Have medications ruined my metabolism?

Lynn_Nanos

I'm at my highest weight ever. I take prescribed abilify (aripiprazole) and prozac (fluoxetine). My goal is to lose 55 pounds. I don't know how much these medications are negatively affecting me. Anyone else struggling with medications that cause weight gain? It's not fair, as I feel like I have to try harder than the average person to lose weight. My age at 49 doesn't help either.

claireychn074

If you’re experiencing weight gain as a side effect of medication, you need to speak to your doctor. Some anti depressants can cause increased appetite but I believe the effects vary, so you need to speak to your doctor about whether these are the right drugs for you. Unfortunately sometimes the side effects have to be endured to get the benefits of medicine, but there might be gentler options for you. Good luck!

AnnPT77

Take heart, don't let yourself believe you're doomed before you even start! There are many people here (I'm one) who've lost lots of weight at older ages, or with health conditions (I'm severely hypothyroid, though medicated for it), or when taking drugs that reportedly can trigger weight gain (I used to be on one, but no longer am).

The blogosphere tends to greatly overstate our potential for "wrecking our metabolism" (usually so they can set us up to buy a cure from them ). There are things that can cause us to burn somewhat fewer calories, but most of them aren't strictly metabolism, and most of them (including some that are metabolism) are somewhat under our control to improve.

First, let's start with age. According to recent research the average person's metabolism doesn't change a lot in adulthood, 20s through 60 or so. (I lost 50+ pounds at 59-60, BTW, so I don't look at this as just some Pollyanna-ish theory.) Here's a key study:

https://pubmed.ncbi.nlm.nih.gov/34385400/

What does change for a lot of people as we age is our lifestyle, and the changes are so subtle and slow that we don't even notice. Simplistic cartoon of what I mean: Young people in our youth were playing frisbee and dancing at clubs for fun; doing physical jobs like waitstaff or warehouse; biking, walking, or skateboarding to get around; later chasing toddlers and digging gardens and remodeling to make a nice home; and so forth. Later in life, many of us transition to desk jobs; sedentary hobbies (or no time for hobbies); socializing at dinners and movies and such; having our own cars in the garage and gas money if we're lucky; empty nesting and enjoying the nice home we've built over the years.

Clearly, not all of those things are true for everyone, but some are true for most of us, I think. And the differences account for potentially quite a few hundreds of daily calorie burn. Research suggests a fidgety person can burn a couple of hundred calories more daily than a similar placid person. I'm not suggesting you fidget, but underscoring that the difference between, say, waitressing and a desk job can be a pretty big variable.

We can work on increasing daily life (non-exercise) movement, and there are ways to do that that are not time-consuming. Many MFP-ers share their strategies in this thread:

http://community.myfitnesspal.com/en/discussion/10610953/neat-improvement-strategies-to-improve-weight-loss/p1

On top of that, many of us become less active and therefore less fit as we age. Unless we do something to counter the effect, we lose muscle mass. That does affect metabolism, though only in a small way if we're talking about bodies at rest. But the loss of muscle mass also makes moving in daily life less easy and less fun, and can encourage us to even less activity and even more muscle loss - a bad down-spiral. Loss of muscle mass is a key factor in lower quality of life - worse health and functioning - as we age, too.

What to do about that is obvious: Work on improving strength, get good nutrition (especially but not exclusively protein) to reverse that course. It's a slow thing to add muscle mass, but very doable. Strength increase can be quite quick at first, though, and that's very useful in daily life!

When it comes to drug regimens and weight gain, in practice most drug-induced weight gain comes from one of the following mechanisms:

1. Drug induced fatigue: Tired, move less, burn fewer calories.
2. Water retention: Adds pounds on the scale, but isn't fat. Frustrating, though!
3. Appetite: Drug causes hunger/cravings, so we eat more.

Calorie counting can help, in the sense that counting calories carefully for 4-6 weeks will give you an idea what your true calorie needs are, so you can adjust accordingly.

In the bummer cases, that means you might need to eat somewhat fewer calories than the average to accomplish X amount of weight loss, but generally it isn't a *huge* difference. It can also help identify water retention issues (if you didn't eat enough calories to account for the gain, it can't be fat, so . . . .). Finally, calorie counting can help you realize that you're craving more calories than your body burns (darned body/drug!), and possibly also - via reviewing your food logs - figure out your best satiation strategies, even with the drug effect in the picture.

I'm not claiming any of this is a walk in the park, but it's worth realizing that a drug can't make you absorb more calories from a food than are actually in that food in total, so calorie counting with MFP can help find a path to weight management, perhaps, even with the drug in the picture.

I'm also not saying that this is going to feel fair, if it turns out you need fewer calories than average in order to lose weight. I get it. But again, the difference isn't likely to be huge. For myself, I don't like to focus on whether some unchangeable thing is fair or not. It doesn't help me move forward; for me, it helps keep me stuck, and focused on things that can't change. I try to tell myself that the only reason to think about obstacles is to strategize about how to get over, around, through, or otherwise past them . . . to focus on the things I can personally control or at least influence, in order to get to my goals.

You may find that your calorie needs are not as affected by your age or drug regimen as you anticipate. Or you may run your 4-6 week calorie level experiment, and find that you need to eat a little less, or add some exercise, or integrate more movement into your daily life in order to make progress. I'm pretty convinced, though, that if you commit yourself to moving forward, you can make progress . . . and that it'll be a very empowering feeling when you do.

Wishing you success!