The item with the biggest lack of progress on the Baby Bucket List is, sadly, my weight. This has been an issue for me, in one way or another, for over a decade! After a depressing look over my weight fluctuations and what my successes and failures have been, I decided its time to bring in the big guns. I talked to my primary care doctor, and she gave me a referral to the Department of Endocrinology. Not just for thyroid issues, Endocrinology (at least in our health system) also acts as a primary care for weight related issues.
So, I have my own Dr. H! I met with him last week, and we worked out a weight loss plan for me. He went over my weight loss history, and said that I actually do really well when I try to lose weight, and we just need to see how to keep it going. It fits in with my ongoing joke that I probably have a killer metabolism, and this is just the best its been able to do to keep up! I’m getting labs and a metabolism test to see if that is indeed the case.

My Dr. H’s philosophy is that there are five rungs in the weight loss ladder- food modification, physical activity, psychological counseling, medication, and bariatric surgery. Based on my history, he felt comfortable getting me started on four rungs!
Food Modification: I’m meeting with a dietician, Rose, once a month to look at broadened food choices, my food journal, awareness of hunger signals, and awareness of full signals. During my first visit, she went over some of the things like eating until fullness, and she said “I’m telling you the simple things not because I think you don’t know these things, but because they are simple enough to start right now.” I’ll meet with Rose once a month to check my progress. The cool thing is that Rose also works in OB for nutrition during pregnancy, so she can follow me all the way through the initial weight loss stage, but then even after I do get pregnant!
Physical Activity: Dr. H said he wants me to do an hour a day, 4 days a week. He doesn’t care what I do, as long as it raises my heartrate. He doesn’t recommend anything specific because one persons perfect activity as another person’s torture. Find something I can tolerate, and do it. The company gym does have trainers for periodic visits, but he said becoming a gym rat isn’t the goal and he’d prefer I find something I can do without a gym.

Psychological Counseling: Due to my eating disorder history and the fact that I slip into some of those patterns pretty quickly, I get to see a psychologist once a week. I figure if I run out of food and weight stuff to talk about, I can just talk about my Mom! {Just kidding Mom!}
Medication: I went on Xenical (the prescription form of Alli) years ago, and dang near shit my pants after eating sweet and sour shrimp in San Francisco. Due to my past experience, I was a little leary when he mentioned medication- however, Meridia sounded reasonable to me. It was originally an anti-depressant but didn’t actually make anyone feel better- but they saw appetite suppression, everyone lost weight! While for some it does have some anti-depressant capabilities (fingers crossed- hah!), Dr. H said that he’s seen good successes with it as a weight-loss tool. He also said that the concerns about cardiac issues have been shown to be minimal in someone without cardiac history, although I am to monitor my blood pressure twice weekly. So I filled my prescription, and started it yesterday! {Update just on Meridia coming in the next few days, but let me just say, I’m calling it a pharmaceutical gastric bypass!}

I will see Dr. H every three months to check progress and get repeat labs, and modify my plan as needed. Although sometimes I think this is overkill, I also see that what I’ve done on my own simply hasn’t worked! I’m hoping the increased accountability and the medication will give me the kick in the ass I’ve needed! I’ve logged my starting weight, blood pressure, and measurements. Stay tuned!
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