My plan

Once upon a time I lost a great deal of weight.  It started when my company had a weight loss contest. I joined our team even though I had no idea if weight loss was even possible on my psych meds.  I had just had a bad blood sugar test and because my family history nearly promises diabetes eventually even if I weren't on atypicals I was somewhat frightened.  So I started a diet that was pretty much just a diabetic diet. And I lost a lot of weight.  In fact at one point I had the 2nd greatest percent of weight lost in the entire company and I think I finished about 5th or 6th in the company.  There was a secret trick though; I was weaning off depakote and it had added weight as well.  However since I was in a clinical trial when I started depakote I knew that unlike most people I had only gained 8 lbs attributed to it; the rest of my early psychotropic weight gain was from lithium which added 50 lbs in just 3 months or so.  And sure enough when the Depakote was all gone I kept losing weight.

Eventually I lost 65 lbs.  A little of that was lost when I was switching to Emsam and was so depressed I wasn't eating but 60 lbs came off and stayed off.  A nice side effect of MAOIs is decreased appetite (they are basically a derirative of speed).  So the first year on the MAOI I kept losing weight slowly and I think eventually was nearly 70 lbs below my starting weight.  It helped that during that time I felt like cooking and what I mostly wanted to eat was soup and quite healthy soups at that.  Soup and yogurt kept me very happy.

Then I started home health and soup wasn't viable for work lunches.  I still kept the weight off but wasn't losing more at that point between needing to eat things I could keep in the car and eat while driving and because I got much less exercise in home health than in nursing homes where I was on my feet and moving 8-10 hours per day.  

About 6 months into home health I had an episode.  I don't even remember if it was mania or depression although I believe it was mania.  Since I had started Emsam I'd been on 600 mg of Seroquel XR, double what I was on before the speed effect hit.  It was perfect for so long; I took meds at 9, fell asleep at 11, woke at 4 and had a wonderful few peaceful hours before work.  Sometimes I had to do notes but that didn't bother me much and often I was able to enjoy a sewing project or do something else that was fun.  When the Seroquel increased I was able to maintain that schedule but it was hard to find a balance between sedation and lifestyle.  We probably tried other meds; I don't remember.  But eventually we found that I could manage well by taking the amount of Seroquel I needed within a range and this kept my sleep even but also kept my mood controlled.  However my weight crept up.  

For a long time the weight gain wasn't so bad.  I gained maybe 20 lbs but it stopped then and I was still wearing clothes that didn't make me feel fat and I looked normal, not overweight or obese.

Eventually I was on more Seroquel to help cope with asthma meds and again I gained a little weight but nothing too dramatic.  

And then came the surgery that I left with severe akasthesia.  I had no choice but to go on very high doses of Seroquel.  Then we added 10 mg of Zyprexa (a lot when combined with huge doses of Seroquel).  And when nothing helped I was hospitalized and put on gabapentin.  My Seroquel dose by then I think was held at about 900 mg and I also started another med for the movement disorder called Cogentin that seemed to cause weight issues.  To make it all worse I was horribly depressed and living on oatmeal which is not the ideal food 3 meals per day.  I had a lithium toxicity and that also triggered weight gain when my dose/blood levels were raised back to levels I'd not seen in years while I was in the psych unit for Christmas.  And in the 3 years since that time I have had to increase my Seroquel to 1200 mg, a whopping dose that is pretty much all I'm allowed to take of it.  Doing that added the last of the weight back.  My body seems to have a fixed point that meds won't raise my weight past but it is far too heavy.  

So I've been contemplating how to lose weight.  The same diet isn't going to work as easily because it relied on foods I can't eat now and some things I simply can't afford.  Cheese was a big part of the diet and the solidified oils I call cheese now are hardly the same.  I also need easy right now.  I've been living on cereal this winter and that's not so good in terms of carbs.  I also let more junk in than I should.

So I'm trying my own variation on the other diet.  When I can I will stick to the recommendations, however I am not going to go overboard with restricting myself.  If my mom has cookies or whatever and I've had my smoothie and am really still hungry then I will eat a cookie or two.

  I'm also trying to make some of it easier on myself by using green smoothies.  A couple of cups of spinach mixed with a few servings of fruit gives me 2 servings of vegetables plus 3-4 of fruit and I am substituing this for either lunch or the evening "meal" that I require to take meds on a full stomach.  It turns out the smoothies are delicious and since it is purely fruits and veggies they are quite healthy.  Tonight I was out of spinach so had a kiwi, a cup of strawberries and 2 bananas and that was about 300 calories with half of the daily fiber requirement.  Yesterday's was spinach, half a pear, strawberries and a banana and that came it at just over 200 calories and a I think 13 or 14 grams of fiber.  

I'm having to go more slowly with this than I expected because it is a drastic change for the digestive system to get that much additional fruit and veggies along with the normal stuff.  My belly was pretty upset the first day or two.  But now it is going easily and I really enjoy the smoothies.  They take only a few minutes to make (and when I get a better blender which is my reward if I do this for 2 months) it will be even faster.  But once this is working then I need to find ways to increase protein.  I can't afford meat and my mom gives me food with meat in it sometimes but I need to find ways to get protein more easily.  I love hardboiled eggs and that's an easy start.  I also like fish and can get frozen fillets relatively cheaply.  And I have a bag of chicken breasts waiting to be cooked.  

So while I'm trying to make one change per week my new plan is to cook at least one crockpot of vegetable based soup each week, drink at least one smoothie daily, make kale chips because I love them and they are healthy and better than crackers which I tend to eat when I want something salty, then to begin making one meal of fish each week and finally to make one crockpot dish of chicken each week.  If I get in the habit of freezing things and having a routine I think I can make this work.  Not sure how to afford some of it but that just will have to work out.  Aldi's has ok produce and some other things and otherwise I'll have to buy what is on sale.  Lots of bananas in the smoothies because I can afford those.  That kind of thing.

I just want to lose even 10 lbs.  I need to lose much more than that but 10 lbs would make up for what I gained with the ankle surgery and last Seroquel increase.  

We'll see how this goes..