Weight gain with hormonal therapy

EnuffZEnuff

I sought out a weight management dr to help with my weight gain. I had seen a nutritionist before and she said 1000 calories daily - drop the carbs and sugar work out 3-5 times a week. Did that and No weight loss.

The new dr put me on a thyroid medicine to regulate my metabolism and dropped me to 750 calories daily. At first you think that's crazy I will starve but you don't.  When you measure out 2-3 cups on low-calorie veggies and fruits you cant eat all that is on your plate.  I also eat 3-5 oz of meat in every meal, plus yogurt, eggs and cheese.  I splurge too when I want (mexican food or Starbucks coffee) just not every day.  I agree with the comments about life style change is a factor.

The hardest thing for me has been drinking half my weight in ounces of water. I weigh 160, so I need to drink 80 oz. minimum.  If I do extensive exercise especially in this Texas heat - I add another 20-30 oz.  I average 60 when I don't focus on my intake. 

The other big issue is dr. discovered being on Tamoxifen has now made me Insulin Resistant (prediabetic) - which leads to weight gain in the mid section, so I take Metformin for that and cut out foods that quickly convert to sugar (like processed foods, white bread, white rice, potato, sweets, soda ...)

If you have tried everything talk to an Endocrinologist about evaluating your metabolism and how to jump start it.

Iwannacookie

Enuff--I am shocked that your doc would ask you to only take in 750cal a day.  It was my understanding that a woman needs at least 1250 cals just to fuel basic tasks.  How do you feel?  Do you have enough energy?

Anonymous

I'm guessing that when goal weight is reached, the 750 cals will have to be modified. My MO told me that the older we get the less calories we need. 1250 might be minimum for a 35 year old, but (and I don't know for sure) as we age, that # might not be right.

Someone else on these boards said she eats 800 cals a day and able to keep her weight down that way; she's on hormonals.  For sure, it takes a lot more exercise than we think to burn off calories.  Walking the dog 30 min for an average 145 lb woman e.g. only burns 95 calories.  1.5 hours of bikram yoga burns anywhere from 400-500 cals for a woman like me (132-134 lbs).  

Something to think about.

enjoyevrymoment

I have always heard that you should never go below 1200 calories, but that is what I am taking in and it sure isn't working.  I weigh 186, was 179 when diagnosed Feb 19, did not gain until a few weeks after starting Femara and have been religious in measuring intake and exercising.  Obesity is a risk factor for breast cancer.  Gosh.  I want to keep my immunity up and get enough protein etc but how in the world... I am making an appt with a dietician.  My TSH is normal so I don't think I will see an endocrinologist at this point.  I am intrigued by the lower calorie days idea, if you get at least 1200 the other days?   Best wishes, everyone!  Thanks for sharing this thread.  It is good to know I am not alone.  While I am keeping it in perspective and know that many of us wish that was all we had to be concerned with, it is still a health concern and one we have to at least try to fight against. 

momswarrior79

my experience so far with Tamoxifen:

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Posted on: 6 hours agoReport this Post

USAJoined: Sep 2013Posts: 8

Kleenie wrote:

I have been on Tamoxifen for almost a year and a half.  I have been overweight for quite a few years now.  When I got cancer and before I went on Tamoxifen I gave up drinking beer.  At first I lost a little less then 15lbs.  I ended up gaining that back after going on tamoxifen.  I am now seeing a nutritionist and being very careful of what I eat.  I am not losing anything.  I haven't been really exercising which I know would probably make a difference but the diet the nutritionist has me on should drop weight even without exercise. Is there any link between Tamoxifen and not being able to lose weight.  I am also on a low dose of Celexa to help with the symptoms from the tamoxifen and over all menopause issues.

I know I need to start some form of exercise.  I have foot and knee problems so it makes it difficult and limits what I can do.  

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bluepearlPowell River, B.C.Joined: Aug 2011Posts: 558

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5 hours ago bluepearl wrote:

Tamoxifen can affect weight issues. When farmers want to fatten up cows, they GIVE them estrogen! So, some women actually lose weight. celexa is weight neutral. (I am on it too). Sometimes I think STRESS alone can either keep us from losing weight or gaining it.....something to do with cortisol levels, a stress hormone. I have found the only "diet" that works for me is limiting simple carbs (bread, white foods, sugar etc), if not eliminating them and even with good carbs, keeping them limited, and eating fruits, vegetables, lean meats such as chicken/fish/turkey, and low fat diary products to be helpful, as well as one or two days, just protein (I use whey powder drinks 2x per day as whey powder can help lose belly fat). I like to have, on Friday night, a small bowl of strawberry swirl ice cream. I have lost 10 pounds. I also walk 1 mile a day (I still do this even with my shingles outbreak which is crappy!!!) and make sure you get decent shoes!!!! I love EArthSpirit; they saved my feet!!!! If you can afford an elliptical exercise machine, they are RECOMMENDED for knee pain. I couldn't go up steps without pain...after using the elliptical 15 minutes a day, starting slowly, my knees are back to normal! (((HUGS)))) This stuff is so hard for us.

Dx 1/6/2011, IDC, 1cm, Stage I, Grade 1, 0/7 nodes, ER+/PR+, HER2-Dx 2/2013, IDC, <1cm, Stage I, Grade 3, 0/3 nodes, ER+/PR+, HER2-Surgery 02/12/2011 Mastectomy (Left); Lymph Node Removal: Axillary Lymph Node Dissection (Left)Surgery 03/10/2013 Mastectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection (Right)Hormonal Therapy 03/18/2013 Tamoxifen

KleenieUSAJoined: Sep 2013Posts: 8

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4 hours ago Kleenie wrote:

Thank you so much for replying.  The nutritionist has me on a veg/protein diet for the time being.  So I am pretty much not eating carbs.  I also drink a protein drink once a day.  Did you find you needed the exercise to get the weight moving?  I am going to have to get myself moving.  It is so hard when your in pain but I know in the end it will help my knees.  I find if I use a stationery bike it helps.  So sorry to hear about the shingles.  My friend had them and it was awful.  Hope you are doing better.

Dx 11/16/2012, ILC, <1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+, HER2-Radiation Therapy ExternalSurgery 11/29/2012 Lumpectomy (Left)Hormonal Therapy 04/14/2013 Tamoxifen

shoppygirlCalgary, AlbertaJoined: May 2013Posts: 484

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4 hours ago shoppygirl wrote:

kleenie

I lost 20 lbs right after my dx as I completly changed my eating habits.That put me at my perfect weight.  Fast forward to a year later post chemo and ooph, I have gained 15 lbs back. I do excersise and watch what I eat but the weight is not moving. I am also 43 years old and in full menopause. I am sure the Tamoxafin and the ooph is the reason. My mother had bc 20 years ago and went from 96lbs to 170lbs after Tamoxafin. 

So I do believe that this drug is the cause of weight issues. 

I try not to get too down about it and remind myself that at least I am still here!  Lol!! 

Less than 2mm of cancer in the sentinel lymph node.

Dx 1/27/2013, IDC, 2cm, Stage Ib, Grade 2, 1/3 nodes, ER+, HER2-Surgery 02/28/2013 Mastectomy (Both)Chemotherapy 04/09/2013 Cytoxan, TaxotereHormonal Therapy 08/12/2013 TamoxifenRadiation Therapy 08/20/2013 ExternalSurgery 01/30/2014 Prophylactic Ovary Removal (Both)

KleenieUSAJoined: Sep 2013Posts: 8

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2 hours ago Kleenie wrote:

shoppygirl

My mom put on weight from tamoxifen too.  she was 76 or 77 when she went on it.  she also ended up with alzheimers.  Not sure if there is any connection or not.

Its very discouraging with the weight.  I'm 53 so I'm sure age has something to do with it too.  I agree I tried to not dwell also.  Glad to be alive. 

Dx 11/16/2012, ILC, <1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+, HER2-Radiation Therapy ExternalSurgery 11/29/2012 Lumpectomy (Left)Hormonal Therapy 04/14/2013 Tamoxifen

momswarrior…Bloomingdale, Illinois USJoined: Jan 2014Posts: 5

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20 minutes ago momswarrior79 wrote:

I know this is a big concern for a lot of us using this drug. Going through treatment alone has caused me weight issues. Issues I clearly didnt have prior to diagnosis. This has been the only drug I have ever feared starting. Back in May I was convinced I would have to deal with the 20+ pounds of weight I gained on chemo. Pissed because I believe that you have to have quality in your life. I didnt want to beat cancer and then be fat and miserable.  I researched and looked for ways on the internet to help me loose weight on Tamoxifen.  Those leads, as most of you already know, werent too promising. I wanted to share what has worked for me these past 2 months. I started using a program through Beachbody called Chalean extreme. She focuses on building muscle. The vidoes are roughly 35 minutes. I complete out my hour long workout with a run.  Right now its 2.4 miles. I also have taken to eating as clean as possible. My diet rarely changes but I do sneak an occasional bad thing. Who cant?? Im staying away from carbs that are high on the glycemic index.  If I do have any starches like bread or such it is whole grains. I cut out all sugar and pop and drink 80+ oz of water a day. By doing this alone I am down 17 pounds and multiple inches with the program and 26 total from April!!! I did recently purchase Beachbodys 3 day refresh (its like a body reset) and Shakeology. I cannot tell you yet my results from adding the Shakes into the mix but I can tell you I have seen what it has done for people.  The results are there!! I lost a total of 2.5 pounds on the refresh and an inch off my waist.  I help care for and educate people in my every day job but felt like I could do something more. So I decided to become an independent beachbody coach. Hoping my story will inspire others. We are all fighters and if this is what I was meant to do with my cancer journey then so be it. I keep you posted on my week results from the 3 day refresh. If I can help in any way please dont be afraid to message me. I would love to!!!!! 

Rdrunner

Body composition is very important, the more muscle you have the more energy you burn even at rest. For hormone positive breast cancer you want to decrease the amount of body fat not necessarily your weight.. muscle weighs more than fat

enjoyevrymoment

Good point Rdrunner, we are more than just a number on the scale, and weights can actually cause muscle fibers to swell and you can see a bump up in the number on the scale which doesn't mean always that you gained fat.  I am noticing far more cellulite and I am thinking I have gained fat even though the number is not significantly different than pre surgery and hormone therapy.  So weights and cardio and reduction of calories are all being done to try to get back on track. 

Anonymous

Actually (not to split hairs) a pound of muscle weighs just as much as a pound of fat, so muscle can't actually weigh more (remember the pound of air and pound of feathers experiment--it's all about the volume). But I get your drift--muscle volume takes up less space, so that you may lose inches, theoretically, but not lose weight as you build more muscle.

Claire in AZ

enjoyevrymoment

Thanks Claire, I was too tired to say that but I knew what our little Rdrunner meant.  Billie Jean King weighed 150 lbs but was all muscle and looked like she weighed far less.  There are people whose number isn't terrible but they have very low muscle mass.  So there is more to the whole pony show than what the number on the scale reads.

Shoot, I am thrilled to be alive and getting healthier in some areas, and we are all doing what we can, one step at a time.  Yipee for us!

Delvzy

hi girls just to join this discussion I finished 5 years of Tamoxifen and put weight on after I went off it. I now have 2kg of weight (mainly tummy ) to lose before our summer. Specialk I may have to follow your anti inflammatory diet and be a bit stricter. I have been nibbling constantly on sweet stuff and found it is really mucking me around at night with restless legs and weight gain Judy 

enjoyevrymoment

Good for you Delvzy for catching it before it is a runaway freight train.   

Claire_in_Seattle

I have not gained weight on anastrazole, and have minimal side effects. I also eat like a horse. But this is because I EXERCISE.

I also disagree with those who say that muscle loss is inevitable. Not if you make sure you do strength training. To give you an idea, I did weights, crunches, and a 5k run yesterday. I will do a 25 mile bicycle ride today. I do x-country skiing in the winter, and the odd hike.

I am fit and toned, and I am in my mid 60s.

But all of this takes discipline. It's like "paying yourself first" for saving. I make sure I schedule exercise into my life. I don't do gyms, but I do have 10lb weights and an exercise ball at home. I made sure I moved to a place with running/walking trails and where it's safe to do a 2 mile walk after dark. I am self-employed and typically work 50 hour weeks.

The new guy I am seeing is also an exerciser, but we won't be doing the ride we planned because he just trashed his knee rollerblading. (Which I don't plan on doing.)

I have also discovered exactly how much exercise I need to do and eat anything I want. It's 50-60 miles of cycling and 12 miles of walking/running per week. So probably burns at least 5000 extra calories. This means I can eat about 700 calories more per day than if I just sat on my butt. And I think it would be difficult to get all the nutrients I need if I didn't do a fair amount of exercise. On top of this, I am drinking wine and having the odd piece of pastry, butter on my potato, etc.

So my recommendation would be to up the exercise. Just so important for all of us. And I expect to continue to exercise once I finish the 5 years in eight month's time. Meanwhile, it's fun to be stronger and fitter than ever, plus all the great stuff I get to see cycling. - Claire

enjoyevrymoment

Thanks Claire I agree with you, muscle loss is not inevitable.  Very motivating.  

TwoHobbies

I was able to lose 10 lbs on tamoxifen once I discovered a different way of eating.  I rarely eat grains and dairy now and I lost 10 lbs a year and a half ago over the winter when I wasn't even exercising. This year I'm on anastrazole and I've lost 3 more.  I do exercise now and I've worked up to a good amount of walking and other moderate exercise.  I exercise because its supposed to help prevent recurrence and of course its good for your overall health but my weight is wholly dependent on what I eat.  I know this because I have exercised this much in the past and still couldn't lose weight although it helped me maintain. 

Anonymous

My daughter just had gastric bypass. She is currently doing the transition diet which includes 2 protein powder shakes a day. I have sampled them so that I can understand what she is going through, and I'm going to swap out (for a while) two shakes for what I've been eating in the a.m./pm, which was healthy and organic but I think just too many calories.  Then I'll eat a healthy, mostly raw meal (which I've been doing) in the evening.  

I'll let you all know how it goes. The protein shake mix I sampled was egg white protein, 24 grams per serving, 2 sugars, 4 carbs, 120 calories, and kept me from feeling hungry for about 6 hours, even with my very active lifestyle. I was super encouraged!

Claire in AZ

islandmom

Claire_in_Seattle,  thanks for the encouragement to continue to exercise.  I started to exercise at the time I started chemo, 3.5 years ago.  I gained weight during chemo and I was flabby.  I started exercising very slowly, first walking, then added spinning, high intensity cardio, and weights.  I am in my early fifties and everything I read says women start to loose muscle at my age.  Slowly, I lost the weight and after about two years of doing weights, I have muscle definition, something I did not have before, all I expected was to slow the muscle loss.   

Ladies it is never too late to start.

 When I notice my weight going up, I watch the carbs.  I try to eat less at the end of the day. I never want to go to bed with a full stomach.  If it is breakfast or lunch I splurge.  Since our family sits down for dinner, it used to be hard not to eat the same as our teenage sons, but I have gotten used to making myself a salad or vegetables, so I eat a small portion of the main dinner. 

MsPharoah

Hello ladies, I am not an expert on the biology of weight management.  I was very concerned about gaining weight on hormone therapy and I do think that it can make maintaining a healthy weight more difficult, but maybe that is because it causes joint and muscle aches and makes it more difficult to be active???  Just a thought.

   I am using a fitbit to log my food and activities and it has been very helpful.  Tracking activity helped me identify that despite exercising every day for 1 hour...that was just not enough for me based on what I was eating.  I made adjustments to my diet and activity and I am now at my ideal weight and feel really good.  It's comforting to know that I can splurge on something decadent to eat...I just have to "pay" for it with extra activity.  

   I agree that we must pay/put ourselves first and take time for exercise...have some fun, and stay limber.

MsP 

 

enjoyevrymoment

I lost two pounds since July at the oncologists office today and that was after Breakfast and Lunch so I was pretty happy.  Crazy how I cannot get away with eating extra any more though to do so.  I was elated to see the scale down and now am just up 6 lbs from the pre cancer weight so am going to keep active and keep those calories reigned in!

Phew, I just don't want to go backwards....

MsPharoah

enjoy...  Kudos for you!  Every pound counts and so glad you are taking things in hand.

MsP