New ADHD diagnosis--meds and weight loss?
December 10, 2010 5:36 PM   Subscribe

ADHD meds and weight loss: How to make this transition as healthy as possible?

I am just going through diagnosis with adult ADHD and despite my initial resistance to the idea, my doctor is right now thinking that I should probably go on an extended-release stimulant to start with and see how that works. He has mentioned several times that one of the benefits of this is weight loss. My BMI is about 33--it's been in the 30-35 range for pretty much my whole adult life.

I'm not opposed to this notion of losing weight, but articles I can find on this concept seem to deal with how bad it is that certain people try to get diagnoses in order to lose weight. I mostly just want to know: What should I expect? How does this actually work and how is it going to feel? What kinds of things should I be making sure I do in order to be sure that I don't suffer any negative health effects from being on this long-term?

I am, yes, a little nervous about it. I think I'm going to end up starting on meds shortly after Christmas at this rate, and I want to be sort of mentally ready for all this. I have never really cared about losing weight before, and I'm sort of afraid of it leading to nutritional deficiencies, that sort of thing, or body image issues, or... I'm not really sure what. My doctor's assurances so far are just "it'll be fine, you'll feel great", and that's not a big comfort!
posted by anonymous to Health & Fitness (9 answers total) 2 users marked this as a favorite
Hmm. I really struggle *not* to lose weight when I'm on adderall. But I'm also an intuitive eater: I eat when I'm hungry and stop when I'm full. When I'm taking adderall, I don't get hungry, so I have to force myself to eat even when I don't feel like it. Also, I tend to get a little jittery if I don't eat enough when I'm taking adderall, so I really try to remember to eat even when I don't feel like it.

The thing is, I'm not sure that everyone would lose weight on adderall. It suppresses your appetite, but some people eat for reasons other than being hungry. If you were, for instance, an emotional eater, then you might still eat even when you didn't feel hungry.

Also, even though I do lose a little weight when I'm taking ADD meds, I always gain it back when I go off the meds.

I guess I basically agree with your sense that wanting to lose weight is a fucked up reason to go on ADD meds. They're pretty great for treating ADD, but they're really not meant to be weight-loss drugs. Do you like this doctor? Do you think you might have a better rapport with a doctor who was interested in treating your ADHD, rather than your perceived weight problem?
posted by craichead at 5:50 PM on December 10, 2010 [2 favorites]

I initially lost weight on ADHD because I lost all my appetite. However, those effects gradually wore off as I kept taking it, and given that a lot of the reason I was overweight was because I was not an intuitive eater at all (ate for comfort, addicted to sugar, etc etc) I gained the weight back pretty quick.

Weight loss, and permanent weight loss, requires a lot more work than taking a drug that suppresses your appetite.
posted by schroedinger at 7:01 PM on December 10, 2010

I lost about 20 pounds on adderal, but it has mostly come back after about 18 month later. So I'd just try to make sure you take it with food, eat health and enjoy a few months of easy weight loss. It doesn't last forever.
posted by humanfont at 7:11 PM on December 10, 2010 [1 favorite]

For the record, I took Adderall XR for about 10 months, and I didn't lose any weight at all. YMMV.
posted by Citrus at 7:42 PM on December 10, 2010

It reduces my appetite, but I have not lost weight. But I don't take a very large dose and don't exercise like I should.

The appetite reduction manifests as just "not hungry". Occasionally I will know that it is time to eat and just not be interested in anything. But the dosing and XR-ness for ADHD treatment is different from "diet pills" and baseball greenies.

One thing to watch out for: in the evening, when the stimulant is wearing off, if you haven't eaten correctly during the day, you might notice a bit of ravenous hunger. I take that as a sign that I didn't eat properly earlier in the day.

(Nothing is permanent. If you eat the same way you did before the diet, you will gain it back. I don't know why people are surprised by this.)

My doctor also mentioned these benefits, but I took it to be him just touting the various benefits. I think doctors just like it when they can prescribe something that has such clear benefit for the main thing, and
posted by gjc at 8:22 PM on December 10, 2010 [1 favorite]

I'm on Concerta, and if anything I've gained weight - but I'm totally an emotional eater. This sounds like a serious concern for you, and your doctor doesn't sound very responsive - maybe you can get a referral to a nutritionist?
posted by Space Kitty at 11:09 PM on December 10, 2010

One thing to watch out for with adderall is that it's very easy to compulsively do things over and over again. My issue is usually drinks (and cigarettes), not food, and I can easily drink seven cups of coffee or seven beers or seven liters of water before any of the usual side effects of caffeine or alcohol kick in, and then feel horrible all day. The same can happen with eating - you might not be hungry at all but adderall will make it impossible to not repeat that comforting hand-to-mouth gesture ad infinitum.

It's harder in general to read what's up with your body, and you might need to pay more attention in order to see if you're hungry, dehydrated, sleepy, etc. because they won't necessarily feel the same. (Though most of the time I was hungrier on adderall and gained back weight I'd lost to stress, sometimes hunger manifested as nausea at the thought of food. huh.)

Just a note, in case you're worried about this - if you do lose weight on adderall, don't feel like you're cheating. It might let you eat better, or stick to an exercise plan, or make you excited and resolute - but these are mental benefits and not physical ones. It's not magically losing weight for you. It has the wonderful ability to let you see the paths your mind usually runs in and choose new pathways and new ways of thinking and doing things. It will give you the energy to do this (if you even want to lose weight), but you will always have this ability, long after you've adjusted to the physical side effects of appetite suppression (which, again, I didn't really experience).
posted by ke rose ne at 11:53 PM on December 10, 2010 [1 favorite]

I lost my appetite on ADD meds, to the point of borderline starvation. The way I get around that now is I make it a rule that I must eat something BEFORE I take a dose. So I eat at least 2-to-3 meals a day because I take 2-to-3 pills a day (I am not on the XR). I've also found that having food in my stomach slows down the speed at which the drugs hit my system and thus I get less jittery.
posted by Jacqueline at 8:01 AM on December 11, 2010

Adderall is definitely an appetite suppressant for me, but less so as time goes on. The overall effect on my eating is less than you'd think: I've generally been ravenous in the evening when the medication wears off.

The major difficulty for me is that without the urge to eat, it's easy to reach "I'm stupid" levels of low blood sugar. One evening shortly after I started taking it, I ended up in the office unable to figure out how to feed myself, and completely forgetting that I had a sack full of Clif bars for just such an occasion.
posted by lore at 5:40 PM on July 5, 2011

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