Colleen de Bellefonds

Sure, not every vegan is like that. But for vegan influencers like Yovana Mendoza, formerly known as Rawvana on YouTube (because she followed a raw vegan diet), that outspoken, often ride-or-die dedication to her vegan diet was not just her personal ethosit was her brand.

"The vegan community tends to be very passionate," says Yovana, who at one point boasted as many as half a million subscribes on YouTube (2 million on her Spanish language channel) and 1.3 million Instagram followers.

But that fervor can quickly turn against yousomething Yovana learned after she was seen eating fish in a now-viral video posted by a fellow vlogger, resulting in a huge outcry from her followers. "I was in shock and felt confused and ashamed at the response," she says.

It's not unusual for vegans to struggle to stick to their strict diets, says Lisa Moskovitz, RD, the CEO of <a href="http://www.nynutritiongroup.com/" id="59b572ce-663a-3f26-aa70-fdbdfd5640f0"> NY Nutrition Group </a> . While it can be a healthy choice for some, restrictions can also lead to nutrient deficiencies over time, which can sap energy and weaken the immune system. A deterioration in health and well-being is often what leads people to ditch veganism, she explains.

But for the influencers who are making a living by preaching the benefits of their diet via YouTube videos, #sponsored Instagram posts, and books, the decision to quit veganism is tied up in so much more than their health.

Here, the stories of how three women decided to quit veganism, coped with the backlash, and found peace with their diets once and for all.

Yovana Mendoza, formerly <a href="https://www.youtube.com/channel/UCZMX5mnCXg8xfULwZBGedjA" id="3769ea6e-9e0c-31b3-a731-d473d9178523"> Rawvana </a> on YouTube, promoted a strict raw, fruit-and-vegetable-based diet she labeled the Rawvana lifestyle for years until she was busted in a 2019 viral YouTube video for eating fish.

When I was 23, I started thinking about my purpose in life. I knew something was off. I was drinking a lot of alcohol and smoking half a pack of cigarettes every day. I was addicted to caffeine, smoking weed, and taking anti-anxiety pills. I never really felt good.

I decided to go raw vegan in 2013 after trying a two-week raw food detox eating plan. I loved it and decided to continue eating that way for good. I started posting recipes on my blog that April and sharing YouTube videos in July and slowly started to build a following of people interested in the raw vegan lifestyle.

Going vegan changed my life in so many ways. I became conscious of how the foods I put into my body affected me, where my food was coming from, and how our food choices impact the planet. It became a big part of my identity. I took things to the extreme right from the beginning; I wanted to live up to the vegan label and be part of a community.

I was raw vegan until 2016, when I began to crave some cooked foods, and decided to listen to my body. I was very open with my followers and filmed my first cooked vegan meal for my YouTube channel. I received a bit of backlash, but most of the feedback was supportive. People know sustaining a 100 percent raw vegan diet is difficult.

I felt really good for the first five years I was a vegan. But around September 2018, I began experiencing symptoms of what turned out to be <a href="https://www.mayoclinic.org/diseases-conditions/small-intestinal-bacterial-overgrowth/diagnosis-treatment/drc-20370172" id="9c146a77-a2d4-332b-addc-6c34f9633ebe"> small intestinal bacterial overgrowth (SIBO) </a> , where an overgrowth of bacteria in the small intestine causes malabsorption of nutrients and digestive issues. I was officially diagnosed in January 2019.

Anything I ate made me super bloated. I had constipation or diarrhea for days on end. I had no energy and slight anemia due to low iron levels.

My doctor told me I had a 30 percent chance of recovery if I stayed vegan and took antibiotics. Or I could adopt a SIBO diet, which is lower in fiber and includes some animal proteins. I went with the latter.

It was hard for me to admit veganism was no longer working for me. I'd put veganism on a pedestal, because I thought it was the diet that would save my life and the planet. But my health was not living up to what I was preaching.

I started with eggs in January 2019 and introduced fish a couple of weeks later, then chicken and meat a few months later.

In March 2019, I was on vacation in Bali with a couple of other YouTubers, and one of them posted a 10-minute video of us touring the country. Near the end of the video, the camera panned toward my plate at a restaurant. I tried to cover my food with my hands, but people quickly identified the fact that I was eating fish.

The backlash definitely hurt me. People called me a fake, a liar, and much worse, and filled the comments sections of my posts with fish emojis.

I think a lot of people felt betrayed and that I should have told them before I started eating meat again. But I wanted that space for myself without others commenting on my decision. I wanted to go through that process on my own to see if it actually improved my health firstwhich it did.

The vegan community tends to be very passionate, so they were loud. I get it. Its their belief system. I was in shock and felt confused and ashamed at the response. But I decided to learn from this situation and grow, evolve, and reinvent myself.

I laid low for a month on Instagram and came back to YouTube four months later, after I changed my public name from Rawvana to Yovana. I've lost more than 120,000 Instagram followers since the video came out, but my YouTube channels are almost back to their original numbers posting videos about my favorite healthy smoothies and even non-vegan recipes. I believe I can help people even more now, after all I've been through. Im so grateful for the amazing social media family thats stuck with me this whole time.

Its taken time to heal from SIBO. I still have a slight buildup of methane in my digestive system, and some foods are still off-limits. But my diet these days is pretty balanced.

People ask if Im vegetarian or pescatarian, but I've decided I don't want to put label on my diet anymore. Id say that 80 percent or more of what I eat is plant-based. Im a very intuitive eater. No foods are off-limits anymore, even grass-fed beef.

I believe in the healing powers of a plant-based diet, but I think every body is different. Our bodies are changing constantly, and its really important to adapt. Eating eggs, meat, and fish helps me to feel more balanced. I might consider going vegan again in the future, but not any time soon. I feel really good.

Alyse Parker rose to fame as a vegan Instagram and YouTube influencer. She shook up fans in March 2019 when she <a href="https://www.youtube.com/watch?v=gpQSOL-4jyY" id="03fd0ef3-0faa-3634-a515-75e9ea81dfec"> announced </a> that she was eating animal products again.

I decided to go vegan about five years ago. I was 19 and in college, drinking and eating a lot of processed foods. I was in a dark place physically and mentally. I saw videos online about people embracing a raw vegan lifestyle and was inspired by how healthy and happy they looked.

Overnight, I went raw vegan and started doing meditation and yoga. I felt better within days. Over four and a half years, I ended up trying every possible form of veganismhigh-fat, low-carb; high-carb, low-fat, you name itto keep it exciting.

When I first became vegan, I looked to YouTubers for guidance and inspiration, so eventually I decided to start my own channel. Within three years, I had more than half a million subscribers and more than 200,000 Instagram followers. People turned to my channels for my "What I Eat In A Day" videos and my honest takes on all sorts of other lifestyle choices from smoking marijuana to growing out my armpit hair.

But over that time, I also developed some gut and digestive issues, like gas and bloating.

The last year that I was vegan I had fatigue, brain fog, and loss of appetite. I couldnt focus or communicate. I was taking 15 supplements a day, but I was definitely under-eating for about six months because I didnt have an appetite.

Blood work showed I was deficient in a lot of vitamins, like B and D, and I had low testosterone levels. I also had high candida levels, or fungal overgrowth, in my blood ( <a href="https://www.thoracic.org/patients/patient-resources/resources/candidemia.pdf" id="c052a108-841d-36b9-a30b-5e48269508a0"> a condition </a> thats more common in people who are hospitalized or have weakened immune systems).

I was finally inspired to reintroduce animal products after friends told me they'd experienced more mental clarity, and better healing from injuries after doing the same. I started with just eggs. I felt stronger and more clear-headed right away.

alyse my mental state for the next six months after i told my followers i was quitting veganism was the worst it had been since i was a teenager

But when I officially announced to my followers that I was eating animal products again in March 2019, most of my fans were really upset. It was really hard. I lost 50,000 subscribers. People felt betrayed and that I was lying to them, and they uploaded at least 100 videos hating on me.

I chose not to read comments for the first week to protect my mental health, but I still felt nauseous and fatigued from the stress and anxiety. My mental state for the next six months was the worst it had been since I was a teenager. Changing yourself is hard enough. Getting bashed by hundreds of people on a regular basis during this personal transition added a whole new level of challenge.

The key to navigating the intensity of social media is having effective practices for emotional wellbeing. I started talking with a therapist and sought support from multiple mentors who I still consult with regularly today.

I didnt post a response video standing up for myself for three months; when I did, I learned that a lot of people wanted to hear my side of the story.

I'm still really honest on my YouTube and Instagram channels (although I've lost about 30,000 subscribes on Instagram; my YouTube audience is still growing), but now I know that if my followers react negatively to something, I need to respond quickly. If I'm honest, and tell people how I'm trying to fix the things I'm struggling with, they respond well. They understand I'm just trying to optimize my diet and get healthier.

These days, I try to abstain from gluten and processed sugar, but I otherwise eat intuitively with a balanced omnivorous diet. I feel the best I ever have. On a typical day, I might eat a smoked salmon bagel with cream cheese for breakfast, a small salad for lunch, and sushi for dinner.

It feels really freeing, empowering, and healthy after years of extreme and restrictive diets to not constantly worry if food is hurting me. Ill never rule out going vegan, but I have no desire to in the future. Were all on our own journeys. We should be compassionate with each other.

Alexandra Jamieson is a chef, author, and former YouTuber who co-created the documentary Super-Size Me. She was vegan for nearly a decade, and authored three books about veganism before announcing her decision to quit the diet.

I decided to go vegan in 1999, when I was 25. Id been getting very sick in my mid-twenties and was having migraines almost every day. My regular doctor just prescribed painkillers and Prozac, but I worried this was just masking my symptoms instead of addressing the cause of my issues.

I went to an integrated doctor who told me to cut carbs, sugar, caffeine, and fast food. I then began researching healthy eating and came across the book <a href="https://www.amazon.com/Diet-New-America-Choices-Happiness/dp/193207354X" id="f36a7038-d27f-3b30-ae25-2087163291d5"> Diet for a New America </a> . It was the first time Id ever heard of veganism. I thought it sounded so healthy and good for the planet and animals, so I decided to try it.

Within two weeks my headaches were gone. The brain fog lifted and I had energy again. It really changed my life. I even signed up for a professional chef training program that was focused on 90 percent vegan foods. About a year later, I met my now-ex-husband Morgan Spurlock, whos a filmmaker. Our conversations led to the 2004 movie <a href="https://www.amazon.com/Super-Size-Me-Morgan-Spurlock/dp/B017JLWPYG" id="b402f2a2-46c1-3798-adae-30a8ca238c4f"> Super-Size Me </a> .

Nine years later, as Morgan and I were separating, I was stressed, and my health had deteriorated. I was exhausted and getting my period every 16 days. I craved meat. I remember going to dinner and salivating over a friends hamburger. I worked with a doctor and did all the things youre supposed to do, like IV treatments and supplements. But my body was falling apart.

I went back and forth for over a year, eating meat secretly, then going vegan, then feeling exhausted and then eating meat again. I was torn. Physically, I felt so much better eating meat, but emotionally I was a wreck.

alex a lot of vegans secretly reached out saying they had health problems but felt like they couldnt tell their loved ones who were vegan i joke that i became a vegan confessional booth

It was terrifying because my entire personal brand and career was built on being vegan. I'd written three books, Living Vegan For Dummies, Cooking Vegan For Dummies, and The Great American Detox Diet and had worked as a vegan chef and holistic health coach for nearly a decade. I felt like a fraud. I worried that I had endangered people by recommending veganism. But I finally decided to quit veganism altogether and announced my decision <a href="https://alexandrajamieson.com/im-not-vegan-anymore/" id="deaf56f0-75e2-3981-afb9-5b90a1d505bf"> publicly on my blog </a> 2010.

There was a lot of backlash. My email inbox was filled with mostly very angry emails from vegans. It was terrifying. It felt like I was targeted by cult because I stepped out of line. I lost a lot of friends, but not everyone.

A lot of vegans secretly reached out saying they had health problems but felt like they couldnt tell their loved ones who were vegan. I joke that I became a vegan confessional booth. One woman told me she was having a hard time eating meat again because people have hurt her but animals never have.

Around that time, I learned through genetic testing that I had <a href="https://rarediseases.info.nih.gov/diseases/10953/mthfr-gene-mutation" id="5a588c97-21cb-33ba-a3da-c5406889f1d1"> the MTHFR gene variant </a> , which <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5247374/" id="aa77118c-428e-3d38-a48c-f37c1b0f4e14"> has been linked to </a> difficulty absorbing iron, and I was chronically dangerously anemic. To this day I have to take iron supplement, but my iron levels are still really low. My doctor told me there was no way I could go fully vegan again.

Today, Im an omnivore. I eat based on how Im feeling. Sometimes that means eating steak or chicken liver pate. Sometimes I go vegan for a week or two.

Now, <a href="https://alexandrajamieson.com/" id="abdcedc5-27d8-3272-ab78-ee45e5888ab9"> as a life coach </a> , I help my clients find clarity about what they need to be happy and healthy. My viral blog post about quitting veganism eventually became the fodder for my fourth book: <a href="https://www.amazon.com/gp/product/B00IWTWHJ8/ref=dbs_a_def_rwt_bibl_vppi_i0" id="494503df-e0a8-370e-a417-2f2587f348ce"> Women, Food, and Desire </a> and my Her Rules podcast on iTunes, which is all about self-care and overcoming obstacles.

Food is a deeply personal and intimate thing. Its a cultural identity and one of the main ways we connect with our family tribe.

When we change our food behavior, other people take it very personally. It helps to be very clear that your needs are important and your wellbeing is valuable.

vegan week this article is part of women's health's 2020 vegan week click here for more

There's a joke vegans love to roll their eyes at: How do you know someone's vegan? Don't worry, they'll tell you.

The Vegans Who Quit

Although you may have seen people boast about their results on blogs or social media, plant-based chef and dietitian <a href="https://www.delishknowledge.com/about/" id="0de51d1e-a311-3ce6-a986-113edbc131ce"> Alexandra Caspero, R.D. </a> , says its not a good idea.

Theres something euphoric about fasting, she tells Mens Health. A certain population is drawn to it. I dont recommend it, but I understand it, she says.

Heres what you need to know about juicing for weight loss and whether its actually a good way to shed a few extra pounds.

Juicing involves squeezing veggies and fruits to <a href="https://www.menshealth.com/nutrition/g20088471/foods-high-in-fiber/" id="f7cef6d3-aadb-33a4-a382-b671654710ec"> remove the fiber </a> , which is the pulpy stuff thats left behind in your juice machine, explains Caspeero. (Smoothies, on the other hand, blend up the entire fruit, which retains the fiber). Some people add a shot of apple cider vinegar, <a href="https://www.menshealth.com/weight-loss/a19540836/apple-cider-vinegar-weight-loss/" id="fbf9951e-2516-3a49-aa0e-ae6c161a2582"> which has been touted </a> to boost weight loss. Most juicing diets last around one to three days, says Caspero, although rarely people juice for up to 14 days.

<h1> Is juicing good for weight loss? </h1>

Since weight loss comes down to <a href="https://www.menshealth.com/nutrition/a28493677/what-is-cico-diet/" id="95d0e0d4-96bc-3891-acb3-cad7749683e9"> eating fewer calories </a> than you expend, and juicing severely restricts calories, it can help you to lose weight at least in the short run, says Caspereo. Whether juicing is a good idea for weight loss is another story.

A small <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438379/" id="90593e73-cb53-30c9-ab2e-6c189b8ec0d3"> 2017 study </a> of 20 people who juiced for three days found that they shed about two pounds, on average, and saw an increase in gut bacteria associated with weight loss. But weight loss isnt necessarily fat loss, explains Caspero: Its usually water loss. When you severely cut calories, you burn through your glycogen (i.e. carbohydrate) stores, which carry water with them. I would never consider juicing a fat-loss diet, she explains.

Juicing fans also often claim that it helps you to detox. Yes, fruits and veggies are full of antioxidants, which help clear out cell-damaging free radicals in your body. But you can get those same benefits from eating whole plants, Caspero explains. Otherwise, there arent toxins that you need to flush out by eating certain foods.

We have livers and kidneys in our bodies that help us cleanse without requiring a restrictive, nutritionally inadequate diet, says Bonnie Taub-Dix, R.D., creator of <a href="http://betterthandieting.com/" id="84a29c1e-84c2-38e0-a688-f15907e1c662"> BetterThanDieting.com </a> and author of <a href="https://www.amazon.com/Read-Before-You-Eat-Taking/dp/1979739722/ref=sr_1_1?s=books&amp;ie=UTF8&amp;qid=1513656967&amp;sr=1-1&amp;keywords=read+it+before+you+eat+it" id="aab2ae7b-a922-3d8f-a0fd-5a0e4ff47131"> Read It Before You Eat It - Taking You from Label to Table </a> .

In the short-term, juicing may indeed give you a confidence boost for making a positive change. But if you deprive yourself for too long, youll likely gain the weight back as soon as you go back to your normal eating pattern, says Isabel Maples, R.D., a spokesperson for the <a href="https://www.eatright.org/" id="469d471a-743c-3036-a208-ca1bbc34d768"> Academy of Nutrition and Dietetics </a> .

Nutritionists say that bottom line, juicing for weight loss isnt realistic or sustainable. Youd be better off getting on a treadmill than getting a juicer, says Taub-Dix.

Although this diet can help you consume more produce it can also leave you hungry. Compared to a full sit-down meal, juice lacks protein, fiber, and fat. Chewing and digesting these nutrients takes time and increases satiety hormones, so you feel fuller for longer.

Its physically not as satisfying. You may want a bigger portion, so you end up getting more calories than youre expecting, says Maples.

While a couple of days of juicing is harmless for most people, say experts, longer juice fasts pose a number of risks and downsides:

<h1> You may be deprived of important nutrients </h1>

A well-rounded diet ensures you get all of the macronutrients and micronutrients your body needs. Restricting yourself to juice means youre missing out on essential nutrients like vitamin B-12 and protein; over time that can lead to nutrient deficiencies. In the long term, youre not providing your body with the fuel it needs, says Caspero.

Glasses of orange juice, grapefruit juice and multivitamine juice, juice squeezer and fruits on wood

<h1> Juicing may trigger you to overeat </h1>

Feeling deprived could lead to you to eat less nutrient-dense food, like brownies, when you complete the cleanseor you may go back to your normal diet.

Any time you make a drastic diet change, you may overcompensate later. And you definitely can gain the weight back, says Maples. Instead of learning to better manage your eating choices, juicing is just a quick and temporary fix.

When you lose weight, you inevitably lose a bit of muscle mass. You can reduce muscle loss by eating more protein and working out. But juice doesnt contain protein, and its so low in calories that you likely wont have the energy to work out. If all you do is drink juice for a week, you can lose muscle, says Maples.

Youll burn more calories throughout the day if you have more muscle mass. So if you lose lean muscle from juicing, youll need fewer calories even at rest. Whats more, severely reducing calories for long periods of time puts your body into metabolism-slowing starvation mode.

The body tries to conserve energy, so we dont starve to death, as a survival technique, says Maples. Most men, she adds, need at least 1,500 calories per day and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5438379/" id="d6c2b779-bd32-3147-aa11-63543fe3f507"> many juice diets are </a> well under that.

<h1> Your gut microbiome could suffer </h1>

Since juicing eliminates fibera prebiotic that supports gut healtha longer-term juice fast could negatively alter your gut microbiome. Youre not giving your gut what it needs to populate the good bacteria, says Caspero.

Two glasses of wild herb smoothie with apple, banana and lime juice

For some people, juicing for two to three days max may help encourage them to eat more fruits and vegetables overall.

Sometimes fasting feels good if youve been eating heavy or feel blah and want a jump start, says Caspero.

Use mostly veggies and up to two fruits per glass max, suggests Maples. Whether you add spices or vinegar is up to youalthough dont count on these ingredients to burn extra fat. The only way to truly burn fat is through exertion, Caspero says.

Beyond that, its a better idea to think of juice as an add-on to your diet instead of a meal replacement. Juicing can be a good way to eat more plants and stock up on vitamins and phytonutrients, says Maples.

Sip on green juice with your cereal instead of OJ, or have it for a midday snack instead of cookies or crackers.

A better long-term meal replacement? Smoothies, which contain fiber but are similarly easy to digest because its broken down, notes Caspero. Be sure to add ingredients like avocado, nut butter, flax seeds, tofu, or chickpeas for the fat and protein you need to stay full and satisfied.

<h1> The wrong way to juice for weight loss </h1>

A pure juice diet for any longer than two to three daysor frequent juicinggets dicey, according to our experts.

I worry about a disordered eating, says Maples. You may need to change the way youre thinking about food.

Also keep in mind that drinking orange or apple juice all day long isnt a juice cleanse: Fruit juices tend to be loaded with sugar and empty calories that will leave you hunting for your next meal far too soon.

Be sure to talk to your doctor if you have a chronic medical condition like diabetes or hypoglycemia before juicing for any amount of time. The sugar in fruit could cause your blood sugar to soar, says Taub-Dix.

Its also better to avoid juicing if you have a history of restrictive eating or eating disorders, Caspero adds, as it may encourage disordered eating patterns.

Surviving on takeout and hitting up too <a href="https://www.menshealth.com/nutrition/a27491762/healthiest-ways-to-drink-alcohol/" id="62fd1617-652d-3d1f-a972-2864af026d7e"> many happy hours </a> has suddenly caught up with you. Now, youre ready to make change after realizing you dont feel great. Is a quick juice fast the best way to get back on track <a href="https://www.menshealth.com/weight-loss/a27554447/13-simple-weight-loss-strategies-that-work/" id="e7bdfcb0-98d7-3d9b-a599-c8a0c27b565...

What You Should Know Before Trying Juicing for Weight Loss

Well, that's basically how it feels trying (and trying, and trying) to lose weight when you have hypothyroidism. The good news: It's not just you. Because (the bad news), it really is harder for those with the condition to drop pounds.

<h1> Hold on, give me a refresher on hypothyroidism. </h1>

ICYMI, hypothyroidism affects about 5 percent of Americans and happens when your thyroid (the small, butterfly-shaped gland in your neck) doesn't produce enough thyroid hormones.

When it's functioning normally, those hormones produced by the thyroid regulate how your body uses energy, keeping the brain, muscles, and organs working; in fact, most people don't even know that their thyroid is there until there's a problem with it, <a href="https://profiles.stanford.edu/marilyn-tan" id="733efd3b-91fa-3d44-aa2d-3b2ad777478d"> says Marilyn Tan, MD, </a> an endocrinologist at <a href="https://stanfordhealthcare.org/medical-clinics/endocrinology-clinic.html" id="cde84c43-ac1f-3545-aabc-3a32320d202c"> Stanford Health Care's Endocrinology Clinic </a> . But when there's a problem, you'll know it-that little gland can cause <a href="https://www.womenshealthmag.com/health/g19992515/9-thyroid-symptoms-to-look-out-for/" id="8a15763c-baf4-3dbc-a1ce-d91897bb89b4"> a whole slew of issues </a> , like changes in body temperature, skin texture, and, yes, weight fluctuations.

Signs your thyroid is out of whack:

For women with hypothyroidism, it often feels like their hormones are working against them when it comes to weight loss, and, well, that's because they kind of are. In addition to everything else they do, thyroid hormones also regulate your metabolism; and low levels of thyroid hormones make for a slower metabolism, says <a href="https://www.bmc.org/about-us/directory/doctor/elizabeth-n-pearce-md" id="26097d11-f9e2-3990-af9a-414a32b10a7a"> Elizabeth Pearce, MD </a> , an endocrinologist specializing in thyroid disorders at Boston Medical Center.

Women with hypothyroidism tell me theyre on 1,200 calorie diet and they cant lose weight. In the end, its much more difficult to lose weight and keep it off," says <a href="https://profiles.bu.edu/Caroline.Apovian" id="59a19710-7ee4-33f9-a9c9-91abe448bb73"> Caroline Apovian, MD </a> , an endocrinologist, weight-loss researcher, and director of the <a href="https://www.bmc.org/nutrition-and-weight-management" id="5c1430a2-dad1-3e99-a7ce-f9498e7f6665"> Center for Nutrition and Weight Management at Boston Medical Center </a> .

But that doesnt mean weight loss is impossible. Here, a few tips that will make losing weight when you have hypothyroidism a little easier.

<h1> First things first: You've gotta get it diagnosed. </h1>

If youre experiencing <a href="https://www.womenshealthmag.com/health/g19683170/thyroid-symptoms-in-women/" id="70ab4b7f-0577-3a6d-a003-81f22fa9f509"> symptoms of hypothyroidism </a> -fatigue, unexplained weight gain, increased sensitivity to cold, constipation, and dry skin-it's time to see your doctor, who will do a blood test to determine your TSH (thyroid-stimulating hormones) levels.

After a diagnosis, you'll likely start treatment for hypothyroidism-and it's a pretty straightforward approach: Youll be prescribed a cheap, safe, and effective synthetic hormone that replaces the one your body should be making on its own. The medication will restore normal levels of TSH.

Something to be wary of, though: at-home thyroid testing. (Particularly when youre trying to uncover the source of unexplained weight gain.) Even if the results are reliable, it will likely be difficult for you to understand how to interpret the lab, or what action (if any) should be taken if you see an abnormal result, Dr. Isaacs adds.

<h1> After medication, adjust your expectations </h1>

In a perfect world, any weight gained by hypothyroidism would magically fall off after you start taking the meds, right? Unfortunately, it doesn't work that way: Normalizing the thyroid with thyroid hormone will not cause the weight gain to be reversed, says Dr. Tan. To lose that weight, you actually need to work at it, which I know seems very unfair because you just gained it easily.

Scott D. Isaacs, MD, medical director of <a href="https://www.atlantaendocrine.com/" id="dc8095a6-0264-30d1-a4c7-c41fe956c170"> Atlanta Endocrine Associates </a> , agrees. If blood tests are normal and youre no longer technically hypothyroid, the weight-loss playing field is essentially "even" in that case, he says-meaning you still have to work at dropping pounds.

Also important: Some info circulating the web suggests that certain medications or combinations of medications can lead to weight loss quicker than others, but none of that has been proven true, says Dr. Isaacs-it's all totally dependent on your body and your weight-loss efforts.

<h1> Rev up your strength-training routine. </h1>

Researchers aren't sure why, but your thyroid hormone affects how your muscles function; in women with hypothyroidism, that equates to abnormal muscle function, which means they'll have a harder time building and maintaining muscle, even after they start meds, according to Dr. Apovian. Women with hypothyroidism have to work harder at every level despite treatment, she adds.

But, working harder to have more muscle will be worth it. That's because muscle burns more calories than fat, so even when youre not working out, having less of it puts you at greater risk of weight gain.

For the best results, Dr. Apovian suggests two to three strength-training workouts a week. Each session should last about an hour and work all of your major muscle groups-upper body, lower body, and core. Aim for three sets of each exercise you do, using a weight thats heavy enough to have you maxing out at eight to 12 reps per set.

<h1> Pick up the pace on cardio, while you're at it. </h1>

Cardio is essential for maintenance of weight loss, says Dr. Pearce-especially if you have a thyroid condition, which again affects the function of your muscles. Dr. Apovian agrees: "[People with hypothyroidism] can lose weight, but they have to do more resistance and cardio than the average person."

Shoot for about 30 minutes to an hour of activity five days a week, suggests Dr. Pearce. That can include any sort of activity where youre sweating and getting your heart rate up, whether its jogging, walking (you get the picture)-whatever keeps you motivated and having fun is the right thing to do.

<h1> Add more protein into your diet. </h1>

Along with proper exercise, Dr. Apovian says protein is the other key to building muscle. Her suggestion is backed by the <a href="https://www.bmc.org/nutrition-and-weight-management/weight-management" id="96d9b216-eaf7-3c7c-ae50-90e3b661000b"> Center for Nutrition and Weight Management </a> , which recommends a higher-protein diet of 1.2 to 1.5 grams of protein per kilogram of ideal body weight for women with hypothyroidism. That means, if your ideal weight is 130 pounds (about 60 kilograms), you should have 70 to 90 grams of protein daily.

A good rule is to build your meals around protein, but also include lots of veggies, healthy carbs like fresh fruit and whole grains, and healthy fats like avocados and olive oil.

Even with these guidelines, it's worth working with an R.D. to come up with a personal diet plan for hypothyroidism, as certain foods or dietary restrictions (think: being lactose intolerant or eating a lot of soy) can screw with your hormone levels even more.

<h1> Don't forget to re-check your weight with your doctor. </h1>

If youre taking thyroid medication, its important to follow-up closely with your doctor-rather than simply refilling your Rx month after month. The dose of thyroid medication is related to body weight. If you lose or gain weight, your dose may need to be adjusted, says Isaacsthis can also affect future weight gain or loss, if your medications aren't tailored to your body.

How To Lose Weight When You Have Hypothyroidism

You know that quote about insanity-the one claiming that its definition is doing the same thing over and over and expecting different results? (It's often attributed to Einstein, but there's no solid evidence of that TBH).

The Best Way To Lose Weight When You Have Hypothyroidism

The heated debate around whether or not circumcision is necessary hinges on two arguments. Theres the case for health, which says that circumcision <a href="https://medlineplus.gov/circumcision.html" id="75ddbe6b-255c-3f81-a60f-ef1f0456eb52"> appears to slightly reduce </a> the very low risk of penile cancer, as well as HIV and sexually transmitted infections. (Ultimately, the American Academy of Pediatrics <a href="https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Newborn-Male-Circumcision.aspx" id="8e921936-36fe-3d9d-a966-7511030387a0"> says </a> these health benefits outweigh the risks, but theyre not great enough to recommend circumcision for all baby boys.)

Then theres the case for sexual pleasure, which says that removing the foreskin might compromise penile function and sensation. Pro-circumcision groups also <a href="http://intactamerica.org/resources/decision" id="c7c7428c-ac26-3982-afd8-2fa99a74d68d"> argue </a> that the surgery is painful and risky, and boys should be able to make their own choice later in life.

But how does circumcision really affect your sex life?

<h1> Circumcision and Sexual Sensation </h1>

The foreskin has the most nerve endings of any part of the penis, says Amin Herati, M.D., a urologist at Johns Hopkins Medicine who specializes in adult circumcision. And the skin on the head of the penis does become thicker after circumcision due to increased friction. Thats made some men concerned that the procedure might decrease sensitivity and pleasure in their penis.

Extensive <a href="https://www.acog.org/Patients/FAQs/Newborn-Male-Circumcision?IsMobileSet=false" id="46ede1ca-476e-3a35-ae2c-ea5bff082fce"> studies, however, have found </a> that circumcision has no effect on the sensation or function of the penis, says Herati. He notes that <a href="https://www.ncbi.nlm.nih.gov/pubmed/28653427" id="56537630-269e-343a-ab2b-830a3f3a5394"> research has shown </a> circumcision cant fix premature ejaculation by making mens hypersensitive penises less sensitive. "The larger nerve fibers responsible for sexual function are at a deeper level" than the skin thats cut during circumcision, he says.

To date, Herati says no patient has ever told him that circumcision affected his sex life. Men whove had the procedure later in life agree.

James* chose to get circumcised last fall at the age of 28 because his frenulum(the skin connecting the foreskin to the penis) was sometimes sore after sex. He was awake during the procedure, which he had at <a href="https://www.theurologyplace.com/adult-circumcision" id="04b1a167-8565-3973-a3dc-9dc2b8565d08"> The Urology Place </a> .

I have had migraines that hurt worse, says James, who took over-the-counter meds to relieve the pain. Within two weeks, he was healed and ready for sex. Neither James nor his wife noticed any differences in their sex life after the procedure. He says his circumcised penis feels more sensitive. Now theres more feeling of the vagina during intercourse, instead of the foreskin sliding back and forth over the head, says James.

For some men, circumcision actually reduces pain and increases pleasure during sex. Sam*, a patient of Heratis, had a condition known as phimosis, where tight foreskin cant retract over the penis. In the two years before the surgery, sex was increasingly painful.

"The breaking point was when I felt deterred from having sex," says Sam. Last summer, in his late 30s, Sam was circumcised; like James, he was awake during the procedure. Post-surgery swelling lasted about eight weeks, and there was discomfort as he got used to the head of his penis being exposed to clothes. It was surreal, to some degree, because I was an adult male getting used to having a 'new' penis," he says.

After circumcision, Sam says sex was pleasurable again. I was surprised and heartened by the genuine support I received from women who knew I had the procedure," he says. "I had the feeling they couldn't wait to be the first to try it. Sex has been wonderful, both in terms of sensation and not worrying in the back of my mind that I could experience pain or discomfort."

I do miss having an uncircumcised penis, because it was more unusual and unique in a way," he adds. "But I'd give up novelty for function.

<h1> How Adult circumcision is done </h1>

If youre among the <a href="https://www.cdc.gov/nchs/data/hestat/circumcision_2013/Circumcision_2013.htm#x2013;2010%3C/a%3E%20" id="52388ee0-d77f-3a8a-a250-6e1ae5d3e9a2"> roughly 40 percent </a> of American men who arent circumcised at birth, you might have considered making the cut. According to Herati, most men who are over 50 get circumcised mostly to fix a condition called balanitis, or inflammation of the head of the penis that scars foreskin so it cant retract. Younger men most often come because theyre self-conscious about having a foreskin. They think looking more normal with a circumcised penis would give them more self-confidence, says Herati.

As an adult, you can choose to either be awake with local anesthesia in the clinic, which takes about 45 minutes to an hour, or you can go under with general anesthesia, which takes 30 to 45 minutes. A doctor makes two incisions, one above and one below the foreskin. Once the skin is removed, the two sides are sewn back together. The foreskin does have the most nerve sensation of all the penis, but when we block that with lidocaine men are very comfortable, says Herati. Youll likely be sore for four to five days and shouldnt have sex for about a month. Then its business back to usual, says Herati.

<h1> Complications of adult circumcision </h1>

Complications (usually pain, minor bleeding, or infection) happen in just 1 to 2 percent of all circumcisions, says Herati, although risk is slightly higher in adults than newborns, according to the American Congress of Obstetricians and Gynecologists. Very rarely, too much or too little foreskin is removed, or the remaining foreskin attaches to the tip of the penis. Surgery can address these problems.

*Names have been changed to allow subjects to speak freely on private matters.

Ever wondered if sex feels better for men who have their foreskin than those who dont? If you were circumcised at birth, it's impossible to tell how the procedure shaped your sex life-you don't know your penis any other way. But the sexual experiences of men who were circumcised as adults could shed light on the ongoing debate around circumcision.

How Getting Circumcised as an Adult Affects Your Sex Life

Cystis fibrosis (CF) is a life-threatening, inherited disease that causes progressive damage to organs including the lungs, pancreas, liver, intestines, sinuses, and sex organs. Affecting about 30,000 people in the United States and 70,000 people worldwide, cystic fibrosis is the most common lethal genetic disorder, says Mark Wylam, M.D., a pulmonologist and the director of <a href="https://www.mayoclinic.org/diseases-conditions/cystic-fibrosis/care-at-mayo-clinic/mac-20353710" id="ccec25ab-ca5f-33ae-a32a-3a5208f095ac"> the Mayo Clinics cystic fibrosis center </a> . Its main manifestation is chronic lung infection, which leads to lung destruction, he says.

Fluid lines the lungs to help cilia (hair-like protrusions) sweep germs out of the airways to be swallowed or coughed up, explains Wylam. In people with cystic fibrosis, that layer is significantly reduced due to a gene mutation that causes a defect in a protein (cystic fibrosis transmembrane regulator, or CFTR) that moves salt in and out of cells. This causes the fluids in the lungs and other organs to be thick and sticky, so instead of moving things along, it plugs up tubes, ducts, and passageways. This traps germs, causing frequent, persistent infections. You end up with essentially flypaper, says Wylam.

People with cystic fibrosis may not have any symptoms for a long time, even as their lung function gradually decreases. Eventually, theyll begin to cough and notice more mucus in their lungs-symptoms that are at first eased by treatments including chest physiotherapy and antibiotics. These symptoms increase in frequency while the germs in the lungs become increasingly virulent and resistant to antibiotics. That can lead to frequent hospitalizations, weight loss, functional decline, and eventually respiratory failure, says Wylam.

Men with cystic fibrosis are also born without a vas deferens, the tube that delivers sperm from the testicles to the penis. And at least two thirds of CF patients also have problems with their digestive system, says Wylam. Ducts in the pancreas can become blocked, reducing absorption of vitamins and nutrients and potentially leading to diabetes. And bile ducts in the liver can also become clogged, causing scarring of the liver and cirrhosis. Enzymes and supplements are very effective at treating digestive problems, and the vast majority of patients are able to overcome these issues, Wylam says.

<h1> Is cystic fibrosis contagious through kissing? </h1>

No. Cystic fibrosis is not contagious, even via kissing, because its a genetic disease. It requires a mutation on the gene, one copy from the mother and one copy from the father, says Wylam. (Having just one copy from one parent makes you a carrier without having the disease.) The mutation causing cystic fibrosis is most common in white people of Northern European ancestry.

<h1> How and when is cystic fibrosis diagnosed? </h1>

In the US, all newborns are screened for cystic fibrosis within first few days of life, since early detection and treatment improves outcomes, says Wylam. Blood is drawn with a heel prick and screened for higher levels of a chemical known as immunoreactive trypsinogen, or IRT, created by the pancreas. If results come back positive, theyre followed up with genetic test to look for a few of the most common of the more than 1700 gene mutations that cause cystic fibrosis. Infants sweat may also be tested to check if its saltier than normal.

Newborn screening identifies the vast majority of cystic fibrosis, says Wylam, with over 75 percent of people with CF diagnosed by age 2. However many less common mutations are milder and therefore more likely to be picked up later in life, he says.

<h1> What are the symptoms of cystic fibrosis? </h1>

Symptoms of cystic fibrosis include:

<ul><li> saltier sweat (and salty-tasting skin) </li><li> wheezing </li><li> shortness of breath </li><li> persistent cough, sometimes with phlegm </li><li> recurrent chest colds </li><li> frequent sinus infections </li><li> year-round allergies </li><li> frequent lung infections (pneumonia or bronchitis) </li><li> trouble gaining weight or growing </li><li> greasy, foul-smelling stools </li><li> severe constipation </li></ul>

In addition to chronic lung infections, complications of cystic fibrosis can include polyps (abnormal growths) in the nose, nutritional deficiencies, diabetes (which affects about 30 percent of people with cystic fibrosis), liver problems including gallstones, intestinal obstruction, osteoporosis, and dehydration caused by electrolyte imbalance.

<h1> Why can't cystic fibrosis patients be around each other? </h1>

In 2013, the Cystic Fibrosis Foundation (CFF) came out with the six-foot rule to minimize cystic fibrosis patients exposure to bad bacteria. It states that starting at birth, people with cystic fibrosis should maintain a distance of at least six feet from other cystic fibrosis patients and people who are sick to reduce their risk of exposure to germs-the most dangerous of which can preclude a lung transplant. (The rule excludes people living in the same household, since they probably already share the same bacteria anyway.)

When you cough or sneeze, 90 percent of bacteria is spread in about a four-foot bubble around you. If you increase that distance, youre less likely to spread or share the germs with people who tend to collect that bacteria, says Wylam. When patients are congregated, germs spread. There used to be CF camps, but theyve been disbanded those because kids would acquire germs they werent previously carriers of.

The rule, however, doesnt concern healthy people without cystic fibrosis, since healthy lungs can effectively clean out the most dangerous germs. The bacteria were talking about are really only pathogenic for people with cystic fibrosis. Our natural defense and cleaning systems dont allow us to have many germs. Were exposed but not colonized, says Wylam.

<h1> Can cystic fibrosis patients be in relationships? </h1>

Despite the six-foot rule, it isnt necessarily unsafe for two people with cystic fibrosis to be romantically involved, says Wylam. Cystic fibrosis patients are tested at least every three months to identify the germs theyre carrying. If two people already share the same unfriendly germs, it wouldnt be risky for them to be together. But if the lungs of just one person in the couple contain virulent germs, a romantic relationship could be risky for the other person. You could always accept that risk, Wylam says.

People with cystic fibrosis can and do have physical relationships like anyone else, says Michael Boyle, M.D., the senior vice president of therapeutics development at the <a href="https://www.cff.org/" id="4de6f215-68ba-3f8e-aaea-04d791f69d1b"> Cystic Fibrosis Foundation </a> . But, because infections are so potentially dangerous for people with CF, they need to be more careful about avoiding germs and shouldnt kiss a person who is sick. That is particularly true when it comes to two people with CF, where a physical relationship could pose a real threat to their health.

<h1> How is cystic fibrosis treated? </h1>

Treatment for cystic fibrosis includes medications and therapies to treat infections and improve lung function (antibiotics, anti-inflammatory medications, mucus-thinning drugs, bronchodilators, chest physical therapy, pulmonary rehabilitation). Enzyme medications can help the body better absorb nutrients, while vitamin and sodium supplements make up for nutritional deficiencies. Many people eventually have surgery to help with breathing problems and blocked bowels.

The most promising current treatment options involve new medicines which restore function of the cystic fibrosis protein, which results in the mucus in the lungs being more normal and improves some of the lung problems seen in CF, says Boyle.

There is no cure for cystic fibrosis. Since thousands of gene mutations are involved, its difficult to find a single treatment that will work for every person with the disease, Boyle explains.

Treatment, however, can ease symptoms and reduce complications. We are making incredible progress. In the 1950s, children with CF rarely lived long enough to attend elementary school. Today, thanks to advances in research and care, most people with CF live into adulthood and are reaching milestones that we never thought were possible, says Boyle. On average, people with cystic fibrosis live into their mid- to late-30s, although many people today are living into their 40s and 50s. Respiratory failure is most common cause of death.

In the future it may be possible to cure CF by either adding normal cystic fibrosis genes to lung cells using gene therapy, or by repairing the defective cystic fibrosis gene using gene editing, says Boyle. The CF Foundation is providing millions of dollars in funding to dozens of groundbreaking research projects to tailor the latest scientific discoveries to cystic fibrosis, with the goal of one day curing the disease.

Everything You Need to Know About Cystic Fibrosis

Given the new movie Five Feet Apart-which is about two cystic fibrosis patients who meet in a hospital and fall in love (played by actors Cole Sprouse and Haley Lu Richardson)-you might suddenly be curious what the condition actually is. You might also wonder whether it really is risky for a couple with cystic fibrosis to be around each other. The answer is yes, but not necessarily for the reason you might think. Here's a basic overview of the disease in the movie and how it compares to real ...

Five Feet Apart Shows Why Relationships Are Risky for Two People With Cystic Fibrosis

Cheating, of course, has consequences. Infidelity is one of the leading causes of divorce, says Lawrence Josephs, Ph.D., a professor of psychology at <a href="https://www.adelphi.edu/" id="4b8457e6-d4b0-3beb-afd8-b86706b29d34"> Adelphi University </a> and author of Psychology Todays <a href="https://www.psychologytoday.com/us/blog/between-the-sheets" id="86b85bca-001f-30e5-a76e-17fc7de09e9f"> Between the Sheets </a> blog. Partners frequently find out, and when they do they often suffer PTSD-like symptoms like recurrent, intrusive nightmares of their partners cheating. They become emotionally deregulated, enraged, depressed, and paranoid, putting their partner under surveillance because of a betrayal of trust, Josephs says. About 25 percent of children are aware of their parental infidelity, too, he adds.

With all the risks, why stray? Here are the most common reasons men cheat, along with tips to avoid the temptation.

Your emotional needs arent being met

The main reason men have long-term girlfriends on the side is their partners arent fulfilling their emotional needs and they need an ego-boost, say Josephs and Ava Cadell, Ph.D., sexologist, relationship coach, and founder of <a href="https://www.loveuniv.com/" id="4ddd8a98-55a4-3772-a4ee-08b98ffcf58a"> Loveology University </a> . Cheating becomes an escapist solution for men who, though they love their wives, dont want to confront issues in their marriages.

Instead of seeking validation elsewhere, try to fix whats broken in your relationship with communication. Start out by spending 30 minutes to an hour daily talking about your day with your partner to act as each others sounding boards, suggests Cadell. And remember that cheating wont fix your problems. If its a long-term relationship, its a serious attachment. Its like having a second wife, says Josephs. Long-term affairs eventually deteriorate, and you end up having all same frustrations as marriages.

Maybe youve gained a few pounds and lost your hair, or maybe your career isnt panning out how you planned. If youre insecure in one area of your life, youll likely feel insecure in other areas too, including your relationships, says Cadell-and you might cheat simply to check youve still got it. Its to pump up virility and self-esteem with validation, not because a man is bored or frustrated in his marriage, Josephs says.

If youre feeling insecure or down, visit a therapist, who can recommend healthier ways to cope like counseling or antidepressants, Josephs says. You can also drop hints by complimenting your partner on a regular basis. Women pick up on this well, and it should trigger her to do the same thing, Cadell says.

Escorts, one-night stands, office flings: Casual sex often happens because men arent getting enough sexual variety and novelty, says Josephs-and instead of talking about it with their partner, they seek out a stranger to meet their sexual needs. Some women have very low libidos and a guys sex drive is through the roof, Cadell says. Research shows that men also want to have more sexual partners throughout their lives compared to women, says Lehmiller. And fights about finances, children, and chores throw a metaphorical wet blanket on the marital bed, says Josephs.

While plenty of men are afraid to talk about their sexual fantasies, both Cadell and Josephs say its essential to negotiate your sex life with your partner before resentment sets in. So if you want sex daily while your partner is in the mood once a week, aim for three times a week. Or shake up a stale routine by starting a sexual bucket list of new things you want to do, both inside and outside the bedroom-from salsa classes and ice skating to tantric sex and bondage. Then take turns planning dates to hold yourselves accountable.

One of the highest predictors of cheating is being cheated on, says Josephs. A man might also revenge cheat as the quickest way to heal an ego after his partner lied to him or publicly humiliated him.

Of course, getting back at your partner is tempting. But remember that cheating just makes a bigger mess. You need to nip anger issues in the bud before it turns into deep resentment and contempt, says Cadell. Instead, try to be the bigger person and assert yourself by being open and honest about how you feel. Tell your partner her actions hurt your feelings and made you feel like she doesnt love or desire you, Cadell suggests. And if you still have trauma to work through, head to counseling.

More often than women, men sometimes cheat because they find themselves in an opportunistic situation-theyre at a work conference or on vacation without their partner, had a few drinks, and flirting leads to the bedroom, says Lehmiller.

To avoid the temptation to cheat, be proactive. Since alcohol is often involved in these situations, says Lehmiller, minimize your consumption at bars and clubs. And try to think ahead and prioritize your relationship. If you have empathy and understand the trauma that infidelity would inflict, you dont want to take that risk, says Josephs.

Plenty of people in high school and college treat dating like a game-and getting away with cheating feels exciting. People often get it out of their system and learn that game-playing doesnt work out in the end, says Josephs. Those who have a good ability to delay gratification and can see the long-term consequences of their actions tend to take a pass on cheating.

Some men, however, are aging playboys who never grow up. When theyre single theyre more likely to have promiscuous casual sex, and when theyre married theyre more likely to cheat, says Josephs. He explains that lifelong cheaters tend to share three characteristics known in psychology as the dark triad: narcissism (theyre arrogant); psychopathy (they dont consider other peoples emotions); and a Machiavellian intelligence (being manipulative to get their way in relationships). That means they tend to think they can break the rules and get away with it, and they feel guilt-free about cheating. Since theyre rarely open to changing, they often only reform when their marriages fall apart.

People abuse their power and cheat to make themselves feel superior, but it cant go on forever. At some point something happens to their health or finances, and they get a wakeup call and realize that the grass isnt greener. Its perfect where it is, says Cadell. So if youve found someone with all qualities you love but just cant keep from straying, its probably time to see a therapist.

Discussing sex and your relationship

A lot of men arent comfortable showing vulnerability and talking about their feelings, but authenticity is linked to relationship quality and satisfaction says Josephs. So communicate about what you want from your sex life and work through your issues with your partner. Also get on the same page with your partner about what constitutes cheating. People often have different ideas. Talk about whats acceptable so its unambiguous and one person doesnt engage in an act that hurts the other person, Lehmiller says. The best time to start these discussions is early in your relationship; the longer you go without bringing it up, the more awkward and difficult it can be later on, he adds.

Odds are, you know someone whos cheated or whos been cheated on-maybe that person was even you. If you define infidelity as sex outside of a relationship without your partners knowledge or consent, about 50 percent of couples cheat in high school and college, says <a href="https://www.lehmiller.com/about-sex" id="b77ce404-9f76-3fdd-a482-164f599636bc"> Justin Lehmiller, Ph.D. </a> , a sex educator and research fellow at The Kinsey Institute; the infidelity rate drops to about 20 to 25 percent...

Colleen de Bellefonds

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