I have gained weight due to medication, what should I do?

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When we suffer from chronic illnesses, we heal ourselves and we gain weight, we should know that there may be two reasons for this state of affairs. The first: a side effect of the medications you take. Second: eating the stress of illness. And the problem is significant. Extra pounds themselves become a threat, making our disease worse.

When a chronic disease is diagnosed in the office, we already know that we will be tied to drugs that can keep it in check for a long time. We take the first prescription given by a doctor a little on faith. Medicines are supposed to help us, but we don’t know yet whether we will be affected by the side effects of a pharmaceutical.

When we come from the pharmacy, we open the medicine box, take out the leaflet and read the indications and contraindications, our eyesight is on the side effects. The list is long, because the manufacturer is obliged to list all, even the rarest, side effects. And here: a curiosity. Doctors say that these really dangerous risks of complications – from the kidneys, vascular system – are not as terrible for patients as the risk of erectile dysfunction (in the case of men) and the possibility of gaining weight (in the case of women). How many patients for this reason do not start treatment? How many interrupts the therapy when the weight indicator goes up? How many will he not tell the doctor about his fears, fearing to ridicule the fact that in the face of an illness he is thinking about a figure?

In order to know how to talk to your doctor about gaining weight while taking medication, it is important to know the groups of pharmaceuticals whose chronic use may be associated with weight gain. The list of accused includes drugs used, incl. high blood pressure, diabetes, asthma, depression. Let’s sort out both the diseases and the groups of drugs that provoke weight gain assigned to them.

Antidepressants

Observations reported by patients themselves indicate that they gain the most weight while taking tricyclic drugs, namely:

• clomipramine (Anafranil, Anafranil SR);

• amitryptyliny (Amitryptylinum VP);

• doxepiny (Doxepin 10 or 25);

• opipramolu (Pramolan, Sympramol).

Drugs from the TLPD group are older generation drugs. They work by increasing the level of serotonin and norepinephrine in the brain, which improves mood and gradually disappears depressive states, but – in parallel – the appetite returns. In a word: we recover, eat and gain weight. Advice? Talking to a doctor and selecting a drug from a different group.

Neuroleptics (antipsychotics)

Used, among others in the treatment of schizophrenia. There is a rule in this group of drugs – the more modern, the greater the risk of weight gain. So why don’t the old ones be used? Because the new ones have fewer other side effects (considered more dangerous) and cope better with the disease itself. And the treatment of schizophrenia is the most important thing.

The risk of weight gain will be associated with taking new atypical neuroleptics, such as:

• olanzapine (Olanzapine, Zalasta, Zolafren, Zyprexa),

• clozapine (Klozapol),

• risperidone (Rispen, Rispolept, Rispolux, Risset).

So what to do if we take any of these medications? Pay close attention to the diet, knowing that: 1) the mentioned preparations indirectly stimulate satiety neurons in the ventromedial nucleus of the hypothalamus, which gives the effect of feeling hungry despite its physiological satisfaction; 2) they increase the concentration of protein (leptin) in the blood serum, which binds to the neuropeptide Y, which in turn stimulates the satiety center, disrupting its function.

Sedatives

Sedatives, such as diazepam (Relanium, Neorelium), can contribute to sleepwalking. After taking the drug in the evening, patients do not remember getting up at night and snacking.

Antiepileptic drugs

An epileptic attack occurs when certain chemicals become too active in the brain and the brain does not control what it works. Since the drugs used here are related to the work of the brain, the side effects are also related to its functioning. There is nausea, drowsiness and headaches. And weight gain – because the work of the whole organism slows down.

This applies especially to preparations containing valproic acid or its derivatives (Convulex, Depakine, Sabril) or carbamazepine (Amizepin, Neurotop, Tegretol). Valproic acid is an inhibitor of hepatic metabolism and inhibits the degradation of insulin, leading to its elevated levels, which results in a decrease in blood glucose levels and a feeling of hunger.

Cyproheptadine derivatives

Some drugs in this group, such as Peritol or Protadine, used to treat anorexia, are also used in the treatment of allergic diseases accompanied by itchy skin. While in the former case their hunger-stimulating effect is beneficial, in the latter case – they may lead to unwanted weight gain.

Estrogen and progestogen derivatives

The most common hormonal drug suspected of promoting weight gain is the contraceptive pill. Clinical trials conducted in 1999 under the supervision of Dr. Christine Pelkman did not show such a link. The only thing that could be found is that the body retains water and sodium through the effects of estrogen on the kidneys, which, however, cannot justify a permanent weight gain. Psychologists, in turn, have observed and proven the fact that control over the amount of food consumed by women using hormonal contraception is loosened. So maybe instead of looking for the blame in the tablets, you need to analyze what, when and how often?

However, problems with gaining weight appear as a result of dysregulation of the endocrine system, both natural (menopause) and artificial (during hormonal supplementation). Despite eating the same amounts of food as before, the number of centimeters is growing, especially around the abdomen.

Older generation beta-blockers

A reduction in the body’s ability to burn calories and fat is a side effect of some medications for high blood pressure, such as:

• atenololu (Atenolol Sanofi, Atenolol Accord);

• metoprololu (Metocard, Metoprolol Egis).

Beta-blockers can also slow down the heart rate, while making us tire faster, which in turn reduces the desire to take up physical activity. So how do you break the vicious circle – on the one hand, take medication regularly and at the same time comply with the recommendations to lose weight, which is necessary to be able to fight hypertension? First try to lower your blood pressure in a non-pharmacological way – through diet and exercise.

Certain antiarrhythmic drugs

Amiodarone (Amiokordin, Cordarone, Opacorden) used in the treatment of arrhythmias has a chemical structure similar to triiodothyronine, which may cause disturbances in the metabolism of this hormone in the thyroid gland. Effect? Hypothyroidism, which in turn leads to a slowdown in metabolic processes and weight gain.

Corticosteroids (Glucocorticoids)

Drugs from this subgroup of steroids are prescribed by pulmonologists, allergists and dermatologists in all allergies and allergies – skin, food, contact and inhalation, as well as in asthma.

The “classics” in this group include:

• hydrokortyzon (Oxycort, Laticort);

• budezonid (Budesonide, Pulmicort, Symbicort);

• betametazon (Triderm, Diprosalic, Bedicort);

• fluticazon (Flixotide, Flixonase, Cutivate, Seretide);

• mometazon (Elocom, Asmanex Twisthaler);

• triamcinolon (Polcortolon);

• flumethasone (Lorinden).

Why do we gain weight after long-term therapy? Well, their action is based on inhibiting the synthesis of proteins in the body, increasing their breakdown and rebuilding adipose tissue that appears in unusual places. Taking glucocorticosteroids, we can notice face rounding, abdominal obesity, thickened neck and limbs thinning at the same time. In extreme cases, these symptoms form a characteristic overall picture known as Cushing’s syndrome.

1. Importantly, taking these drugs must not be stopped too early (the treatment lasts up to 2 years), and the doses must not be reduced. Unauthorized manipulation of dosages means that the dosage of the hormone must eventually be increased when the therapy is resumed, which means that the patient is gaining even more weight.

Thyroid hormones and thyreostatics

Some synthetic hormones (Euthyrox, Letrox) used in the treatment of hypothyroidism, where one of the symptoms is weight gain, on the one hand they accelerate the metabolism, on the other – cause the body to reduce the amount of muscle tissue, resulting in overweight. Drug-induced hypothyroidism can also be caused by poorly dosed drugs used in the treatment of hyperthyroidism (the so-called thyreostatics, e.g. Metizol, Thyrosan) and drugs used in the treatment of arrhythmia (amiodarone) or bipolar disorder.

I have gained weight, what to do?

Yes, up to five kilos. With such weight gain during treatment, we can cope on our own. All you need to do is modify your diet, get more exercise and accept that gaining weight is the price of recovery. With a greater increase in weight, the problem is complicated, because the extra pounds, a side effect of the therapy, become a threat themselves. We treat diabetes and we gain weight. Effect? Worsening of diabetes. We treat high blood pressure, drugs work, we gain weight. And what’s next? We are threatened with metabolic syndrome related to fat stored in the abdominal area. This fat again “turns up” our blood pressure, increases the risk of ischemic heart disease, hyperlipidemia, and diabetes.

But there is also the other side of the coin: even if we find that the drug is responsible for the weight gain, we should not stop the therapy ourselves, or reduce the doses. For if the drugs used modify the functioning of the endocrine system (insulin, thyreostatics, glucocorticosteroids), discontinuation of them may be life-threatening, and in the case of neuroleptics and antidepressants – a withdrawal syndrome, or cause the disease to relapse. A better solution is to visit a doctor and consider together whether you can replace a given drug with another.

In addition, there is a chance that as research progresses, new slimming drugs will appear that can be used together with others, analogous to the possibility of administering probiotics with antibiotics today. There are high hopes for compounds influencing the activity of peptides regulating appetite in the central nervous system.