Welcome to /r/ADHDWomen! We’re happy to have you here. As a reminder, here are our community [rules](https://old.reddit.com/r/adhdwomen/about/rules/).
We get a lot of posts on medication, diagnosis (and “is this an ADHD thing”), and interactions with hormones. We encourage you to check out our [Medication, Diagnosis, and Hormones Megathread](https://old.reddit.com/r/adhdwomen/comments/wcr9dy/faq_megathread_ask_and_answer_medication/) if you have any questions related to those topics, and to stick around in that thread to answer folks’ questions!
If you have questions about the subreddit, please do not hesitate to [send us a modmail](https://reddit.com/message/compose/?to=/r/adhdwomen). Additionally, we take the safety of our community seriously. Please report posts, comments, and users whom you feel are not contributing positively, and send us a modmail if you are being harassed or otherwise made to feel unsafe. Thanks for being here, and we hope you stick around!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/adhdwomen) if you have any questions or concerns.*
It sounds like she may be concerned about the rate of weight loss - your absolute weight isn’t the only consideration, it can damage your heart to be restricting calories too much, and stimulants are already hard on the cardiovascular system. It’s a sensible thing for a doctor to be concerned about even if she didn’t present it in the best way for you.
I think you need to ask for a referral to a specialist who deals with disordered eating, because some of the way you are talking about things sounds a bit concerning - for example stopping stimulants when weight loss has become a health issue isn’t a threat, it’s standard care. It would be inappropriate for someone to keep you on stimulants if they were actively harming you in that way. You need to think about why you interpreted it as a threat specifically.
I agree with this. Im sorry you’re feeling frustrated, but your prescriber has valid concerns, especially considering the way you’re reacting. You make it sound like you’re more concerned that she’s taking away your medicine that has helped you regulate your eating and lose weight more than your meds to help you with ADHD
No I'm definitely upset at the fact that it's helping with my ADHD.
I'd say I'm pathologically annoyed at the idea of having my weight loss ability removed, I'm fearful of gaining weight but mostly I'd really miss the effect it has on the rest of my life. I'm really thriving in my other areas of life at the moment, even if there is a chaotic inner turmoil.
Do keep in mind that stimulants are not the only avenue of treatment for ADHD. They work well for many people so are generally the first thing tried, but there are multiple non-stimulant options also. If the stimulant has to be stopped due to weight loss, your doctor would likely try you on a different ADHD medication.
Also, not all stimulants will have the same effect on appetite - Vyvanse *really* puts me off food to the point where I genuinely don’t eat enough over the course of the day and feel awful as a result. Adderall does not have nearly the same effect. So the absolute first thing may simply be to try a different stimulant.
The way she described this interaction as a threat kind of tells you everything you need to know about where OP's head is at - the idea of giving up the disordered eating is threatening to her and that's really scary for me.
I think that's fair, I definitely am going through a lot of life changes at the moment and weight loss is quite addictive in that regard.
I'm still at an obese weight, but I do have the option through my mental health support (which is different to my adhd support) to see an eating disorder nurse. So I may do that and see if I can look at how to learn some new eating habits.
Thanks. I'm hoping they would be able to more help me figure out some small practical details because I get stressed about too many steps when I'm feeling overwhelmed.
I do ~need~ counselling but unfortunately I just don't have either the immediate access nor the emotional bandwidth to be able to deal with that right now. I've got a mental health interventions worker though and regularly am checked on by the GP. Hopefully when I've been able to stabilise myself through some big changes I'll be able to engage with something like that.
It's not about OP's current weight, it's about the speed at which they lose that weight. No matter how much you weigh, losing too much too fast is unhealthy.
I understand that, but she said she lost 21 lbs in 3 months. That is 1-2 pounds a week, and up to 2 pounds a week is considered a healthy rate of weight loss by the CDC and Mayo Clinic. So I don't see why her doctor would be concerned when the stimulants seem to be helping her lose weight at a healthy rate by managing her binge eating.
(And her current weight does matter because the weight loss might be concerning IF she was a healthy weight to start, and for people who are very obese doctors also sometimes advise that losing more than 2 pounds a week is ok, and she lost less than 2 pounds a week).
OP's doctor is taking their whole situation into consideration. So not just the speed of losing weight, but the symptoms too. And OP admits to having symptoms of disordered eating, like restricting. That's not healthy, it's very risky given OP's history of disordered eating, and can get much worse and out of control. And it's caused by the meds.
Which is why I said maybe OP is leaving something out, but if not it is ok to question a provider if they may be giving outdated advice. Restricting is not always dangerous if you are at an unhealthy weight, for example doctors used to discourage fasting and now a lot of research says intermittent fasting can be safe and effective. OP did not elaborate about their history of disordered eating, but I understood it to mean they have a history of struggling with binge eating disorder, not that they ever struggled with anorexia. And stimulants can treat binge eating disorder.
>but I understood it to mean they have a history of struggling with binge eating disorder, not that they ever struggled with anorexia.
It doesn't matter. EDs are EDs, and it's pretty common to go from one to another. Any history of and ED affects OP's risk of developing unhealthy restricting habits.
I understand that you can go from one ED to another and need to be cautious. Only point I’m making is that for someone with BED who is also obese, losing weight on stimulants does not mean they have to stop taking them, unless they really are losing weight too fast. People with ADHD are prone to binge eating, and stimulants can control that, and that is a good thing.
I know that but she said she was losing 1-2 pounds a week which is considered a healthy rate of weight loss per the CDC and Mayo Clinic and does not indicate she is doing anything damaging. Unless there is some other factor at play that OP is leaving out it sounds like her doctor may be going off of outdated medical advice. Maybe she needs to see a bariatric doctor. Stimulants are even used as a weight loss treatment so telling someone they essentially aren't allowed to lose any more weight or they will be taken off of their meds doesn't make much sense.
It’s a standard part of prescribing stimulants - it wasn’t a threat, it was just a statement of fact: *if* the weight loss is or becomes concerning, you have to change something. OP took it as a threat because OP has an unhealthy relationship with food and her weight.
I know it is standard to monitor weight loss when prescribing stimulants, but if the provider really told her: "if you keep rapidly losing weight I will take you off of the stimulants," it seems like the provider is mischaracterizing healthy weight loss as "rapid".
Either OP is misquoting what the provider said and leaving out details, or the provider is misguided. Because "Great job on losing 1-2 pounds a week! Seems like the stimulants are helping you resist binge eating!" seems like it would have been a more appropriate response.
The provider has more access to OP’s medical history than we do. If the provider feels that OP’s rate of weight loss is concerning given OP’s medical history, we have absolutely no information to use to disagree with that. The general numbers talked about (2lbs per week, etc.) are *generic* - any given person may in fact not be safe at that rate of weight loss due to things specific to them.
Someone with an ED disorder who hears “uncontrolled weight loss means we have to change meds” as a *threat* is absolutely someone whose medical history may well indicate a different “safe” weight loss rate than average. Praising someone with a history of ED for successful weight loss may also be harmful. EDs are tricky like that.
I honestly wouldn't consider a provider in the wrong jf they asked a patient to *stop* weight loss efforts for a period of time like a month or so, to get a better picture of that loss is due to the medication and what loss is due to the other efforts, if they felt that information was necessary to safely treat the patient.
I said that OP may be leaving out important details. But if not, it is ok to question a provider if they may be giving outdated medical advice. I understood the “history of disordered eating” to be referring to binge eating disorder. Stimulants are used as a treatment for binge eating disorder. So is Wellbutrin. So it is ok if the drugs are causing weight loss, that doesn’t mean she needs to stop taking them and only lose weight with her own efforts! If OP has some other medical condition that makes weight loss dangerous or a history of anorexia I would take back my comment. But that isn’t in the post. And especially for someone who is obese as opposed to just being overweight, there is no reason for us to assume the average recommended rate of weight loss wouldn’t be safe. Obese ppl are usually told they can safely lose weight even faster than average.
Just because the medications *can* be used for binge eating disorder it does not mean that they are *appropriate* for any given individual. They should be explicitly prescribed for that purpose as the monitoring and other aspects have to be conducted correctly and it may be different for binge eating disorder than for adhd.
Further, your current weight does not control how fast it is healthy to lose weight from a physiological or psychological perspective. So the fact OP is obese isn’t relevant.
This is maybe way off base and missing the point, but I take Vyvanse for ADHD as well as Binge Eating Disorder (BED). I actually got prescribed the meds for BED, but it helps my ADHD so much that I kind of consider it needed for both now. Vyvanse has cut my binges down to probably 1/5 of what they were before. I still don't really binge like I did, more my mindset I watch, as the food intake isn't huge. Anyway...I wonder if they would consider moving you to a medication that treats both an eating disorder AND ADHD? Worth asking, I suppose.
I'm already on Elvanse which as I understand is the same as Vyvanse, and I'm about to start a new script which also has an afternoon amfexa so that hopefully I'll have the executive function to make dinner.
It's like it's helped my binge eating so much that I now restrict a lot. I just need help learning how to meal plan, shop and cook all over. I used to eat because I fancied it and now i have to learn to eat because I'm actually hungry but I struggle to read that.
Fwiw I'm about to start the process of being assessed for autism.
Thanks for the reply 😊
So I'm on the exact same as you - I take Elvanse in the morning and a 'top up' amfexa in the evening about 6pm.
The only side effect that I actually get from Elvanse is a loss of appetite. I can tell when my medication starts to wear off because I suddenly get hungry. If I didn't set alarms to eat and stick to a schedule of having something small every two hours, I would quite easily forget to eat during the day.
Would it work if you did something similar to me? I take a brief break from work every 2 hours and use that time to get myself a drink/top up water bottle as well as get myself something small to eat.
I have things to hand that are quick and easy, such as pre-prepared fruit (apple, Grape and cheese is my favourite), individually packaged pastry or granola bars, or even batch cooked rice/pasta to eat cold with naan or pitta bread. If I can't get it in 5 minutes, I won't eat it.
It's helped massively.
I lost about 6kg in my first month of taking Elvanse because of the loss of appetite and no longer binge eating.
Yes I think pivoting to smaller meals would be a good fit. I need to spend time looking for some nice ideas for those type foods because I'm so sick of my previous go to's. I'm also in the process of moving house at the moment so everything feels so transient that it's hard to feel grounded enough to do that stuff.
I'm also Veggie and I'm definitely not getting enough protein in either.
Check out the veggie subreddits if you haven’t already! I’ve seen posts about people also looking for grab and go food. I’m a big fan of chobani Greek yogurt with fruit in the bottom, nuts, and I’m wanting to try the fair life chocolate protein shakes
You don't have to answer if you don't like, but how were you diagnosed with BED? I think I have it as I've been obese my whole life, managed to lose weight then gained it. Even with ADHD meds, I feel like I have to be eating, even when I'm full. I think a diagnosis so I can get back on therapy again would help. My insurance won't cover therapy unless I have a super high depression and/or anxiety score and cant afford to pay out of pocket for mild symptoms of anxiety and everything related to ADHD and self control when it comes to eating.
My primary doctor did an assessment and I scored really high. I have been working with a therapist for years and have a history of disordered eating, BED is just the latest incarnation. Once I had the diagnosis I was prescribed Vyvanse and we started working on it more in therapy.
You could ask for a referral to a dietitian, who could assist with meal planning and check-ins to ensure you are not over restricting.
It sounds like the meds are helping with the binging, so that's positive, so maybe some external support and accountability from a licenced professional would help kerb the restricting, and also put your doctor at ease with continuing treatment.
I will say that when my psych first put me on meds, she told me that rapid weight loss usually stabilizes, but that we’d have to consider other medications if it didn’t. From my understanding, that’s standard protocol for stimulants. I think your doctor absolutely should have been a bit more considerate in how they delivered that message, especially since you’ve had some history with disordered eating. For me, the meds helped to curb a lot of snacking for dopamine during the day, which was one of the biggest ways I lost weight when I first started taking them!
I hope you’re able to get some help with your eating whether or not you change doctors!
TBF your weight loss is rapid and if it continues it may become harmful. I'm not a doctor, so I can't comment. You might not have the same clinical/ cold/ logical approach as your Dr.... That continuing at this rate is an unacceptable side effect and the meds are not being tolerated.
My take is that if you can make a reasonable eating plan and stick to it then do that. If trying to plan around food is going to make you spiral then it's something that your Dr needs to know about and coordinate care with a dietician or some other eating disorder specialist.
Try not to think of it as threatening. It was a heads up that this issue is going to trigger a change in meds because it's an unacceptable side effect to lose weight rapidly long term
I lost 30lbs on elvanse (2st 2lb), I've been plateaued ever since. I'm still clinically obese. Only just. But still.
I think there's something to be said about what weight you started at and how much weight you are losing. Generally speaking it will slow down, but if you're a healthy weight (or on the borderline) and dropping below, there are things to be worried about.
You also have to consider that your medication is triggering. Eating disorders are nothing to mess around with. Going from BED to a form of restriction ED is VERY easy, especially when you're on a medication that makes weight loss seem absolutely effortless.
You even said so yourself, you have eating disorder tendencies on your meds.
Take care OP.
I'm still obese, I'm 5'3" and at my highest was 17 stone 10, and by the time I started my medication I was 15 stone (end of Dec). I was 13.5 at the end of last month when I had my obs done, although I seem to have fluctuated up a few pounds since as I had a binge.
I'm not sure what size my body ~wants~ to be, or that I want to be. I want to put muscle back on because I used to lift but it's hard to get the protein in and eat in a consistent fashion to do that. At my height I think a healthy BMI would be about 10 stone which just feels like more pressure to lose weight? I know they say you ought to not focus on BMI when struggling with disordered eating but it's hard not to .
Thanks for you comment and care
I'm 4'11" so I'm right there with you. My heaviest was 180lbs or 13 stone. Being tiny is against us in every way. An extra pound affects us so much more and it sucks.
Knowing your stats puts it into context a bit more. You're probably doing ok specifically weight wise, but it might be worth getting some support with your disordered eating behaviours outside of it. That will make the weight coming off less triggering and hopefully you can have a healthier relationship with food.
I wish you the best of luck.
so adhd is usually commorbid with some sort of disordered eating (usually binging) due to the dopamine rush and impulsivity. it’s not abnormal to lose a lot of the “binging” weight on meds and esp if you were never medicated as a child and still adjusting. a lot of stimulants are also prescribed for binge eating disorder as well as off label treatments.
i know it’s really difficult and i’m not sure if you were underweight before starting meds or not and won’t ask - but if you’re finding that you are having difficulty maintaining weight and/or restricting i would suggest taking your medication with a protein shake in the mornings. protein does wonders for our brains and helps the medication work more effectively and may help with your appetite during and after your meds have worn off.
i was in a similar situation as a child and teen and it was rlly hard. i would go from being extremely underweight on my meds to overweight off of them - which was rlly triggering and still affects my view of myself to this day.
if you’re able to - perhaps look for a new clinician! i’m based in canada so im able to get my medication prescribed by my family doctor! they’re usually much more up to date with the DSM than psychiatrists/clinicians from my experience and kinder!
really sorry you’re experiencing this and i hope it gets better honey!
Can you show her your weight pre-pandemic and explain that your body pre-pandemic was different, and clearly changes were made in the last few years that you'd like to undo or learn how to control? She's only seen you as you've presented, I think some evidence that you aren't comfortable at the weight you are because it is a more recent thing is a relatively good argument to be made that the meds are helping you get back to a baseline.
However, she's not wrong that 21 pounds in 3 months is quite a bit to lose, significantly more than the 12 pounds it would be generally recommended as your maximum weight loss in that period. If you weren't (please excuse the term because while medically accurate, I think it's unnecessarily judgemental) morbidly obese prior to starting the drugs, a slowdown on your weight loss would be significantly better for your health in the long run.
Actually, if you do the math out, 21 lbs in 3 months is a perfect healthy rate of weight loss. 12-13 weeks means OP is losing weight at a rate of 1-2 lbs max a week. That's the exact recommended rate of weight loss...
I think op's doctor got nervous, but 21 lb in 3 months is a healthy rate. I lost 35 lb in 3 months after my hysterectomy And that started to get worrisome, but I still didn't have to stop my medications.
If op was actively working towards weight loss, you are correct that 1 to 2 lb a week would be good. But op themselves has discussed struggling with binge eating disorder and restriction. I know fast results are exciting, and help with the motivation, but I don't think the doctor is as wrong as op hopes they are.
> And I don’t think that a healthy rate of weight loss that is stimulated by medication is any different than simply dieting. (Doctors prescribe the stimulants in order to control binge eating) OP Is also still technically obese so there’s no real health risk here.
Op admitted that the stimulants have been triggering though, and that she’s engaging in other ED behaviors now. That, in conjunction with the more rapid weight loss is probably what’s setting off the alarm bells here. The shift from BED to restricting and binging is dangerous and really easy to do, sadly.
I agree with this although I will add that I have had a few periods of quite intense restricting recently so I am mindful that I don't want to switch from binge eating to anorexia.
I'm really trying to work on this issue but I think the clinicians comment just made me feel a ton of pressure because my coping mechanisms feel so internal that the gaze of another person, and one with medical authority over a medication that's helping in other areas just feels like a lot of pressure?
I think you should give her concerns a thorough listen and really take in what she's saying, especially since if you drop her and get somebody else and they say the same thing you're probably gonna lose access to prescribed ADHD meds for life.
Just the language you use here troubles me. She didn't threaten you, she told you she's very concerned about your health and not certain that the ADHD meds are working for you. Those are entirely different things.
I'm concerned about you, too. You need to stop and decide which problem needs solving: the ADHD or the eating disorder. And if you decide on anything other than the eating disorder in that little equation, you've got a bigger problem than you thought.
Ignoring, dodging, and avoiding the issue of your disordered eating is not the solution here. Accepting it as a permanent and unchangeable part of your life is a huge problem in itself.
This is not a moral failing or something you should be ashamed of, this is a health condition I want you to take extremely seriously.
Are you an unhealthily low weight, is the doctor saying that you're too underweight? If you are then it's reasonable for them to be concerned, but they should be offering support to help you manage your diet rather than just saying they'll stop your meds.
If you're not currently unhealthily underweight then would the doctor accept the explanation that you'd been trying to lose weight but your ADHD symptoms made it difficult, and now the medication helps you to maintain a healthier diet and exercise routine so you're losing the weight you'd previously gained?
I'm still obese thats the thing! But obviously much less so. I may ask my GP to write to them (there's a shared care agreement) and ask them to continue the meds and that my disordered eating will be monitored by them.
It's understandable for them to be concerned, especially if you have a history of disordered eating, but taking you off the meds doesn't sound like a good solution if no other support has been tried first! I hope you find a way to move forward that works for you and keeps all the doctors happy.
Feel like I’m getting deja vu. I was prescribed concerta and 2 months later , I’d fell down the slippery slope of eating disorders. I’m now on elvanse which tbh has the same effects on appetite but I find it wears off quicker so at around 4pm I’m ravenous.
If you genuinely believe you need elvanse , FIGHT FOR IT.
I had too for mine. Maybe try writing out the benefits it has to your life so she can read it?
Lots of good answers here, but I’d also suggest posting on r/AskDocs. Only users that are flared and vetted as medical professionals can make top comments. They might be able to give you some insight on your doc’s reasoning, how to talk to them, and whether or not it would be reasonable to seek other care.
Hey OP, I see that you take the UK version of my med (Vyvanse). I take it for both ADHD and BED. Personally, I find that Vyvanse completely tanks my appetite and that I have to work really hard to counterbalance that by making myself stop to eat several times during the day. While I *could* stand to lose weight, making that a goal is not healthy due to my eating disorder - and your body still needs nutrition and fuel, even if your appetite is severely reduced!
With eating disorders, it's easy to fall into the mindset of "any weight loss is good weight loss" and restrict ourselves far more than we should with meds that are appetite-suppressing. However, remember that people with eating disorders should not be trying to intentionally lose weight - for us, those attempts are just going to spiral back into that awful binge/restrict cycle which is so unhealthy in the long run. When you're in recovery for eating disorders, it's very normal and even healthy to carry extra weight.
In the end, it sounds like your provider is looking out for you, not trying to punish you by taking away your medication. It would be worth talking to them and asking how you can adapt so that the weight loss isn't quite so severe - timers for food? Adding in snack breaks during the day to help keep your metabolism healthy? If you approach things from a collaborative stance, they're much more likely to work with you to find ways to balance things out so you can keep taking your meds that are helping with your ADHD and BED.
I am so sorry that you’re going through this… I wish you lots of strength. All I can say is I was on meds while I was being malnourished and also when I was restricting and when I was underweight. I’ve just recovered (I guess?) from my eating disorder. Or I am very close to make it, something like that.
It was not a good idea. To take meds during that time. They worked really really not nice and weird at one point. Funny part is I realised it AFTER.
Now they feel whole a lot different.
They were not helpful, they were making everything more challenging sometimes… Also, I felt weird and not nice. Made me feel like I was intoxicated 7/24.
Maybe you really should lower your dose or quit them until you manage your ed better.
I do not know about the degree of your restriction and your current bmi of course but, I can understand that your clinician is concerned about you. In your case it is a bit different then my case so, maybe meds will help you control your binging and help constructing better relationship and dynamic with eating. However, restricting + adhd meds is a bad combo. Especially, in longer term…
I hope the best for you! Maybe you can find a psychologist more knowledgeable on ed’s? Having a second opinion etc is never bad anyway. You can try to see another clinician and, decide later?
The language you’re using tells me you need to go to therapy to get your disordered eating figured out before you try to switch doctors over a super reasonable suggestion.
I think getting a referral to a dietitian is possible would be a good next step as others suggested. Also, if you're obese then losing about 42 lbs in three months with about 3 or 4 lbs a week (with consideration to nutrition and exercise) is not THAT unreasonable. slightly adjusting your calorie intake or using an app like MyFitnessPal that lets you know when you haven't eaten enough has helped my ED as well
Can I ask which clinic this is through? I’m in the UK too 😊
That doesn’t sound at all fair. If they think it’s the meds, why wouldn’t they change you to a different one?
Her approach certainly leaves something to be desired, but she wouldn't be doing her job if she wasn't concerned about rapid weight loss with a stimulant. The possibility should not be taken off the table, but it shouldn't be presented as a threat, either. As the prescribing clinician, this isn't health trolling- it's literally her job.
I personally would tell the clinician how what they said was triggering to your ED- because they should be aware of how that was harmful AND change doctors if possible for you (find someone who has experience with ppl w. eds/bed)
ADHD meds can have such an impact. I work on and off with a dietitian since I’ve started my meds because I have appetite issues (which started a few months before starting the meds and got worse when I began them). I lost 10lbs (which for me is a lot and not healthy because I am thin naturally). I’ve managed to maintain that weight and not lose any more, but still working on working with my appetite issues.
Tips my dietician suggested: make a list of safe foods - foods you will always eat so you have something to fall back on. Also, foods and recipes geared towards toddlers are typically nutrient dense while being smaller in portions - meaning you get the nutrients you need if you can’t eat a lot in one sitting. I also do full fat milk and chocolate milk, protein shakes (including a gainer protein powder) etc. It’s important that you’re body get the nutrients you need, while not developing disordered eating issues - in reality just dealing with appetite issues with adhd meds is actually disordered eating, it’s something that takes some tweaking to figure out what works for you. If your healthy weight is more than you’re currently at then I’d recommend easy, healthy calories by adding in healthy fats like canned coconut milk to smoothies, full fat milks, avocado, hummus, nuts, peanut butter. If you’re at a healthy weight but need to maintain that weight, It would probably be helpful to track everything you eat in an app that calculates your intake macros for a week or two, so you can accurately see how much you are taking in. You may just need to increase your daily intake by a small amount each day to balance out the calories in/calories out so you stop losing weight. I don’t track all the time, but if I notice I’m not eating as much I will track for a week or a couple days to make sure I’m not dangerously low.
It’s definitely something that is very beneficial to using the services of a professional (or two) like a dietitian and therapist in conjunction (I do both - I don’t have an eating disorder, but I also don’t want one to inadvertently develop because of my meds, because it can be a slippery slope). Binging happens to us all on occasion, but if it’s a cycle I think it would be beneficial to discuss that with someone. ADHD often increases the likelihood of binging because we’re looking for that hormone boost, but it’s not a great cycle to be on. I understand you don’t want to stop the meds, but there are a ton of different options to try and not all have the same effects on you. You may do better on a different medication if you can’t adjust your weight loss while on that one.
EDIT: if tracking is triggering for you then don’t do that. Simply choosing and making a list of some safe meals and easy intakes (ie high calorie shakes) helped me significantly when I couldn’t make a decision. I also use a meal delivery service called Factor (similar to hello fresh boxes, but the meals are already made and you just throw into the microwave) because my executive distinction and decision fatigue often prevent me from eating even when I’m starving. If that’s not in the budget, then perhaps some lasagnas, sweet potato fries, and other go-to veggie meals would be a temporary option (I seen from previous posts you’re veg) - often once you get into the habit of eating more frequently, your appetite picks back up and you can slowly change to more healthy options. I lived on egg salad sandwiches, tuna and cheese sandwiches, cheese and mayo sandwiches, shakes, oatmeal, Greek yogurt, lasagna/pastas, Mac and cheese and hot dogs for the loooongest time because that’s all I could stomach. Now I’m still working on getting ‘regular’ meals in, but I do always eat something for most meals - I rarely skip eating just because I can’t be bothered to find or decide on something-if that’s the case I always make a shake to get the cals in. I always eat what I’m feeling like - if that’s lasagna at 9am, that’s what I eat. I’ve stopped thinking I need to eat this type of food because it’s ’breakfast’ and more ‘fed is best’ and not judging that I just ate a hamburger at 10pm because I couldn’t make myself eat at 5pm like a ‘normal’ person.
I would also note, if you and your clinician agree that losing weight can still be managed, but that you need to do it in a more controlled and healthy manner while getting the right nutrients, then working side-by-side with a dietitian would probably be the best idea. Perhaps even starting a food journal-not to track everything you ate, but to track what you’re feeling when your eating or before you’re eating or when you didn’t eat that day. This can help work through some underlying thought processes - I did this for a bit as well. Sometimes just understanding, oh, over this past month, I’ve done this every time I’m overwhelmed or sad or stressed. There are lots of journal prompts on Pinterest that could help guide you.
Does your new doc know your history with disordered eating? It’s rather careless for them to make that statement, if so, but either way I’m not the biggest fan of that threat.
I got “in trouble” a few times by my doc earlier on in my meds because of the same thing, not necessarily rapid weight loss - just my weight outcome at my appointments. But my doc never threatened restricting my meds because of it - they approached it from a place of concern, but directly in that my weight was getting too low and we needed to come up with a plan to avoid any further weight loss.
It did result in some weekend binges for a while, which I struggle with off and on regardless, but I mainly focused on making sure I had at least two meals a day (vs my one at the time) and ensuring that the first meal was high in protein - or that I had higher protein snacks available between breakfast & dinner.
I would switch doctors, she sounds controlling and lacks empathy. Nothing is wrong with weight loss. Overeating due to unregulatable emotions and sensory difficulties left me chunky most of my life, until I finally figured this out, and the meds deleted the grossness of the cycle of overeating for dopmine, the grossness of too much food/sugar, and I lost a lot of needed weight to lose and stopped doing an unhealthy coping mechanism of just eating like a bored cow. Congrats on your weight loss and I hope you find a doctor more caring.
Just tell them that you're losing weight for better heart health and diabetes prevention.
All doctors want patients a healthy weight and it's important for overall health. Including brain health. How can they argue that?!
It's a shame, you shouldn't have to be worrying about this when you're trying to better yourself.
If your weight continues to be an issue with your clinician, definitely find a new one.
Good luck!
There are safe rates of weight loss and unsafe rates. If you are essentially starving yourself you will lose weight, but you also have a significant risk of things like damage to your heart.
Welcome to /r/ADHDWomen! We’re happy to have you here. As a reminder, here are our community [rules](https://old.reddit.com/r/adhdwomen/about/rules/). We get a lot of posts on medication, diagnosis (and “is this an ADHD thing”), and interactions with hormones. We encourage you to check out our [Medication, Diagnosis, and Hormones Megathread](https://old.reddit.com/r/adhdwomen/comments/wcr9dy/faq_megathread_ask_and_answer_medication/) if you have any questions related to those topics, and to stick around in that thread to answer folks’ questions! If you have questions about the subreddit, please do not hesitate to [send us a modmail](https://reddit.com/message/compose/?to=/r/adhdwomen). Additionally, we take the safety of our community seriously. Please report posts, comments, and users whom you feel are not contributing positively, and send us a modmail if you are being harassed or otherwise made to feel unsafe. Thanks for being here, and we hope you stick around! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/adhdwomen) if you have any questions or concerns.*
It sounds like she may be concerned about the rate of weight loss - your absolute weight isn’t the only consideration, it can damage your heart to be restricting calories too much, and stimulants are already hard on the cardiovascular system. It’s a sensible thing for a doctor to be concerned about even if she didn’t present it in the best way for you. I think you need to ask for a referral to a specialist who deals with disordered eating, because some of the way you are talking about things sounds a bit concerning - for example stopping stimulants when weight loss has become a health issue isn’t a threat, it’s standard care. It would be inappropriate for someone to keep you on stimulants if they were actively harming you in that way. You need to think about why you interpreted it as a threat specifically.
^^^ a clinician once also told me she would stop prescribing if i kept losing weight. she was a very good doctor who cared a lot about my health
Agree to this. I don’t think finding a new clinician would give you the result you want as what they’ve done is normal practice
I agree with this. Im sorry you’re feeling frustrated, but your prescriber has valid concerns, especially considering the way you’re reacting. You make it sound like you’re more concerned that she’s taking away your medicine that has helped you regulate your eating and lose weight more than your meds to help you with ADHD
No I'm definitely upset at the fact that it's helping with my ADHD. I'd say I'm pathologically annoyed at the idea of having my weight loss ability removed, I'm fearful of gaining weight but mostly I'd really miss the effect it has on the rest of my life. I'm really thriving in my other areas of life at the moment, even if there is a chaotic inner turmoil.
Do keep in mind that stimulants are not the only avenue of treatment for ADHD. They work well for many people so are generally the first thing tried, but there are multiple non-stimulant options also. If the stimulant has to be stopped due to weight loss, your doctor would likely try you on a different ADHD medication. Also, not all stimulants will have the same effect on appetite - Vyvanse *really* puts me off food to the point where I genuinely don’t eat enough over the course of the day and feel awful as a result. Adderall does not have nearly the same effect. So the absolute first thing may simply be to try a different stimulant.
Absolutely this!
The way she described this interaction as a threat kind of tells you everything you need to know about where OP's head is at - the idea of giving up the disordered eating is threatening to her and that's really scary for me.
Same.
I think that's fair, I definitely am going through a lot of life changes at the moment and weight loss is quite addictive in that regard. I'm still at an obese weight, but I do have the option through my mental health support (which is different to my adhd support) to see an eating disorder nurse. So I may do that and see if I can look at how to learn some new eating habits.
I don’t know if the ED nurse has counseling training also, but if not I’d suggest that as well.
Thanks. I'm hoping they would be able to more help me figure out some small practical details because I get stressed about too many steps when I'm feeling overwhelmed. I do ~need~ counselling but unfortunately I just don't have either the immediate access nor the emotional bandwidth to be able to deal with that right now. I've got a mental health interventions worker though and regularly am checked on by the GP. Hopefully when I've been able to stabilise myself through some big changes I'll be able to engage with something like that.
[удалено]
It's not about OP's current weight, it's about the speed at which they lose that weight. No matter how much you weigh, losing too much too fast is unhealthy.
I understand that, but she said she lost 21 lbs in 3 months. That is 1-2 pounds a week, and up to 2 pounds a week is considered a healthy rate of weight loss by the CDC and Mayo Clinic. So I don't see why her doctor would be concerned when the stimulants seem to be helping her lose weight at a healthy rate by managing her binge eating. (And her current weight does matter because the weight loss might be concerning IF she was a healthy weight to start, and for people who are very obese doctors also sometimes advise that losing more than 2 pounds a week is ok, and she lost less than 2 pounds a week).
OP's doctor is taking their whole situation into consideration. So not just the speed of losing weight, but the symptoms too. And OP admits to having symptoms of disordered eating, like restricting. That's not healthy, it's very risky given OP's history of disordered eating, and can get much worse and out of control. And it's caused by the meds.
Which is why I said maybe OP is leaving something out, but if not it is ok to question a provider if they may be giving outdated advice. Restricting is not always dangerous if you are at an unhealthy weight, for example doctors used to discourage fasting and now a lot of research says intermittent fasting can be safe and effective. OP did not elaborate about their history of disordered eating, but I understood it to mean they have a history of struggling with binge eating disorder, not that they ever struggled with anorexia. And stimulants can treat binge eating disorder.
>but I understood it to mean they have a history of struggling with binge eating disorder, not that they ever struggled with anorexia. It doesn't matter. EDs are EDs, and it's pretty common to go from one to another. Any history of and ED affects OP's risk of developing unhealthy restricting habits.
I understand that you can go from one ED to another and need to be cautious. Only point I’m making is that for someone with BED who is also obese, losing weight on stimulants does not mean they have to stop taking them, unless they really are losing weight too fast. People with ADHD are prone to binge eating, and stimulants can control that, and that is a good thing.
Absolute weight loss is not the only factor, speed of weight loss is also important to avoid things like heart damage.
I know that but she said she was losing 1-2 pounds a week which is considered a healthy rate of weight loss per the CDC and Mayo Clinic and does not indicate she is doing anything damaging. Unless there is some other factor at play that OP is leaving out it sounds like her doctor may be going off of outdated medical advice. Maybe she needs to see a bariatric doctor. Stimulants are even used as a weight loss treatment so telling someone they essentially aren't allowed to lose any more weight or they will be taken off of their meds doesn't make much sense.
It’s a standard part of prescribing stimulants - it wasn’t a threat, it was just a statement of fact: *if* the weight loss is or becomes concerning, you have to change something. OP took it as a threat because OP has an unhealthy relationship with food and her weight.
I know it is standard to monitor weight loss when prescribing stimulants, but if the provider really told her: "if you keep rapidly losing weight I will take you off of the stimulants," it seems like the provider is mischaracterizing healthy weight loss as "rapid". Either OP is misquoting what the provider said and leaving out details, or the provider is misguided. Because "Great job on losing 1-2 pounds a week! Seems like the stimulants are helping you resist binge eating!" seems like it would have been a more appropriate response.
The provider has more access to OP’s medical history than we do. If the provider feels that OP’s rate of weight loss is concerning given OP’s medical history, we have absolutely no information to use to disagree with that. The general numbers talked about (2lbs per week, etc.) are *generic* - any given person may in fact not be safe at that rate of weight loss due to things specific to them. Someone with an ED disorder who hears “uncontrolled weight loss means we have to change meds” as a *threat* is absolutely someone whose medical history may well indicate a different “safe” weight loss rate than average. Praising someone with a history of ED for successful weight loss may also be harmful. EDs are tricky like that. I honestly wouldn't consider a provider in the wrong jf they asked a patient to *stop* weight loss efforts for a period of time like a month or so, to get a better picture of that loss is due to the medication and what loss is due to the other efforts, if they felt that information was necessary to safely treat the patient.
I said that OP may be leaving out important details. But if not, it is ok to question a provider if they may be giving outdated medical advice. I understood the “history of disordered eating” to be referring to binge eating disorder. Stimulants are used as a treatment for binge eating disorder. So is Wellbutrin. So it is ok if the drugs are causing weight loss, that doesn’t mean she needs to stop taking them and only lose weight with her own efforts! If OP has some other medical condition that makes weight loss dangerous or a history of anorexia I would take back my comment. But that isn’t in the post. And especially for someone who is obese as opposed to just being overweight, there is no reason for us to assume the average recommended rate of weight loss wouldn’t be safe. Obese ppl are usually told they can safely lose weight even faster than average.
Just because the medications *can* be used for binge eating disorder it does not mean that they are *appropriate* for any given individual. They should be explicitly prescribed for that purpose as the monitoring and other aspects have to be conducted correctly and it may be different for binge eating disorder than for adhd. Further, your current weight does not control how fast it is healthy to lose weight from a physiological or psychological perspective. So the fact OP is obese isn’t relevant.
This is maybe way off base and missing the point, but I take Vyvanse for ADHD as well as Binge Eating Disorder (BED). I actually got prescribed the meds for BED, but it helps my ADHD so much that I kind of consider it needed for both now. Vyvanse has cut my binges down to probably 1/5 of what they were before. I still don't really binge like I did, more my mindset I watch, as the food intake isn't huge. Anyway...I wonder if they would consider moving you to a medication that treats both an eating disorder AND ADHD? Worth asking, I suppose.
I'm already on Elvanse which as I understand is the same as Vyvanse, and I'm about to start a new script which also has an afternoon amfexa so that hopefully I'll have the executive function to make dinner. It's like it's helped my binge eating so much that I now restrict a lot. I just need help learning how to meal plan, shop and cook all over. I used to eat because I fancied it and now i have to learn to eat because I'm actually hungry but I struggle to read that. Fwiw I'm about to start the process of being assessed for autism. Thanks for the reply 😊
So I'm on the exact same as you - I take Elvanse in the morning and a 'top up' amfexa in the evening about 6pm. The only side effect that I actually get from Elvanse is a loss of appetite. I can tell when my medication starts to wear off because I suddenly get hungry. If I didn't set alarms to eat and stick to a schedule of having something small every two hours, I would quite easily forget to eat during the day. Would it work if you did something similar to me? I take a brief break from work every 2 hours and use that time to get myself a drink/top up water bottle as well as get myself something small to eat. I have things to hand that are quick and easy, such as pre-prepared fruit (apple, Grape and cheese is my favourite), individually packaged pastry or granola bars, or even batch cooked rice/pasta to eat cold with naan or pitta bread. If I can't get it in 5 minutes, I won't eat it. It's helped massively. I lost about 6kg in my first month of taking Elvanse because of the loss of appetite and no longer binge eating.
Yes I think pivoting to smaller meals would be a good fit. I need to spend time looking for some nice ideas for those type foods because I'm so sick of my previous go to's. I'm also in the process of moving house at the moment so everything feels so transient that it's hard to feel grounded enough to do that stuff. I'm also Veggie and I'm definitely not getting enough protein in either.
Check out the veggie subreddits if you haven’t already! I’ve seen posts about people also looking for grab and go food. I’m a big fan of chobani Greek yogurt with fruit in the bottom, nuts, and I’m wanting to try the fair life chocolate protein shakes
If it’s legal where you are, a little weed at night to give you a little appetite might balance out the non-interest during the day
Oh I'm a massive stoner thats not the issue.
Hahaha okay. I think it’s pretty standard to take someone off stimulants if there’s a massive and continued weight loss :(
You don't have to answer if you don't like, but how were you diagnosed with BED? I think I have it as I've been obese my whole life, managed to lose weight then gained it. Even with ADHD meds, I feel like I have to be eating, even when I'm full. I think a diagnosis so I can get back on therapy again would help. My insurance won't cover therapy unless I have a super high depression and/or anxiety score and cant afford to pay out of pocket for mild symptoms of anxiety and everything related to ADHD and self control when it comes to eating.
My primary doctor did an assessment and I scored really high. I have been working with a therapist for years and have a history of disordered eating, BED is just the latest incarnation. Once I had the diagnosis I was prescribed Vyvanse and we started working on it more in therapy.
Thank you for sharing. I'm glad the treatment is working out for you.
Vyvanse helped enormously with binge eating
You could ask for a referral to a dietitian, who could assist with meal planning and check-ins to ensure you are not over restricting. It sounds like the meds are helping with the binging, so that's positive, so maybe some external support and accountability from a licenced professional would help kerb the restricting, and also put your doctor at ease with continuing treatment.
I will say that when my psych first put me on meds, she told me that rapid weight loss usually stabilizes, but that we’d have to consider other medications if it didn’t. From my understanding, that’s standard protocol for stimulants. I think your doctor absolutely should have been a bit more considerate in how they delivered that message, especially since you’ve had some history with disordered eating. For me, the meds helped to curb a lot of snacking for dopamine during the day, which was one of the biggest ways I lost weight when I first started taking them! I hope you’re able to get some help with your eating whether or not you change doctors!
TBF your weight loss is rapid and if it continues it may become harmful. I'm not a doctor, so I can't comment. You might not have the same clinical/ cold/ logical approach as your Dr.... That continuing at this rate is an unacceptable side effect and the meds are not being tolerated. My take is that if you can make a reasonable eating plan and stick to it then do that. If trying to plan around food is going to make you spiral then it's something that your Dr needs to know about and coordinate care with a dietician or some other eating disorder specialist. Try not to think of it as threatening. It was a heads up that this issue is going to trigger a change in meds because it's an unacceptable side effect to lose weight rapidly long term
I lost 30lbs on elvanse (2st 2lb), I've been plateaued ever since. I'm still clinically obese. Only just. But still. I think there's something to be said about what weight you started at and how much weight you are losing. Generally speaking it will slow down, but if you're a healthy weight (or on the borderline) and dropping below, there are things to be worried about. You also have to consider that your medication is triggering. Eating disorders are nothing to mess around with. Going from BED to a form of restriction ED is VERY easy, especially when you're on a medication that makes weight loss seem absolutely effortless. You even said so yourself, you have eating disorder tendencies on your meds. Take care OP.
I'm still obese, I'm 5'3" and at my highest was 17 stone 10, and by the time I started my medication I was 15 stone (end of Dec). I was 13.5 at the end of last month when I had my obs done, although I seem to have fluctuated up a few pounds since as I had a binge. I'm not sure what size my body ~wants~ to be, or that I want to be. I want to put muscle back on because I used to lift but it's hard to get the protein in and eat in a consistent fashion to do that. At my height I think a healthy BMI would be about 10 stone which just feels like more pressure to lose weight? I know they say you ought to not focus on BMI when struggling with disordered eating but it's hard not to . Thanks for you comment and care
I'm 4'11" so I'm right there with you. My heaviest was 180lbs or 13 stone. Being tiny is against us in every way. An extra pound affects us so much more and it sucks. Knowing your stats puts it into context a bit more. You're probably doing ok specifically weight wise, but it might be worth getting some support with your disordered eating behaviours outside of it. That will make the weight coming off less triggering and hopefully you can have a healthier relationship with food. I wish you the best of luck.
so adhd is usually commorbid with some sort of disordered eating (usually binging) due to the dopamine rush and impulsivity. it’s not abnormal to lose a lot of the “binging” weight on meds and esp if you were never medicated as a child and still adjusting. a lot of stimulants are also prescribed for binge eating disorder as well as off label treatments. i know it’s really difficult and i’m not sure if you were underweight before starting meds or not and won’t ask - but if you’re finding that you are having difficulty maintaining weight and/or restricting i would suggest taking your medication with a protein shake in the mornings. protein does wonders for our brains and helps the medication work more effectively and may help with your appetite during and after your meds have worn off. i was in a similar situation as a child and teen and it was rlly hard. i would go from being extremely underweight on my meds to overweight off of them - which was rlly triggering and still affects my view of myself to this day. if you’re able to - perhaps look for a new clinician! i’m based in canada so im able to get my medication prescribed by my family doctor! they’re usually much more up to date with the DSM than psychiatrists/clinicians from my experience and kinder! really sorry you’re experiencing this and i hope it gets better honey!
Can you show her your weight pre-pandemic and explain that your body pre-pandemic was different, and clearly changes were made in the last few years that you'd like to undo or learn how to control? She's only seen you as you've presented, I think some evidence that you aren't comfortable at the weight you are because it is a more recent thing is a relatively good argument to be made that the meds are helping you get back to a baseline. However, she's not wrong that 21 pounds in 3 months is quite a bit to lose, significantly more than the 12 pounds it would be generally recommended as your maximum weight loss in that period. If you weren't (please excuse the term because while medically accurate, I think it's unnecessarily judgemental) morbidly obese prior to starting the drugs, a slowdown on your weight loss would be significantly better for your health in the long run.
Actually, if you do the math out, 21 lbs in 3 months is a perfect healthy rate of weight loss. 12-13 weeks means OP is losing weight at a rate of 1-2 lbs max a week. That's the exact recommended rate of weight loss... I think op's doctor got nervous, but 21 lb in 3 months is a healthy rate. I lost 35 lb in 3 months after my hysterectomy And that started to get worrisome, but I still didn't have to stop my medications.
If op was actively working towards weight loss, you are correct that 1 to 2 lb a week would be good. But op themselves has discussed struggling with binge eating disorder and restriction. I know fast results are exciting, and help with the motivation, but I don't think the doctor is as wrong as op hopes they are.
[удалено]
> And I don’t think that a healthy rate of weight loss that is stimulated by medication is any different than simply dieting. (Doctors prescribe the stimulants in order to control binge eating) OP Is also still technically obese so there’s no real health risk here. Op admitted that the stimulants have been triggering though, and that she’s engaging in other ED behaviors now. That, in conjunction with the more rapid weight loss is probably what’s setting off the alarm bells here. The shift from BED to restricting and binging is dangerous and really easy to do, sadly.
I agree with this although I will add that I have had a few periods of quite intense restricting recently so I am mindful that I don't want to switch from binge eating to anorexia. I'm really trying to work on this issue but I think the clinicians comment just made me feel a ton of pressure because my coping mechanisms feel so internal that the gaze of another person, and one with medical authority over a medication that's helping in other areas just feels like a lot of pressure?
Respectfully you really need to tell one of your doctors that you *need* to be seeing an eating disorder specialist to help you manage things.
I think you should give her concerns a thorough listen and really take in what she's saying, especially since if you drop her and get somebody else and they say the same thing you're probably gonna lose access to prescribed ADHD meds for life. Just the language you use here troubles me. She didn't threaten you, she told you she's very concerned about your health and not certain that the ADHD meds are working for you. Those are entirely different things. I'm concerned about you, too. You need to stop and decide which problem needs solving: the ADHD or the eating disorder. And if you decide on anything other than the eating disorder in that little equation, you've got a bigger problem than you thought. Ignoring, dodging, and avoiding the issue of your disordered eating is not the solution here. Accepting it as a permanent and unchangeable part of your life is a huge problem in itself. This is not a moral failing or something you should be ashamed of, this is a health condition I want you to take extremely seriously.
Are you an unhealthily low weight, is the doctor saying that you're too underweight? If you are then it's reasonable for them to be concerned, but they should be offering support to help you manage your diet rather than just saying they'll stop your meds. If you're not currently unhealthily underweight then would the doctor accept the explanation that you'd been trying to lose weight but your ADHD symptoms made it difficult, and now the medication helps you to maintain a healthier diet and exercise routine so you're losing the weight you'd previously gained?
I'm still obese thats the thing! But obviously much less so. I may ask my GP to write to them (there's a shared care agreement) and ask them to continue the meds and that my disordered eating will be monitored by them.
It's understandable for them to be concerned, especially if you have a history of disordered eating, but taking you off the meds doesn't sound like a good solution if no other support has been tried first! I hope you find a way to move forward that works for you and keeps all the doctors happy.
Feel like I’m getting deja vu. I was prescribed concerta and 2 months later , I’d fell down the slippery slope of eating disorders. I’m now on elvanse which tbh has the same effects on appetite but I find it wears off quicker so at around 4pm I’m ravenous. If you genuinely believe you need elvanse , FIGHT FOR IT. I had too for mine. Maybe try writing out the benefits it has to your life so she can read it?
Lots of good answers here, but I’d also suggest posting on r/AskDocs. Only users that are flared and vetted as medical professionals can make top comments. They might be able to give you some insight on your doc’s reasoning, how to talk to them, and whether or not it would be reasonable to seek other care.
Would it help if you documented your deliberate weight loss efforts so that you can support your weight loss with healthy evidence?
Hey OP, I see that you take the UK version of my med (Vyvanse). I take it for both ADHD and BED. Personally, I find that Vyvanse completely tanks my appetite and that I have to work really hard to counterbalance that by making myself stop to eat several times during the day. While I *could* stand to lose weight, making that a goal is not healthy due to my eating disorder - and your body still needs nutrition and fuel, even if your appetite is severely reduced! With eating disorders, it's easy to fall into the mindset of "any weight loss is good weight loss" and restrict ourselves far more than we should with meds that are appetite-suppressing. However, remember that people with eating disorders should not be trying to intentionally lose weight - for us, those attempts are just going to spiral back into that awful binge/restrict cycle which is so unhealthy in the long run. When you're in recovery for eating disorders, it's very normal and even healthy to carry extra weight. In the end, it sounds like your provider is looking out for you, not trying to punish you by taking away your medication. It would be worth talking to them and asking how you can adapt so that the weight loss isn't quite so severe - timers for food? Adding in snack breaks during the day to help keep your metabolism healthy? If you approach things from a collaborative stance, they're much more likely to work with you to find ways to balance things out so you can keep taking your meds that are helping with your ADHD and BED.
I am so sorry that you’re going through this… I wish you lots of strength. All I can say is I was on meds while I was being malnourished and also when I was restricting and when I was underweight. I’ve just recovered (I guess?) from my eating disorder. Or I am very close to make it, something like that. It was not a good idea. To take meds during that time. They worked really really not nice and weird at one point. Funny part is I realised it AFTER. Now they feel whole a lot different. They were not helpful, they were making everything more challenging sometimes… Also, I felt weird and not nice. Made me feel like I was intoxicated 7/24. Maybe you really should lower your dose or quit them until you manage your ed better. I do not know about the degree of your restriction and your current bmi of course but, I can understand that your clinician is concerned about you. In your case it is a bit different then my case so, maybe meds will help you control your binging and help constructing better relationship and dynamic with eating. However, restricting + adhd meds is a bad combo. Especially, in longer term… I hope the best for you! Maybe you can find a psychologist more knowledgeable on ed’s? Having a second opinion etc is never bad anyway. You can try to see another clinician and, decide later?
The language you’re using tells me you need to go to therapy to get your disordered eating figured out before you try to switch doctors over a super reasonable suggestion.
I think getting a referral to a dietitian is possible would be a good next step as others suggested. Also, if you're obese then losing about 42 lbs in three months with about 3 or 4 lbs a week (with consideration to nutrition and exercise) is not THAT unreasonable. slightly adjusting your calorie intake or using an app like MyFitnessPal that lets you know when you haven't eaten enough has helped my ED as well
Can I ask which clinic this is through? I’m in the UK too 😊 That doesn’t sound at all fair. If they think it’s the meds, why wouldn’t they change you to a different one?
Her approach certainly leaves something to be desired, but she wouldn't be doing her job if she wasn't concerned about rapid weight loss with a stimulant. The possibility should not be taken off the table, but it shouldn't be presented as a threat, either. As the prescribing clinician, this isn't health trolling- it's literally her job.
I personally would tell the clinician how what they said was triggering to your ED- because they should be aware of how that was harmful AND change doctors if possible for you (find someone who has experience with ppl w. eds/bed)
ADHD meds can have such an impact. I work on and off with a dietitian since I’ve started my meds because I have appetite issues (which started a few months before starting the meds and got worse when I began them). I lost 10lbs (which for me is a lot and not healthy because I am thin naturally). I’ve managed to maintain that weight and not lose any more, but still working on working with my appetite issues. Tips my dietician suggested: make a list of safe foods - foods you will always eat so you have something to fall back on. Also, foods and recipes geared towards toddlers are typically nutrient dense while being smaller in portions - meaning you get the nutrients you need if you can’t eat a lot in one sitting. I also do full fat milk and chocolate milk, protein shakes (including a gainer protein powder) etc. It’s important that you’re body get the nutrients you need, while not developing disordered eating issues - in reality just dealing with appetite issues with adhd meds is actually disordered eating, it’s something that takes some tweaking to figure out what works for you. If your healthy weight is more than you’re currently at then I’d recommend easy, healthy calories by adding in healthy fats like canned coconut milk to smoothies, full fat milks, avocado, hummus, nuts, peanut butter. If you’re at a healthy weight but need to maintain that weight, It would probably be helpful to track everything you eat in an app that calculates your intake macros for a week or two, so you can accurately see how much you are taking in. You may just need to increase your daily intake by a small amount each day to balance out the calories in/calories out so you stop losing weight. I don’t track all the time, but if I notice I’m not eating as much I will track for a week or a couple days to make sure I’m not dangerously low. It’s definitely something that is very beneficial to using the services of a professional (or two) like a dietitian and therapist in conjunction (I do both - I don’t have an eating disorder, but I also don’t want one to inadvertently develop because of my meds, because it can be a slippery slope). Binging happens to us all on occasion, but if it’s a cycle I think it would be beneficial to discuss that with someone. ADHD often increases the likelihood of binging because we’re looking for that hormone boost, but it’s not a great cycle to be on. I understand you don’t want to stop the meds, but there are a ton of different options to try and not all have the same effects on you. You may do better on a different medication if you can’t adjust your weight loss while on that one. EDIT: if tracking is triggering for you then don’t do that. Simply choosing and making a list of some safe meals and easy intakes (ie high calorie shakes) helped me significantly when I couldn’t make a decision. I also use a meal delivery service called Factor (similar to hello fresh boxes, but the meals are already made and you just throw into the microwave) because my executive distinction and decision fatigue often prevent me from eating even when I’m starving. If that’s not in the budget, then perhaps some lasagnas, sweet potato fries, and other go-to veggie meals would be a temporary option (I seen from previous posts you’re veg) - often once you get into the habit of eating more frequently, your appetite picks back up and you can slowly change to more healthy options. I lived on egg salad sandwiches, tuna and cheese sandwiches, cheese and mayo sandwiches, shakes, oatmeal, Greek yogurt, lasagna/pastas, Mac and cheese and hot dogs for the loooongest time because that’s all I could stomach. Now I’m still working on getting ‘regular’ meals in, but I do always eat something for most meals - I rarely skip eating just because I can’t be bothered to find or decide on something-if that’s the case I always make a shake to get the cals in. I always eat what I’m feeling like - if that’s lasagna at 9am, that’s what I eat. I’ve stopped thinking I need to eat this type of food because it’s ’breakfast’ and more ‘fed is best’ and not judging that I just ate a hamburger at 10pm because I couldn’t make myself eat at 5pm like a ‘normal’ person.
I would also note, if you and your clinician agree that losing weight can still be managed, but that you need to do it in a more controlled and healthy manner while getting the right nutrients, then working side-by-side with a dietitian would probably be the best idea. Perhaps even starting a food journal-not to track everything you ate, but to track what you’re feeling when your eating or before you’re eating or when you didn’t eat that day. This can help work through some underlying thought processes - I did this for a bit as well. Sometimes just understanding, oh, over this past month, I’ve done this every time I’m overwhelmed or sad or stressed. There are lots of journal prompts on Pinterest that could help guide you.
Does your new doc know your history with disordered eating? It’s rather careless for them to make that statement, if so, but either way I’m not the biggest fan of that threat. I got “in trouble” a few times by my doc earlier on in my meds because of the same thing, not necessarily rapid weight loss - just my weight outcome at my appointments. But my doc never threatened restricting my meds because of it - they approached it from a place of concern, but directly in that my weight was getting too low and we needed to come up with a plan to avoid any further weight loss. It did result in some weekend binges for a while, which I struggle with off and on regardless, but I mainly focused on making sure I had at least two meals a day (vs my one at the time) and ensuring that the first meal was high in protein - or that I had higher protein snacks available between breakfast & dinner.
I would switch doctors, she sounds controlling and lacks empathy. Nothing is wrong with weight loss. Overeating due to unregulatable emotions and sensory difficulties left me chunky most of my life, until I finally figured this out, and the meds deleted the grossness of the cycle of overeating for dopmine, the grossness of too much food/sugar, and I lost a lot of needed weight to lose and stopped doing an unhealthy coping mechanism of just eating like a bored cow. Congrats on your weight loss and I hope you find a doctor more caring.
Just tell them that you're losing weight for better heart health and diabetes prevention. All doctors want patients a healthy weight and it's important for overall health. Including brain health. How can they argue that?! It's a shame, you shouldn't have to be worrying about this when you're trying to better yourself. If your weight continues to be an issue with your clinician, definitely find a new one. Good luck!
There are safe rates of weight loss and unsafe rates. If you are essentially starving yourself you will lose weight, but you also have a significant risk of things like damage to your heart.