weight loss question please

[Smellydog9]

I would welcome some advice. Been on prednisone since February 2023, also on tocilizumab injections. Currently taking 7mg prednisone. I am trying to lose some of my weight gain. I tried 1500 calories a day and lost nothing. Now doing low carb but weight not moving. My daughter gets married in August and my outfit doesn’t fit 🙁. Do I just need to be patient until I reduce the prednisone further? Thanks

[DogAgilityObsessed]

You have a great day to look forward to but I quite understand you wanting to lose weight before.

Everyone is different of course but in case it helps you, I lost over 3 stone while on about 10mg pred a day, just over a year ago. And I've kept it off. I did become obsessed as my food intake was the only thing I seemed able to control in my life at the time.

I did the Fast 800 diet (using the paid for app) and it was so worth it. While everything is calorie counted, all the work is taken care of for you - as long as you weigh and measure everything.

People say it is hard to lose weight while on pred and I do think that can be true. But I wouldn't reduce the pred too soon just because you want to lose weight. If you make yourself ill or in more pain that won't help at all. You won't be able to relax and smile if you are hurting. Better to buy a new outfit and feel comfortable, happy and focussed on your daughter.

[Smellydog9 in reply to DogAgilityObsessed]

Thanks. I have an app to use and can do low carb and let it do the counting. I just need to keep going I guess.

[Koalajane in reply to Smellydog9]

I lost over 3 stone by cutting my carbs drastically.

I feel so much better for it. I lost it at the start of my PMR diagnosis. Are you able to exercise to help lose some weight?

Good luck but whatever enjoy the wedding

[Smellydog9 in reply to Koalajane]

I am doing quite a bit of exercise, aqua and tai chi and walking the dog.

[Loyd in reply to DogAgilityObsessed]

I feel your pain and it is hard! I’ve been on pred for PMRfor 5 years and also have end stage ankle arthritis and basically find it so hard to walk (can do very little exercise!). I was weighed at the hospital during Covid two years ago 86 kilos!! I realised I had to do something!! I did a 1200 calories a day and no carbohydrate at all. It worked and I’m now 61kilos. Gone from size 18/20 to a 12. Still on a low dose of pred. It will work for you. It’s calories in and calories out. You just have to know how many you are using and cutback to less than that. I worked out I was using about 1500 a day and if I ate that I lost nothing. I hope that helps and I wish you the best. Enjoy your special day!

[SnazzyD]

Hello, how long have you been on low carbs? Also, have you done a food diary? It is surprising quite how much carb one can be taking in on the quiet.

[Smellydog9 in reply to SnazzyD]

About a month on low carb. I’m using an app to count the calories and macros but also following the Freshwell food plan.

[PMRpro Ambassador in reply to Smellydog9]

Low carb really doesn't require calorie counting - the low carb bit is the important bit when on pred. It sounds to me as if you are making it very complicated.

[SnazzyD in reply to Smellydog9]

How low is low carb? I found calories were not as important as the nature of those calories. I stuffed my face as long as it was protein or veg. I also had to have almost no salt because the sodium retention made me blow up with fluid.

[Smellydog9 in reply to SnazzyD]

I’m not having bread, potato, rice, pasta or starchy veggies. Some berries. Think that should be okay. Having natural yogurt, eggs, cheese, milk etc and lots of vegetables and seeds, tofu etc.

[PMRpro Ambassador]

It is possible to lose weight while still on pred but you may need to go to very low carb, almost keto levels, to actually lose weight. SnazzyD and I had to get to very low levels to actually lose although maintaining is easier for me.

As Snazzy said - keeping a food diary and working out exactly how much carbohydrate you are eating can be very enlightening, A very common mistake is eating lots of fruit - it may be healthy but there can be a lot of sugar hiding there!

[Rynn33]

I found that 1500 didn’t do much because it wasn’t creating much of a calorie deficit because my activity level wasn’t high enough with the aches and pains. I’ve lost weight while on Pred via 2 approaches - 800 kcal and 30 min walk daily and 1200 kcal and 1 hour walk daily - both diets were lower carb and no bread alcohol or added sugar/fruit juices.

[Lickle]

I lost over 22 pound at the beginning of my going on Pred and have kept it off, but find it hard to lose any more. I'm tapering down to 9mg per day after today.

I found that it is best to go completely No Carbs at all. Especially bread. I am now having the occasional gluten free crackers and bread, but keeping it as a rare treat. The theory being that much of the protein in fat and meat products transfers to where the carbs are needed.

Don't eat the low fat products especially in yoghurt. I've been adding a small tin of sardines/mackerel plus cheese to my lunches and a couple of dessert spoons of Extra Virgin Olive Oil and green tea and you'll be surprised at the positive effects very quickly.

[sidra1968 in reply to Lickle]

Question for you, did you develop any terrible breath? The last time I did very low carb and did lose wight, I ended up having such bad breath after about 6 weeks (I mean so bad that getting into my car an hour after I had driven somewhere I could smell an awful smell, as did my passengers), that I had to stop. I guess again I am rare, because no way could I continue to work or even go anywhere with that bad of a smell emitting from me. I have googled it, but just find the "keto breath" advice of gum/mints, but no one has said it was as terrible as mine was. I might just go 1200 calories and low-ish carbs. Thanks in advance!

[PMRpro Ambassador in reply to sidra1968]

We don't recommend keto - just very low carb. However - was your previous attempt with keto while you were on pred? It is very difficult to get into ketosis when you are on pred and that is what causes the bad breath.

[Lickle in reply to sidra1968]

I haven't noticed the bad breath problem, and nobody has mentioned it to me either. I just cut out all Bread, Pasta, Rice, and Potatoes, but I still eat root vegetables like Carrots and Parsnips. I also include a couple of eggs regularly, either hard-boiled with lunch, or I might make a mushroom/ham/tomato omelette or similar for a dinner.

[Smellydog9 in reply to Lickle]

Thanks. This is what I’m doing. I’ll keep going and be very careful with the carbs.

[Smellydog9 in reply to sidra1968]

No very bad breath but I don’t eat meat or fish so could possibly make a difference???

[Pixix]

I lost a stone on the keto diet in six weeks! Think you still have time!!