FM Why weight gain is a problem and What to do about it

Discussion in 'Fibromyalgia Main Forum' started by happycanuk, Nov 8, 2006.

  1. happycanuk

    happycanuk New Member Treatment & Research Information

    Why Weight Gain is a Problem With Fibro, and What to Do About It

    Weight gain is a particular problem for Fibromyalgia patients, explains eminent FM specialist/patient Mark Pellegrino, MD, in his book on treating FM, Fibromyalgia: Up Close and Personal.*

    Why? “Because of our slow metabolism, it is difficult for us to eat less and notice a difference. Because of our pain, it is difficult for us to increase our exercise level to burn off more calories,” writes Dr. Pellegrino. “Ideally, we need a diet that improves the efficiency of our calories burned by providing us with the right ‘quality’ of food to enhance our metabolism and calorie-burning abilities.”

    Following are excerpts, used with permission of the author, from Chapter 17 of Fibromyalgia: Up Close and Personal - “Nutritional Approaches In Fibromyalgia.”

    Nutritional Approaches In Fibromyalgia
    by Mark J. Pellegrino, MD

    A common problem observed in Fibromyalgia is weight gain. Many women complain to me that weight gain became a major problem once Fibromyalgia established itself. It is not unusual for a person to put on a 25- to 30- pound weight gain in the first year after Fibromyalgia was diagnosed. Various factors are involved in weight gain and include:

    1. Decreased Metabolism. Various hormone changes can slow down the metabolism in Fibromyalgia. Studies have shown hormone deficiencies or imbalances (cortisol, thyroid, serotonin, growth hormone) in Fibromyalgia. Insulin and other hormones are probably affected as well.

    Dr. Leslie J. Crofford (1998)** has described hormonal abnormalities in Fibromyalgia and how they interfere with physiologic communication between the brain and the body. Closely linked with hormones is the autonomic nervous system. The autonomic nerves are the small nerves vital in the coordination of the body’s hormones, and thus they play a role in the regulation and delivery of nutrients to our cells.

    The hypoglycemic roller-coaster effect is a good example of the combination of hormonal endocrine imbalances and autonomic nervous system dysfunction leading to hypoglycemic symptoms. Overall, neuroendocrine abnormalities in Fibromyalgia probably interfere with the body’s metabolism (by decreasing it), and part of the treatment involves replacing or supplementing hormones to help improve the body’s metabolism.

    A slower body metabolism means fewer calories are burned on a daily basis to “run” the body’s machinery. If fewer calories are burned with no change occurring in calories consumed, weight gain will result over time. Also, women in their late 30s and 40s often develop Fibromyalgia along the same time as early menopause (decreased estrogen). This can further decrease metabolism and increase the potential for weight gain.

    2. Hypoglycemia [abnormally low blood sugar]. As I mentioned earlier, increased sensitivity to insulin will result in too much glucose being removed from the blood stream and pushed into the muscle. All this extra glucose pushed into the muscles has nowhere to go as the muscles have very limited ability to store glucose.

    The body is forced to go into a fat-storing mode where it converts this extra glucose into fatty tissue. Contrary to the popular myth that obesity is a result of eating too much fatty foods, obesity is usually the result of eating too many carbohydrates. A carbohydrate rich diet causes weight gain by converting the extra glucose into fat and, if Fibromyalgia causes more insulin activity and sensitivity, then the weight gain can be even greater.

    Another myth is that most overweight people overeat. Actually, most overweight people do not overeat. They may have a craving for carbs and the carbs are easily converted to fat. Fibromalgia facilitates this process. A diet modified in protein and lower in carbs may help.

    3. Medicines. Side effects of medicines used to treat Fibromyalgia can cause weight gain by decreasing metabolism, altering hormones, causing fluid retention, and increasing appetite. The most common offending medicines are the antidepressants.

    Medicines such as estrogen and prednisone can also contribute to weight gain. If certain medicines are causing weight gain they may need to be stopped or adjusted depending on the individual’s medical needs.

    4. Decreased activity due to pain. People with Fibromyalgia hurt more and are not as active because activity increases pain. Thus, it is difficult to increase the energy expenditure or calorie burning related to exercise and activity. Less calories burned can mean weight gain. Any treatment program in Fibromyalgia must include attempts at increasing overall activity level.


    We’ve discussed some of the basic problems of Fibromyalgia, the metabolism changes and the dysfunctional carbohydrate responses, especially. The problems contribute considerably to many of our most bothersome symptoms, including aching; fatigue; brain fog; irritability; anxiety; dizziness; carbohydrate craving; irritable bowel syndrome; food intolerance; and food sensitivity.

    The American “diet aggravates and perpetuates our Fibromyalgia problems. We may have tolerated the higher carb, low fat diet before we got Fibromyalgia, but since we got Fibromyalgia, this diet no longer works for us and it’s probably making it worse.

    Because of our slow metabolism, it is difficult for us to eat less and notice a difference. Because of our pain, it is difficult for us to increase our exercise level to burn off more calories. Ideally, we need a diet that improves the efficiency of our calories burned by providing us with the right “quality” of food to enhance our metabolism and calorie-burning abilities.


    1. Good proteins.
    n Meats, such as lean meats, skinless chicken, turkey and fish. Lean cuts of steaks, sausage, and bacon contain higher amounts of saturated fats so they should be kept to a minimum.
    n Eggs. This breakfast staple is a great source of protein; egg whites are healthier.
    n Tofu.
    n Soy meat substitutes.
    n Dairy products. These include cheese, cream, butter, skim milk, cottage cheese and unsweetened yogurt. Try for low fat dairy products.
    n Legumes. This class includes beans, peas, peanuts, lentils, and soybeans.

    2. Good carbohydrates
    n All vegetables. Vegetables are a source of carbs that are highest in fiber and lowest in sugar. Some vegetables such as corn have more carbs than others.
    n Fresh fruits. Avocado, raspberries and strawberries have the least carbohydrates of fruits. Avoid dried fruits.

    3. Good fats
    n Plant oils, especially olive oil. Other vegetable oils are acceptable including soy, corn, sunflower and peanut.
    n Fish oils (rich in Omega-3)
    n Almonds
    n Avocados

    4. Others
    n Salad garnishes which include nuts, olives, bacon, grated cheese, mushrooms and other vegetables are allowed.
    n Flaxseed oil. A healthy supplement which contains essential fats.
    n Artificial sweeteners and sugar-free beverages are allowed in moderation. If you feel you are sensitive to aspartame, avoid products that contain it (NutraSweet) or substitute a different artificial sweetener, such as sucralose (Slenda) or saccharin (Sweet’n Low). Stevia is a sweet supplement alternative to sugar. Xylitol is another one of nature’s sweeteners like Stevia that won’t raise blood sugar levels and can substitute for sugar.

    [Note: Dr. Pellegrino’s detailed list of FOODS TO AVOID includes what you don’t see here, such as sweets; breads & pastas, especially white-flour based; rice, especially white; potatoes; partially hydrogenated oils (trans fats); carbonated drinks; alcohol except in moderation. Other sections address SPECIAL EATING PROBLEMS such as food sensitivities & IBS, SUPPLEMENT STRATEGIES, and DEFICIENCIES IN FM.]


    1. Think Protein Always
    A key with this diet is not to eat any carbohydrate foods by themselves, even if they are considered good carbs. “Orpaned” carbs will increase the risk of hypoglycemia/insulin hypersensitivity in someone with Fibromyalgia, so foods that have some protein in them should be consumed every time we eat. Therefore, we shouldn’t eat pancakes and syrup for breakfast because it doesn’t contain any protein. Insulin is controlled by the balance of protein and carbs each time we eat.

    If we want a salad for lunch, we should not just eat plain lettuce and vegetables. We need to have a protein source in our salad as well, such as chicken, tuna, turkey, eggs, cheese and more. We should not eat a plain spaghetti supper. We should have spaghetti and meatballs (made with lead ground chuck meat) or lean sausage. If we crave a snack, we shouldn’t eat a sugar cookie. A small bag of cashews would be a better protein-laden choice for a snack. Once you are trained to think about protein every time you put something in your mouth, it becomes easier to stay within the framework of the Fibromyalgia diet.

    2. Avoid The Rush
    Hypoglycemia is often the result of a sudden surge of glucose in our bloodstream after eating a carbohydrate-rich food. The Glycemic Index of foods is a measure of how fast the carbohydrate triggers the rise in circulating blood sugars. A GI over 70 is high. Examples of food with high GI are: Rice Crispies – GI 80; corn muffin – GI 95; mashed potatoes – GI 88.

    To avoid a carbohydrate surge, take a few bites from proteins first whenever you eat. Even if you are eating good carbs, if you take the first few bites from protein, you can minimize the carbohydrate “rush.” Eating proteins first activates the protein digesting enzymes and slows the absorption of carbohydrates. Plus, proteins require hydrochloric acit for proper digestion, carbohydrates don’t. If we eat carbohydrates first, hydrochloric acid may not be activated and subsequent proteins eaten may not be properly digested. Foods rich in fiber and fats also slow the absorption of carbohydrates.

    3. Eat Until Full
    Try to eat at least 3 meals a day and have 1-2 snacks. At meals, eat until you are comfortably full but not stuffed. Some people with Fibromyalgia actually do better by eating 5 to 6 smaller meals a day or by eating 3 smaller meals and 2 larger snacks. Those who are bothered by irritable bowel syndrome sometimes can do better by eating smaller portions more frequently. Eat slowly and take your time to chew food well.

    4. Weekdays: Behave!
    I recommend that the Fibromyalgia diet be followed strictly for 5 days each Monday through Friday, and I allow people to splurge a little on the weekends. That is, the diet is 5 days “on” and 2 days not so “on.” This allows people to follow the basic rules during the week (more proteins, good carbs, good fats) but also allows the anticipation of favorite foods over the weekend...

    ….This Fibromyalgia diet can help decrease sugar cravings, help rebalance your body’s chemistry, especially insulin and blood glucose levels, and can help you shed weight.

    * Fibromyalgia: Up Close & Personal by Mark Pellegrino, MD, was published in 2005 by Anadem Publishing. This very helpful book written by a popular and caring doctor who has FM, is available at bookstores across the country, at (visit our books page at, and from Anadem Publishing ( © Anadem Publishing, Inc. and Mark Pellegrino, MD, all rights reserved.
    ** “Neuroendocrine Abnormalities in Fibromyalgia and Related Disorders,” Leslie J. Crofford, MD, American Journal of Medical Science. 1998;315:359-366. Dr. Crofford is Associate Professor of Internal Medicine, Rheumatology, at University of Tennessee Health Sciences Center.

  2. texasmaia

    texasmaia New Member

    Fantastic Article....encouraging and inspiring too!!

    Thanks for sharing it with us.
  3. beeleaf

    beeleaf New Member

    That's good info.
  4. Sandyz

    Sandyz New Member

    This post will be helpful for a lot of us. I have gained so much weight since having this and wondered why. This explains alot.

  5. hugs4evry1

    hugs4evry1 New Member


    Nancy B
  6. Susan07

    Susan07 New Member

    Thanks for pointing out this article.
  7. llama

    llama New Member

    I like a physician who is realistic. He seems to see the big picture, that it's not easy to rigidly stick to something all the time.

    His approach of some leniency on the weekends makes sense to me.

    When I was first diagnosed with Diabetes, I told the doc. right then and there that there was no way that I was never going to have a piece of pie or a cookie again! That's just not realistic.

    My main staple food is cottage cheese. Quick, no prep., can just eat a few bites of this protein as he suggests and then have a limited amt. of good carbs.

    Despite, this knowledge, I too gained about 20lbs. to 30lbs. rapidly after Fibro hit full force (also was started on insulin and that initially, at least for me, really packed on the pounds!)............Jill.........
  8. texasmaia

    texasmaia New Member

    ....after diagnosis for me (at 40) I have gained almost 70 lbs!!!!!!!!!!!!

    I am now 43 and still there. The carb frenzy hit me hard. Still my enemy. I am needing the motivation to change. I've done it in the past for short periods like 2 months. I don't get any results and I go back to my old eating habits.

    I've been wanting to exercise but just had this ol neck operated on 2 months ago and am still unable to do much. Really is frustrating to be in this cycle and not feel like you will ever get out. I feel like a gerbil in a wheel, running around like crazy with no stop mechanism.

  9. Mini4Me

    Mini4Me New Member

    When I read things like this, it makes me wonder and doubt my diagnosos.

    I have lost 10 pounds in the last year (I thought from these DD).

    I have lost my appetite. I'm not able to cook (in too much pain). Food is nausiating to me.

    Maybe I'm not really suffering with fibro/CMP at all?

    Any advice for a scrawny (getting scrawnier) fibro/CMP patient?
  10. happycanuk

    happycanuk New Member

    I started gaining weight about 10 years ago. Out of nowhere came these added pounds. I had never had a problem with weight before. It started with anti-inflammatories, found out I couldn't take them, as they were raising holy havoc with my stomach. I was always hungry, even after eating a big meal. My stomach felt like it was gnawing on itself. So, had to eat. Then came all the cortisone injections (Facet joint injections and Epidurals). Didn't know it at the time, but that was the cause of this horrid yeast problem. The Dermatologist actually enlightened me. CORTISONE MAKES YEAST GROW LIKE CRAZY!!!! I never had a yeast problem before that, but for the past 7 years, I haven't been able to get rid of it.

    Now, I have been on a diet, following my Naturopaths directions to eliminate yeast, and I have lost only 12 pounds in 7 weeks!! NOT GOOD and I haven't had anything really good to eat in all that time!! No sugar, No white flour, no starch, no nothing lol Only a serving of protein, veggies, salad and a couple of pieces of fruit, plain yogurt and almonds. That about covers it.

    When the fatigue hits, is the time I crave and would literally KILL for sugar. Don't care what kind it is lol Anyway, the Naturopath has kind of eliminated the fatigue for the moment, with vitamin therapy and the yeast program I am on. I feel pretty good, even if the darn pounds won't leave!

    I guess this article is a generalization. I know other people that have FM and they aren't affected by weight gain. I guess it is like all other diseases, they affect all of us differently because we are all individuals.
  11. Lolalee

    Lolalee New Member

    Thanks, happycanuk, for this great article. Makes so much sense. I always feel a surge of energy when I eat protein. My doctor ALWAYS, yes ALWAYS, stresses the benefits of eating small portions of food every 3-4 hours, i.e. 1/4 or 1/2 apple w/ 10 almonds, veggie sticks (avoid too many carrots because of sugar-content)w/low fat cream cheese (thinned w/low-fat milk, add herbs).

    I am focusing on this now. Baby thing at a time.

    Thanks for the article.

  12. Its not bad we have fibro but then pack on the pounds.
    To the gal MCD56 that ate a dozen donuts! If that is you on your profile, lucky you! You are gorgeous, how do you do it and eat like that!?
  13. Daisys

    Daisys Member

    When I started eating this way, I lost 20 pounds in a year, half of my goal. Then I stalled for several years. I was in the middle of menopause.

    Once I started getting hormonal support (female, thyroid, and adrenal), plus better deep sleep, I lost another 10. Now I've hit another plateau but am content to have lost 30 lbs, pretty much painlessly! I'd take the last 10 tho!

    For me, the biggest help was finding out how harmful gluten is for me. I avoid it entirely now.

    Here's my rules:
    Protein at every meal and snack.
    Oils: olive, coconut, grapeseed oil, and butter. NO TRANSFATS.
    Meats: Grass-fed beef if at all possible, for the higher omega 3 content. The only thing I avoid is soy that is not fermented because I hear it can depress thyroid function. Tofu is ok.
    Veggies: no limit, except for very starchy ones. (Like baking potatoes--I scoop out the white in half of a potato skin, add the goodies and enjoy)
    Fruit: I eat some every day. Usually blueberries, strawberries and apples. Not unlimited, and not alone.
    Nuts for snacking.
    Sweeteners: stevia, xylitol, splenda, Canadian sugar twin, in that order.
    Grains: Non gluten--mainly amaranth, quinoa, and coconut flours (also nut flour).

    I enjoy eating. The difference now is I don't get hungry between meals and my weight is stable.

    If I eat at a restaurant, I order the steak, salad with no croutons, and sometimes ask for more veggies instead of rice, potatoes, whatever. (Or I just eat a bite or two if I feel like it.)

    Not only did I lose weight, I lost GERD, some of my muscle soreness, IBS, and some headaches.

    The one thing that changed for me, is now I cook almost all my meals from scratch. It used to take longer, but doesn't anymore now that I'm used to it and set up for it.

    I highly recommend this way of eating!

  14. zenouchy

    zenouchy Member

    Study after study shows that when you don't get enough sleep, people eat more. Since many of us get bad sleep, I wonder if we eat more to compensate? Who knows? I actually LOST ten pounds during my first year with fibro because I had read all of the incidences of people gaining a lot of weight and exercise was one of the few things that helped me get rid of pain.

    HOWEVER, now that my pain is much better due to the Guai Protocal, it's tougher. I exercise a little less. I'm not FORCED to exercise every single day, and sometimes I hurt if I do that, whereas before if I DIDN'T exercise every day, I felt pain. Which isn't as good for the waistline. I have to be a little more careful now.

    Plus, the hypoglycemia. I'm VERY prone to dangerous blood sugar drops!! Therefore, I think I overcompensate slightly. I'm about 8 pounds over where I want to be. I eat VERY well and exercise a lot, but I can't get the weight down. The meds play a part, and then I wonder about age. I haven't changed anything and eat better than I did before, so who knows? The body is just mysterious!

    Much love, Erika
  15. abcanada

    abcanada New Member

    I haven't yet officially been diagnosed with FM, but my docs are leaning towards that. In the past (5-6 years ago) I had no problems gaining weight. Now I can't gain a pound if my life depended on it. I'm 112 lbs soaking wet and constantly struggle to put on weight. Being so thin, i feel like getting really sick could do me in. It is not pleasant either being too thin. I'm really sick of hearing how skinny I am. Not a nice word. I think i get too tired to even eat at times, and find myself forcing food into me so I don't wither away into nothing! Funny thing though, I used to be really strong, and had great arm muscles. I still have the muscles, but no strength to them. Wishing everyone well, Laura

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