Lost Weight While On Psych Meds?
May 28, 2022 12:40 PM   Subscribe

This is my question: Have you, or anyone you know, been able to lose weight while taking psychiatric meds? I’m not looking for weight loss advice from people who aren’t taking these meds. I want to hear from people who have experienced this particular side effect, from a drug that they require to live a healthy life.

I’m bipolar 1 and take Zyprexa 20mg daily to keep myself medicated and able to function well. Taking it is a must for me. I also take a few other psych meds like lamictal, clonazepam and topiramate.

I’m currently at the low end of obese at 220lbs. Times when I’ve not taken my psych meds, I’ve lost my psych med weight (down to 180lbs), but I’ve also had periods of mania that lasted significant periods of time. I can’t live that way.

I know that weight loss is a matter of cutting calories taken in, and increasing calories burned through exercise. I've had a hard time losing weight while on my psych meds. I'd like to know that it IS possible to lose weight in spite of them. Thanks!
posted by furtheryet to Health & Fitness (17 answers total) 6 users marked this as a favorite
I have lost weight while taking an SSRI (at different times, either Zoloft or Celexa). I maintained my lowest adult weight for a few years while taking Celexa, Abilify, and topiramate.
posted by maleficent at 12:52 PM on May 28, 2022 [1 favorite]

Yeah, topiramate caused me to lose weight as well. However, Zyprexa (and its relatives) caused me to gain weight. Oh yeah, Remeron too. Yuck.

SSRIs/SNRIs have been weight neutral for me for the most part.
posted by kathrynm at 1:08 PM on May 28, 2022 [1 favorite]

I lost weight on Wellbutrin, mostly because of lowered appetite. However Wellbutrin ratcheted up my anxiety.

I also lost weight on Effexor.
posted by rogerroger at 1:24 PM on May 28, 2022

Effexor decimated my appetite and I lost a significant amount of weight while on it. (For me that was a negative side effect, one of many it had, and I went off after six weeks, and the withdrawal was yet another awful experience. My appetite and the weight returned.)
posted by obfuscation at 2:04 PM on May 28, 2022

I lost weight when I was taking both topiramate and amphetamine salts.
posted by The Underpants Monster at 2:19 PM on May 28, 2022

Best answer: I know that weight loss is a matter of cutting calories taken in

This is not always true. It is also a function of metabolism, activity level, intestinal flora, and many other factors. Weight gain and weight loss are not fully understood. Many psych meds have the confirmed psych effect of causing weight gain. This is a new problem with some categories of drug; on balance, many doctors and patients believe it is worth the trade off.

It might be possible to get your weight down even while staying on your medication regimen. I'd suggest you talk to your doctor, let them know this is important to you, and see if it would make sense to try a different drug combination. Your doctor or a dietician might have other suggestions for getting your weight down. But it's not as simple as "reducing your calorie intake" and you shouldn't feel any guilt about your weight gain. You are making the right decision take care of mental health needs, and this is one of the tradeoffs that comes with that.
posted by Winnie the Proust at 2:32 PM on May 28, 2022 [16 favorites]

I was able to lose weight on psych meds, yup. I lost with a keto diet but honestly I just find eating A Diet that gives me instructions and portions is what makes it work for me.
posted by DarlingBri at 2:47 PM on May 28, 2022

I lost weight on Prozac, but it may have been attributable to gastrointestinal side-effects rather than metabolic or lifestyle changes.
posted by mumkin at 3:25 PM on May 28, 2022

Response by poster: I'm mainly interested in atypical anti-psychotics such as Zyprexa, that have a documented history of weight gain, not drugs such as topiramate that are known to cause weight loss. My psychiatrist and I have tried many other combinations of meds, but this particular drug is the gold standard for dealing with my mental cooties. It is a trade-off I've got to live with. What I don't have to live with, hopefully, is staying obese. I'm hoping for some motivation.
posted by furtheryet at 3:29 PM on May 28, 2022

Zyprexa made me gain something like 20 lbs in a month because it gave me type 2 diabetes, and at the time they didn't know or didn't warn patients about that. I lost the weight by walking my dog a lot more, but I don't remember if I was still on the medication.

I would suspect if it's causing a blood sugar spike, that a keto type of diet would work well because there aren't as many carbs to spike the blood sugar.
posted by crunchy potato at 3:55 PM on May 28, 2022

IANYD, but ask your psychiatrist about adding on metformin to your regimen.
If your weight is at all possibly causing or worsening sleep apnea, get that looked into and treated.
posted by gemutlichkeit at 4:28 PM on May 28, 2022

Best answer: My wife is bipolar 1 and currently on Wellbutrin (though we just added that back in), Adderall, Depakote, and Geodon. (Yes, it's a party.). She was on Abilify for years, but it jacked her A1C up (as in literally raised it), so they swapped it for Latuda, which was a DISASTER, before going on the Gedon.

In the meantime, she's lost 50 pounds in the last 18 months or so. She's been moving more, drinking less high test beer, eating more fruits and vegetables, etc. It's been slow and she's been keeping it off. The adderall might have helped with that a bit, but considering there are literally t-shirts that say "the depakote made me eat it" we figure the two meds are currently balancing each other out.
posted by joycehealy at 6:32 PM on May 28, 2022 [1 favorite]

I'm taking an atypical antipsychotic (aripiprazole aka Abilify) with an SSRI (vortioxetine aka Trintellix/Brintellix). The meds improved my life dramatically but in just the first year of taking the Abilify (with a different SSRI) even at a low dose of 5mg I gained about 20kg. Now, that wasn't too awful for me because before that I was underweight. But I felt that the extra weight was still a bit much for me, so I went on a low-carb, low-fat diet, under medical supervision, basically lots of lean protein and veggies, and lost about 10kg in a few months. I also went for daily walks at a faster pace than normal, about 5000 to 8000 steps a day, which I believe helped a bit with the weight loss, but it was mainly the diet really. It wasn't too bad to follow, I had no quantity restrictions, I didn't feel like I was starving, and I had a lot of energy.
So in my experience it's possible to lose some weight while on atypical antipsychotics, of course everyone is different and weight loss is definitely not a simple mathematical calculation of calories in calories out, but if you feel like you want to try losing some weight, don't be discouraged by the fact you're taking these meds.
posted by bitteschoen at 1:58 AM on May 29, 2022 [1 favorite]

I’ve lost just over 50 pounds in the last three years and I’ve been on a fairly high dose of Abilify most of the way. I started tapering about a year ago and have been completely off for the last few months.

If it makes you feel better, the rate of weight loss never really changed as we reduced the dosage (to my great disappointment). But it is a clue that maybe the drug wasn’t a significant factor for me.

I also took Wellbutrin for a long time — including the whole time I gained the weight in the first place. It came from two pregnancies without losing weight in between, plus a little 15-pound bonus from Seroquel before the babies. God, I hated Seroquel.

I definitely believe that weight loss and gain is more than calories in/calories out, but like I said, I wish I could have blamed more of mine on the meds. I’ve only been successful because of some intermittent fasting and a struggle to strictly only eat when I’m hungry. I also work out to a ridiculous degree, but honestly, it’s counterproductive. a) it makes me hungrier, and b) if I eat too much less or fast too much, it negatively affects my running, and I love running too much to take a break to focus on weight loss instead.
posted by liet at 8:35 AM on May 29, 2022

I have managed to lose weight while on medications that generally cause weight gain. But I did that by spending 2 hours a day exercising and getting between 15k and 20k daily.
posted by bq at 10:58 AM on May 29, 2022

I refused to go back on an atypical antipsychotic 7 or 8 years ago when I started having auditory hallucinations with my depression. My doctor put me on Haldol. It definitely has its own set of side effects, especially the tremors, but those went away as my dose went down. So maybe give that a shot?
posted by kathrynm at 1:34 PM on May 29, 2022

I have had some success with it to a point.

I was 240 at my heaviest. I'm down to 220ish now. Being moderately active helps me; being vigorously active does not, as my appetite increased hugely in proportion. I'm active at work and take a long hike once a week. Finding active hobbies I want to engage in is much better than Working Out both for my own stress and self-evaluation.

For both activity and diet, making small, incremental changes over a period of years has helped. Snacking was a big problem for me, and sugar intake. Slowly swapping out higher sugar foods for lower sugar ones, slowly decreasing portion sizes, and finding times when I could walk instead of driving have made a positive change. Not keeping around pre-made sweets and instead forcing myself to actually cook the sweets myself when I wanted them greatly reduced my overall junk intake. I also found a couple of easy boxed meals I could make and modified them to be tastier so I wouldn't get fast food quite so much.

I had to give up pursuing the ideal in favor of the somewhat better, essentially. It's gotten me off the blood pressure meds I used to take. If I tried a little harder I'm sure I could lose more, but it needs to be gradual for me or it won't be sustainable. I'm also only on one medication, so YMMV.

Basically I would just recommend making it as low-pressure and easy on yourself as possible. It's really easy as a mentally ill person to start beating yourself up over every new endeavor that you fail to complete 100% successfully.
posted by the liquid oxygen at 4:06 PM on May 29, 2022 [2 favorites]

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