Losing Weight Gained From Medications

Fighting Back Against Weight Gain

There's hope for weight loss
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One of the challenges faced by people with mood disorders is weight gain from their medications—as many as 55 percent on antipsychotic medications may experience this side effect. Weight gain caused by medication comes from a lack of satiety (feeling full) and an increased appetite for foods high in carbohydrates and fat. In addition to being physically dangerous, extra weight can be a stumbling block to good mental health if you feel uncomfortable in your own body.

Patients will try anything to lose the weight. Marcia's experience is similar to many who have gained weight from their medications. To lose the weight, she's tried: walking 80 minutes a day for three months; a rigorous exercise program for ten weeks; the South Beach Diet for a short time; and a $2,000 diet plan for three months. She had some success with South Beach but hardly any success with the other programs. If your meds caused weight gain, your story is probably similar. You've tried and tried, and the weight just keeps creeping up.

Medications That May Cause Weight Gain

  • Seroquel (quetiapine)
  • Risperdal (risperidone)
  • Clozaril (clozapine)
  • Zyprexa (olanzapine)
  • Remeron (mirtazpine)
  • Paxil (paroxetine)
  • Lithobid (lithium)
  • Depakene (valproic acid)
  • Depakote (divalproex sodium)
  • Tegretol and Equetro (carbamazepine)

A presentation by Dr. Rohan Ganguli and Nurse Practitioner Betty Vreeland focused on weight gain and medications. Dr. Ganguli began by saying he had treated many obese patients for years without really thinking about their weight. Then a colleague did a survey that found that of their patients diagnosed with schizophrenia, less than 20 percent were in the normal weight range, and fully 60 percent were obese.

Dr. Rohan Ganguli said that, unfortunately, "... it has been assumed that people with schizophrenia are socially unaware and that, unlike the rest of us, this really does not matter to them." Yet when they asked these patients how they felt about their weight, a wide majority of the overweight and obese patients said they wanted and had tried to lose weight.

Dr. Ganguli and his fellows developed a program that clinicians could easily provide to their patients. It involved 14 weeks of group sessions with training in areas including developing good eating habits, burning more calories, and changing snacking habits. Self-monitoring in the form of daily weighing and food and exercise logs was key.

They Lost Weight

The results after the 14 weeks were very encouraging—two-thirds of patients lost at least three percent of body weight and around 40 percent lost five percent of body weight or more.

One of the program's ideas was that of "wasting" food. Many people with schizophrenia eat at fast food restaurants because these are inexpensive and convenient.

A key part of the program's strategy was teaching people it was OK not to eat the entire meal.

Preventing Weight Gain

Finally, they tested the program with patients who were just starting on some of the medications that are known to cause weight gain, including Seroquel (quetiapine), Risperdal (risperidone), Clozaril (clozapine) and Zyprexa (olanzapine). In all cases, intervention prevented weight gain in more patients than in the control group, although the success rate depended on the medication. In this small study, the most dramatic difference was with Seroquel, where more than 60 percent of the control group gained significant weight, compared to only 10 percent of those in the intervention group who gained.

Lifestyle Barriers and Interventions

A set of challenges exists for those with mood disorders that might not in other populations, including the metabolic effects of their medications, impact of symptoms on motivation, poor dietary habits, and high rates of sedentary behavior. Chronic poverty is also a factor for those with mental illness, which affects quality of life, self-esteem and the ability to pursue "leisure" activities such as participating in exercise.

A meta-analysis of 17 studies and nearly 2,000 participants looked at successful lifestyle interventions for those living with serious mental illness. The study found that programs of at least a year's duration had more consistent outcomes. Some of these interventions included physical activity, nutritional advice, behavioral programs, and free fruits and vegetables. Successful outcomes included improved blood pressure, weight loss, BMI reduction, smaller waist circumference, and lower cholesterol.

The Message

Mental health practitioners of all kinds need to address compassionately the problem of overweight/obesity in their patients and realize that these patients do care. And these mental health professionals can help. A doctor who says, "Join Weight Watchers" may not realize that some people aren't up for going to meetings when depressed, and some just aren't "group" people. A therapy group, with people who have gained weight because of their psychotropic meds, might, instead, be helpful.

But just knowing what made these programs successful can help. Knowing that there is solid research to show it is possible to lose weight and still take medications like Seroquel (quetiapine) makes a difference.

A Word from Verywell

Weight loss while on psychotropic meds isn't going to be fast. But although it may be difficult, you can have the encouragement of knowing it's been proven possible to lose weight on psychotropic medication.

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Article Sources

  • Naslund JA, Whiteman KL, Mchugo GJ, Aschbrenner KA, Marsch LA, Bartels SJ. Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis. Gen Hosp Psychiatry. 2017;47:83-102.

  • Ganguli, R., Vreeland, B., & Newcomer, J.W. Strategies to integrate physical health care into mental health: Monitoring and managing weight gain in the mentally ill. Physicians Postgraduate Press, Inc. March 2007.