When Medicine Makes You Fat
By LOREN BERLIN
Sometimes drugs that heal your body can cause side effects that dampen your spirit. Loren Berlin, who has ulcerative colitis, writes about gaining weight as a result of a drug treatment.
Two years ago, when I was 29 years old, I experienced my first flare from ulcerative colitis, an autoimmune disorder of the colon with intermittent cycles of disease activity and remission. I lost five pounds in less than a week, was unable to eat or drink, and was bleeding internally from the ulcers and inflammation decimating my large intestine.
My gastroenterologist prescribed prednisone, a corticosteroid that vanquished my symptoms in seventy-two hours. Literally. One day I was on the verge of hospitalization. Three days later I was no longer bleeding. It was amazing. But it wasn’t free.
Prednisone is infamous in the medical community for its side effects. It can cause osteoporosis and diabetes. It suppresses the immune system and can lead to insomnia and depression. Sure, that all sounded undesirable, but I didn’t worry about it. Instead, what concerned me was the significant weight most patients gain as a side effect of the drug.
My entire life, I’d felt self-conscious about my body. My hips were too wide, my thighs too flabby, my tummy too much like Winnie the Pooh’s after a morning with his honey pot. So I exercised. Forty-five minutes a day, four days a week. Religiously. And I ate reasonably. Fresh mangoes, spinach salads, frozen yogurt instead of cream cake. My body tightened, but didn’t shrink. After a few years of this, I learned to accept my size eight curves. No, they weren’t ever going to land me on a billboard, but I felt attractive. I had a healthy body that categorically designated me a medium in department stores.
Then I got ulcerative colitis. Suddenly the treatment for my disease threatened to erase my years of laps in the pool and squats in the living room. And there wasn’t much I could do about it. I needed the medicine, and the drug caused weight gain. It was that simple.
Initially I got angry. It seemed unfair that I should have to lose my hard-earned shape to regain my health. These weren’t the terms I wanted to negotiate. But my gastroenterologist and my blood tests told me that what I wanted and what I needed were at odds, and needs trumped wants.
During my first few weeks on prednisone, I rebuked myself for my immaturity, for crying when my favorite jeans no longer fit, for snorting at my boyfriend when he complimented me. After about six months on prednisone, I had gained 14 pounds, a 10 percent increase in my body weight.
I scolded myself for placing so much emphasis on the superficial when I should have been grateful for a drug that could control my illness. There I was, actively worrying about my pant size while my body attacked itself. I was stunned by my own vanity.
Over time, my life regained some semblance of normalcy. I returned to my classes in graduate school and started getting dressed up for nights out with my girlfriends. The fact that I still cared about my looks meant that I hadn’t allowed myself to be resigned to my disease. I still planned to be out in the world, doing my thing. And I still wanted to look good doing it.
Other medications have since put my illness into remission, and I no longer need prednisone. Exercise and healthy eating have helped me drop 8 pounds. But because my disease cycles between remission and flares, I will probably relapse. When I do, I may or may not require prednisone.
If I do, it’s likely that I will once again have to cope with weight gain as a byproduct of restored health. But now, I’ve come to realize that my vanity, in the midst of a serious illness, isn’t such a bad thing. In caring so much about my appearances, I am acknowledging that my illness is just one part of a whole person. I’m a 31-year-old woman with the same goals and insecurities as any other 31-year old woman, with or without a chronic health problem.
And looking in the mirror reminds me of a fundamental truth. I am more than my disease.
Ms. Berlin, who works at a nonprofit organization in Durham, N.C., has written other stories about living with ulcerative colitis. Read about her diagnosis in “When the Body Decides to Stop Following the Rules,” and her remission in “In Fleeting Health, Moments to Savor.”
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