One of the morning news shows had an "expert" on to talk about how fatigue leads to weight gain.
The doctor leapt to the conclusion that anyone who gains weight while they are not sleeping well is amusing themselves during the sleepless nights by eating.
At the point that I gained 20 lb in one year, my house did not have central heat. This being California, it also does not have insulation in the walls, so in winter, it can get down to 50 degrees overnight; even colder in the kitchen which has doors and windows that allow heat to escape. Believe me, there is no food that is worth getting out of my nice warm bed at 3 AM to walk into a chilly kitchen and shiver for.
One of my doctors didn't ask if I did it, he simply announced that I had to stop eating in the middle of the night. In fact, in the last 6 weeks that I was working, I ate LESS than normal, because after working a full day, I had no energy left to fix dinner. I'd simply collapse on the couch and stay there till I had to leave for work (which meant no breakfast, either).
These doctors also assume that you would only gain weight if you're not exercising. In the time frame that I gained 20 lb in one year, I was walking at least 4 miles a day -- same exercise routine I'd had before.
In fact, it's been documented time and again by CFS researchers that the CFS causes changes in metabolism which lead to weight gain. It has nothing to do with what you eat or how you exercise.
If my weight gain were related to exercise levels, then I should have ballooned when I got too sick to walk to work and started taking the bus, and again when I stopped working and went back to eating. Instead, my weight was about the same in May 1999, when the weight gain was first noticed, as it was in July 2000, and in November 2000, and in September 2001. The only noticeable jump in that two-year period was when I gained 4 lb in one month while taking Synthroid (which would normally cause weight loss). If that's not an indication that my hormones went wacko and caused the opposite of the normal reaction, I don't know what is.
Any doctor who assumes everyone "eats out of boredom" needs to explain to me why, when I was home all day, every day, and bored out of my skull, my weight didn't budge.
I lost 30 lb in the year that I was on the sleeping pill that worked consistently. And gained it all back in a couple months after stopping that pill and going back to my prior routine of being awake most of the night. Since I was basically bedridden by the side effects of the sleeping pill, you can't say I lost weight because I exercised and gained weight because I didn't. Quite the opposite -- I lost weight while unable to exercise, and gained 30 lb in a matter of weeks when I was again able to be up and about.
As much as doctors like to lay the blame for weight problems on the patient, and claim she's lying when she says that she does exercise and doesn't eat to excess, the fact is, I have seen it for myself, that the key to my weight is sleep -- not food. When I go into relapse and the quality of my sleep is poor, I gain weight without changing my eating habits (or while eating less because I'm too exhausted to shop or cook). When I go into remission, the weight drops off even if I'm eating more because I'm feeling well enough to shop and cook again.
Cortisol is a hormone related to sleep. Cortisol is a hormone related to weight. The link has been proven repeatedly, including in research centers where the patients had no access to food at 3 AM, so couldn't have been munching their nights away. What is so difficult for these doctors to understand about that?
I'm not saying there aren't people who spend their sleepless nights in front of the fridge. I lived with one. What I *am* saying is that there are many explanations for weight gain, and the doctors should not accuse the patient of overeating without getting the facts.
A good friend of mine was taking medications known to cause weight gain. Her doctor continually bullied her to lost weight by eating less. She wound up in the hospital, where it was determined that she was eating almost nothing, surviving mostly on ice water, trying to appease the doctor demanding that she get down to a certain weight -- a weight that was impossible to reach because of the medication she was on, and not because she was eating far too much. He never asked her to keep a food diary, he just assumed that the only reason anyone would be overweight is because they overeat, and at every visit snarked at her "it's not working, eat even less", without finding out how much she was eating in the first place.
Doctors need to learn to listen to the patients and not ignore them. With so many things, there are easy explanations for symptoms and there are less obvious explanations. Leaping to the conclusion that someone is overweight because they eat too much may be correct in 90% of cases. But then there are the 10% like my friend with her medication side effects, and me with my sleep-related cortisol imbalance, who gain weight even on fewer than 1000 calories a day; telling someone like that to cut back their food intake substantially can cause more problems.