Possible trigger warning? This post talks about weight loss, but no numbers or behaviors designed to achieve weight loss. Unintentional weight loss. But I felt the need to put a little warning up because I live in fear of being triggering for someone.
I have had to have the "do you actually want to get better because it doesn't look like it" conversation twice in two days now, once with H. and once with R.
R. was pretty appalled at how much weight I've lost just in the last week. And I honestly have no explanation for it. I know it wasn't a fluke of fluctuation between last week's weigh in and this one, because I weigh myself every day and have watched it go down steadily all week, each time dropping to a new "lowest since earlier and earlier date in June" level. The only variable in my life that has changed is that we doubled my Prozac dosage a week ago. Other than that my food and exercise have been the same as for the past month. I do tend to shed weight when I'm stressed and not sleeping well -- I lost a bit without changing food/exercise after my Nana died last fall, but I was at 200% stress levels a few weeks ago and my weight didn't drop like this, so who knows. I'm not sure if R. believed me that I haven't cut my food intake.
I've been feeling pretty awful too, all the old familiar sensations that come from being in energy deficit. How can something be so scary and seductive at the same time?
Anyway, I really cannot afford to slip farther right now; I start the written portion of my comprehensive exams (I have one week to finish; 30-page limit) on Monday. I'm not worried about the material being too difficult but am worried about my stamina and focus. I guess I need to make it a priority to rest up this weekend.
That brings up the only other potential drug side effect I've noticed: I've been sleeping really restlessly. I don't have trouble falling asleep, just staying asleep after 1:00 or so. But then again, it is normal for me to wake up a few times per night and to be up for the day by 4:00. It just seems like I haven't been going all the way back to sleep after middle-of-the-night wake-ups like I typically do. Dunno. Like I said in a previous post, it's hard to tell without an experimental control for myself. I am not noticing any mood improvements so far; I completely felt like the sky was falling for a few days this week even though nothing bad actually happened. I've only been taking it for 3 weeks, though, and R. said to wait at least 6 before we start to decide if it just isn't working for me.
I hope everyone has a great weekend, love y'all.
3 comments:
I have no direct experience with prozac but have been on zoloft and celexa at various points as well as researched other ssris obsessively (hello, reasons I should be medicated) and have a couple thoughts: I think initial weight loss with prozac is not unheard of, and may stability/reverse over time. It is understandable that R (is this the dietician?) would be concerned given your history and I'm not trying to help you make excuses for being underweight, but I do believe you that you haven't changed eating/exercise habits. Also, I know prozac has a longer half-life than most of the other ssris and may take longer to have an effect. I noticed improvements relatively quickly on both zoloft and celexa (within a couple weeks, I think), but I can't swear to the timeline and my mood was so fucked up both times I caved and agreed to try meds that it's hard to say when what changes occurred, and my psych always assured me that these drugs take several weeks to really get going and was surprised when I said I felt better that quickly. ANYWAY my point is that I am not particularly surprised you haven't noticed major mood changes in just 3 weeks, esp since you've been tapering up for some of that.
Re sleep: I had horrible insomnia when I first started celexa but it went away when I started taking it in the morning instead of night. I think you said you're already taking it in the morning, but if not that would be something to try. Otherwise I do think prozac is supposedly one of the more "activating" ssris, and perhaps sleep problems would be less problematic on something like zoloft or paxil. It may also be something that improves with time as your body acclimates.
Hang in there, I know this sucks. PS I am not a doctor.
Hey there!
Could be the SSRI because everyone is different, but I would say that any permanent weight change is unlikely. Now, given my job, I see lots of people with EDs begin SSRIs and I never see weight loss (or gain) as a direct side effect. Sometimes I see a change of, at most, 2 pounds, that, like Kaylee said, stabilizes or reverses with time. So if the SSRI is causing significant weight loss (more than a couple of pounds), you'd be a rare case (in my experience that, of course, is limited). I'm more apt to believe that our weights and bodies are just weird and, really, if there's anything recovery has taught me, its that our bodies cannot be so easily figured out. The calories in - calories out formula is less reliable than we think. It's possible you have changed your eating or exercise without realizing it, but it's also possible your metabolism just shifted and you need more food even though there's no logical reason why.
I'm also interested in the conversations you had with H and R about wanting to get better. What was/is your response? I don't want this to come across as attacking or accusing. I'm more actually curious what you think about their question. I think uncertainty around motivation and recovery is totally normal - so no judgement if that's the case. It's also totally normal to want to get better in some ways but not want to get better in other ways. ("I want to feel normal but I don't want to gain weight" type of thing). And I think the answer to their question is really informative and can be a place where a lot of rich work can be done... and ultimately one of the keys in beginning to help you get traction.
I know unintentional weight loss is difficult, and I'm sorry. I will say a few things about that, and I do also absolutely believe you haven't changed your food or activity levels. As has been said, our bodies do not make sense with amounts of food and other quantitative measures. Many things can affect weight that we can't pin down.
I know this is a very stressful time for you, but I also (like Laura) am curious about your responses to H and R. To me, the drop in weight despite no changes indicates that maybe what you're currently eating isn't enough. I'm not a doctor (well, not *that* kind). Nor am I on your treatment team. I can only say that from my own experience and from what you've shared with me. I've argued this same point with my people also, and their response is: I'm glad you're not restricting, but it seems you still need to be eating more. Bodies are funny like that.
I also wonder if your sleep is indicating something about your weight or eating. It could be the Prozac, but I might also suggest it's related to your health in other ways? I really hope your prelims go well, and I hope that you get more restful sleep. Hang in there, and please know that I'm here if you want some support from me!
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