should i switch to maintenance to combat medication?

cosmiqrecovery · January 2016

i'm not sure if this is even the right place to be asking, but i'm in a very tough spot right now and i could use advice.

i've been in the process of a lean bulk for about 5 months now. i've been gaining about a pound a month pretty consistently (102 -> 107). since i'm also recovering from roughly a decade with binge-purge type anorexia as well, i'm trying to focus less on precise measurement of everything i eat and more on increasing physical strength. that's been a huge motivator in my recovery.

here's where it's getting 10 levels harder.

i've been recently diagnosed with schizoaffective disorder by my therapist, and he's sending me to a psychiatrist to be put on anti-psychotics. i don't put any kind of medication in me without doing my research, and between the people i've talked to on forums and the things i've read, i'm pretty much doomed to gain weight. a lot of weight.

it's been a battle to even get myself to seek out any of his referrals knowing this. i'm really becoming aware of how flimsy my recovery really is. recovering from the eating disorder was entirely self-started and maintained. professional treatment has been out of the question because of money. the only reason i'm able to see my therapist is that he's fascinated by my case and does it for free, and i'm in the admissions process for using low cost behavioral health center services in the city. even with a full time job i still fall well below the poverty line.

so, backstory out of the way, let's say i do get put on the APs. most of the ones on my insurance seem to list "increased appetite; weight gain" as an almost-guaranteed side effect. should i attempt to cut back to maintenance calories to offset the damage it might do? or should i just keep bulking, go 200% harder at the gym and hope that going in with a good amount of muscle mass will offset any overeating? i feel like i'd probably make myself sick backing out cold turkey if i gained too much too fast. lived through withdrawals before, would not like to relive the experience. i'm also open to measuring everything again but i have a bad feeling it would become obsessive again.

i'd be interested in hearing anyone's experiences with medications and weight gain. gaining seems to be a universal truth among the people i talk to on more mental health related boards.

_runnerbean_ · January 2016

I'm a mental health pharmacist. A large number of antipsychotics do list weight gain as a side effect. However this is due to an increase in appetite. If you eat the same amount as you used to you will not gain weight. I have seen some people intentionally lose weight while prescribed some of the "worst offender" medicines. Being aware of this potential side effect has put you in a great position to eat well once you start treatment. Ask your psychiatrist about this at your appointment as they can chose something that has a lower potential for appetite increase. Hope you feel better soon.

LKArgh · January 2016

cosmiqrecovery wrote: »

i'm not sure if this is even the right place to be asking, but i'm in a very tough spot right now and i could use advice.

i've been in the process of a lean bulk for about 5 months now. i've been gaining about a pound a month pretty consistently (102 -> 107). since i'm also recovering from roughly a decade with binge-purge type anorexia as well, i'm trying to focus less on precise measurement of everything i eat and more on increasing physical strength. that's been a huge motivator in my recovery.

here's where it's getting 10 levels harder.

i've been recently diagnosed with schizoaffective disorder by my therapist, and he's sending me to a psychiatrist to be put on anti-psychotics. i don't put any kind of medication in me without doing my research, and between the people i've talked to on forums and the things i've read, i'm pretty much doomed to gain weight. a lot of weight.

it's been a battle to even get myself to seek out any of his referrals knowing this. i'm really becoming aware of how flimsy my recovery really is. recovering from the eating disorder was entirely self-started and maintained. professional treatment has been out of the question because of money. the only reason i'm able to see my therapist is that he's fascinated by my case and does it for free, and i'm in the admissions process for using low cost behavioral health center services in the city. even with a full time job i still fall well below the poverty line.

so, backstory out of the way, let's say i do get put on the APs. most of the ones on my insurance seem to list "increased appetite; weight gain" as an almost-guaranteed side effect. should i attempt to cut back to maintenance calories to offset the damage it might do? or should i just keep bulking, go 200% harder at the gym and hope that going in with a good amount of muscle mass will offset any overeating? i feel like i'd probably make myself sick backing out cold turkey if i gained too much too fast. lived through withdrawals before, would not like to relive the experience. i'm also open to measuring everything again but i have a bad feeling it would become obsessive again.

i'd be interested in hearing anyone's experiences with medications and weight gain. gaining seems to be a universal truth among the people i talk to on more mental health related boards.

I am not a dr, but this is my personal experience from have more than one ill close relatives, and having been in support groups, discussed this with other patients, drs etc.
Schizophrenia and related illnesses are hard. If someone tells you you can skip pills, or not be in touch with your dr or experiment, they are lying. It is a nasty illness, and schizoaffective disroder is even worst. What you are facing is not going to be easy. I am not saying this to scare you, I am telling you that without meds, there will come a day when you will be a totally different and extremely miserable person. If able to survive at all. Being alive, and functioning and being able to find something positive in life is by far more important than any weight gain that might happen.
Furthermore, often uncontrollable appetite comes with the illness for many people, not with medication. They typical untreated schizophrenic according to every dr I have talked with has an addiction. Often this addiction is food. Many of the people you see gaining weight and experimenting with their antipsychotics, they eat far more when actually not medicated. So, medication and controlling your illness, will also help you have a healthier relationship with food, do not worry about this.
Talk to your dr about your fears. And about your past. He/she can help you or refer you to a therapist to help you. Do not panic, you are not alone in worrying. The drs have seen all this before and know how to help.

cosmiqrecovery · January 2016

thank you both, i'll make sure i'm up front about my history with whoever i end up seeing. i wouldn't even be considering taking the referrals at all if i weren't already so much worse off than i've ever been. hopefully mindfulness will be enough for me to fight the hungries then!

Shells918 · January 2016

Being on similar meds I can tell you that it's a struggle but I am winning the battle. I do get the late night munchies but I drink sugar free hot cocoa when I need a sweet fix. I'm on a low carb dr monitored plan and I exercise a lot to help with weight loss. In 3 months I've lost 6.5 pounds but 19 inches. Would I like to lose faster? Of course, but my mental health is more important so I do everything I can to nurture my mind and my body. You can do it but it takes work.
Good luck.

kachedada · January 2016

I would suggest learning to control the portions you give yourself at meal times, also try low calorie snacks between meals. Most of this will depend on your schedule, but like runnerbean said, it's the increased appetite that will influence weight gain. Try talking to your psychiatrist about your concerns they should be able to help you find medications that will have less of an impact on your appetite.

should i switch to maintenance to combat medication?

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