Weight-Loss Tips for Fibromyalgia Sufferers

The crippling pain and fatigue you feel with fibromyalgia can leave you inactive and overweight. Other symptoms and even your medication will too – up to 30 pounds for some sufferers. And that only makes ailments worse. It’s not your fault, and you can regain control. Here’s how to battle that bulge... You know fibromyalgia comes with muscle pain, depression and headaches. Excess weight may be another symptom – or the reason why you’re sick. "It's a chicken and egg situation," says Kent Holtorf, M.D., a leading fibromyalgia specialist and founder of Holtorf Medical Group, San Francisco."We don't know if the fibromyalgia causes weight gain or vice versa." Where does all that weight come from? It’s not just from lack of exercise. Several aspects of fibromyalgia contribute to these excess pounds. When you have fibromyalgia, the appetite-signaling hormone leptin may be out of sync. That sends inaccurate hunger messages to the brain, making you eat more, says Holtorf. Or your thyroid, which regulates metabolism, could be dysfunctional. That can slow the body's ability to burn calories. Plus, the condition itself causes a metabolic slowdown. "Fibromyalgia patients have a 25% lower metabolism, on average, than someone without fibromyalgia of the same age and body weight," Holtorf says. That’s 500 fewer calories burned per day, the equivalent of eating two dinners every night. Some fibromyalgia medications, such as Lyrica (pregabalin), also increase appetite. This combination of factors make many people with fibromyalgia gain weight – as much as 30 pounds or more, says Jacob Teitelbaum, M.D., medical director of the national Fibromyalgia and Fatigue Centers and author of From Fatigued to Fantastic! (Avery/Penguin Group). But don't despair. You can still take control of your weight. And you should. Obesity can make symptoms worse, according to a recent University of Utah study. The hard part, when you’re exhausted and sore, is getting started. Here, experts offer proven techniques to overcome common weight-loss obstacles. 1. You hurt all over. Fibromyalgia pain can vary daily and travel to different areas of the body. Some days, you may not feel like moving at all. When your whole body hurts, it’s hard to believe you'll feel less pain if you’re more active. But it’s true. Light, consistent workouts help you move better throughout your day, says Rae Marie Gleason, executive director of the National Fibromyalgia Association. "It won't reduce fibromyalgia pain itself, but exercise makes it easier to function with less pain while doing daily activities." The key is sticking with a regular program. If you start and stop exercising, your muscles have to “rebound” with each new beginning. The solution: Exercise in a heated pool, says Gleason. Warm water relieves muscle pain. Find warm-water pools in your area, or look on the Arthritis Foundation's website for warm-water exercise classes. When you're working out on land, take a hot bath or shower first to warm up muscles, recommends Gleason. To avoid straining muscles, never stretch without warming up thoroughly first. 2. Exercise leaves you too sore. If you were unable to move after the last time you worked out, you might be afraid to try again. "If you do too much in the beginning, you'll be wiped out for days," Holtorf says. The solution: Start slowly and gradually increase. Short, daily workouts – even for just three minutes a day to start – work better than longer, more aggressive workouts fewer days a week. If you're unsure of how to start exercising safely, find a personal trainer, physical therapist or "physiatrist" (a medical doctor trained in diagnosing and treating pain) experienced in working with fibromyalgia patients. Or, check out the Fibromyalgia Information Foundation, a website developed by a nurse practitioner featuring videos of exercises specifically designed for and performed by people with the illness. Working with people familiar with fibro helps you watch your limits. "You want to push a little but not so much that you can't move for the rest of the week," Holtorf says. If you go too far, therapeutic massage (before or after exercise) from a qualified masseuse can ease muscle pain. It helps loosen muscles, reduces trigger points (tender areas) and relieves muscle spasms, according to the National Fibromyalgia Association. 3. You're exhausted from lack of sleep. Many women with fibromyalgia fall asleep and wake up several times during the night, leaving them wiped out the next day. Restless leg syndrome and sleep apnea (both common with this disorder) are likely causes. The solution: Ask your physician to refer you to a sleep lab to identify the underlying problem. Look for a lab run by a neurologist (most are run by pulmonologists – doctors specializing in lungs and the respiratory system – looking for breathing problems). To determine correct treatment, a neurologist will check your brain patterns using an electroencephalogram (EEG) test, which records electrical impulses. 4. You're too depressed to exercise. Muscle pain and other symptoms of fibromyalgia can leave you feeling like your life has been turned upside down. "Chronic pain eventually leads to frustration and depression," Gleason says. When you have fibromyalgia, feel-good brain chemicals such as dopamine and norepinephrine are also likely out of whack, which can play a role in depression. Exercise helps by releasing endorphins. These neurochemicals block pain and stress, improving your mood, says Gleason. The solution: Find a health care professional who recognizes depression as part of the symptoms of fibromyalgia and prescribes medication, if necessary, says Gleason. Since the stress of the disease can make depression worse, try mind-body practices such as yoga, which offers the dual benefits of stress reduction and exercise. Find instructors experienced in working with fibromyalgia patients. And be patient. Easing into an exercise program means it may take weeks before you can exercise hard enough to feel the mood-lifting effect of endorphins, says Gleason. 5. You constantly crave sweets. Do you turn to comfort food packed with carbohydrates, refined sugars and sweets as a way to self-medicate against the pain of fibromyalgia? These foods release insulin, a hormone that packs on fat, says Teitelbaum. And sugar often becomes addictive, making you crave even more. A deficiency of vitamins or minerals, including B-vitamins, magnesium and chromium, may also cause food cravings and reduce your metabolism, says Teitelbaum. The solution: As a preventative measure, take a complete multivitamin to keep energy levels up. And ditch the sodas, substitute fruit for sweets, and read labels carefully. Avoid ingredients ending in "-ose," such as sucrose and fructose, says Teitelbuam. 6. You feel headachy and groggy. Do you often walk around in a daze? Brain fog is common with fibromyalgia. And a dysfunctional thyroid is often to blame. "More than 26 million Americans suffer from an underactive thyroid [hypothyroidism], and less than one third are properly diagnosed or treated," Teitelbaum says. You could also have an iodine deficiency. Low iodine levels contribute to decreased energy, says Teitelbaum. "And when you get tired, muscles tighten." Think of how your neck and shoulders feel after sitting at a desk all day. A tight neck and sore shoulder muscles can then lead to headaches, says Teitelbaum. The solution: Seek out a physician familiar with fibromyalgia to check your thyroid levels for the hormones T4 (thyroxine) and T3 (triiodothyronine). Treating the thyroid will fix your metabolism. “Without it, long-term weight loss is almost impossible,” Teitelbaum says. Ask your doctor about supplements such as alpha lipoic acid (an antioxidant) and D-ribose (a sugar molecule), which may boost metabolism. "Ribose is the heart of energy production in the body," Teitelbaum says. Alpha lipoic acid also gives you more drive by turning blood sugar into energy. 7. You’re not sure how to eat better. For many women, sticking with fruits and vegetables and eliminating processed foods reduces fibromyalgia symptoms. But some experimentation is necessary. "Studies have yet to find a specific diet beneficial to those with fibromyalgia," says Joseph G. Skender, M.D., director of rheumatology for Beaumont Hospital in Royal Oak, Mich. The solution: Strip out all foods with preservatives or colorings. A clean, all-natural diet helps you stay healthy, according to Dawn Weatherwax, R.D., CSSD, LD, owner of SportsNutrition2Go.com. Here’s a good start: Replace sugars and artificial sweeteners with natural agave nectar or honey. Stick with hormone-free chicken and meats, grass-fed beef and organic fruits and vegetables. And drink plenty of water, which helps rid the body of toxins. For more information and expert advice, visit our Fibromyalgia Health Center. How Much Do You Know About Fibromyalgia? Described by Hippocrates in ancient Greece, fibromyalgia is one of the world’s oldest medical mysteries. The disease – a complex illness marked by chronic muscle, tendon and ligament pain, fatigue and multiple tender points on the body – affects about 2% percent of Americans, most of them women.