(This post is part 3 of the weight loss series. Read part 2 here)
As I stated in parts 1 and 2 of this series, I utilized medications throughout to assist me in my journey. Medications for weight loss are NOT for everybody. If you are interested in trying them, please consult with your doctor to see if any of these medications are appropriate for you.
The first time I ever tried a medication to help assist with weight loss was in 2019 when I started taking Contrave…. or rather, the combined medications of Wellbutrin and naltrexone because obviously, my insurance wouldn’t cover a brand name medication without costing me an arm and a leg. When you are doing the two separate pills combined, it’s not an exact match to Contrave but it was a cheaper alternative. As with my past experiences with weight loss, I did good for about two weeks and then I fell off the bandwagon. I think what partly had to do with this is because my doctor wanted to follow up in two months after starting it, which knowing myself was FAR too lenient… I had plenty of time to come up with excuses as to why I wasn’t losing weight. But regardless of that, I didn’t feel like it helped… at all. The Wellbutrin wasn’t giving me decreased appetite and the naltrexone did not help with cravings. Really the only helpful part was that by taking the Wellbutrin it made me realize that I actually had some depression and it made me feel back to normal. I still continue on the Wellbutrin to this day, but obviously not for weight loss reasons.
This is a medication that I am sure many of you have heard about. It’s a medication that has been classically prescribed for weight loss due to its appetite suppressant properties and increasing energy levels. However, finding a doctor to prescribe it may be difficult to find. I know a lot of primary care doctors will not prescribe it and will refer to doctors who specialize in weight loss. I’m not saying your doctor won’t prescribe it but just be prepared to do some research.
I was fortunate enough for the nurse practitioner I found to prescribe me phentermine in which she first placed me on phentermine 37.5mg 1/2 tablet twice daily at 10am and 2pm. This medication can affect your heart and increase your blood pressure so it was important that I checked my blood pressure regularly to make sure that my heart was handling the medication okay.
So phentermine is technically an amphetamine-like medication (hence the possible cardiac concerns) that is used to suppress your appetite. Because of this, you may feel stimulated or have an increase in energy. I never felt particularly “wired” on the medication but I just felt like I had enough energy to do the things I wanted to do. It always seem to give me that extra push to go out for my walk or motivate me to be more active. It does make you thirsty but the plus side of that is that it makes you drink more water. But the best part about it? You literally do not think about food. I did not have any cravings, I didn’t have the urge to overeat and some days I just didn’t feel like eating (even though I did). It was such a strange yet liberating feeling to break free from my food addiction. Despite the wonderful powers of this medication, it did have some drawbacks to it.
I got headaches with it although I do suffer from headaches normally, it just seemed as though they were intensified with this. Brace yourself for constipation. Never had an issue in that department before but it became bad enough that I had to use stool softeners and natural laxatives to keep things normal. If I took the other half pill too late, I would have trouble sleeping. It was like I couldn’t wind down but that only happened if I didn’t take it on time. I had some SERIOUS mood swings and my boyfriend can attest to that. I became very irritable and everything bothered me. That put an additional strain on our relationship which is going to be the topic of my next blog in this series. After being on the medication about three months, I started to notice that it no longer had the effect on me like it used to. The cravings start to come back, I started to lack energy, I could just tell that it isn’t working anymore and that’s when I knew it was time to adjust the medication.
When phentermine wasn’t as effective, my nurse practitioner added in a medication called Tenuate. Tenuate is similar to phentermine that it is an appetite suppressant but it does not give you the boost of energy or that stimulated feeling. At first, I didn’t really notice anything happening with the Tenuate. I was now taking the phentermine 37.5 tablet once daily but I added in the Tenuate 25mg 1-2 tabs as needed at 5pm to help with overeating at dinner time. I tried to stay on that regimen but I really just wasn’t noticing a difference at that time. I felt like I was having terrible cravings and they were so hard to control. By this point, I was 4 months into my weight loss and I was down 40lbs so as you can imagine, it was very disheartening to start to feel old habits rearing its ugly head when I had already come so far. I tried this for two months without much movement on the scale so at this point, she needed to try me on something else.
She then prescribed me Vyvanse 30mg in September 2020. Although Vyvanse is used to treat ADHD, it has also been FDA approved to help with binge eating disorder. In theory, it is supposed to help modify the desire to overeat so my practitioner thought it may be beneficial to try to see if that would help me overcome the issues I was having with cravings. Well, I was only on it for six weeks because of how OUTRAGEOUSLY expensive it was… even with a pharmaceutical discount card and the pathetically small percentage that my insurance company was willing to cover. Now mind you, I don’t have any form of ADHD so I was interested to see how this medication was going to affect me. I didn’t feel “high” off of it but rather just super concentrated. The girls at work would be like “are you okay? You are flat today.” So it wasn’t that I was flat but I was focused and when I am focused, I tune out everything else around. But did this affect my cravings? I think it may have but I also wasn’t on it long enough to truly get a good idea if this was effective or not. I wish I could have experienced this medication longer to give a proper review about it.
Phentermine 30mg once daily and Tenuate 25mg twice daily
I was off of the phentermine while I was on Vyvanse so the nurse practitioner wanted to put me back on phentermine and incorporate more of the Tenuate. She changed the time of the phentermine to 1pm and I was constantly forgetting to take it at that time. I started to not use the phentermine as much but relying more on the Tenuate. When I used the Tenuate by itself, I noticed very quickly how GREAT this drug was at suppressing appetite. If I started to get some hungry horrors in late afternoon before I was going home from work and knew I wouldn’t be having dinner for a while, I would take the Tenuate and it seemed like immediately I wasn’t affected by the little craving voice living rent free in my brain. I did not and do not have any side effects to that medication and I still take it to occasionally help with appetite suppressant. It also makes you incredibly thirsty so make sure you have enough water with you. I do know that they make a long acting version of this medication but I haven’t tried that… yet.
Other non-prescription recommendations from my provider to assist in the weight loss
Lipostat: an intramuscular injection that is injected every week into your glute! I hated this honestly. I did it for four weeks and that was four weeks too many. Even with the lidocaine, it still burned and my butt was sore after and I didn’t think it helped… not even the slightest.
Isagenix: a cellular cleanse. This was a very interesting regimen and it was tough to do but I did it… two days worth of it. The nurse practitioner “cultivated” the cleanse by getting together all of the things I needed which consisted of powders for shakes, probiotics, fat burners and a whole bunch of other stuff. Here’s a picture of the schedule… the HOURLY schedule… that you do for a full two days.
So yes, this “worked” but I was miserable for those two days but I did lose seven pounds… I gained back 4 when I started to eat like a normal human again. If you need a jumpstart to lose weight, this is a good recommendation. Otherwise, not worth it.
Unfortunately though, I had to stop seeing my provider, at least temporarily because the cost of the office visits were really adding up. I have been off majority of all meds except for the occasional Tenuate here and there so I reached out to my primary care doctor to see if there were any other alternatives. He was going to prescribe me Saxenda, which is technically a high dose of Victoza which treats diabetes (which I do not have) but the medicine in Saxenda works on the hormones in the GI tract that cause you to feel full. As wonderful as this sounds, the medication was definitely not covered by my crappy insurance and for some god awful reason, insulins in America are upwards of $1000. Needless to say, I couldn’t get it… at least not yet. I will see what happens in the future because I have read some really great success stories on it and I’m always willing to try something new. For now, I am just sticking to what I had been doing but minus the medications because honestly, I needed a detachment from them.
Overall, the combination of the medications to see which ones helped me was a lot of trial and error and I don’t think I ever got it right. But obesity is a hard disease to treat because there is so much mentally that goes into it. It’s never as simple as saying “okay, decrease your calories and increase your activity.” Although those things are obviously important, sometimes you need that extra push to help get you through. Despite all of the things that I tried, I still was able to lose 80lbs. I would attach a pic of when I was at my highest weight in 2019 at 308lbs but I don’t have enough courage to put that out there. The pictures below are progress pictures 266lbs on June 30, 2020 and then 222.8 on November 21, 2020 (I currently am still hovering around this weight).
As successful as I have been with my weight loss, it also had some turbulence along the way too. My next blog will focus on the toll it took on my relationship – the good and the bad. Making a dietary lifestyle change is not easy in general and when you are adding in medications that alter your mood and challenging your comfort levels, someone is bound to suffer from it and unfortunately, it tends to be the ones closest to us. Please come back to check out part 4 of my weight loss series and to dive deeper into the affect weight loss has on the people around us.