DEAR DR. GOTT: I am a 32-year-old male who has been struggling with weight ever since I started on Nardil in 2004. During that time my weight ballooned from 180 to 220 pounds, despite lowering my caloric intake to 1500 calories a day and doing two hours of high intensity cardio five days a week. The Nardil gave me a heightened energy level so it wasn’t difficult to maintain, though I didn’t experience any weight loss.
Since going off Nardil in 2009 I have had low energy and sleep disruptions. My weight has dropped to 210, fluctuating occasionally between 205 and 215. Despite my best efforts, I cannot drop my weight any further, though adding vitamin B has helped with my energy. Hormone tests have come back normal, so there is not an issue there.
I have a desk exerciser under my desk at work that I typically manage to use for about two hours a day — little resistance but continuous — as well as doing high impact cardio at the gym two to three times a week.
My average daily diet consists of one chocolate doughnut during the workday and in the evening, one dry deli sandwich and a small bag of baked potato chips. From time to time I’ll get frustrated and stop exercising and start eating more. At those times my weight will only increase by about five pounds.
My question is, has the Nardil permanently affected my ability to lose weight? Do I have any hope of getting down to my pre-Nardil weight?
DEAR READER: Let’s begin with the drug you discontinued three years ago. Nardil is generally prescribed to treat symptoms of depression, fear and anxiety and is generally dispensed after other anti-depressants have been tried without success. It is not recommended for severe depression or bipolar disorder. There are several conditions that would preclude you from having taken this drug, to include being on diet pills, medication for asthma, having ADHD, and being on over-the-counter cough and cold solutions, or diet remedies.
While on the drug, you should have avoided foods high in tyramine, to include aged and smoked meats, beer, wine, yogurt, fava beans, sauerkraut, liver and a great deal more.
Side effects, in part, include rapid weight gain, agitation, chest pain, cardiac arrhythmias, dizziness, drowsiness, impotence, dry mouth and insomnia. You admit to weight gain a relatively well-known effect of the medication that your physician should have paid careful attention to.
I am going out on a limb here because I simply do not know and cannot guess what the long-term effects of Nardil are. However, I do not feel the drug is presently affecting your ability to maintain an acceptable weight three years later. Rather, I feel your entire diet is horrendous. You do not indicate what you take in for fluids. Do you drink lots of coffee, high-fructose juice drinks, or excessive amounts of sugar alternatives in diet sodas? Regardless of your answer, I feel you would definitely fare better and feel better if you modify your meals to include fresh fruits and vegetables, lean protein (meats, or vegetarian alternatives), whole grains, and low-fat dairy products. Remember to eat a balanced, wholesome breakfast each morning as it is the most important meal of the day. Include snacks during the day if you feel the need, which might include fresh carrots, celery, broccoli and cauliflower with a low-fat dip for flavor. Forfeit those chips or save them for an occasional treat. Hide the salt shaker and use alternative seasonings. Concentrate on the quality of foods you consume rather than the caloric count and you just might be pleasantly surprised.
Coupled with your present exercise program, you are an excellent candidate for reducing your weight to the 180 pound range. In fact, if I can be so bold, I challenge you to stick to a more healthful diet for a month or two while maintaining your exercise regimen and report back to me. I will print your findings regardless of the reading on your scale. Hopefully I won’t end up with egg on my face because of an unanticipated weight gain.
Readers who would like related information can order my Health Report “A Strategy for Losing Weight — An Introduction to the No Flour, No Sugar Diet” by sending a self-addressed, stamped envelope and $2 (US check or money order) to my attention at P. O. Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
