I want my side effect back
July 23, 2016 12:38 PM   Subscribe

I'm naturally very skinny and throughout my teens and early twenties I struggled to put on weight. I'm 5' 10" and I weighed around 9 stone (126 pounds). If I put a lot of effort into eating more I could put on a little bit of weight, but then after a few weeks I'd lose it all again. I started taking quetiapine for depression 6 years ago and, after taking it for a couple of years, I gained around 20 pounds without trying.

This was a really wonderful surprise -- for the first time in my life I felt like I was at a healthy weight. I felt a lot stronger and looked a lot better.

Then about six months ago I reduced my dosage from 200mg to 150mg (mainly because I was sleeping way too much -- quetiapine is very sedating) and, a few months later, I suddenly lost pretty much all of the precious weight I had gained. For about three weeks I had no appetite at all, and I had to force myself to eat anything. I saw a doctor (and got a blood test which came out fine) and she wasn't sure what could be causing it but she said that the reduction in dosage was the most likely culprit. At the end of the three weeks I was down to a little over 9 stone. I started eating again and I put on a few pounds, but just over the past few days I seem to have lost it all again, even though I'm eating fine. I haven't weighed myself but I feel as skinny as I did before I started taking the meds. It feels like my body went out of its way to get back to its natural weight. I've thought about increasing my dosage again, but I am sleeping less and I feel a little better on the lower dosage so I don't really want to do that. It also seems kind-of unhealthy to increase the dosage of a drug because you like its side-effect.

Has anyone else experienced anything like this? Could it just be a temporary thing or will I have to get used to being skinny again?
posted by Chenko to Health & Fitness (14 answers total) 2 users marked this as a favorite
How old are you? It's not uncommon for people to change metabolism as they age. I was similarly skinny to you in my youth and even into early 30s but as I approach 40 I'm now fairly normal in my height/weight. My point is that if you're young(ish) you might consider changing nothing and waiting a few years.
posted by SaltySalticid at 12:43 PM on July 23, 2016

Best answer: If you are concerned, there are things that will increase your appetite if weight gain is something you want. Ask your doctor.

You can also increase calories by drinking something like an ensure with your meals.
posted by AlexiaSky at 12:44 PM on July 23, 2016 [4 favorites]

this may sounds dumb, but it's possible exercise might work? and if not, well, you could end up awfully toned :o)

(seriously, if i go cycling, i want to eat soooo much more it's crazy. i have to watch myself or i'll put on weight just because i am exercising.)
posted by andrewcooke at 12:50 PM on July 23, 2016 [4 favorites]

Response by poster: "How old are you? It's not uncommon for people to change metabolism as they age."

I'm 29. Before this happened I thought the weight gain might have been caused by ageing because it happened so long after I started taking the meds.
posted by Chenko at 12:56 PM on July 23, 2016

You could try taking digestive enzymes. There are OTC versions of them, though they can also be prescribed. You should be able to google up a source online.

When my son was put on digestive enzymes, he gained 20 pounds in one year. He started at 103 pounds at age 14, so that was quite a substantial weight gain. After that, he felt better and was generally easier to deal with. He is still on the thin side, but not bag of bones thin.
posted by Michele in California at 1:01 PM on July 23, 2016 [1 favorite]

Best answer: If you're 29 it may still be a little soon for age-related metabolism change; mine didn't change until I was about 33. And it changed BIG TIME (I went from averaging about 125 when I was 33 to averaging about 175 just a few years later).

I wouldn't get hung up on how you look; I know that's an easy thing to say, but honestly, there are things I miss about my formerly skinny self. There are things I appreciate about my more rubenesque self, don't get my wrong, but hindsight made me realize "huh, it actually wasn't that bad, and I was kind of worrying about nothing".

The biggest problem I faced was, I realized my biggest problem was that my hyperdrive metabolism was making me kind of a lazy eater, and that was a bigger problem; I would eat an entire bag of Cheetos at once, because "Oh, I'm naturally skinny and can get away with it." I could "get away with it" in the sense that I wouldn't gain weight, but it wasn't exactly healthy. And the problem I faced was having to step up the health of my eating habits.

You have the perfect opportunity to learn how to appreciate really good, healthy, wholesome food for its own sake right now, and learn to experience it as pleasure. A slice of chocolate cake is great, but so is a really, really fresh salad. Or a perfectly-seasoned cut of meat or piece of fish. And really well-prepared food doesn't just taste good, you feel good after that. But in the moment, it just tastes damn good and that's all you care about.

And if you get used to appreciating food for its own sake like that, then whatever your current size happens to be won't matter quite so much to you on an emotional level. And, you will also be set up to transition into your new weight better when that change does come (for it will).
posted by EmpressCallipygos at 1:43 PM on July 23, 2016 [2 favorites]

Best answer: I think AlexiaSky has the right idea. It isn't talked about much outside of fitness circles but gaining weight can be a process that requires just as much rigor and effort as losing weight, but it is certainly doable. It sounds like your weight is a real source of distress to you and gaining weight -- in a systematic way that is sustainable for you long term -- could help to ease that distress.

Some general tips for gaining weight that I've found useful in the past:

1. Eat regularly throughout the day, without regard for hunger. Set reminder alarms on your watch or phone for every ~3 hours.

2. Eat foods that have a higher caloric density so you can take in more calories without feeling physically full. Fat is a classic. You can pour a tablespoon of olive oil over most meals without particularly noticing it (if anything you may find that your home cooked meals suddenly seem more like restaurant food), but if you're eating 4-5 small meals per day, that's enough of a caloric surplus to gain a pound per week. Nut butters, avocado, and dried fruit are foods that are "easy to eat" but pack a lot of calories.

3. Let taste be your guide. Eat foods that taste good to you; it's less of a chore to eat large quantities of them. Sounds obvious but many people seem to ignore this one for various reasons. If you don't like breakfast foods, don't skip breakfast, eat something you like in the morning and it becomes breakfast. That kind of thing.

4. Finally, this may be a bit counterintuitive, but do you exercise at all? You need to eat, often a lot, to fuel an exercise habit and if you have something to do that is fun for you, that might be the motivation you need to eat more. Even better if it's something that helps you gain muscle, which is really the best kind of weight to gain.
posted by telegraph at 1:49 PM on July 23, 2016 [1 favorite]

Have you tried My Fitness Pal? I'm asking because it's not just for folks who want to lose weight. There's a forum for folks who want to maintain weight, and another for those who want to gain. It's also quite helpful to post what you're eating, in your case not for the purpose of losing weight, but so you can get suggestions from others about how to round out your meals to add more calories. Might be worth a look.

I like others' ideas about exercise - I know that you can gain quite a bit from strength training (as andrewcooke points out, you WILL want to eat more!)

Good luck! From one "skinny" to another, it's hard to gain. (Until you turn 35 - ask me how I know!)
posted by onecircleaday at 4:38 PM on July 23, 2016

There are definitely antidepressants that are known for weight gain; Remeron (mirtazapine) is the one that I have heard the most about. It might be worth seeing if adding that helps.
posted by mister pointy at 5:35 PM on July 23, 2016

You sound a little bit manic, I'm wondering if the weight fluctuations and your concern about them are symptomatic of something else.

Age related metabolic changes are somewhat ethnicity dependent (and there are large differences within ethnicities), but that can be a contributor.

If you asked, I'd really recommend some strength training - start with lower weights and more reps and then see if heavier weights works for you. This might help re-calibrate your appetite. You don't even need to go to a gym; you can jury rig stuff for cheap (lot of internet resources such as plans on making pvc pushup equipment) to getting a couple of mats, a bar, clips, and some plates. Check craigslist.

Best fitness equipment investment I made was for an adjustable pull-up bar (the kind that you screw into a doorframe). Use good form and pay attention to both contraction and release. Velocity will also affect whether you stress slow/fast twitch muscles. "Crossfit" is generally shit when it regards pull-up bars.
posted by porpoise at 11:22 PM on July 23, 2016

Best answer: I was thrilled to have kept weight on after my pregnancies, after being barely over 100 pounds most of my life. After my third child's first birthday, I went back to work full time, and lost all the weight. I was back down to 103. It was heart breaking. People started picking on me again. I feel your pain.

I moved to a fluff job and committed to eating every few hours, just a few snacks here and there to increase my metabolism enough to want food more. I also increased my physical activity and focused on getting the right amount of sleep during the correct sleeping times. The weight came back. And then I hit forty and became curvy, which was very exciting.

Eat small meals every few hours. If you don't feel like you will be hungry, finish every meal with a bit of chocolate. The sugar will have you hungry again in no time. Go for a walk outside every day.
posted by myselfasme at 4:38 AM on July 24, 2016

Response by poster: "You sound a little bit manic, I'm wondering if the weight fluctuations and your concern about them are symptomatic of something else."

I'm curious why you think I sound manic. I feel normal but hypomania is something I have to watch out for when changing meds. What about my question made you think I was manic?
posted by Chenko at 10:14 AM on July 24, 2016 [1 favorite]

I just felt something about your sentence cadence. It felt a little breathless. Sorry if I caused any consternation.
posted by porpoise at 1:43 PM on July 24, 2016

Response by poster: That's ok, thanks for letting me know. I don't think I'm hypomanic, but I'll talk to my doctor about it.
posted by Chenko at 1:59 PM on July 24, 2016

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