100) Back from family camp: being Mrs. Gloop

We had a very nice week-long trip at our favorite summer family camp destination where we participated in many musical and other performance arts activities.  I played Mrs. Gloop in the Willy Wonka and the Chocolate Factory musical production.  Unlike Kitchen Bitch, Mrs. Gloop loves to indulge her son, Augustus (whom I'm certain has hypothalamic obesity and hyperphagia!), in all the treats he can muster to eat.  I sang a solo with Augustus to celebrate his gluttony (sung with an exaggerated German accent):

MRS. GLOOP:

Ve give him...

Fruit juice for breakfast

Plus melons und mangos

Und cereals, bananas, and cream!

AUGUSTUS:

Zen fried eggs mit bacon

Tomahtoes und mushrooms

Mit bread rolls und buns by ze ream!

BOTH:

Und coffee und toast

Spread mit butter und marmalahd

Sweetmeats und neat treats galore!

MRS. GLOOP:
Und vat does Augustus do ven breakfast's through?

AUGUSTUS:
I eat more, I eat more, I eat more I eat more, I eat more!

Well, we had a great time performing the musical and of course I could not help smirking at the irony of my role in the play.  While I did not behave exactly like Mrs. Gloop towards Sasha, we also made a conscious decision to resist policing him during the week.

The spread of food was abundant and it was always hellish to police Sasha in the pre-oxytocin days:  food is served buffet-style.  Although the food is delicious and well-prepared with healthy options (an amazing salad bar every meal, for example), there are also an array of "carbolicious" foods at every meal (breakfast cereals, breads, pasta, pizza, rice, some desserts, etc.) in addition to there being bread, butter, peanut butter, and jelly available all through the day until midnight.  In the past, we used to check up on him whenever we could during and between classes but it was impossible unless we were with him in every class (which we weren't).  This was the first year going to camp since having him on the therapeutic dose of oxytocin so we decided to just let go...

Well, he definitely took full advantage of his food freedom and chowed down pretty well on the high carb foods and on the peanut butter sandwiches between every meal.  We did our best to just let him make his own decisions about food choices and to resist the urge to control him. As a result, he ended up gaining 3 kilos (7 pounds) during the week!  I am not surprised about his desires to indulge himself since we do not stock these types of foods at home.  I am also not surprised that he gained all the weight that he did during the week of excessive carbohydrate consumption.  He was not the only one who gained; the rest of us also put on some extra pounds, thanks to the buffet-style meals. Fortunately, it has been very easy to resume our lower carb (50- 100 g/day) lifestyle back at home. As expected, Sasha has returned right back to his home eating habits and is losing weight (over one kilo lost in last five days) rapidly once again. At his endo appointment yesterday, his doctor was very impressed with his weight loss (BMI at 22.5) and she saw him with his net weight gain after returning home from vacation.

I have learned that Sasha can and will behave somewhat like Augustus if given the opportunity. Oxytocin is not a magic weight loss drug. If one eats like Augustus Gloop, one will gain weight (yes, even with oxytocin). Fortunately, our all-you-can-eat vacation lasted only one week and resuming our moderate eating and lower carb lifestyle (with help from oxytocin) makes it possible to lose the weight he gained.

We have one last vacation to Seattle before Sasha starts high school (gulp). In Seattle, we will do some sight seeing, visit friends, and I plan to meet up with pedi-endo and HO expert (co-author) Dr. Christian Roth at the University of Washington, to discuss and hopefully wrap up the editing of the OT/Naltrexone case report I plan to submit for publication soon.

99) Off Naltrexone, behavior and weight are holding steady

Sasha has been off naltrexone (100 mg/day) for about two weeks now.  So far, we haven't seen much of a difference- there were a couple of incidents of more "food intensity" (increased insistence about being in control of food, displays of unhappiness when not getting his own way around food) last week but it may have been because we were more sensitive to changes.  Fortunately, there were no signs of extra food sneaking/stealing. His weight has remained exactly the same as it was last week so this is reassuring that the therapeutic effect (re: energy metabolism) of the experiment is remaining intact even with the removal of naltrexone. We have been a little more generous with carbohydrates.  He has had some legumes, oatmeal, Chap Jae (Korean glass noodles), and once last week, we even went out for dessert and permitted Sasha to order a bread pudding dessert (modest sized piece but made of sugar and butter and flour).  After the sugary dessert, we went back to our regular lower carb eating and it did not seem to trigger any ill effects such as increased carb seeking.

An article about how chronic consumption of sugar blunts activity of pathways that mediate satiety.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175817/

I'm hoping that this implies that non-chronic consumption (an occasional once-a-week treat, perhaps?) may be less risky for the mediation of satiety. If we can keep this balancing act, I will be very pleased indeed!

Tomorrow we are heading to a week-long vacation at our favorite performing arts family camp. They serve excellent tasty and healthy food but there is always the spread of cereals in the mornings and the peanut butter and jelly sandwich bar that is there between meal times. We will be performing Willy Wonka and the Chocolate Factory (musical based on book by Roald Dahl) and I have been cast as Mrs. Gloop! The irony has not been lost on me. I only hope that Sasha does not behave like Augustus Gloop at camp...