Did you skip over the part where she’s not hungry? And finds a steak to sit nauseatingly in her stomach for hours? Do you really think “gorge until you eat yourself sick” is a great solution for “I have no appetite and most foods repel me”? Even with incremental adjustments, it’s going to be a long, long time before monstro can manage that kind of meal. I think “ensure right before bed” is a suggestion more likely to meet with success.
By the way, there’s no nutritional difference between fruit juice and sugar-water, except for a few nutrients most people consume in excess already.
LSLguy, great advice, but the problem isn’t just that monstro isn’t eating enough. It’s that she has almost no appetite. She’s already struggling to get down the meager amount of food she’s eating.
Wellbutrin is notorious for causing this kind of situation. I know thinner people who have had to discontinue use because their appetite was so suppressed and the weight loss too severe.
monstro, I often struggled with low appetite during times in my life when I had lots of anxiety (not saying this is why you are, just that I know what it’s like to look at a meal and have very little desire to eat it), and one thing that has always been helpful in getting me to eat more total food is giving myself many tasty/savory options at each meal, rather that trying to force myself to eat larger portions of one thing.
It’s also a matter of stretching your stomach back out. You can do this slowly, but you should be giving yourself a slightly ‘uncomfortably full’ feeling one or two meals per day. Promise yourself to eat another half serving of something that you don’t really want, and power through it.
As far as the ‘junkiness’ of your diet; whole grains are all very well and good, but even if you eat mostly whole grains 3 meals per day you’re not even close to getting your RDA of most vitamins and minerals. Plus your cereal and pita might be labeled as ‘Heart Healthy Whole Grains!’ but in order to get that label, all manufacturers have to do is add a little whole grain flour to an otherwise majority refined-and-bleached white flour product.
I ran an approximation of the meal you outlined in your OP (1500 calories or so of fortified cereal with milk, wheat pita, cheese, fruit, fried chicken, brown rice, ice cream, brownie) through some software I have that calculates the nutrition of most foods and it was deficient (ie nowhere close to your RDA, which I consider a minimum) in: vitamin A, folate, B1, B5, C, D, E, K, choline, calcium, copper, iron, magnesium, and potassium. All of which are important and all of which a lack of can make you feel pretty crappy in various ways, even if blood tests would not show a serious deficiency.
A multivitamin and the fact that you get sunlight should keep you out of direct danger of severe symptomatic deficiencies, but your diet is not a nutritious one by any stretch. I would suggest adding more vegetables, eggs, meat, and seafood (small portions).
Hunger can be dependent on social cues. Maybe you need to find more opportunities to eat with friends, colleagues, or other groups. The social cues of others eating has been shown to increase appetite.
I looked for links but don’t find anything very scientific but lots of hits for “social eating”.
The right kind of resistance training can stimulate your appetite.
The saying is that the old “breathing squat and pullover” routine could put ten pounds on a broomstick.
You do:
[ul][li]5-10 minutes of generalized warmup.[/li][li]One set of crunches - 25-30 is a good goal to shoot for.[/li][li]One set of twenty reps in the squat. Pick a weight you can usually handle for ten reps - this will take a bit of experimentation. Do the rep (head up, back flat, descend to where your thighs are roughly parallel to the floor, come back up without letting your back round). Then you take two-three deep breaths. The bar should move on your shoulders. Then do another rep, repeat the breaths, until you reach twenty reps. [/li][li]Then, immediately, without any rest, you do one set of 15-20 reps in the pullover. [/li][li]Walk around gently until your breathing and heart rate recover. This may take several minutes, but don’t hurry. [/li][li]Then you do 1-2 sets of 8-10 in the bench press,[/li][li]One set of lat pulldowns, 8-12 reps.[/li][li]One set of one-arm dumbbell rows, each arm.[/li][li]One set of 12-15 reps in the barbell curl.[/li][/ul]That’s all. If you feel like you need to do more, you are not working the squat hard enough.
Do this routine three non-consecutive days a week. Generally, trainees find that their appetites increase the next day, sometimes markedly.
If milk agrees with you, drink 4-5 glasses a day between meals. If it doesn’t, try yogurt. Add an egg a day to your diet.
I would do the exercise routine instead of your day’s walking; certainly not in addition to it.
IIRC monstro walks to and from work daily, and does not have a vehicle, so that’s going to stay a part of her life. But walking, even at a good clip, doesn’t burn very many calories, and I don’t see it as a problem if she can manage to slowly condition herself to eat enough and gain back 5 lbs.
Strength training (I just do squats, deadlift, press with my barbell since I am too poor to join a gym) helped me gain pounds of visible muscles, and it definitely makes me hungry.
Yoga isn’t shabby for building strength and muscle you know. And it burns calories and requires amino acids to rebuild and strengthen your muscles, so you need to be eating to compensate!
Though its always great to eat nutritiously, increasing calories, whatever the source, is most specific to the OP. Whether the calories are “empty” or not seems like a secondary concern.
Many our CF patients used to pound sodas, even the diabetic ones when they were having severe enough weight issues. (I was a Nutrition major/diet tech, not a doctor/medical professional)
We also made a lot of custom milkshakes: Carnation Instant Breakfast milkshake, Boost/Ensure milkshake, Boost/Ensure with whole/chocolate milk…anything to make food as calorie dense as possible.
You can just pound them and deal with the side effects, or do it slowly like taking a small sip every 5 minutes or so over many hours. It’s probably better in the evening so it doesn’t interfere with your meals.
If you have zero appetite, you may need to view food/supplement intake like taking meds, side effects and all.
If you do have to force feed yourself, I would recommend the supplement route so it doesn’t spoil your taste for normal foods.
Here is a list of some calorie dense foods. Its in reference to weight loss, so when it says to avoid them or limit the portion sizes, do the opposite.
My anxiety/depression puts me off my food quite a lot. It’s a pain in the ass, especially since it’s one of those things you’re really not supposed to complain about as a girl.
What helped me most was two things:
If you can drink something besides water, do it. Whenever you’re thirsty, get a few sips of OJ, or milk, or fruit-juice-from-real-fruits-(the no extra sugar kind is better for you, the sugary kind has more calories… it’s a toss-up.) Hell, even sweet tea or soda has sugar/calories in them, but I don’t feel like those are very good suggestions for you.
Don’t drink so much you feel sick, but do drink things with calories in them. Beer is good.
Also, keep snacky foods around. I keep almonds and cashews at my desk, and nibble constantly. They’re little enough that I don’t feel full, and they’ve got lots of fat and protein in them. My best friend carries around those little yogurt tubes they make for kids. There are snack-sized bags of “mini” just about everything under the sun, from cookies to whole-grain crackers. Keep one of the baggies open, and whenever you look at it, eat one of them. They’re just little, but they’ll add up over the day.
If you’re worried more about losing weight than being unhealthy in general, try to eat more fruits than veggies - fruits are usually a lot higher on the sugar - therefore more calories per ounce of food.
Think about maximizing your calories where you don’t feel them. Breakfast cereal? Slice half a banana into it. Eating a pita? Put some hummus on it. (or the other half of banana.) Eating a sammich? Load it with mayo or olive oil. Toast? Slather with butter or PB. Frozen pizza? Get those baggies of salami or pepperoni and cover it with those, and some extra full-fat shredded cheese. Berries? Cover with cream or whipped cream and sugar. Goal is to eat stuff like what you normally eat, but make it more calorie-laden without adding a lot of bulk.
Once you’re a little more used to eating substantive things, and eating when you’re not really hungry, THEN you can start adding volume (slowly), and your stomach will stretch out to accommodate the new normal.
I don’t think the situation is as dire as I thought it was. I weighed myself on my bathroom scale this morning. 114, yet again. I drove to work (I do have a car, rhubarbarin;)) and weighed myself on the 8th floor scale. It read 118. A sigh of relief, with some confusion thrown in. Later, I weighed myself on another floor’s scale. 116, and this was after I had eaten the breakfast and lunch I’m about to lay out. I weighed myself at my therapist’s office later today. 118. So the truth is…I don’t know if I’m in that bad of shape. I think my scale is experiencing some non-linear calibration issues. I’m probably right where I have always been for the past year. 117-118. Underweight but not critical. Yay.
For breakfast this morning, I was all about getting some protein. So I went to the breakfast counter at Kroger’s and requested some bacon strips and some scrambled eggs. The lady said that that would be $4, but if I got them all on a biscuit, it would just be $2. WTF. OK, so I got that. And man, was that a humongo biscuit and a humongo dollop of cheesy eggs. She gave me just two puny strips of bacon, which was fine with me. I was already gagging inwardly.
I could only finish half of it. Ya’ll, the biscuit was HUGE. Like the size of a newborn baby’s head. With all those cheesy eggs, it was just a little too much. But I did eat half, drank my Billy’s greens (hippie algae powder, for those who don’t know), and then ate the other half for lunch. It stayed in my throat all day and I didn’t feel right for the rest of the workday. There was a time when I could have eaten that thing in a few seconds and then eaten a normal lunch. Times, they have a’changed.
For dinner just now, I downed a milkshake from McDonalds. I feel so much better and I wish I had another. Maybe if my lactose intolerance doesn’t “bubble” up on me, I’ll run out and get one. That milkshake was very refreshing and nourishing with my apartment being a little hot box.
My goal is to get to 125 before winter comes. I can do that, I think. Thanks for all the advice!
Have you tried fruit smoothies? With some Greek-style full-fat yogurt, protein powder, couple cups of berries, heavy cream and plenty of ice, you could get a helluva lot of calories+nutrients and still feel like you had a milkshake.
Ok, not exactly like a milkshake, who am I fooling?
Monstro, I noticed that you like those Stouffer’s frozen goodies. The Italian lazagna is my favorite. Try adding shredded cheese to it for the last minute or two. That adds some fat and makes it really tasty. I also add some of those French onions that are used in casseroles. I also can eat only a third at a time, but these added calories should help you gain. (They certainly do me!)
I am sure you realize that individual scales vary and that weight varies during the day. You still have the facts that you had verified the accuracy of your home scale with a weight, that your home scale is the scale that you use consistently, and more important the combination that you’ve been noticing your yoga clothes not fitting as snugly as they should and that you are feeling tired and always cold. So while the contradictory measurements are reassuring some, they should not eliminate your concern.
That said your declared goal is a reasonable one - to put in other terms, two pounds a month of gain is realistic. That means at least 300 Cal over maintenance per day, and again you really are not even doing maintenance yet.
If you don’t mind my asking, are your periods regular? One sign of significant underweight in a woman is developing irregular cycles or even becoming anovulatory. And the lowered estrogen could (I know you know this) change your brain chemistry making meds having different side effects than they had before and even directly effecting your appetite centers.
Sorry, a McD.'s milkshake for dinner does not cut it. Nor does a whole day of that, with a baby head of biscuit and eggs, even with the Billy’s Greens. The algae and other good antioxidant stuff in there is fine, but it does not mean you can get away without real fruits and veggies and some Vitamin D source.
Thanks for putting me back in line, DSeid. Everything you said is right.
Re the scale thing. I really do think it’s my scale at home that’s warped. I get weighed on my therapist’s scale on a regular basis (weekly, if not biweekly) and it’s one of those medical type dealies. Now maybe that one is off, and it’s not like it always reports the same numbers either (a couple of weeks ago it had me at 121). But it usually hovers around 118. When it’s measuring 118, usually my scale at home is measuring 116. I imagine that it’s normal for a person–especially a woman–to fluctuate +/- 5lbs throughout a month. So we’ll see if my scale bounces up when that time o’ of the month comes runnin’ around the corner (any day now). If it doesn’t, then I’ll know something isn’t right about that scale.
I can’t argue with anything else. I didn’t mean to make it sound like I’m only going the Mickie D’s route from now on. Only that that milkshake was the only thing yesterday that brought me any comfort or satisfaction. I did go to the store yesterday and get some real food (still, not any vegetables, but I did pick up some more fruit). I will make myself eat solids today for dinner. But if I simply cannot, the milkshake will be my go-to.
I think Vitamin D is the one vitamin I get plenty of, by the way. Two hours in the sun everyday…if I ain’t generating enough from that, then there’s no hope for me! And surprisingly, I do NOT feel tired. If anything, I have a little too much energy (that constant restlessness thing). I don’t know where it’s coming from; it’s not like I’ve always been like this. And it’s only physical energy, not psychological, “manic-type” energy. Regardless, I do need more iron and stuff like that. I’ve always been anemic.
My periods are regular, but I have a shortened cycle. Like 20 days instead of 28 days. It sucks because I hate having them and appreciate the vacation time, but the periods themselves are normal (not heavy or painful, nor unusually light or short). I will admit that things aren’t quite right upstairs during the days leading up to it. My motor difficulties worsen, I stutter more, have more typos and speak-os, and my thoughts become repetitive. But this pattern existed before I became underweight.
Your cycle staying at your baseline is reassuring.
If milkshakes are going to be your fall back plan, then you may want to experiment with making you own that at least includes not only some ice cream but also some Ensure Plus or yogurt and maybe some frozen berries or banana chunks blenderized in. Good Luck!
monstro: Sorry my advice, though well-intentioned, wasn’t at all relevant. I read the first few posts & hit reply before I got to the rest of your story. That’s something I almost always end up regretting. This thread is no exception.
It appears to my non-expert eyes that you’re fighting some combination of a legit medical problem, a drug interaction / side effect problem, and a mental /eating disorder problem. And right now it’s slowly starving you to death.
If I may be so bold, altering your diet is diddling around at the edges; you need to get to the root causes of your situation. And that means real medical help. If the docs you’re using now aren’t trying hard to change something major & pronto, then change docs. This needs to be fixed soon for your long term health.
aside:
If you *do *want to try to increase your eating, choose carefully. A breakfast counter in a grocery store is likely to serve a greasy gut bomb that would make even a trencherman like me feel bloated & ill. Which in turn will add even more negative reinforcement to your appetite challenge.
Stick to real food low in grease. As an example, an egg or even two done in a non-stick pan or with a smidgen of butter is very different from eggs fried while swimming in 2 tablespoons of commercial grill lubricant. Use small bites, chewed thoroughly.
Mostro’s sisyphean efforts at figuring out what’s medically wrong with her, are chronicled elsewhere on these boards. Let is suffice to say, lack of medical investigation is definitely not her problem. She is also under care of what appears to be a very competant mental health professional, in case you were concerned.
monstro I hope I am not overly speaking for you, I just figure it must be tiring sometimes to trot out the whole damn story.
What HelloAgain said. And LSLGuy, don’t you think saying mostro is ‘starving to death’ is a bit over-dramatic? Turns out she might not even have lost more than a pound or two in the first place. Yes, she doesn’t eat that much or have a good appetite but lots of people don’t, especially when they take Wellbutrin. And she’s going to work on eating more, with a goal of gaining 5-10 lbs in the near future. Problem nearly solved.
People can be quite healthy not eating low in calories and/or being underweight. If they are too thin and are not healthy (feeling freezing cold all the time is not good for instance), then they need to make changes, which monstro is doing.
Also eating incredibly high in fats (good-quality, natural fats like coconut oil and grass-fed butter - I do avoid ‘grill grease’ and most vegetable-based oils like the plague) is a big part of what got my weight up from BMI 15-16 to my current all-time high of BMI 18 (which is still too thin to my eye, but a vast improvement). Everyone’s different but fat is a necessary component of the diet and some people can really thrive with lots of it, especially skinny people who need to maximize calories.
If you want to know your honest-to-goodness weight, go to place that sells large amounts of seed or feed or maybe just produce. Their scales are checked by the government for accuracy.
As for setting goals, you might try setting consumption goals instead of weight gain goals. And try to stop thinking and talking of food as if it is your enemy. You don’t have to “cram” it in your mouth. In fact, “grazing” may make it easier to consume. Food and calories are your lifeline.
Consider making a list of the things you love and try adding them to your vegetables if that is what it takes to get them down. Do you like spicey food? Try adding a little mayo and a bit of dry mustard to succotash and putting the combo on rye bread with ham. (I learned that one in Denmark and my friends love it!)
I appreciate the backup, guys. It’s hard not being able to post on the StraightDope at work. Damn government, not wanting it’s workers wasting time on the internets.
Zoe, I wonder if Southern States has a scale like that. They’re just up the road a bit.
I get hungrier when I go outside of my routine. I like to imagine it’s because my brain is all like “oh shit, stuff is happening, better stock up on food b/c it’s the end of the world”. But I don’t know why my appetite does this. Maybe you’re the same way.
Also, and this is gonna sound weird, but I’m wondering if your appetite increases when you know beforehand that you don’t have to do anything to prepare or cook anything. When you visit me, for instance, I’m the hostess, so you don’t have to do anything except eat what I give you. And I know personally that cooking sort of dampens my appetite. There’s truth to the saying that the best tasting sandwiches are made by someone else.
Some good advice has been given on page 1, so I want to add bits and pieces that occurred to me.
First, I don’t know the background of your medical problems, sorry, I’m also not Doctor so I can’t talk about possible side effects of your meds. However, when you say :
and this
I’m wondering if a side effect of either the meds or your initial condition is either
dry mouth, which makes eating dry stuff like bread, cheese difficult; might change how things taste; and might make esp. a greasy taste linger for a long time
and/or a change in the bacteria/ biochemical composition in your mouth. Some meds or diseases change the mouth chemistry so much that others can smell the change in your breath.
If it’s dry mouth, is soup, smoothies, yoghurt, milk shake better than bread and cheese? A juicy lasagna or pasta with sauce better than pita?
Can you “rinse” your mouth with a glass of milk or a bit of bread (to get rid of the oils) or a glass of tea/ fruit juice after eating, so that the lingering taste doesn’t spoil you for the rest of the day?
There was already the suggestion to start nibbling snacks, whether it’s carrot sticks with a rich dip (instead of low-fat yoghurt dip, make a cheese dip from Gouda) or simply chips/ crackers (usually bad for you).
Also eating together with others IF those others don’t bug you about eating like a bird.
That reminded me that a lot of tips about the psychology of eating and how the mind works on the appetite you just need to turn around to gain weight. So:
you always clear empty plates away when eating several courses. (If you see you have eaten a lot you feel fuller).
You always put your portion on a big plate, so that it looks small.
you eat soup from a very deep plate, so that you don’t notice how much you’re eating.
you don’t dawdle during the first 20 min. That doesn’t mean you gulp down - you still need to enjoy eating!, but it takes 20 min before the first body sensors kick in and tell you " yes, food is getting into the stomach", so anything you eat during that time will be less noticeable than later.
I think it’s best if you first slowly extend your stomach and appetite, and add important stuff later.
Meanwhile, a reminder: people who are on chemotherapy for cancer often feel nauseous because of it, and some loose appetite or have dry mouth, yet they need a lot of energy; they drink those special weight lifter shakes/ high calorie shakes. It’s just a glass full but with 2 000 calories and essential vitamins. So maybe while you’re trying what works best, you can stave off further loss with these temporary measures.
Spices and ethnic food were already mentioned. You said you don’t plan to eat only at McD, (and I’m certainly against them in principle) but if you like eating there and their milk shake tastes good, then keep going there.
I don’t know how your infrastructure is like: are there other mom& pop stores or deli where you can get milk shakes freshly made, or is McD the only fast food around?
Do you like warm (cooked) food better than cold? Traditionally warm food is bigger in portion and calories, but if you select cold food well (or eat baked food cool) you can also add the calories.
And surprisingly, I do NOT feel tired. If anything, I have a little too much energy (that constant restlessness thing). I don’t know where it’s coming from; it’s not like I’ve always been like this. And it’s only physical energy, not psychological, “manic-type” energy. Regardless, I do need more iron and stuff like that. I’ve always been anemic.