Weight gain has been one of the worst side effects I've experienced from having RA for the past 18 years, and it seems to be even worse of a problem the older I get. The main causes of the weight gain, I'd argue, are due to long-term prednisone use and physical inactivity. My "normal" healthy weight that I held onto fairly easily after high school and during college (some post-college years too) was 40-50 lbs less than what I weigh now. Incredible! I can't believe it when I stop to think about it. I try not to think about it too much though, or else I'd be constantly wallowing in the depths of extreme depression and self-loathing. Still, being this overweight is something that really bothers and upsets me, and trying to lose weight (while taking prednisone) feels like a futile, nearly impossible pursuit. I keep trying, and nothing keeps happening.
Prednisone and other corticosteroid medications are sneaky friends/foes to those of us with uncontrollable inflammation. While prednisone is often the most effective RA drug--it often works fast and well--it also has some of the most severe side-effects. Many times I have to ask myself: What's worse, my pain getting better or looking like a humpback whale? I guess I'll choose the whale, if I have to. Being severely crippled and disabled from pain is worse than feeling and looking like a big fat faux-pregnant blob, but not much.
I know I'm hard on myself regarding my weight and physical appearance, but I just want to look and feel like my old self again. I want to fit back into cute stylish clothes and not feel embarrassed by shirts or dresses that semi-cling to my abdomen. I'm tired of wearing shapeless, tent-like T-shirts and elastic waist skirts every day because I can't fit into my shorts or pants right now. This is maddeningly frustrating. Depressing. Esteem-crushing.
I've been eating a vegan diet for the last three weeks, which is a major change to my eating habits. I thought for sure that by now I would have lost some weight from giving up dairy and meat. But no, not a single pound. What is going on? WHAT'S WRONG WITH MY BODY?! I feel like I've been sacrificing a lot and eating much less, but maybe I've been fooling myself. I'm not sure.
What I'm sure of is that this fat--especially my giant stomach and "buffalo hump" neck lump--is hanging around, quite literally. I feel so disgusting and uncomfortable. Since I'm having to give up a lot of my favorite foods right now, can't I at least lose some weight? I don't know whom I'm asking this of--God maybe. Hey God, can you please take a second and zap some of this blubber from my body? You know, like divine liposuction. That would be awesome, thanks. Sadly, so far my losing-weight-prayers have gone unanswered. Maybe I'm not begging enough?
But seriously, losing weight while having RA and taking steroids for years is extremely difficult and it's something that most able-bodied people don't realize. Another thing most people don't realize is that even if you're able to taper down or off of steroid medication, that doesn't mean the weight just magically disappears. No. You're stuck trying to get rid of all of that unwanted fat the old-fashioned way. Over and over and over again. It's exhausting; I'm not surprised when I or other people don't have the energy or determination to keep doing it.
Despite the food sacrifices and frustration from not seeing results, I am determined to keep working at losing weight. I have to. My self-esteem, self-confidence, and most importantly my physical health depends on it. I know that my RA symptoms would be much better if my body wasn't working extra hard to drag around all of these unnecessary pounds of fat. Being overweight also causes much more pressure and wear on your joints and can lead to other serious health problems, whether you have RA or not.
So now the challenge is this: being strict about tracking my food and calories every day. I managed to lose weight doing this a few years ago, but since then I haven't been able to get back on the calorie-counting wagon. It's not fun, however it's necessary, I've decided--especially since I'm not losing any weight from my new vegan diet. Even if I'm cutting out a lot of foods now, that doesn't mean that I'm not consuming more of other things. I suspect this is the case. According to the SparkPeople website and app (which I used before successfully), my total allowed caloric intake per day is 1,200-1,500 calories. I figure that if I can at least not go over the upper end of that range to start with, then hopefully something will start to happen. And by "happen," I mean pounds of fat melting away with me being able to fit into my favorite dress again and no longer resembling the Hunchback of Notre Dame. Goals!
Another important challenge that should be part of this weight-loss plan is getting more and regular exercise. Since my flare-up began in mid-April, I've found it hard to get back to riding my bike every day (or several times a week at least). Bike-riding, swimming, and light weight-lifting are basically the only types of exercise I can do, because of my constantly painful feet and ankles. No running or even leisurely walks for me, sadly. Thankfully, biking is something that I really enjoy and it's also a great workout, so I have to get back to doing it ASAP.
I also really enjoy swimming and doing water exercises, but I do get kind of lazy about actually dragging my lumpy body to a pool. The inconveniences of having to drive somewhere, change clothes, take showers, and drive back home--it's all a pain. Yet, as soon as I lower my aching body into the water I feel immediately lighter and a sense of relief. Admittedly, it is worth the wet and damaged hair, skin and hair that smells like you bathe in household cleaning products, and the embarrassment of strangers seeing you in an unattractive muumuu-like swimming suit. Um, I think so anyway. No, no, it is.
Today I have started over with food tracking and so far it's going well. Although night-time is my "bad time," so we'll see if I can stay strong when I get home from work, exhausted and weak-willed. I've done it before and I know I can do it again. I also vow to take my bike out for a short ride later tonight, after the heat and humidity of Minnesota's typical August stickiness has gone down a bit. Being faithful to my diet and caloric intake without also exercising doesn't work quite as well, I've been noticing.
Weight-loss is a billion-dollar industry which helps illustrate the fact that losing weight is not easy and that most of us struggle with it--especially people suffering from RA and chronic pain. So many desperate people throw money at weight-loss programs and weird diets (who on earth thinks the Grapefruit Diet or other fads are a good idea?) and often don't see any benefits. Also frustrating, we live in a very impatient society where everyone wants a quick fix without doing a lot of work. Pop a pill, buy that weird exercise contraption that's on late night infomercials, eat all your meals from a juicer, or pay to look just like Marie Osmond. Easy!
Losing weight the healthy way, and keeping it off, is actual work and not gimmicks, which many people don't want to acknowledge--myself included. It takes time, motivation, dedication, energy, perseverance, and a lot of mental and emotional strength. I do want to keep working at it though, persevering against prednisone's vicious attacks, and to help myself look and feel better for the long term. My RA and my skinny jeans will thank me for it, I think.
When was your last flare?