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Living Well : Support and Motivation

Stress and Eating

Some people respond to stress with a trip to the fridge. But there are lots of healthier strategies, like listening to music or taking a walk

Stress in our lives

Stress involves your body, mind, environment, and behavior. People respond to stress in different ways. What disturbs one person may be meaningless to another. Some people respond to stress with a racing heart and anger; others respond with nausea and fear. How we think and act are keys to how we handle stress.

People who wish to lose weight often cite stress as a major issue. Some people point to a single stressful event, such as the loss of a loved one. Some people respond to stress by eating more; others eat less. Many people find it hard to exercise when they are stressed; others feel that stress makes it hard to keep the weight off and puts them at risk for weight regain.

If you get used to eating to take the edge off stress, it could become automatic. Food may start to affect your brain in a manner that helps with stress.

It is no surprise that stress has an effect on eating and physical activity. Clear links exist between stress and health. Stress may affect many aspects of your health: it may make you more likely to catch a cold or more prone to a chronic ailment such as heart disease, diabetes, or asthma. As such, it makes sense that lower stress leads to people who are happier and healthier. Less stress also helps control how much one eats, how active one is, and how much one weighs. Please remember to discuss any stress-related issues with your healthcare provider.

How could you keep stress from thwarting your weight control? Here are 2 possible solutions:

  • Respond to stress with other activities. Eating is one way to cope with stress. Most people can find other ways to take the edge off. What can do it for you? Can it be music, a good book, a walk, a visit with a good friend, or something else? Keep a few healthy activities at hand so that you know what you can do when stress makes you want to eat
  • Reduce stress. This is appealing because less stress may help with other areas of your life. Stress management techniques may also help

Stress management

How you perceive personal events can be crucial to how you respond to them.

Here are 2 examples of stress management:

  • Relaxation training. Good stress management programs teach relaxation skills. When you start to feel stressed, try to counter it with relaxation techniques. Relaxation skills may help you calm down before stress leads to overeating or another regrettable result. Some techniques are self-massage, thinking about a favorite place, and noticing small things. Pay attention to the textures of things near you or the way you breathe. A short break may also help lower your stress
  • Appraisal. When you experience a stressful event, you first appraise the situation and then respond. The appraisal (how you think) determines how you feel and respond. Suppose your boss gives you a poor evaluation at work. If you appraise it poorly, you might suffer a blow to your self-esteem, become depressed, and eat more than you need. You might even blame the boss, get angry, and strike back in some way that is potentially harmful. If you appraise it well, you may choose instead to think of ways to improve your job performance

Relaxation training and modifying the appraisal process constitute the key parts of a good stress management program. To find one, ask a healthcare professional for assistance.

Here are some examples:

  • George’s boss gave him a poor performance evaluation. "I really screwed up this time," he said to himself. "I will probably get fired for this." George’s self-esteem suffered greatly. He thought about it many times during the workday. Each time it came to mind, he worried more. He skipped his breaks and drank coffee instead. When he got home, he began to eat. At the end of the evening, his self-esteem had worsened when he realized how much he had eaten
  • Jerry also received a poor performance evaluation from his boss. "I goofed this time, but it’s not the end of the world," he told himself. "I'll ask my boss for specific feedback on how to improve." Jerry’s more positive and realistic thoughts helped his self-esteem rise above the occasion. When he caught himself worrying, Jerry let it go and took a short break. He listened to his breathing until he felt more relaxed. When he got home, Jerry went for a walk

Stress and physical activity

As mentioned before, stress may be closely linked to physical activity. Many people skip their physical activities when they feel stressed. When stress arises at work or home, it may be hard to get active; you may have trouble finding the time, energy, or motivation. Yet, physical activity may be just what you need. Many people feel better and may even have less tension in their muscles after just one session of physical activity. Daily physical activity may give you a calming effect on an ongoing basis.

The good feeling that comes with exercise is due in part to hormones that improve mood. Many people feel a "high" after physical activity. This improved mood may help you stay calm when stressful events occur. Physical activity also fights fatigue and insomnia and may help reduce anxiety and depression.

The next time stress makes you want to skip your physical activity, remember that activity may be exactly what you need to lower the stress and keep you productive. Even if you feel rushed, take some time for yourself. A short walk will help you feel better; most people can find a few minutes for a quick walk.

Clearly, a short bout of physical activity is better than eating when you feel stressed. Not only will you feel better, you will use calories rather than gaining them.

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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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