• Joseph Couture

Psychiatric Drugs and Weight Gain

Modern psychiatry pretty much only has one tool in its toolbox- drugs. I've seen medications work miracles on people. They have their place, for sure. But putting aside discussions of their overuse and appropriateness in many cases, you need to understand that in addition to affecting your brain, they are going to affect your body.

The side effects are legion and often devastating. But focusing today on one in particular, weight gain, understanding a bit about how they will impact you can help you overcome very significant problems down the road.

Anti-psychotics are notorious for causing weight gain, some more so than others. Olanzapine and Zotepine are amongst the worst offenders. They achieve their anti-psychotic effects through one mechanism, but also affect other aspects of brain chemistry. This can differ from drug to drug, but the consequences are largely similar- they affect both your appetite and food cravings. Antidepressant drugs also cause weight gain through mechanisms that have the same type of effects.

In the case of some anti-psychotics, they suppress your feeling of being full, causing you to continue eating even when you are not hungry. Antidepressants may cause you to crave certain foods, particularly those high in carbohydrates like bread, pasta, chips and sugary sweets. Depression by itself is also known to cause similar cravings.

In our society, gaining a lot of weight can cause a person to be stigmatized, judged and deemed to be less attractive. This in turn negatively impacts a person's self-esteem and for some people deepening their depression and leading to a worsening of a person's ability to control their impulse to eat and again making the situation worse.

Some doctors will try to counter the weight gain by adding yet another pill, the drug Metformin. This is a drug used in the treatment of diabetes. While it is not clear how this drug causes weight loss- or even if it substantially does- many psychiatrists will prescribe it to try to lesson the weight gain of other specific medications. But it is by no means a wonder drug and will not solve the problem for most people, only perhaps reduce it by a tiny bit.

The best solutions are to try to make sure that you do not keep foods easily accessible that are the worst for causing weight gain. Keeping a good supply of healthy snacks and low-carbohydrate foods in your home can help you avoid over-eating the wrong things. Adequate sunlight in the winter (artificial sun lamps are helpful) and regular exercise are extremely helpful, with exercise being the most helpful thing you can do for both depression and maintaining a healthy weight. In fact, many studies show that regular exercise is just as effective, if not more so, as a treatment for depression.

The problem, of course, is that if you are depressed you don't have the energy and motivation to get moving. It certainly isn't easy, but if you can just find a way to get started the improvements in your mood can happen fairly quickly and the benefits build on each other. The more you start to feel good, the easier it is to do more and then you feel even better. It won't be easy, but beating yourself up certainly won't help. Show yourself some loving kindness and compassion, which is the best treatment ever.