Over 2/3 of the US population is overweight or obese, yet many of the medications used to treat obesity-related medical conditions such as diabetes, hypertension, and depression can actually cause weight gain – even several pounds or more a month.
It can be the drug itself or side effects from the drug. Some medications can stimulate appetite, and as a result you eat more. Drugs that trigger increases in appetite may work in the brain and affect your satiety (fullness). Others may affect how your body absorbs and stores glucose, which can lead to fat deposits in the midsection of your body and affect insulin resistance. Some drugs cause fluid retention. Some drugs cause calories to be burned slower by changing your body’s metabolism. Other drugs cause fatigue and shortness of breath making it difficult for people to exercise. Weight gain may increase the chance for high blood pressure, high cholesterol, diabetes, and sleep apnea. It is often difficult to distinguish between weight gain from a drug and weight gain from other reasons, like diet or lack of exercise, because it can be a slow process. For many drugs, it is not known exactly what causes the weight gain.
Both patients and doctors need to be more aware of possible weight effects from medications. “One of the first things I review in initial weight loss consultations are medications,” states Obesity Medicine Specialist Dr. Theresa Garza. “I ask them how long they’ve been taking the medication(s), and if they’ve noticed any weight related changes.”
The effects aren’t the same for everybody, though. One person might gain 15-25 pounds on one drug. Another might not gain anything. Even if you suspect you are gaining weight from a medication, do not lower the dose or stop taking the medication without speaking with a healthcare professional first.
Common medications that are weight-positive (cause weight gain) include (but are not limited to):
- Diabetes – Insulin, Glyburide, Glipizide, Actos
- Anti-depressants – Celexa, Lexapro, Remeron, Zoloft, Paxil, Amitriptyline
- Mood stabilizers – Lithium, Zyprexa, Seroquel, Risperdal, Clozaril
- Seizure/migraines – Depakote, Lyrica, Neurontin
- Blood pressure – Metoprolol, Propranolol, Atenolol (older B-blockers)
- Antihistamines – Zyrtec, Benadryl, Allegra
- Steroid Hormones– Corticosteroids (prednisone), Depo-injections
Better alternatives (medications that are weight-neutral or promote weight loss) include (but are not limited to):
- Diabetes – Metformin, Victoza, Byetta, Januvia
- Anti-depressants – Wellbutrin
- Mood stabilizers – Geodon
- Seizure/migraines – Topamax, Zonegran, Lamictal
- Blood pressure – ACE inhibitors, Angiotension II Receptor Blockers, Ca2+ Channel Blockers
- Allergies – Nasal spray
- Steroid Hormones – Avoid corticosteroids (use NSAIDs if possible), low-hormone contraception
What Can You Do?
- Ask – when you are prescribed a new medication, ask if the drug is known to cause weight gain and express your concern for weight gain. Discuss any alternatives that are less likely to cause weight gain.
- Be aware – if you have been gaining weight after starting a new medication, ask your doctor. Most weight gain is seen early on – within six months of starting. However, sometimes it can be slow and you don’t realize it’s medication-related weight gain until several months later. Be keen with your body’s eating, activity, and response to medication.
- Be smart – know about medications prescribed for your medical condition(s) that may cause weight gain. Research online. While some medications don’t cause weight gain, they may make it more difficult to lose excess weight.
- To offset weight gain or to help work off excess weight, consider keeping a food diary and activity log. Become a mindful eater (avoid junk food, soda, and sweets). Increase activity. Aim for increasing protein and lowering carb intake.
Dr. Theresa Garza is a Dallas Weight Loss Specialist who is Board-Certified by the American Board of Obesity Medicine and the American Board of Family Medicine. She has been in private practice for weight management for nine years. Dr. Garza specializes in non-surgical weight loss, weight management programs, and metabolism testing. Dr. Garza has been named Top10MD – an honor 1-in-3 doctors succeed with in the United States. To schedule a consultation with Dr. Garza, click on her profile or call her office at 972.303.8955.