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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by CareBear04 on January 22, 2004, at 20:35:45
Hi all. Sorry if this message is sort of contrary to the problem most people struggle with. I'm just wondering how much weight loss is too much? Since starting Wellbutrin, I've lost about 15 pounds. I'm 5'5 and was pretty small to begin with. Now I weigh around 100 pounds, and I feel healthy, but I've noticed that clothes don't fit well anymore, and there's not really any smaller sizes to go down to. Wellbutrin has worked really well for me, so I don't want to go off it. I've been on many other drugs that have made me fat. Since it's wintertime, no one really notices the weight loss under layers of sweaters and coats, but I'm concerned at how fast this all is happening. I try to eat regular meals, but I still lose weight. Should I wait until my doctor notices or should I bring the issue up? What do you think the doctor's response would be?
Posted by dragonfly25 on January 22, 2004, at 20:50:56
In reply to Too much weight loss?, posted by CareBear04 on January 22, 2004, at 20:35:45
it sounds like if you lose anymore you will be underweight. i would mention it to your doctor, you may need to lower the dose. i don't think your doctor will react badly.
this site can help you calculate you your BMI, normal is somewhere between 18ish and 24ish (i think)
http://nhlbisupport.com/bmi/bmicalc.htm
Posted by Dr. Bob on January 22, 2004, at 21:05:49
In reply to Re: Too much weight loss?, posted by dragonfly25 on January 22, 2004, at 20:50:56
> this site can help you calculate you your BMI...
Here's another:
http://www.dr-bob.org/tips/bmi.html
:-)
Bob
Posted by CareBear04 on January 22, 2004, at 21:34:21
In reply to Re: Too much weight loss?, posted by Dr. Bob on January 22, 2004, at 21:05:49
Thanks for the links. So they say that I'm underweight... Does weight loss stop at some point with Wellbutrin? I'm only on 150mg, which is only half of the standard dose. If I lower it further, i don't think i'll get any benefit at all, and I don't want to stop this medication since it's been really helpful. Are there other alternatives for activiating ADs? I've been through the SSRIs and Effexor. I don't want any more sedating drugs. It seems like all that's left is the MAOIs, and I'm not sure I could get them prescribed. I haven't been suicidal in awhile, but I have made serious attempts in the past, so I would understand if no one wants to be responsible for giving them to me. Any alternatives I'm missing? I don't want to talk to my pdoc unless I know there's something out there that can work as well as WB.
> > this site can help you calculate you your BMI...
>
> Here's another:
>
> http://www.dr-bob.org/tips/bmi.html
>
> :-)
>
> Bob
Posted by dragonfly25 on January 23, 2004, at 8:22:48
In reply to Re: Too much weight loss?, posted by CareBear04 on January 22, 2004, at 21:34:21
i think the weight loss will stop in time, but make sure you don't lose much more. i lost about 10lbs on wellbutrin and another drug, now i don't have that problem anymore. i had to make a point of eating. do talk to your doc about this though. just make sure you eat even when not hungry, so you don't skip any meals.
Is the wellbutrin making you nauseaus at all? or has it just taken your appetite aeway?
dragonfly
Posted by leegirl on January 23, 2004, at 9:32:56
In reply to Too much weight loss?, posted by CareBear04 on January 22, 2004, at 20:35:45
I lost about 15-17 pounds while on Effexor. I just couldn't bring myself to eat, or I could only tolerate specific foods like yoghurt or fruit. Anorexia is a documented side-effect with many anti-depressants. I had the same problem with Prozac, only not so severe or long lasting. I did inform my Doc about the weight loss, but he didn't seem too concerned (splendid fellow...that's sarcasm)
Posted by metalflipflop on January 23, 2004, at 17:12:41
In reply to Too much weight loss?, posted by CareBear04 on January 22, 2004, at 20:35:45
dear carebear,
reading your post was so nice for me (sorry, not b/c you are having a tough time with this), but b/c i am going through the exact same thing. i am on zoloft, lamictal, and cytomel, and i have had awful problems trying to eat. i am 5'6 and down to 109 (well, up to 109). the worst part is that depression/PTSD made me not want to eat, and now what's helping it makes me not want to eat too. for me i think it's the lamictal, which has been pretty activating and also made me a bit nauseated.
my nutritionist (i am recovering from a bout of trauma-induced anorexia--bad timing for all this) suggested for nausea and lack of appetite to try 'multi-enzyme formula'--digestive enzymes that can help your stomach get to the hunger point better and metabolize food faster so you can eat more. she also told me to drink boost or some other supplement drink. if you mix them with milk, they aren't that bad...
also you can write out a meal plan for yourself in the morning and try, try, try to stick to it throughout the day. your weight is quite low, even if you have a small frame. i wouldn't recommend trying something like remeron though, which basically just makes people really want to eat. i did that for a few days and was SO sedated (though i slept wonderfully), and i started to crave carbs. so it wasn't just wanting to eat more in a balanced way, it was like, Sugar! Chocolate! Doughnuts! NOW! anyway, i'm on enough drugs!
so i think what's really important is to get as much protein as you can, and go for calorie-dense! for me it is finally getting better as i have adjusted to all these foreign substances in my body.
good luck, and if you have any good tips let me know.
liz
Posted by BackOfClass on January 23, 2004, at 20:52:03
In reply to Too much weight loss?, posted by CareBear04 on January 22, 2004, at 20:35:45
This is something I have struggled with my whole life but thanks to Zyprexa I wiegh more then ever. This may seen extreme, but ask your doctor to consider the drug Oxandrin. That will help. :)
Posted by CareBear04 on January 25, 2004, at 11:11:51
In reply to Re: Too much weight loss? ?CareBear04, posted by metalflipflop on January 23, 2004, at 17:12:41
hey liz,
thanks so much for your advice. it's really good to know that i'm not the only one in this situation. i'm also on a ton of drugs (6 prescribed by my pdoc and 3 more for other conditions). i've never been on lamictal, but i'm on zoloft, too, and i think it's pretty appetite-suppressing. and no matter how much it might be good to gain some weight, i hate being on drugs that make me blow up like a balloon (eg, depakote, zyprexa...) there's something unnatural and disturbing to me about gaining weight that way. i've also had body image issues for a long time. i know i'm not fat, and even though i know i shouldn't be losing this much weight, i still get anxious when i gain weight, though i don't restrict food or purge or anything. you said you see a nutritionist? what happens at those appointments? is it generally supportive, or is it like YOU MUST GAIN WEIGHT?! i just started seeing a new pdoc, and i don't yet feel comfortable talking to him. should i see my primary care dr and ask her for advice? i'll let you know if i find anything out. thanks again!
cb> dear carebear,
> reading your post was so nice for me (sorry, not b/c you are having a tough time with this), but b/c i am going through the exact same thing. i am on zoloft, lamictal, and cytomel, and i have had awful problems trying to eat. i am 5'6 and down to 109 (well, up to 109). the worst part is that depression/PTSD made me not want to eat, and now what's helping it makes me not want to eat too. for me i think it's the lamictal, which has been pretty activating and also made me a bit nauseated.
> my nutritionist (i am recovering from a bout of trauma-induced anorexia--bad timing for all this) suggested for nausea and lack of appetite to try 'multi-enzyme formula'--digestive enzymes that can help your stomach get to the hunger point better and metabolize food faster so you can eat more. she also told me to drink boost or some other supplement drink. if you mix them with milk, they aren't that bad...
> also you can write out a meal plan for yourself in the morning and try, try, try to stick to it throughout the day. your weight is quite low, even if you have a small frame. i wouldn't recommend trying something like remeron though, which basically just makes people really want to eat. i did that for a few days and was SO sedated (though i slept wonderfully), and i started to crave carbs. so it wasn't just wanting to eat more in a balanced way, it was like, Sugar! Chocolate! Doughnuts! NOW! anyway, i'm on enough drugs!
> so i think what's really important is to get as much protein as you can, and go for calorie-dense! for me it is finally getting better as i have adjusted to all these foreign substances in my body.
> good luck, and if you have any good tips let me know.
> liz
Posted by metalflipflop on January 25, 2004, at 21:47:28
In reply to Re: Too much weight loss? » metalflipflop, posted by CareBear04 on January 25, 2004, at 11:11:51
hi cb,
okay, well, my nutritionist and i had something of a love/hate relationship for a little bit. mostly b/c, i went in there, really nervous, got my body comps done, gave her a food log, and she was like, "yeah, you have a problem--yeah, you better do something." it was so aggressive, i was like, screw you, i'm never coming back. once i calmed down though, and my therapist talked to me, i did realize that she is really competent, especially at helping people with mood and anxiety disorders gain or lose weight, working with medication and all.
nutritionists can be annoying sometimes though, in my experience...
but i go every few weeks, first she weighs me, then measures my body composition with electrodes on me via a bio-electrical impedance machine. it spits out percentages of body fat, lean tissue, and level of hydration. i used to make food logs all the time, got SO sick of it, so now we just talk about how it's been going, when during the day i have the most problems eating, what i'm lacking in my diet etc.
it's good to have someone to report to sometimes. it also helps me with not being afraid to gain weight, b/c i get reality checks from her. you could ask your pcp for referrals, since she knows your situation pretty well.
good luck (i'm eating pizza).
liz
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