What I Learned from Taking a Drug that Causes Weight Gain

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Today’s post will be somewhat personal because I’ve been quite sick. The problem, as usual, is my digestive system – the ulcerative colitis that originally inspired the Normal Eating method. When an emotional eater has health-mandated eating restrictions, he or she must resolve emotional eating in a very deep way to avoid getting triggered. And thus the Normal Eating method was born.

This time around my challenge was a little different. I wasn’t trying to follow a special diet that I hoped would cure me (though I did make certain changes I’ll talk about shortly). I was – and am – taking a drug that I know from past experience causes pronounced increase in appetite and water retention, potentially leading to rapid weight gain and "moonface" (puffed out cheeks): the dreaded Prednisone.

First key point: When you are sick enough to need this drug, it puts the importance of appearance in perspective. When you are so sick that you cannot leave home or enjoy life at all, a fast 20 pound weight gain and a head like a basketball seems a small price to pay to be functional and pain-free. That said, I did not gain 20 pounds this time.

When Your Body Betrays You

The first time my doctor put me on Prednisone for colitis, I wasn’t forewarned about the increased appetite and water retention. I felt endlessly hungry so I endlessly ate. I gained weight very quickly, and my usually oval face became perfectly round. People I knew didn’t recognize me. I didn’t realize how much my appearance had changed until I saw myself in a photograph, and then I cried.

The worst part was not actually the weight gain, but the moonface – the puffed out cheeks from water retention. I didn’t feel pretty anymore, but moreover I didn’t feel like me anymore. I felt like I was in someone else’s body.

My overwhelming feeling this time around was that I didn’t want to put myself through that again. I wanted to spare myself the pain of reliving that experience. My main thought was PROTECT: Protect self from pain.

This is important because how you think about your food choices has everything to do with how you feel about them. What you do out of self-love and self-protection is freely chosen and empowering. Then it’s not about the food you’ve chosen to eat or not eat, it’s about the benefit you want to give yourself. You’re moving towards something, not away from something. Your main focus is not the food, but rather the goal you are trying to achieve (incidentally, through food choices).

Freely Choosing

How do you get to the point where you can freely make food choices in your own best interest, without feelings of conflict or deprivation? In the end, it comes down to how you think about it – what you say to yourself in the moment when you are deciding what you will or will not eat.

What I said to myself was, "This is war, and I am fighting for my life. I am going to get well, and I am going to do it on my own terms, without losing my physical sense of self, to the extent it is possible for me to control this."

I’ve been able to minimize the Prednisone side effects this time because I have developed the inner freedom to make food choices that feel like choices, exercises of personal power, and not restrictions imposed from without. I was able to decide what to eat without any sense of inner conflict. This is what the Normal Eating method is all about.

I also learned some interesting things along the way.

Mindfulness versus Habit

When I started the Prednisone, I became very conscious and deliberate about what I chose to put in my mouth, much more so than before. My strategy was this:

  • Pay scrupulous attention to hunger and satiation. Know that my body’s cues are distorted because of the drug, and eat the bare minimum needed to satisfy hunger.
  • Avoid foods with high calorie density and low nutrition (e.g. sweets) because my body is leading me to eat more than it really needs. Don’t go hungry, but minimize foods that will encourage fast weight gain.
  • Minimize salt to reduce water retention.

At first it was easy – the Prednisone hunger doesn’t happen immediately. And I had a surprising realization: I’d been eating slightly more than my body needed, simply out of habit. For example, I didn’t need a whole bagel at breakfast. My body only wanted half that.

I’ve always gained weight easily, but much more so since turning 50. I weigh 10-15 pounds more now than I did at 30. Until this exercise in hypermindfulness, I didn’t think there was anything I could do about it. I wasn’t eating emotionally or compulsively – I was eating what I always had eaten. But I weighed more.

Now I realize that this was the problem. I was eating what I always had eaten, but my body was not as it always had been. I was older and had less muscle mass. Perhaps I also moved less. I wasn’t eating to fill emotional needs, but in eating out of habit I was not fully eating according to my body’s hunger and satiation cues. It turns out that going on autopilot is a great way to gain weight with age!

In the first two weeks of my hyper-mindful eating, I actually lost 5 pounds. I gained this back when the relentless Prednisone hunger kicked in, but the gain stopped at the 5 pounds I lost.

I’m now starting to taper off the Prednisone, and my only side effect has been a slight moonface and hoarseness from the water retention. Maybe when I’m off the Prednisone my weight will return to what it was when I was 30, just by paying more attention to my body and not eating out of habit. That would be nice.

Age, Beauty, and Health

All things being equal, everybody would prefer a vigorous, healthy, youthful, normal-weight body. After all, this defines beauty. We are genetically programmed to be attracted to health. A youthful shape signals reproductive capability.

But all things are not equal.

If you are over 50, you’ve probably noticed that your proportions have changed, even if your weight has not. I always used to be a full size smaller on top than on the bottom, no matter what my weight. That is no longer true. Suddenly I’m bigger on top. People tend to get thicker around the waist with age.

This doesn’t only apply to women, but as an example, look at pictures of Betty White over time. Notice what happens to her figure as she ages. She doesn’t get fat, but she gets thicker around the middle and other things shift and change. That’s part of life, and to stress about it is a waste of energy. It’s self-respecting to look the best we can, but beauty is not the most important thing in life and, as we get older, it becomes increasingly out of reach.

On the plus side, though appearance doesn’t improve with age, wisdom and peace of mind do. I may have looked better at 30, but I’m a lot happier at 54. And everybody else I know in my age group feels the same way.

But most important is this: No matter what your age, if you are healthy, you are blessed. If you’ve never been seriously ill, you don’t fully realize how blessed.

Honor yourself by looking your best, but try to keep it in perspective. It’s not the most important thing.

Please post your thoughts and experiences. I’d love to hear from you!


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