How Can Medications "Make" You Gain Weight?

Lofteren

Many neurological medications (including antidepressants) increase impulsive behaviors. For some people this is sexual promiscuity, gambling, smoking cigarettes, using illicit drugs, etc... and for others that means eating impulsively. I have had patients tell me that they started taking a certain medication and that they immediately gained 100lbs which I think is bullshnizzy. There has to be some accountability for ones' actions; however, I understand how some drugs could make maintaining or losing weight more difficult.

Iwishyouwell

Actually it was THEM that ate & got overweight, not the pills that made them do it. The pills made them hungry, but did not make them eat more.... the pills did not say EAT OR I'LL STOP WORKING or EAT OR I'LL KILL YOU.

THEY made the choice to eat more. People have to stop blaming other things.

I agree with you in the same way that I agree with the other poster who talked about some women blaming pregnancy for excessive, obscene weight gain. I'm a firm believer that you need to own whatever goes into your mouth. It's the same way that I gained a ton of weight when my mother unexpectedly passed away 4 years ago. I stopped caring about my weight loss and overate in light of that tragedy, but my mother's death didn't "make" me overeat. It gets under my skin when people say that stress, loss of a loved one, a firing, whatever, "made" them gain weight. No your response to overeat made you gain weight. Own it. Doesn't mean you have to judge it, or even make another decision, but at least own it. If you can own that your choices put it on, you can own that your choices have the power to strip it off.

Having said that Neandermagnon brings up an EXCELLENT point regarding people who managed their weight naturally, using reliable hunger signals. For the person who has never had a weight problem, never needed to regulate their calories, a medication increasing their appetite and thus leading them down a road of overeating makes sense. After all only those of us with dieting experience and weight issues, real or imagined, would think it natural to modify our intake in opposition of hunger as a response to an increase in appetite. For people who have always relied on hunger cues, and never dieted, they aren't even in the frame of mind to think those once reliable cues are now sabotaging hem.


Thanks everyone for your thoughts. I've wondered about this topic for a long time and have found very little info on the "why" behind the weight gain.

albayin

I have never been pregnant so I can't speak for that. But I think "blaming" it for weight gain is fine as long as we don't just sit there doing nothing about it.

I like to blame my genes for being chubby and "big boned" but I have never stopped trying. I am frustrated, yet but I know if I stop, only worse things can happen.

squishycatmew

This has always baffled me. When people claim a drug(s) "made" them gain weight does the drug actually interact with your physiology in a way that begins to cancel out the laws of thermodynamics or does it increase your appetite to such a ravenous extreme that avoiding over consumption is just more difficult?

there are quite a few people who've never been obese because they have always had a good natural ability for portion control, i.e. they eat when they're hungry and stop eating when they're full. Doing this has worked for them for their whole life... so if they take a medication that increases appetite, they will just carry on doing exactly what's kept them at a healthy weight all their life, and eaten when they're hungry and stopped eating when they're full... and the result will be that they'll gain weight, because they are now overeating.

People don't get much warning about this side effect, and without actually counting calories (never needed to do that before if they've always been a healthy weight before) it's hard to know when to stop eating if you're on medication like that........ so yes people do get fat as a direct result of taking medication that increases the appetite.............. it's totally understandable why someone in this situation would think that the pills are making them fat... because in a sense they are. The pills have screwed up the one thing - good appetite regulation - that's kept them a healthy weight up until that point.

Its really easy to look at people in this situation and say "well you overate" - yep they did. And they never overate before they were on that particular medication, so really, I think they can blame the pills. That doesn't mean they can't remedy the situation with some calorie counting... but it was the pills that caused them to overeat and get fat.

Actually it was THEM that ate & got overweight, not the pills that made them do it. The pills made them hungry, but did not make them eat more.... the pills did not say EAT OR I'LL STOP WORKING or EAT OR I'LL KILL YOU.

THEY made the choice to eat more. People have to stop blaming other things.

How could they know they were overeating if they just carried on eating when they're hungry and stopping when they're full though? People who stay a healthy weight their whole lives don't diet or count calories... all they do is that... eat when they're hungry and stop eating when they're full......... but if you do that, unknowingly, while on pills which are increasing your appetite, you end up overeating, even though you don't know that they are until after you gained a bunch of weight, how can anyone do anything about that until they've already gained the weight?

ETA: also, just because something isn't someone's fault, it doesn't mean they can't take responsibility for it and make changes to stop it continuing. You don't have to blame yourself for sh** that wasn't your fault to be able to deal with it... I said in the post that it can be remedied with calorie counting, but you can't blame someone for gaining weight in circumstances where they had no way of knowing that they were in danger of it happening.... and not blaming themselves doesn't stop them from being able to remedy the situation. Blaming yourself for stuff that wasn't your fault is actually bad for mental health... being rational and knowing that sometimes sh** happens that's not your fault but you still have to deal with it anyway, and also knowing that other times sh** happens because you brought it on yourself and have to deal with it... a wise person knows the difference and avoids beating themselves up over stuff that wasn't their fault while still taking whatever steps are necessary to fix it....

Yes, exactly. Personal responsibility is great - if you want to lose weight, or exercise more, or improve your diet or your health, you have to take responsibility for that, and if you don't do what you said you would, and it subsequently doesn't work, then that's entirely on you. But there's nothing to be gained by taking personal *blame* for things which may have not been fully under your control (like weight gain precipitated by an unexpected increase in appetite due to medication) - just because you're the one choosing to put food in your mouth doesn't mean that you magically know that continuing to do what you've always done, eating when hungry and stopping when full, is suddenly going to stop working for you. "Blame" is pointless (and also implies that gaining weight/being overweight is somehow morally wrong, which is ridiculous).

Lofteren

This has always baffled me. When people claim a drug(s) "made" them gain weight does the drug actually interact with your physiology in a way that begins to cancel out the laws of thermodynamics or does it increase your appetite to such a ravenous extreme that avoiding over consumption is just more difficult?

there are quite a few people who've never been obese because they have always had a good natural ability for portion control, i.e. they eat when they're hungry and stop eating when they're full. Doing this has worked for them for their whole life... so if they take a medication that increases appetite, they will just carry on doing exactly what's kept them at a healthy weight all their life, and eaten when they're hungry and stopped eating when they're full... and the result will be that they'll gain weight, because they are now overeating.

People don't get much warning about this side effect, and without actually counting calories (never needed to do that before if they've always been a healthy weight before) it's hard to know when to stop eating if you're on medication like that........ so yes people do get fat as a direct result of taking medication that increases the appetite.............. it's totally understandable why someone in this situation would think that the pills are making them fat... because in a sense they are. The pills have screwed up the one thing - good appetite regulation - that's kept them a healthy weight up until that point.

Its really easy to look at people in this situation and say "well you overate" - yep they did. And they never overate before they were on that particular medication, so really, I think they can blame the pills. That doesn't mean they can't remedy the situation with some calorie counting... but it was the pills that caused them to overeat and get fat.

Actually it was THEM that ate & got overweight, not the pills that made them do it. The pills made them hungry, but did not make them eat more.... the pills did not say EAT OR I'LL STOP WORKING or EAT OR I'LL KILL YOU.

THEY made the choice to eat more. People have to stop blaming other things.

How could they know they were overeating if they just carried on eating when they're hungry and stopping when they're full though? People who stay a healthy weight their whole lives don't diet or count calories... all they do is that... eat when they're hungry and stop eating when they're full......... but if you do that, unknowingly, while on pills which are increasing your appetite, you end up overeating, even though you don't know that they are until after you gained a bunch of weight, how can anyone do anything about that until they've already gained the weight?

ETA: also, just because something isn't someone's fault, it doesn't mean they can't take responsibility for it and make changes to stop it continuing. You don't have to blame yourself for sh** that wasn't your fault to be able to deal with it... I said in the post that it can be remedied with calorie counting, but you can't blame someone for gaining weight in circumstances where they had no way of knowing that they were in danger of it happening.... and not blaming themselves doesn't stop them from being able to remedy the situation. Blaming yourself for stuff that wasn't your fault is actually bad for mental health... being rational and knowing that sometimes sh** happens that's not your fault but you still have to deal with it anyway, and also knowing that other times sh** happens because you brought it on yourself and have to deal with it... a wise person knows the difference and avoids beating themselves up over stuff that wasn't their fault while still taking whatever steps are necessary to fix it....

Yes, exactly. Personal responsibility is great - if you want to lose weight, or exercise more, or improve your diet or your health, you have to take responsibility for that, and if you don't do what you said you would, and it subsequently doesn't work, then that's entirely on you. But there's nothing to be gained by taking personal *blame* for things which may have not been fully under your control (like weight gain precipitated by an unexpected increase in appetite due to medication) - just because you're the one choosing to put food in your mouth doesn't mean that you magically know that continuing to do what you've always done, eating when hungry and stopping when full, is suddenly going to stop working for you. "Blame" is pointless (and also implies that gaining weight/being overweight is somehow morally wrong, which is ridiculous).

You have really twisted around the meaning of the previous statements. No one said that being overweight is immoral and "blaming" is not actually pointless, only the way that you express it is. By identifying the cause of weight gain (i.e. blaming) you can correctly address the issue and by placing the responsibility of your weight gain on the medication you are just removing the "blame" from yourself. That blame is needed for one to make a change for the better.

squishycatmew

This has always baffled me. When people claim a drug(s) "made" them gain weight does the drug actually interact with your physiology in a way that begins to cancel out the laws of thermodynamics or does it increase your appetite to such a ravenous extreme that avoiding over consumption is just more difficult?

there are quite a few people who've never been obese because they have always had a good natural ability for portion control, i.e. they eat when they're hungry and stop eating when they're full. Doing this has worked for them for their whole life... so if they take a medication that increases appetite, they will just carry on doing exactly what's kept them at a healthy weight all their life, and eaten when they're hungry and stopped eating when they're full... and the result will be that they'll gain weight, because they are now overeating.

People don't get much warning about this side effect, and without actually counting calories (never needed to do that before if they've always been a healthy weight before) it's hard to know when to stop eating if you're on medication like that........ so yes people do get fat as a direct result of taking medication that increases the appetite.............. it's totally understandable why someone in this situation would think that the pills are making them fat... because in a sense they are. The pills have screwed up the one thing - good appetite regulation - that's kept them a healthy weight up until that point.

Its really easy to look at people in this situation and say "well you overate" - yep they did. And they never overate before they were on that particular medication, so really, I think they can blame the pills. That doesn't mean they can't remedy the situation with some calorie counting... but it was the pills that caused them to overeat and get fat.

Actually it was THEM that ate & got overweight, not the pills that made them do it. The pills made them hungry, but did not make them eat more.... the pills did not say EAT OR I'LL STOP WORKING or EAT OR I'LL KILL YOU.

THEY made the choice to eat more. People have to stop blaming other things.

How could they know they were overeating if they just carried on eating when they're hungry and stopping when they're full though? People who stay a healthy weight their whole lives don't diet or count calories... all they do is that... eat when they're hungry and stop eating when they're full......... but if you do that, unknowingly, while on pills which are increasing your appetite, you end up overeating, even though you don't know that they are until after you gained a bunch of weight, how can anyone do anything about that until they've already gained the weight?

ETA: also, just because something isn't someone's fault, it doesn't mean they can't take responsibility for it and make changes to stop it continuing. You don't have to blame yourself for sh** that wasn't your fault to be able to deal with it... I said in the post that it can be remedied with calorie counting, but you can't blame someone for gaining weight in circumstances where they had no way of knowing that they were in danger of it happening.... and not blaming themselves doesn't stop them from being able to remedy the situation. Blaming yourself for stuff that wasn't your fault is actually bad for mental health... being rational and knowing that sometimes sh** happens that's not your fault but you still have to deal with it anyway, and also knowing that other times sh** happens because you brought it on yourself and have to deal with it... a wise person knows the difference and avoids beating themselves up over stuff that wasn't their fault while still taking whatever steps are necessary to fix it....

Yes, exactly. Personal responsibility is great - if you want to lose weight, or exercise more, or improve your diet or your health, you have to take responsibility for that, and if you don't do what you said you would, and it subsequently doesn't work, then that's entirely on you. But there's nothing to be gained by taking personal *blame* for things which may have not been fully under your control (like weight gain precipitated by an unexpected increase in appetite due to medication) - just because you're the one choosing to put food in your mouth doesn't mean that you magically know that continuing to do what you've always done, eating when hungry and stopping when full, is suddenly going to stop working for you. "Blame" is pointless (and also implies that gaining weight/being overweight is somehow morally wrong, which is ridiculous).

You have really twisted around the meaning of the previous statements. No one said that being overweight is immoral and "blaming" is not actually pointless, only the way that you express it is. By identifying the cause of weight gain (i.e. blaming) you can correctly address the issue and by placing the responsibility of your weight gain on the medication you are just removing the "blame" from yourself. That blame is needed for one to make a change for the better.

…do you actually know what the word "blame" means? It's not "identifying the cause" (which in the case at hand would, in fact, be the medication, even if the immediate cause is overeating).

oedipa_maas

Oh man, this thread. I feel like I'm taking crazy pills. Wait, I AM taking crazy pills!

Anyway. I've been on a variety of psychotropics and some definitely put 10-20 lbs on me, much of which was lost when I was taken off the medication in question (e.g., Paxil, Seroquel). With very little effort you can pull up dozens of medical studies on the NIH web site that support weight gain as a real phenomena/side effect. I'm on 5 meds for my bipolar disorder, including an anti-psychotic, and luckily I haven't experienced weight gain. Out of all the myriad psychiatrists I've seen in my life, not a single one has denied that certain medications can cause weight gain. Instead, they've worked with me to tweak my meds and come up with better solutions so that ALL of my health issuess are being addressed and taken care of.

Just because you don't believe something doesn't make it illegitimate.

Iwishyouwell

"Blame" is pointless (and also implies that gaining weight/being overweight is somehow morally wrong, which is ridiculous).

I think that comes down to one's personal view of obesity, no? I loathed being fat, it's one of the worst things that ever happened to me due to the detrimental ways I let it affect my self perception ever since childhood. For me being gluttonous, and the resulting obesity, absolutely was "morally wrong". God bless people who can be neutral about their fatness, and I'm not going to push my views on anyone else. But it's not ridiculous for me personally to view overweightness/obesity as quite wrong.

thisistrished

i take tablets that increase your appetite and can cause weight gain. i think part of the issue for me was i saw it as an excuse for me gaining a few lbs here and there when i was down. now things are back on track and i have a new determination and the lbs are falling. sometime i do think it is a state of mind.

amberj32

I'll go one better. I always think it's at least a little silly when I read a woman say something like, "I gained 80lbs because I was pregnant." Hmmm...let's think this through. You're baby only weighed how much when he/she was born?

Before all the ladies out there get angry, I know, I know. Hormones, stress, etc. Life happens. Hey, I got all the way up to 365lbs without even getting pregnant. Not judging. I just think in some way it helps when you're honest and at least take some of the blame by saying, "I went overboard a little."

Same for medications. My two cents.

I agree. And no offense taken. I only gained 22 pounds when I was pregnant but I was also only 17.

OP - I think there are many reasons why and how medications make you gain weight. I do know before I was diagnosed with type 2 diabetes I was ravenously hungry all the time, no matter what I ate! Now that I'm on diabetes medication I have a more normal appetite.

Iwishyouwell

Oh man, this thread. I feel like I'm taking crazy pills. Wait, I AM taking crazy pills!

Anyway. I've been on a variety of psychotropics and some definitely put 10-20 lbs on me, much of which was lost when I was taken off the medication in question (e.g., Paxil, Seroquel). With very little effort you can pull up dozens of medical studies on the NIH web site that support weight gain as a real phenomena/side effect. I'm on 5 meds for my bipolar disorder, including an anti-psychotic, and luckily I haven't experienced weight gain. Out of all the myriad psychiatrists I've seen in my life, not a single one has denied that certain medications can cause weight gain. Instead, they've worked with me to tweak my meds and come up with better solutions so that ALL of my health issuess are being addressed and taken care of.

Just because you don't believe something doesn't make it illegitimate.

I don't think anyone is denying that certain medications can have an enormous impact on weight. I know I certainly am open to all answers and would never say that actual weight gain from medication is "illegitimate".

But the question is do these medications actually FORCE your body to gain fat. As in if your TDEE is, for example, 2200 a day and you eat 2200 calories a day, or less, will the medications still cause fat gain (as opposed to weight from water retention)? Or is the major contributor a radical change in appetite that leads easily to over consumption, and thus fat gain?

Kalikel

I'll go one better. I always think it's at least a little silly when I read a woman say something like, "I gained 80lbs because I was pregnant." Hmmm...let's think this through. You're baby only weighed how much when he/she was born?

Before all the ladies out there get angry, I know, I know. Hormones, stress, etc. Life happens. Hey, I got all the way up to 365lbs without even getting pregnant. Not judging. I just think in some way it helps when you're honest and at least take some of the blame by saying, "I went overboard a little."

Same for medications. My two cents.

Youre always so funny! But OMG with the "Before all the ladies out there..." !!

Too late, bud!

When you grow and carry a person and everything required to support that person inside YOUR body, then we can hear it. We can't hear it when you're all weepy over some old Little House rerun that has tears streaming down your face...or some commercial where the dad walks his daughter down the aisle. Not even when you're mad, for no real reason except that your husband walked in the room and you suddenly realize you liked it when he wasn't there and the walls need a different color paint and well, everything just sucks and this house isn't good enough to bring a baby into it!

First, there must be...

Nausea a lot to the point that you're never sure if you're really going to vomit or not, vomit at inconvenient times that you really tried to get to the stall to expel but were a couple feet short so now it's all over in the movie theater bathroom, heartburn so bad there are bottles of Tums all over the house, in the car and at work, you have swollen EVERYTHING, stupid ugly clothes, can't tie your damn shoes (which isn't so bad since they don't fit your swollen feet, anyway), tiredness out of nowhere for no reason since you slept and only woke up uncomfortable twice, shooting pains shrieking down you leg and then, THEN, to top it aaaaalllll off, you get the joy and privilege of giving birth, which I'm sure you've heard isn't everyone's favorite thing to do and leaves you with two gifts that keep on giving, in the form of hemorrhoids and a leaky bladder.

When you've done all of that, we can hear from you about how, since the person that you PUSHED OUT OF YOUR BODY only weighed ten little pounds, how the weight gain was nothing but the pregnant woman being piggy and using the excuse of pregnancy to indulge herself.

God really should've made it a toss up over who, exactly, would have to be pregnant.

No, I didn't gain eighty pounds, but it was pregnant young. I gained more than ten, that's for sure!!

(But usually you're just funny.

SomeNights246

I'll go one better. I always think it's at least a little silly when I read a woman say something like, "I gained 80lbs because I was pregnant." Hmmm...let's think this through. You're baby only weighed how much when he/she was born?

Before all the ladies out there get angry, I know, I know. Hormones, stress, etc. Life happens. Hey, I got all the way up to 365lbs without even getting pregnant. Not judging. I just think in some way it helps when you're honest and at least take some of the blame by saying, "I went overboard a little."

Same for medications. My two cents.

women are supposed to gain a certain amount of fat when pregnant, which is to support breastfeeding. Some women lose that fat easily while breastfeeding - others don't lose it until they stop breastfeeding. Others don't lose it at all, or need to diet in order to lose it. The body basically becomes a life support machine for another human for 9 months and prepares to be the sole source of nutrition for that baby for 6-9 months, and a major source of nutrition for a further 4-5 years (that's what the body's expecting to do; we evolved without formula milk or baby foods or any kind of dairy products, so babies had to be breastfed until age about 5-6)

There are charts available from doctors and midwives that advise women how much they should gain through pregnancy, and it's a lot more than the 7lb that the baby weighs on average.

Excessive weight gain during pregnancy is a problem though and can increase the risk of complications in pregnancy and childbirth so I don't disagree with you about the general point you're making, I'm just saying that the amount of weight a healthy woman gains in a healthy pregnancy is actually quite a bit more than the weight of the baby.

I like you. A lot.

This post and your first one are what I came in here to say.

But you said them much better than I would have been able to.

hookilau

I'm not sure why people keep obsessing on this "law of thermodynamics" junk. Yes, I know what it is. I mostly think people say it as an attempt to sound smart but lets be honest. The human bodies thermodynamics is an extremely complicated system dictated by thousands of enzymes doing their jobs. It is not beyond reason to think that a drug may influence an enzyme or set of enzymes (especially in the case of antidepressants) that may alter the metabolic system of that person.

Thank you for saying this, I couldn't agree more.

oedipa_maas

Oh man, this thread. I feel like I'm taking crazy pills. Wait, I AM taking crazy pills!

Anyway. I've been on a variety of psychotropics and some definitely put 10-20 lbs on me, much of which was lost when I was taken off the medication in question (e.g., Paxil, Seroquel). With very little effort you can pull up dozens of medical studies on the NIH web site that support weight gain as a real phenomena/side effect. I'm on 5 meds for my bipolar disorder, including an anti-psychotic, and luckily I haven't experienced weight gain. Out of all the myriad psychiatrists I've seen in my life, not a single one has denied that certain medications can cause weight gain. Instead, they've worked with me to tweak my meds and come up with better solutions so that ALL of my health issuess are being addressed and taken care of.

Just because you don't believe something doesn't make it illegitimate.

I don't think anyone is denying that certain medications can have an enormous impact on weight. I know I certainly am open to all answers and would never say that actual weight gain from medication is "illegitimate".

But the question is do these medications actually FORCE your body to gain fat. As in if your TDEE is, for example, 2200 a day and you eat 2200 calories a day, or less, will the medications still cause fat gain (as opposed to weight from water retention)? Or is the major contributor a radical change in appetite that leads easily to over consumption, and thus fat gain?

That's a good question. I understand a little better what you meant. I'm curious now. I think I might ask my shrink about it!

Iwishyouwell

If you get an answer from the shrink, please post!