Archive for April, 2008

Weight Gain Problems as Mental Illness Stabilizes

Tuesday, April 29th, 2008

Last year after my son’s major psychotic break started and went on and on for six months, he actually lost weight… I guess about thirty pounds or so. The weight loss was a good thing because he was a little overweight to begin with, therefore the weight loss made him look to be at a healthy weight again… not too thin and not overweight.

solitary man in desert

photo by greggoconnell

Now as the severity of his mental illness symptoms has abated DS has started putting on weight again. I would say in three months he has put it all back and more. I went with my son to one of his psychiatric appointments and the doctor, after making a visual observation, decided to change one of his medications.

This is interesting how no weight scale is used. If I go to my regular doctor for anything at all, they make me step on the scale. I have never seen a scale in a psychiatrist’s office.  I have read that this is becoming a matter of debate. The majority of medications for treating mental illness cause weight gain. Obesity is becoming a major contributor in the USA for many serious health problems, such as heart disease, stroke, diabetes, etc. and any doctor should be concerned about this side of their patient’s health.

Then again, where mental illness is concerned, medication compliance is a serious issue. It is a common thing to hear of a person going off their medications and having relapses. I wonder if psychiatrists do not want to draw attention to a person’s weight gain because it will cause only more reluctance to take the medication. Psychiatrists and their patients have to walk a very fine line. This is something very hard to do where the science is so inexact, and the medications leave a great deal to be desired for being effective without serious side effects.

So, how do my son’s medications cause his weight gain? From what I have read they interfere with his body’s ability to recognize fullness after eating. He can eat and eat and eat (and he does) and never know when he has had enough. For the last couple of months I have tried talking to DS about this problem and let him know that he cannot trust his body’s ability to signal fullness. Also with him being a young man and not having much experience with dieting or counting calories or all that, I have tried suggesting to DS that he merely look at his plate, put a reasonable amount of food on it, eat, and be done.

I have also talked to CA (the woman who takes care of him in her personal care home) about creating fewer opportunities to overeat by cooking less at a time to begin with or putting away the extra food in the refrigerator after putting portions on their plates. She says, he always asks for more and it is hard for her to say “no.” I can understand this. I don’t always like facing his angry moods either, and I am always treading softly. (Yes, I am a wimp.) CA also made me aware that DS is buying cookies and sugary drinks in large quantity at the grocery store when they go together. He takes them to his room and eats them there, so there is no hope of her being able to regulate it. I agree this is a big problem also, so I have told her I will try to discourage him from taking as much money from his checking account, talking to him about having a plan for how he will spend his money.

This weekend when he was home for his visit, I tried to enlist him in talking about behavior modification to prevent overeating, using myself as an example. Yes, I could lose a little weight also. Last year while DS was losing thirty pounds, I was putting on thirty pounds. I had my pad of paper and pen and was writing down ideas and trying to elicit suggestions from DS. I then tried to get DS to do the same for himself. He was not interested. He knows he has a weight problem, but he says he is sure he can exercise it off. I expressed skepticism about that, but when I could tell I was not going to change his mind, I suggested we make a trial of it. We then talked about his exercise goals, and before his dad took him back to CA’s, I spoke with her by telephone within DS’s hearing about his new exercise goals. She wanted to argue with me about the futility of the program without controlling eating, and I had to say, “I agree, but we are making a trial of this, it’s a first step, and hopefully we can make adjustments in the future if we need to.”

Before DS left, all three of us, Dad, DS and I, took our turns stepping on the scale and we recorded our weights on the calendar. I am trying to make this weight loss program a supportive thing and hopefully not a competitive one. I never can get myself to lose weight for external reasons; I have to be ready to do it for myself, so I don’t know if I will be able to lose weight right now while I am dealing with some other stresses and goals in my life.   I have found weight loss to be rather difficult when I cannot make it my number one priority all day long.

From the way I see it, my son has just the opposite problem. He has very little to do all day long, so I can see that eating and sleeping may be his escape from boredom. Also I still wonder how much his schizoaffective disorder has affected his ability to focus on a goal or any task for that matter. While his delusions do not appear to be as severe as they were last year, he sometimes does not seem to be “all there.” This falls in line some with what I learned in my NAMI Family-to-Family class. Mental illness has positive and negative symptoms, meaning it adds things (like delusions) that were not in a person’s life before and takes away things also.