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Psychopharmacology
“Help! My Meds Are Causing Me to Gain Weight"
Preventing good medications from adding unwanted pounds
Posted October 31, 2019 Reviewed by Hara Estroff Marano
Have you been hesitant to start a new psychiatric medication due to fear of gaining weight from it?
Are you looking for the perfect diet to combat changes noted on the scale after starting a new medication?
Weight gain can be a frustrating and unwanted side effect of medications, yet a successful medicine regimen can be life-changing. Obesity and overweight caused or worsened by psychiatric medicines are among the most common and difficult-to-treat problems confronting prescribers of many classes of psychotropics. As we discuss in our book, medication-related weight gain is a leading cause of treatment discontinuation. Before you dismiss a medication due to possible unwanted side effects, try understanding your habits.
As a registered dietitian and psychiatrist, respectively, we have worked with many patients who felt significantly better on a new medication that also resulted in weight gain. But before you try a fad diet to manage added pounds, it is often helpful to compare that diet with established guidelines. For example, the Keto Diet encourages avoiding fruits, whole grains, lean proteins and low-fat dairy while encouraging bacon-wrapped cheese, parmesan crisps smeared with butter and coconut oil added to your morning coffee. Take a moment and ask yourself: Will avoiding fruits and vegetables, which provide fiber, antioxidants, and a variety of nutrients really what is best for you? Is it healthy to choose foods rich in saturated such rather than low-fat dairy?
If an idea seems too good to be true, it probably is. In our experience, sustainable long-term habits are typically more rewarding and associated with longer-term success than brief flirtations with the latest popular diet.
A balanced lifestyle is vital for mental health. Seek sensible approaches that enhance your overall health to minimize or avoid unwanted weight gain.
1. Fuel your brain! Eat on a schedule or every three to five hours. Organized meals and snacks provide your body with the nutrients it needs to energize your day.
Infrequent meals tend to lead to increased hunger at night, leading to larger portions with higher calorie intake than if you had eaten more regularly. Waiting too long between meals may set you up for low blood sugar and feeling hungry, making it difficult to manage emotions. Many poor decisions are made when we are irritated and hungry. Take a moment to think about your last snack. Was it planned, or did you just grab what was free on the conference table or finish off a bag of chips you had stashed?
Planning your snacks gives you an opportunity to eat the food groups your body needs that are not consumed at meals. If you find you are lacking in dairy and fruit at meals, enjoy cottage cheese and pineapple or yogurt with fresh blueberries as your afternoon snack.
2. Move your body! We need 30-60 minutes of exercise five days a week (150 minutes [30 minutes daily, five days a week] supports general health, while 300 minutes [60 minutes daily, five days a week] is needed for weight loss). Exercise helps release endorphins, alleviate anxiety and promote heart health. Make movement fun. We are more likely to continue being active if it’s something enjoyable and not seen as a punishment. Walk with a friend, join a kickboxing class, try out a yoga practice on YouTube, explore local trails or learn a new sport.
3. Listen to your body for hunger and fullness. Our bodies are great at telling us if we need more food or if we are satisfied—but we are not great at listening. When you are eating, take a moment to check-in for hunger and fullness. Do you feel content? Do you want to keep eating simply because you want to finish the uneaten food on your plate? Discover the taste of what you are eating. Appreciating what you are eating slows down intake, allowing you to recognize fullness cues. The goal is to stop when you are content.
4. Hit the pause button. People experience physical and emotional hunger. Eating with emotional hunger is typically a reason for unwanted weight gain. We often eat in the absence of physical hunger when we have an unmet emotional need. Do you eat in the evening when you are lonely? Did you have a rough day and deserve to treat yourself to a pint of ice cream? Push your imaginary pause button. Handle loneliness by writing a letter, calling a loved one or emailing a friend. Reward yourself by relaxing in a warm bath or watching an extra Netflix show episode. Combat your anxiety by laughing at funny animal videos or listening to a meditation soundtrack.
5. Hydrate! Our hunger and thirst mechanisms are similar—and easily confused. To calculate your hydration need, divide your body weight by two and drink that many ounces of fluid. Example: 250 pounds = 125 ounces of fluids. Minimize caloric beverages and experiment with flavored waters. Carry a bottle of water with you throughout the day.
6. Honor your preferences. Nothing is worse than trying to eat healthy when you really want a cookie. Instead of a cookie, you eat an apple first. Unfortunately, that urge wasn’t satisfied, so you move on to eat a yogurt. But the cookie looms large. Don’t go all in and hurriedly down five cookies in a row. Honoring your preference doesn’t equal throwing balanced eating out the window. Balance variety and moderation to fuel your body properly.
Would any of the tips above be beneficial for you? Keep in mind, you are more than a number on a scale. The success of a medication may outweigh the risk of five additional pounds.
Co-author: Kim George, MS, RD, LD
