For any doctors out there? is there anything i could get to help me?

Question

i am a little overweight and am finding it hard to lose it. I am 26 years old and my BMI is 25. I need to lose between 6 and 8 kilos. I have a 20 month old son who keeps me busy, work part time and am fairly active. We have been through some major changes with moving interstate and leaving family and friends and im feeling like maybe im a little depressed? Find it hard to get out of bed, hard to motivate myself to exercise, and i am over eating.
I know that the feeling down and lack of motivation will pass, not that serious, so i dont want medication for that.
Is there something else i could ask my doctor for to help me lose weight? I also have PCOS and it's important not to let my weight get out of control for that reason too. What could someone prescribe me to help me lose that 6 or so kilos fairly quickly?

Answer 1

Your best bet at losing weight (and keeping it off) would be to keep treating your PCOS. I wont get into the medical technicalities of it...but our bodies work against us when we try to diet making it nearly impossible to lose weight. If you are treating the PCOS correctly, then that doesn't happen. You should be on metformin (or another insulin sensitizing drug)

I wouldn't recommend any diet pills (stick with a multivitamin and omega fatty acid supplements). You might also want to add a calcium and vitamin D supplement (Ive read it helps with weight loss too..but I dont know for sure). Those diet pills probably wont work much anyway. Here's some basic PCOS info:

The underlying cause of PCOS is insulin resistance (IR). The best treatment for PCOS is going on an insulin sensitizing drug such as metformin (1500-2550mg per day) combined with a low carb diet and exercise. There are a few important things to know:

1. Many women "pass" the test for IR, but still respond positively from the metformin. No one knows exactlly why..my thought is that the test is not a sure fire way of detecting the IR.

2. You must be on a high enough dose of metformin. I've heard women complain that their bodies dont start working even though they've been on metformin for awhile. Some doctors are hesitant to up the dose past 1500mg...but for some of us it takes more. I don't respond until my dose is around 2000mg a day.

3. It can take a few months on the correct dose, before your body is regulated.

4. It is important to treat your PCOS even if you are not trying to get pregnant. There are higher risks for many things (high blood pressure, blood clots, diabetes, and many other things) when you have PCOS, but if it is treated properly, then those risks are lowered.


When the PCOS is treated properly, all of your symptoms may not disappear, but they should improve some. It will also be a lot easier to lose weight.

There are TONS of books about PCOS and dieting. There are two that I recommend. Here's the links at amazon for those (if you're interested):
http://www.amazon.com/o/asin/0809224275/...
http://www.amazon.com/o/asin/0007131844/...

I also recommend a couple web sites:
http://pcos.itgo.com/
http://www.inciid.org/faq.php?cat=infert...

http://messageboards.ivillage.com/iv-bhp... This one is a great message board where you can ask all your PCOS questions or just chat with the women who are also dealing with PCOS. Good luck.

Answer 2

You should not be aiming to lose the weight quickly. You should be developing a set of habits that enable you to lose weight and to keep the weight off. Crash diets and exercise binges will lose the weight for you for a short time, but when your old habits kick in you'll be back to square one, plus you will have less faith in the process that secured you the weight loss in the first place.

Have a look at the wikipedia site. It's not a bad place to start.

Here's an excerpt from emedicine regarding Polycystic Ovarian Syndrome

Medical Care: Medical management is aimed at the treatment of metabolic derangements, anovulation, hirsutism, and menstrual irregularity.

Metabolic derangements
Diet and exercise: In patients with PCOS who are obese, endocrine-metabolic parameters markedly improve after 4-12 weeks of dietary restriction. Their SHBG levels rise and free testosterone levels fall by 2-fold. Serum insulin and IGF-1 levels also decrease. Weight loss in patients with PCOS who are obese is associated with a reduction of hirsutism and a return of ovulatory cycles in 30% of women. A moderate amount of daily exercise increases of levels of IGF-1 binding protein and decreases IGF-1 levels by 20%. Modest weight loss of 2-5% of total body weight can help restore ovulatory menstrual periods in obese patients with PCOS. A daily 500-1000 calorie deficit with 150 minutes of exercise per week can cause ovulation.

Metformin: This is an antidiabetic drug that improves insulin resistance and decrease hyperinsulinemia in patients with PCOS. Ascertain that kidney and liver function are normal and that the patient does not have advanced congestive heart failure before starting metformin. The usual starting dose is 500 mg given orally twice a day. Common adverse effects are nausea, vomiting, and diarrhea. Patients who develop these adverse effects can be instructed to decrease the dosage to once a day for a week and then gradually increase the dosage. Also, inform patients that they have a high likelihood of having ovulatory cycles while taking metformin. of the US Food and Drug Administration has been not approved metformin for this indication; therefore, this use is off label.
Anovulation

Metformin: Metformin therapy resulted in ovulation in 46% of patients compared with placebo. Metformin combined with clomiphene resulted in ovulation in 76% of patients compared with 42% in patients who received clomiphene alone. Metformin also has a small but beneficial effect on metabolic syndrome.

Management of infertility: Patients with PCOS who are infertile but who desire pregnancy should be referred to a reproductive endocrinologist for further evaluation and management of infertility.
Hirsutism
Hair removal: Short-term nonpharmacologic treatments of hirsutism include shaving and use of chemical depilatories and/or bleaching cream. Measures like plucking or waxing unwanted hair can be associated with folliculitis and ingrown hairs. Long-term measures include techniques such as electrolysis and laser treatment of unwanted hairs.

Weight reduction: Weight reduction decreases androgen production in women who are obese; therefore, losing weight can slow hair growth.

Oral contraception: Women who do not wish to become pregnant can be effectively treated for hirsutism with oral contraceptives. Oral contraceptives slow hair growth in 60-100% of women with hyperandrogenemia. Therapy can be started with a preparation that has a low dose of estrogen and a nonandrogenic progestin. Preparations that have norgestrel and levonorgestrel should be avoided because of their androgenic activity.

Spironolactone: Antiandrogens, such as spironolactone, are effective for hirsutism. Spironolactone 50-100 mg twice daily is an effective primary therapy for hirsutism. Because of its potential teratogenic effects, spironolactone should be prescribed with an oral contraceptive. Adverse effects of spironolactone include GI discomfort, and irregular menstrual bleeding (which can be managed by adding an oral contraceptive).

Eflornithine: Eflornithine (Vaniqa) is a topical cream that can be used to slow the hair growth. Eflornithine works by inhibiting ornithine decarboxylase, which is essential for the rapidly dividing cells of hair follicles.
Menstrual irregularity

This is treated with an oral contraceptive, which not only inhibits ovarian androgen production but also increases SHBG production.

Pregnancy should be excluded before therapy with oral contraceptives is started.
Surgical Care: Surgical management is aimed mainly at restoring ovulation.

Ovarian wedge resection: This procedure has fallen out of favor because of postoperative adhesion formation and the introduction of ovulation-inducing medications.
Laparoscopic surgery: Various laparoscopic methods, including electrocautery, laser drilling, and multiple biopsy, have been used with the goal of creating focal areas of damage in the ovarian cortex and stroma. Potential complications include formation of adhesions and ovarian atrophy.
Consultations:

An endocrinologist should be consulted for follow-up evaluations of biochemical and metabolic derangements.
A reproductive endocrinologist should be consulted if the patient is infertile and desires pregnancy.
Diet:

Women who have impaired glucose tolerance should start a comprehensive program of diet and exercise to reduce their risk of developing diabetes mellitus.
Obese women with PCOS can benefit from a low-calorie diet for weight reduction.
Women with abnormal lipid profile need to be counseled on ways to manage the dyslipidemia. Such ways include eating a diet low in cholesterol and saturated fats and increasing physical activity. Guidelines from the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III) (2001) serve as a guide for the treatment of women with PCOS and dyslipidemia.
Activity:

Encourage moderate physical activity in these patients, provided they have no contraindications to vigorous physical activity.