To think if doctors are prescribing drugs known to have the side effect of weight gain they should also give out dietary advice with the prescription?

[LunchpackOfNotreDame]

I'm on a lot of medication which has weight gain as a known highly common side effect with it. It would be nice if I could be advised as to how to circumvent the weight gain and given appropriate advice and support with it.

Is that something that is possible or will I forever more be unable to get below a size 18

@mreverything: stop minimising the problem. Of course the meds don't make you gain weight 'for no reason'. There are many intersecting reasons, but the answer is not as simple as 'eat less and move more.'

I think one of the problems is that many GP's are sorely undereducated about psychiatric care and medications.

I also take Quetiapine ExWife, it works well for my bipolar but the weight gain is ridiculous. Unfortunately its the only drug that has worked for me and I really need to take it, and I take both types which makes the weight gain even worse. They have also given me a heart murmur. I hardly eat, I hardly have a spare moment with 4 young dc and full time study, I am not a lazy person. These meds make me a bloater! I came off meds whilst pregnant, at full term I was 2 stone less than my 'usual' weight on meds and I was able to actually eat normally for a change!

yanbu! Drs should be able to treat the conditions caused by the very treatments they prescribe

YANBU.

But - I do give the relevant advice and hardly anybody takes it on board.
Or it leads to very dangerously ill people refusing a drug because they are worried about weight gain.

For the record, the drugs (particularly psychotropic ones) do not in themselves put weight on people, but they CAN increase appetite.

I like this site btw.

A previous poster mentioned lithium causing metabolic changes, could you tell us more about that please?

I think that many GPs are sorely underfunded with resources AND time.
Most psychiatric drugs of that calibre will be prescribed by a consultant psychiatrist - maybe they should take on the dietary education instead of shunting more unresourced work to primary care?

Pacific I did say doctors not any specific type of Doctor

It's not just antipsychotics but also antiepileptics (used for pain management) and tricyclic antidepressants.

I am going to make an appointment to discuss my weight and see if my drugs can be changed in any way

I think it was MrEverything

I take 3 medicines that have weight gain listed as a common side effect. I have altered the way I eat majorly because I can't exercise due to being severely disabled and I haven't put on any weight. I do get hungry but my joints just can not cope with extra weight, so I drink a lot of water.

Hopefully they can find you some weight neutral alternatives OP.

Quetiapine is a bastard for weight gain.

DH had no extra fat on his body when we met. He eats very well, works out a lot, is a weight lifter as well as doing cardio but when he moved up to 600mg he gained weight. Not a massive amount but he's not had much luck shifting it.

My relative went on it and went from a size 10 to a size 18 in a year. Of course weight gain doesn't come from magic but I can guarantee you my husband does not eat more or move less since increasing his dose.

Lunchpack, I know

I sometimes gets… I dunno, tired at the expectation of being an expert in Everything and being available to Everybody at All Times Immediately for Everything that might be going wrong in people's lives. I do love my job though btw

Yes, many meds can contribute to weight gain. Or stop appetite dead - which can be just as difficult.

I'm pretty sure I ate fairly normally when psych meds (mainly chlorpromazine and later olanzapine) from being underweight (not dangerously severe but bmi around just below 16) all the way up to a bmi of 27, the trouble with these meds is you're kind of too chilled out at higher doses to properly care.

Have maintained a much lower weight on lithium alone with lower doses of antipsychotics taken less regularly.

Drs should not be encouraging people to be fat anyway, and if they make them fat the prescriber should take responsibility. Lots of psychs routinely prescribe atypical antipsychotics, which cause metabolic syndrome, and how many roll up their sleeves to treat hypertension, diabetes and dyslipidemia?

I was seven stone before I started on antipsychotics and within three years had doubled my weight. I also have a vomiting disorder as a result of somatization. I've lost three stone but I have to really watch what I eat. Weight gain is a recognised side effect of all antipsychotics - mine knock me out still within an hour after ten years and when I was on a high dose I was like a zombie sleeping 16 hours a day.

dontrun Ah minimising, MN's favourite word. I never said 'eat less, move more'. Get that chip off your shoulder, eh?

thedevil I will find the info I have and send it to you via PM. Lithium is generally better monitored than other psychiatric drugs IME and works very well, so it does have to be weighed up.

Thanks, am a fan of lithium and its modest magical properties.

I know it enhances neuronal growth cones, inhibits with phosphatidylinositol system, inhibits adenylate cylase, promotes hippocampal neurogenesis, enhances BDNF expression

and poss some effect on MARCKS (myristolated alanine-rich c-protein kinase)

"Drs should not be encouraging people to be fat anyway, and if they make them fat the prescriber should take responsibility. Lots of psychs routinely prescribe atypical antipsychotics, which cause metabolic syndrome, and how many roll up their sleeves to treat hypertension, diabetes and dyslipidemia?"
the difficulty with having a lot of contact with medical professionals and the interest in your own condition is that it becomes easy to start feeling like 'I know all this information, why doesn't my doctor?', while forgetting that every single medical condition can be understood in this much detail, but not by one individual. Medicine is enormous and complex and the more we understand the harder it becomes for anyone to be a 'generalist'. In much the same way that my obstetrician is managing my pregnancy, while an endocrinologist manages my diabetes, I'd far rather have a psychiatrist recognise the limit of their expertise, roll their sleeves back down and refer patients to someone whose job it is to understand the metabolic disorders associated with antipsychotics.

yep Quetiapine (slow release) here to and big weight gain also terrible joint pain really effects my day to day living

I feel for you op.

I've been on heavy steroids on and off since late 2012 and in that time I've put on a huge amount of weight. I currently weigh 18 stone, five of which I gained in 2014 alone after a brain biopsy and huge increase in meds.

My neurologist is currently trying to control my symptoms with immunosuppressants but I've just failed to respond to one and am being placed on another. While this is happening my drug dose is moving up and down which does affect my weight gain, and also makes me exhausted and depressed.

Last time I saw him, my neurologist apologised for my weight gain, but he explained it was unavoidable. I'll be on high dose steroids until I respond to something, then low dose forever.

I will have to wait until then to lose weight as just now I'm unlikely to be successful and need not to limit my intake of certain things, like calcium. I've tried to diet and failed at the moment, I can't stick to anything and I feel awful all the time.

But what he said to me may be good advice for you; prioritise. You can investigate other options and lose weight but only when your most serious health condition is being successfully managed. Being fat will kill you, but not straight away. Hopefully you will be able to tackle your weight once you have managed the symptoms of you illness and feel better.

Coffee High dose steroids are quite another matter. :( They are nasty little buggers that do cause weight gain and water rentention that is not purely due to over eating. Although, to add insult to injury, they make many people ravenous. They do the job very nicely though which makes it so hard to get off them, especially if other treatments don't work.