Can painkillers cause cravings and weight gain? page

[oliviascotland]

I've been doing really well on Primal over the last couple of months, and feeling so much healthier (and thinner!), but a couple of weeks ago I dislocated my kneecap, and repeated the experience again last week. I've had to resort to taking some painkillers (as few as I can get away with, it must be said - usually just at night - codeine and naproxin). But, since then I've not only been craving sweets - something that I got over months ago - but have also put on weight (I hasten to add that I haven't been eating the sweets - don't have any in the house, and can't get out to get any!). Could this be down to the painkillers? Or could it be down to the fact that I'm not able to exercise? Does anyone have any suggestions?

Sorry to be a nuisance ....

[CandylandCanary]

Chronic pain can deplete the hell out of your endorphins. Sugar, simple carbs, alcohol etc all will give you a quick zap of endorphin effect, so I'd say the pain itself can cause carb cravings.

I don't know about the painkillers themselves, but if it's in the side effect list, then it probably knocks some chemical system out of whack. There's a LOT of them in there.

I'm on like, 3 antidepressants and I'm in ED recovery, so figuring out and managing weight gain due to meds is something I've had to deal with. Here's what works for me:

-The understanding that, at bottom, the ONLY thing that causes weight gain is calorie surplus. I'll probably get some heat for this here, but imo, calories do count. Even PB works mostly by cutting out foods that tend to make you eat more and more (carbs, grains, sugars) and focusing on foods that promote satiety and are hard to overeat: protein and fat, low carb veg, etc. But it all comes down to calories in the end. Various meds can mess somewhat with your metabolic rate, but again- in the end, in most cases, it is calories. A med that makes you gain weight is a med that just makes you eat more. More food=more calories=calorie surplus=weight gain. When it's that simple, it's less scary because it's not unpredictable and mysterious anymore. You know WHY it's happening, and you can do something about it immediately.

-You can manage the situation just by monitoring your weight weekly or even daily (just get a baseline going for daily variations in hydration, etc) and keeping your calories in balance or deficit (if you want to lose weight). There's BMR calculators on the web, just google for it. Get one with an activity multiplier and also (if I get your username right and you're a gal), one for women, and that measures age variation too. Then just stay in balance or under. Not too much under, though. That WILL cause cravings for everything, because starvation makes your brain freak out and usually it starts demanding really high-calorie, high-sugar, high-fat stuff to get you more food nownownow. That's counterproductive.

-A knee injury can make exercise difficult, so you may also have lost some of your daily activity that would otherwise burn more calories. That can cause weight gain- because you've fallen into calorie surplus- if you continue to eat the same way you did. You could just add some light weightlifting with your arms, though. Maybe add that while you watch a favorite tv program or something. You can easily do it sitting with your knee up.

-not having crap carbs in the house is a good idea. But also proactively DO have some other primal-friendly replacement. Then it's just easier to have the primal snack than go through the hassle of going out or getting someone else to get it for you.

-keep a diary of your cravings- time of onset, your mood, any possible emotional/stress causality, how bad the pain is, etc. Just being AWARE helps a lot, and people just don't remember all these details unless they keep a record. You don't have to do this forever, just until you get a good picture of what's going on. You'll probably see patterns and cause-effect stuff fairly shortly. Also put in whatever primal or alternative snack you had instead of a junk carb snack, and whether it worked. Put down the time when your craving ceased. Sometimes try just ignoring the craving for an hour- do something else to keep you busy- can make it fade on it's own. Sometimes it will persist. But that's important data too. There's a lot of anxiety and urgency associated with cravings. If you've written down 'I had coconut oil and nuts instead and that killed the craving' a lot lately, it's a lot easier to feel like this 'works' and you'll be more motivated to take that option in the future.

There's also the classic that I recommend to anyone with carb cravings: l-glutamine. Get it either in capsule or powder form at health food stores. I'd actually recommend the powder form, it will hit you faster. Glutamine can kill a carb craving cold.

[john_e_turner_ii]

When I was 17 years old, I tore my ACL playing soccer. I finally had surgery to take care of it, and I gained about 20 pounds over 3 months due to inactivity and eating more due to boredom. When you go from being very active to being completely sedentary, your food requirements should dramatically decrease. If not, the extra food you do not burn will go to fat.

[emmie]

I don't know about the cravings, but I have Rx painkillers for my arthritis that I only take 'as needed.' I noticed that they cause me to retain water--and thus I'll show a gain on the scale. I asked my doctor about a different type of painkiller because of this, but he said, "They all do that." So that might be the cause of your gain. The water will eventually go away once you aren't taking the meds any longer.

[oliviascotland]

Thank you all for taking the time to reply!

Candylandcanary - I will definitely be trying your suggestions, which make a lot of sense, especially the glutamine and the diary! Also, your comments about calorie balance is a very good one as I have been finding that I am not hungry and have not been eating as well as I should as a result (skipping meals which, in itself is not a bad thing, but overeating at other meals). I am staring surgery in the face at the moment (or should that be "staring at the waiting list for surgery!"), and I really want to get this sorted beforehand, so that I don't go crazy afterwards.

I also think that Emmie might well have a good point, and that water retention could play a part - I have been very puffy around the face and hands the last week or so!

And I hope you recovered very quickly from your surgery, John - I know all about eating from boredom, and have been trying very hard not to do that. And yes, some of the weight gain could well be from being fairly active and doing quite a lot of exercise to being able to do nothing. I have been trying to eat less overall, and have stuck to primal, but think that a food diary - maybe even FitDay - might be the way to go to see if I can track things a bit.

Thank you all again - you've been most helpful!

[Adrianag]

Longterm use of NSAIDs can cause a Leaky Gut which can contribute to weight gain and metabolic issues. In your case I don't. thinkyou've been on them long enough for this. My guess is lower energy requirements due to inactivity.

[CandylandCanary]

Glad I could help out a bit.

Also- dunno if you've undergone surgery before or not. But if you haven't- be ready afterwards. The physical shock and (initial) greater pain and greater immobility all adds up to MORE endorphin reserves burnt, more everything burnt brainwise. Therefore: more cravings for sweets or simple carbs.

Some people I know just cut themselves some slack for the first few days- have some favorite treats, have some booze (if meds allow it), don't stress about it too much. A lot of the medications, as you mention, can kill your appetite anyway. I basically ate nothing for 24-32hrs post-surgery just because the anesthetic destroys my appetite and makes me too woozy to know what's going on anyway. If that happens, you could easily do one total cheat day- eat whatever you want- and still end up losing weight because even 3000-4000kcal in that one day is still not going to dent the deficit you built with the 24-48hrs of fasting before it.

But you could also just make sure your house is ready afterwards with lots of primal treats. Some comfort eating isn't going to kill you- if it's short-term. You can work your 20/80 and have mostly primal alternatives and some non-primal stuff. Basically, immediate post-surgery is not the time to beat yourself up about your diet. Heal up first.

But you can exercise damage control while doing this easily. If you've got a husband or kids that live with you, it's even better to assign them to just keep track of what you're eating on fitday. They'll probably be bringing you all your meals and snacks anyway. The necessity of an intermediary person between you and food is advantageous. They'll be much more coolheaded about what's going on with your diet. I'd suggest that you tell them to just let you know where you are in terms of protein, fat, carbs and calories. It's okay to go over, if you feel you don't have the energy to eff around with this stuff right now. But it helps so much just to be AWARE.

Good luck with your recovery. Also, it's kind of crunchy-granola hippie advice, but it works: supplementing with vitamin C megadoses or a good B complex can enhance your pain meds. I did this for all my surgeries. You can do this for cheap just by eating a grapefruit daily. But okay it with your doctor first. You don't want to screw around with meds without medical oversight.

[oliviascotland]

Thank you again, Candylandcanary - very sensible advice indeed. The last time I had surgery, the anaesthetic affected me for 10 days with nausea, fatigue and loss of balance, so I will have to rely on my poor, long-suffering husband for a while! I am currently eating through what is stored in our freezer, in the hopes of cooking lots of primal-friendly meals to simply defrost and heat (lots of stews etc, and some goodies like primal icecream and muffins) as I know I won't be able to stand without crutches for very long. However, I don't see this surgery happening this year as the National Health Service here in the UK can take its time! As I won't be able to drive, and we live in the middle of nowhere, I will have to be very organised with everything well in advance.

Thanks to your previous advice, I have noticed that the ibuprofen I've been taking is the culprit - the tablets the chemist gave me are sugar coated ones, and that seems to be triggering the problems for me! Not something I would have thought about at all - so I have now switched to capsules and am finding the problem much relieved. Also helps that I am slowly getting back to a bit more normal - walked the dog (slowly, and on crutches - but still a good mile walk) yesterday, and hopefully using the crutches will count towards "lifting heavy things" ...

[CandylandCanary]

We've got the same situation in Canada. Waitlists for surgery and all of that. But eh, it beats the American system, which I think is barbaric to the point that it almost disqualifies the USA from being a truly civilized country. (Sorry Americans! No offense.)

Weird that the sugar in the pills was enough to trigger you. But it happens. And for some reason, pill manufacturers just love using sugar and corn as binders.

I'd say using crutches is a lot harder than just walking. Therefore it would indeed be more of a workout. You're getting arm stuff in there, rather than just your legs.