So... I woke up the other day and thought... how'd I get so fat?  This thought didn't suddenly appear out of nowhere... it had been rolling around (hah... fat... rolling) in the back of my mind for some time.  Of course, whenever I thought of my ever-increasing waistband, there were a ton (hah... fat... ton) of accompanying thoughts: some weight gain is understandable in this situation, it's difficult to exercise when you're having surgery every other month, people are supposed to gain weight after menopause, being happy is more important than being healthy.  After I worked through all of those thoughts I decided I probably ought to get around (hah... fat... round) to losing some weight if I didn't want to be fat forever.  I started exercising again.  I changed my eating habits.  I did a lot of things.  What I didn't do was lose weight.

It's a lot easier to post slender, edgy post-surgery photos than it is to post
puffy faced, rolls of back fat post steroid treatment photos.  Go figure.

A couple of months ago I saw my oncologist and she asked about my weight and if I was doing anything about it.  Instantly I became defensive, offering lots of reasons (some of which are included above) that I thought it was reasonable that I weighed thirty pounds more than I did when she first saw me.  She suggested a diet and a gym membership... I can't even afford... well... anything.  Joining a gym is not an option.  When I got home and thought about it more, though, I started to become less defensive and more curious.  I sat down at the computer and looked up "breast cancer and weight gain" and "chemotherapy and weight gain" and (especially) "herceptin and weight gain".  The search results I got back were somewhat heartbreaking... literally hundreds and hundreds of women who had gained weight during breast cancer treatment in a very specific way and wondered why they couldn't lose it no matter what they tried.  These women thought that they were doing something wrong, or not doing something right.  These are some of the things you might read if you perform the same search:

"I can't stand this, as it is I'm already feeling down on myself and then this weight doesn't seem to stop. I feel very swollen and my stomach is just big! It's like most of my weight is going to my stomach."

"I am also a very serious runner. I was fortunate that the chemo and radiation didn't stop me from continuing to train and work out, although at a reduced level.  I am currently training to run the Boston marathon in April... I am doing pretty significant mileage right now - at least 30-35 mile weeks with long runs between 18 and 20 miles - and working out at least twice a week.  My mileage has increased over the last two weeks very significantly so I can't understand WHY I'M GAINING WEIGHT!"

"My middle is bigger than my new foobs, and it ain't pretty.  I always wear a jacket/blazer!!!!"

"I too have experienced significant, rapid weight gain approx 3 months after beginning Herceptin. Oncologist and Radiation docs both said it must be due to forced menopause and that there's nothing that can be done about it. I walk/run 2.5 miles per day and eat healthier than anyone I know. The weight gain has been driving me so crazy in recent months that I have decided to forego any further Herceptin treatments after having had 11 so far."

"My stomach is huge, I've never had a stomach like this, I look six months pregnant, I am not a big eater never have been, but it doesn't matter, I wakeup with this huge stomach and after a couple of cups of tea I'm full, I even started drinking Stevia, going low fat, (ice cream) it's awful, I have no money for new summer clothes so I've started this desperate way of trying to get rid of this stomach wrap, that's what it's like as if someone wrapped my middle section with fat and only the middle section."

"I have my last Herceptin February 26th and I have gained about 20 lbs. during this matter how I watched what I ate!"

"I gained 3-4 lbs a week and have excessive gain around my stomach areas. My doctors have no clue, I also called the manufacturers of Herceptin and they had no clue either... It is really driving me crazy. I can't fit any of my clothes and can't stand to look at my self in the mirror."

"My sister was here for my treatments and between the fourth and fifth it hit my belly, my sister was so surprised when I showed her.  One women wrote that it took her a year to lose it.  There has to be a reason so many of us gained weight in the belly section, I just wish I knew what it was"

"I have gained all this weight around mid and upper section of my body, I look like the michelin man, it's gross."

"I also exercise at least 3 days a week and in past few weeks have gained some weight. Also notice my face seems puffier and fatter. So lovely! And yep also tummy is bigger."

I went back to my oncologist a few days ago and this time I brought up my weight.  I told her about the forums I'd found online and my concerns that there really wasn't anything I could be doing to change my weight at this point in time.  Amazingly, this time she agreed that my weight gain was normal and that anybody on steroids (I get an IV steroid with each herceptin treatment) could gain weight in a similar way.  From past experience with steroids (due to lupus and kidney issues) I am familiar with the puffy face and larger upper body, but honestly I've never had it happen to such an extent as this.  I have to think that if  our doctors aren't warning us that this will happen, and even someone who's been on steroids before didn't realize that this was happening for this reason, that it's no surprise that so many women are confused and upset about their weight during breast cancer treatment.  If you continue to read posts and forums and blogs concerned with breast cancer related weight gain you'll find that some women have been told that there is no chance their weight is related to their treatment, while some have been told it's all due to steroids, some have been told it's because they've gone through menopause, and some have been told it may be due to herceptin (or some other non-steroid medication).  One woman was told to eat one lean cuisine and all the salad she wants until she loses the weight.  What.  The.  Fuck.  Really.  What the fuck.

To be fair to my plastic surgeon, my chest reconstruction isn't turning out nearly
as lumpy as it looks in this photo... I think it was the lighting and the way I was
leaning over because there isn't really a comfortable way to stand when you've
suddenly gained thirty pounds.

Friends and relatives (and acquaintances and coworkers and neighbors) expect a certain number of physical changes during cancer treatment.  Radiation (which I did not receive) and chemotherapy (which I did) are common enough these days that nearly everybody is familiar with some of the more unpleasant appearance-related side effects.  When a woman loses her hair because of cancer treatment she is given support.  There are organizations devoted to making sure that women have wigs and hats and scarves and while it's still tremendously unpleasant most women resign themselves to the fact that it's temporary and a necessary evil to be grudgingly tolerated while treating cancer.  The same happens to a lesser extent with a lot of the other physical side effects... rash, skin pigmentation, scarring, etc.

When a woman gains a significant amount of weight as a result of her breast cancer treatment the result is often the opposite.  Not many people realize that weight gain with cancer treatment is so common... a lot of people think that cancer patients all lose weight.  Women will frequently try to disguise the fact that they're steadily gaining weight and unlike how they've dealt with their hair loss they often feel somehow personally responsible for the amount of weight that they've gained.  While a woman's friends will go out of their way to make sure she feels more comfortable about her hair loss and has whatever she needs to make that process easier, many friends don't even realize that a cancer patient is struggling with her weight gain and may be having difficulty finding clothes that fit.  I don't really know of any organizations designed to help struggling cancer patients with the cost of buying clothes that fit after gaining weight with treatment, although there are tons (again... fat... tons... hah) of groups to help with every other aspect of our physical appearance.

This is a much better view of how smoothly my reconstruction is healing, also a
grand view of my giant rolls of back fat that I can feel any time I stand up straight.
I am currently hunched over as I type this, because it's more comfortable.

My friends have tried to be supportive... "You don't look fat!" they say.  They are big, well-meaning liars.  Liars!  I have outgrown my pants and my skirts and most of my shirts and there are whole generations of younger chins hanging out underneath my previously solitary chin.  I know I'm fat.  This method of support is about as effective as if they would have come up to me when I lost my hair and said "You're not bald!"  They did try saying "You look good bald." but not a lot of people believe that and pretty much everybody knows that you just put up with being bald and then your hair grows back.  I wish my friends could all realize that this would work with the fat, too... I'll lose the weight when I'm done with these medications, but in the meantime I just need to deal with it as best I can.

Which brings me to my second complaint... being fat hurts.  I happen to think that people who weigh a lot can be attractive.  Anyone who's studied art history realizes that "thin is beautiful" is a relatively recent concept and there is a lot of modern attention being paid to the fact that beautiful people come in all sizes.  Unfortunately, however, it's not healthy to weigh a lot.  I think perhaps that it doesn't hurt all overweight people, or maybe they gained their weight slowly enough that they didn't notice how it impacted them, but it hurts me.  As I gain weight, my joints hurt more, my skin even hurts in places, and exercising (which I need even more now and continue to do) is way more difficult.  I now have a roll on my back that is very uncomfortable when I stand up straight, and I am out of breath a lot faster when walking around town.  My feet have been hurting after my walks when they didn't seem to hurt before.  It's difficult to find a comfortable part of my body to sleep on, and when I lay my head on my pillow the puffiness of my face even hurts.

This is a good demonstration of how disproportionate steroid weight gain can be...
in the past when I've gained weight my proportions have stayed fairly consistent,
but now my upper body is huge.  It kind of seems to me the way old men gain weight.

Finally, gaining weight is expensive.  I have less than no money.  People think that they're broke (and I've thought this before) but they're still buying a soda or renting a movie or driving to the park... I'm not doing any of that.  With very few exceptions, I buy some groceries and pet food and medication and that's it.  I barely make my rent.  I drive to the hospital once or twice a week (a year into treatment people stop giving you rides... they don't mean to, they just slowly ease back into their old routines).  I outgrew most of my wardrobe a couple of months ago and most of what was left a couple of weeks ago.  I can't afford to buy new clothes.  Luckily I can sew and have some fabric here, otherwise I would be naked (during one of the few times when I'm not okay with being naked, heh).  I borrowed a couple of pairs of pants from a guy friend and took my recycling back and bought a few more things from a local thrift store that charges by the pound.  Combined with what I've made that gives me a few pairs of pants, maybe five shirts, two skirts, and a dress.  This will hopefully last me another month until I'm done with the drugs and can start losing the weight.

So... I guess my point here is that if you've gained weight on your cancer treatment, you're not alone.  You didn't do anything wrong to gain the weight and lots of other women are struggling with the same issues.  If your friends imply that you just need to eat less or exercise more you can point them here.  With your middle finger.  Fuck that.  Yeah, it sucks.  Yeah, people don't like to admit that they suddenly weigh more than they used to.  Yeah, you're probably not going to like looking in the mirror for a while.  You didn't like looking in the mirror when you were bald, either (probably).

Why yes, yes I do have old man beer belly.  Thank you steroids.  It's what I always wanted.

Some things that do help me deal with this are to keep in mind that really the only person who looks at you and thinks of what you used to like and thinks that you're really fat... is you.  Most people look at you and just see a woman, not a woman who used to be thin.  When I look at women who weigh a lot that I don't know, usually I just think "Wow, she's really pretty." or "That lipstick shade is great." or "I wonder where she got that shirt." and those are probably the things that people think when they look at you.  You're the only one that looks at you and sees your graduation photo or your wedding photo or how you looked last year.  Honest.  And even though it doesn't look the same as a more natural weight gain, it doesn't look as odd as you think it does.

Don't be afraid to explain things better to your friends... they'll probably be happy to help after they realize how much this is affecting you.  Maybe some of them can loan you clothes, or give you clothes to trade in for other clothes at the stores that do that.  Maybe you have a friend that sews and he or she can help you alter what you have.  Keep an eye out in the news section... I'm working on a piece explaining how to alter or make clothes easily and inexpensively for those of us that are having wardrobe issues and when I finish it I'll post there with a link.

One of the few outfits that still fits, although that used to be a wrap shirt and not a shirt
that just ties together in the front.

Anyhow, I just wanted to get the word out a little more that weight gain does happen with a lot of breast cancer treatment so that people wouldn't keep thinking that it was just them or that they were responsible for getting fat or wonder how to deal with it.  I'm not an expert and my solutions may not be the best, but it often helps me just to know that other people are dealing with the same thing.  Also, I do realize that weight gain is not specific to cancer patients, but it's often more difficult to deal with (in my opinion) in this situation because it's so sudden and happening at a time when you're dealing with other painful and expensive issues.  It's also the only kind of weight gain that I'm currently experiencing, so it's what I'm going to write about, right?