Help Please!! Seriously.

Training Bodybuilding
1

Hey T-Nation. Been gone for a while and decided to come back because I’m in serious need of some help. Sorry if I’m not posting this in the correct section.

So here’s the deal:

My sister was diagnosed with POCS 4 years ago. And I’ve had the misfortune of watchning the sickness turn her beautiful figure of 5’8" 150 lbs into the 285lb person that she is today. She gained a whopping 135lbs in a little over three years.

I watched her do everything from cutting to one meal a day while doing heavy cardio to experimenting with bulimia in an effort to stop the weight gain. Unfortunately she hasn’t really been listening to my advice of 7 light meals a day with heavy cardio.

But either way in all her efforts her greatest accomplishment was to slow the weight gain. She never lost a pound and at no point was able to maintain her weight. She just keeps on gaining, the only thing that changes is how fast she gains.

Anyways a few weeks ago she talked to a friend of a friend who happends to be a doctor and deals with this disease quite offen. He basically told her the only way she can lose weight is through a gastric bypass, anything else will just be a waste of time.

So this idiot basically killed whatever motivation she had left after 4 years of watching her body go to crap for working out and trying her hardest to keep the weight off. I absolutely think that saying she can’t lose the weight naturally is BS.

I just refuse to believe that. So i’m curious if anyone has any experience with this disease or any other obesity inducing illnesses and if there is any way to keep the weight off without resorting to surgery, which she can’t afford.

Thanks T-Nation. I appreciate any input on this matter.

2

Hey, if the only way she can lose weight is actually through a gastric bypass…and dieting is a no-go, you might want to check this out:

A morbidly obese person I work with just had this done. I do not know if he is working out or not, but he has lost a lot of weight in just 2 months.

edit-might not be a good idea if she does not want or can not afford surgery. I was just thinking this was better than an bypass.

3

Thanks Gkhan!

I was actually just discussing the lapband with her the other day. The conversation kind of ended with a “yeah that would be great if I could afford it” kind of feel. Her company insurance is crap. Grrr…

4

I am no doctor but from what I could find many of the weight gain problems would seem to be tied into insulin levels and resistance. While there are natural alternatives you may consider her talking to her doctor about Metformin.

Dietarliy I would go high protein because of the higher thermic reaction, low fat (except for fish oils) little to no saturated as this would exasperate the androgen related part of the condition, and little if any startchy carbs, stick to PLENTY of vegtables (primarily cruciferous) to balance out blood acid levels from high protein intake and low activity. Hope that helps.

5

Shortly after I was married, my wife was diagnosed with PCOS (about 6 years ago) by an endocrinologist. The endocrinologist put her on metroformin and advised she needed to take advice from a nutritionist.

Essentially, she followed an Atkins diet of low carb, high protein diet. While she only stayed on the Metroformin for about a month because of side effects, she did not experience any significant weight gain.

She continues to monitor her diet and exercises regularly and her condition has not induced any significant weight gain. She is still at her weight when we got married.

7

[quote]AlteredState wrote:
Does she have any signs of androgen excess, such as hirsutism, acne or oily skin?

I ask because excess androgens will be converted to estrogen which will only compound the weight gain problems.

However, a low dose of an AI would serve to block the conversion of T to E, just as it does in men, I think.

This would not be a ‘cure’ obviously, but should alleviate some of the symptoms.

The other mechanism is, as laroyal points out, due to elevated insulin levels. In this case, metforminand/or a low carb diet should help.

Basically, which pathogenic mechanism is in place for your sister? Elevated LH and FSH, or elevated insulin?

Find out and we can probably assist more.

Either way, the elevated androgens can be blocked from converting to E. She shouls ask her Dr about using an AI (aromatase inhibitor).

Good luck.

PS - Considering this is a hormonal disease, for someone to suggest that only a gastric band will work, seems to be very short sighted.[/quote]

Well put, that also covers (in better detail) my reasoning for high vegtable intake (specifically cruciferous ones) because of their estrogen blunting effects.

8

I’m sorry I haven’t responded, just started a new job and already working crazy overtime. I love it!!

Thanks for your help I really appreciate it!!

Yes she does have oily skin and acne. She’s also begun to grow more hair on her body, she has skin tags on her neck, and dark rings around her neck and arms. She also doesn’t get her monthly menstrals anymore either. Like at all, and hasn’t for the past year. Those are all the sypmtoms I know about.

Thank God were movin in together on the 1st so I’ll be able to help her with diet and exercise, I’m just worried that my level of expertise isn’t enough to really help her.

9

Okay. Little weird telling you this since I’ve told no one, but whatever. I have PCOS, have for years. The goods new? It can be absolutely controlled and gotten under control through the correct diet and exercise. The bad news? It is a life long commitment, and it takes a major lifestyle change.

She needs to learn how to meticulously manipulate her insulin levels with diet. I mean, she needs to keep a detailed food log and monitor the exact percentages of fat/protein/carbs going into her body, and note when the weight gain stops. No other diet is going to work…I tried them all, trust me.

For me, the diet had to have a high amount of fat (fish oils!), a good amount of protein, and very, very little carbs - I’m talking less than 30g a day. Most places say to keep protein highest, but for me, this was never effective. Keeping the fat higher keep the weight off.

In addition, bad foods have to go - all processed foods have to absolutely go. Starchy veggies like potatoes and corn have to go. She pretty much has to eat meat, veggies, nuts, oils, and fruit, and start drinking only milk, tea, coffee, and water. Very little saturated fat!

And…she has to start exercising at least an hour a day, and more than just running on a treadmill - something hard and something that involves the entire body. Kickboxing, racquetball, anything addictive, intensive, and that can be done for a long period of time that she enjoys.

This may sound like a jail sentence to some, and for the first four weeks or so she’s not going to be in the best mood, but after a month or so the diet becomes normal and the body changes start becoming apparent.

I was pushing towards the 325 mark at my highest; I developed skin tags on my arms and neck (which I can give instructions on getting rid of them ;)); my periods had likewise stopped for about 18 months before I went low carb.

Something interesting I noted, and this was the key that stopped a lot of the unwanted symptoms - after about 6 weeks of being very low carb, I just wanted some sugar, so I ate about 6 apples that day, a major sugar high - and three days late my period started.

I experimented, and for myself, I ate low carbs for the first half of the month, dropped extremely low for a week, and then spiked on carbs and my period would always start a few day later.

It was at this point that the weight started coming off fast - I’m talking, one month losing nearly 40lbs sort of fast (which led to gallbladder issues, argh). It did slow down, took about a year in total to lose it all. The adverse symptoms went away.

Today, a couple years after starting this, I don’t maintain a low carb diet constantly, though I do keep the carbs low in general - most of my meals are fish/poultry/beef with some rice and a lot of veggies, and snacks are nuts and couple pieces of fruit.

My period has returned, without diet manipulation. There is no more adverse effects - skin tags, weight gain, hair growth. Diet plays a big role in helping the symptoms, but I’m also convinced that regular, good, intensive exercise helps push it to a more effective level.

I exercise dame near every day.

It’s possible that this may not help her, but I am yet to meet/email a women with this issue that hasn’t been helped greatly by going low carb. If she nails the diet and starts really exercising in a way that will help increase muscle/strength, there’s a very good chance everything will change.

Here are some links that you may find interesting:

http://www.mja.com.au/public/issues/nov16/kidson/kidson.html#suba0

http://www.obgyn.net/pcos/pcos.asp?page=articles/pcos_and_diet_mckittrick

http://www.rtfm.com/lowcarb/lc-pcos.html

Good luck, and sorry for the mini essay.

11

Wow thanks for all the info squiggles and alteredstate. I’m really happy to hear that there is a way to control this naturally. Now the hard part getting her to make that life style change. I think 2 years ago that would have been no problem, but now that she’s so down and given up most hope for a change. I’m not sure it’s possible.

I appreciate all your help very much. Thanks to everyone who offered their input.