Brief Answer:
Welcome to HCM. I have reviewed your question

Detailed Answer:
You asked if interferon had anything to do with "this." Interferon is known to be associated with both weight loss and weight gain. However, you only received it twice, so I do not see how it would have long term effects on your weight management unless. . .

During the course of therapy there is a possibility that interferon may adversely affect the thyroid gland. Have you had any thyroid studies done? TSH, free T4, reverse T3, urinary iodine, free T3? If your thyroid is not regulated, you will exhibit weight issues.

Yo-yo weight management causes a derangement in your body's metabolism. The end result, such as in your case, will be maintaining an overweight status while not eating enough calories to sustain that weight status. Your metabolism has dropped. Aging also drops metabolism significantly with every decade of age. The more body fat you have, the lower your metabolism.More than likely you have lowered your metabolism and it will be a challenge to get it back up.

In your case,if you were my patient, I would first assure that all necessary labs had been run for thyroid function and for anemia (iron, B12, folic acid). Replete and treat as necessary.

Work on increasing metabolism by small frequent meals. Alternate your calorie level to fool your body. I realize your leg is a problem, so look to arm exercises or anything you can do to build some muscle somewhere and to get your heart rate up a bit. Activity will greatly help take the pounds off even if you must go back to physical therapy to get your exercise in. They can also teach you home exercise.You can look toward You Tube for instruction on exercise routines or my pinterest site under my name on the internet. I have a Fitness Board.

Have you tried controlling appetite hormones and metabolism by using the low glycemic diet? This might be a consideration. Overweight individuals have an insulin problem and the low glycemic diet improves sugar control.

If no kidney stones in your family or personal history, clear green tea taken 4-5 times per day increases metabolism according to many studies and will help to burn calories.

Bone loss should be treated by a specialist as there are differing mechanisms for bone loss. The correct drug for the problem needs to be chosen. An osteoporosis specialist can run a blood test to better tell which classification of medications is best for you and what supplements you may need. Definitely test for and supplement with vitamin D3 if low. Calcium is important as is vitamin K (if not on blood thinners).

If you are not getting all the nutrients you need, you might want to consider a good quality multivitamin small enough to swallow or chew easily.

Below are strategies to choose from to break a plateau:

Keep the Food/Symptom Diary again if you are not still doing it. Sometimes, as the same old regimen is repeated, boredom slips in. Calories begin to creep back in, portion sizes aren’t watched like they used to be. Go back to the basics: weigh, measure and revisit portion sizes and food choices. Studies have shown that people very gradually increase their calories over time on a meal plan so going back to actually measuring and recording resets the brain to back to remembrances of how it “should be” or portions “should look like”.

Intermittent-Fasting Routine: For this plateau buster, the weight loss is facilitated by moving calories. For 2-3 days either a very low calorie diet (800 calories) or a fast can be chosen to throw the body’s expectations off. Do this for two days then go back on your meal plan for 3 days and then fast or follow a very low calorie diet on an every- other- day basis. There are various renditions of this manipulation. Now, hunger is still a problem with this type of plan unless your fasting days take you into ketosis. Not appropriate for diabetes.

Fasting is associated with increased ghrelin and decreased obestatin in the blood circulation. Specifically these naughty hormones are ghrelin and obestatin. Both hormones play intricate roles in playing with our regulation of diet induced thermogenesis,
     Calorie-Restricted Optimum Nutrition (CRON): This meal plan, originally developed in life-     extension research, was found to be effective at keeping the body lean and mean, but it is not      practical to live on such small amounts of food with supplementation for extended periods of      time. These human studies continue, but now the rage is to look for CRON mimetics that make      life more livable. However, short term use can blast a hole in a plateau! This link will explain the      
     diet in entirety: http://www.scientificpsychic.com/health/calorie-restriction.html


Macronutrient Manipulation: Take your meal plan and flip flop it. For example, low carbohydrate high protein for one month may be different. Some meals will be turned from a meat based to a vegetarian based or from a regular carbohydrate diet to a low glycemic carbohydrate, high protein diet. Again, your body is fooled for a bit.

Then, don’t forget the little plateau “busters”: a) drink 8 oz. glass of water or sugar free beverage prior to a meal; b) achieve adequate hydration, but not too much – 1 ml per kcal or 8 glasses per day and consume high water foods such as melons, hot cereals; c) keep your sodium to the recommended level of 2,300 mg. sodium/day or higher if exercise requires it.

Exercise and Lifestyle

Change Your Workout Routine: Keep your metabolism guessing! Here are some guidelines creating new work-outs for your toolbox. Have fun with the following ideas!

Redesign your old work -out program by changing one or more variables – frequency, intensity, duration.
     FREQUENCY: Change the number of times you do a work out per week
     DURATION: Change the length of time you do a specific workout
     INTENSITY: Increase your target heart rate for 20 minutes of the cardio portion of the routine

Add Yoga or Tai Chi to your routine – pay attention to breathing exercises and isometrics
Use Video exercise programs to increase compliance
Try to get fresh air and walk daily!

Remember to adjust your fluid and meal intake to the type of sports you are in – professional athlete vs. weekend warrior.

Get in touch with your hunger signals again and what that feeling is like.

Plan ahead for parties and social events.



Thermogenic Aides
or
Where’s the Pill?

A pill is not our long-term answer. Short-term like in Breaking a Plateau, it is reasonable.

And, our top contenders for Thermogenic Aides are:

Green Tea: This herb has been used medicinally for a very long time. Studies have shown that green tea can help reduce obesity when consumed on a daily basis. I seems to work by increasing metabolism after eating. Green tea may also reduce the appetite, fat absorption and storage. To break a plateau, drink 6 0z of caffeinated green tea 3x per day until weight loss established again.

The chemicals responsible for green teas effect on weight are primarily from ECGC, catechins and polyphenols

Green Tea should be respected as a known adjunct to reducing the BMI, body weight, body fat, reduction of overall fat cell generation, decrease in fat absorption and in the suppresses of appetite

Hot, Spicy Foods: Incorporate the use of hot chili peppers and turmeric in meals. These spices cause a slight sweating reaction and a greater response to the food thus elevating thermogenesis.

Resveratrol: Resveratrol has been on the market for many years and has been used medicinally for generations. Controversial human trials continue, but studies have shown that 150 mg of trans-resveratrol will cause weight loss in obese but not normal weight humans.

Vitamin D/Calcium: Approximately 90% of our world’s population is deficient in vitamin D. Vitamin D is actually a hormone and recent reports suggest our rise in obesity is related, in part, to our lack of Vitamin D and Calcium


These nutrients/foods- all thermogenic teas-can be
used alone or in combination to break the plateau. No adverse side effects have been found, but caution and supervision should be provided for the elderly, those with chronic health conditions, diabetes and/or heart disease

Vitamin C: Vitamin C is inversely related to body mass. Individuals replete in vitamin C oxidize 30% more fat during moderate exercisers than those who were depleted. Dosage should be 250 mg by food (preferably) or supplement.

Transformation of our Mindset

•     Change your mindset – see yourself as you want to be, see yourself as you wish to look. This is best done in a state of meditation or prayer
•     Mentally visualize how you will handle challenges you know may tempt you and be ready for them. The more you practice your responses the easier it will become.
•     Positive Self-Talk (I look good today or I feel good, what a beautiful morning)
•     Increase use of support groups ( they can help push us through challenging emotional times that lead to overeating)
•     Self-hypnosis
•     Add a buddy system


Accepting and anticipating challenging weight plateaus will encourage success as each plateau is out-witted. So, take the challenge and win, out-win that plateau! Once your energy level is restored and the pounds start coming back off again, slowly start easing back into your original (or revised) meal plans and exercise routines.

I highly suggest a referral to a Registered Dietitian to individualize a diet plan for you after you visit your personal physician to address the items noted above. A Registered Dietitian near you can be found by searching for the Academy of Nutrition and Dietetics, checking "find a dietitian" put in your zip code and you may find one near you who can follow you and help you meet your weight loss goals.

Please feel free to contact me again if you need clarifications.
Regards and Best of Luck, XXXXXXX Shattler, MS,RDN

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