I'm so huge and fat, I'll be dead in five years

[AppleJuiceAvid]

In my early 30s, 5ft4 and last time I got on the scales, I weighed 26 and a half stone. Currently on the antipsychotic Aripiprazole (15mg daily) and Fluoxetine (20mg daily). Before that, I was on Olanzapine and Paroxetine. Before that I was on Sertraline. Before that I was on Mirtazapine. Before that I was on Citalopram. Got a parent who has hypothyroidism. At the beginning of the year, I had blood tests after a stomach bug and got told I am deficient in Vitamin D and B12. I was prescribed some Vitamin D to take twice a week, but I have not been taking it consistently. My face is puffy and I get hairs on my chin and a few on my chest. Periods are irregular and when I do get them, they get quite heavy. I'm tired all the time and the house is a mess, but I just have no energy to do anything. I barely manage to get up for work. Got left pelvic pain and left hip hurts when walking. Ankles seem swollen and feel sore when I lie down in bed at night. Get out of breath going up the stairs and too fat to reach my toenails to cut them. I want to lose weight, but just feel hopeless.

OP, is the weight gain solely down to the meds, or were you already significantly overweight before them? Do you have a history of yo yo dieting? Do you often feel out of control around food - like you just can’t stop?

If any of that applies to you, then alongside the suggestions re seeing your GP, an endocrinologist, WLI - have a look at Overeaters Anonymous.

I had no idea about the raised cholesterol. Wonder what other side effects of antipsychotics they don't tell you enough about.

First of all, you recognise there is a problem. That's the first step. Your lethargy and negative approach to life in general is all tied up with your weight. You obviously want to change, so I would suggest taking things one day at a time. Set yourself small goals. Short periods of walking and increase the distance every week. Start being 'conscious' about what you eat and aim to make healthy food swaps when you can. Small changes will suddenly show on the scales. Just try to be positive. It IS possible to change. Good luck! X

Are you being treated for your b12 deficiency? It's surprising the amount of symptoms you can get from being deficient. Being both vitamin D and vitamin b12 deficient can really affect both your mood and energy levels to a significant degree. Its also worth aiming for optimal levels of these, rather than 'normal' (which can be set questionably low in the NHS). Hoping things get much better for you x

I didn't want to read and run - just wanted to say this sounds so hard ! I hope you can find some more help and some answers x

You are helpless because your weightgain and likely inability to lose caused by the antipsychotic. I know someone who was a body builder went in it and has been morbidly obese since. Significant weight gain and inability to lose weight is very well documented side effect of it. First step would be to discuss if this medication can be changed or if you can take a weight loss drug to manage the weight gain.

It’s pretty depressing the NHS are gatekeeping it.

as other posters have mentioned gastric sleeve surgery is available on nhs purely for obesity. It’s crazy to think they’d prefer people to go through a major operation with lifetime consequences rather than prescribing it.

There's also an immediate family history of thyroid cancer, which I think may rule out Mounjaro- which is the weight loss injection I was eyeing up.

Ah @AppleJuiceAvid , I feel for you. On quetiapine, with similar problems including high cholesterol. I don't really have an answers, but I'll cross my fingers for you and hope that the switch off olanzapine might help as it's meant to be the worst for weight gain.

Mounjaro wont ask about ur family thyroid history... only your history. I take fluoxidine, im on heart tablets arythmol, I take a statin and im on blood thinners, plus I was a type 2 diabetic (in remission now due to my weight loss) and I take mounjaro with no side effects. Can't ur gp perscribe mounjaro free, I pay for mine but I know a lot of people get it free x

I really hope that the people telling her to come off her psychiatric meds are not doctors.

And I doubt that the people saying she will definitely be eligible for GLP1s on the NHS on the basis of the information given are the kind of doctors that are actually prescribing GLP1s (if at all), because the criteria is both national and very strict.

If ask for a thyroid blood test and buy myself Mounjaro if I could afford it or Wegovy which is about half the price of Mounjaro. If it saves your life it is not expensive. I'd also ask my GP for cognitive therapy for the depression. Depression drugs have some nasty side effects and weight increase can be one of them. They can also be addictive.

Pressed too soon. I'd also ask for water tablets if your ankles are swollen.

No medical advice OP (I’m unqualified to give it) but I’d say that you have an age advantage.

I sorted out my obesity when I was 50/51 years old. I wish I’d addressed it twenty years prior. I regret the wasted time.

It’s great that you appear to be ready to take steps at age 30ish and I wish you luck.

As far as I know you can't have those WL injections with aripiprazole.

OP this is a huge issue to deal with alone. Are you under a psychiatrist or just a GP? If a psychiatrist I'd get them to write to your GP and recommend you for weight loss surgery, whilst reviewing all your meds. If not a psychiatrist then your GP should be applying to CMHT to get you in front of one for titration - 15mg aripiprazole is high. Are you diagnosed with a specific neuropsychiatric illness? So many questions, would you not be better off getting this moved to mental health topic?

Vitamin B12 can cause depression and anxiety as well as numerous other symptoms including overwhelming tiredness. It can be caused by poor diet but may also be due to Pernicious Anaemia (nothing to do with iron count).
Do you know what your level was? Did the GP prescribe any vitamin B12 tablets? Are they retesting? I would strongly advise that you find out what your level was and what the local range is. If you are below the range the GP should commence vitamin B12 injections - one every other day - preferably until symptoms cease - however in reality they usually only give you 6 loading doses then one injection every 2 - 3 months (often insufficient). They should also arrange for you to be tested for pernicious anaemia, however the test is know to show a lot of false negatives but if you do test positive you must have B12 injections for life.

Take a look at the symptom check list on the Pernicious Anaemia Society website and also consider joining the Vitamin B12 Health Unlocked forum as there are many very knowledgeable people on there who will be able to help you with test results and advice.
Please check this out as lack of treatment for Vitamin B12 can cause serious illness, permanent nerve damage and even death.
I wish you all the very best x

Can you afford private weight loss surgery? . It is hard, scary and expensive but you will get your life back. It’s transformative.

I don't have specific advice, but just to say, don't give up! There is plenty of hope for you.

Depression, does not pass, simply through the sheer willpower of "snapping out of it" It is a persistent medical, recognised clinical health condition, that persists and requires active management. Acknowledging the condition and feeling help are the first most vital steps .lt's a serious mood disorder, that requires active management. It alters the brain chemistry and motivation, meaning it will not pass and you cannot snap out of it.
This OP must seek help for this, before anything else.

Just do something positive each day. If you say your home is a mess, clear a small area and try to keep it tidy, then continue the next day.
A daily walk, to be outside, no matter what the weather brings, is beneficial and I appreciate for now you can't walk for long.
I don't know what all the medication is for but you sound unhappy and recognise this. So I think you want to change and that's where you start. It's easy to pile on the pounds and harder to shift especially if you're inactive. Eat good food, cut out snacks, drink water, nothing fizzy. Learn to cook healthy meals as that gives you energy too and you will feel better. I wish you all the best.

If you are thinking/can afford of WLI - talk to a reputable provider like SwiftDoctor or pharmulous who are really helpful and knowledgeable, and happy to talk to you (avoid Asda!). There are other types of WLI other than Mounjaro. They will help you feel full and cut out the food noise which you won’t realise you have until it’s gone. I actually feel full now, before I could keep eating and never feel full.
Regarding B12, you need to take it, lack of B12 can give you fatigue, brain fog, irritability, mild -severe depression amongst other things. I’m on it everyday and it has helped a lot. It has actually reduced the severity of my hot flushes and helped me sleep better, I don’t get pins and needles as much, I’m less irritable. Please, please start taking it.
Also, ask the gp if they can refer you to slimming world for a free 12 weeks, it will give you a healthy eating structure and i believe you can go when taking WLI. I would normally be the first to bash Slimming world having been a member - but the weekly meetings are actually supportive even if they are wrapped in saccharine.
it’s hard, really hard, but you’ve taken the first step by asking for help on here. Good luck.

What makes you think you can’t have with aripiprazole?

I can't have / didn't want weight loss injections. I had a gastric sleeve and I've lost 8 stone and kept it off for 3 years. Much bigger weight loss possible with a gastric bypass. Surgery sounds dramatic but its not a dangerous operation, worst risk is weight going back on.

My helpful GP told me at the start of 2025 that if I didn't lose weight I'd not see my kids grow up. That sentence really hurt me but it gave me the kick up the backside I needed. I paid for wli and am 6 stone down and completely turned my life around.

I hope the realisation your health is at risk continuing as you are may result in you not being here.

Have a chat with your doctor about your medication, I'm on mirtazapine and still can get a Wli so some medication doesn't interract. But these only work if you change mindset, change habits and want to improve health.

Good luck

I’ve lost 4 stone over the last 2 years, I get the battle both physically and mentally. A good support network is helpful, but mostly it’s finding the hope and space inside your mind to try. Certainly try and get help.