Depression and weight gain

As a teenager, I thought I was fat. Most girls do, I suspect. I was a size 10 or 12, but I remember having a hard time finding pants that fit well; most seemed geared for straight body types, not my curvy hips. 

Twenty-one years ago, when I was 19, I had what I call my breakdown. I wasn't functional. I was in college and more often than not didn't make it to class; I must have made it to work sometimes, but I don't remember. Eventually I was diagnosed with major clinical depression and prescribed an SSRI, a selective serotonin reuptake inhibitor. 

My journey with depression could be a whole other blog, but there's one very important piece for now: over the years, my weight more than doubled. 

Off and on meds

About a year ago, I had a new nurse practitioner at my psychiatrist's office, and he asked me to go over my medication history. The sad truth is, I'm not sure I remember all the meds they've tried me on over the years, nevermind the dates, but first there was Zoloft, then Paxil (or vice versa). Then I went off meds for a few years, and when my depression spiked again, my MD worked with me to try St. John's Wort. When the maximum didn't help, she referred me to a psychiatrist. 

It was one of the best experiences of my life. The psychiatrist was warm and caring; she made me feel normal without diminishing my depression. She was the first to put me on a cocktail of meds: Wellbutrin, Effexor and trazodone. That psychiatrist closed her private practice, so I saw a new doctor who eventually changed the Effexor, which was raising my blood pressure, to Zoloft. 

For most of the past several years, my depression has been stable and pretty well controlled with meds (except for my hormones — which could be yet another blog). There have been exceptions, times when the depression was so severe that I went on disability. At the best of times, I would try to lose weight, with varying degrees of success. 

Weight Watchers, round 1

My most successful attempt at losing weight was my first. I was 24, and my mom and I joined Weight Watchers together. We walked every morning (we were living together), and I went from a size 20 to a size 14. 

I think that my first Weight Watchers attempt might have overlapped with the time I was off meds, but I just don't remember. I don't remember what changed, either: why I stopped Weight Watchers or how I gained back the weight — and then some. I do know by the time my mom died when I was 28, I was a size 26. And by that time, I was carrying some serious shame about my body. 

Other attempts, and asking for help

I've tried Weight Watchers several times since, Jenny Craig, and both homepathic and injectable HCG. I walked, I joined Curves, I walked. I haven't been below a size 22 in years. A few years ago, my doctor prescribed high blood pressure medicine. Eventually, she suggested weight-loss surgery. Partially because I was so upset, I switched doctors. 

In 2013, I turned 40. Suddenly I was noticing obese women in their 50s and 60s who used canes or were confined to wheelchairs. I got a rash, partially from heat and partially from weight. I asked my new doctor for help. 

She said there were two options: medication and surgery. The medication is contraindicated because of one of my anti-depressants, so that left surgery. Desperate, I asked for a referral. 

The option of surgery had been in my mind for years, even before my previous doctor suggested it. My husband's aunt and uncle had surgery three years ago, and I saw the difference it made for them. Most importantly, I realized I'd been struggling with my weight for 21 years — more than half my life. I'd tried smart ways of losing weight and more desperate ways. I finally accepted I couldn't do it on my own.