Medication Induced Weight Gain

One bug bear I have is when well meaning folk tell me that I can lose the weight induced by medications I have to take because obviously I'm fat because I eat too much - right? - WRONG!

Blaming/shaming folk carrying some extra weight due to medications by telling them that its because they are eating too much and not a documented fact of taking the medication is wrong and insensitive. If you happen to be lucky enough to not suffer from side effects then I am genuinely pleased for you. If you are someone who doesn't have to take these medications and are being judgemental - then shame on you!

I have gained a lot of weight - several stone over the years because I have to take medication for my conditions. I have no choice in the matter - and have discussed my agonising over whether or not to take them  with my Consultant and rheumatology specialist nurse because I'm only human and find it upsetting watching my body change despite my best efforts to stop it happening.

All of my health care professionals have informed me - with their medical training and knowledge to back it up - that the weight gain is out of my hands and that I am doing everything within my power to keep it reined in as much as possible. They made me realise that I have to choose between being slim or having quality of life. Obviously, opting for a better quality of life is the route I chose, as well as many others like me, and have to take the extra timber I carry as a side effect of that choice.

It annoys me so much that unqualified or misinformed folk believe that it is due to overeating that this weight is put on - admittedly in some cases it can be down to eating more than usual. However, often the increased appetite can be down to the medications which means for some is hard to satiate the hunger.

So, what are the culprits and why do they cause weight gain in many of us taking these medications?

If you are unfortunate to have any of these common medical conditions then it is highly likely you have been prescribed medications which will cause weight gain.

• schizophrenia
• obsessive compulsive disorder (OCD)
• bipolar disorder
• depression
• type 1 or 2 diabetes
• high blood pressure
• epilepsy and seizures
• allergies
• pain and inflammation 

It is commonly found that some medications are more likely than others to result in you gaining weight, although not all of us will be unlucky, there are some who are fortunate enough to avoid this occurrence.

So why do medications for these conditions and others like them cause weight gain?

Common reasons why your medicine might cause weight gain include:

• Well, they can cause an increase in appetite which is due to the brain being affected regarding the feelings of satiety when you just can't seem to feel full. So - although yes it can cause over eating it is a compulsion that may be difficult to control.
• Some medications can cause you to retain fluid (water) within the body and increase weight.
• Another side effect they can cause is elevated fat storage - for example, insulin can increase fat storage.
• Yet other drugs may cause you to have a slowed metabolism.
• A side effect can cause a side effect, such as fatigue or weakness, leading to less activity, exercise, and calories burned.
• Finally, for a large number of medications it is recognised that they can cause weight gain in those of us who are unlucky enough to suffer from that side effect - however, they don't know exactly why this happens. 

Some well known culprits for causing weight gain are;

• Some antidepressants this is because they can interfere with the neurotransmitter serotonin  and that may affect appetite changes. Some can increase antihistamine in the body and your appetite, it may also cause sedation and fatigue that lower levels of activity. It is well documented that tricyclic antidepressants (TCAs) are notorious for increasing appetite and for causing weight gain. Interestingly, it was found in clinical studies that weight gain was reported in 12% of adults (with a weight gain of more than 7% reported in 8% of adults) also increased serum cholesterol (15%) was also documented. Another interesting fact is that in some cases it has been found that for some people, the weight loss at the outset may be temporary, and then  weight gain may be an issue later down the line due to the therapy. 
• Antihistamines are commonly used to treat a number of conditions, most commonly a variety of allergies and skin reactions. I will quote the following which is very interesting..
  "Newer 2nd generation antihistamines, such as cetirizine (Zyrtec), loratadine (Claritin, Alavert) and fexofenadine (Allegra) selectively antagonize histamine H1 receptors. These drugs, which are available without a prescription, have been associated with weight gain. Antihistaminic activity can also boost appetite, as noted with several other drugs that cause weight gain. A study compared the use of antihistamines and the risk of obesity. Users of cetirizine (Zyrtec) and fexofenadine (Allegra) had significantly greater weight, BMI, waist circumference, and insulin levels. Cetirizine (Zyrtec) can lead to drowsiness in roughly 10% of patients, more than other 2nd generation antihistamines. Cyproheptadine, an older H1 antihistamine, has actually been used to increase weight gain in patients with chronic diseases and failure to thrive. The 1st generation diphenhydramine (Benadryl) is also linked with weight gain when used on a long-term basis. Other 1st generation antihistamines include brompheniramine, chlorpheniramine, and hydroxyzine."
• Antipsychotics and Mood Disorder Treatments - these medications are prescribed to treat mental health conditions for example - schizophrenia or bipolar disorder, sometimes they are also used in conjunction with anti depressants for severe depression too. All of the classed antipsychotic drugs are known to  produce some metabolic changes, however each specific drug has different risks. It has been researched and proven that these drugs can elevate an enzyme called AMP-kinase within the brain of those taking them which blocks the brain histamine-1 receptor and cause an increase in appetite It is often very important for patients to take these drugs and so the risk of weight gain is less important than the risk of stopping taking the medication. It is therefore advised that these people are monitored by having a regular check and assessment of their weight, waist measurement, lipids, blood pressure and blood glucose levels. Some figures relating to weight gain affects are -"patients may gain from 7% to 10% of their body weight. These drugs can have antihistaminic activity and also block serotonin, which may contribute to the weight gain effect."
• Beta blockers have been documented for a long time as being known to lead to weight gain. 
• Birth Control - it is documented that those with higher doses of estrogen or progestin-only birth control can cause weight gain. It is also true that the medroxyprogesterone (Depo-Provera) injection that is given every 3 months can cause significant weight gain in some women.
• Corticosteroids - I think we all are aware that these can cause changes in our metabolic rate, and lead to increased appetite and overeating. They can also lead to extra deposits of fat in your midsection (stomach area) and face - hence "moonface".
• Diabetes medications - some of the medications used to treat type 2 diabetes can lead to weight gain and fluid retention.
• Anticonvulsants and Mood Stabilizers - many anticonvulsant medications are associated with significant weight gain; up to 30 to 40 lbs (15 to 20 kg) in some cases over the long-term.

From what I have been told by my medical team is that it is often the side effects of the medications on a persons body that causes the weight gain and not the drug itself. How you react varies from person to person.We are all different and so our reactions and how much it affects us will vary. These side effects can be stimulated appetite, where your brain doesn't receive the message that you are satiated. Some may make your bodies absorption and storage of glucose change which will result in fat deposits around your middle. Another side effect can be changes to your metabolism meaning you can't burn off calories as easily or as quickly as others which causes weight gain. Some may be due to fatigue meaning lowered activity and calorie burning  and yet others the accumulation of fluid within the body.

How much weight you gain varies depending on each individual and how their body reacts. Some luckier ones only gain a few pounds and then no more, others may find it adds up slowly over a period of time, when the weight continues to go on slowly over time. The latter is especially true for those of us living with chronic health conditions.

If you add onto the medication side effects a lack of mobility, fatigue and post exertional malaise then weight gain is almost inevitable for some of us. 

What is hugely important is to learn to love the new curvier you and ensure you are regularly monitored to ensure nothing negative is going on unnoticed in the background with your health.

I have been told categorically by my health care professionals that I am fit enough within the realms of my illness and that I have to learn to accept the weight I have gained due to the medications I have historically and am also currently taking. I have regular blood tests and check ups and can categorically say I eat far less now than I ever have and that over eating is definitely not the cause of my weight gain. 

All I ask is for those of you who judge without knowing the facts - you are wrong to say overeating is the cause of weight gain and that we are making excuses blaming our medication to cover for it. Shaming and blaming those of us who have had no control over the added timber to our bodies is out of order and should cease immediately. Be grateful that you don't have to live with this and need these medications to ensure a decent quality of life. 

I make no apology for this slightly ranting blog post because it is a topic very close to my heart and deeply affects me personally as well as some of those I love too.

So, if you have nothing nice to say - kindly say nothing at all and keep your judgemental opinions to yourself.

.... and breathe!

~ Brightest Blessings ~ 

 x~X~x