Screw you, Dane Cook.
My brain is geared to like certain things: Puppies, dirty jokes, and data. I’m a scientist, so I made a career out of at least one of these.
I also cry with joy when I hear that the pumpkin spice latte is back each year; data only gets you so far. My brain is geared to love sugar.
But like all the best love stories, the affair I had with sugar came with complications.
Damned lies and statistics
Five years ago, I was an obese scientist. The statistics on me? At 5’9’’ and 244lbs at the age of 26, I had a large amount of weight to lose. I wore a size 16-18. My BMI was 36. But my numbers at the doctor’s office were okay. My cholesterol wasn’t low but it wasn’t too high. My blood pressure … well it was just borderline. My doctor hadn’t poked at my weight too much. She’d raised an eyebrow about it, but she hadn’t put me on a diet. I mean, why would she, all my data was fine, right?
I was also steadily gaining weight, and that trajectory also indicated a grim future. Where would I tip the scales in a decade, and would all the data still look “fine?”
But it was just 6lbs this year, maybe another 3lbs the next, it wasn’t that much, right?
The data also said that only 13% of people who lose a large amount of weight manage to keep it off long term. As a scientist, I could have chosen to accept the statistics, continue to live a life that was overweight (albeit without health problems), and accept that this was what life had planned for me.
As a science communicator with a focus on busting pseudoscience, the subjects of health and fitness come up frequently on my website. Detoxes. Cleanses. Green juice enemas. There’s always a new ingredient to avoid as the “toxin” du jour. Every year there’s a new hot diet. And with each new diet, it’s another repackaging of the last one. Cut carbs. Cut fat. Only eat certain types of fat. Or is it only certain carbs with certain fats?
If every one of these was the answer, why are people still fat?
I tried, and failed, at most of the mainstream diets through my life with varying degrees of success, but the weight kept coming back, each time with some additional weight (you’ve heard this story before). Playing sports through school (volleyball and basketball) kept me “healthy overweight.” Multiple shoulder operations sidelined me from my sophomore year of college until I was 24 and made it nearly impossible to keep a steady workout routine. During this time, I went from a healthy size 12 up to a size 18.
The end of healthy overweight
What’s the longest headache you’ve had? Most people say three days to two weeks when I ask that question.
On March 7th, 2010, I got the worst headache of my life and it didn’t go away.
This horrible ache took residency behind my left eye and refused an eviction notice. I consulted endless doctors and it took eight months to find the first doctor who would start getting my headaches under control, but in the meantime, I needed to find something, anything, to help. My initial (and wrong) diagnosis was cluster headaches. Being a scientist, I read everything that I could on it and read that vigorous exercise could help.
So I went to the gym. Exercise instantly became my drug of choice. It was the only time that the left side of my head felt exactly like the right side. Whether it was blood flow around the nerves that were inflamed, blood oxygenation, or feeding the angry troll dancing on my left cheekbone (I named him Dane Cook because, like the comic, he’s not fucking funny), exercise helped.
I couldn’t be at the gym all the time. Get off the exercise bike and like clockwork, the intractable pain was back. I needed medical help to manage my headaches.
I don’t like the drugs, but the drugs …
My doctor tried me on a few medications. Medical treatment for chronic severe headaches like this are generally tricyclic anti-depressants, anti-inflammatories, and seizure medications. Throw them at the wall and see what sticks. One medication made me throw up blood. One medication made me so tired I could barely get out of bed and almost fell asleep behind the wheel twice. One made my joints swell.
And then Topamax happened. I maintain that it saved my life.
Topamax is an anti-convulsant. Though it’s normally prescribed for epileptics, it’s prescribed off label for many other purposes. This includes nerve pain, migraines, cluster headaches, and as a mood stabilizer.
Up to 20% of patients report appetite suppression. I was in that 20%.
Turn me off
Imagine that the person highest on your to-do list is in your bed (Jeremy Renner, Matt Damon, whoever they get for the next Bourne instalment with great biceps … and for the gents, Kate Upton. Because Kate Upton). Imagine they’re naked, because how else would you imagine Kate Upton? Imagine it’s been three months since anybody’s acknowledged any of your more rancid thoughts.
Now imagine not feeling anything.
Apply that to food. That’s what life is like on Topamax. Your appetite is just down for the count. Look at cookies, candy, sushi, anything, even when you probably should be hungry, and thinking “nah, I can’t get it up for that.”
The problem with magic bullets? It means you’re under fire.
Just like all the other medications, Topamax has side effects. Drugs don’t just act on the target system (in this case, a facial nerve). The drug was hitting my hypothalamus, a tiny portion of the brain that regulates body temperature, fatigue, and as I was finding, hunger.
The other side effects I experienced included paresthesia, occasional vertical nystagmus, aphasia, and thinning hair. If I plan to have children, I need to be off of it for a period of time as it increases risks of birth defects. Each time my dosage was increased to match my headache, I would get a few nosebleeds the first week and get an upper respiratory infection (both are known side effects). Aphasia is rough; it’s a condition where you have difficulty finding words. The lab I was working at when I was struggling with my headaches was less than kind about the fact that I suddenly couldn’t find the words for “GC/MS injection port.”
Also, it made carbonated beverages taste like they’d been doused with Lysol. I have a Diet Coke addiction. I still consider this the worst side effect.
Please remember, this was the best option I had. The other medication options resulted in nearly crashing my car or throwing up blood. The Topamax options were, by comparison, merely inconvenient. And struggling with intractable, severe pain that leaves you in tears will make you put up with a few inconveniences.
Down goes the weight
The takeaway here isn’t that I took a pill and woke up skinny. Also, through my weight loss I was getting regular blood tests and seeing a doctor once a month because we were still trying to figure out why I was in so much pain. I didn’t know what was making me sick through all of this. I didn’t know if it was idiopathic, if I’d done something that caused it, if it was something in my diet (more on that later) or if it was just going to go away one day as mysteriously as it arrived.
But while my doctors were working on it, the gym was there for me. It gave me a place to focus while I was lost in pain and Topamax was merely moderating it.
The reports are mixed and I’m sure it depends on what somebody has to lose, but the average weight loss on Topamax is around 20lbs.
I lost 90lbs over the course of about nine months. What did I do?
- I made going to the gym a part of my daily routine. It helped the headache and it gave me focus.
- I used my newly limited appetite for a healthier spread of foods. Craving salt? Olives or popcorn. Craving sweet? I reached for an apple. I knew that I needed the nutrients, so reaching for chips or sweets when my ability to eat was limited was depriving me of nutrients that I needed. Those habits have stuck.
- I didn’t cut out any one food group. I cut down on everything. Want a cookie once in a while? Eat the fucking cookie. If people were pressuring me to eat the cookie because diet sabotage is fun, I happily said “I’m not hungry, but thank you. I hope you enjoy it for me.”
- I started small at the gym and worked my way up. Twenty-five minutes a day on the bike and a weight circuit was very doable and didn’t scare me off by destroying me my first week.
- I plateaued at 60lbs of weight loss when I didn’t change my routine for a few months and was holding steady at 75 minutes on the bike, and decided it was time for a change, so …
- I hopped on a treadmill and new love was born. Four months later, I crossed the finish line of my first half marathon.
- Nine months after that, I completed my first marathon. Three months after that I ran a race called the Goofy, an ultra marathon which combines a half marathon and a marathon as a double header.
Running did so much more for me than weight loss. Everyone was right, cross the finish line of your first marathon and it will change your life. Even when you’re sick and you spend a lot of time in pain, you feel capable. You feel free. Amidst all this pain, I’d found so much more than just weight loss. I found strength.
The fat scientist had run a few marathons, was down to 167lbs, a healthy BMI of 24.4 and a resting pulse rate of 47bpm, low blood pressure and healthy cholesterol. In my illness, I found what I needed to take care of myself. I felt great. The data says end of story.
But I was still sick.
When I was training for my marathons, I felt a click in my left hip on a seven-mile run. My orthopedic surgeon thought it was a case of bursitis. After I ran the Goofy, I went through a few months of testing. It turned out I ran both the marathon and the Goofy on a torn labrum in my left hip. I needed hip surgery.
I was afraid to gain the weight back in the face of having to take time off from running. Runners often gain weight when injured (something James Fell, the owner of this website, will corroborate). Additionally, I was still trying to figure out if there were dietary triggers for my headaches.
And then I found food bloggers. (Food Babe, I’m looking at you.)
GMOs! Pesticides! Go organic! Soy is good for you … or is it bad for you?
I went vegetarian, borderline vegan. I cut out corn because the built in pesticides in the GMOs were going to kill me. Or maybe they were tricking my liver into making me fat. We were supposed to eat clean, because that’s a thing. And then soy because phytoestrogen, obviously. And wheat is bad for you because … something?
That’s what you do when you’re sick and desperate. You will do anything for the promise of relief.
While not working out, I lost weight. After I started cutting food groups, I dropped another 14lbs in a month. My doctor, who had known me since I was 16, asked the strong 28-year old scientist who ran marathons, “do you have a self esteem problem?”
No, the food might be making me sick, of course!
I mean, it is, right? Right?
In health finding sickness
My doctor asked me to keep a food diary. It was good science; this could prove more definitively if there were or were not triggers for the headache. I would put things back into my diet instead of blindly cutting foods out. We only found one pattern; I had severe gastric side effects when I ate anything with gluten. A doctor suggested that it might be gluten three months earlier. I brushed it off. “That’s just a trend, right?”
My first firm diagnosis from this whole mess was celiac disease. That’s the real gluten disorder. It’s not the “I live in California and I order gluten free to annoy you before ordering a beer” gluten disorder.
I quickly became a lot more realistic about food. I went back to being someone who ate everything (except gluten) in healthier portions. When I hear someone say, “I can’t eat that,” the phrase is incorrect. They won’t eat that. Someone with a peanut allergy can’t eat that.
Further testing on my left hip showed I had arthritis from running on the labrum tear. I also had scoliosis and malformed hip sockets that were going to need major reconstruction in about 15 years.
I wasn’t even 30. Hold my pumpkin spice latte, I can’t even.
Wait, didn’t I also have problems with needing a few shoulder operations? How could one skeleton have that many disparate problems?
The simple answer: it doesn’t. Not disparately.
However, my additional diagnosis of Ehlers Danlos Syndrome, a joint condition that can present with a headache, explained a lot. This is a rare presentation, but rare means possible. EDS symptoms include hypermobility, dislocations, scoliosis, and in my case, a headache. I could take my diagnosis and find ways to keep myself healthy.
It wasn’t the answer to Life, the Universe, and Everything, but it was an answer.
Where does this leave me now?
I’d found a great neurologist who specialized in my types of headaches. She halved the amount of Topamax I was on; I’m able to eat a healthy amount now. She added in an anti-inflammatory that didn’t upset my stomach. I wake up, take my medication, and get on with my day. What had once taken over my life is now less than one percent of my time. My headaches have been under control for about two years. It’s there lurking, but the days of cursing Dane Cook are behind me.
After I cut gluten and went back to eating responsibly as I had for most of my weight loss, I bounced back to 165lbs. I was adsorbing nutrients again and felt much better. I haven’t worked out as steadily for the last two years to give my hip some time to heal, but the healthy eating habits stuck. It’s helped maintain my weight. My diet today is heavy in vegetables, but there’s definitely room for the occasional pumpkin spice latte.
So the total weight loss is closer to 80lbs, but I’m trying to re-lose that last ten pounds now that I’m cleared to exercise again. I’m 5’9’’ and I was once a size 18. I’m currently a size 8. I was a size 6 at my smallest and that’s what I’m aiming to get back to; nothing too extreme. I won’t be changing my diet much (Buddy, the Science Dog, would be very sad if I didn’t occasionally bring treats of bacon). I’m just making small cuts in portion sizes as already I have a healthy diet. With exercise, now that I know the challenges I’m facing with my joints, I can focus on weightlifting and cycling as opposed to running. I have to be careful with weightlifting as to not dislocate anything, but I’m working with a trainer and not pushing my joints. I’m exercising right for my body’s needs and capabilities.
Being good to my body is a lot more of a priority now. For exercise, that means I smile wistfully at the treadmill as I head towards the weight room. I miss running like I miss a limb, but I’d rather not destroy one because I had to be reckless and run another marathon.
Magic bullets and magic feathers
I know that people were expecting the story of how I lost weight strictly with diet and exercise and without any bullshit diets. I’d rather give everyone the truth. My health is complicated, but aren’t all the good stories?
I think this all begs the question; would I recommend Topamax for anyone else? That’s complicated too.
Anecdotally, I first heard about Topamax years ago from a co-worker who was on it, likewise for headaches, and lost a lot of weight. I’ve seen two friends try it out without the same results as me. The weight loss is a side effect, and you also only have a one in five chance of getting it. You’ll likely get some other side effects too. I considered changing medications several times due to the side effects (Diet Coke = Lysol taste, don’t forget that), but everything else for my condition was, at the time, a much worse option. Most of the side effects have waned, but it does pose risks of birth defects. I’ve already started staking out other medications for when I decide to have children, but while it’s working for me I’ll stay with it.
Diet and exercise played huge factors in the changes in my body and health. I’m very glad that I found Topamax, both for headache relief and for the help it gave me in losing weight. But if I hadn’t needed it for the headaches, knowing that I was capable of running an ultra marathon? I don’t know if I would have taken it for weight loss alone. Topomax is sometimes prescribed solely for the purpose of aiding weight loss, but it’s muy importante to understand that such medications aren’t about getting ready for bikini season. They’re prescribed only when a physician decides that the health risks associated with your excess body fat exceed the risks from the side effects of taking the drug. Like any responsible diet and exercise program, it’s a decision that would have to take a lot into consideration while talking to your doctor about it.
The beginning of healthy sick
I’m going to be “sick” for the rest of my life, but most days I feel just fine. Getting into shape and taking care of my health was a huge part of that. It wasn’t my weight that caused my condition, but the circumstances of my condition stopped my weight from eventually causing any other problems. No matter what choices I make, every day my reality includes Ehlers-Danlos Syndrome. I’m going to make choices that preclude me from adding type II diabetes, hypertension, or a host of other ailments to my list of diagnosis. Being sick involuntarily is enough, why would I volunteer for this?
Statistically, I should have gained back the weight by now. But then again, I also have two diseases that are allegedly rare and I’m managing that pretty well.
I like data, but it isn’t everything.
I think I prefer sugar. But that’s not a complicated relationship.
Yvette d’Entremont has a B.A. in theatre, a B.S. in chemistry, and a M.S. in forensic science. She’s worked as a professor, an explosives chemist, a toxicology chemist, and a method development analytical chemist. Currently she resides in Southern California and runs Science Babe full time at facebook.com/sciencebabe and scibabe.com.