When the Scales of Justice Definitely Seem Tilted the Wrong Direction!
Here’s a news flash that won’t be much of a surprise to anyone who has already completed their treatments for breast cancer – it’s not uncommon for women going through chemotherapy to begin gaining weight. On a cosmic level it seems absurd that at a time when life is already being unfair, yet another undesirable side effect could be added to the mix.
If you ask most people what their mental image is of a person who is dealing with cancer, they’d likely describe someone who is thin and gaunt. The reality is that a woman may actually start looking a bit cherub-like between the steroids, the hair loss, and the chemical cocktails she is taking.
Women who have been struggling with their weight prior to diagnosis, may actually think they will lose weight during treatment – and while they certainly wouldn’t call this a benefit – they may be hoping the experience will at least allow them to lose some unwanted pounds. This is most often not the case.
Most oncologists will tell their patients that trying to lose weight during chemotherapy is not necessarily a good idea for several reasons. Probably most importantly, it’s unwise to deprive your body of essential nutrients at a time when it’s already under incredible stress.
On an average, women undergoing chemotherapy for breast cancer will gain between five and eight pounds. Obviously, some women gain less (or even lose weight) and some women gain more (as much as 25 pounds over their pre-treatment body weight.)
After struggling to battle breast cancer, battling increased girth can be highly distressing for many women. Since our culture places such a high premium on being slender, this added “baggage” comes at a time when a woman may already be feeling less self-confident than usual – and her body image may be suffering as a result.
Additionally, she may not only be upset about her appearance, but may feel real concern about how these extra pounds are going to affect her ability to stay cancer free. Research has found that survivors who are overweight or obese are more likely to have their cancer recur than thinner survivors. It’s believed that since fat cells in the body make small amounts of estrogen, the more fat cells you have, the more estrogen is present. Since estrogen nourishes some types of breast cancer, this is obviously a real problem. Belly fat appears to be more detrimental than fat around the hips or thighs.
Exactly what contributes to this weight gain during chemotherapy? There may be many factors at work. Not only is your diet affecting your weight, but the medications you are taking, the amount of exercise you are getting (or not getting), and changes in your metabolism all play a role.
Although chemo may make you feel nauseous much of the time, it may also cause you to crave comfort foods like pasta, bread, rice, and mashed potatoes. All of these carbohydrate-laden choices can really pack on the pounds, especially if you are not feeling up to much in the way of exercise.
Not only may your diet change dramatically, but your body composition is liable to shift as well. When it comes to chemo-induced weight gain there is yet another unfair shift! Unlike typical weight gain caused simply by overeating and lack of momentum, where you are gaining both lean and fatty tissue, the weight you gain during chemotherapy is comprised only of fat. The change in body composition that is brought on by chemotherapy is normally seen as a part of the normal aging process. Unfortunately, in terms of body composition, a woman going through chemotherapy ages 10 years in the course of a year.
The premature menopause often brought on by chemotherapy may be another culprit contributing to weight gain. Menopause brings on changes in the lean muscle/body fat balance, as well as a slowing in your metabolism. Although menopause does not necessarily mean a woman will gain weight, it does make it more difficult to keep the pounds off.
For most women going through chemotherapy there is also a decrease in their physical activity. It’s a bit difficult to feel like jogging or working out when you are dealing with the fatigue, nausea, and pain often associated with treatment. In fact, many women who haven’t been faithful in regards to exercise, now find their activity level dropping even further because they often have to cut back even on light activities like housework.
Tamoxifen has also been thought to increase weight gain, but there isn’t a lot of scientific research to support this belief. In fact, two large clinical studies failed to find a link between Tamoxifen and weight gain. It may simply be that many women taking Tamoxifen are also going through menopause (or have gone through menopause) so the weight simply comes with the territory.
It is not unusual for people taking steroids during chemotherapy to experience water retention. Fluid retention during treatment can also lead to weight gain. Although this is usually only temporary, it’s a good idea to follow a few simple precautions if you discover you are retaining fluid. You will want to make sure you:
Elevate your feet as often as possible
Don’t stand for long periods of time
Avoid tight clothing
Try not to sit with your legs crossed
Reduce your salt intake
Weigh yourself daily
Well, that certainly provides you with plenty in terms of “bad news” if you are either getting ready to begin chemotherapy – or have been struggling with your weight before, during, or after! Exactly what can you do to best maintain or lower your weight once you’ve had chemo?
It probably goes without saying, but we’re going to say it anyway – this is not a time to go on any sort of fad diet. Your body and immune system are already stressed out. You need to be even more mindful than usual about what you are putting into it. As a rule of thumb, you want to just say no to any diet that asks you to completely avoid a specific food group. That just simply isn’t sound science, and can actually be harmful.
You also want to make sure you don’t fall prey to foods and supplements being sold under the guise of “Preventing Cancer”. It seems every other day there is some new “miracle food” that is so full of antioxidants and bioflavonoids it’s being touted as a way to avoid cancer. If only it were that simple. Hopefully, the day will come when someone can definitively say what helps to prevent cancer, where it can be found, and how much we need in order to have it work. At the moment that information simply does not exist.
A diet that’s high in fruits, vegetables, and whole grains that pays attention to controlling the amount of fats consumed, may be a start. And there is an added benefit. Eating this way also is heart healthy, and since heart disease kills more women than breast cancer, it’s probably a good idea to be heart smart as well!
While you are monitoring your carbs (and we’re talking unhealthy carbs here like white bread, white rice, white pasta, refined sugar and the like) you should be finding ways to add protein to your daily routine. A recent study discovered that when you follow a protein-rich eating plan and combine it with exercise, the two work together to help you lose weight. Not only that, but people following this sort of pattern lost fat, not muscle, when they began to shed the pounds.
Okay, here’s the really bad news. Are you ready? Exercise is absolutely necessary if you want to lose weight. OUCH! Sure, there are some of you out there who wake up every single morning all bright eyed and bushy tailed – and ready to push your body to its physical peak. If only everyone could be that enthusiastic. Unfortunately, it’s more probable that you dread exercise, or at the very least, avoid it whenever possible. It doesn’t help that the more you weigh, the less you often feel like exerting yourself physically, so it’s a sort of downward spiral. It’s hard to convince a tired, chubby body that something as simple as walking around the block will make everything feel better. It is, however, absolutely true that exercise improves how we feel.
When you factor in that being more physically active also helps to fight off a recurrence, it seems only logical that controlling chemo weight gain is of great importance.
For women who find the struggle overwhelming, looking for a support group is a good idea. Talking with other women who have faced a similar situation is always of benefit, even if all it does it show you you’re not alone. It’s also important to keep things in perspective. While dealing with your treatment for breast cancer, your primary focus needs to be on regaining and maintaining your health.
It’s normal to worry a bit about your weight if it’s fluctuating in the wrong direction, but giving this matter too much emphasis at a time when all of your energy needs to be concentrated on healing, just doesn’t make sense. Feel free to make like Scarlett O’Hara and tell the world “I can’t think about that right now. If I do, I’ll go crazy. I’ll think about that tomorrow.”
Article last reviewed: 6/29/10