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Living Well : Support and Motivation

Coping with Pressures to Break Your Diet

Don't let other people's agendas affect your resolve

Strategies for resisting the pressure to eat

Coping with other people’s pressure on you to eat can be a challenge. Friends, relatives, and acquaintances may encourage you to eat. Some mean well. Others might not. All of this can make it hard to lose weight. Let’s look at some reasons why people may try to push you to eat:

  • They may not know that offering you food is a problem. Some people may not know about your struggle to lose weight. You may need to gently tell them what it’s like. Once they know, they may want to help
  • They may feel bad if they eat in front of you. Some people feel it’s wrong to eat when others are not eating. They don’t want to be rude. They offer you food to be polite. Tell them you feel fine not eating, and they should go ahead and eat if they wish
  • They may think you’re starving. People who think like this wonder how they would feel in your shoes, and feel bad for you. Many people associate food with love; offering food is their way to show they care. Assure them that you’re fine and tell them they can help by not offering you food
  • They want to test your determination. These people may tease you to see how serious you are about your program. This may seem cruel, but it happens. Show them just how serious and determined you are
  • They may be jealous of your success. Other people may be jealous of your success. Even thin people may be jealous that you are succeeding at something and proud of your achievements. This is their problem; don't make it yours
  • They may not want you to succeed. This is rare, but it can spell trouble. You can spot it in acts of sabotage: the person may get a craving for your favorite food and say things like, “You’ve failed before and you’ll fail again.” Ignore these comments. Confronting a person like this rarely helps; it can make things worse. Again, this is their problem; don't let it bother you. If this person offers you food, refuse in a polite way. In time, this person will get the message and quit trying

When others pressure you to eat, stand up for yourself. Refuse, but don’t react harshly. Be polite even if you think they don’t mean well. Be firm. After a few polite refusals, most people will get the message and quit pestering you.

For instance, if Aunt Irma offers you her homemade fudge, you might say, “Gee, Aunt Irma, I love your fudge, but I'm not very hungry. I would enjoy a cup of tea.” If you are out with friends and they stop to get ice cream with you in the car, say, “I’ll pass, but go ahead! I know how much you love ice cream.”

Some people have trouble asserting themselves. If you’re one of them, try to think ahead of situations where others may pressure you to eat and plan how you’ll respond. Practice it. When the situation arises, you will be prepared to be polite but firm.

Strategies for resisting the pressure to drink

Alcohol, like many other beverages, is a source of extra calories. A regular beer has as many calories as a regular soda. Ounce for ounce, wine and liquor have many more calories.

You may face pressure to drink alcohol. This is like the pressure to eat, but it happens in a different way. The pressure may be indirect. For example, a friend who knows not to give you a soda might still pour you a glass of wine. On the other hand, when you see those around you drinking alcohol, you might feel like drinking, too. This can happen even if no one offers you a drink.

Most of the tactics we gave you for turning down food also work for drinks. If you don’t want to drink, be polite but firm. Plan how you will respond when someone offers you a drink. Remember that people might not be aware they should not encourage you to drink. When they see how firm you are and hear your polite refusals, they will learn in time.

If you choose to drink, log the drink in your food planner and tracker. Wines and spirits don’t have nutrition information on the label. You can usually look up these calories in your food planner and tracker.

Some strategies are specific to the pressure to drink. If you choose not to drink, you can offer to be a designated driver. People will expect you to stay sober; the calories you save can be a bonus!

Another strategy to try and reduce your number of drinks is to have water or diet soda after each alcoholic drink. If you decide not to drink, try to keep water or a diet beverage at hand. This way, you can be less tempted if you get thirsty.

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INDICATION

Qsymia® should be used together with a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obese) or
  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol

Limitations of Use:

  • It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke
  • It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products

It is not known if Qsymia is safe and effective in children under 18 years old

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

Qsymia can cause serious side effects, including:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Women who are pregnant must not take Qsymia. Women who can become pregnant should have a negative pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy. If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Possible side effects of Qsymia include:

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Common side effects of Qsymia include:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to VIVUS, Inc. at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please read the Qsymia Medication Guide and Full Prescribing Information.

The Q and Me Patient Resources and Education site is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved.

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

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