option; my psychiatrist says it's more stimulating and I struggle with chronic fatigue, so that would be a benefit.

The methylphenidate (methamphetamine is just the street drug, right?) is PRN for fatigue.

I was in nursing school, but I got too depressed to complete a homework assignment and failed a course. Given the intensity of the stress/depression cycle that I experienced, I thought it wouldn't be a great idea to give it another go at that time. I'm actually looking at truck driving school this fall.


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## Seirende (Sep 8, 2020)

Aaaaaand now I'm gaining weight again.


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## Deola (Sep 17, 2020)

It is interesting to read other people's experiences, so it is much easier to start


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## Emily Starton (Sep 24, 2020)

Deola said:


> It is interesting to read other people's experiences, so it is much easier to start



Indeed


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## Ronfyre (Nov 28, 2020)

I once gained 30 pounds in 6 months, lost it the next 6 months.  Came to a realization that I needed to change after ripping my pants at work bending over - mortified. 

Did it by eating 90% raw vegetables and egg whites.  That was over 10 years ago.  I still stay healthy by following these rules: 1) containerizing all healthy lunches beginning of the week so I can grab and go (I eat the same thing every day to simplify shopping and packing; we do it for the kids too), 2) pre-cook M-W dinners (leaves a little space for variation if we want to skip one and then eat another day without wasting), 3) lots of egg whites (only way to cook en mass and have easy peeling is by steaming) and veggies (I vary dips to keep me from getting tired of it; also more recently I have been stuffing egg whites in low calorie soups); 4) drink water constantly, especially before meals (I keep 100 ounces on my mind and count out ~25 ounce bottles until I get there each day).

Also, before all that, I made a chart of all foods I liked, regardless of how healthy they are, calculated calories per gram (weight), and then sorted with the lowest calories per gram at the top and drew a line where I reasoned that I could eat tons from there on up the list without having to count calories all day.

R


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## OceanBossMan263 (Nov 28, 2020)

I recently started low carb combined with intermittent fasting. Keep carbs under ~55 g per day, eat only between noon and 8pm (except Sundays 8am so I can enjoy an egg white omelet). Lost 12 lbs in just under a month, very noticeable in the face and chest.

Lots of water, black coffee or tea, some sweeteners or diet drinks are acceptable and won't break the fast. 

I find it easier to follow than the more restrictive keto type diets. Gives some wiggle room to have flavor and not go overboard. Gave up beer, but you can do well with seltzer or liquor. Tito's mixes well with low-carb drinks.


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