Bipolar Weight Gain
I’m overweight. I don’t say it lightly, but I am always honest about it. In the nearly three years since my bipolar diagnosis, I’ve put on about 15 kilos/33 pounds.
First we introduced lithium into my regimen. I gained some weight. Then we added lamotrigine, and I gained some more. Last year came quetiapine, and even more weight gain (but on the upside, I finally sleep, every night).
I don’t know about everyone else, but aside from hair loss, or maybe those rare fatal rashes, I can deal with just about any side effect from my medication as long as it’s NOT weight gain.
It’s not just the meds, either. Bipolar episodes can cause my weight to fluctuate by quite a bit. I’m the opposite of a lot of bipolar people in that I eat more when I’m depressed and am far too busy to be bothered with food when I’m manic, but either way, these drastic changes in mood have major effects on my body.
That all feels pretty unfair, but I’m not going to just chalk it all up to evil medication and illness, throw my hands in the air, and surrender to something I feel I can’t control. Giving up would be so easy, but I’m just one of those people who refuses to be a victim.
I’m still fighting every day, but the fight is made much harder by medication that makes it difficult for me to feel full, or that revs up my appetite while slowing down my metabolism. Fortunately there are still plenty of things I can do to keep my weight in check and keep myself feeling as fit and healthy as possible.
Baby Steps
One of the fundamental changes I’ve made during my battle against weight gain is to walk every day. I got a step counter, set a daily goal, and found small ways to move more. Here in the Netherlands, bikes are the main mode of transportation. There are bike paths everywhere you could ever want to go, and often you can go from one city to another by bike without ever having to cross an actual road.
Biking is certainly healthier than driving or taking the bus, but since I’ve been biking everywhere for years and it comes easily, I decided to step it up a notch (pun intended) by walking more. I still bike long distances, but now I walk the shorter ones. Taking the kids to school in the morning or picking them up in the afternoon takes 2 minutes by bike, but 5 on foot, so I walk it every single time now.
A round-trip from home to school and back at a brisk pace nets me about 2,000 steps towards my daily goal, six more minutes of daylight, and 10 minutes of moderate exercise in place of 4 minutes of leisurely cycling.
Doing this twice a day means that every weekday I walk at least 20 minutes that I didn’t before, and it adds up to a minimum of one hour and 40 minutes more walking each week. These extra miles every week may seem insignificant at first glance, but when you add them all up they make a pretty serious contribution to my health and wellbeing.
One thing for me to keep in mind, though, is making sure these changes fit well enough into my daily routine. If it’s too time consuming, out-of-the-way, or difficult, I’m much less likely to stick with it. Fitting shorter walks into my normal routine may not be perfect, but it’s a very good start, and one I can manage while juggling everything else that comes with being bipolar.
Watching What you Eat
We know that some dietary changes are necessary for maintaining a healthy weight, but are always fogged by suspicion and old wives’ tales (bananas and ‘belly fat’, anyone?) and are often met with resistance.
We have strong emotional ties to some of the foods we eat, and it can be very stressful or upsetting to consider changing those habits. Certain foods are familiar and comforting; we love the chocolate chip cookies mom always baked or the macaroni and cheese we ate all the time in college.
Unfortunately, these foods are not always our friends. Many of them are unhealthy, and our attachments to them can be as well.
When I figured out that I was sensitive to wheat (run-of-the-mill flour and everything made with it) and needed to remove it from my diet, my first reaction was to think of all the foods I would miss. Cake, cookies, bread, gravy, ramen, spaghetti rings… It seemed like most of my favorite foods had flour in them. It was downright painful to think of giving them up forever.
There are plenty of good substitutes out there these days, though, and I tolerate other grains well, so I can make delicious pizza dough or fresh pasta from spelt flour. Once I approached the issue with an open mind, I realized it wasn’t so bad. I lost some old favorites but gained new ones in the process, and I feel healthier as well.
In addition to going wheat-free, I’ve found that cutting way back on my sugar intake makes a big difference in the way I look and feel; I tend to pack on the pounds no matter how few calories I eat if I’m consuming a lot of sugar, and my mood swings are off the charts. Alcohol has the same effect on me as well, so I drink less.
One of the final big adjustments I made was to stick to portion-controlled snacks - I find it much harder to eat three granola bars than I do to eat too many cookies from a big package. Getting up to open another portion of something after I’ve finished one has an immediate effect on me: I see that I’ve had enough, and I stop at one.
These changes can be a lot to take in, and they don’t happen overnight. Whether you have a lot of dietary changes to make or just a couple, take your time. Introduce one thing every week or two. By giving yourself time to acclimate to one new habit at a time, you’re far more likely to adhere to the new routine than if you try to upend everything at once.
And remember, it’s not a fad diet that’s over in a month; these are lifestyle changes you’re making for a healthier, happier you. There’s no rush.
Write it Down
Doing things consistently can be really difficult for me, but one thing I’ve learned to do every single day is to keep track of what I eat and how much I move, even if I do too much eating and not enough moving.
I’ll admit that I took the easy way out – my activity, food, and even sleep are recorded in an app that I can access from my phone, tablet, and computer. I have an activity tracker that automatically uploads my activity and sleep data, and even adjusts my daily calorie goal if I’ve been really active (or not active enough).
There are so many great apps and programs for tracking food and activity these days that almost everyone has access to at least one, if not a handful. But if you like to keep it analog, a simple notebook or memo pad does the trick.
Make sure that whatever you use – app, notebook, etc. – is always available to you. The fewer excuses you give yourself not to track it, the more you’ll pay attention. Long-term records of sleep, activity, and eating patterns can also be really valuable information to share with your psychiatrist or therapist. You may even be able to spot an oncoming episode by watching for changes in these patterns.
It’s all About You
In the end, there’s no one standard formula for fighting the weight gain that many people experience with bipolar disorder. It comes down to finding what works for you, and working it into your life in such a way that you can keep doing it without a lot of added stress.
Whether it’s a step counter, a strict dietary regimen, or just keeping track of what you eat and when you exercise, you need to find a way to make it your own – and to own it. Accept the good and the bad, and remember that it won’t change overnight. You’re in this for the long haul.
I’ve lost three kilos out of that 15 over the last two or so months; I’m in charge of my body again, I’ve figured out what suits me best, and I really like the way that feels.