We are excited to hear stories about people who choose to make positive lifestyle changes like Birdie Varnedore and lose significant amounts of weight. When we read about people who have accomplished wonderful results for their days, weeks and months of dedication and commitment, we are encouraged to continue in our own quest to reach new health and fitness goals. However, for every wonderful success story like Birdie’s, there are several other people out there that have been equally dedicated and committed to their health that didn’t see the same results. They kept careful track of how many calories they consumed on a daily basis, exercised faithfully and sacrificed a great deal. Unfortunately, instead of seeing the scale move 100 pounds in 10 months, they only saw their scale move a couple of pounds. Some of them heard family members, friends or even their doctor tell them they must be doing something wrong or “cheating” with what they were eating or how much they were exercising. If this sounds like an experience you have had in your healthy living journey, this blog is for you! As a Clinical Dietitian earlier in my nutrition career, I worked with patients who were fortunate enough to receive a solid organ transplant of a liver, kidney and/or pancreas due to end-stage organ disease. I say fortunate because many die each year waiting for this limited life-saving resource. While each of the paths that led these patients to their transplant was very different, the road they followed after their transplant was very similar. Immunosuppressive medications, outpatient clinic visits, rejection episodes and various secondary medical issues would be hills and valleys they would all encounter as they traveled the post transplant highway of living. I LOVED my job for a variety of reasons. One of the biggest reasons was that I followed the patients as outpatients after caring for them in the hospital. There was consistency in the nutritional care, intervention and education they received. I worked closely with the medical specialists, surgeons, nurse specialists and pharmacists and the nutritional care of each patient was an integral part of the multi-disciplinary care they received in the hospital and after they went home. This is not always the case when patients move from hospital care to outpatient care and I believe it has changed over the years as things in the hospital setting have changed. However, at that time, it was the most ideal of situations to help provide the best and most cost effective care to these very special patients. Although nutrition was an integral focus of after care, and I had the benefit of seeing each of the patients regularly for the first year after their operations, there are some realities that just can’t be changed even with the most ideal of circumstances. Regardless of how well I educated, how carefully I monitored or how compliant my patients were, the one consistent thing I witnessed in my patients over the five years I worked with them was their battle with their weight after transplant. Prednisone and other immunosuppressive medications caused even those that had never had a weight problem before to deal with a rapid and often uncontrollable episode of weight gain in the first few months post transplant. Add to that, additional medications that became necessary after rejection episodes or to combat other newly developed health complications as well as other issues that limited their ability to exercise consistently and you have a constant and ongoing weight battle. Many patients who previously in their life had been able to cut back on treats and increase their activity for a few weeks to drop a few extra pounds now found even following a strict calorie controlled diet and balancing their intake closely with their activity did little to slow the rate of weight gain or to bring about the loss of the 20 plus pounds they gained after transplant. Patient frustration and tears would meet me when I entered their room in the hospital after a re-admission or as they came to my office at the clinic. My love of nutrition education and working to help people find what might work for them came from working with these dear people and their families. Little did I know back then that a few years later I would join these people in their weight control frustrations. While I didn’t have a transplant, I did have a portion of my thyroid removed back in the spring of 2002, which changed many things for me. I learned, as many of my patients did, that eating at the right level, and exercising intensely and faithfully doesn’t always allow you to return to your “normal” weight. The weight you were before your medical condition changed. I have been active since about the age of 10, when I started playing softball. I was a three-sport participant throughout junior high and high school and attended college on a volleyball scholarship, which allowed me to remain very active well into my 20s. Throughout my 20s, I maintained a pretty set weight and was always able to lose the vacation or holiday pounds by watching my intake and increasing my activity for a few weeks. I had healthy pregnancies and returned to my pre-pregnancy weight within six months after delivery of both children. Of course I wasn’t happy or content with my body at the time like many women, but I was healthy and able to maintain my weight fairly easily. Last week I was talking with a long time friend who also has thyroid disease. While she has not had any of her gland removed, she does have hypothyroidism and taking Synthroid for more than five years and battling with the ever creeping weight gain. She is in her mid 40s just like me and was sharing her frustration at not being able to lose weight when she works so hard. My friend shared that she has been running three miles a day five to six days a week in addition to yard work and other family related activities. Additionally, she has been doing concentrated strength training three days a week. After six weeks of focused exercise and controlling her calorie intake, she has lost only one pound. She told me with definite conviction that “everything they say about balancing intake with exercise is just not true, at least not for me.” Our children are the same age and she has always been active, lost all her baby weight after children and able to maintain her weight. We have worked out at the same gym since having our first children and meeting a few years later. My friend and I are not alone. There are many others like us out there that are working really hard, watching what they eat, exercising faithfully and seeing little results on the scale. So now what? Check out the Weight Busters: Finding Strategies to keep Moving When the Scale Will Not article to find out what next steps you can take. We will look at positive ways to move forward regardless of our life stage. Many people feel they are the only ones doing what they should with diet and exercise but are seeing very small results. If you are one of us, it would be encouraging for you to post and let us know you are in our “club”. What shall we call our club? |
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