PSA: Be Informed About the Drugs You're Putting In Your Body and How they May Affect your Weight

_Emma_Problema_
_Emma_Problema_ Posts: 261 Member
edited November 20 in Food and Nutrition
I just wanted to take a moment to remind people that it's important to thoroughly research the effects of the prescribed medications, supplements (yes, that includes your multivitamin and protein powder), and recreational drugs (yes, that includes alcohol and caffeine) on their body and on their weight. I don't want to scare anyone out of taking necessary medication and I'm definitely not of the opinion that drugs are universally bad (far from it!), but it's important to be informed, especially when Big Pharma rakes in major profits, recreational drug use is increasingly seen as a social necessity, and the FDA refuses to regulate the supplement industry.

1. Medications used to treat Mental Illness

As someone who struggles with major mental illness, I have spent a lot of time on what mentally ill people like to call the "med-go-round". Psychiatry is really a very new science and a lot of it is guess work and trial and error. About 1 in 6 people take a psychiatric medication, so I'm betting this affects quite a few people on MFP. I would recommend looking at published, peer-reviewed papers using sites like PubMed and asking your college-aged children, neighbors, summer interns, etc. for help accessing journals if you don't have access. Sites like crazymeds.net, which unfortunately seems to have gone through a site maintenance issue but seems to at least be kind of up and running, and drug forums can have useful information, although be wary of taking someone else's personal experience or claimed expertise as fact. Stanford's "What Meds?" and the material on the NIMH website are also good sources. Also, be aware of who is funding a particular study and what medical professional is giving out information because Big Pharma likes to play dirty.

From my own personal experience and my experience interacting with many people with mental illness and their loved ones as a volunteer at a major mental health advocacy organization, the effects of psych meds on your weight can be drastic. I was on Abilify, an antipsychotic that is used to treat a wide variety of mental illnesses, for about a year and put on a little over 50 pounds in that timeframe with most of it being gained in the first 3 months. That sounds extreme but it really isn't for a lot of people who have been on psych meds. I also thought I had done my homework and looked into Abilify. It was heavily marketed as being the only "weight-neutral" antipsychotic, or the only antipsychotic that didn't cause weight gain. I ignored the stories I'd heard about gaining weight on Abilify from people in the mental health community and wrote their stories off because I thought they must have just gained weight for other reasons and then blamed their meds. Last December, the drug company that sells Abilify paid a settlement of almost $20 million in response to lawsuits concerning their duplicitous marketing of Abilify, including their claim that weight gain was not a relevant side effect. Were there other factors that may have contributed to the weight gain? Likely yes. Did the medication still help? Yes, which is why I stayed on it for a year before deciding that it wasn't worth the damage to my health and self-esteem. Would I have still tried it if I had known? Probably, but I really wish I had been better informed and had read the studies I have now so that I could have been more vigilant in monitoring my eating and weight.

On the other side of that, I've recently started regularly using the stimulant meds that I've had a love/hate relationship with since I was diagnosed with ADHD in elementary school and was confused as to why I was dropping weight a lot more quickly than expected. After looking into it a bit more, I figured out that weight loss on stimulant meds isn't simply a matter of appetite suppression and my metabolism on ADHD meds is likely a bit higher than I calculated. Who knew? Maybe a lot of people, but I was surprised that even as a person with an educational background in a health field, lots of personal interest in mental health, and a lifetime diagnosis of ADHD, I only recently learned about the impact that stimulants have on adrenaline and how that affects metabolism and energy expenditure.

I REALLY don't want this to be taken the wrong way and to dissuade people from taking meds. I know people whose lives have been saved by psych meds and families who have been torn apart by mentally ill family members who refuse to take their medication because they think it's all "poison". I just think it's important to be informed and to make informed choices about what you choose to put in your body. I also think it's foolish to rely on your doctor to have all of the answers. Psychiatrists usually have very little training in nutrition and can be seriously lacking in knowledge of obesity. My first psychiatrist, who I loved and think of as a very intelligent man, told me I should just try to do cardio a couple times a week in order to prevent weight gain and said nothing of monitoring my eating. The PA I see now told me that I should just not eat after 8 pm. So helpful and evidence-based! Also, I've never come across a doctor who saw my dedication to researching medication options as a problem. Many of them have trouble keeping up on the newest research or are just kinda lazy and appreciate your input as long as you're not telling them exactly what to prescribe.

2. Medications for Physical Illness

Well, this is certainly going to be underwhelming after my long rant on meds for mental illness. I have very little experience with meds for physical illness because I'm in my 20's and the only medication I've used to treat physical illness other than antibiotics is Albuterol, or my inhaler for exercise-induced asthma. My mom, however, is a long-time diabetic and I've seen the many effects her diabetes drugs have on her body and weight. I also watched my skinny little Italian Greyhound turn into a fluffy little chubs when she was put on Prednisone after being diagnosed with bone cancer.

I guess my thoughts on meds for physical illness are similar to my thoughts on meds for mental illness. Research, be wary of the claims made by Big Pharma, get info from multiple sources. Try NIH or the many sites the focus on drug info. Also, Wikipedia can be surprisingly informative, although I'd double check the sources used. Physical illnesses with treatments that have a higher likelihood of affecting weight: Diabetes, Epilepsy, Heart Disease/Irregularity, Allergic disease, Migraine Headache disorders, Chronic Pain/Injury, Autoimmune disorders, and Cancer.

3. Supplements

This is taking longer to write than I thought it would and I have to go back to writing my thesis so I'll try and make this quick.

Again, do your research. Look at possible negative health effects and interactions with your prescription medications. Do your best to make sure you're buying from a reliable source because you may be ingesting something that's completely different from what you thought you were taking. The supplement industry is largely unregulated and there have been many reports of scams, injury, and even death in the history of supplement sales, including in recent years. Even something as ubiquitous as a multivitamin can cause harm and there actually is such a thing as having too much of a vitamin or mineral. Seriously, be careful! Some really nasty things have also been found in different protein powders and a lot of companies have gotten into trouble for having inaccurate labels. Given how big the market for protein supplements has gotten and how many different companies are in the game, it's important to do some digging before you make a purchase. For some decent sources of information, check out Examine.com, r/supplements (the supplements subreddit), and labdoor.com.

4. Recreational Drugs

I'm not going to go into detail about my own experiences for career/incrimination purposes, but I've dabbled in recreational drugs. I don't subscribe to the "illegal drugs are bad" rhetoric and believe in bodily autonomy. While I don't deny the problems that can result from substance use and/or abuse, I think each individual should make an informed decision about if and how the use of recreational drugs may fit into their life. Some people decide that they don't want to take on the risks or can't manage their use and choose sobriety and that's totally fine by me! Others are regular users and that's fine by me too, as long as it's done in a way that doesn't inflict harm on others and the benefits outweigh the risks in terms of their mental and physical health. I'm in the middle of that spectrum and have had both harmful and beneficial experiences and make an effort to be aware of how my use may or may not impact my physical and mental health depending on the substance, amount, frequency, and setting and adjust as needed. I know people tend to have very strong opinions about drug use and hope too much discussion on whether drugs use is good or bad or right or wrong can be avoided.

Again, do your research to the extent that you can. The War on Drugs has done a lot of damage in regard to allowing people to make educated and responsible decisions about their substance use, but there is information out there. Try erowid.org, DanceSafe.org, Shroomery.org, and other sources of information that are oriented towards harm-reduction and safety. There are some decent subreddits on recreational drugs as well. Wikipedia again has some useful info that just needs to be double checked and there is an increasing amount of published research on recreational drugs, although it's once again worth noting what studies are funded by who and being aware of bias and agenda. Be aware of how underlying mental and physical health conditions are affected by substance use and always play it safe. When possible, test recreational drugs as the illicit ones are obviously unregulated and can be cut with some very, very bad things. In general, it's best to stay away from "designer drugs" and drugs that have not been researched to any extent.

Also, I'm definitely not just talking about the use of illicit substances. Alcohol, nicotine, and caffeine are all drugs and should be treated in the same way. Your morning coffee (or three) does, in fact, make you a habitual drug user and there are health benefits and risks that come with that. If you go out binge drinking every weekend or have a glass of wine every night, you are also a habitual drug user. Do the research on how long and short-term use of these substances affects your health and your weight. Recreational drugs that are known to have a larger effect on weight include but are not limited to, opioids, tobacco, alcohol, marijuana (strangely the opposite of what you might think or at least more complicated), recreational amphetamines, cocaine, and mdma.



Lastly, as a kind of unrelated side note, always double check to make sure your prescription meds/supplements/recreational drugs don't have any important interactions. Look at how each drug is metabolized (which enzyme system is used to break down which drugs and if multiple drugs use the same pathway) and whether possible side effects (like risk of seizure or heart problems) are compounded.

Ok. I really should get back to working on my thesis now. I hope this was at least somewhat helpful or informative.

Replies

  • RedSierra
    RedSierra Posts: 253 Member
    edited July 2017
    Good reminder to read about side effects. Thanks for posting it.
  • CTcutie
    CTcutie Posts: 649 Member
    Even Ibuprofen can cause temporary water weight gain- it typically goes away after a few days of cessation :-/
  • Spliner1969
    Spliner1969 Posts: 3,233 Member
    Well thought out opinions. Makes me want to think more about the protein powders I'm using. ;) A while back I stopped using the brand I do now because of protein spiking, but in the end it was readily available and I was ok with it giving me a little less protein than what was advertised since the other stuff out there which seemed better was less protein per calorie anyway. Ease of purchase (local supply) and price won out.
  • rybo
    rybo Posts: 5,424 Member
    For being 100 pages long that was pretty interesting & well written.
  • _Emma_Problema_
    _Emma_Problema_ Posts: 261 Member
    edited July 2017
    CTcutie wrote: »
    Even Ibuprofen can cause temporary water weight gain- it typically goes away after a few days of cessation :-/

    Definitely true.

    Getting back into lifting heavy weights again+ using Ibuprofen for DOMS = 6 extra pounds of water weight

    I've avoided the scale this week because it just doesn't make sense to see the high numbers.

    Water retention is so weird. Did you know that sleep deprivation also causes you to hold on to less water? I learned that after a very late night trying to meet a deadline and finding myself 4 pounds down on the scale. The more I learn, the less helpful my weight seems as an accurate measure of fat loss.

  • _Emma_Problema_
    _Emma_Problema_ Posts: 261 Member
    Well thought out opinions. Makes me want to think more about the protein powders I'm using. ;) A while back I stopped using the brand I do now because of protein spiking, but in the end it was readily available and I was ok with it giving me a little less protein than what was advertised since the other stuff out there which seemed better was less protein per calorie anyway. Ease of purchase (local supply) and price won out.

    I hear you. One of my protein powders came from Costco and while it's made by MusclePharm, who got in big trouble after protein spiking one of their products, and doesn't seem to be well-tested, I've decided to just finish it anyway. I'm still on the fence as to whether I want to just get cheap protein supplements from Costco again or invest in something that's been tested and might be of better quality/without or with fewer contaminants. I've heard good things about the price and the quality of MyProtein, but I've been pretty pleased with my Optimum Nutrition purchases.
  • _Emma_Problema_
    _Emma_Problema_ Posts: 261 Member
    I have to sort of disagree. Yes, medications can effect your appetite or make you lethargic. However, in my experience the weight gain comes from an increase in food consumption, a lowering of activity level, or a combination of the two. I'm on Geodon (AAP like Abilify), Prozac (SSRI), and Mirena (IUD hormonal birth control), all medications I've seen scapegoated for weight gain on this site. I also occasionally smoke something that is legal in my state and known to increase appetite. By not giving in to my food cravings, lying hunger pangs, and desire to spend all day in bed I've lost 65 pounds. The medications can make it hard, but losing weight is frequently hard. I do understand your point about how many medications can cause weight changes when we aren't paying attention to our CICO. I just would hate to see anyone take your post and use it as an excuse for why they haven't lost weight.

    I understand your point and where you're coming from but I'm not really as worried about people using medications as an excuse for gaining weight. I'm actually more worried about people going off of very useful medications or avoiding certain medications because of weight gain that's been misattributed to a medication, but I think that's another discussion. I think that way of thinking centers on our society's need to blame the individual for being fat/gaining weight when it's actually a lot more complex than individual behavior. I also think that you can't use your personal experiences with your individual body and use that as a basis for how people should think about everyone's bodies and experiences. Ok, so I have 3 points.

    1) The way in which a medication or substance affects an individual varies considerably. Some people don't gain weight on antipsychotics or antidepressants. Some people gain a lot of weight on them. Some lose weight on them. There are trends and probabilities involved in assessing side effect risk but it's still individual. You just can't base knowledge on personal experience. I'm also on Mirena and have been on Prozac with no changes in my weight. That doesn't mean they can't affect the weight of other people.

    2) The ways in which these medications may cause weight gain is complex and not completely understood at this point. Increased hunger/food consumption and decreased activity level are just two possible mechanisms. At least in terms of antipsychotics, things like metabolic slowdown and increased storage of calories as fat, are thought to play a role. My psychiatrist told me that many of his patients swear up and down that they haven't been eating more but have gained weight and some have even gone so far as to meticulously count calories to no avail. I, personally, didn't notice any changes in my eating patterns and didn't feel hungrier while on the meds or sense any kind of cravings for carbs or sugar or anything like that. Again, it's all individual, but it's a lot more complex than just "stop eating so much and you won't gain weight".

    3) When it comes to obesity or weight gain/loss, nothing is simple or easy. While the fundamental idea of CICO is correct, it comes with many, many caveats. I congratulate you on your weight loss but try not to use it to shame other people. Again, there are SO many factors when it comes to weight that it really doesn't make sense to use the "this worked for me so it should work for you" framework. Please try to be a little kinder and less focused on blame. Not all "fat people" are lazy or uneducated or trying to make excuses.

    Also, as an interesting caveat, like I said in my post the effect that marijuana has on weight is very complicated and not yet fully understood. While it can lead to binging in some people, marijuana users actually weigh less on the whole than people who don't smoke regularly. Fun fact!
  • lkpducky
    lkpducky Posts: 17,762 Member
    edited July 2017
    It costs a considerable amount to support the years of research and development that go into a drug candidate. It can take years to go from finding the drug candidate in the first place, testing it in a smaller population for safety, then testing it in a much larger population (thousands if possible) to generalize the results to the general population of people who could be treated with that drug. In addition, some outcomes (eg, heart attacks or strokes) may take longer to happen and so the drugs have to be tested over years. Then the investigators have to figure out how to get as many people tested as possible because some people may drop out of the trial.
    Most drug candidates get eliminated on the basis of negative results after money and resources have been used.

    tl;dr: testing drugs is not a cheap endeavor. As far as drug companies being for profit, I don't think that you are proposing that all this be done for free, but are you proposing some sort of cap? if so, how would you define what said cap would be?
  • caliallie2
    caliallie2 Posts: 19 Member
    It's good to know that certain prescription drugs can cause weight gain and yes much of it is from appetite increase and some from how it affects your hormones, insulin etc.. Its important to know this so that if you gain weight on a prescription medication and its out of control you are prepared for it and can add exercise, measure your food and be prepared to satiate your increased appetite with things you can eat in bulk and abundance but not gain too much weight, i.e. greens, salads, veggies, instead of twinkies, ice cream and peanut butter and jelly sandwiches. Additionally, if you can't seem to get in under control, talk to your doctor and see if there is another medication that might work and have less collateral damage. The truth is though, that if you are using a medication that is WORKING for a mental health disorder, thats a blessing! Do your best to figure out a way to control the weight gain and stay on your medication.
  • nutmegoreo
    nutmegoreo Posts: 15,532 Member
    Ah, thesis procrastination strategies. How well I know these. Let me guess your home is spotless too.

    People need to take responsibility for what they put into their bodies. From foods to medications to supplements. If food sources are adequate, supplements are unnecessary. However some goals can be hard to hit without. The problem is the amount of misinformation that is out there. I don't see BigPharma as the evil you seem to see it as. But making informed choices is difficult when people don't know what questions to ask, or are scared to offend their medical team. Reading the list of side effects can be daunting and enough to scare many people away, particularly when some of them are effects people had while taking the drug, but not necessarily caused by the drug (correlational). These things all get reported as side effects. Evaluating the evidence can also be difficult, particularly because so many don't actually question the source of the information.

    I would completely disagree with you that recreational drugs are becoming seen as a social necessity. If you feel that's the case, perhaps consider changing your social circle. I'm not judging what you choose to do, just the statement of necessity.
  • Polo265
    Polo265 Posts: 287 Member
    CTcutie wrote: »
    Even Ibuprofen can cause temporary water weight gain- it typically goes away after a few days of cessation :-/

    For sure! This past winter I've had dental surgery and shoulder surgery and subsequently was using ibuprofen on a regular basis. I gained lots of weight, primarily because of inactivity, but lots of it was water weight because of the pain meds and ibuprofen. I still have to take ibuprofen for my shoulder and arthritis, but I try to limit it.
  • brentleyann1
    brentleyann1 Posts: 37 Member
    Birth control is another huge weight changer. It's listed in the possible side effects. I got the implanon and gained 50lb in 3 months while trying to lose weight after having my daughter. I had to beg the dr to remove it and I lost the weight in 2 months without starving myself. It was clearly the medicine.

    My mom takes anti anxiety medicine for IBS and she's overweight from that. Her dr agreed. My mom was tiny her whole life until she started taking it but now she's too scared to change because she'd rather be fat than deathly ill from IBS.
  • Amy8Lyn
    Amy8Lyn Posts: 27 Member
    I have to sort of disagree. Yes, medications can effect your appetite or make you lethargic. However, in my experience the weight gain comes from an increase in food consumption, a lowering of activity level, or a combination of the two. I'm on Geodon (AAP like Abilify), Prozac (SSRI), and Mirena (IUD hormonal birth control), all medications I've seen scapegoated for weight gain on this site. I also occasionally smoke something that is legal in my state and known to increase appetite. By not giving in to my food cravings, lying hunger pangs, and desire to spend all day in bed I've lost 65 pounds. The medications can make it hard, but losing weight is frequently hard. I do understand your point about how many medications can cause weight changes when we aren't paying attention to our CICO. I just would hate to see anyone take your post and use it as an excuse for why they haven't lost weight.

    I understand your point and where you're coming from but I'm not really as worried about people using medications as an excuse for gaining weight. I'm actually more worried about people going off of very useful medications or avoiding certain medications because of weight gain that's been misattributed to a medication, but I think that's another discussion. I think that way of thinking centers on our society's need to blame the individual for being fat/gaining weight when it's actually a lot more complex than individual behavior. I also think that you can't use your personal experiences with your individual body and use that as a basis for how people should think about everyone's bodies and experiences. Ok, so I have 3 points.

    1) The way in which a medication or substance affects an individual varies considerably. Some people don't gain weight on antipsychotics or antidepressants. Some people gain a lot of weight on them. Some lose weight on them. There are trends and probabilities involved in assessing side effect risk but it's still individual. You just can't base knowledge on personal experience. I'm also on Mirena and have been on Prozac with no changes in my weight. That doesn't mean they can't affect the weight of other people.

    2) The ways in which these medications may cause weight gain is complex and not completely understood at this point. Increased hunger/food consumption and decreased activity level are just two possible mechanisms. At least in terms of antipsychotics, things like metabolic slowdown and increased storage of calories as fat, are thought to play a role. My psychiatrist told me that many of his patients swear up and down that they haven't been eating more but have gained weight and some have even gone so far as to meticulously count calories to no avail. I, personally, didn't notice any changes in my eating patterns and didn't feel hungrier while on the meds or sense any kind of cravings for carbs or sugar or anything like that. Again, it's all individual, but it's a lot more complex than just "stop eating so much and you won't gain weight".

    3) When it comes to obesity or weight gain/loss, nothing is simple or easy. While the fundamental idea of CICO is correct, it comes with many, many caveats. I congratulate you on your weight loss but try not to use it to shame other people. Again, there are SO many factors when it comes to weight that it really doesn't make sense to use the "this worked for me so it should work for you" framework. Please try to be a little kinder and less focused on blame. Not all "fat people" are lazy or uneducated or trying to make excuses.

    Also, as an interesting caveat, like I said in my post the effect that marijuana has on weight is very complicated and not yet fully understood. While it can lead to binging in some people, marijuana users actually weigh less on the whole than people who don't smoke regularly. Fun fact!

    Wow. Was not aware that being successful at losing weight and not making excuses was shaming people. I don't recall ever calling the obese lazy or uneducated. I'm sorry if you are injecting your own bias into my post. You are aware that I am still obese, right?

    There really aren't so many factors when it comes to weight. You eat more than you burn, you gain. Do the opposite you lose. It's simple science. I gained over 100 pounds from not paying attention to what I was eating after starting on various AAP's. I could have believed it was some unknown mechanism causing the weight gain, I did read about the possibility, but decided to try accurately logging my food consumption and exercising more. It worked. It has worked for many others on this site.

    I personally had to get to a good place mentally before I could start losing weight. If that is the kind of caveat you are referring to, then yes that is a well known roadblock to losing weight for many. There is no solid conclusion as to why people gain on the medications I take, but I will tell the people of MFP what worked for me and ask them to try it themselves before giving up and blaming their medication.



    I think it’s easy to go back to "calories in, calories out" and the end all be all to weight loss and gain, but as OP states, it’s not always that simple. Background; I am a personal trainer and an amateur bodybuilder. I have been successful with IIFYM for many years and used it through off season and training. I have maintained a healthy weight for over 4 years. About a year and a half ago I began taking an antidepressant for anxiety and depression, as mentioned in the side effects some lost and some gained on the medication. I kept my routine 100% as I took my new RX, I did not wander from my training or macros, tracking and weighing as I always did. As of today I have gained approximately 30lbs. I think we are ingrained to say; well you gained because maybe you didn’t track as well, or maybe you were lax on training etc. As OP mentioned, every single person is different and it IS possible to gain weight from a medication and NOT from behavioral changes.
    And to the comment that people “need to take responsibility for what they put into their bodies” while I agree with this on a nutritional standpoint, I object when it comes to medication. While you can do your research and work with your doctor, sometimes there are only so many options for treatment and some conditions require medication.
    I do find this an interesting subject, I’m glad it was brought up!
This discussion has been closed.