Help Doctor I’m Gaining Weight: Psychiatric Medication Induced Weight Gain

One of the biggest challenges we face in the field of psychiatry is medication adherence. A large portion of the people fail to get better either because they do not start the medication, or do not take it as prescribed. One of the most common reason cited by patients for stopping medication is weight gain. In this article I will detail the approach I take to weight management for patients on psychiatric medications.
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[@rebecca414]

Telling someone to stop eating junk food when the medication you are taking makes you crave junk food doesn’t help! 😔😔

[@ShrinksInSneakers]

It's a fair point, however I think healthy lifestyle is the foundation for the treatment of all health conditions. Starting the habit of eating healthy most of the time, and beginning an exercise routine is only going to help improve overall health and wellbeing. I agree we should not put the all the responsibility on the patient but I do believe we should attempt to control those aspects of our health we have some control over, diet and exercise being primary examples. I also think it's unfair to say all weight gain is the result of medication side effects. Like all things in life it's a gray. I stand by my points regarding diet and exercise being the appropriate place to start. I appreciate the comment

[@sofalvarez]

My psychiatrist prescribed diet pills and honestly is the best thing that he could do to help me. I’m in antipsychotics and mirtazapine, it is IMPOSSIBLE to mantain a healthy weight when on those meds! I feel u sister

[@sofalvarez]

@@ShrinksInSneakers lol have u had depression and or bipolar disorder? It is not a matter of will power... seriously 🤦‍♀️ it is amazing how far shrinks and doctors in general can sometimes be from their patients real feelings.

[@rebecca414]

@@ShrinksInSneakers I went from a super healthy weight, i exercised and ate really healthy to gaining 40kg (88 pounds) after I started on anti anxiety medication. Trust me, I’m not exaggerating. I became a different person who was constantly eating 24/7. It’s quite literally ruined my life. Drs and Specialists shrug their shoulders and say ‘oh well’ those are the side effects!

[@rebecca414]

@@sofalvarez thank you Sofia 🙏🏻

[@Balbroa]

My nurse and psychiatrist will deny it every time I bring up weight gain

[@ShrinksInSneakers]

It's well documented for medications like Zyprexa, not sure why they would deny it.

[@Balbroa]

@@ShrinksInSneakers sorry what I really meant was they don’t listen to me whenever I explain. They just don’t care is how they come off lol

[@sinan.alhawat]

Thank you for this. Is there a recommended way to deal with the “appetite attack” when it hits? I take mizatopine and close to the time of the dose I feel like out of control, starting to look for anything to eat. Also can a body get used to mizatopine so it does not cause the level of increased appetite?

[@justinebourke9449]

@@sinan.alhawat this is true. It seems like the brain, after getting accustomed to it's sugar fix after a dose of medication, actually begins to anticipate it close to the time of taking it, so the intense craving can beginning before the drug is even ingested! These drugs have so many extremely unpleasant, unhealthy and even dangerous effects on the system and the psyche. By the vast majority of reports from patients that I have heard and also in my own experience, the prescribers just do not explain These side-effects adequately if at all, before starting to prescribe. Also the tendency is to increased dosage over time and continue to prescribe same or similar for years. Even being on meds like this for months can cause horrific withdrawal symptoms when the patient decides to quit them. That is never discusse at the beginning of treatment. I have heard so many accounts of people having terrible withdrawals even when tapering down .

[@BarkorBite]

Its drives me nuts I've gained forty pounds in 2 years and the doctor says I can't go back to square one and it's healthy weight but I don't feel healthy at all.

[@BeingBetter]

I've gained 40 pounds in the last few years since taking lithium orotate (not prescription lithium) and my other supplements. I don't know if they're related, but it's possible. I think part of why I gain weight is because I'm not manic and I'm not running around all over the place and never sleeping.

[@riology2234]

I've been prescribed a 5 mg Olanzapine as an adjunct with 20 mg Vortioxtine for MDD, not sure how much would it affect my weight, given l'm in a calorie deficit for months prior to the start of Olanzapine, would like to know your thoughts on that plus how good/ bad is the idea of getting an antipsychotic for depression (unipolar depression)?

[@stephaniestoll1960]

I know this is about medication but something that has little sde effects including no weight gain is TMS therapy. Not everyone is right for this treatment but it might work for some. It also has had great feedback with improving ptsd and depression.

[@ifrankensteinsmonster]

I've noticed around 7 kg weight gain since I've started Mirtazapine... I've learnt that the weight gain could be due to strong H1 blockade and strong 5-HT2C blockade... H1 blockade causes your appetite to increase, and 5-HT2C causes impaired thermogenesis... But I've not noticed any appetite increase yet... I don't know whether H1 blockade sedation can increase weight gain, if it is then the sedation has significantly decreased now when I'm at 60 mg... Does increasing Mirtazapine dose also decrease 5-HT2C blockade alongwith H1?... I want to know the exact reasons for my weight gain, as now I'm having a little osteoarthritis on my right leg knee joint due to heavy weight to handle( My height is 176 cm, and weight before being admitted as an in-patient was around 81, now it's 88 😓 )

[@billiardbob618]

Terrified of this bc I’ve heard of some people gaining a LOT of weight extremely quickly on antipsychotics - like an unusually high amount of weight.

[@ShrinksInSneakers]

metabolic issues are a common problem. Talking with your doctor about medications that have the lowest risk for metabolic side effects is a good idea. In many cases I will start with a medication like ziprasidone or latuda due to the lower risk. The worst offenders of weight gain are medications like olanzapine, so I try to avoid it early in treatment.

[@arielleanderson4976]

Do you know if Zoloft is difficult to lose on? I think part of my struggle may be mental, thinking I have no chance of weight loss and self sabotage in turn of this thought process. However, I can adhere to caloric control. Is that all that is needed for loss? Or is it possible that no matter what I do, it won't come off without stopping the Rx. I dont think that is an option for me right now or maybe ever. What can i do to combat the 50lbs I have gained? I eat healthy, oats, whole grain, only water, never soda, or juice, rarely eat red meat, eat fish and chicken, eggs veggies etc. Is it the amount I am eating? Any advice? I have terrible health insurance right now, with almost no access to competent medical providers, I brought this up to my Dr. he says to eat healthier. salads not cookies. I'm like ok check. what next? Im not very active, im tired a lot. could this also be the cause? I have never had issues losing weight before. I have had 3 children and lost 50 lbs after each simply walking and watching my calories. I have a huge appetite on zoloft but I CAN control myself, if I have incentive, like knowing it will work and I'm not fighting a losing battle. Weight loss is very mental, and I need to know if I have a chance to lose and maintain a lifetime healthy weight on this medication or if I should just accept the weight because it will never move while on it..what do you think?

[@DogMommy.]

I feel like I'm gaining weight on this medicine

[@neetusharma198]

Is taking 2.5 mg Aripiprazole daily causes weight gain and diabetes .Plz reply.

[@rubywolf1239]

omg can you read minds. this is the topic I am battling with

[@rubywolf1239]

I find it frustrating because it's Thales first time a Antidepressant is working (mirtazapin + venlafaxin) I hoped to get a hold of it but it's just getting worse and worse. I am getting in touch with my psychiatrists but he's on vacation. it's really tempting to just stop talking it but I know I would risk falling into a hole again.

[@richmrstonestone]

I'm about to stop Latuda... From a general wellness perspective, how is out of control binge eating a mental health positive????

[@justinebourke9449]

Exactly!! I really hope you have tapered down slowly from this before stopping completely so as to minimise withdrawal symptoms.

[@AngelinaParker1]

I'm tapering off Latuda. Gained a lot of weight from it and anxiety attacks use to happen all the time. I'm not an advocate of Latuda.

[@dianamonicamanta9289]

Hello, could you please tell me if 30 mg of Mirtazapine taken at bed time can cause hipoglicemia during sleep and in the following day? What about in combination with 120mg Duloxetine + 150 mg Wellbutrin taken in the morning? Is this combo good? OCD personality, anxiety, depression, weight gain phobia and ocd mechanism coping actions due to this, plus compulsive eating. Thanks. You

[@ShrinksInSneakers]

I have not had an issue with glycemic control on the medication. I have patients with diabetes who are on mirtazapine and their glucose has been stable. Cymbalta 120 mg is a high dose, the combination makes some sense from a neurotransmitter perspective. What is the primary issue being treated with this combination? Is this obsessive compulsive disorder proper or obsessive compulsive personality disorder? My answer would change based on this information.

[@dianamonicamanta9289]

@@ShrinksInSneakers Thank you very much for answering, it really helps to receive a second specialized opinion. The primary reason is a depression and anxiety(phobia) due to a compulsive eating episode which started lots of years before and brought me 10kg in a short time - 3 months. Managed to counteract somehow the overeating and the weight, through healthy food choices and sports(gym), aerobics, walking etc. The depression was socially masked and the anxiety always relapsed when I couldn't keep the above mentioned routines, eg: when doing a 9-5pm office job involving too much sitting. I have been on escitalopram as well as on citalopram and the compulsive and overeating stopped but It didn't help me on the cognitive side at the office, and I switched to venlafaxine 75mg. With this I felt like never in my life, was able through go through as for me stressful situations withouth overeating, and I was amazed that I was able to concentrate and retain the information at work. It also gave me energy and lots of motivation to do let's say OCD personality routines, cleaning, working, working out. I felt very good from the personality perspective like I was living the life I wanted if I wouldn't have had the eating disorder and the phobia of gaining weight. There is a body dismorphia as well, which developed since body change then with the weight gain. Now I manage to relieve the tension somehow through power walking every day, but I am still gaining weight and have huge appetite. I askedif mirtazapine lowers blood glucose because when I did not take wellbutrin for couple of days, my energy increased -my anxiety that I have to move, my motivation in doing things in a proper order, and I felt unstable faster as with wellbutrin included, unstable in the sense that I had to eat every 1-2 hours.

[@dianamonicamanta9289]

with wellbutrion I can still manage to do other things than eating. To shortly answer to your question there is an OCD personality but also OCD regarding eating, weight and movement. Obsessed by food, to be healthy and if it is not, to be just a bit of unhealthy, same kind of menus, obssesed about the body to have it and feel it as is not changing, high sensory feeling, attention goes on the body a lot, and movement to control the weight and contaract the eating. I am facing a lack of concentration since many years and the only mechanism I addopted was to chew something, food or chewing gum. I appologiaze for the long speech, and I would remain grateful if you could give your oppinion on this. I am thinking to change the treatment scheme because it is a nightmare, although I eat enough for my body type and activity, I always overeat at night after mirtazapine.

[@dianamonicamanta9289]

Just that I don't know how to do it to tapper them. 2 Years ago I was taking just 60mg duloxetine but yes I had huge anxiety and energy, couldn't stay still, walking 2 times per day, almost 25000 steps/day. But never felt sick or having low blood glucose. If I do not take mirtazapine I cannot sleep, and If I do not take wellbutin I eat too often. Maybe to take of Wellbutrin and then also Mirtazapine and stay with just 120mg Duloxetine and then decrease to 90-60mg as before, and then switch to another treatment scheme which could help me with focus, concentration and motivation? Thanks

[@ShrinksInSneakers]

@@dianamonicamanta9289 sounds like a good plan. The Wellbutrin seems like an unnecessary add on at this point. Before making any changes talk with your doctor let them set you up with a schedule to taper off safely and avoid withdrawal. I'm also a big believer in lowest effective dose and reassessing the need for high doses after symptoms are controlled and there has been a significant period without episodes usually 6-12 months. Besides vortioxetine which does have readable evidence for cognitive enhancement, cymbalta is the second best option for improving cognition. For the eating component I would do CBT. It sounds like the thoughts you have surrounding health and eating may predispose you to an eating disorder and changing the way you think about food, and the relationship with food and body image would be a good idea. Hope this helps and please talk with your doctor about the situation this information is for educational purposes only

[@linhchitrinh8405]

I'm on Queatipine 200mg for bipolar disorder and I'm about 50kg with height of about 158cm. It's hard to lose weight. Are there any mechanism that's behind difficulties when using meds for bipolar disorder? Please make a video about that or answer my question please!!! I just need solution for my weight loss asap 😭😭😭

[@kaths_rockxbye5601]

I feel you. From 47 to 57 at the same height as you all because I take meds for migraines (that help me survive). Looking for solutions too

[@tamesmorful]

Its terrible. From 65 to 73kg!! I am not eat too much and execercise daily!! I am desesperate!!

[@zz-ic6vy]

Did you find out anything? I struggle too.:

[@zz-ic6vy]

@@tamesmorfulYou are not alone. I was 63-65kg, and now i am 80kgz I worked out, got slimmer but my weight didn't change.

[@iKam1Kaz1]

I guess Ive gotten lucky as some of the medications im prescribed which should cause weight increase or increase in appetite. Ive found if any thing ive had no weight gain and even have lost some weight. Is this common to happen to me?

[@gothsurfshorts]

on what medication?

[@justinebourke9449]

That isn't common, it's almost a given that people put on weight quickly and find it very hard to lose but everybody is different and some people are lucky in that regard. Which medication are you taking?

[@edwardmaier2705]

I’m at 326 lbs and I’m on clozapine

[@ShrinksInSneakers]

That is a difficult place to be, Clozapine is by far the best medication for schizophrenia but it does come with a worse side effect profile including weight gain. There are ways of mitigating some of that weight gain like starting and titrating metformin. If you haven't subscribed to the channel please do, and spread the word about what we are doing here. I also have daily instagram content @Shrinks_In_Sneakers

[@Nmethyltransferase]

Explain the risks and benefits, and offer Mounjaro to everybody.

[@tejimoljoseph8139]

Does keto works?

[@justinebourke9449]

It certainly helps a lot to reduce weight and further gaining of weight but the problem is that you have to fight extreme craving for carbohydrate. I was put on several psychiatric drugs some yrs back for severe anxiety and depression .. the highest dose was seroquel and the cravings were immediate.. Ihad started keto diet as my boyfriend was on it and staying with him it was practical for us both to eat the same anyway.. let me tell you the incessant craving for carbs( both sweet and savory) was absolutely torturous Even when I did occasionally cave and have some, the craving could not be satisfied... I did gain weight even on this diet but it was minimal. However the craving drove me so insane and the meds also gave so many other horrific side-effects ( aswell as only increasing my anxiety) that I stopped taking them altogether after a couple of weeks. Keto does work but you have to stick to it strictly as guided. Best of luck with it, I hope things are better for you now if you were having issues?

[@AbianahAlmeida]

So un helpful antipsychotics slow your metabolism and fat burning so “eating less” won’t help

[@justinebourke9449]

Exactly!! I really hope you have tapered down from this slowly as it's not a good idea to stop abruptly..

[@justinebourke9449]

Sorry..the above reply was meant for a different comment! But I see your point and sadly it is the case for a vast number of people. In my case, I found antipsychotics prescribed for anxiety/depression/insomnia unhelpful and also they exasperated the problems by adding such unpleasant side-effects and unhealthy weight gain and elevated cholesterol levels.