Help for balloon [wo]man

May 7, 2013 11:01 AM

What can I do in the short term to feel better while losing weight when everything seems to make me gassy, swollen and uncomfortable? My doctor's answer to everything seems to be "Lose weight!". That's not going to help these problems in the moment. TMI descriptions follow...

I am significantly overweight and have been so since my tween years (I'm 40 now). Right now I have over 100 lbs that I'd like to lose and I have begun to chip away at it by tracking my calories through myfitnesspal and working out at a gym. While I've been unhappy with the weight for a long time there have been some changes in how my body is reacting to the extra weight that has helped to spur me along, so to speak.

I get an upset stomach a lot, even when I eat really bland foods like oatmeal. Just this morning I had some oatmeal, immediately felt bloated and had diarrhea within an hour of breakfast. In addition, I often find myself belching after every meal and sometimes when I'm just drinking water. Whenever I mention these sorts of symptoms to my doctor her only response is to lose weight. Well, it's going to take me a very long time to get down to a "healthy" weight and I would love some options so that I don't have to be uncomfortable day in and out while I'm working on this.

The second issue I've noticed is that my feet are swelling on a regular basis. I am currently on high blood pressure medication and when I first when on it, my feet would swell so we adjusted the dosage down and the problem seemed to be corrected. Well, I've been on this medication for about 8 months and my feet are suddenly swelling almost daily and the joints in my feet hurt. Yeah, I know that age and weight will do this to your feet but is there something I can do to combat the problem while I work on weight loss? I don't have a hugely salty diet so I don't think that is the issue.

Any advice on how to deflate my tummy and my feet?

posted by jezemars to Health & Fitness (24 answers total)

Best answer: If your doctor is dismissing your concerns, find another doctor. Losing weight is hard enough without having to worry about the swelling and GI issues you're having to deal with as well.

Also, yay for taking care of yourself!
posted by tigerjade at 11:10 AM on May 7, 2013 [10 favorites]

Wow, I am really sorry your doctor is being dismissive like this. In your shoes I would find a new doctor who takes you seriously, or insist that your present doctor does so. Your symptoms could be consistent with Crohn's, celiac, or other GI-tract stuff that should be taken seriously.
posted by pie ninja at 11:11 AM on May 7, 2013 [2 favorites]

The belching and the bloating may be acid reflux. I had that as well -- belching after eating and a bloated/gassy feeling, but no heartburn pain -- and was also advised to lose weight. What helped quickly however was Nexium/Prilosec. I did have to get a prescription, but there are other types of this medicine available OTC such as Pepcid AC.
posted by Lescha at 11:12 AM on May 7, 2013 [1 favorite]

I'm just wondering what your diet is like? It's great that you're counting calories, but it's just as important what type of calories you're eating. If you're subsituting foods for "low fat" versions, these are often high in sugar and/or salt to make them more flavoursome. It's better to stick to smaller portions of real, good quality food. Make sure you're getting all the food groups and not just thinking low-cal.

Also, although it sounds counter-intuitive when you're retaining fluid, make sure you drink lots of water - lots - to keep yourself hydrated and to help eliminate the toxins from your system. Strawberries and tomatoes are good diuretic foods, as well as some others.

Finally, if your doctor keeps brushing off valid concerns I'd think about switching. Has she checked you for IBS for example? This has nothing to do with weight, so if you're suffering from it now you shouldn't be palmed off until some time in the future when you meet her requirements.
posted by billiebee at 11:12 AM on May 7, 2013 [1 favorite]

Best answer: It is possible that you have some sort of food sensitivity or allergy that is contributing to the bloating. What you described is exactly how I felt after eating almost anything. A couple of years ago I got fed up with doctors not knowing WTF was wrong with me, so I tried an elimination diet. Proper elimination diets are difficult, but worth it (in my opinion). My issue turned out to be a gluten intolerance. I have since eliminated gluten from my diet, and if I accidentally have some (usually at a restaurant that doesn't handle cross-contamination issues well), I have exactly the symptoms you describe from eating the oatmeal.

For the swelling, I also had this when I was heavier. What kind of blood pressure medication are you on? I was on an ACE inhibitor alone and had the swelling issue, but now am on a combo ACE inhibitor + diuretic pill and that seems to have sorted it out. I also noticed that the swelling and water retention in general lessened once I stopped eating processed sugars, but that may just be how my body does things, because bodies are weird.

And nthing finding another doctor. Your doctor is being dismissive of your concerns, and your concerns are valid. You have a medical issue that needs to be addressed. I suggest asking for a referral to a gastroenterologist because they will be best equipped to help you sort out the digestive issues, but also look for a new GP that won't just dismiss your medical concerns because you're overweight.
posted by bedhead at 11:15 AM on May 7, 2013 [4 favorites]

How about walking immediately after you eat? That might help.
posted by Dansaman at 11:18 AM on May 7, 2013

And if not Acid Reflux, Barretts?

Agreed on finding a new primary care person.

I had swelling issues (still working on the weight) but once that got resolved (not blood pressue) its made it easier to lose some weight.

Seconding bedhead on the elimination diet, too. Me it was my interleukins and some other kind of weird mechanics that managed to kill the swelling for nearly a year now? I don't remember.
posted by tilde at 11:24 AM on May 7, 2013

Immediate belching after eating could be a signal that you are eating too fast and gulping air with your food. This was a side effect of being heavy for me which went away when I lost weight. It can also be a sign that your trousers are too tight (I read a medical paper where the authors called this the 'Waist to Girth Discrepancy' and pointed to it as a major cause of stomach discomfort for men now that suspenders are out of fashion. )
posted by srboisvert at 11:26 AM on May 7, 2013

Have you tried a low-carb/paleo diet? It really helps me feel less bloaty and full.
posted by dawkins_7 at 11:28 AM on May 7, 2013 [4 favorites]

Best answer: Another doctor. Because Fat is not an answer to every damned question on the planet. Make that point with your (and your insurance co's) money and time.

Tell the new doctor up front that Because Fat will not be an acceptable answer. Gas symptoms can be indicators of poor gallbladder function (and a lot of people losing weight have gallbladder troubles along the way), the doctor ought to care about that and at least be interested in benchmarking over several months to determine severity.

You may need to log both food and symptoms meticulously to identify any real cause and effect. Eliminating some low-hanging culprits like grains (oatmeal's not the healthiest/most nutritious food in the world, neither are a lot of other bland foods) for a couple of weeks may help you identify what's setting you off.
posted by Lyn Never at 11:31 AM on May 7, 2013 [8 favorites]

FYI, just so you don't get freaked out by googling it, Barrett's esophagus is a result of longstanding gastric reflux. If you don't have a history of chronic reflux over many years, you probably don't have Barrett's.

I suggest that people here not throw out potential diagnoses of pre-cancerous conditions if they do not know the details of what they are talking about.

Have you tried asking your doctor "what do you suggest I do to ease these symptoms while I am in the process of losing weight?" I agree that you should not need to be this explicit, but good communication is a 2 way street. If you've been direct and nothing has resulted, a new doctor is a good idea.
posted by treehorn+bunny at 11:33 AM on May 7, 2013 [6 favorites]

These symptoms are exactly the kind of things that prompt referrals to the GI practice where I work as a nurse. A GI work-up would be very appropriate. Your symptoms may have little to do with your weight, but they might be exacerbated by excess weight, and be preventing your doctor from evaluating them in their own right.

Your feet swelling might be related your blood pressure, or your blood pressure medication, or it might be something else. If it is your blood pressure, I wonder if your doctor has suggested a diuretic? They are usually prescribed as a first-line hypertension med these days, and are often used in conjunction with other antihypertensives. This should be well within the scope of your primary care physician, as it's one of the most common conditions they treat.
posted by citygirl at 11:34 AM on May 7, 2013

What helped quickly however was Nexium/Prilosec. I did have to get a prescription, but there are other types of this medicine available OTC such as Pepcid AC.

Prilosec (Omeprazole) is available OTC - and generic, although I would suggest a Rx as they are much less expense for a 30 day course if you have insurance.
I take 20mg Omeprazole once a day for my moderate GERD.

You do need to see a gastroenterologist for your symptoms. I'm guessing you are just going to a general practitioner or internal med doctor right now? A gastroenterologist will examine your symptoms and possibly do a test like a barium swallow or stomach scope.

First though, keep a food journal. Your doctor may end up having you do this anyway so start now. I know you are already counting calories, but a food journal involves tracking what you eat, AND how it makes you feel, and when.

If you have some sort of food sensitivity or GERD (acid reflux) you can see a dietitian/nutritionist to work out a diet for yourself that also keeps up your weight loss goals.

As far as foot swelling, how much weight have you lost since they adjusted your dose? You may need to adjust you dose again.
posted by Crystalinne at 11:35 AM on May 7, 2013

Damn, "lose weight" is not good professional advice. If it were as easy as that, no one would be overweight.

Here is a different take on how to eat. Now I've posted this twice in the last week - I swear I'm not a shill! I just think different approaches work for different people, so it's good to have options. Again with the full disclosure - I haven't read the book, only this synopsis. But afterward I did make some changes with regard to (lowering) fiber and water intake, and I feel they've helped me. Good luck.
posted by vignettist at 11:50 AM on May 7, 2013

Seconding the idea of giving Paleo a whirl. It doesn't have to be low-carb necessarily, but it does cut out wheat (which is a *very* common culprit for what you are describing), and it usually means cutting out a lot of dairy (but not necessarily all.) It sounds a bit fad-ish, but man did it make my stomach the most *peaceful* it has ever been (not to mention the least puffy/bloated/etc.)
posted by thegreatfleecircus at 11:55 AM on May 7, 2013

Definitely a new doc, because gas and bloating, while usually harmless, can be symptoms of many more serious conditions.

Since you're a woman, please play it on the safe side and tell your OB-GYN about your symptoms, too. Gas (and bloating, but abdominally) can be symptoms of ovarian cancer (something I never knew before seeing a PSA on a bus recently). The chances are SO slim that it's anything serious -- but they're nevertheless real, so to hear that your doctor is just attributing it to your weight is so angering to me.
posted by artemisia at 11:58 AM on May 7, 2013

I'm so glad you are taking care of yourself and decided to make a lifestyle change. Good on you! As others have said, please do get another doctor and perhaps one that specializes in nutrition. Keeping a diary of your food is much more important than counting calories. As you change your regular diet your digestive system may protest, so take it slowly and do not be discouraged with the discomfort. With your new doctor you can find out if you have an allergy or any other possible digestive issue. I had IBS and once I changed my diet and took better care of myself and monitored my stress levels I rarely suffered from the symptoms and I lost weight to boot. It was not my intention, but it was a side effect of just learning how to eat foods that were nutritious and good for me in appropriate proportions. Once you see some small improvement and feel better, you can be more motivated to exercise. The very intention of deciding to change an old habit will naturally move you towards your goal. In short, don't focus on the loosing weight, but focus on living a healthier lifestyle and being kind to yourself. The appropriate Dr, nutritionist or acupuncturist can help guide you. Keep on going on.
posted by happysocks at 12:02 PM on May 7, 2013

I've been happy on Paleo as others have said but I think your main issue right now is your doctor dismissing your concerns because of weight. As you have noted, that behavior isn't helping you at all with your gas issues. Definitely get a different doctor who can help you!
posted by sweetkid at 12:03 PM on May 7, 2013 [1 favorite]

Another doctor and do an Elimination Diet. I did the JJ Virgin Diet and discovered that I'm sensitive to Wheat, Eggs, Chocolate, peanuts, and tree nuts. I never knew and now...I'm not having gut problems like I used to.

I also stopped drinking soda, that has made a HUGE difference.

I do low carb/Atkins and I find that it's the best for me. So a paleo diet may work, I prefer dairy in my diet so YMMV.

I can't stress enough how important it is to see if you have sensitivities. Although it's super hard some days, not eating wheat has changed my life.
posted by Ruthless Bunny at 12:14 PM on May 7, 2013

Talk to a doctor (maybe a different doctor) about possible gallbladder issues. If that is it, dietary changes can help.

Eat watermelon to help the swelling go down.
posted by Michele in California at 12:33 PM on May 7, 2013

All of the above suggestions are good, but I have a few additional ideas.

Additional gas and bloating could be from something as simple as changing your diet. If you are adding fiber to your diet in the form of cereals, granola bars, nuts, and that sort of thing, bloating and gas are not uncommon. Changing the diet by adding more vegetables can add more gas. Adding fiber should be done slowly. Plenty of water should be consumed with fiber.

Peppermint tea can be helpful with gas and bloating. I use chlorophyll capsules or Beano when gas is a problem. Milk is generally my big cause of bloating. I do walk after meals.

Keeping a food diary is a pain in the neck, but it can often lead to ideas on what is causing problems. It also helps when discussing diet with health professionals. It has been the best tool in my quest for weight loss.

It is an exciting journey to become healthier as we age. Remember, you are not alone! I wish you better health!
posted by Leah at 12:43 PM on May 7, 2013 [1 favorite]

Nthing the elimination diet. As with bedhead, I have a gluten intolerance that manifests like this (with a side order of intolerances to fructose and sometimes dairy fat.) FWIW, going off gluten didn't just make me feel tons better; I also lost about ten pounds with no particular effort on my part.
posted by Andrhia at 12:51 PM on May 7, 2013

Bloating and gas can be signs of simple things like GERD, which can be handled with diet changes or Prilosec, or they can be signs of serious problems like ovarian or pancreatic cancer. Your doctor is a jerk if he doesn't bother pursuing the cause of your problem just because you're overweight. When I smoked, everything that was wrong with me was because I smoked. Then I quit smoking and gained weight and then everything that was wrong with me was because I was overweight. Then I changed doctors and oh, my - what a difference.

Get thee to a new physician.
posted by aryma at 4:33 PM on May 7, 2013

If your doctor dismisses your legitimate health concerns because of your weight, it's time to dismiss your doctor.
posted by inertia at 12:45 PM on May 8, 2013