Losing more than planned due to meds, and not sure how to proceed- thoughts?

I recently (this past Friday) started taking a new prescription to treat ADHD.  One side effect is weight loss, and I knew that going in.  I have been at goal since this past August and happy where I am, but here is my angst:

1.  Once I hit goal my BMI is pretty steady at 24.5 if you factor ou****er weight fluctuations that are associated with the monthly cycle.  So it is not like I am overly thin.  I am comfortable where I am, but still have some belly fat.

2.  The only reason I decided to not lose more is because I have cancer, and want some reserves in the event something comes up that makes it tough to eat.  This is a mildly irrational fear.  I have no current known cancer left, but it has a nasty habit of popping up every few months.  It is not systemic- just persistent skin cancer.  Some of the meds cause me to not want to eat on occasion, as I am very sensitive to meds.  Something as simple as antibiotics cause me to lose weight.

3.  I don't "have" to take ADHD medication.  I finally decided to treat it due to my non-stop long hours at work pretty much 7 days a week, my terrible driving that is strongly affected by it, and in general fed up with the lack of focus and organizational issues that go along with it.  

I have lost 5 pounds in 2 days since starting the meds.  I normally eat now about 1800 calories a day (range is 1600-2000) and on Friday it dropped to 800 and yesterday to 900.  I am hypoglycemic and my carbs are at the very lower limit of what I know I can tolerate.  I, for now, am stopping my beloved exercise until I can adjust or stop taking the meds to try and slow down the loss.  

I don't know.  I am thinking that I am going to give myself a 20 pound window of loss to see if I can adjust.  Ideally I would like to be a cancer free, exercising, safe driving, and a focused person on a regular basis.  I don't want to be dealing with an eating disorder/low weight due to the medicine.  20 pounds lost (15 more) would put me at a BMI of 21.8.  This is still well within the normal weight range, but I guess I am having trouble getting passed the loss of reserve calories that may be needed for future health reasons. 

Do you think this is just a fat person mindset and I just need to let go of it?  Usually I have a lot of clarity in my goals, but dang if this is about as fuzzy as it can get for me.  

Any thoughts would be appreciated.

My personal opinion is that any BMI from 18-24 would be fine, and as long as you don't drop below 18 I wouldn't worry about it. Unless you start feeling bad. They say skinny people live longer, and I plan to test the theory myself.

Again, just my perspective, but yes you do sound like you are justifying being at the upper end. Nothing wrong with it, and I do think you recognize it so that is a positive.

Good luck with the meds, I hope they clear your mind.

I agree that if I knew my Bmi would stay in that range then I wouldn't think twice about it.  But when you lose when you are not trying there is the risk that it can become too much.  I am far enough outside of that range for now, but just like my loss was cumulative from surgery losing 3-5 pounds a month long term is going to be an issue.  Hopefully like another poster said, the first five drops but after that no problem.  I agree with you about justifying to an extent in that I am doing some soul searching to see if that is what it is versus it being truly managing the weight.  I appreciate your post, thank you.  

ADHD is a nasty little demon to live with. If you don't take the meds to help, you drive yourself nuts. If you do, you drive yourself nuts. I don't have it, but I am around it. You being so aware of it, is huge.

First question, is the new med helping? Are you feeling better and keeping your focus with it? Do you feel more in control of your driving?

Anything that messes with our weight is a weight issue for us, imo because we will always think about it in that regard. So, yes it is fat thinking, but with a huge caveat, losing 5 lbs in a week set off an alarm in your head which it absolutely the right thing, again imo. In this case, I would say that being so aware of fat thinking put you in a place that allowed you to see a potential problem.

You always seem to make a good plan that works best for you, so I would say that your 20 lb plan to see if your weight re-stabilizes is a good idea. I might only cut it to 15 lb, just because of the cancer issue.

Good luck.

Thanks Slim,

You are right about something I did not consider.  Your part about always thinking about weight because it is an issue and the alarm bell is spot on.  I wonder if 20 years ago when I was a normie if I would have even paused to consider this.  

The meds are helping for sure.  The difference in my driving is downright scary- I truly had no idea, even though I thought I did.  My daughters are ADHD and my older one stopped taking her meds.  This is making me want to force her due to the driving implications.  She wrecked our van last year from rear ending someone, and the ADHD has a lot to do  with not noticing/awareness.  I was really nervous at school Friday about what the effects were going to be, so I can't tell quite yet the full impact- but my instructional delivery was tighter for sure.  Not so sure if my efficiency overall improved though.

I appreciate your response!

20 years ago I weighed 135 and I am willing to bet that I wouldn't have given it two clicks. So strange how we change after obesity. I'm one of the people who hopes to always stay aware of how much I hated being being fat. I don't necessarily ever want to *feel* normal again. I like a little fear of being obese again. It keeps me on my toes.

Your issues have always been unique and you have always found very intelligent ways of dealing with them.

You seem to already have a plan and a good one, imo. I might just tighten it up a little bit to 15 lbs loss, but I'm sure that you will be on top of it whatever you decide.

Ah teenagers - ADHD, hormones, wanting to be independent. I don't envy your predicament. The only thing I could think to do is to tell her that she has a choice. She can take her meds and drive, or she can stop her meds and hand over her keys. Too many people can be harmed by her choice to stop the meds AND keep driving.

Keep us updated on how you do.

Wow! You almost exactly described my situation. I am less than 4lbs from goal. Talked to my doctor to get a handle on my ADHD and he gave me 20mg of XR Adderall. The first few days I felt WEIRD and wasn't eating. Dropped 5lbs also!

I have gained a pound back but am trying really hard to eat. Like to stick to my normal routine. However, I have taken 10 days off of exercise because I was sick so I'm not sure how much I will drop if I start in on the exercise.

I think the best part is that you're aware of it. You are looking to lead a healthy life. Your nutrition is important if you have cancer so maybe this is a way to buy you a little room to get healthy carbs into your diet like fresh fruits and veggies.

I'm sorry about cancer but it sounds like you have some great things going on also. Stay positive and keep working on ways to stay healthy. We are here for you!

Hi Econ,

I do not fall into the low carb camp and have incorporated fruits and veggies routinely since month 3.  I am scared to death of the XR version... that is the extended release, correct?  This stuff is already keeping me up at night a bit, and I am not taking the extended release version.  

I am trying to stick to my routine, but my quantities are way down.  My frequency is off too.  Even when I eat I don't feel like eating now, and I have to make myself.  I could totally see me forgetting to eat if I do not regiment the eating.  

One thing that freaks me out completely is eating when I am not hungry.  That is exactly what got me so fat to begin with.  So eating now feels like it is a slippery slope due to not feeling hungry, even though I get intellectually that my calories are way down- under what they even were during my weight loss phase.  

Let me know how the xr works for you.  I am glad that you stabilized after a few days, so maybe for me this won't be an issue after all.  

I really appreciate your post!

Hello HappyTeacher!

I am so happy that you have been a lovely teacher for us! :)

First, congratulations on your wisdom and awareness, and I second what the two posters above me have said.

You are juggling a lot here, a lot of complex variables. For me, when I am confronted with similar, I try to remind myself that I am not capable of controlling everything. I try to focus on what I CAN control or influence now...and for the rest, I do my best, and then hope for the best...

So, here, you are very wisely aware of your goals and your health concerns. All are very wise and thoughtful, and it can not be but for the very very best interest of your future and your health that you think ahead so carefully, and you think ahead about possible scenarios and consequences. This is part of my definition of mental health...!

But. My friend, you are talking about foregoing your beloved exercise. Exercise helps to keep you sane, it feels good, it regulates your many body dynamics, it lengthens life and enhances quality of life. I would hate for you to give all of that up for something that may or may not happen in the future!

I would like to suggest that you focus right now on stabilizing your current health situation, the stuff that is real and present and is right now in front of you -- stabilizing your caloric intake to a helpful level -- ,  adjustment to this new, powerful, and potentially very very helpful medication, and emplacing your lovely exercise routine into all of this. The need for a few extra pounds in the event -- G-d forbid! -- of future cancer is a thoughtful idea, but may not be an appropriate goal at this particular time, when you have so many other things going on. (Besides, you ARE benefitting from your few extra pounds, you are just benefitting in a situation of the new meds and losing weight because of them, rather than from a cancer situation...)

Somehow, I think that the future will take care of itself, will unfold as it needs to...besides, I trust your wisdom and ability to meet the future as it comes, and your ability to create answers as they are needed...

Right now might be an excellent time to make an appointment with your local Registered Dietician, who may be able to help you to brainstorm various solutions that you maybe haven;'t thought of.

I am thinking of the wisdom of the Serenity Prayer...

...and I send you HUGS. You are taking beautiful care of yourself, looking at everything from a 360 degree perspective...

Love, Swizzlequeen

Oh Duh,

I didn't even think about going to the Nut.  I will make an appointment.  Thank you!  Good advice on taking care of the here and now.  The exercise thing is only temporary until I can get the calories working better.  Exercise can drop blood sugar, and at the moment I am struggling to keep that managed due to not eating enough.  Although today the I am getting more carbs in and shaking off that low sugar feel.  The problem is that I am behind on my protein because I needed to get the carbs in.  Sheesh.

Thank you for your very thoughtful post, and I will try not to overthink this!