If you're a fan of Gretchen Kubacky, PsyD, you know she's educational and great listening. If you're not, here's your opportunity to change that!
Dr. Gretchen's upcoming webinar contents and registration information include: --screening clients for PCOS and other health and endocrine disorders --physical and psychological presentations of PCOS --common comorbidities --how PCOS-prevalent hormones affect the brain and the development of mood disorders --why coordination of care is so critical --preferred treatment methods --what to expect during the course of treatment --psychotherapist self-care --additional resources
In addition to her psychology training, Gretchen lives with both PCOS and diabetes; her first hand experience helps bring a compassionate perspective to this challenging and often overlooked aspect of PCOS.
You may listen to this webinar separately, or register for the entire PCOS professional training. Information can be found either on our Facebook page, or at www.afterthediet.com/AftertheDietWorkshop.htm.
Nonprofessionals are more than welcome to participate!
First of all…it's great to be back! I was traveling, and while it's kind of fun to say I saw both the Atlantic and Pacific oceans in the period of a week, I do like my base camp and I really missed reading research. I'm looking forward to getting back into my daily groove.
Last week, I read an article in the New York Times about insurance companies, and how they are starting to ask consumers to absorb the cost of medications by asking that these medications be paid for not by flat copayment, but proportionate to the cost of the medication.
Nice. First we're convinced that we absolutely need all these drugs, and that we can get them for cheap, then once we're dependent on them…we're thrown under the financial bus.
Right now, the medications that are being sold under this new proportionate plan are not any of the medications that I focus on with this blog. However…since several of the medications you readers are on, are some of the most popular medications out there, I suspect it won't be long before these insurance companies start to see dollar signs in terms of the quantity of people they can expect to help finance this venture. Categories of medications like antidepressants…and insulin sensitizers and statins, which are commonly prescribed when the antidepressants start to mess with hormone balance.
That's the bad news.
The GOOD news is, I finally felt vindicated for having sat through this scenario for the last 25 years, wishing people would see what I have always seen…that when you take responsibility for your own health, and don't depend on people who make money off of you to help you, you have a good chance of getting better results. Think about it. Why would a drug company spend millions and millions of dollars to develop a product that you eventually wouldn't need once you started using it?
My goal, ever since I started what I do, is to put myself out of business. I started learning to play golf last year and it has been very frustrating to have to put it aside to attend to the demands of my growing business. I have a children's story I'd like to publish. And there are a couple of screenplays roaming around in my head that I'd love to get into theaters.
But the drug and insurance industries don't have that goal. Their goal, as is the goal of most corporations, is to increase market share and return on investment. Which means you can (1) increase the dosages of medications you sell to already existing customers, (2) find new customers for your medications by either creating new diagnoses or finding off-label uses for your already developed products, and/or (3) increase the price you charge for the product. Hmmmmm…nowhere in there do I see"helping the patient feel better".
Of course, I'm not naive. I know some medications are entirely necessary and even life-saving. But I also see so many conditions that could drastically improve with a few judicious lifestyle choices.
Last week I listened to the husband of a friend tell me what it was like to go through an in-vitro fertilization (IVF) procedure with his wife. He was near tears as he spoke about the trauma, the callousness of the providers, the emotional stress…the expense, and the feeling of failure as a human being when the entire investment of time, emotions and money did not produce the desired result.
He drove me to the bus stop, and I headed to the airport. As I was standing in line to board my plane, a colleague phoned me. She'd gone through my professional training and had been using my protocol on women with infertility. And she told me, that with just a few nutritional tweaks, these women were getting pregnant! Not only that, their depression was responding with equal profundity. Even the women who'd failed with the same IVF procedure as my other friend and who had given up on ever having children, were seeing results.
There's something very wrong with a system that promotes a $20,000 emotional and financial (mis)adventure over a $12 bottle of Coscto fish oil…but we as consumers need to shift our expectations for help from those who stand to make money off of our misfortunes and invest in choices, behaviors, and financial purchases that are empowering and affirming. You'll never get a company making money off of you to change how they do things if it means less money. But we can certainly get their attention if, collectively, we start to say"no" to some of their answers to our problems and"yes" to options that make more sense.
You bet the power of where you pull out your wallet is tremendous. And when groups of thousands of wallets get together…well, that's the vision I have that will finally get these screenplays out of my head!
Eating well. Physical activity. Adequate sleep. Less stress. It's that simple. It's incredible what prioritizing these four areas can do to your overall health. Not to mention your budget.
For the last few weeks, we’ve been looking at the grief process through the lens of DABDA (a model that focuses on the stages of grief – denial, anger, bargaining, depression, and acceptance). When it comes to dying, acceptance is important¸ but not necessarily critical – if you’re terminally ill, you may die before you reach a place of acceptance. With PCOS though, you’ve got a life-long condition. If you don’t accept it, you’re likely not taking care of it properly. The good news is that acceptance is something you can learn.
Acceptance looks like:
• Generally being pretty okay with what’s going on, even when it’s unpleasant (so you don’t like hearing that you’ve got pre-diabetes, but you’re going to do the recommended diet consistently) • Eating, sleeping, and exercising appropriately, even when you don’t feel like it • Practicing good self-care, even when it’s inconvenient • Having a stress reduction practice, such as meditation, yoga, or therapy • Being grateful for what you do have (if you can’t quickly create a list of at least ten items, you may be dealing with low self-esteem or depression, which can be helped through therapy) • Being genuinely happy about the positives of your life – kind of like being grateful, it’s about having a balanced perspective, rather than just focusing on the negatives • Treating others with kindness, because it’s the right thing to do, and you’re not so angry about where you are and what you’ve got that you’re taking it out on them • Not constantly comparing yourself to others, because you don’t need to – you know you’re not perfect, but you’re okay with it, and you’re working on what you can In other words, happiness is about balance, perspective, equanimity, self-respect, and self-care, all coming together to remind you on a regular basis that you’re actually pretty okay, in spite of your PCOS – and even though the PCOS is a drag¸ you believe you can manage it.
Although this concludes our review of the DABDA process, we’ll look at bringing it all together (remember, grief is a non-linear process, and these emotions can pop up at any time, or repeatedly) and incorporating it as a permanent point of reference.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
This week continues our discussion about PCOS and the grief process, through the DABDA (denial, anger, bargaining, depression, and acceptance) model. Depression is so common among PCOS patients that I write about it quite often. It’s important for you to remain conscious of the clues that you may have depression. Many, if not most of my PCOS patients have some form of depression.
When we’re talking about depression in the context of death and dying, it looks like it does in PCOS too. If you’re suffering from depression, PCOS-related or not, it might look like:
• Sleeping too much or not enough • Eating too much or not nearly enough • Being irritable, snappish, and short-tempered • Feeling suicidal • Feeling hopeless about your future • Feeling helpless to do anything to make things better • Having an overall gloomy, pessimistic perspective on life
It is certainly easy to feel down when you think about the fact that PCOS is so challenging, misunderstood, and often misdiagnosed, and mistreated. It is one of those conditions that benefit less from standard medical treatment and more from diet, exercise, and good self-care. It comes with embarrassing physical symptoms that are time-consuming and costly to manage. There’s not a lot of research being focused on the condition. All of that is definitely overwhelming.
Not to mention, the hormonal imbalance inherent to PCOS can cause depression, even if you manage to maintain a positive attitude, take good care of yourself, and have a good support system. Sometimes, depression invades your mind and soul, because your body’s overwhelmed your coping mechanisms. Depression is best-treated by a professional therapist, sometimes with the assistance of a medical doctor known as a psychiatrist (a specialist in psychotropic medications – medications for mental health conditions).
Next week, we’ll talk about the final stage of the DABDA process – acceptance.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
Long ago, I had a client who needed me to help her stay on course in the grocery store. Most of the time she did well, but one day, as we were wrapping up the trip, she accidentally zeroed out her calculator (which was her indicator she was staying within budget), just as she had three items left to put in her cart. The next series of behaviors humbled me as her dietitian, because I saw just how useless it is for anyone helping someone with an eating disorder to assume that there is any kind of logical/rational thinking when a person encounters a stress.
My client broke out into a profuse sweat. She removed all of the planned menu items from her shopping list and proceeded to the frozen food section, where she loaded up on ice cream, pizza, chicken wings, you name it. She was in such a zone that I couldn't get her attention.
I learned from this, that waiting until you're stressed out, to implement stress management behaviors, doesn't work. By that time, too many hormones and too much momentum are headed in the wrong direction for there to be much of a chance to think your way out of the problem. The same thing happens with anxiety and sleep medications. If you're taking them on an"as needed" basis, by the time you realize you need them, you've got far more momentum to overcome than you would if you implemented proactive stress management behaviors.
One of my favorite proactive remedies is lavender. It's an herb whose essential oil has repeatedly been observed to have powerful anti-anxiety, antidepressive, sleep-enhancing qualities. I was reminded of lavender this morning when I ran across a new study suggesting that lavender essential oil has the potential to be as potent as lorazepam (Ativan) for anxiety management, without thhe addictive potential. The beauty of this essential oil is that you can apply it throughout the day on your wrists, helping to keep anxiety at bay before it becomes overwhelming. Lavender sprays and pot pourris can be helpful as well. Of course, they will be more useful when used regularly and proactively than if you wait until you're completely freaked out (when you may not remember to use it, anyway).
Lavender is also an herb that can be used in cooking! Here's a link with some interesting recipes, including lavender scrambled eggs and lavender oatmeal.
I think Mother Nature is the most incredible pharmacist. I hope this is an option with potential for at least some of you with anxiety, depression, and sleep disorders that intensify your PCOS.
Kritsidima M, Newton T, Asimakopoulou K. The effects of lavender scent on dental patient anxiety levels: a cluster randomised-controlled trial. Community Dent Oral Epidemiol. 2010 Feb;38(1):83-7. Epub 2009 Nov 23.
Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010 Feb;17(2):94-9. Epub 2009 Dec 3.
This week we’ll talk about bargaining, from the perspective of how bargaining plays out in relationship to our PCOS, and the sadness and grief that are often parts of PCOS. Bargaining is part of the DABDA (denial, anger, bargaining, depression, and acceptance) model that is typically applied to chronic/terminal illness. In the dying process, bargaining looks quite similar to what it looks like in PCOS, although it tends towards making deals with god, or trying to manipulate doctors. In PCOS, it looks more like this:
• Making a deal with god to be more attentive to him/her, if only the PCOS will go away • Trying to negotiate with doctors – “Okay, so I’ll take the metformin like you said, but I’m still going to keep eating fast food, and it should all balance out, right?” • Negotiating with your dietician, personal trainer, etc. – “I’ll do the cardio, but then I don’t have to do weights today.” Or, “I’ll come in three times a week, but only if you cut your fee in half.” Or, “Look, I know that dark green leafy vegetables are really good for me, but they give me gas, so can’t I just have a (pre-sweetened, sugar-laden, actually junk food) yogurt instead?” (HUH?! As you can see, we get very creative with our attempts to avoid what we don’t want, and get what we do want instead.) • Over-exercising in order to compensate for eating badly – we develop a strange, twisted, internal logic that allows us to, essentially, do whatever we want. We convince ourselves that there are no consequences. • Eating badly but taking lots of medication or supplements – this is another favorite form of a secret internal balancing plan that absolutely has no scientific or logical merit. It doesn’t just apply to food. • Figuring, I’m young, I can do what I want until ___ age, then I’ll behave – the damage is occurring now, the bad habits are just getting more cemented as daily behavior, etc.
And here’s the thing about these games that we play with ourselves, our partners, and the professionals who try to help us – who’s it hurting? Really? You know the answer to this one. It’s only hurting you. I know reality is uncomfortable, but you’re spending so much energy on this bogus bargaining practice. What if you applied all of that energy to grounding yourself in reality, and taking small, manageable steps towards getting your self-care practices in line with what you know (or at least believe) to be true?
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
This post continues our mini-series on PCOS and the grief process. Today, we’ll focus on anger, which is the second stage of the grief model known as DABDA (denial, anger, bargaining, depression, and acceptance). Anger is a tricky emotion. People often label anger as bad, or undesirable. They deny it, refute it, avoid it, hide it, and act out around it. Anger and sadness that feel unmanageable are two of the most common reasons people show up in my office.
In death and dying, the person who is dying may be angry at god, the doctors, herself, her family, the guy who gave her the disease, the environment, and a number of other things. Likewise, the loved ones who are losing someone may have the same types of anger. In chronic illness, we may have the same targets for our anger, which may result in self-hatred, low self-esteem, acting out, and damaged relationships.
There is SO much to be angry about when it comes to PCOS, I’m sometimes surprised that we’re not all raging, all the time. At various times in learning that you have PCOS, and then starting to deal with it, and then just living with it for a long time, you might experience anger towards:
• God, because you have it • The universe, for creating this thing • Doctors, because they can’t cure it • Your parents, because they gave you the genes that cause it • Any woman who doesn’t have it • Men, because they can’t have it • The medical industry, because they haven’t cured it either • Your body, because it’s not working “right” • Other people, for not understanding • Anyone who has children, if you want them and don’t or can’t have them • Anyone who seems to enjoy perfect health, in spite of living an obviously unhealthy lifestyle (think, daily consumer of fast food who still has a perfect cholesterol panel, and no weight issues) • Yourself, for not doing your self-care better, or more perfectly • Any other medical professional, personal trainer, or other well-meaning individual you’ve ever encountered who said something stupid, irrelevant, pointless, misdirected, or just generally lame, in an effort to get your body to behave • Dieticians who tell you what to eat without understanding your particular brain chemistry
All of this anger might lead you to act out, which could look like:
• Eating whatever you want, whenever you want – in spite of knowing better • Failure to exercise – again, in spite of knowing better • Overspending – because if you’re going to be fat, you might as well look good • Unhealthy sexual behavior – “I’ll take whatever I can get, since no one would want me otherwise.” • Manifesting other illnesses that are stress-related • Being verbally or emotionally abusive towards your spouse, your kids, or others
Note that these things are not purely related to anger; they may also be indicators of other conditions, including mental health disorders.
These are big lists, and you are absolutely right to have a lot of anger about a lot of things related to PCOS. But you can’t live in anger all the time. Well, you can, but it’s surely not a healthy choice. So, how do you deal with all this anger, and get it out of your system, so you can move on to something more productive? And why do you even need to do that in the first place? I believe you need to get over the anger for the simple reason that Freud was right on this count – anger turned inwards becomes depression, and we’ve already got enough trouble with that, given the hormonal set-up we’re dealing with. Also, it tends to lead to negativity, self-hatred, and a more pessimistic perspective, none of which is helpful.
You can get rid of your anger in a lot of ways. Journaling, talking to friends, and talk therapy are certainly good choices. Creative expressions may help as well – creating collages, photographs, movies, music, or poetry that express your feelings are all great. I don’t like to encourage violence, but some clients report that there can be some great satisfaction in doing things like playing one of those video games where things explode when you hit them.
In other words, anger is actually a healthy emotion, but you’ve got to handle it the right way. Next week, we’ll address the concept of bargaining, in the context of grieving your PCOS.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
I recently mentioned that I was embarking on a mini-series of blog posts about the grief process, and how it relates to PCOS. I talked about a handy summary term known as DABDA, which stands for denial, anger, bargaining, depression, and acceptance. Denial is present in our lives in many ways, and it’s actually a very helpful defense – sometimes our minds go into denial, because unconsciously, they know that we’re not quite ready to handle a crisis, trauma, or issue yet. For example, the woman who sees signs of cheating in her marriage, yet overlooks the hints, bypasses opportunities to question her husband, and insists that her neighbor can’t be right – yet she KNOWS in her heart that it’s true. That’s denial.
In death, denial is often quite literally a failure to recognize or believe that a person is dead, that they died a certain way (i.e., suicide), that the death was unavoidable, or that they are not at fault in the death. While one is in the process of dying, the denial may simply be a belief that it is not possible to be dying from THIS – not me, not now.
Specific to PCOS, denial looks: • “I don’t have PCOS – it’s something else – they just haven’t come up with the right diagnosis for me.” • “PCOS is no big deal – I mean, I had to have an IVF and all, but whatever – I got my baby, and now I can ignore it.” J • “PCOS isn’t like a terminal disease or anything, so why do I have to deal with it?” • “Having a baby will fix it. That’s 10 years away, but in any case, I don’t have to deal with it now.” • “Those medications don’t really work (so I’m not going to take them).” • “If I just can find the right combination of supplements, this will all be okay.” • “If I go gluten-free, I’ll be cured – but that’s so impossible, I won’t even try.” • “I’m pretty sure that dark chocolate is a health food, so I’m going to have this entire 3.4 ounce bar.” • “Exercise is overrated – I’ll just gain weight if I gain muscle mass, right?”
Denial’s great when it really is needed and protects you, like the child who is being molested and denies it until she’s an adult, when it’s actually safe for her to tell someone. Or when you just got a cancer diagnosis, and you don’t quite get that your particular cancer has a 75% mortality rate – and maybe if you realized that before you got a chance to explore treatment, you’d consider suicide to be a good option. Sometimes it’s protective.
Yet, as adults, most of the time, denial is working against us. It prevents us from seeing the real picture of what’s happening with our bodies, our lives, and our relationships. It prevents us from grieving. It keeps us from making decisions that will improve or protect our future. It stops us from eating better, or exercising more, or getting enough sleep (another favorite form of denial that I hear all the time is “I don’t know how I do it, but I can totally get along on five hours of sleep” – to which I say, BALONEY!). It stops us from spending money on the help we really need. It allows us to continue engaging in damaging behaviors, poor self-care, and unhealthy relationships.
If reading this gives you a little stinging sensation of recognition, there’s good news. You can start to acknowledge reality. Talking to someone who cares about you, sharing your fears and the thoughts you’ve been hiding, is a good start. If you can’t do that, put it in writing – it’s amazing how seeing it in black and white can help to bring clarity to your random thoughts.
Next week, I’ll address anger, and the insidious impacts that it has on your health.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
Scientists have reported that myo-inositol can be a safe supplement to use to promote ovulation and fertility.
I have known about inositol for years, as it is also a supplement that can be helpful in the treatment of anxiety, obsessive-compulsive disorder, and panic disorder.
Since 80% of the women with PCOS coming to my website are reporting some kind of anxiety, depression, and/or mood swings, it seems that using inositol as part of your overall health and fertility program may not be a bad idea. Even if you don't have a DIAGNOSIS of anxiety, it's so easy to feel stressed out when all you want is to conceive!
The supplement can be a bit expensive…but it's far cheaper than in vitro fertilization. And it's simply a form of a water-soluble B vitamin. If it can't hurt, and it might help, at least one issue you are looking for help with…why not give it a shot?
Papaleo E, Unfer V, et al. A novel method for ovulation induction," Gynecol Endocrinol, 2007; 23(12): 700-3.
Harvey BH, Brink CB, Seedat S, Stein DJ. Defining the neuromolecular action of myo-inositol: application to obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2002 Jan;26(1):21-32.
Palatnik A, Frolov K, Fux M, Benjamin J. Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder. J Clin Psychopharmacol. 2001 Jun;21(3):335-9.
That is the number one reason I hear from my clients about why they cannot do yoga. They fear that because of their weight, they are not going to be able to move in a way that is"right".
The good news about yoga is, there is no"right" or"wrong" way to do it! There are plenty of people in those classes with injuries, arthritis, unique anatomical makeups, and sheer lack of flexibility. And they do just fine.
A good yoga class will offer more than one option for a pose, to give each person in that class an opportunity to participate. You can start with…and even stay with…the first option, or if you're feeling like you would like to challenge yourself…try a new option. And even if you can't do the first option, or hold it, the first time around, the effects of your moving your body in new and different ways are still there.
So with yoga, you simply get credit for showing up and trying!
Afraid you can't get through a class? The power of a simple pose can be significant. A simple downward dog (see photo) is associated with the following:
•Increased strength in your arms, shoulders, sides, chest and upper back, while stretching the muscles in your ankles, calves, thighs and lower back.
•Improved digestion.
•Improved symptoms of menopause, and relieved menstrual discomfort.
A recent inCYST post on grief really resonated with me. Perhaps it’s because I’m a Certified Bereavement Facilitator, so a lot of the work I do is directly related to grief, particularly “out of order” deaths such as suicide, homicide, and miscarriage loss. Or perhaps it’s because there’s so much sadness and loss surrounding chronic illness that, for me, the issue of PCOS cannot be addressed without looking at the issues of loss. In any case, I want to introduce a commonly used model for grieving, since I’ll be talking in more detail about it over the next few weeks, and relating the elements back to PCOS.
Elizabeth Kubler Ross was a physician who worked with terminally ill patients. The model was first described in relationship to terminal illness, and the process that patients go through as they struggle to reach acceptance of their situation. It has come to be applied extensively to grief therapy work. The model is known as DABDA, which stands for denial, anger, bargaining, depression, and acceptance. I’ll be devoting a post to each of these five items.
The first thing to know about grieving is that grieving is a non-linear process, with unpredictable timelines and variables, and that no two people grieve the same way. It’s estimated that most people grieve adequately and appropriately on their own, but about 30% would benefit from the assistance of a professional grief counselor. All of those phases of grieving – denial, anger, bargaining, depression, and acceptance – may occur in order, out of order, simultaneously, repeatedly, in an overlapping fashion, or perhaps not at all before you finally reach a state of peaceful resolution around the loss.
Also, the “normal” grieving process may go awry if you have multiple losses, too many losses occur in a short period of time, or you’re not permitted to grieve openly. For example, your mother dies, and then three months later your sister and brother-in-law are killed in a car crash. Or you’re close to 40, and end up having five IVF cycles in the space of eight months, and five miscarriages. Then you have something called “complicated bereavement.” Complicated bereavement typically needs some outside help to work through.
Grieving doesn’t just take place in the context of death or a diagnosis of terminal illness. Grieving can occur in relationship to chronic illness, loss of finances, sexuality, spouse, freedom of movement, employment, and even in response to seemingly positive situations, such as the birth of a child, which also means leaving something else behind. There may be grief associated with graduating from school, leaving a job or a neighborhood, or a myriad of other situations.
In reference to PCOS, losses may include loss of femininity, loss of reproductive capacity (infertility, miscarriage), loss of health or the illusion of health, loss of freedom (all of the things you can’t or shouldn’t do if you want to be healthy), finances (the money spent on non-covered health practitioners, supplements, special dietary items, personal trainers, etc.), sexuality, relationships, and many other things. There is often a great deal to be grieved, which contributes to the chronic low-level sadness that accompanies many PCOS patients. You may not have labeled what your feeling as grief, but that may in fact be precisely what you’re feeling and doing.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
6:30 a.m., Miami International Airport, feeling jet-lagged and just about destroyed from over 24 hours of travel, I looked through my stupor at the people who have come to reside in my head as “The Airport Couple,” a poignant lesson in what happens when you don’t take care of yourself. I love to people-watch at the airport, but this was not my usual people-watching.
They both have canes, are morbidly obese, and have extra-large sodas and pound bags of candy – plain M&Ms for her, peanut for him. The breakfast of champions, especially if it’s Diet Coke. They are struggling to breathe, to move, to walk, and even to eat the candy, yet they persevere. They both have an unhealthy pallor that comes more from poor health than bad airport lighting. Neither one makes eye contact with anyone else, not even their spouse. Their isolation, even in the midst of dozens of people, is profound.
Their misery and shame is palpable, and I feel like I should avert my eyes from their pain, and the practice of their addiction to food/sugar. It hurts to watch them, but I am unable to stop glancing sideways at them, in the way that children do when they notice a grotesquely fat or deformed person and simply cannot keep themselves from staring. I am wondering how they are going to make it onto the plane, and if they’ll even survive the flight, let alone whatever comes next. Selfishly, I hope I won’t have to spend the next six hours stuck sitting next to one or both of them. I feel intense sadness for the way that they’re trapped in their bodies, in their diseases, and their disconnection. I wonder which diseases they have, and how many. I make assumptions about diabetes, thyroid disorders, cholesterol problems, and heart disease. As time passes, and my flight is delayed, I add gout, emphysema, and of course depression to the list.
She is probably 52, but looks closer to 70. Walking is laborious, studied, and painful. Her thighs are so fat that her ability to walk a straight line is distorted. Yet she proceeds to the nearest shop to purchase more snacks for him; clearly, this is a form of care-giving. I think he is older, although it is hard to tell. He is almost immobilized, stuck in the confines of the narrow, hard-railed bench/chairs that are uncomfortable even for people of average size. I look for an oxygen tank, certain that must be part of their apparatus. He is wearing extra thickly cushioned diabetic shoes. I wonder about toe amputations. I think long and hard about this human catastrophe, and how preventable almost all of it is.
We struggle, day in and day out, to manage our PCOS, and whatever other diagnoses come with it. We get tired of eating right, limiting sugar and other carbs, avoiding alcohol and grain-fed meat, getting up at 5:30 a.m. to make it to the gym, taking supplements, and going to the doctor quarterly for check-ups. We complain that it isn’t fair that we’re stuck with this condition. We deal with, or don’t deal with, our depression, our anxiety, our obsessions and compulsions, or the thoughts that we might be bipolar. We adhere to diets and violate the diets. We struggle, and wonder why. I’ll tell you why – you don’t want to be The Airport Couple.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
In a study I did with over 1,000 women with PCOS who visited my website, over 85% described symptoms of anxiety and/or depression, conditions commonly treated with antidepressants. Therefore, any information I find regarding these medications and their effect on pregnancy is crucial to share.
In the study referenced in this post, over a period of almost 10 years, a total of 1,780 women who experienced 1,835 pregnancies over this time while also receiving either paroxetine (Paxil) or a combination of Paxil and at least one other antidepressants, during the first trimester of pregnancy. These women were compared to 9,008 women experiencing 9,134 pregnancies while on other antidepressants and antidepressant combinations that did not include paroxetine, in the first trimester of pregnancy, over the same period of time. The researchers report that there is a modest increased risk of congenital malformation (birth defects) in women who use paroxetine alone or in combination therapy during the first trimester of pregnancy.
Bottom line? Since often times you don't even know you're pregnant during that first trimester, if you are trying to conceive, or even having sex, and you are being treated for depression, it would be prudent to discuss an alternative to paroxetine with your caregiver.
Better safe than sorry!
Cole JA, Ephross SA, Cosmatos IS, Walker AM. Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf. 2007 Oct;16(10):1075-85. Comment in: Pharmacoepidemiol Drug Saf. 2007 Nov;16(11):1181-3.
Most of you know that your PCOS is an inflammatory disorder. But if someone asked you what that meant, would you be able to explain it? I've found that it's a pretty meaningless and misleading term to most people. So I like to use a visual. This visual has had such a profound impact on some of my clients that they've printed it out and they hang it on their computers or other prominent place to graphically remind them of the importance of making proactive choices.
Inflammation is a misleading term because most people, when they hear it, tend to think of swelling, as you might experience if you sprain your ankle. In the case of inflammatory disease, it's really more oxidation that we're talking about. (Hence the focus on antioxidants by the supplement industry).
But even then…what is oxidation? It is the metabolic effect of oxygen being broken down. Outside of your body, the easiest illustration I've come up with is rust. When metal reacts with oxygen, and an oxidative process occurs, rust is the result.
It's no different in your body. An inflammatory, or oxidative process, is essentially the rusting out and deterioration of your tissues. It happens when the balance between processes that oxidize outweigh those that do repair work.
One of the most important places where this oxidation has effect is in your brain and nervous system. Oxidative processes are known to destroy neurons! For example, depression, another inflammatory disorder and one which commonly co-exists with PCOS, is known to destroy neurons in the hippocampus, the brain's memory center. And as many of you know, loss of memory, concentration…brain fog…are common side effects of PCOS.
Take a look at this photo. If the balance in your own body is tipped toward inflammation, it's literally like your brain and nervous system are rusting out. Yes, this is your brain on inflammation.
Your job is to reverse that process.
And it can be reversed! Studies also show that the hippocampus rebuilds those lost neurons as an indication of resolving depression.
What to do?
1. Remember that the substance that the brain needs in order to rebuild neurons is DHA. It's not sugar, it's not flax, it's not a vitamin or mineral. It's DHA, the fish oil that is found in fish and marine algae. Dr. Artemis Simopolous, omega-3 expert, has written that treating depression with DHA requires a dose of about 1000 mg per day. That is about 4 times what is recommended on the bottles of most supplements, and eating fish a few times a week is far below that. If you really want to experience the benefits of omega-3's, you likely need to up your dose.
2. You need to remember to take your fish oil! I know, it sounds funny, that in order to improve your memory you need to remember to use the thing that improves your memory…but that's one of the biggest barriers I've seen to PCOS success…consistency. If you cannot put your fish oil next to your milk in the refrigerator, or remember to take it when brushing your teeth, program your computer or smart phone to remind you to do so. I cannot reinforce the importance of consistency.
3. Slow down the rusting out process. Anything that raises metabolism, speeds up the rusting out process. That means extra stress. Sleep deprivation. Diet excesses. Dietary deficiencies. Too much exercise.
4. Eat a variety of foods from a variety of food groups. There are so many antioxidants available to you, none of them is the be-all-end-all…you need to mix it up so you get the most opportunity to benefit from the entire palette.
My hope is that now that you've seen what inflammation is, you will understand why it is so important to take action and do the repair work, then rust-proof yourself against further damage.
This just in from registered dietitian and licensed acupuncturist Karen Siegel. Karen's practice is in Houston, Texas, if you are interested in consulting with her.
Acupuncture Benefit Seen In Pregnancy By SHIRLEY S. WANG
Acupuncture designed to treat depression appears to improve symptoms in pregnant women, suggesting it as an alternative to antidepressant medication during pregnancy, a study found.
The study, published Monday in the journal Obstetrics & Gynecology, is the largest to date examining the effectiveness of acupuncture to treat depression in pregnant women. It was funded by a grant from the government's Agency for Healthcare Research and Quality."Acupuncture that we have tested works for pregnant, depressed women," said Rachel Manber, a study author and professor at Stanford University. However,"no single study is enough to make policy recommendations," she said.
Depression in pregnancy is a risk factor for postpartum depression. Postpartum depression is associated in some studies with poorer cognitive and emotional development in children. Some have linked depression in pregnancy and low birth weight.
As many as 14% of pregnant women are thought to develop depression at some point during their pregnancy, according to the study authors, comparable to numbers who suffer from postpartum depression. Antidepressants are generally considered safe for use in pregnancy, but research has been limited and concerns continue to grow, according to the National Institute of Mental Health.
Acupuncture attempts to treat conditions by stimulating points on the body, most often with needles stuck in the skin and moved by hand or electrical stimulation, according to the National Center for Complementary and Alternative Medicine.
In the study, 150 clinically depressed pregnant women who weren't previously taking antidepressants were randomly assigned to get either acupuncture for depression, acupuncture not specifically designed for depression, or massage for eight weeks. Some 63% of women in the acupuncture-for-depression group responded to treatment, compared with 44% in the other groups.
Printed in The Wall Street Journal, page D3, February 23, 2010
OK. Today's the day. There was finally a quiet morning to read the research about d-chiro inositol. Ever since I posted a link to Sasha Ottey's interview on the topic on her PCOS Challenge radio show, traffic linking to us with that keyword has been very high. I've known we needed a blog post, but I just wanted to be sure it was scientifically accurate and presented information in a way that was beneficial, not hurtful.
What is inositol? It is a chemical that is necessary for several body functions, including: cell structure, insulin function, nerve function, fat breakdown, and maintenance of healthy cholesterol levels.
Inositol comes in nine different forms. Two of those types of inositol, myo-inositol and d-chiro-inositol, have been found to have therapeutic value. Myo-inositol supplementation has been found to alleviate symptoms of bulimia, panic disorder, obsessive-compulsive disorder, agoraphobia, depression, and bipolar disorder. d-chiro-inositol supplementation has been found to be useful for symptoms associated with insulin, high androgen levels, and menstrual irregularity. It is also reported that myoinositol can help prevent hair loss.
Both categories of symptoms are common in PCOS, so it appears that inositol levels and metabolism may be problematic with a high percentage of readers of this blog.
One thing you can do to help improve your levels of both myo- and d-chiro-inositol is to know their dietary sources. Myo-inositol is found in brewer's yeast, liver, milk, whole grains, brown rice, oats, nuts, citrus fruits, molasses, legumes, raisins, and bananas. The best sources of d-chiro-inositol are buckwheat and garbanzo beans (hummous, anyone?)
The theory is, that women with PCOS have trouble converting myo-inositol into d-chiro-inositol. So they need to bypass that metabolic bottleneck with a supplement.
I haven't had the opportunity to use d-chiro-inositol with my clients yet. I haven't wanted to recommend anything unless I'd researched it. But I had a client once, with severe OCD, who responded well to myo-inositol in a way medication and behavioral therapy never achieved. The only issue she had with the supplement was the large dose she needed to take (10 grams per day) in order to see benefit.
Fast forward to today, I've been wondering for awhile if maybe the symptoms attributed to myoinositol deficiency weren't actually myoinositol issues at all, but d-chiro-inositol issues, and the large dose needed was because the conversion in this population is so low.
So here's the best way I would think it would work to determine if d-chiro-inositol deficiency is your problem.
1. Be sure to include all the foods I mentioned above in your diet on a regular basis.
2. Try d-chiro-inositol. Give it three months of regular use to see if it helps. --If it helps with your insulin levels, androgen levels, and menstrual cycles, then by all means continue using it! --If it helps with the above, but doesn't help with binge eating, mood, or obsessive thinking, then consider adding some myoinositol to the mix.
3. And please, check back with us. I'm really curious to know what happens. If d-chiro-inositol also helps with mood, etc., that's very important information.
Recommended doses of each: myo-inositol 12-30 grams per day d-chiro-inositol 100 mg, twice per day
I know, I know, if you're obsessive, you're going to want to take the higher dose of myo-inositol, or even double the dose I've listed.: ) I strongly encourage you to resist the temptation and start low and titrate up as you need to.
I spent quite a bit of time in the supplement department at Whole Foods, to get an idea of what readers would find if they went to buy inositol. As you can see at this link, the options on amazon.com, as they are in most health food stores, are primarily myoinositol.
If you'd like to purchase d-chiro-inositol, the most popular source for women with PCOS appears to be www.chiralbalance.com.
It’s normal to have some anxiety from time to time. Everyone experiences anxiety as a normal reaction to threatening, dangerous, uncertain, or important situations. When you’re taking a test, going on a trip, or meeting your prospective in-laws for the first time, you’re going to have anxiety. Psychologists classify anxiety as normal or pathological. Normal anxiety can enhance your function, motivation, and productivity, such as the person who works well under pressure.
But there’s a larger problem called Generalized Anxiety Disorder (GAD), and it affects an estimated five to seven million Americans. People with GAD experience pathological anxiety, which is excessive, chronic, and typically interferes with their ability to function in normal daily activities. GAD patients are about 60%women/40% men, and women with PCOS are affected by anxiety disorders more often than other people, just as we’re more affected by depressive disorders.
There are biological and environmental risk factors for GAD, which include the following:
• Genetics (Research has shown a 20% risk for GAD in blood relatives of people with the disorder and a 10% risk among relatives of people with depression.)
• Sleep deprivation, sleep inconsistency
Stress in the following areas can intensify symptoms:
• Financial concerns
• Health
• Relationships
• School problems
• Work problems
Symptoms include trembling, general nervousness or tension, shortness of breath, diarrhea, hot flashes, feeling worried or agitated, trouble falling asleep, poor concentration, tingling, sweating, rapid heartbeat, frequent urination, and dizziness. A panic attack, which is an extreme manifestation of anxiety, may feel like a heart attack, and sends many patients to the emergency room. If you’re having these types of symptoms, you should definitely make sure you’ve seen a physician to rule out medical conditions.
This type of anxiety is obviously more severe than normal anxiety, and can even be quite disabling. There might be a tendency to expect the worst without clear evidence, with particular worries about health, finances, job, and family. Individuals often can’t relax, sleep or concentrate on the task at hand. This disorder affects the quality of work and home life. You may know that your worry is excessive, but don’t feel like you can do anything about it. There are also some cultural issues — many people in the United States who are diagnosed with GAD claim to have been nervous or anxious their whole lives. Eastern societies, on the other hand, perceive and treat anxiety differently, as something associated with pain. So anxiety may be seen as normal in one setting, and pathological in another setting.
GAD is associated with irregular levels of neurotransmitters in the brain. Neurotransmitters are chemicals that carry signals across nerve endings. Neurotransmitters that seem to involve anxiety include norepinephrine, GABA (gamma-aminobutyric acid), and serotonin. Anxiety may result in part from defects in serotonin neurotransmission, and drugs that augment this activity may be useful in the treatment of anxiety disorders. However, many therapists believe that GAD is a behavioral condition and should not be treated with medication. Further, some believe GAD is more closely related to depression than to anxiety. I tend to believe that there’s a spectrum, and usually, if you’ve got depression, you’ve got some anxiety, and vice versa. There also seems to be a correlation between GAD and other psychiatric disorders, including depression, phobia disorder, and panic disorder. Anxiety is a risk factor for sleep disorders such as insomnia.
If you have numerous symptoms of anxiety, it’s important to be evaluated by a mental health professional who can help you identify the causes of your anxiety, and teach you ways to manage your anxiety. Many forms of therapy are effective, and I see great results in my anxiety clients who practice yoga or meditation (or both!). If that’s not enough, you can be evaluated by a psychiatrist and try some of the highly effective anxiety-reduction medications.
Gretchen Kubacky, Psy.D. is a Health Psychologist in private practice in West Los Angeles, California. She has completed the inCYST training. She specializes in counseling women and couples who are coping with infertility, PCOS, and related endocrine disorders and chronic illnesses.
If you would like to learn more about Dr. HOUSE or her practice, or obtain referrals in the Los Angeles area, please visit her website at www.drhousemd.com, or e-mail her at AskDrHouseMD@gmail.com. You can also follow her on Twitter @askdrhousemd.
One of the more frequent searches bringing readers to our blog is"vegetarian" and"fertility"…and"vegetarian" and"pcos". I've also noticed when doing Fertility Friendly Food Tours at Whole Foods, that a disproportionate percentage of women attending these classes, are vegetarian. And, in my individual counseling, it's not uncommon to learn during an assessment that if a client is not currently vegetarian, she was at some point in her life.
So I wasn't surprised to find this study reporting that women with PCOS tend to be deficient in vitamin B12.
I often teach that PCOS is a counterintuitive illness. By that, I mean that what often needs to be done is the opposite of what you might think. In this case, rather than immediately assuming that the most important strategy is to restrict food choices because your appearance suggests overnutrition, it may actually be to add foods back into your diet to correct underlying deficiencies.
This B vitamin is found almost exclusively in animal products, including fish, meat, poultry, eggs, milk, and milk products. It is also found in some fortified breakfast cereals, but if you're avoiding carbohydrates as well as trying to be vegetarian, you're likely not getting enough vitamin B12 in your diet.
Some fermented soy products, namely tofu, tempeh, miso, and tamari, may contain vitamin B12, if the bacteria, molds, and fungi used to produce them were vitamin B12 producing. This is a project I'll look into and blog about in a later post.
Finally, some nutritional yeast products also contain vitamin B12. Lucky for you Aussies reading this blog, that means Vegemite and Marmite, made from yeast extracts, can be excellent choices to include in your diet!
It is possible to obtain vitamin B12 by taking a vitamin supplement, but the amount of the vitamin that is actually absorbed through the digestive tract may be very low. For this reason, physicians who note a low vitamin B12 level may recommend an injection, to bypass the digestive tract.
Women over 14 years of age, if not pregnant, should be consuming 2.4 mcg of vitamin B12 per day. They should aim for 2.6 mcg per day when pregnant, and 2.6 mcg per day when breastfeeding.
It's clear, if you don't do vegetarian eating in a thoughtful, proactive way, it carries considerable health risks. As you've seen before in this blog, inCYST believes that healthy vegetarian eating is about what you DO choose to eat, more than what you DON'T choose to eat.
It is a good idea, if you're vegetarian, or ever have been, to ask your physician to check your vitamin B12 levels. A low status is easy to correct and that can be part of your strong foundation for managing your PCOS and improving your mood, insulin function, and fertility.
Kaya C, Cengiz SD, Satiroğlu H. Obesity and insulin resistance associated with lower plasma vitamin B12 in PCOS. Reprod Biomed Online. 2009 Nov;19(5):721-6.
From inCYSTER Karen Siegel…contact information for her Houston clinic is listed below.
"Yes. Another reason to keep encouraging the fish oil supplementation."
Public release date: 16-Dec-2009
Contact: Public Affairs Office public.affairs@apa.org 202-336-5700 202-336-5700 American Psychological Association
New study links DHA type of omega-3 to better nervous-system function Deficiencies may factor into mental illnesses WASHINGTON — The omega-3 essential fatty acids commonly found in fatty fish and algae help animals avoid sensory overload, according to research published by the American Psychological Association. The finding connects low omega-3s to the information-processing problems found in people with schizophrenia; bipolar, obsessive-compulsive, and attention-deficit hyperactivity disorders; Huntington's disease; and other afflictions of the nervous system.
The study, reported in the journal Behavioral Neuroscience, provides more evidence that fish is brain food. The key finding was that two omega-3 fatty acids – docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) – appear to be most useful in the nervous system, maybe by maintaining nerve-cell membranes.
"It is an uphill battle now to reverse the message that 'fats are bad,' and to increase omega-3 fats in our diet," said Norman Salem Jr., PhD, who led this study at the Laboratory of Membrane Biochemistry and Biophysics at the National Institute on Alcohol Abuse and Alcoholism.
The body cannot make these essential nutrients from scratch. It gets them by metabolizing their precursor, α-linolenic acid (LNA), or from foods or dietary supplements with DHA and EPA in a readily usable form."Humans can convert less than one percent of the precursor into DHA, making DHA an essential nutrient in the human diet," added Irina Fedorova, PhD, one of the paper's co-authors. EPA is already known for its anti-inflammatory and cardiovascular effects, but DHA makes up more than 90 percent of the omega-3s in the brain (which has no EPA), retina and nervous system in general.
In the study, the researchers fed four different diets with no or varying types and amounts of omega-3s to four groups of pregnant mice and then their offspring. They measured how the offspring, once grown, responded to a classic test of nervous-system function in which healthy animals are exposed to a sudden loud noise. Normally, animals flinch. However, when they hear a softer tone in advance, they flinch much less. It appears that normal nervous systems use that gentle warning to prepare instinctively for future stimuli, an adaptive process called sensorimotor gating.
Only the mice raised on DHA and EPA, but not their precursor of LNA, showed normal, adaptive sensorimotor gating by responding in a significantly calmer way to the loud noises that followed soft tones. The mice in all other groups, when warned, were startled nearly as much by the loud sound. When DHA was deficient, the nervous system most obviously did not downshift. That resulted in an abnormal state that could leave animals perpetually startled and easily overwhelmed by sensory stimuli.
The authors concluded that not enough DHA in the diet may reduce the ability to handle sensory input."It only takes a small decrement in brain DHA to produce losses in brain function," said Salem.
In humans, weak sensorimotor gating is a hallmark of many nervous-system disorders such as schizophrenia or ADHD. Given mounting evidence of the role omega-3s play in the nervous system, there is intense interest in their therapeutic potential, perhaps as a supplement to medicines. For example, people with schizophrenia have lower levels of essential fatty acids, possibly from a genetic variation that results in poor metabolism of these nutrients.
More broadly, the typical American diet is much lower in all types of omega-3 than in omega-6 essential fatty acids, according to Salem. High intake of omega-6, or linoleic acid, reduces the body's ability to incorporate omega-3s. As a result,"we have the double whammy of low omega-3 intake and high omega-6 intake," he said.
### Article:"Deficit in Prepulse Inhibition in Mice Caused by Dietary n-3 Fatty Acid Deficiency"; Irina Fedorova, PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Anita R. Alvheim, PhD candidate, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, and National Institute of Nutrition and Seafood Research, Bergen, Norway; and Nahed Hussein, PhD and Norman Salem Jr., PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Behavioral Neuroscience, Vol. 123, No. 6.
(Full text of the article is available from the APA Public Affairs Office)
Norman Salem Jr. can be reached at nsalem@martek.com or at (443) 542-2370 (443) 542-2370. He was with the National Institutes of Health until 2008, when he became the chief scientific officer and vice president of Martek Biosciences Corp. in Columbia, Md., an ingredient supplier of DHA. He states that he and his co-authors conducted this research while with the NIH.
The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare. -- Karen Siegel, MPH, MS, RD, LD, LAc Acupuncture & Nutrition Clinic 9660 Hillcroft, Suite 202 Houston, TX 77096 713/721-7755 713/721-7755 www.AcupunctureandNutritionClinic.com or www.Karensclinic.com
Last night evening news reporters shared that a new anti-obesity drug is headed toward approval. I Googled this drug,"Contrave", to learn more.
On the the manufacturer's website, there was some technical information about this drug (see below). What caught MY eye, however, was a deviation from facts to the following commentary:
We believe that bupropion helps initiate weight loss while naltrexone may sustain weight loss by preventing the body’s natural tendency to counteract efforts to lose weight.
Really? It has been scientifically proven that the body has a natural tendency to resist weight loss?Well, if you believe that you're helpless and without any solution other than a medication, you're more likely to help this company's profit margin. That's what they need you to believe in order to satisfy their investors!
The buzz on the news was that the drug has been shown to induce a weight loss of 5%. That means if you're 250 lbs, you can expect to lose about 12 1/2 of them. We've been taught as health professionals, to tell the public that a small weight loss of 10% of body weight can have important health effects, and not to focus on large, drastic changes. But taking a pill to achieve only half of that? Not impressive at all.
I'm insulted for this blog's readers. Can't you do better than that? Can't you just tell the truth about the drug and trust that it has potential in certain cases? Which I'm sure it does? I like to think most people who I have ever come in contact with, deserve much more credit than that. They can make intelligent decisions and do not need to be manipulated in this fashion.
Here are the facts about the medication.
1. It is a combination of two medications that have been used for a variety of clinical purposes, naltrexone and bupropion (Wellbutrin).
2. Naltrexone is an opiate antagonist. According to NIH, it is"used along with counseling and social support to help people who have stopped drinking alcohol and using street drugs continue to avoid drinking or using drugs." The link above provides a pretty long list of contraindications and side effects, and they include pregnant and trying to become pregnant…not likely a great option for many of our readers.
3. Bupropion is an antidepressant that has been found to help facilitate weight loss. It's been used for this off-label purpose for a long time. Not that it can't help, especially if there is depression accompanying your weight gain (not ABOUT the weight gain but as a co-existing condition). But I believe there are many things about most of our audience that can be done to alleviate depression and normalize weight which should be tried BEFORE resorting to medication.
If anyone from Orexigen can produce peer-reviewed research supporting the claim that the body resists weight loss, they're welcome to comment on this blog.
Until that happens, I maintain that any time someone tries to tell you that you can't do something, and your believing them holds potential to transfer money from one bank account to another, you should consider the tactic a challenge to prove them dead wrong.
