chemo, weight gain and weight loss

My oncologist warned me that I might gain weight on chemo. Most people think the opposite – that chemo makes you nauseous, so you don’t eat, so you lose weight. Get cancer, get skinny.

Apparently with breast cancer, my oncologist is right. They give you steroids and other drugs to manage the nausea and give you an appetite, and that means you don’t stop eating. Add to that any existing tendency towards emotional eating, and it equals weight gain.

I wasn’t worried too much about gaining weight on chemo. I had lost 40 pounds on a low carb diet in the summer before my double mastectomy (and another 5 pounds of breast tissue during my surgery, just saying), and I knew low carb would work again if necessary.

I wanted to try fasting during chemo, because I’d read about studies they’ve done with rats where fasting helped the chemo target only the cancer cells, but Mom can tell you that that failed miserably on my first chemo, so I gave up the notion.

My diet did change drastically while on chemo, though. I had been eating low carb, which meant lots of (large) salads. And then I read that chemo patients should avoid raw fruit and vegetables while their immunity was low, to avoid infection from e.coli or other pathogens on the food.

I experimented a bit during the first few chemos, but basically settled on a high carb diet of soft, cooked comfort foods. I told myself, You’re going through chemo, give yourself a break, eat whatever you feel like eating, and we’ll address any weight gain once you’re done.

My favorite foods during chemo were banana bread, muffins, brownies, challah, water crackers, white rice with butter, fruit yogurt, hard boiled eggs and pasta. So that’s what I ate. (Whenever I didn’t have mouth sores, I also ate more protein – chicken and fish, plus scrambled eggs or omelets when my white blood cells were high – and lots of cooked vegetables. But yes, right after each chemo I basically had a pure carb fest).

The result was that by the end of chemo 5 (out of 6), or after 15 weeks, I had gained 20 pounds.

I like to think I’m pretty enlightened about weight issues, and very body-size tolerant of others, but when it comes to my own body there are just weights where I’m more comfortable, and weights where I begin to get really physically uncomfortable (knee problems, etc.). And that 20 pounds was putting me back into the latter geography. Plus some of my clothes stopped fitting.

So after the first awful week or so of chemo 6, I said goodbye to the carb comfort foods, and once my white blood cell counts were past the danger zone, I started eating salads again, and shifting my diet back to its low carb normal.

When I’m doing low carb, I track everything I eat on MyFitnessPal, so that I know exactly the number of grams of carbs I’ve eaten. If I don’t track religiously, I start lying to myself about what I’ve eaten, and my emotional eating takes the reins, and the carbs skyrocket again.

It’s been 6 weeks since chemo 6, and I’ve lost 11 of the 20 pounds I’d gained. I love low carb; after the first week it’s painless (I’m not hungry or craving carbs, and if I want food when I’m not hungry (emotional eating), I just eat low carb foods). I’m still eating lots of foods that I truly enjoy, and that satisfy me. (Example: last night I suddenly wanted Kentucky Fried Chicken and fries, so I got some. And easily stayed within my daily carb limit.)

I’m looking forward to fitting back into all of my clothes again very soon.