It’s hard enough to have a healthy relationship with food at the best of times, but when you have rheumatoid arthritis (RA), there are some extra challenges. A chronic condition like RA can mess with your appetite. Medications can make you gain weight, make you nauseous, or cause you to lose your appetite. When your disease is active, chewing or swallowing can be difficult.
You can improve your personal “eco-system” by making good and appropriate food choices. Here are some strategies to help you manage those challenges.
You can't avoid food. Nor can you avoid the headlines that aim to convince you that this diet or that superfood is what you need in order to be healthy. The choices are mind-boggling.
Fortunately, there's room to experiment. Try eating at different times of the day. Experiment with smaller meals. Broths, smoothies, and soups are sometimes a more palatable way to get your nutrients. Different types of diets, such as gluten-free, paleo vegetarian, flexitarian, and pescatarian may be worth a try. Food can be a friend or a foe, so it's important to learn to listen to your body.
When you're not hungry
Certain medications such as non-steroidal anti-inflammatory drugs (NSAIDS), and some antibiotics may cause nausea. Be sure to talk to your doctor if the symptoms do not subside.
In the meantime, try eating smaller meals. Drink plenty of water. If you're sensitive to the smell of some foods, consider avoiding them for the time being. Remember to follow the directions (take with food, take one hour before breakfast, etc.), when taking medications. Ignoring them may set you up for digestive trouble.
Does this pill make me look fat?
Some medications are known to cause weight gain and increased hunger. If you're on steroids, you may notice a change in your weight. For example, with a course of prednisone, you likely feel compelled to eat, then eat some more. Perhaps you're taking anti-depressants to help you manage your mood. In which case, weight gain is a possibility.
Weight gain is hard on already stressed joints. By being forewarned, you can put a plan in place to help manage your weight. Plan out your meals in advance and have plenty of healthy snack alternatives available for those times when you must eat something.
Poor sleep can impact your weight. When you're tired, you may indulge in a sugar hit to help you with a burst of energy. Unfortunately, it's short-lived as your blood sugars spike, then drop off drastically, leaving you feeling tired all over again. The cycle repeats itself as you reach for another hit of sugar/energy.
Instead, learn to tune in to your body. People with RA generally need more sleep and rest than the general population. What do you really need? In my case, I've finally learned that more often than not, it's sleep or at least rest.
Socializing is good for the soul. It's also good for the appetite. Food often tastes better when you share a meal with a friend.
If you live alone, organize a weekly or bi-monthly pot-luck with your friends or neighbors. Take a cooking class, where you'll get to sit down to enjoy that week's lesson. Have you ever noticed that a sandwich often tastes better when someone else makes it for you? Take turns meal-sharing/cooking. If you like to cook, offer to teach someone how.
If your plan is to lose weight, your social circles matter. The Berkeley Wellness article “Weight-Control: Two Traps to Avoid” states: “As shown in a study in the New England Journal of Medicine in 2007, people are more likely to become obese if they have family and friends in their social network who have become obese.”
The attitudes of your family shape who you are, even when it comes to your relationship with food. My parents and grandparents grew up during times when food was scarce — during wartime and WWI, the Great Depression. I recall my grandmother often saying: “Eat! Eat! Are you sick?” It was an early lesson that I took to heart and “weight.”
Fresh air and exercise
Spend time moving, preferably outdoors. The benefits to your health and well-being are immense. Not only does exercise improve your appetite, but it also reinforces the commitment you make to yourself to live better. Small changes in one area can lead to improvements in other areas. For example, you may be inspired to add a variety of fruits and vegetables to your grocery list. I'm fortunate to live in an area with a lot of ethnic markets, so I like to search out unusual produce, like Buddha's Hand, and learn to prepare them. It keeps meals interesting.
Then there's stress eating!
I could have been the poster child for stress eating. My runaway train of emotions led to an equally uncontrollable amount of stress eating. If I was upset, angry, frustrated, or tired I stuffed myself. This was a vicious cycle that seemed unstoppable. When I hurt, not just physically, but emotionally, and mentally, as well, I would eat.
A stress-transformation practice helped me to recognize my patterns. Stress and inflammation are two peas in a pod. The uncertainty of living with a chronic illness can be stressful. It's to your advantage to be diligent about transforming your stress. Start simply, by paying attention to how you're breathing. You're doing it anyway, so make it count. Even as you read this, your awareness will change and you'll breathe a little deeper. From there, add in other techniques that enable you to put the brakes on stress.
When it hurts to chew or swallow
RA can affect your temporomandibular joint (TMJ), or jaw. Chewing may be painful and difficult. Prior to eating, it may be helpful to use ice or heat packs (whichever helps more), on your jaw. Also avoid gum chewing as this can exacerbate TMJ problems. Stress and night grinding increase TMJ pressure. Regularly practice stress techniques. Your dentist can fit you with a night guard, which can provide some relief.
Some RA patients develop a swallowing disorder (dysphagia), due to changes in the larnyx. Symptoms include difficulty swallowing, coughing or gagging while eating, heartburn, and regurgitation. Talk to your doctorif you have these symptoms. In the meantime, slow down when you eat, and chew your food well before swallowing. Consider using a blender to soften your food.
Talk to your doctor if you suspect that your medications are impacting your appetite. You might also consider seeing a naturopath, nutritionist, or dietician. Support can also come from within your community, your family, or your friends.
RA is unpredictable. Food is one area in which you can exercise control. Make healthy food choices to nourish your body, as well as your relationships. You'll feel that much better when you do.