I have a client who has endometriosis. She has been dieting hard and working out very hard but she can't lose any weight or fat. Due to the disease she is taking special hormones to assure that it stays under control. What can I do to help her, if anything? Do you think it's hard because of the hormones or is she lying about what she's eating?
Endometriosis is a condition where the lining of the uterus is found in locations outside the uterus, typically in the woman’s pelvis. Estimates of its occurrence in women are between 5-10%, making it one of the most common diseases on the planet. Its etiology is not certain, with several theories bandied about. Pelvic pain is the most common symptom and often leads to an eventual diagnosis of the disease. Confirmation of the problem can only be achieved through a laparoscopy. In this procedure, the suspect mass is identified, removed, and examined to determine if it is indeed endometrial tissue. Since the endometrium produces the hormone estrogen, the wayward tissue also produces the hormone. For this reason, hormonal therapy, often with progesterone via Depo-Provera, has proven popular. Identifying and removing the misplaced tissue achieve the greatest outcome. For additional information on endometriosis, try these web sites:
Now to your question. Weight gain is associated with Depo-Provera use and is believed to be due to its steroid-like appetite stimulation and to altered tryptophan metabolism. Although data is mixed regarding weight gain and Depo-Provera use, it is a commonly cited side effect and reason for discontinuation of its use as a contraceptive. Any drug that is associated with a weight gain not attributable to an increase in fluid volume (water weight) must be the result of the user eating more and/or moving less, as weight gain only occurs from a change in the relationship between energy in and energy out. There is nothing about your client’s disease or treatment that prevents her from losing weight or fat. If she is increasing the intensity, duration and frequency of her workouts, as well as manipulating the mode used, then there is one answer to her lack of progress; she is eating too many calories.