Is your Medication Making you Fat?
You've put on 5 pounds in 1 month. Is it your medication or the chips you've been eating? You may be able to blame your medication if you added 5 pounds in the first month of starting a new medicine and haven't changed your lifestyle. Let's talk about the biggest players when it comes to weight gain and some good alternatives you and your doctor can think about.
1. Corticosteroids (Prednisone)
What are they taken for? Autoimmune disorders, severe asthma, some skin conditions, preventing rejection after transplant.
How much weight gain do they cause? On average, 2-13 Kg ( 1kg = 2.2 pounds) in more than 50% of people taking it for a year. This is our first place winner.
Low fat options? Not really unless you switch to a non-steroidal anti-inflammatory drug (NSAID) or an oral inhaler for asthma.
2. Insulin therapy: Long Acting (Lantus) and short acting (Humalog)
What is it taken for? Diabetes type I and II (adult onset) and gestational diabetes.
How much weight gain does it cause? An impressive 4.6 Kg weight gain over 5 years for all types of insulin studied.
Low fat options? None. Oral medications are an option only for adult onset diabetes.
3. Thiazolidenediones: Actos and Avandia.
What are they used for? Type II Diabetes, Polycystic ovary syndrome.
How much weight gain do they cause? Results of premarketing trials show a mean weight gain of 1-3 Kg.
Low fat options? Medications in another class like metformin, byetta or Januvia.
4. Beta Blockers: Inderal, Atenolol, Metoprolol, etc.
What are they used for? High blood pressure, migraine headaches, tremor, coronary artery disease, atrial fibrillation among other things.
How much weight gain do they cause? All beta blockers can cause weight gain of 1-3.2 Kg.
Low fat options? It appears Carvedilol (Coreg) causes less weight gain than the older beta blockers.
5. Antipsychotics: This whole class of drugs is trouble but Clozaril and Zyprexa are the biggest players
What are they used for? Schizophrenia, Dementia with psychotic features, bipolar disorder
How much weight gain do they cause? Clozaril is the biggest culprit with Zyprexa a close second causing 2.8 Kg (1 kg = 2.2 pounds) weight gain in 6% of people taking it. Risperdal is also a key player with an average of 1.1-2.6 Kg
Low fat options? Haldol or change class of medication to an atypical antipsychotic.
6. Selective-Serotonin Reuptake Inhibitor (SSRI) Antidepressants.
What are they used for? Depression and Anxiety disorders, chronic pain
How much weight gain do they cause? Paxil is the biggest offender causing the most weight gain with Zoloft a close second and then Prozac. The weight gain, if it does happen, averages 1-3 Kg.
Low fat options? Lexapro, Wellbutrin (not an SSRI but an atypical antidepressant)
7. Mood stabilizers/Anticonvulsant medications: Neurontin, Tegretol, Depakote, Lamictal, Topamax.
What are they used for? Chronic pain, migraines, seizures, bipolar disorder, depression, neuropathy.
How much weight gain do they cause? Weight gain of > 16 pounds in 3% of people taking Neurontin. Depakote also results in weight gain in some of 1-2 Kg.
Low fat options? Topamax causes weight loss in 3% of people and Lamictal is generally weight neutral.
8. Conventional Mood stabilizer: Lithium
What is it used for? Bipolar disorder
How much weight gain does it cause? In 11-65% of patients (depending on the study) Lithium causes an average of 10 Kg weight gain or more.
Low fat options? Not in this class of drugs.
9. Atypical antidepressants: Remeron (Mirtazapine), Wellbutrin, Effexor, Cymbalta.
What are they used for? Depression, Obsessive-compulsive disorder, Bipolar disorder, Anxiety.
How much weight gain do they cause? Remeron is the biggest culprit here causing a weight increase of 7% of the patient's body weight in 12% of people taking it. Effexor and Cymbalta cause a more modest weight gain of 0.5-1 Kg on average.
Low fat options? Wellbutrin, Serzone
10. Tricyclic antidepressants.
What are they used for? Depression, insomnia, chronic pain.
How much weight gain do they cause? Elavil (amitryptiline) is the most common drug still used in this class and Elavil and Imipramine both result in 0.4-4.12 Kg weight gain per month on average.
Low fat options? Not really, which is why we don't prescribe these as often. Doxepin may be better than the others but switching to an SSRI should be your strategy.
Dr O.
Categories: Overview
Support Groups: Anxiety, Arrhythmias, Arteriosclerosis, Asthma, Bipolar Disorder, Bipolar Disorder - Teen, Chronic Fatigue Syndrome, Chronic Pain, COPD & Emphysema, Coronary Heart Disease, Depression, Depression - Teen, Diabetes Type 2, Diets & Weight Maintenance, Fibromyalgia, Heart Attack, High Blood Pressure, Insomnia, Obesity, Panic Attacks, Parkinson's Disease, Polycystic Ovarian Syndrome (PCOS), Schizophrenia, Seasonal Affective Disorder
52
So since I am on Risperdal and Zoloft, that is probabaly why I have gained so much weight? I know part of it is because when I was really depressed I ate a lot but I know that other part is because of the medicince. These medicines really help, but my family doctor told me I had to lose weight. How can I do this if the medicine is making me gain weight?
By beth18 September 27, 2008 12:32am
51
I took Tegretol when younger, I put on 2 stone in a month, the doc took me off them. Later for different seizures they put me on Epilim, over the spell of 5 years I put on nearly 4 stone, when they lowered the dose I lost a stone in weight but because I was still taking it within a year and a half most of it went back on and even after coming off of it the weight stayed. I am now on Keppra and the only time I put on weight was when they upped the dose from 1250mg to 2000mg over the spell of 8 weeks, I put on 9 pounds and then it levelled out, dropped a couple of pounds and stopped at that but I still have all that extra weight and one dr said I would have trouble losing it.
By angelglory August 3, 2008 8:17pm
50
Bentleyfox: You are so right
Lyrica is a big culprit: in studies done on diabetics for neuropathy the average weight gain was 5.2 kg over 3 years. In studies on Lyrica lasting more than 12 weeks a weight gain of >7% occurred in 9% of patients...that is also impressive.
Dr O.
By DrOrrange July 6, 2008 7:01pm
49
You haven't mentioned lyrica ( pregabalin( I've put on nearly a stone in weight over the last 18 months while on it.
By bentleyfox July 6, 2008 8:15am
48
Dr. O-
I'm often on inhaled, oral and injected steroids for asthma which I've taken since about 2001.
At one time, I was 90-100 pounds. Now I'm probably around 140. As I'm barely 5-foot, this is a tad ridiculous and I'm sure doesn't help the asthma or the amount of drugs I need to take - a vicous unending cycle.
Personally, I can't wait for medical science to have a nother solution other than steroids. I believe this will come in my lifetime, but in the meantime, this remains a weighty issue :-)
On a more serious note- are there any studies on weight gain using drugs like Humira and Enberyl? I saw one case on the news which claimed a patient didn't gain weight on Humira. What has been your experience with these drugs? And have you seen/used them to treat asthma?
Thanks. I'd be interested as I don't qualify for Xolair and these other drugs would be my only other option at this moment besides more salumedrol injections.
By orsonwelz July 5, 2008 2:09am
47
nana94: Its a great question and the mechanism is unknown. We dont know if beta blockers cause fatigue and thus the weight gain or a decreased metabolism....we just dont know.
By DrOrrange July 4, 2008 12:34am
46
How do the beta blockers and antidepressants you listed cause you to gain weight?
By nana94 July 3, 2008 1:33pm
45
OMG #1;2;4;6;7;9; what a downer....All I can do is keep trying.
By bigouie July 2, 2008 7:12pm
44
I take Paxil twice a dayk, 20 mg. and Buspirone twice a day l5 mg. I have tried at various times to come off this medicine one at a time, but I get such severe anxiety I have stopped trying. I am also a recovering alcoholic of 21 yrs.,
Do you think this is a seriously high dose for a person to take on a daily basis? And do people take these things fo the rest of their life.
Thanks,
By marsidoats July 2, 2008 2:03pm
43
I take Paxil twice a dayk, 20 mg. and Buspirone twice a day l5 mg. I have tried at various times to come off this medicine one at a time, but I get such severe anxiety I have stopped trying. I am also a recovering alcoholic of 21 yrs.,
Do you think this is a seriously high dose for a person to take on a daily basis? And do people take these things fo the rest of their life.
Thanks,
By marsidoats July 2, 2008 2:03pm
42
I take Paxil twice a dayk, 20 mg. and Buspirone twice a day l5 mg. I have tried at various times to come off this medicine one at a time, but I get such severe anxiety I have stopped trying. I am also a recovering alcoholic of 21 yrs.,
Do you think this is a seriously high dose for a person to take on a daily basis? And do people take these things fo the rest of their life.
Thanks,
By marsidoats July 2, 2008 2:03pm
41
Hi, Dr. O. I take Coreg (just switched off Metoprol), Metformin, Actos, Cymbalta, and lots of others for diabetes, CAD, fibro, CFS, depression, psoratic arthritis, osto arthritis, HBP, bad cholesterols, etc. I'm also being evaluated for bi-polar. I also have constant chest pain....have to ride the bus to the ER once or twice a month just to get it under control. I've had a terrible time trying to loose weight. Now if I have to go on something for the bi-polar, I'm really scared of more lbs. Also have ADHD, which I don't take anything for because of the CAD. Thanks for letting me vent. Anything I could try besides the moderate exercise and nutrition and meditation I'm already doing?
By mizziggie July 2, 2008 12:38pm
40
Abilify is interesting because the AVERAGE weight gain in studies compared to placebo is 0.7 kg. However in people who have a BMI < 23 when they start the medication their weight gain is more impressive...about 2.6 kg.
Dr O.
By DrOrrange July 2, 2008 11:43am
39
What about the new one, Abilify?
By Girlffmedic July 2, 2008 6:35am
38
mirzation all so puts on weight.
Gabapention retains water weight
By inlotsofpain June 30, 2008 4:52pm
37
hELL YES DEALING WITH
By anderla June 30, 2008 6:38am
36
since onset/ diagnosis fibro, chronic pain, depression, anxiety, bipolar, and being sleep deprived 7+ yrs ago.. with the roller coaster ride of meds my dr.'s/pain clinic has tried, I too have gained 75+ lbs... and most of the meds i could not take, but would cause immediate 10-15 lb mo jump in weight with no change to diet and exercise. one month up then next down but recently have had the most weight gain of all. I had to change pcp/ no longer seeing psy due to shut downs.. so my meds have been removed or reduced. I was on Marinol, topamax, clonazepam for the last couple of years. I had to stop taking topamax, everytime they tried to increase made me sick and gained extra weight, clonazepam has not changed and pcp removed marinol which honestly is the ONLY MED i have been put on since onset that has helped at all physically, mentally, and emotionally (by calming). Don't get me wrong I don't promote alot of the meds they put you on but, this one actually was helping some not 100% heck not even 50% but it made the difference between dragging one leg when walking and having several days of not being able to move physically from the waist down to walking kinda normal. I gained 30lbs right out of the box with this med but, the little bit of progress i gained physically made me feel more like a person not some freak no one could understand, i felt at that pt, i could deal with the weight to get back some partial mobility and maybe use it to help take the weight back off. I stalemated for the entire stint of marinol until i had a gal bladder removal last fall. so can you explain to me why i could not go up or down? and why the sudden change after gal bladder removal caused so much weight gain? my dr doesn't want to listen or doesn't understand (personally i don't think he wants to deal with me) for he just shrugs like i'm just what he sees fat and inactive.
personally i think it is a per person %% on the weight gain. some i ballooned on and some i lost on but, the fact remains that over the last couple of years in efforts to control weight my diet is better (not perfect) but, better. And I am gaining weight fast, I don't understand. can you explain this??
By aharddaynnight June 29, 2008 6:10pm
35
Glad for the last two comments which remind me to state the obvious: if these are working for you and others havent (like Remeron for VixyPixiePants) than it may be worth the tradeoff...annoying as it is.
Dr O.
By DrOrrange June 29, 2008 3:42pm
34
I'm taking Mirtazapene and it's caused me to balloon despite changing my life style for the better (gym at least 5 times a week, low fat/calorie diet).
: (
It's the only anti-depressant out of five that I've tried that has given me any benefits and now it's making me fat and that's only going to lead me to feel more depressed!!
Bloody annoying.
By VixyPixiePants June 29, 2008 11:14am
33
it seems to me that the medicines that really work cause the most wieght gain i think that unless it is causing obesity then it should be looked at as a price worth paying for stability with bipolar. i take lithium and resperedal along with lamictal and my former slim self has been swallowed by my wieght gain. my advice to all is to try to lose what you can and don't have hopes to be slim again - good luck to all of you bipolar brethren
By elishab June 29, 2008 1:30am