Before I was a VTE blogger, I was a health and fitness blogger. Before I started writing about my blood journey, I wrote about my weight-loss journey. Before I was diagnosed with a DVT and PE, I was diagnosed with insulin resistance as a pre-cursor to diabetes, which motivated me to make changes in my life related to nutrition and fitness. I started running half marathons and eating better – and I eventually reversed the damage being done to my body and came off insulin-sensitivity drugs. In the process, I became enamored with nutrition, fitness and running and continued training – and writing about it – up until that weekend in June of 2012 when un-relenting calf pain turned into a blood clot in my lung and I was out of the fitness game for the next three years.
During my recovery, I gained back all of the forty pounds I had previously worked so hard to lose – and then some. I stopped focusing on making good choices when I ate food and while I didn’t go overboard, my body reached its highest weight ever and I plateaued there. There was nothing I could do – or wanted to do – to change it at the time. My singular focus was on recovery from my blood clot including managing my pain, decreased lung function, leg swelling, a fluctuating INR, multiple doctor visits, physical setbacks, emotional trauma and the numerous lifestyle changes that come with all of the above. Still, in the back of my mind, I knew I had to get the weight off. Once physically recovered from my blood clot, I still felt horrible, lethargic, fatigued and out of control because of my weight. My self-esteem took yet another beating when I already didn’t have much self-esteem left. Eating – and the choices I was making about food – were wrecking havoc on my emotional health.
It’s hard to eat consciously on a regular day, let alone when you are managing an ongoing illness. Now, some of the most common questions I receive at BCRN are, “How do I eat healthy on a blood thinner and how do I lose weight after a blood clot?” While I am not a doctor, nor am I a nutritionist, I am sharing what as worked for me and some tips that I believe can help benefit anyone who is trying to lose weight or make better choices when it comes to food. Studies tend to show that in terms of weight loss, diet plays a much bigger role than exercise – and just because you are taking an anticoagulant does not mean you can’t eat for weight loss and/or optimal health. As a rule, it is important to discuss any dietary changes you want to make with your physician before you make those changes. I talked to three of my doctors – hematologist, endocrinologist and GP – before I made these changes.
Overview: Establish or find a nutrition plan.
Worst first, right? When talking about nutrition for weight loss, it is important to find a diet plan that works for you (here is the only place you will see me use the word “diet” in this context. I refer to the way I eat as a lifestyle, not a diet because it is how I prefer to eat and it is what makes me feel good). The internet, books, magazines, etc. are filled with an overwhelming amount of information about how to eat, when to eat, what to eat and what’s the right way to do things. The thing is, though, finding a plan is just as individual as the blood clot treatment plan you are on. There is no right way because each of us is different.
I have spent many years researching ways to eat and tried a multitude of the plans that are out there – Weight Watchers, Paleo, Whole 30, Low-fat, Autoimmune Protocols, Gluten-Free, Blood Type Diet, Low Calorie, High Calorie – all of them have their pros and their cons. Finding one that works is entirely up to you.
I have chosen to incorporate pieces and parts of these plans to make my own plan, with the guidance of my doctor. The basics of my plan include:
- 1,500 calories a day (or about 500 calories a meal) – drastically cutting calories does not work for anyone.
- A focus on eating macronutrients each day with a goal of not more than half of my daily intake of nutrients being carbohydrates, about 30 percent of my daily intake of nutrients being fat and about 30 percent of my daily intake of nutrients being protein.
- I do not eat (or I limit) white grains (rice, pasta, bread), potatoes (all kinds), sugar (and alcohol), dairy (cheese, sour cream, milk, creams, etc.), soy, whey, protein powders.
- I eat chicken, beef and fish (although I do limit my intake to a few times a week as a personal choice), beans, eggs, nut butters, vegetables (the list is large: peppers, onions, mushrooms, spinach, broccoli, green beans, tomatoes, squash, asparagus, etc.), sweet potatoes, whole grains (limited to once a day and is either whole grain rice or bread), fruit (apples, oranges, bananas, grapes), olive oil, coconut oil, butter (not margarine) and on occasion bacon fat or lard. I cook with almost every spice except rosemary and fennel.
- I eat three meals a day and an afternoon snack, usually. I eat breakfast every single day (not an easy accomplishment) within one hour of waking up. A typical day for me is brown rice, spinach, and an egg fried in butter for breakfast; more spinach and beans or roast beef on a whole grain tortilla and spinach with mustard for lunch; chicken/steak and vegetables or a sweet potato with almond butter and vegetables for dinner. Snacks might be an apple with almond butter or Greek yogurt.
- I do allow myself to have treats. I eat out about once a week with no restrictions, have a pinch of sugar and sometimes cream in my tea each morning and consume wine every now and then.
Fill up on good things – what works for you.
Finding out what makes you feel good – and is healthy – is important. Once you do, eat those things in excess, even in spite of calories goals. I eat spinach every day because it makes me feel healthy, strong, energized and full. Eating protein makes me feel full. Eating nut butters, fruit and on occasion chocolate makes me feel happy. If I am hungry at the end of the day, I eat a sweet potato, popcorn or a even a piece of chicken, even if I am going over on my 1,500 calorie goal.
Cut out the bad things – what doesn’t work for you.
In the beginning, I read It Starts with Food by Dallas and Melissa Hartwig, which gave me a lot of insight into how poor nutrition might be affecting our overall health, including inflammation in the body. I did the Whole 30 Challenge where I eliminated grains, dairy, sugar and alcohol according to the plan for 30 days. At the end of the thirty days, I started adding things back into my diet that I previously loved to eat and was certain I couldn’t continue living without. Certain things made me feel horrible – and still do to this day. I avoid milk and white grains (rice, pasta and bread). On the other hand, I do love white rice – especially from Chinese take-out with a lot of hot sauce. I eat it once in awhile, but I am prepared to face massive joint swelling and pain the next day so my once in awhile is really only that – once in awhile.
I rarely eat anything that is not whole – meaning I eliminate processed foods or things that come out of a box, a bag, a container, etc.
Consistency is key.
When talking about nutrition – especially if you are taking medications that can be affected by food, like warfarin – it is important to talk about consistency. Consistency is more important than elimination, especially when discussing the foods that are healthy for you. I eat about the same amount of spinach everyday. I eat about the same amount of protein in a day. I eat about the same amount of carbs in a day. I eat about the same amount of calories in a day.
I also consistently cook at home, make two or three meals out of one (before it even goes on my plate I divide it up) and shop the perimeter of the grocery store (that’s where you find whole foods like vegetables, fruits, eggs and meat).
Write it down, somewhere, somehow.
In writing down what I eat everyday (as a means to keep track of calories), I realized two things: We as human beings consume entirely way too many calories without realizing it and we eat generally the same things each day without realizing it. Write down what you eat. I think you might find consistency is more present than you realize and you eat more than you realize. I use MyFitnessPal mobile app (or checkout the desktop version) to keep track of my calories and macronutrients. It’s free to download for iOS and Android. You can also use a paper or electronic journal.
Drink water.
I exclusively drink water – and black tea in the morning with sugar and sometimes cream. If you feel thirsty, you need to drink more water. I don’t really pay attention to cups or ounces, but I do drink to not be thirsty. If I go out, I order water. I don’t drink soda, juice or coffee very often, if at all. If I want flavor in my water, which I rarely do, I put my own sliced lemon or lime in it.
Treat yourself.
You cannot eat according to plan 100 percent of the time. It’s not healthy, either. What I refer to as treat (not cheat) meals are important to your mental attitude. I do this about once – maybe even twice – a week. I do not take a treat day, but I take a treat meal where I eat what I want (usually from a restaurant) and do not worry about calories, nutrients or goals. I may or may not write my treat meal down. I eat what tastes good and looks good to me (insert Chipotle here). Over time, I have found my desire to do this is less and less and I tend to have treats that are not really meals – a chocolate bar, a glass or two of wine, or French fries with my salad at dinner.
Don’t do weight loss alone.
Apps like MyFitnessPal have a community component where you can “Like” and “Comment,” just like Facebook. Find a group, an app, an online forum, a book, etc. – anything to make connections with other people who are on the same journey as you. Not only is it motivating, it also helps hold you accountable to your own goals.
To sum it up, this is what works for me – and might not work for you too. This is what I discussed with my doctor – your doctor might make different recommendations. All of that is okay.
Weight loss takes time, dedication and hard work. Changes can be slow – they should be slow, as should weight loss. With small changes, comes lasting progress. I take one day at a time. My today is not my yesterday or my tomorrow. By eating to feel good and fueling my body well, I have noticed I feel much better – and while I am losing weight slowly, the emotional benefits far outweigh the physical ones. I feel more confident, happy and secure in my decisions to take care of myself. For me, self-care extends far beyond my initial recovery to caring for my body and my mind from this point forward.
Reader Writes In: Are you trying to lose weight or eat healthy after a blood clot? What works for you? What is your favorite treat?
There is hope for healing and you are not alone,
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Oh, I forgot the wonderful book by nutritionists Evelyn Tribole and Elyse Resch, Intuitive Eating. Here’s a wonderful quote from the book The Diet Survivor’s Handbook by social workers Judith Matz and Ellen Frankel: “Being a diet survivor means that you will never deprive yourself again for the purpose of weight loss. Making choices about what to eat for other reasons is evidence of self-care.”
One more thing – intuitive eating means no food police – no good food, no bad food – just food. And have you seen this recent article? https://www.psychologytoday.com/blog/food-junkie/201509/your-fitbit-is-ruining-your-relationship-your-body
And here is the Food for Thought Pyramid – the most wonderful thing I’ve seen today!!! Click on the sample to view it. http://www.food-for-thought-pyramid.com
Thank you Sara for the wonderful advice—I cannot tell you how I appreciate your feedback and happy to know that no I’m not alone –but yet terrified of this whole PE–but I know with the Grace of God and the people on here I will get thru this–
I caught a horrible cold with headache body aches sore throat and cough –ended up losing a lot of weight not that I was overweight but I actually needed to gain weight I was not hungry at all–taking a stronger cough med so I can sleep at night and feeling a little bit better today–so hopefully I will see the light at the end of the tunnel..
Heidi
If you are hanging onto weight when you are eating organic, getting lots of fiber and exercising, and drinking lots of water, something else might be going on. This is what I have done: I had my genes tested through 23andme, I had tests with Cyrex labs for Gluten Cross Reactive foods, I went to Doctor’s Data and had the ca-EDTA test done for heavy metals. I also take quality probiotics and have been increasing the fiber with psyllium seed fiber.
Stay away from gluten and sugar. No sodas, white bread, rice, corn or soy. Eat 25 grams of fiber a day and take a doctor formulated probiotic with s. boulardi, many strains of lactobacillis, and biffidobacteria. There have been studies where they have taken the microbiome from heavy individuals and then given it to people who were thin, and the recipients got fat. Improve your gut bacteria.
Just a FYI…many of the foods listed above contain vitamin K. Anyone on Warfarin or Coumadin shouldn’t eat anything with vitamin K, especially spinach, broccoli and green beans which you have listed as items that you eat. Here’s a link to a list of items you shouldn’t eat while taking either of these medications:
https://www.coumadin.com/pdf/Foods_With_VitaminK.pdf
Actually you need vitamin K in your system. You need to adjust warfarin to the amount in your body- not the other way around. If you stop having vitamin K then you will cause more overall issues in the long run. Please don’t advise people to not “eat anything with vitamin k”
I don’t believe you should stop taking vitamin k and eating less vegetables that have vitamin k in them. I took warfarin for 2 years . During that time the doctor told me not to eat “K”, and I studied and decided to and have been fine. BTW, I eat very clean food, little sugar and am gluten free. I have removed myself from warfarin for over a year and am using natural supplementation that works very well. I do not believe I will have another blood clot even though I have Factor IV. It works. Stop taking the drugs if you can. Trust your body.
“I don’t believe you should stop taking vitamin k and eating less vegetables that have vitamin k in them.” I agree. I am doing the same thing Betty is doing. Clean food, little sugar and lots of fruit and veg. I feel better than I did when I was taking warfarin which is a rat poison. It also causes osteoporosis. Let food be your medicine…
I found that I can do water aerobics classes and water exercises and my legs do not swell. My Dr. suggested it because after my blood clots I could not walk even a mile without my legs hurting and swelling so bad that they were numb, which caused me to fall. But now I can do 75 minutes a day and they do not swell. I feel wonderful now and back to my old self.
I find myself in a bit of a quandary according to the nurse at the PE clinic I need to loose weight – she got my BMI as obese due to clonking the scales thing down on my head so I cringed and lost 2 inches height – she didn t take anything off for my clothes – I had a bone scan some years ago and my bones are in the top 90% of density(heavy bones) I used to be very sporty – cycling,distance walking and ski ing so still quite muscelly – do you get my drift -at the most I m slightly overweight round my tummy having had 3 large babies and an appendectomy which shot my tummy muscles – but no excess fat elsewhere – the reason I have to loose weight is that despite this being my second P E I may not have to be on blood thinners for life(I don t want to be on them long term as I m frightened about bleeding issues) I m four weeks on – feeling lots better than last time -doing 2 mile walks but the only way I can do this and keep going all day(not having daytime nap) is to eat regularly and have snacks mid morning and afternoon else my blood sugar drops and I get shakey. By the way my nice doctor said on no account diet just eat healthily I ve given up cakes sweets and alcohol but weight is same as ever. Do I leave it for time being then just go on crash diet just before seeing specialist? Any suggestions – So good to have this site to write on I ve got to the stage where friends & family no longer enquire about my health & if I d chatted to them about above would have been yawning & changing subject after 2 lines. I still feel far from 100%-about 40 and if I m honest somewhat depressed that I m back in the same position having clawed myself back to health after my last one. I have wonderful friend I can moan to anytime and no ill effects from Xarelto -can eat & drink what I like as doesn’t work like that. (was on warfarin last time and didn t get on with it) One further note – when I was on warfarin I printed out list of vitK content in green veg and tried to keep level same.
Hi, Louise – BMI is meaningless and most savvy nutrition experts have written extensively about the need to drop it as a measure of fatness, which it was never intended to be in the first place. It’s a shame that so many in the medical profession cling to it. Concentrate on listening to your body, eat a wide variety of foods that support your nutritional needs, enjoy joyful movement and you’ll be doing what you need to do.