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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.

96 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 🙁

  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.

  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?

  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.

  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

Comments: 1 2 3 4


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