QUESTION: Doc, I am losing hope. I can’t understand why I can’t lose weight. I started focusing on losing weight almost five months ago. The change in my lifestyle was dramatic as I watched my diet and joined the gym immediately. I attended group sessions for bootcamp and toning classes, as well as kickboxing and hip hop classes three times a week, but none of these has made a difference in my weight control.
I am 34 years old, have a good job as an accountant and a sound education. My sense of self-worth has decreased because of my physical appearance and I fear that it is crippling me socially. People judge on outward appearances and lose interest if you are overweight.
I have no other medical problems according to my knowledge and enjoy doing things outdoors. My life is hectic at work and since breaking up with my boyfriend more than a year ago I have met no one worth dating.
The stress of the break-up was huge but with all my working hours and my mom’s death, everything just got so heavy that I lost my discipline with exercise. That’s how I put on these pounds.
Since then it seems like everything has changed. I constantly feel large and bloated and have less energy. My clothes are all too small and I refuse to buy new clothing until I reach my target weight. Last week I became dizzy at work and almost passed out when going to the bathroom. I eat breakfast every day and couldn’t figure out why this happened.
During a medical check-up two days later I was told I have high blood pressure and must lose weight. I was also started on new medication to control my blood pressure.
I feel my health is threatened by the new diagnosis of hypertension. It scared me because my mother died after suffering a stroke. She became paralysed on her right side and struggled to talk and even swallow properly.
She passed away within two months of the stroke and I was told she had developed a bad lung infection, which was the final blow.
I don’t want to follow in those footsteps, especially if I can do something about it. Is high blood pressure hereditary? What are my chances of suffering a stroke too? Could it be that all this is due to stress and being overworked?
My pet hate is taking pills every day and I hope I can lose weight so that I can get off all medication.
My confidence is shaky right now and I am getting desperate for anything that will give me results. Friends of my sister suggested appetite suppressants and green tea, which I used for a week but felt no difference.
Please advise me on how to move forward and what other options I have.
ANSWER: This is a very sincere account of your frustration and your honesty is appreciated. Your life phase in itself is a challenging but exciting one. I always stop the consultation in private practice and ask my patients : “When last were you truly happy ?”
The responses are often an overwhelming rush of tears and emotion. Asking the question makes people stop and ponder – focus on themselves without interruption for a short minute or two. The conversation eventually leads to what makes you happy and why those elements are absent from your current life. The revelation can be liberating and ownership of this lies central to many health and wellness issues.
I noticed how incredibly busy you are and the social and family stressors that you carry are by no means small things.
The human body is designed for survival and can deal with stress by compensating, to a point. The physiological response to this can have long-term health side effects.
Cortisol and adrenalin are released during chronic stress and have a pronounced effect on metabolism and weight management. The thyroid gland is a very important regulator of metabolic rate. Stress doesn’t discriminate between race, gender or social standing, and everyone possesses different abilities when it comes to coping with stress.
There are several coping mechanisms that you can learn and improve on. These include: breathing techniques, quality of sleep, exercise and diet – the cornerstones of stress reduction.
Life skills, like effective time management, communication and goal-centred living, are crucial in overcoming stress.
Mild stress can be useful to kickstart action and provide the initial energy for tough tasks. Chronic stress can have detrimental physical and emotional outcomes, even paralyse your ability and lead to underachieving.
An inability to cope with stress steals potential and robs talented people of amazing capacity.
Planning ahead and setting boundaries are key to being a winner. Stress is a treatable condition, not a life sentence. My advice is that you get a full physical examination and a baseline of where you are in terms of blood sugar, cholesterol and thyroid hormones. Your eating plan must be scrutinised by a dietician and your training programme designed according to your needs and lifestyle.
Getting a clean bill of health before embarking on a radical lifestyle change is a good idea.
A checklist to consider when you are struggling to lose weight.
* A faulty scale.
* Inconsistency of what you wear while on the scale – empty those pockets.
* Times and frequency of meals.
* Diet portions and balance.
* Poor understanding of appetite control and sustained blood sugar.
* Water retention secondary to medical conditions: kidneys.
* Thyroid hormone issues.
* Undiagnosed diabetes.
* Brain masses that affect the pituitary gland.
* Hormone replacement and oral contraceptive meds.
* Increased muscle tissue mass from training.
* Too much or too little sleep contributes to obesity.
* Food allergies or intolerance.
* Side effects of medications.
* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.
He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.
If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen. Catch him in Cape Town on 567 CapeTalk, most Fridays at 1.30pm.
The advice in this column does not replace a consultation and clinical evaluation with a doctor.