Tips on managing crazy weight gain on birth control (Visanne)?
July 21, 2013 1:09 PM   Subscribe

If I eat 3 meals a day, I can put on 2-3 pounds a day. If I eat 2 meals and a snack, I can maintain my weight. I am so hungry it is ALL I can think about. Halp!

So, after a very long and extremely painful 18 months, my gyno finally diagnosed me with endometriosis and put me on Visanne to control it. 4 months later, the pain is very bearable and hardly bother me at all - YAY.

However, I've noticed several problems re: food and weight. Firstly, it makes me ravenously hungry ALL THE TIME, like I start thinking about my next meal about an hour after the last one, and it's all I can think about until then. I start fantasising about breakfast about 10pm and that lasts until I fall asleep.

When I do eat three (normal) square meals a day, I can put on 7 pounds in a week. If I eat two meals a day and a snack, I can maintain my weight. I am starving all the time. My normal weight is about 138 lbs and I'm now 146. I'm 5 foot 6. I did mention this to my gyno who said it was normal. Does anyone else have any experience with this, and any tips on how to manage it (if at all?). I'm beginning to not fit into my clothes anymore now. Any advice much appreciated!
posted by everydayanewday to Health & Fitness (22 answers total) 2 users marked this as a favorite
Best answer: Eat a lot of vegetables and high-fiber foods. Fiber makes you feel fuller longer. I recommend bran flakes with just a few chocolate chips on top. The chocolate chips (like, only 10 per bowl of bran flakes, with skim milk) really help make it not taste boring.

Salads with very little or no dressing, crudités (baby carrots, celery, broccoli) are good too.

If you are a healthy weight, you might just have to get comfortable with a few extra pounds in exchange for the pain you were in before the diagnosis. Not great advice, I know, but I have had a similar problem and just getting more comfortable with my bigger body has been good for me. It is a challenge, I know.
posted by k8lin at 1:30 PM on July 21, 2013 [3 favorites]

Oh also gum is good. And try drinking more water. That is good for you and will help you feel fuller.
posted by k8lin at 1:31 PM on July 21, 2013 [1 favorite]

Yeah, I agree on the vegetables: try to find foods that are bulky and will fill you up without many calories. Fruit has more calories than vegetables, but will probably still work well--it's still a lot of fiber and water. Also low-fat vegetable soups and broth-based soups.

But also, I don't think this is a 100% typical response to birth control. A lot of people gain (or lose) a small amount of weight, but ravenous hunger all the time seems extreme. Talk to your doctor about it. Maybe there's a different type of birth control you can try. For example, would the mini-pill work? It has lower doses of hormones. Or the Nuva Ring I think also uses smaller amounts of hormones, since it's applied locally through the vagina, rather than systemically through your blood--which also might make it less likely to cause these side effects.
posted by pompelmo at 1:52 PM on July 21, 2013

When I do eat three (normal) square meals a day, I can put on 7 pounds in a week. If I eat two meals a day and a snack, I can maintain my weight.

Well, what are you eating? How much carbs/fiber/protein/fat? More of some and less of others will leave you feeling hungry.

Anecdata point: when I was in a lose-weight phase of eating, I had a hard time getting up to 1000 calories a day when I was keeping my carb intake below 50g/day, because the fat/protein/fiber I was eating instead kept me feeling fuller for much longer.

Bodies are all so different, though; YMMV is pretty much a given, especially because of the HBC (which I've never been on so I can't speak to that aspect at all).
posted by rtha at 2:16 PM on July 21, 2013

Keep an eye on the amount of added sugar in all sorts of food. We've been pretty attentive to it lately, and seems that it's helped my wife and I lose a few pounds. When you think about how much sugar (4 grams = 1 teaspoon of sugar) is typically in processed food (20 - 30 grams is what I notice), that's a lot of empty calories.
posted by hick57 at 2:18 PM on July 21, 2013

Response by poster: On a typical day I will eat porridge for breakfast with raisins and prunes and a teaspoon of maple syrup. I drink a cup of fruit juice with this. Then I'll have a sandwich for dinner and a low-cal chocolate bar to help my cravings (never more than 140 cal per bar). Then for tea I usually make soup (carrot and coriander/broccoli and blue cheese, pea and mint typically) and have two pieces of bread. Recently I've had to switch out my dinner for a small bowl of cereal or I put weight on.
posted by everydayanewday at 2:46 PM on July 21, 2013

I don't see where the protein is in your diet. Are you sure you're getting enough?
posted by elizardbits at 3:16 PM on July 21, 2013 [7 favorites]

Best answer: Just because it's "normal" doesn't mean that you have to accept it as your only choice. It's certainly worth asking your gynecologist what other meds are options for you and how they might affect your weight and appetite. It is *not* your fault that your gyn blew you off the first time, but it is a sign that you may have to be more blunt.

Example: "Dr. Smith, while Visanne is working great to control my pain, the side effects are unacceptable. If I eat three healthy meals a day, I find that I'm gaining up to 7 lbs/week. I can only maintain my weight by eating 2 meals and a snack, which leaves me ravenously hungry all the time. We need to explore other options to control my pain that won't cause these side effects."
posted by epj at 3:24 PM on July 21, 2013 [7 favorites]

Best answer: You're battling a hormone shift that is obviously disrupting your usual ability to restrain weight gain. Eating more fiber and protein, as well as small amounts of good fat (olive oil, nuts) can help curb your appetite. Don't cut out carbs completely, but be aware of how much refined carbs you're eating and look for more filling alternatives.

Your typical diet doesn't seem very calorific, but it also seems to be perfectly designed to spike your hunger. You're taking in a lot of sugar (dried fruit, maple syrup and juice) at breakfast and a lot of bread (refined carb, or refined-ish carb even if it's "real" whole grain) the rest of the day. These are the kinds of food that can spike your blood sugar, but the crash soon afterwards makes you hungry again.

If you want porridge for breakfast, how about porridge + fresh berries + some nuts and seeds + a splash of milk (cow, almond or soy) AND a hard boiled or poached egg (if you like eggs). Fiber and protein help you feel full.

At lunch and dinner, try some quinoa, brown rice or steamed sweet potato instead of bread. Put a little butter on the sweet potato.

Don't drink fruit. Fruit juice is pretty damn close to pop with some vitamins dripped in it. Eat fruit, with the fiber.

Are you eating 5-10 servings of veggies a day? (Serving = 1 cup of salad greens, 1/2 cup of anything else). If you eat salad, don't buy commercial low fat dressing (it's almost certainly full of sugar), but figure out how to make a dressing based on a small amount of healthy fat like olive oil. Fat also helps you feel full.

Instead of the low cal chocolate bar daily (which probably has even more added sugar), can you try one small piece of really good dark chocolate after supper each day?
posted by maudlin at 3:34 PM on July 21, 2013 [21 favorites]

Yes, eat more protein! My fool-proof breakfast is non-fat Greek yogurt mixed with chocolate protein powder. Tastes like pudding, 250 calories, astoundingly filling.
posted by baby beluga at 3:37 PM on July 21, 2013 [2 favorites]

Nthing fiber might help some. Lots of veggies and some whole fruit. Eat whole grain when you eat grains.

I don't see a much protein in your day. Bumping that up might help, too.

I see a lot of sugar in your diet, which I definitely second cutting. In my mind, simple carbs fall pretty close to that category. Juice is a straight-up sugar bomb, and isn't helping you.

On preview, this exactly:

"Your typical diet doesn't seem very calorific, but it also seems to be perfectly designed to spike your hunger. You're taking in a lot of sugar (dried fruit, maple syrup and juice) at breakfast and a lot of bread (refined carb, or refined-ish carb even if it's "real" whole grain) the rest of the day."
posted by moira at 3:42 PM on July 21, 2013

Response by poster: I'll sometimes eat chicken on my dinnertime sandwich (although most of the time I use egg). I know I eat way too much sugar - I crave it constantly. Cutting it down will be the hardest part.
posted by everydayanewday at 3:44 PM on July 21, 2013

Yeah, sugar is evil that way. It causes a cycle of craving that is tough to break.
posted by moira at 3:47 PM on July 21, 2013

I should add to that: it's been my experience and that of many others that the cravings do stop after a while.
posted by moira at 4:10 PM on July 21, 2013 [2 favorites]

Best answer: Definitely go back to your doctor and talk to her about it; even if you have few other options, it's not OK for a doctor to just pooh-pooh your concerns. And when you see her, push for a blood-sugar test. Ravenous hunger may be a sign of insulin resistance issues. When I was given Seroquel for sleep I was a remorseless eating machine and gained quite a bit of weight. The Seroquel was messing with my blood sugar and making me insulin resistant; triggering MASSIVE hunger pangs as well as low blood sugar in the AM and feeling foggy and cranky if I didn't snack, snack, snack. I quit the Seroquel and am losing the weight and my appetite is normal.

Eating a high-protein, low-carb diet will help a LOT. But do get your blood sugar checked just in case your meds are triggering insulin resistance.
posted by Rosie M. Banks at 4:13 PM on July 21, 2013 [6 favorites]

Eating sugar totally creates and sustains sugar cravings!
posted by rtha at 5:12 PM on July 21, 2013 [2 favorites]

Best answer: Longer answer since I hit post instead of preview: less bread and fruit juice, more avocado and good fats and protein. And if you have the kind of, um, restraint problems I do, do not keep "bad" carbs in the house. If I think I will want a cookie, I will buy one (overpriced!) cookie from the bakery instead of a whole package of cookies. Likewise, I find a couple of squares of really good dark chocolate much more satisfying than a whole bar of crappy chocolate.

Two eggs scrambles with a little cheddar mixed in and a dollop of cottage cheese on top is about 220 calories and keeps me from feeling OMG STARVING for many hours.
posted by rtha at 5:17 PM on July 21, 2013 [1 favorite]

I started taking 10g of hydrolyzed collagen (it's basically gelatin) in the am in my protein shake for reasons totally unrelated, but I have found it very true that that it's incredibly satiating. I have to remind myself to eat (not my usual issue...) Also, it's more protein.
posted by atomicstone at 5:39 PM on July 21, 2013

Best answer: For me the key to weight loss was keeping my glycemic load as low as possible. check out this site which tells you how to calculate glycemic load for the foods you eat. You want to keep your overall load at 99 for the day, and you can see how fast the load ramps up when you eat even " good carbs" like fruit juice and wheat products.

Note: I'm not on any medication that causes weight gain, but these tips could still help you.
posted by sweetkid at 6:29 PM on July 21, 2013 [1 favorite]

Best answer: In addition to talking to your doc about this possibly outlier response to your HBC, poke around on askme for recs of low-carb-type recipes (we have a million, I swear), and I'd recommend also looking for a calorie/carb/fiber/protein tracking app (if you have a smartphone, that is, and even if you don't: keep a notebook and look stuff up on your computer at the end of each day). It was enormously helpful to me to see pretty much exactly what I was eating in what percentages of my diet to come to an understanding of what makes me gain/lose/remain at a steady weight.
posted by rtha at 6:35 PM on July 21, 2013 [1 favorite]

I had the exact same problem when I switched from a regular birth control pill to one where you have your period every three months. I gained 15 pounds in about 6 weeks. I know this doesn't directly answer your question, but after attempting to manage my eating, I finally had to switch to a new (period every month) pill. I immediately lost 10 of the 15 pounds and my eating habits went back to normal within a couple weeks.
posted by skycrashesdown at 8:21 AM on July 22, 2013

The only thing that stops my insane cravings is fat and protein. It may seem counterintuitive, but it stops my insane hunger in its tracks, and I lose tons of weight quickly. Then I forget the awesomeness of life without desperate hunger... And have to restart the process. Paleo is the best thing that ever happened to me, and I recommend it heartily, despite its faddishness.
posted by thegreatfleecircus at 7:55 PM on July 23, 2013 [1 favorite]

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