The main reason is that medications can affect our appetite. My medication makes me crave sweets like never before. A woman I met in my bipolar support group had just been diagnosed with the disorder and subsequently put on a mood stabilizing drug. Within a matter of weeks she had gained 20 pounds. The weight didn’t just suddenly appear. It happened because this woman couldn’t stop her cravings for donuts.
Another cause for weight gain is leading a sedentary lifestyle. I had to go on disability several years ago because I was too sick to work. When there’s suddenly not much to do in your life, it’s easy to end up sitting in front of the TV and snacking all day. Or worse, spending your time in a depressed state and can’t even get out of bed.
My first major weight gain was seven years ago. I was prescribed an anti-psychotic medication to help with sleep. I got a great night’s sleep, but I also gained almost 50 pounds. I told my doctor I needed to get off the medication because my self-esteem had plummeted and I was feeling more depressed because of it.
My Experience Losing Weight On Bipolar Meds
I was desperate to lose the weight. Even though it was expensive, I decided to join a pre-packaged food weight loss program. I was working at the time so was able to afford it.
In four months, I was able to lose all the weight I had gained and got off the program. I was taught how to eat right and make better food choices. I kept the weight off for several years.
Then mania took hold and I again found myself on a mood stabilizing drug that causes weight gain. Forty extra pounds made its way back to me. I knew how to eat right. I was just too vulnerable to other factors. And there was no way I could get off this medication. I’ve been able to experience some stability lately because of it and I decided it was time I take control.
Bipolar Disorder, Medication, And Weight Management—goodbye For Good, Extra Pounds!
I can’t afford a weight loss program so I decided to use what I know. In the past three weeks, I’ve lost ten pounds.
Basically I am counting calories all day and choosing foods that fill me. Protein is key. I eat six times a day.
Breakfast – Special K bacon, egg, cheese frozen breakfast sandwich, 250 calories. Small glass of Tropicana 50 percent less sugar orange juice.
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Dinner – Sometimes I’ll eat a frozen Lean Cuisine or Weight Watchers meal, but mostly I eat what my family is eating, I just eat a lot less. We grilled hamburgers last night and I ate half a hamburger with a small amount of potatoes. It seems like it would starve you, but as you go along, your stomach adjusts to the smaller amount of food.
Evening Snack – yogurt or a 100 calorie snack. The 100 calorie bag of microwave popcorn actually gives you quite a bit.
I won’t lie to you. When I first started it was very difficult and I wanted to eat chocolate and potato chips instead of a banana. But then I looked at pictures of myself at the weight where I felt best and decided that’s what I wanted more. I keep those pictures in my bathroom to remind me.
Bipolar Disorder Medication Guide
I also stopped drinking diet soda. It actually makes you crave calories. And I’m staying away from my favorite pumpkin spice latte at the coffee shop. It could be my lunch and dinner for all the calories it has.
I’ve been forcing myself to move more too. I love riding my bike and I’ve been doing it as often as I can while the weather is still nice. I went out to dinner the other night with my family at my favorite Italian restaurant. I made sure to fit in a bike ride that day to counter the extra calories. I only ate half my dinner and saved the rest. I was completely satisfied.
I must say it’s important to talk with your doctor first before adjusting your diet. Some mood stabilizing drugs are more effective when taken with food and sodium levels sometimes need to be monitored. Strenuous exercise also needs to be approved by your doctor.
Lithium Weight Gain
To learn more about healthy eating and bipolar disorder, read the Supportive Nutrition chapter in our book, Healthy Living with Bipolar Disorder.
Subscribe to our My Support Newsletter and receive messages of hope and management tips through our blogs and webinars, research updates, also learn about upcoming events, and more!The more complicated answer involves looking at genetic predispositions, because gaining weight is highly individualized. Whether your treatment for bipolar disorder will cause you to gain weight depends heavily on the type of medication you take and how it interacts with your body. For example, the size of your thighs may
Grow while on one drug, but not on another, even if the second drug is associated with weight gain in other people.
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The medications that are used to treat bipolar disorder are mood stabilizers, antidepressants, antipsychotics, and antidepressant-antipsychotics. Some of these medications are also anticonvulsants.
No one knows for sure why these medications cause weight gain. Research is still being done on these pills. However, scientists suspect that antidepressants and antipsychotics may trigger food cravings and increase the appetite. The drugs may also slow your metabolism, increase blood sugar, and cause diabetes-like symptoms. The mood stabilizer lithium is also likely to destroy your thyroid, which is part of the reason psychiatrists monitor blood draws every three months or so.
A mood stabilizer is just that: a medication used to steady your mood. These medications help manage the extreme highs of mania and extreme lows of depression. A mood stabilizer also prevents the reoccurrence of these manic and depressive episodes. Gains of 20 to 35 pounds are not uncommon when taking these drugs, especially lithium.
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According to the Mayo Clinic, mood stabilizers are the most likely culprits when it comes to packing on the pounds, even more than other drugs like antidepressants. You will probably gain weight on them. Lithium, valproic acid (Depakene), divalproex sodium (Depakote), and carbamazepine (Tegretol) all may increase the risk of weight gain.
Antipsychotics are another class of medications that treat bipolar disorder, preventing psychotic symptoms like hallucinations and delusions. Antipsychotics that are associated with weight gain include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), and asenapine (Saphris).
Antipsychotics that are less likely to cause weight gain are cariprazine (Vraylar), lurasidone (Latuda), ziprasidone (Geodon), and aripiprazole (Abilify). Whether these latter medications make you gain weight is highly dependent on the individual person, though these are associated with less weight gain than the others.
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Antidepressants like tricyclics–like Elavil and Tofranil–and monoamine oxidase inhibitors (MAOIs)–like Parnate and Nardil–tend to cause patients to gain weight with both long-term and short-term use.
Other antidepressant medications may also have weight gain as a side effect. Selective serotonin reuptake inhibitors (SSRIs) are a class of medications that affect the brain’s ability to process serotonin, a feel-good chemical. Escitalopram (Lexapro), paroxetine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft) are all members of this class that increase the risk of weight gain. These SSRIs are the most risky antidepressants when it comes to weight gain, and patients report gaining more on them than on other antidepressants.
The antidepressants venlafaxine (Effexor) and nefazodone (Serzone) are associated with the least weight gain, whereas bupropion (Wellbutrin) is actually associated with weight loss.
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Antidepressant-antipsychotic combination medications both treat depression and stabilize moods. The medication Symbyax combines the antidepressant fluoxetine (Prosac) and the antipsychotic olanzapine and is associated with weight gain. Another combination medication, perphenazine/amitriptyline, also lists weight gain as a side effect. There are no weight-neutral combination medications.
Weight gain from bipolar medication use is a very common problem. Many of these drugs cause weight gain. As many as 25 percent of people report gaining some weight on antidepressants, and some people gain up to 100 pounds or more. I personally gained over 70 pounds on a combination of lithium and Depakote over a period of three-to-five years, weight which I have yet to shed.
But I still think that taking my medication was worth the weight gained. As I told my psychiatrist in the mental hospital when I was separated from my newborn, I didn’t mind gaining a few pounds if I could just get my sanity back and be reunited with my baby. While I gained more than I thought I would–and the weight has been stubborn to remove–I would still choose the medication if I had to make the decision over again. Lithium saved my life; Depakote saved my sanity. Gaining weight was an unfortunate side effect, but one as worth it by all means.
Can Mania Cause Weight Loss Or Weight Gain?
If you’re distressed about this side effect, talk to your doctors about the risk of weight gain associated with the medications you’re taking. Your doctor might consider changing the dosage amount or the medication you’re taking. Lifestyle changes might also help, though that’s less likely. Still, try to get some exercise to see if it helps. (For a post on how to work out with kids, click here.) And, of course, eat
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