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Preventing and Reversing Weight Gain Associated with Psychiatric Medications

Many people who carry the bipolar diagnosis also carry something else – extra pounds – primarily due to the medications used to treat mania or depression. Atypical antipsychotics, including Zyprexa and Seroquel; anti-manics, including lithium and Depakote; and even some antidepressants have been known to pack on the pounds, despite a person’s best efforts to stay fit and trim.

105 Comments to
Preventing and Reversing Weight Gain Associated with Psychiatric Medications

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Comments: 1 2 3 4

    Hi- I gained 30 lbs in three months while taking Zyprexa and 9 mos later I can’t lose the weight – even though I am medication free and I diet and exercise. Before taking Zyprexa I easily lost weight.
    Also – most of the weight seems to be in my abdomen making me look pregnant.
    So – has my metabolism been permanently changed by this drug? (I’ve asked several doctors and all they will say is that it’s ‘possible’ that this change is permanent but they can’t say for certain.
    I am really angry with the psychiatrist who prescribed this drug and didn’t tell me about the weight gain.

    Thanks for any info on this.

  2. Hi, my name is Jen. I am 39 years old. I was diagnosed bipolar 1 with severe depression, anxiety disorder and panic attacks about 5 years ago. When I was 28, I was diagnosed with cancer. This was my first bout with weight gain due to medications. I weighed 127 lbs and stood at 5’3″ and went to an astounding 190lbs. After surgeries and meds I EASILY lost a lot, down to 135 at 30 years old. I could handle that. But once diagnosed all of these mental conditions, I was once again at the mercy of medication. I have tried all kinds of medications that I had bad reactions to, or they simply didn’t work. I was on abilify for two years. Great med, but i went back up in weight to 180. My cholesterol was not readable it was so high, over 400. I was tapered off the abilify. I joined a gym and started to diet. Lost 15lbs. But, got very sick and needed a mood stabilizer. I started taking seroquil, only 50mg..that is super low. I also take Zoloft 200mg, 75mg klonopin, and when needed Xanax. In a matter of four weeks I gained 15lbs right back. I have severe constantipation, belly distention. I purchased a glucose meter and will be testing that tomorrow. I take the Seroquil at night. It puts me to sleep very quickly, but I wake up starving and have been having major heart burn. Zantac 300mg. I can say the seroquil is amazing with my mood. I feel mentally perfect until I stand up and feel how fat I am. That makes me depressed. Going to see if we can try topamax or metformin. I will let ya know!!!! I think mental and physical health go hand in hand. This post has been up since 2008!!!!! And NOTHING has come about.

    • Does the Sereqeul really help you sleep? How many milligrams does it take? My doctor has me on 200 mg of Thorazine to sleep but it does
      work well. 300 does. But you are dealing with the weight gain 🙁

    • Hi Jen, I am responding to your comment because I can definitely tell you seroquel causes a lot of weight gain with people taking it because I researched it and also I was on it for a short time, maybe 6 months and I gained 50 lbs and I believe it made me hungry all the time but after I came off it I had trouble losing the weight until I did weight watchers and I’m on Geodon which is weight neutral so I know it was definitely the seroquel

  3. Went to phychiotrist today. She will not prescribe metformine, but wrote a letter to my primary requesting it be prescribed because I have metabolic syndrome. My primary called and said, well let’s get some blood work done and see the outcome. Good idea, although I was told they won’t prescribe it either!!!!! Their answer: DIET AND A NUTRITIONIST!!!! already been that route, for 5 years. This is crazy.

  4. I have been diagnosed with bipolar and have been on lots of meds. I have gained 30lbs on Seroquil but this is the only med that helps me sleep. I need to loose this weight in 6 months for my wedding. The dressed has already been purchased before I gained this weight.

    • Hi Christine, I don’t know if you got help yet with your sleep issues besides seroquel which I gained weight on also but I take hydroxizine for sleep 25 Mgs and melatonin but I also take hydroxizine for anxiety and it’s similar to Benadryl except prescription strength and it works very well for me and I have been on it for a long time and I only recently added melatonin because of how long I have been on it

  5. I thank God every day that we even have medications that can help us with our depression. Think back 100 years. People were just sent to institutions to rot and suffer incessantly. My life would be a living minute-by-minute hell if it weren’t for meds.

    That being said, we still need more options and I know that right now scientists are working on it (the anticipation is killing me :)). I’ve gained weight on these meds like everyone else here. I’m going to ask my doctor to switch me from Zyprexa to Geodon or Tegretol. Or something else. I’m hopeful– he’s a good doctor–but hurry up scientists! We need more options! 🙂

  6. I’ve gained 15 lbs on Olazapine but I’m on Topamax too. I work out constantly. My weight gain I thought was just from the holidays, but I’m always hungry since I’ve been on it. I was 120 now I weigh 135.

  7. I was diagnosed bipolar two years ago. Doc put me on depakote and lexlapro. Within weeks i had gained 15 pounds. I took myself of all of the meds and lost all of the weight was back down to 125 @ 5’5. Of course i started to spiral down hill, eventually landing myself back in the hospital where they put me on lexpro and lithium soon after ariving home i gained 25 pounds went off meds again and ended back in the hospital with a suicide attempt. This time they put me on geodon and pristiq and i lost all the weight again until dosages were increased to 80 mg geodon and 100 pristiq i then gained about 15 pounds and stayed steady at this weight for about six months. I started having manic episodes and started to see a new doctor. My new doc weaned me off of pristiq and geodon he said this was not a good combination for bipolar disorer so he put me on zoloft 50mg for ocd and seroqel 300mg and tegretol 2x a day for a total of 800mg. I have gained so much weight in the last 4 months i now weigh173 and i feel so deprssed from the weight gain. I am so tired i can barely get up during the day. Idk what to do?

    • Hi Crystal, I don’t know if you are still on the same meds as when you posted awhile ago but I can tell you your weight gain was definitely from seroquel because it made me gain almost 50 pounds in about 6 months or so because I was constantly hungry but I am also on Geodon and it is weight neutral so I don’t know why you where taken off of that and I am still on Geodon and have recently lost about 35 lbs on weight watchers but it took about a year to lose because of metabolic syndrome caused by Geodon which figures and if I eat any sweets I gain 1 or 2 lbs overnight and then I have to stop doing that to maintain my weight unfortunately but that’s how it goes on these meds and Geodon has also caused me to have an irregular heartbeat now so I am doing research on a replacement but we’ll see if I can find another one where I can lose weight and not have so many other side effects because I think all these type of meds do have the potential to cause something not so good for you but I have been on Geodon for probably at least 5 yrs now

      • Hi Crystal,
        I know your comment is from a while back but I have had similar issues with my medicines. I have been on geodon for about 5 years also and it has caused metabolic syndrome. No matter what I do I cannot lose weight. I work with dogs so I would say on average I walk and hike around 45 miles a week. I am an extremely active person. Geodon is now causing irregular heart beat for me also. I will have to find a replacement shortly. I was wondering if you came up with a new medication regiment after the geodon and can you let me know about it?

        Thanks you,

  8. After a suicide attempt almost 2 years ago they threw me in a mental hospital at the age of 16. They diagonised me with severe depression, and put me on lithium, cymbalta, and trazadone. Since then I’ve gained 40 pounds, and it’s not even like I’m inactive. I still have the same muscle I’ve always had, so I can usually hold my own on the gymnastics team. But I keep losing skills all because of the weight I’ve gained. My parents are trying to bribe me to lose weight – not even they understand that it’s not my fault. At least my psych gets it, and is in the process of switching me to lamictal. I just wish it could be faster, it’s my senior year, I should not have to deal with this, I already have enough on my plate.

  9. Thanks for this post and comments people. It makes me feel less alone in my struggle with weight. I am six feet tall and used to weigh 75kg until I was hospitalised with psychosis and given abilify and effexor. Following this I put on 45kg in 12 months. I was depressed and coped by binge-eating (say 1.5Litres of flavoured milk and 200g chocolate in one shift at work). It was almost like a kind of self-harm. Later I experienced mania and was diagnosed with bipolar. I have stabilised my weight at 120kg, but have not the motivation to lose the weight.

    Okay that’s not quite true, I really want to lose the weight so I can get back to my usual activities. I don’t mind being fat that much, although I don’t like the stretch marks.

    People always give the usual advice about motivation, but they don’t understand that having bipolar, my brain is filled with concrete.

    I will keep trying my best. Small changes.

    • Hi Sarah, I know you posted on here awhile ago so I don’t know if you are still on the same meds as then but I can definitely tell you Effexor causes a lot of weight gain and like you said it also kind of makes you not care as much about the weight gain unfortunately but Effexor when I was on it made me eat 2 McDonalds Big Macs at a time or a whole pumpkin pie at once and I don’t do that like I used to on Geodon and I’m on a fairly high amount which is 180 Mgs at night but Geodon has caused me to have an irregular heartbeat and metabolic syndrome so Geodon is more weight neutral and I’m not starving like on Effexor but I do have to watch what I eat and can easily gain weight if I eat the wrong things like too many sweets but at least I have been able to lose almost 35 lbs in about a year and I went from 175 from seroquel and got off that and now I’m down to about 142 and I still want to lose a bit more but unfortunately it’s taking a lot longer to lose anything compared to people not on meds that cause weight gain at weight watchers

  10. I’ve always been the skinny one. I wore size zeros and 2s well into my 50s. I just turned 57. Over the last few years on Cymbalta and more recently (dis)Abilify I’ve ballooned to size 10-12. It feels like I’ve been eaten by an alien. My cholesterol skyrocketed, now I’m on a statin. My psych doesn’t get it. She says I’m better off heavy than depressed. And, this isn’t old age, I’ve cut back to eating almost nothing. A hard boiled egg for breakfast and one fillet of fish or chicken breast for dinner. I have zero appetite and have to force myself to eat. Now my lower back is hurt and I can’t exercise. I’m positive that this extra weight is contributing to my back problems. I don’t have medical insurance so my options are severely limited. My psych (with a non-profit) has restrictions on what and how many medications she can prescribe. I’m also being treated for hypothyroidism. I’m positive that years of being on and off of a plethora of depression meds has totally screwed up my previously excellent metabolism. I don’t know what to do! This extra weight is going to kill me! What good are all of these bipolar meds doing me if they’re eventually going to kill me? I’m a hermit, I have next to nothing to wear and I’m embarrassed to be seen in public. I have tiny bones and a tiny frame I want my old body back!!!! Does anybody know if metformin will help? One Dr. at a free clinic speculated that I’m insulin resistant but he didn’t prescribe anything. My diet is all protein as it is, I can’t do this without the assistance of medication. I’m tempted to quit all of my meds but I know what will happen if I do and I don’t know if quitting will eliminate this metabolic nightmare. Sorry ’bout the rambling rant….

  11. i hear all of you! i’ve gone from size 1 or 2 to size 17/18; from 100 lbs to 185. i’ve been on Seroquel which began the gain and changed to Risperdal and Effexor which seem to keep pushing me up. is there no end? i HATE being this way! fat and ugly! my dr’s don’t seem to hear me. does anyone want to start a petition that we can send to all the guilty pharmaceutical companies demanding they do SOMETHING?

    • Absolutely.
      Trouble is, the Pharma companies probably own shares in the food companies we purchase from when the cravings kick in!

  12. I just wanted to know if once I stop taking quetiapine and citalopram, the weight I gained will go. I have always been fit, active and thin, gaining weight to he extent that I am nearly clinically obese is terrible. Is there anyone out there who can tell me that once you come off the meds you lose the weight as I am reducing mine?

  13. Like many contributors to this discussion, I thought I was very much alone in this weight gain.
    I gained about 15 to 20 kg over maybe 6 months of being on Olanzapine. Granted, I also drank a little too much beer, did not exercise and ate rubbish, but the problem I noticed like many here is that the cravings exist for food, I drive cabs and would eat a burger on the road then eat a meal at home later, etc.
    I am lucky that I have what seems to be a mild schitzophrenia, voices and some paranoid, so I can get away with not taking my meds for a while, exercising like crazy, then take my meds maybe twice per week to keep head balance.
    This works for me at the moment but of course the standard warning is not to stop taking, not to be ignored.
    Hopefully big pharma will do something about the side effects but I won’t hold my breath.

  14. I gained 60 lbs in a year on Depakote and Depo-Provera, the birth control shot when I had just gotten out of high school. I plateaued there for a long time, until I started Topamax… Miracle!! I went from 215lbs to less than 140 lbs in less than a year!

    Recently though I had a psychotic break and my doctor doubled my Risperdal (6mg) now I’ve gotten up to 150lbs in the last couple months or so.

    I am diagnosed schizoaffective bipolar type with psychotic features, also I have generalized anxiety disorder and PTSD. I am currently taking Risperdal, Topamax, Xanax, and Zoloft. I think I may ask my dr about Metformin… I don’t want to go back to the weight I was, I am finally starting to feel like my old self again… 🙁

  15. What’s up, just wanted to say, I enjoyed this article. It was
    inspiring. Keep on posting!

  16. my husband (59 yrs old) started getting injections of abilify in July300mg/once a month-has gained 40lbs-psychiatrist told him he’s not concerned-
    Husband has long history of noncompliance-this weight gain is going to result in noncompliance again-a vicious circle-no monitoring by the medical professionals

  17. I am 63 been on ability, cymbal ya and Adderrall for about 3 years. I have gained 50 lbs. I always was at 102-105, now I’m at 151. It’s all in my stomach. I look like I’m 7 mos pregnant; even had several people ask me if I was expecting – at 63! I go into deep depression when I go off. Eat healthy, small portions and exercise but weight keeps going up. I’m at my wit’s end. Embarrassed to go anywhere. I was always the skinny girl that everyone hated. No more ?

  18. This is a warning about antipsychotics: the article states that some (first or 2nd generation) antipsychotics are less likely to cause weight gain. In passing, the author notes that some antipsychotics may produce movement disorders. Let me explain what “movement disorders” means. It means “tardive dyskinesia” (TD), which arises from long term use of ANY antipsychotic. In its common form your face and tongue may be in motion constantly, biting yourself, sticking out your tongue every minute. It means having your eyes blink so fast and constantly that you are essentially blind. It means not being able to finish a meal because your mouth is so cut up it hurts to chew. There are other forms of TD, far worse than what I’ve just described. There is no established cure for TD which MAY disappear when you stop taking the antipsychotic. But in many cases, TD is irreversible. To be blunt, TD is brain damage. If you don’t suffer from psychosis, if you are offered a 2nd generation antipsychotic just to boost response to an antidepressant, make your doctor read aloud the “Physicians Prescribing Information” sheet. Don’t settle for the patient’s info guide. Ask your physician how long you will be on this drug and when you will come off it to check for TD symptoms. For every year you are on a 2nd generation antipsychotic, your risk of TD rises 5%. Middle age women have a 30% risk of TD. If your doctor says TD can be fixed by just changing from one 2nd generation antipsychotic to another, flee. Your doctor hasn’t kept up with the newest research on 2nd gen antipsychotics. Switching to another 2nd gen drug can just mask TD symptoms–it hasn’t cured or fixed them. If you are fighting weight gain, antipsychotics are probably not the answer. I was on risperdone about 12 years as a booster drug. I’m 85 lbs overweight. My depression is treatment resistant. And as you might have already figured out I have TD.

    • When I started taking latuda I started having dyskinesia about a month in. My patch prescribed cogentin and after a few days on it I stopped having problems with it. I took the latuda for only about 4 months though so I’m not sure if there would be any long term issues in that short of time. My doc prescribed zyprexa today because I’m rapid cycling again which causes me to have all sorts of problems. After reading up on it I’m now concerned about dyskinesia again as well as weight gain as I’ve gone from 254lbs to 220 in the last 9 months and I’d really like to not go back but continue to lose.

  19. I gained over 40 pounds in about 2 months when I first got diagnosed with bipolar and started taking Seroquel. If I had known how huge a risk weight gain was on that drug, I never would have taken it. It’s been almost a year and I still haven’t been able to lose any of that weight. Now my psychiatrist prescribed Risperidone and after reading some of the “horror stories” I’m paralyzed with fear that this will have the same side effect. I was on numerous other medications (Geodon, Lamictal, Sertraline, Gabapentin, etc.) and though I don’t believe they caused weight gain, they were ultimately not helpful in treating my symptoms. I’m honestly reconsidering taking this medication because weight has always been a huge issue for me and now it feels like I have to choose between being healthy physically or mentally and either way, I’m going to be miserable. I feel doomed. It’s a lose/lose situation and I’m getting very nervous about all of it. I already weigh myself daily and keep a food journal to keep on top of any major issues that arise but tonight was my first dose of the new meds and I am filled with dread about what will happen over the next couple of weeks.

  20. I’m very grateful for all these comments. I’m on Seroquel and have been for 4 yrs now. The medicine itself is working great for me. But I’ve gained 80lbs on it. I’m naturally a thin person and only 5’1. I recently changed my diet and i try to eat healthy now. I’ve been able to drop 30lbs, but the rest of the weight is not coming off. So I’m going to talk to my psych this week to try a different medicine that doesn’t cause so much weight gain. I’m nervous because the Seroquel has my anxiety, mania, and depression in check. But my self esteem is horrible. Anybody have any similar situations or advice to give? Switching meds is never easy

  21. Many of these stories are heartbreaking and a few startling. My story is different in some respects but I believe it can be helpful to others here.

    I am a 66 year old man. I was diagnosed Bipolar I when 53. I had been on Meridia (Sibutramine) 10mg for 14 months when diagnosed. It was prescribed by a PA at my primary care doctor’s office on a casual request by me for something to suppress my appetite. I started on 5mg in July 2003. My weight was 255. I immediately began losing 3lbs a week without any lifestyle changes. I have always been sedentary. To me the only apparent difference was I lost any appetite for starchy carbs and had little interest in eating at all. In 6 weeks I had lost 18lbs and became completely manic. I was an introvert and became a loud and obnoxious extrovert. Family and friends were concerned. I went back to the PA and talked about my mental state. He dismissed my concern and increased the dose to 10 mg. After 6 months I had lost 70 lbs. After that I continued to take the Meridia for 9 more months but lost no more weight. But I was so manic that I maintained my weight lose getting by with 2 hours sleep a night. In September 2004 I fell into a very deep depression, had a psych break and was hospitalized for a week and out of work for three months. Fortunately I had great health insurance and both long and short term dis ability insurance.

    After I recovered my wits I began educating myself what had happened to me. Meridia is an SSRI and acts on brain chemistry as the SSRI psych drugs do. I am probably genetically disposed to BiPolar (genetics is sometimes a factor). The amount of weight loss and my psychic response to Meridia was extremely unusual. I was on a diet pill forum as I lost weight and nobody else reported the kind of weight loss I experienced. But the damage was permanent and I have to live with BP.

    Once hospitalized I was put Clonapin, Seroquel, Depakote, Risperidone, and Ambien. I was assigned a psychiatrist and a therapist and have been under the care of both specialties ever since. Major side effects noticed, the weight gain and loss of libido. The later was more of a concern than weight at the time.

    It took four years and three psychiatrists to get a personalized cocktail of psych drugs that kept me stable for most of the time. During that time, in addition to the meds mentioned above, I was on/off: Lamictal, Cymbalta, Lamotragine and Lithium. Additionally I was being treated for hypertension, cholesterol, atrial fibrillation, hyperthyroid, arthritis and kidney problems. So I took about 12 meds plus others if I got temporarily sick with something else. In addition to acknowledged side effects, the potential interactions between so many drugs is astronomical. I read all the fine print when I get a new drug. But my best source of info on various interactions and side effects is my pharmacist. In my experience no doctor can keep track of all these effects that constantly change with med changes and life events. Pharmacists know this stuff and have databases to consult. And a pharmacist consult is free. I also do my research about meds on reliable online med sites (not pharmaceutical company sites) and I usually compare what several say. I see a number of doctors and I tell them all my psychiatrist is in charge of meds. All other meds must work with psych meds. This is a quality of life issue for me.

    I gained back all the weight I lost on Meridia back within 6 months of being diagnosed with BP. And I gained an extra 20lbs. So for 10 years my weight has been 270-285 (5’9). Unlike most posts here, I am indifferent to weight gain. My age and the fact that my interests are intellectual – reading, music, and playing games spares me the anguish of concern for my weight that is apparent in most posts. But at the urging of various doctors I have made a lot of efforts to lose weight. Diets, gym regimens, exercise, even gastric bypass (not approved by psychiatrist). Never got below 270. I long ago accepted the acknowledged side effects of my psych meds and weight gain/slow metabolism was most prominent. When I explained this factor to non-psych doctors they just ignored me and said, “ Yes but lets try this…”. So over the years I just learned to ignore their weight loss advice. Friends and relatives have also been well meaning but misguided due to an inability to relate to how my meds work. Same with written weight lose advise that is not focused on dealing with psych meds.

    But now I am pre-diabetic and so my weight is a serious concern. For several years my psych meds have been consistent: 900mg of lithium carbonate, 50mg of Seroquel, 100mg of Lamotragine, 10mg Ambien, .5mg Clonazepam (as needed).

    In January my Primary Care doc wanted to put me on a combo of Wellbutrin and some anti smoking drug that he had heard was effective for weight loss “in a few cases.” Given my experience with Meridia, I was not receptive to taking drugs for weight loss but said I would ask my psychiatrist. Psychiatrist said no, definitely no but I could stop taking Seroquel since it had been so long since I’ve had problems and my dose was small.

    So after 12 and a half years I stopped taking Seroquel cold turkey at the end of January. Some sleep disruption but I can nap in the day since I’m retired. In March I began to notice signs I was losing weight. Our scales are broken. But my watch and rings were getting loser and continue to loosen. I am more flexible and can do routine household tasks without losing my breath. My hips and knees are not as painful as I walk around. So I am hopeful. My next psychiatrist appointment is not for another month. I’m not setting any goals nor changing my routine or diet. My diet is already pretty spartan. And since lithium makes me thirsty I sip ice water all day long which is helpful in weight loss. The psychiatrist also said that he would lower my lithium dose to 600mg from 900mg next time.

    I’ve read most of the posts here. This is a good forum for getting a sense that we are all struggling with dealing with side effects of psych drugs. The way these forum is organized various issues are addressed in different threads. A couple of tandem issues I don’t remember seeing on these posts that I believe are important to our concerns here:

    – The need for therapy to complement psychiatry (meds). I have great insurance. I have seen my psychologist for therapy at least once a month since 2004. I have seen the same psychologist since 2008. I consider therapy every bit as essential to my management of bipolar as the meds. My therapist has helped me 1) own my disorder and recognize it required lifetime of care and management. 2) teach me what I could and could not control as I struggled to cope. 3) understand that friends and family were never going to “get” what I was going through. 4) gain the confidence to make lifestyle and relationship changes necessary to remove or reduce “triggers” for mood swings.
    To me therapy works like magic. To be able to talk about whatever is on my mind to a “stranger” who gives me their undivided attention and does not judge me has been incredibly valuable.

    – For the many women here I hope you are getting your gynecologist and possibly an endocrinologist (insurance allowing) involved in how psych drugs are affecting your bodies. Based on what I’ve learned over the last 12 years, if I were a woman, I would definitely want them working with my psychiatrist.

    – I have encountered a lot of people carrying around prescription anti-depressants that were prescribed by a family doctor or other general practitioner. Based on my experience, I would never accept a prescription for a “long term” psych drug from anyone other than a psychiatrist. That’s treating a symptom, not a cause. Again, I am fortunate to have good insurance and live in a city with world class health care.

  22. I’ve struggled for years with the side effect of weight gain from Zoloft. I’ve tried going off of the med over and over, and I’m never able to function well without it. My doctor doesn’t take my concerns seriously, and denies that the drug has anything to do with the weight gain, even though I can see a direct cause and effect relationship. I’d like to try something like metformin to control the weight, but I don’t have anyone to go to, to discuss this option. Help!

Comments: 1 2 3 4


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