Taking the meds that won't make you sick and kill you
July 15, 2013 6:14 AM   Subscribe

Are you taking anti-psychotics or other crazy meds? Have you managed to get the weight gain under control or indeed back off again? Share your experiences!

I've been on quetiapine (Seroquel) for about 18 months now. I'm prescribed 250mg but I usually take 150mg otherwise I am too tired and hungry to function. Over that time, I was also in a living situation that made me very stressed, leading to eating the quickest to prepare food possible so I could hide upstairs, and also binge-eating (I'm in a happier living situation now with my SO.); I was also on a team at work with someone who described himself as a 'body fascist', going on extreme diets and criticising the shape and size of others, and at one point going to the toilet on a work meal out to make himself throw up (then coming back to make a joke about it.) I also have the contraceptive implant in my arm, which they say is linked to weight gain, but for various reasons this is the only contraceptive that's good for me and I'm not going to change it for the time being.

Anyway, during that period I've put on about a stone and a half. I'm currently 16.9 stone and 5ft 10. I think a good weight for me is about 14.5 stone, so for a while I've been thinking that I need to lose some weight. I know that's not compliant with BMI, but I have a very curvy figure even at my lowest weight, and that's the weight I felt most comfortable with in the past, having been smaller (thanks, undiagnosed mental illness).

hen my mum got asthma followed by high cholesterol and angina, leading to arterial surgery. My dad had heart problems throughout my life, but I put that down to lifestyle (very heavy smoker, fried everything, would drive to the local shop instead of walking for five minutes). My mum had a dad who died of heart disease young, but she ate small portions, walked a lot, and so it was unexpected. This is scaring my SO who has said he worries that I don't get enough exercise, and that the chances of me having heart problems is higher and he doesn't want the time we have together to be compromised or even shortened.

I'd like to know whether anyone has managed to balance psych med side effects with weight loss. I know I don't like the gym but do like less stationary exercise such as walking, swimming and cycling in the park (bike has been stolen though, dammit). My issue is the constant hunger which makes willpower hard. There are often a lot of snacks in my office, and I'm also wary of linking food to being 'good' or 'bad' - I'm very much for body positivity and my inner Andrea Dworkin is already recoiling at the idea of Going On A Diet, and I don't want to be obsessively self-flagellating like my colleague. Coming off the meds is not an option, but while I've found them life-changing and often said that I'd rather be fat than in hospital, being fat isn't helping me - my clothes aren't fitting, I feel out of breath walking up hills, and my general body image isn't great. So any experiences or tips would be great!
posted by anonymous to Health & Fitness (10 answers total) 3 users marked this as a favorite
I take a number of meds that really screw with my weight, also I have high blood pressure and the usual beta-blockers will reduce heart-rate which is counter-productive for aerobic exercise.

I'm 50 and post menopausal, so I've decided to live with it. I do some walking every day. I don't eat everything not nailed down, but I'm not being super watchful either.

Basically, to stave off hunger, eat smaller, more frequent meals. Try to eat lots of fruits and veggies. And go more protein, less carbs for satiety and reduction of hunger.

When I do Atkins, part of geting into ketosis is that after the first couple of days, the hunger and cravings disappear, which can be a thing worth doing to see if it helps you. (Everyone is different, so sometimes you have to experiment around to see what works best for you.)

More activity can only benefit you. It doesn't have to be "exercise" it can be strolls with your SO, dancing naked in the living room, cleaning the garage. Just moving is good for you.

Hang in there and find ways to love yourself as you are, today.
posted by Ruthless Bunny at 6:36 AM on July 15, 2013 [1 favorite]

Something you might want to ask your psych about are alternative anti-psychotics. Obviously take what works best for you but solian or lamotrigine may not have the same effects, and I'm sure there are other options. Anecdotally, seroquel seems to make more people bone tired. The other two aren't side effect free by any means but something else may just fit you better.

With the gnawing hunger, plan for it. You can't argue with that kind of unholy, digest-your-own-stomach hungry. Keep lots of high volume-low consequence snack food around, it takes a little bit of preparation. Cut up celery (I can eat a bunch if I get started) or whatever you like. Fill up on lots of water, herbal tea, etc. Sometimes I try to tell myself 'being hungry isn't an emergency, you're eating when you get home in an hour' and I come out the other side. The more I do this the easier it gets.

Ignore the office snack offerings by deciding 'no' before you see it, and also pre-arm with your own snackpile. 'I know there are muffins but I don't want any today because I have packed a container of vegetable sticks, yoghurt, some grainy crackers, hommous, strawberries and dried apricots. I'm really looking forward to eating them.'

When you have this together for a little bit you might notice you feel a bit better during the day (good fuel etc) and the activity is easier to get into. I find being accountable to someone else helps me get my arse moving, so maybe a class or a playdate with a friend?
posted by Trivia Newton John at 6:45 AM on July 15, 2013 [1 favorite]

Seriously, drink more water. Throw some fruit in it if you need flavor. It might not fill you up for long, but then you can just drink more water.

Or foods like celery where calories spent eating >= calories in the food.

I'm in the same boat with the binge eating. Spent the past 3 years in restaurants so I'd eat when I got the chance, hungry or not since I didn't know when my next chance to eat was. And most of that time was working the fryer...

I was on Pristique, then an SSRI I don't remember the name of but I can check my posting history if you want to know. The doctor would ask how my appetite was. So I'm assuming they could have effected it somehow. But it's really hard to judge when you're around food all day and get to grab a little pretty much whenever you wan.
posted by theichibun at 7:24 AM on July 15, 2013

Mod note: This is a followup from the asker.
I should have said, I drink something like three litres of water a day, and tons of green tea as well. I don't drink soda at all and haven't since I was about fourteen, so I'm fine with plain water! However, the usual tips given out to curb cravings etc. don't really work with seroquel, as there is a tendency for your stomach to tell you 'eat now in case you can't eat later and you die of hunger' even when you have just had a perfectly fine lunch. Sigh.
posted by cortex (staff) at 7:39 AM on July 15, 2013

Are the benefits greater than the side effects? I tried Abilify when my depression was really severe. It seemed to help, but I was always thirsty, craved sugar intensely, gained weight, and decided the risk of diabetes was too scary. (finally making real gains against Depression without it) For heart health, exercise is key, and that increases mental health as well. Your sweet bf can help by exercising with you. Add 3 half hour walks a week, or go hiking or whatever form of getting moving you both enjoy. DDR on the Wii, even.
posted by theora55 at 8:05 AM on July 15, 2013

YMMV, but:
I'm prescribed 250mg but I usually take 150mg otherwise I am too tired and hungry to function.
I find the higher dose to be LESS tired- and hungry-making than the lower one, once you acclimate. Are you taking this at night? I also take my larger dose (400 mg) of Seroquel at night and then a tiny one (50 mg) in the morning.

I haven't had much weight gain, but I am also working out like a crazy person (ha). Running, cycling, yoga.

Via MeFi's own The Last Psychiatrist, here's a great article on how Seroquel works, and how larger doses affect you very differently than smaller doses. (It's not just more of the same.)
posted by fiercecupcake at 8:45 AM on July 15, 2013 [1 favorite]

I've beaten weight gain caused by meds (it's the weight gain without meds that's killing me now), and I was also on meds that cause that sudden starvation feeling. So, I know where you're coming from!

To beat the hunger, I kept a supply of things I could eat when that feeling hit without needing to judge or pick or whatever. The fridge had cut-up fruit and veg, the pantry had low-fat nuts, crackers, and similar crunchies, and I always carried a couple of "safe" snacks with me. My work bag (or drawer, depending on the place) had the same.

You know how you're just not a soda person? I do that, too - I drink water 90% of the time. And when I was on those powerfully convincing meds, I picked other things that fit the same guideline. "I'm just not a ______ person" or, even better, "I am a ______ person", is quite powerful. And it's becoming helpful to me again, now that I remembered it after a while.

You like some great exercise activities, and it's so worth the time to give yourself over to the fun of enjoying it regularly. Thinking of exercise opportunities as a daily reward instead of as a punishment or chore is a huge mindshift that makes it easier.

Aside from those things, I found that being on an anti-anxiety medication unexpectedly lowered my random cravings. I discovered this while on another medication, after I had all of that other stuff in effect. Wish I'd known sooner! But I needed to be on it, so if that's not the case for you, it probably wouldn't have that benefit. Just putting it forward, just in case it's a helpful thing.
posted by batmonkey at 8:48 AM on July 15, 2013

Memail! I gained a significant amount of weight on psych meds, and I've done some very silly things to mitigate Seroquel hunger. I've been slowly losing the weight by exercising more than I thought was possible and just letting myself eat all the things. Fat is better than hospital!
posted by grippycat at 9:37 AM on July 15, 2013 [1 favorite]

You can certainly exercise without dieting. You'll get the cardiovascular benefits you desire (not getting so winded), the health benefits your boyfriend desires, and it's likely your clothes will fit better, even if you stay the same weight and especially if you do some sort of weight-training (push-ups and squats count!). And I find that I'm much happier with my body image when that image is based on my (literal) strength and endurance rather than just on my weight.

You might want to read about the "Health At Every Size" movement (if you haven't already), which is very much about being healthy and body-positive no matter what your weight is -- I think it's good, sensible, feminist way of approaching things.
posted by jaguar at 12:25 PM on July 15, 2013 [2 favorites]

A lot of people find ziprasidone (Geodon) to be weight-neutral.
posted by xekul at 5:26 AM on July 16, 2013

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