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Judith J. Wurtman, PhD

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Pills and Weight Gain: Are Your Meds Making You Gain Weight?

Posted: 01/26/11 03:42 PM ET

When I go for my annual checkup, I am weighed with my clothes on so I try to make my appointment during the summer months. Even so, I always weigh more on his scale than on my own when wearing only a towel. But tell that to my doctor. He is too busy checking the computer and his notes for updates on tests, prescriptions and recent illnesses to listen to my protestations about the weight I just gained in his office.

As frustrating as this is, it doesn't compare to the annoyance and helplessness someone must feel when confronted with a 15 or even 50-pound weight gain after a year on antidepressants or mood stabilizers. And unfortunately, when the association between taking these meds and gaining weight is pointed out to the physician, the response is too often disbelief, disapproval or disinterest.

The following cruel and unacceptable remarks represent only a few repeated to me in emails from women after their primary care doctors challenged their claim of antidepressant-associated weight gain.

"Don't blame it on your Prozac, you are just eating too much."

"If you exercised more and stopped snacking, you wouldn't have gained the weight."

"You women are all alike, always blaming something on your overeating."

"Antidepressants will make you lose, not gain, weight. Your problem is not with the medication. Your problem is with you."

The primary care doctor's refusal to believe in the weight-gaining potential of antidepressants is not rare, even when a patient, whose weight has been normal and stable for decades, has suddenly gained 30 pounds in one year.

However, if a patient walked into the doctor's office with blue eyebrows or orange teeth after a year on antidepressants, one imagines that the physician would immediately investigate this side effect of the medication, if only to prevent frightening patients in the waiting room. But when a formerly fit and lean patient grows chubby with sagging muscles and claims that she can't stop eating ever since going on drug X for anxiety or mood swings, the doctor often ignores this change in physical status as a side effect of the drug.

Getting your doctor to recognize and respond to the fact that your antidepressants or mood stabilizer caused your weight gain can be done without jumping up and down on the scale. But it takes homework before going for your checkup and the ability to talk fast. After all most office visits these days are restricted to 11 1/2 minutes.

Before you go:

1. Read the package insert. You may need a magnifying glass, but somewhere in the list of adverse events (a quaint way of saying side effects) weight gain will be listed. You can make a copy of the insert using the magnification tab on the copy machine so your doctor can read it, too.

2. Look up the medication in the PDR (Physician's Desk Reference). Libraries may have this available. The adverse events will be listed there with the frequency with which the side effect is found. For example, dry mouth is often listed first as it is a very common side effect. Make a copy. The book is much too heavy to take to the doctor's office.

3. Google the medication or medications you are taking. Put in the name of your medication and weight gain. Print out reference, articles or even blogs that seem similar to your own experience.

4. Call the customer service representative of the pharmaceutical company that produces your medication and ask for information on weight gain from studies using the drug.

5. If you weigh yourself frequently and record your weight, bring in the record of your weight gain after taking the medication.

6. Some doctors will tell you that you should be losing weight on your SSRIs. That was believed to be true when Prozac was first introduced. Then a national study to test the weight-loss ability of Prozac was carried out. It failed. The volunteers gained back all the weight they had lost initially and then some.

7. Contact national organizations such as NAMI (National Association of Mental Illness) for resource material on weight gain and psychotropic drugs (this is the name given to antidepressants, mood stabilizers and related medications).

8. Put all your documents in a folder and gently present it to your physician.

Warning: Convinced or not, your physician will most likely recommend a lean protein, along with vegetables and fruit, diet with moderate to non-existent amounts of carbohydrates.

Don't go on such a diet. The absence of carbohydrate will leave you serotonin deficient and even less able to control the medication-induced cravings. Make sure you eat moderate amounts of carbohydrate with little or no protein and little or no fat an hour or so before meals. New serotonin will be made and will help squash the cravings caused by the medication.

And next year when you come back for your checkup, you won't have to worry about what to wear when you are weighed. You will be thin.

 

Follow Judith J. Wurtman, PhD on Twitter: www.twitter.com/stopmed_wt_gain

When I go for my annual checkup, I am weighed with my clothes on so I try to make my appointment during the summer months. Even so, I always weigh more on his scale than on my own when wearing only a...
When I go for my annual checkup, I am weighed with my clothes on so I try to make my appointment during the summer months. Even so, I always weigh more on his scale than on my own when wearing only a...
 
 
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02:31 PM on 01/30/2011
Effexor helped me gain at least 30lbs. I know because I've been on it twice, and both times I've been taken off them, I've lost all the weight. Anyone who thinks "You just eat too much" has never gone through anything like this.

Wellbutrin made me lose my appetite so that I had to force myself to eat. I lost 50lbs.

Antidepressants and Mood stabilizers work differently for everyone, obviously, or else, we'd all be taking the same. Read the insert or look it up on the internet, most if not all of these medications specify that you could gain or lose weight. Wellbutrin is prescribed for weight loss sometimes, there's an answer for all the skeptics.
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Andrea Pennington, M.D.
The singing integrative medicine doctor, acupunctu
10:56 AM on 01/29/2011
My heart goes out to those of you dealing with this issue. I dealt with it myself and found it frustrating when my doc didn't believe me either and I'm a doctor, too!

If your doctor patronizes you, doesn't hear you out or trivializes your reaction to medication - GET ANOTHER DOCTOR!

As a physician and weight loss specialist it has been my experience that many anti-depressants can and do increase weight gain due to a combination of increased appetite and decreased metabolism. It's a rough combo to fight and really requires a significant increase in physical activity while watching calories.

I do not recommend that my patients go off of their meds - if they are helping the depression - just because of weight gain. By joining a walking group, monitoring food intake, trying acupuncture and other tricks we get around the weight issue TOGETHER.
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Phoebe917
old hermit who lives in the woods
02:41 PM on 01/29/2011
i had lost a lot of weight due to depression. no appetite whatsoever. my physician placed me on cymbalta, and she stated it may help my appetite. didn't do a thing. i feel better, but my appetite is still not up to par. i literally am force-feeding myself. i think every body is different in how we react to chemicals.
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Dave Harrison
Fighting for the little guy!
12:08 AM on 01/31/2011
Hi Doctor, I have the opposite problem. I have lost 40#, no appetite. Now what do I do/take ? Smoke a joint?
09:01 AM on 01/29/2011
"You women are all alike, always blaming something on your overeating."
No one in history has ever said that, in those words, out loud to someone. It sounds like her inner voice yelling at her, or just a total fabrication. But the sentiment is true except for the ridiculous gender assignment. Men blame all kinds of erroneous things for their troubles, too, instead of looking in the mirror for the truth.

Gaining weight is increased caloric intake. Paxil doesn't put food in your mouth. Stop blaming your serotonin. Poor serotonin. It's the latest scapegoat for everything. People want everything. They want to boost their serotonin re-uptake with synthetic chemicals and then blame the serotonin re-uptake for their miseries, which is what led them to take synthetic chemicals in the first place. Obviously you're going to feel like increasing caloric intake when you feel less depressed. OMG. You want to scapegoat something? Figure out who you're angry at, besides me, who you've always been angry at, and throw the synthetic chemicals away safely.
http://www.psychnews.us/addicted.html
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main945
01:15 PM on 01/29/2011
You women are all alike, always blaming something on your overeating­."
No one in history has ever said that, in those words, out loud to someone.

Are you kidding, what alternative universe do you live in. I was having sever pain and could not lift my left arm, but my doctor couldn't see me so her assistant suggested I go to the emergency room. Thousand of dollors later and upteen heart test I was released with 'should change antidepressent medicine, all in her head' on my chart. I made an appointment with my doctor and waited the 3 days to see her. I had tennis elbow! Wrapped my arm and didn't use it until the pain went away.
So yes, doctors say stupid things to women, which is why I have a women doctor. Men think like you and should not treat women because they are bias against them.
12:49 AM on 01/30/2011
First of all, I'm a woman. Second, your dr., unless you left something out, said "it's all in her head". And if you'd been a man he would have said, "it's all his head". Just because you weren't treated effectively by umpteen doctors says more about mainstream medicine than it does about gender bias. "You women are all alike..." None of your umpteen doctors ever said anything like that to you. And I'm a psychologist working with doctors. Male or female doctor, if they're critical people to begin with, they say the same things about men and women both--he's whiny, hysterical, etc. And as a woman who used to go to doctors, I found women doctors more skeptical, stingy with valid medicine, and grandiose than almost every male doctor I've gone to.
01:49 PM on 02/03/2011
If the doctor told you you'd gain weight on your antidepressant, would you say, oh then never mind. I'll deal with my depression without medicine. ?
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Hallywood
08:16 AM on 01/29/2011
ZOLOFT MAKES U LOOSE WEIGHT CHECK THAT OUT
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Hallywood
08:15 AM on 01/29/2011
AWESOME ARTICLE, AND I ALWAYS READ THE LEAFLIT BEFORE TAKING ANY NEW MEDS!!!! AND ALSO CHECK ON-LINE
12:49 AM on 01/29/2011
There is more than anecdotal evidence about weight gain with antidepressants. Is this more prevalent in women? That might be why it is so difficult to convince doctors of it. The patient should not bear the burden of convincing the doctor of a side effect that is fairly common (at least in women).
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avg american
It's about jobs, jobs, jobs...
12:19 AM on 01/29/2011
Great Article. It has been my experience that doctors do not care about the side effects of prescription drugs. As long as it fixes the immediate issue.

Doctors do not tell you that anti-depressants interfere with sex drive and the ability to climax either.

OK folks, here it is, for the small population suffering from bipolar or manic-depression, this does not apply to you.

Life doesn't always feel good and it is ok to grieve, cry, get angry and …kill the coffee grinder.

Popping a pill that makes you fat and takes away your orgasms so that you can stuff your pain and plaster a grin on your face while working longer hours at work, isn't going to fix your suffering or help deal with the pain.
04:38 PM on 02/02/2011
If the doctor told you you'd gain weight on your antidepressant, would you say, oh then never mind. I'll deal with my depression without medicine. ?
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avg american
It's about jobs, jobs, jobs...
07:43 PM on 02/02/2011
Respectfully:
Health risks associated with weight gain and obesity.
1. “The risk of heart attack, congestive heart failure, sudden cardiac death, angina or chest pain is increased in persons who are overweight or obese.
2. A weight increase of 11-18 pounds raises a person's risk of developing type 2 diabetes to twice that of individuals who have not gained weight. Over 80 percent of people with diabetes are overweight or obese. This may account for the newly invented word, "diabesity"®, which signifies the close association between obesity and diabetes.
3. Obesity is associated with an increased risk for some types of cancer including endometrial (cancer of the lining of the uterus), colon, gall bladder, prostate, kidney, and post-menopausal breast cancer. Women gaining more than 20 pounds from age 18 to midlife double their risk of post-menopausal breast cancer, compared to women whose weight remains stable.
4. The risk of gallstones is approximately 3 times greater for obese patients than in non-obese people. Indeed, the risk of sympomatic gallstones appears to correlate with a rise in body mass index (BMI). “
http://www.annecollins.com/obesity/risks-of-obesity.htm for more reasons...
http://www.cdc.gov/obesity/causes/health.html

IMHO doctors that think that sexual dysfunction and a 20lb or 30lb weight gain are acceptable side effects, need to get their heads examined. When did that become ok?
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trying this again
09:10 PM on 01/28/2011
Wow, if my primary care manager had that attitude, I would see someone else. I am on two different antidepressants, Wellbutrin and Lexapro, and have not gained weight. I am losing weight. However, when I was on Prozac I gained 40 pounds despite exercise and diet. Plus my thyroid went bad for a little while.
01:35 PM on 01/28/2011
I have been on Lexapro for 8 years and birth control for 10. Maybe these drugs increase appetite or decrease metabolism, but no drug can MAKE you gain wait. It goes back to the golden rule of science - Matter can be neither created nor destroyed. For weight to go on your body it has to come in through your mouth an not get burned off or expelled. Don't be afraid of taking these drugs if they are going to help you. You can manage through whatever happens metabolically with more activity and less food. I admit that it isn't easy and I may have to work harder at maintaining my weight than the average woman, but I feel good and that is the most important thing.
12:18 AM on 01/28/2011
I was on medication last year and I gained about 25 pounds even though I didn't change my diet from the previous. Now that I'm finally off the medication I am trying to lose the weight and it is slow going.
06:38 PM on 01/27/2011
For years I was on every antidepressant known to man. I slept too much, they diagnosed depression every time. finally I was diagnosed after a sleep study. I have narcolepsy. I started on Xyrem (helps me sleep better at night), and I lost over 70 pounds in a year and a half while still eating donuts and goodies too. I went on cymbalta for fibromyalgia, the first year I was on 30 mg, and I stopped losing. I went to 60 mg and have gained back 30 pounds in the last two years. I'm going to see my GP and see if I can stop the Cymbalta and do wellbutrin or zoloft. I never gained weight on either of them. i really don't need an antidepressant, but sometimes I dwell on things a lot. Then I need it. So I want to stay on an antidepressant, just not one that makes me gain. I was only 30 pounds overweight, now I'm 60 pounds. and with fibro I can't do a lot of exercising. I can barely work, much less exercise.
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Leslie Robinson Goldberg
Writer
10:35 PM on 01/26/2011
Thank you for this article. I went on Celexa briefly and went off after my appetite went through the roof. I didn't want to end up fat and depressed. My mother was on Prozac and struggled mightily with her weight. No one told her that Prozac could cause weight gain. She was once in the hospital for a week on an IV and didn't lose an ounce. Finally after years and years a doctor told her the antidepressant could have that effect. Really unfair.
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katmeyster
Proud practical progressive atheist
09:36 PM on 01/26/2011
Doctors always seem to metaphorically pat my head and say "settle down little lady" for just about anything. You can tell them anything, and if it doesn't fit into their idea of what is wrong, they just do not listen. I'm sure there are some empathetic, well-researched physicians who listen -- I just have never had one myself. As for medication causing weight gain, I can see them try to hide their eyes rolling back in their head in judgment. I try to avoid these creatures as much as possible.
08:43 PM on 01/26/2011
birth control does, and so does my asthma medication.
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zambiedude
08:30 PM on 01/26/2011
Yes it does and if people actually read the side affects of drugs they may realize that sometimes the side affects out way the good, if i read anything that says increased suicidal thoughts, can result in self injurious behavior and so forth maybe its time to think of a different solution...