When Medicine Makes You Fat

View PDF | Print View
by: Guest Total views: 593 Word Count: 1904   

Sometimes drugs that heal your body can cause side effects that dampen your spirit. Loren Berlin, who has ulcerative colitis, writes about gaining weight as a result of a drug treatment.

By Loren Berlin

Two years ago, when I was 29 years old, I experienced my first flare from ulcerative colitis, an autoimmune disorder of the colon with intermittent cycles of disease activity and remission. I lost five pounds in less than a week, was unable to eat or drink, and was bleeding internally from the ulcers and inflammation decimating my large intestine.

My gastroenterologist prescribed prednisone, a corticosteroid that vanquished my symptoms in seventy-two hours. Literally. One day I was on the verge of hospitalization. Three days later I was no longer bleeding. It was amazing. But it wasn't free.

Prednisone is infamous in the medical community for its side effects. It can cause osteoporosis and diabetes. It suppresses the immune system and can lead to insomnia and depression. Sure, that all sounded undesirable, but I didn't worry about it. Instead, what concerned me was the significant weight most patients gain as a side effect of the drug.

My entire life, I'd felt self-conscious about my body. My hips were too wide, my thighs too flabby, my tummy too much like Winnie the Pooh's after a morning with his honey pot. So I exercised. Forty-five minutes a day, four days a week. Religiously. And I ate reasonably. Fresh mangoes, spinach salads, frozen yogurt instead of cream cake. My body tightened, but didn't shrink. After a few years of this, I learned to accept my size eight curves. No, they weren't ever going to land me on a billboard, but I felt attractive. I had a healthy body that categorically designated me a medium in department stores.

Then I got ulcerative colitis. Suddenly the treatment for my disease threatened to erase my years of laps in the pool and squats in the living room. And there wasn't much I could do about it. I needed the medicine, and the drug caused weight gain. It was that simple.

Initially I got angry. It seemed unfair that I should have to lose my hard-earned shape to regain my health. These weren't the terms I wanted to negotiate. But my gastroenterologist and my blood tests told me that what I wanted and what I needed were at odds, and needs trumped wants.

During my first few weeks on prednisone, I rebuked myself for my immaturity, for crying when my favorite jeans no longer fit, for snorting at my boyfriend when he complimented me. After about six months on prednisone, I had gained 14 pounds, a 10 percent increase in my body weight.

I scolded myself for placing so much emphasis on the superficial when I should have been grateful for a drug that could control my illness. There I was, actively worrying about my pant size while my body attacked itself. I was stunned by my own vanity.

Over time, my life regained some semblance of normalcy. I returned to my classes in graduate school and started getting dressed up for nights out with my girlfriends. The fact that I still cared about my looks meant that I hadn't allowed myself to be resigned to my disease. I still planned to be out in the world, doing my thing. And I still wanted to look good doing it.

Other medications have since put my illness into remission, and I no longer need prednisone. Exercise and healthy eating have helped me drop 8 pounds. But because my disease cycles between remission and flares, I will probably relapse. When I do, I may or may not require prednisone.

If I do, it's likely that I will once again have to cope with weight gain as a byproduct of restored health. But now, I've come to realize that my vanity, in the midst of a serious illness, isn't such a bad thing. In caring so much about my appearances, I am acknowledging that my illness is just one part of a whole person. I'm a 31-year-old woman with the same goals and insecurities as any other 31-year old woman, with or without a chronic health problem.

Ms. Berlin, who works at a nonprofit organization in Durham, N.C., has written other stories about living with ulcerative colitis. Read about her diagnosis in "When the Body Decides to Stop Following the Rules

Ms. Berlin, what a great attitude you have! I wish all patients were like you.

As for UC, what a horrible disease. Though we don't have a cure, the medicines developed over the last 20 years have allowed UC patients to drastically decrease or eliminate toxic medicines like prednisone and cytoxan.

This type of success story in US medicine is one that rarely is acknowledged in this blog. - jack



Ms. Berlin - Thank you for publishing this article - at 22, I have struggled with multiple chronic disorders most of my life that have me on long term steroid treatments as well as off and on other medicines that have made me fluctuate in weight. I do my best to control in a healthy diet and exercise but it is not always easy! I struggle with the same thoughts of "how can I be so shallow when underlying all of this is an illness that is being treated?" but it is still frustrating. I was happy to hear you say that you see yourself as the whole person - to anyone that struggles with an illness - As Ms. Berlin said, you ARE more than your disease - you are exactly what you make yourself to be. - Chronic Too



Jack thinks Ms. Berlin has a great attitude. I think she has a tragic problem.

I support her, and I admire her honesty, but her resignation of her "size 8 curves" (before her medically induced weight gain) is evidence of a crazy standard for body image.

I believe whole-heartedly in making an effort to shape a healthy body. I have no problem with legitimately overweight people undertaking weight loss and fitness, and I do not believe we should resign ourselves to fatness, if we don't want to be fat. No reason to give in to this, if one feels strongly about it.

But the drive to be THIN, as a way to force one's body into an artificial standard of beauty, is sad and an unfortunate use of someone's life energy.

This young woman is only being honest-which is a good thing-and it's understandable that she doesn't want to gain 10% of her body weight (that's enough to FEEL, just in terms of feeling comfortable with movement and feeling pressure on joints). Still, this is no way for a bright, presumably lovely (she sounds lovely) and talented young woman to expend her emotional energy.

I see my beautiful friends, and their wonderful young adult daughters, circling around this stupid wagon, and I wish so much I could influence them to stop obsessing about thin-ness and beauty. They would be equally as beautiful, with 20% less spinning (undertaken mostly to afford snacking while maintaining size 2-4 bodies) and 5 or 10% more healthy calories. But I keep my mouth shut, because it's a sacrosanct subject.

When, oh when will it end? Such a waste. - Wesley



Boy do I know how this is . at 15 I was diagnosed with Juvenile Diabetes, a disorder that causes one to scrutinize not only their weight but every bite and morsel put into their mouth. Much like the author, at 5"8 and 150 lbs I felt too curvy, too fleshy and too big. I learned to deal with it. At 19 I began to rapidly lose weight, but also an A1C level spiking higher and higher. The cause was Addison's disease, which requires replacement of the stress hormone cortisol. The skyrocketing blood sugar levels combined with the nonexistent cortisol levels were detrimental to my autonomic nervous system and a year later though my health is excellent . I have gained 35lbs. It makes me weigh (no pun intended) the odds of blood pressure and cortisol drugs and being my ideal size. The drugs always win. Good luck to the author any chronic illness is a battle from which we do not emerge sans scars. - Monica



I was reading along feeling very sorry for Ms. Berlin and picturing someone quite oversized from the descriptions of her body. Then she announces she is a size 8! She doesn't give her height, but I am 5"2' and while I am currently a size 6, that came after a late-life weight loss to combat diabetes. Most of my life I've been a size 8 or even 10 following the births of four children. I never thought I was fat or unattractive.

On rereading the article, I see less of an acceptance and more of an obsession with body image. This is very unfortunate for Ms. Berlin in general, although I certainly applaud her efforts to maintain a healthy weight in spite of the complications of her illness. - Anthro



A size 8 is not big, believe me, who used to be size 6 or 8 while in my teens and 20s. Please look at yourself, then look around you, and if you still feel too large, please find a good psychologist to help you. Even the writer Anthro (above) talks about being a "size 8 or even 10' after having four children, as if size 10 is a horror. This is not healthy, ladies. - Mary Ellen



Working in the mental health profession, I have noticed what seems like a high incidence of UC and Crohn's diagnosis in females w/ current and prior eating disorders. Is there some correlation b/w the two? (Perhaps due to use of laxatives for purging or other unhealthy means of controlling weight?) I'm not a medical professional and I have not done any research on this topic. Are my observance's just coincidence? - MSW



I have been living with ulcerative colitis since my diagnosis in June 1997 and Ms. Berlin's story is similar to mine. Perhaps what one should take away her piece is the utter loss of control one has during a flare-up when taking prednisone. Even though you know you don't need to eat, your brain continues to tell you that you are hungry and it's not easy to fight off.

I am fortunate in that I have a relatively moderate case of UC but even so I have gone on and off prednisone several times in the past nearly 12 years. Living with a chronic disease and taking medication every day is difficult, but it's something that you can accept. During a flare, you are reminded exactly how tenuous your "good" health is and how quickly you can get very, very ill. The uncontrolled weight gain is merely a symptom of the larger problem and makes you realize that no matter what you tell yourself, you are not well, you are not "normal", and you have a very serious and isolating medical condition.

Those who used this story as an opportunity to comment on the tragedy of body-image are missing the point entirely. The weight gain is a metaphor for the loss of control and the realization of your own mortality. - D

Additional information:

Ulcerative colitis
Colitis Treatment & Support
Ulcerative colitis - MayoClinic.com
Treatment of ulcerative colitis - Wikipedia, the free encyclopedia
Ulcerative Colitis , Help and Information , Symptoms and Treatment
Should I have surgery to cure ulcerative colitis ?
What is the treatment for ulcerative colitis ? Ulcerative Colitis
Ask Your Doctor About Ulcerative Colitis : Symptoms, Treatment and
Ulcerative Colitis - Treatment
MedlinePlus: Ulcerative Colitis

Related "Therapies & Treatment":

• Maggot therapy hemorrhoid hope 'premature'
  LONDON, UK - Maggots may not have the miracle h ...
• Off the Beaten Mat: An Interview with Mark Gerow of Lunarythms Yoga
  A girlfriend turned me towards the Sivananda Ashra ...
• Paula Chaney personal trainer nutrition consultant life coach
  While working as a nutrition consultant with a per ...
• 9-year-old hit by pickup attends class holiday party
  Dreelon, 9, sustained life-threatening injuries in ...
• American College of Physicians Issues Guideline for Drug Treatment
  All reproduction, other than for an individual use ...

Comments

Add Comment