Losing weight

Losing weight, ah, yes. My lifetime challenge. I wore "chubby" sizes as a kid. I was put on my first diet either the summer I turned 11 or the summer I turned 12 (can't remember). I've gone on and off Weight Watchers so many times.

Last May I started going to Kaiser's metabolic weight loss clinic, hoping that maybe they'd have some magic for me. At first it didn't look good. Phentermine made me crazy depressed in the evenings and I had to stop taking it. Metformin, normally used to treat diabetes but also prescribed to prevent diabetes and help drop a little weight, made me feel like I had cement in my veins and changed my weight not at all.

Finally, in August, I agreed to try another drug, Contrave. It's a combination of the antidepressant Wellbutrin and another drug, Naltrexone, which helps addicts get off opiates. It sounded good to me because of course I struggle with depression, but also, I'm convinced that I'm addicted to chocolate and other sweets. I took my first pill on September 12, a little less than 2 months ago. That morning I weighed 240 pounds on my scale at home. I'd been bouncing around in the 239-242 range all summer, unable to keep even one pound off for more than a few days. When you're that heavy, and you can't do anything about it, life is pretty awful.

This morning, November 6th, I weighed 226 pounds. That's right -- in two months I've lost 14 pounds. I actually count it as 15.5 pounds, because when I started going to the metabolic weight loss clinic back in May, I weighed 241.5 pounds. Also, a day or two before I started Contrave I weighed 241. If I hadn't taken the Contrave I would have been back up to 241.5 a day or two later. Anyway. I know it doesn't matter. What matters is that I've lost at least 14 lbs in 55 days. That's about two pounds a week, a nice comfortable healthy weight loss.

Without doing anything except taking a pill.

I don't mean to imply that the pill takes off weight magically. You have to eat right and exercise. But I was already doing that. I've eaten a pretty good diet (breakfast, lunch, and dinner, that is) for decades. It's gotten worse with the twins and my teaching -- we eat out too much, etc. But it's not like I'm living on Mcdonald's hamburgers. And I exercise. I'm not a gym rat, but I walk. I walk the twins to school and back, and I walk all over campus. For someone as heavy as I am, it's pretty substantial exercise. What I have always done that's gotten me in trouble is eat chocolate. I crave chocolate. If I hear the word chocolate I start thinking about it and pretty soon I have to have it. I almost cannot say no to that urge. A few times in my life I've given up chocolate for some length of time -- twice for a full year. But the whole time, each time, I was fighting against the cravings, and when the time period ended, I went right back on the drug. The chocolate, I mean. My drug.

The way my doctor explained it to me (and I know I probably have it slightly wrong), we have natural pathways in the brain that help us become addicted to sugar and fat. Sugar and fat help us put on weight, so it was useful to the species to crave those things once upon a time. Opiates use those same pathways in the brain, already neatly laid out for them. And the drug Naltrexone blocks those pathways. Someone taking Naltrexone is unaffected by opiates (a possible problem if I should need major painkillers for some reason). In my case, I also have become unaffected by chocolate.

It's actually a very strange experience, because I still crave chocolate socially. That is, I still turn to chocolate to calm myself down, comfort myself, make myself happy, etc. I still think, regularly, multiple times every day, "Oh, I know, I'll have some chocolate." But the weird thing is that now there is no answer from those pathways in my brain. My brain (this other part of my brain, that is) doesn't respond "Yes, chocolate, give me chocolate, I must have chocolate now." Instead, it doesn't respond at all. It's like the door's closed, nobody's home. My social brain pokes at it again: "Chocolate, I said, wouldn't some chocolate be a great idea right now?" No answer. I can poke and poke and poke, and there's never an answer. Sometimes, a few times, I go and get some chocolate anyway, because I can't BELIEVE I don't want it. I'll eat a little bit. It still tastes good. But it doesn't "ring my chocolate chimes" anymore. My chocolate chimes are missing. I know they're not gone forever -- they're behind a wall of Naltrexone. But I can't touch them. I eat a little chocolate and then I'm done. It doesn't comfort me, it doesn't soothe me, it doesn't make me happy. It doesn't work. Black tea with a little milk has become my new comfort food. Black tea with a little milk has a lot fewer calories than chocolate.

The Contrave has some other effects, too. It substantially reduces appetite in general, so I only eat when I'm really hungry -- three meals a day. It makes me sick (stomach cramps, nausea) if I eat too much or eat a very fatty meal, so I've learned to stop eating a lot sooner than I used to. Supposedly it also revs up your metabolism a little, so that may be helping too. But I think the main reasons I'm losing weight are that I eat small meals, I don't eat between meals, and I don't use food as a drug -- because I can't. Other than the nausea if I eat badly, I have experienced almost no side effects from Contrave, except at the very beginning. At the very beginning it made me quite sick. But that went away a long time ago. For me, it is like magic.

I am not weighing or measuring anything. I am not counting calories or points. I can see how that might be necessary somewhere down the road, but it isn't now. I have not eaten a single piece of the kids' Halloween candy. I've thought about it -- I've thought "Oh, I think I'll just have a little bag of M&Ms." But I haven't done it. The other part of my brain is simply not interested.

I don't know how long I can stay on this drug. I don't know how long the weight loss will be so easy. I do know that if I go off the drug, my chocolate addiction will bloom again. This isn't a cure -- just a treatment.

I have lost 15.5 pounds (or 14, whatever) in less than two months, after struggling from May to September and failing to lose anything at all. My clothes are fitting better. It is unspeakably wonderful.