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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by NikkiT2 on September 6, 2002, at 17:57:25
I have an appointment next week with my doctor about my weight. I've put on an hell of alot over the past 3 years of ssri taking. I have also developed a buffolo hump that he is concerned about. As such he wants me to lose some weight asap and see how this affects the hump.
Anyway, I'm not keen to try Xenicol (thats what its called in UK anyway) due to its side effects such as "leaking"oil... What are my other options out there??
Thanks all
Nikki
Posted by bark23 on September 7, 2002, at 14:56:24
In reply to Prescription Slimming aids, posted by NikkiT2 on September 6, 2002, at 17:57:25
Well you could try the amphetamines or similar chemicals like phentermine or diethylpropion. Some docs are not to happy about prescribing these though, especially if you have a history of drug abuse. They can also cause a lot of anxiety and agitation if youre prone to that. The anorectic benefits are also relatively short lived. Fenfluramine, a serotonin releasing med, is a bit better both in terms of both drug abuse and agitation, but might be dangerous in combo with an SSRI (although not necessarily so). Sibutramine (sp?; well its Meridia in the US) releases serotonin and norepinephrine (and possibly dopamine to some extent) and is also better in terms of drug abuse, but I would think the same caution applies that I mentioned with fenfluramine. Meridia, fenfluramine, phentermine, and diethylpropion are all schedule IV instead of II in the US, which is the case for a lot of the others, so your doc might be more open to trying those if not the traditional amphetamines. (I dont know how they do it in the UK, but here the lower the #, the higher the abuse and/or dependance potential is) The benefits of some of these might last longer. There is also an anticonvulsant out there called topiramate (topamax in the US) that causes weight loss. It also is a good mood stabilizer for some people, and has no abuse potential, although can cause agitation in a small # of people. It may cause cognitive problems in some people though. All these meds can actually boost your response to your antidepressant too. Hope some of this helps.
matt
Posted by Ponder on September 11, 2002, at 13:15:10
In reply to Prescription Slimming aids, posted by NikkiT2 on September 6, 2002, at 17:57:25
Nikki,
What do you mean by a "buffalo hump?"> I have an appointment next week with my doctor about my weight. I've put on an hell of alot over the past 3 years of ssri taking. I have also developed a buffolo hump that he is concerned about. As such he wants me to lose some weight asap and see how this affects the hump.
>
> Anyway, I'm not keen to try Xenicol (thats what its called in UK anyway) due to its side effects such as "leaking"oil... What are my other options out there??
>
> Thanks all
>
> Nikki
Posted by NikkiT2 on September 11, 2002, at 14:55:13
In reply to Re: Prescription Slimming aids » NikkiT2, posted by Ponder on September 11, 2002, at 13:15:10
A hump forming at the top of your spine... often seen in "older" ladies as s sign of ostearoposis (sp!)... but I'm only 27
Nikki
Posted by utopizen on September 11, 2002, at 16:52:21
In reply to Re: Prescription Slimming aids » Ponder, posted by NikkiT2 on September 11, 2002, at 14:55:13
I heard of a good diet doctor in the Bronx... he was featured in Requirem for a Dream. He did work wonders on that old lady in it... =)
Posted by Ponder on September 12, 2002, at 5:01:07
In reply to Re: Prescription Slimming aids » Ponder, posted by NikkiT2 on September 11, 2002, at 14:55:13
> A hump forming at the top of your spine... often seen in "older" ladies as s sign of ostearoposis (sp!)... but I'm only 27
>
> NikkiNikki,
I am sorry you are having to deal with this. These psych meds can really play havoc with your weight, energy, etc. For me, the illness itself causes weight gain as well. What a battle!Lamictal has been great for me in that respect. I have lost all my Effexor weight and am down 40 pounds or so in the last year since switching to Lamictal. Obviously, it doesn't work that way for everyone, but it's been very effective in releiving my depressive symptoms and normalizing my weight.
Has your doctor done a bone mineral density test to see if you ARE developing some osteoporosis? As I understand it, the test is relatively cheap, quick, and painless.
Anyway, best of luck with it all. I hope your doctor can figure out something other than diet pills. They just don't work for long. An adjustment in your meds would seem like a better idea to my way of thinking.
Posted by utopizen on September 12, 2002, at 6:50:28
In reply to Re: Prescription Slimming aids, posted by Ponder on September 12, 2002, at 5:01:07
Anyone buy a book called "Realizing the Law of Thermodynamics: What It Can Mean for Your Weight Loss Plan"?
Of course not, since it would be two sentences long. That's boring.
I'm a great believer in using prescription drugs to help out conditions, but I thought I'd like to share something I came across with all of you while I was reading a medical article about the history of weight loss drugs.
I am, and always will be, a metabolic machine. I try to eat as much as I can, but no matter what I always remain the same weight- about 170. Which sounds big, but believe me, I'm very thin, 6'3'', and have been referred to as "scrony" (even though I have a "natural cut" complex of muscles in my extremeities, these are hidden in clothing).
I'm also vegan, which people try to coorelate to my weight, as if I don't know what I weighed when I was a nonvegan. It didn't change a pound in my weight, even when I ate meat. But I still recommend others to go vegan or vegetarian with a high emphasis on dairy/cheese avoidance. It may help you if you are already overweight, as vegetarians in general average a 10 lb. weight differential from the population.
Just avoid the Atkins Diet, since the American Heart Association considers it damaging to the heart and the American Kidney Foundation (or Assoc.?) considers it damaging to the kidney. That's two respectable ambassadors to my organs I try to listen to.
Anyway, the article I read, which was written by an M.D., said much of the problem is that Americans do not receive reminders that the only proven way of losing weight and keeping it off is to burn more calories than they intake. The American Heart Assoc.'s head dietician said this as well.
Television networks, according to this report, avoid reminding the public this because they receive a heafty portion of food industry ads that rely on over-eating habits. If you don't believe it, go to consumerfreedom.com. The group receives millions in funding from companies in industries including the food industry to do nothing but appear in the media as "defenders of consumers" to try to fight off people trying to battle over-eating in America. This is an organized over-eating machine from ABC to KFC.
While I can't tell anyone not to do, I would like to simply offer a reminder that you are in control of what you can do with yourself, not me or anyone else.
And despite watching Oprah and other shows that have showed obese people stuffing donuts as they voiceover on the broadcast how they're physically addicted to over-eating, the fact is there's no special gene that physically causes someone to grasp a donut and shove it into their mouths... and the obesity epidemic is largely new in this country, with only a 20-year history at this point.
So obviously, we as Americans are over-eating. Please do not confuse this post as implying that -you- are overeating, since I am passing no judgements on anyone on this board. But medical speaking, I believe the very term "over-eating" simply means that you are intaking more than you are burning off. So it's a neutral term in the medical world, even if it sounds like a loaded word...
So exercising iand going veg is great, since they will help your cholesterol and organ systems as much as your weight. Plus vegans enjoy the added benefit of feelings a bit better about themselves morally, a good thing for those who have depression.
As rough as some presciptions are, I would at least advise you to avoid non-prescription diet aids as much as possible, since they receive even less review and control.
Just remember, burn more wood than you cut. I know it sounds overly simplified, but it's a point that requires emphasis because the television shows try to make you think this is too simple, and that a more complicated approach is necessary, and that there are genes that make food physically addicting, and that you need to be "empowered" and "feel good about yourself" and all of that anti-scientific nonsense.
The fact is, the obesity epidemic is new, and people in other countries don't have different genes than we do.
(Note: referring to the obesity epidemic is a general reference to measuring over-eating, and does not imply you are obese).
I'm sure none of you would listen to Oprah if she tried to give you advice on an AD... it is as equally anti-scientific for her to suggest someone can sidestep the Law of Thermodynamics with motivational empowerment bunk.
Thanks for listening. I have to say I can't know what it's like to be overweight, and I just try eat as much as possible because I require 3000 calories a day to keep my system healthy. So hopefully any words like "obese," "over-eating," or "anti-scientific" were understood as words of neutrality, as I like to call their context.
And most important, please remember the only thing you can do to empower yourself is listen to science, and not a show that tells you what to eat before they break for a KFC ad that pays them to say that.
Posted by Ponder on September 12, 2002, at 11:52:20
In reply to Re: Prescription Slimming aids » NikkiT2, posted by bark23 on September 7, 2002, at 14:56:24
Matt,
Do you happen to know if Topiramate induces weight loss when taken in small doses? If a person were doing OK on their medications with the exception of weight-gain, would the addition of a very small dose of T. allow the benefit of weight-loss without causing the "dumbing" effect?
Posted by IsoM on September 12, 2002, at 12:53:17
In reply to Prescription Slimming aids, posted by NikkiT2 on September 6, 2002, at 17:57:25
Nikki, question your doctor. Weight gain & that 'buffalo hump' can be caused by an overproduction of cortisol if your adrenal glands or pituitary is out of whack. Sometimes, meds can affect endocrine glands in some people. Don't just let your doctor assume it's osteoporosis. Make him check it out. Get a referral to an endocrinologist if necessary. There are tests that can be done cheaply, measuring hormone levels by blood tests.
Check out this from MEDLINEplus & click on the hyperlinks too, to read more if you suspect it may apply to you.
http://www.nlm.nih.gov/medlineplus/ency/article/003112.htm
It doesn't sound logical to expect bone loss that severe at your age - not enough to cause the osteporosis hump at 27.
Posted by sjb on September 13, 2002, at 13:39:39
In reply to Re: The Law of Thermodynamics, posted by utopizen on September 12, 2002, at 6:50:28
I think most of us know that overeating is not a good thing to do. I also think that most of us, esp.women, know the caloric content of just about every food item and have read a ton of information of the subject.
However, I don't think it is that simple for those of us who struggle with weight/food to simply say we have the power to reach for the food or not. You have never had a weight problem, (thank your Lucky Stars!), but you are here on this board for I guess, at the least, depression. Would you tell anyone on this board struggling with depression to "pull themselves up by the bootstraps"? I doubt it. We hear this from well meaning folks who don't have a clue what depression is like and I know when I hear it, I want to scream. Most who have experienced depression know that is not that easy to "snap out of it" and would never advise another depressive with these phrases.
Because you never have had a weight problem, I would guess that you have never gone on a diet which usually includes, forbidding certain foods, retricting, trying to supress hunger, etc. I believe that's where a lot of problems start. I think it somehows screws up your satiety brain set point or something.
I know I never had "a problem with food" until I tried dieting. I have since battled a problem with binge eating. When the urge hits, yes, I'm the one who picks up the food and stuffs it in my mouth, but the cravings are so overwhelming, I just can't describe it how much I'm NOT in control. It's like a monster inside me takes over and my only focus is to get the foods I crave and binge on them. I've tried all the tricks, call a friend, go for a walk, wait a certain amount of time, etc. but my ENTIRE thought process is on that food and I can't stop thinking about until I get it. It's feeling that I would knock down my own mother if she were in the way of me getting to that food.
If everything were as simple as you say, there would be no addiction of any kind, including sex, gambling, alcohol, drugs, etc. Most folks in the throws of addiction are not stupid. Most alcolics know that excess alcohol is not a healthy endevour. This is not a education problem, per se, at least for most of here in modern America. Would you tell an alcoholic to "just say no"? Don't get me started on Nancy Reagan.
There remains debate on weather food addiction belongs with the other addictions and I can't say I have totally concluded what side is right, maybe one or the other is right depending on the individual. Most nutricians I have dealt with maintain that there is no "bad" food, however OA and others of the addiction model disagree. A lot of those that come down on the addiction side say flour and sugar are to be totally avoided. As an endurance athlete, I have a problem with that. These things are often a useful aid in recovery from a hard workout.
However, I have also found that there are many items that I binge on that I have difficulty eating in moderation. I would love to be able to totally avoid these items, but have not been able to do so. If it's willpower problem, well, than I admit I have a weak one.
I'm rambling all over that place hear but I think I've made my point that simply "saying no" and not picking up the food is too simplistic for some of us.
Posted by utopizen on September 13, 2002, at 14:19:20
In reply to Re: The Law of Thermodynamics, posted by sjb on September 13, 2002, at 13:39:39
Please take note of the terms of civility that is available on this board.
I also suggest opening further comments in this thread to psycho-social if they dwell overly so on non-medicative approaches to eating.
Please note the following comments are in no way, implied or not, directed towards you or anyone else on this board suffering from an over-eating disorder of any kind. They are simply clarifications of the assumptions you appear to have made on my behalf.
-----
>>
> Because you never have had a weight problem, I would guess that you have never gone on a diet
>>
Go vegan. Then ask every chef at every place you ever go out to eat if they use animal products in any part of their food making, including the touching of animal products in their preparation. So yeah, I guess you could call this a "diet," only it's not as supported as most others...I do not eat animals, and do not appreciate others over-looking the fact that I take every effort to ensure this fact remains at each meal.
And please, do not suggest that I ever targeted this post to women. I never even mentioned gender in my post. Men also have over-eating issues as well.
Part of what helps this board thrive is a certain regard for each other and our collective values. It may benefit you to explore these values on the Psycho-Social board.
Thank you.
Posted by bark23 on September 14, 2002, at 0:44:05
In reply to Re: Prescription Slimming aids » bark23, posted by Ponder on September 12, 2002, at 11:52:20
Unfortunately Ive read its really only apparent at around 200mg. But you might be one of the many to not be cognitively impaired.
> Matt,
> Do you happen to know if Topiramate induces weight loss when taken in small doses? If a person were doing OK on their medications with the exception of weight-gain, would the addition of a very small dose of T. allow the benefit of weight-loss without causing the "dumbing" effect?
Posted by utopizen on September 14, 2002, at 17:43:30
In reply to Re: Prescription Slimming aids » Ponder, posted by bark23 on September 14, 2002, at 0:44:05
Everyone should use Desoxyn for the rest of their life.
The FDA has approved Desoxyn for weight loss in the first few weeks of treatment (no diet aid has ever been approved for a longer duration), but doctors are not bound by this... so take methamphetamine, please.
Posted by sjb on September 16, 2002, at 11:14:27
In reply to Re: The Law of Thermodynamics, posted by utopizen on September 13, 2002, at 14:19:20
I apoligize if you some I my message offended you personally. That was not my intention.
I did not think your post was directed at women and I well aware that many men also have food and weight issues. However, I think we can all agree that women, in general, seem to agonize over it, perhaps, in part, due to media images, pressures, etc.
My basic point was that most of us educated in good nutrician.
Posted by NikkiT2 on September 18, 2002, at 15:31:49
In reply to Osteoporosis not only cause of buffalo hump... » NikkiT2, posted by IsoM on September 12, 2002, at 12:53:17
I had the cortisol test last month - the 24 hour urine test. It didn't show anything up... he also did a full blood work up (thyroid, testosterone etc) which showed nothing either.
Could it be just due to weight gain?? I haven't seen it on anyone else my size / shape though
Ta
nikki xx
Posted by NikkiT2 on September 18, 2002, at 15:34:49
In reply to Re: The Law of Thermodynamics, posted by utopizen on September 13, 2002, at 14:19:20
I'm already vegetarian... I'm not willing to go vegan as I feel my diet then would get unhealthy...
nikki
Posted by IsoM on September 18, 2002, at 16:03:22
In reply to Re: Osteoporosis not only cause of buffalo hump... » IsoM, posted by NikkiT2 on September 18, 2002, at 15:31:49
"Could it be just due to weight gain?? I haven't seen it on anyone else my size / shape though."
Exactly - that's why it doesn't seem to make sense that it's osteoporosis. If he did a full blood work up, ask if he checked the parathyroid glands too. They're responsible for the control of the levels of blood calcium.
27 & osteoporosis? - I've NEVER heard of it & I've read of lots of very unusual medical problems. I love these medical puzzles you can read about in science or medical journals 7 most times, I know the answer, being familiar with them.
Just how much weight gain has happened with you? And is the weight evenly distributed or is it in unusual places or any particular pattern to the distribution?
Posted by IsoM on September 18, 2002, at 16:29:51
In reply to Re: Osteoporosis not only cause of buffalo hump... » IsoM, posted by NikkiT2 on September 18, 2002, at 15:31:49
Nikki, got thinking & realized it would be easier for you to read some info & decide directly if any of it does apply to you rather than me trying to second guess your symptoms.
Check over this site on Lipodystrophy, changes in body fat distribution & body shape. It's related to taking HIV meds but that doesn't imply all people having this change are taking HIV meds. The info is still good for others. And check out the different hyper-linked Fact Sheet 108 on blood tests:
http://www.aidsinfonet.org/553-lipodystrophy.htmlYou may even want to check out this about the parathyroids & osteoporosis:
http://www.endocrineweb.com/hyperpara.htmlBut a common expression told to medical students is
"If you hear hoofbeats, think horses, not zebras." (unless you live in Africa!)
In other words, the hump may just be from gaining too much weight. If you're vegan, is there a reason for your weight gain (poor eating habits, too much food, too high fat intake, etc) that would explain why you've gained weight? Most vegans & vegetarians aren't overweight as their diet is much healthier & lower in fat than most.
Posted by NikkiT2 on September 19, 2002, at 6:46:30
In reply to Re: Osteoporosis, buffalo hump, a little more... » NikkiT2, posted by IsoM on September 18, 2002, at 16:29:51
Thanks for all of that... I'll get to reading the links now.
I've put on 5 stone very quickly... not sure why.. I know my cheese intake is a little higher than it oculd be, but other than that we have quite a healthy diet. My husband eats alot more than me and has lost some weight... strange!!
Doc has prescribed xenicol now to try and get some weight off to see what happens to the hump..
Nikki xx
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