Max Carmody, MSc
To not gain weight on psychiatric medications, first of all, talk to your doctor about changing your medication if it is causing rapid weight gain to one that does not cause weight gain for you, or a more manageable level of weight gain. If your medication is causing milder weight gain, consider trying Metformin, especially if you are on antipsychotics. And, as is always good advice, consider eating healthier, and moving more.
What are Psychiatric Medications?
I’m not a medical doctor, but having struggled with mental health and taking many drugs over the years, these are things that I have learned about through personal experience. Psychiatric medications are medications that are used to treat mental health disorders. They work by adjusting the number of major chemicals, or neurotransmitters, in the brain. There are five main types of psychiatric, also called psychotropic, medication (although some doctors say four). These types are antidepressants, stimulants, anti-anxiety medications, antipsychotics, and mood stabilizers. I’ll give a brief description of each of these.
Types of Psychiatric Medications
Antidepressants are used to treat depression. There are many different types. Selective serotonin reuptake inhibitors (SSRIs) steadily increase the amount of serotonin in the brain. Serotonin is a neurotransmitter regulating mood, sleep, and many other things. There are selective norepinephrine reuptake inhibitors (SNRIs) which increase the amount of norepinephrine in your brain, which makes you feel more awake and alert. Then there is also Bupropion. Antidepressants can result in weight gain, sometimes a lot. There is some research also showing that they do not tend to cause as much weight gain in the first 6 months, but can result in more weight gain after a year or so of being on them.
Anti-anxiety medications treat multiple anxiety disorders, such as panic attacks, phobias, and generalized anxiety. They include beta blockers, which can treat physical symptoms of anxiety, such as nausea, trembling, and increased heart beat. They are rarely responsible for weight gain, so we will not be discussing them too much.
Stimulants help to manage unorganized behavior. They can have a calming effect, and increase concentration. They are often prescribed for people with ADHD. It is more common for stimulants to result in weight loss, than weight gain, so we will also not be discussing these much.
Antipsychotics help to manage psychosis. Psychosis often results in people being separated from their reality and experiencing hallucinations or delusions. They can help people to think more clearly, and become calmer. They are used for a wide variety of different conditions, with some of the main ones being schizophrenia or bipolar disorder. These are heavy hitters in terms of weight gain, they probably cause more weight gain than any of the other categories.
And finally, there are mood stabilizers. These help to regulate extreme emotions. They are primarily used to treat bipolar disorder, or extreme mood swings. These can result in a lot of weight gain, like antipsychotics.
Why do Psychiatric Drugs Result in Weight Gain?
There are different theories for why psychiatric drugs result in weight gain, and the research is often inconclusive. A lot of scientists think that they may actually make you hungrier. They may make you crave more sweet and high carb foods. Some think that due to the sedating effects of many psychiatric medications, they may cause you to be more lethargic and exercise less.
From my personal experience however, I think that there is more going on than this. I have gained a large amount of weight, like 10 or 14 pounds, in as little as 2 weeks from psychiatric medication. And I was eating healthy and exercising, I don’t believe that I was eating anymore than usual. So although some scientists seem to think that they only cause weight gain because they result in more eating or less exercise, I believe that there is more going on than that. I believe that they are actually affecting the underlying metabolism or something similar. If you would like to read more about why psychiatric medication leads to weight gain, you can find an article here that I wrote on the topic.
One Great Trick – Take Metformin
Metformin has been a lifesaver for me. Again, I don’t claim to be a doctor, so I don’t know exactly what types of people or what classes of psychiatric drug that Metformin will work for. But honestly, I think it’s worth a shot, or at least worth discussing with your psychiatrist or general practitioner. A lot of psychiatrists don’t even know that it helps with weight gain. I complained to my psychiatrist that I was gaining weight due to one of my medications, and they did not suggest it to me. Some of my psychiatrists have also not wanted to prescribe it to me directly, but insist that instead I get it from my general practitioner. I can only present so much information in the scope of this article, however if you are struggling with weight gain, I would HIGHLY recommend doing your own research on Metformin, and advocating for yourself with your care providers. Show them the research you have found, if they don’t know about it, and explain why you think that it may prove to be beneficial for you.
So what is Metformin, actually. Metformin is typically used to treat diabetes, weight management for psychiatric drugs is more of an off label use for it. According to WebMD, “Metformin is used with a proper diet and exercise program and possibly with other medications to control high blood sugar”. It works by helping to restore the body’s proper response to insulin that you naturally produce. It may be especially helpful if you’re on antipsychotics, I’m not sure if it works for other classes of drugs like antidepressants, although it may. In one study, 7% of people on antipsychotics without using Metformin lost weight, compared to a whole 40.7% of patients using Metformin. In another study, only 16.7% of patients treated with Metformin gained more than 7% of their body weight, 63.13% in the placebo group, on antipsychotics but no Metformin, gained more than 7% of their body weight. These are HUGE differences people, backed by research, so look into this stuff.
Switch to Another Drug
If you’re taking a drug that is making you gain a lot of weight, you may want to switch to another drug that does not cause weight gain, or at least so much weight gain. Everyone is different, but for me, even if a drug is working on my psychiatric symptoms, but it’s causing a bunch of weight gain, I’m going to stop taking it. I have stopped taking drugs that caused extreme rapid weight gain. It’s just a deal breaker for me, I’m willing to make the extra effort and try new drugs until I find one without, what I consider to be, an intolerable side effect. Try shopping around until you find something better. A lot of people don’t do this, and they end up obese from their drugs. It’s really tough to get that weight off, so better to just not get all that drug induced weight gain in the first place if you can avoid it.
Standard Diet and Exercise
If the weight gain from your drug is on the milder side, you may be able to control it with pretty standard diet and exercise techniques. This is pretty basic stuff that most people already know how to do. Try going for more walks, going hiking, or getting on the elliptical more than you used to. Work on eating healthier, and not eating so many sugary foods. Try to fill yourself up with more protein, so that you end up eating less overall. If your drug induced weight gain is extreme, these methods will probably not be enough, you may gain massive amounts of weight no matter how much you diet and exercise. But if it is milder, I would recommend this, as everybody should really be eating healthy and exercising anyway, and it’s also just a good thing for your general health.
If you are struggling with mental health issues, and would like to learn more about meditation and mindfulness, you can find a concise e-book here on the topic.